You hate Obama's health care penalty for the uninsured?

[Ivan Seeking]

Under the new health care mandates, which are now effectively "the law", if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year. This seems to be at the crux of many objections to the new system: What gives them - the government - the right?!?!?! Right?

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured. If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.

Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives you the right to treatment that you can't possibly afford?

[humanino]

The point you raise is just exactly what I was discussing about half an hour ago. I cannot believe anyone could care about their "right" to die on the side of road.

I understand that some republicans have put forward similar propositions. If consistent, they should either support this law, or negotiate changes, not fight and oppose vehemently.

[WhoWee]

Under the new health care mandates, which are now effectively "the law", if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year. This seems to be at the crux of many objections to the new system: What gives them - the government - the right?!?!?! Right?

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured. If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.

Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives your the right to treatment that you can't possibly afford?

Have you read the law?

[cronxeh]

The uninsured people still end up costing others. When you are hit by a car and laying there unconscious bleeding on the street, someone calls 911 for you. Hopefully in about 30 minutes you will be in the emergency room, and there is nobody there to ask you if you have insurance at that time. You get your emergency treatment for free, because the hospital can't collect.

Sure they will bill you, but value of money today is far greater than whenever you will be able to pay, and it adds up. Some patients can never pay off the emergency visits and those bills are never collected on. With universal, mandated coverage you ensure that the hospital does not have to raise costs for silly things like a toothbrush and ER visits because of their operating expenses. The hospital gets paid, gets to balance their sheets. And stays in business.

Now imagine the hospital did not get paid. A hospital that closes down in the neighborhood will affect entire region, put additional strain on other hospitals in the area and threaten public safety.

I think the ultimate 'beef' you have with this healthcare 'thing' is that the federal government could've just became one big health insurance company from appropriated income tax. As is the case with AIG, the government should not be in a position where it becomes bankrupt, other than that > 1.0 GDP national debt we have at the moment.


This healthcare overhaul bill should've made it illegal for any hospital or nursing home to be a for-profit entity, pitted the pharmaceutical companies against each other in bids, manufacturer of medical equipment as well. You need to bring down the cost of medicine and medical equipment, which is ridiculously overpriced. They are taking advantage of the helplessness that people feel when they are sick, as if they would pay any price for the drugs.

Whether it is because of the cost of patents for the medicines or simply pharma companies gouging prices to cover internal costs, it is clearly not a manufacturing issue. These drugs are expensive because pharma companies say they are.

[russ_watters]

Under the new health care mandates, which are now effectively "the law", if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year. This seems to be at the crux of many objections to the new system: What gives them - the government - the right?!?!?! Right?

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured. If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.

Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives you the right to treatment that you can't possibly afford? We tax people to pay for police, why not tax people to pay for ambulances? Why does it have to be paid for with private health insurance? Fining people to convince them to pay a private insurer to pay a government sponsored emergency service seems awfully round-about and can't possibly be an efficient use of funds. People should pay for such things directly.

As a fiscal conservative and a believer in freedom and equality of opportunity and treatment under the law, I think people should pay their fair share for things like emergency services. So I think the ~42% of the population that is currently freeloading needs to start paying at least something for the services they get....including the emergency care they currently get for free. Currently, more than 40% of the population pays nothing or has a negative federal income tax burden, a growing fraction of freeloaders that is up from 20% in 1980 and 30% in 2003: http://www.taxfoundation.org/research/show/207.html

Rather than taxing the middle class and rich to pay for more feebies for those who currently contribute nothing, we should be forcing people to pay for the services they use. Maybe that will mean I'll see fewer satellite dishes on the row-houses when I drive through Norristown on my way to work, but so what: your mother never said things would be handed to you on a silver platter.

Stepping back from emergency services, I went about 3 years without health insurance when I was in my 20s, then had individual insurance (I was self-employed) for another 5. In that time, I went to the dentist once, had my wisdom teeth out and had a hernia operation. Both surgeries were payed for mostly out of pocket because I had a high deductable, so while I paid $8000 or so for insurance over that time, I still payed about $6000 out of pocket for the services I got. I'm glad I went without insurance for a few years, but I would have been better off going without insurance another few years. Regardless, as a person living in a supposedly free society, I should have the right to make such choices for myself.

[mheslep]

As do most Americans, I pay a fee for private medical insurance that in turn pays for any 'extended medical treatment' for my family. Thus, also as most Americans under 65, I demand not a thing from the federal government by way of medical benefits, at least for now. As for emergency 911 services, they are provided by my local county, paid for out of my existing state and local taxes, and depending on the situation reimbursed by insurance. I'd prefer the federal government stay the heck out either domain, thank you very much.

[TheStatutoryApe]

if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year.
Couldn't this be construed as a Bill of Attainder?

[Argentum Vulpes]

I'm still of the firmly believe that if the point of this bill was to drive down the cost of health care in this country, and make it more affordable for everyone then the bill missed some big things. Frankly these things should of been addressed before the government took upon its self an expansion of power.

First standardization of coding and billing for all insurance companies. Second Tort reform. Third the AMA limiting the number of doctors that enter the field each year. Link (http://wallstreetpit.com/5769-the-medical-cartel-why-are-md-salaries-so-high) Fourth standardization of fee rates for procedures, by setting a maximum amount allowed to be charged. There was about 1000 dollar difference between several hospitals in Seattle for Chest pain. Look at some of the differences between facilities in your state. Link (http://www.nlm.nih.gov/services/procedcosts.html)

Just a few ideas instead of this insurance/big pharmacy/government new hire stimulus bill we have now.

[russ_watters]

Stepping back from emergency services, I went about 3 years without health insurance when I was in my 20s, then had individual insurance (I was self-employed) for another 5. In that time, I went to the dentist once, had my wisdom teeth out and had a hernia operation. Both surgeries were payed for mostly out of pocket because I had a high deductable, so while I paid $8000 or so for insurance over that time, I still payed about $6000 out of pocket for the services I got. I'm glad I went without insurance for a few years, but I would have been better off going without insurance another few years. Regardless, as a person living in a supposedly free society, I should have the right to make such choices for myself. We all know, of course, that when you are young and healthy, you pay into the healthcare system and don't use the services, but when you are old and sickly, you get more money out than you pay in. So lets stop pretending everyone is on a level playing field and give people individual health savings plans that let them build-up coverage over a lifetime rather than just getting it when they get old. That will convince the young that they aren't flushing their money down the toilet by buying health insurance they have almost no chance of using.

[mheslep]

So far I am unable to locate anything in the health bill that actually lays out an enforcement mechanism for the mandate. The mandate itself is in there, but I can not find the words naming the agency that will come round and actually collect the money if one doesn't mail it in. One would expect the IRS but I can't find it.

[russ_watters]

I'm still of the firmly believe that if the point of this bill was to drive down the cost of health care in this country, and make it more affordable for everyone then the bill missed some big things. Frankly these things should of been addressed before the government took upon its self an expansion of power.
.... Realy? How silly of you! First standardization of coding and billing for all insurance companies. Second Tort reform. Third the AMA limiting the number of doctors that enter the field each year. Link (http://wallstreetpit.com/5769-the-medical-cartel-why-are-md-salaries-so-high) Fourth standardization of fee rates for procedures, by setting a maximum amount allowed to be charged. There was about 1000 dollar difference between several hospitals in Seattle for Chest pain. Look at some of the differences between facilities in your state. Link (http://www.nlm.nih.gov/services/procedcosts.html)

Just a few ideas instead of this insurance/big pharmacy/government new hire stimulus bill we have now. Yeah, of course I agree. I think the healthcare bill was just a big federal power grab that did very little to address the very real problems in our healthcare system. Tort reform is a biggie for me and of course the government won't address that since most aren't just in the pockets of the ABA, but are actually lawyers themselves.

I wish I had the power to generate my own work like lawyers can!

[jreelawg]

So they deprive us of water, and then decide to finally compensate by giving us cholera tainted juice?

There are better ways to solve a problem, many ways to cut costs, and all of them have been removed, or not introduced to the bill.

The solution to one problem is another problem.

The precedent set through this route makes for a slippery slope of future corruption. How many supreme court cases can be argued now citing this mandate?

Better to settle with the devil for now? But in the long run? Will we regret it?

[Argentum Vulpes]

[/sarcasm on]

But Russ if the point of the bill wasn't to drive down the cost of heath care, that would mean the Democrats and Obama lied to us. I just don't think I would know what to do if our elected officials were lying to us.

[/sarcasm off]

[TheStatutoryApe]

So far I am unable to locate anything in the health bill that actually lays out an enforcement mechanism for the mandate. The mandate itself is in there, but I can not find the words naming the agency that will come round and actually collect the money if one doesn't mail it in. One would expect the IRS but I can't find it.

I have been reading a text book on basics of constitutional law. It has apparently become a common practice to put these things in motion and work out such details later. There have been challenges against congress on the basis of Delegation of Powers but they are rarely heard and generally rejected. Apparently the only time that such challenges have been successful was during the New Deal era when the supreme court was intent on dismantling the legislation. Since then Congress has more or less been given carte blanche to delegate powers as it sees fit.

I'm wondering if one would be required to submit proof of medical coverage to the IRS. That would just be ridiculous.

[jreelawg]

First of all, Obama campaigned against the mandate, and I believe one of his arguments was that it would give leverage to the insurance companies to price gouge and take further advantage of us.

They lie because it is a job requirement. The simple fact is that you cannot win without lying. So like I said before good intentional people are forced to lie on behalf of defeating the lunatic on the other side. It's shameful, but like I also said before there is no hope.

[Brian_C]

Whether it is because of the cost of patents for the medicines or simply pharma companies gouging prices to cover internal costs, it is clearly not a manufacturing issue. These drugs are expensive because pharma companies say they are.

You just discovered the concept of "supply and demand". Well done.

[TurtleMeister]

if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year.Couldn't this be construed as a Bill of Attainder?
Couldn't this also be construed as a tax on the poor? The rich will get their health care because they have the money. The poor will opt to pay the fine (tax) because they cannot afford the health insurance.

[jreelawg]

And as there will now be a broader excuse to raise prices, and as unemployment skyrockets, and as we are continuously mislead, or undereducated about the role of nutrition, and as Americas children become increasingly type 2 diabetic, where will we get?

One problem is that nutritional education and research is very very weak.

So while I eat healthy, my calculated risk is based on an average in a place where the vast majority are on a death wish with their eating habits. And in the classroom, instead of telling us about health super foods and health restoring diets, they concentrate on drilling it into our heads that junk food is good for you, in moderation.

Sure, but not as good for you as healthy food in moderation.

[jreelawg]

I bet a lot of money could be saved by outlawing fast food chains in elementary and middle school cafeterias, and by giving students water or milk instead of super sized corn syrup water.

[calculusrocks]

So far I am unable to locate anything in the health bill that actually lays out an enforcement mechanism for the mandate. The mandate itself is in there, but I can not find the words naming the agency that will come round and actually collect the money if one doesn't mail it in. One would expect the IRS but I can't find it.

Here - http://thehill.com/blogs/on-the-money/domestic-taxes/87697-republicans-assail-irs-provision-in-health-care-bill-

I found the link in the drudge report archive.

[calculusrocks]

Under the new health care mandates, which are now effectively "the law", if you don't have health insurance, you will be fined according to a sliding scale that reaches a maximum of something like $1500 per year. This seems to be at the crux of many objections to the new system: What gives them - the government - the right?!?!?! Right?



There are lots of objections, but this is one that many people disagree with.

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured.

I never agreed to this contract. I only pay taxes because I'd go to jail if I didn't.


If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.


I see what you're saying. But seriously, government isn't doing this out of some act of charity. This is an act of power. Few of the promises of this health care are going to be kept. Government is trying to monopolize all charities by charging so many taxes that people don't have any money left to donate to those causes! After stealing as much as it can get away with from the private sector, it then points the finger at the private sector for not giving enough. In a true free market understanding people would create their own safety net.


Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives you the right to treatment that you can't possibly afford?

The short answer is that I don't. Here's an extreme hypothetical, maybe not so extreme. What if there was a cliff that people loved to climb, but 95% of the time on any given attempt, the man breaks every bone in his body. Does the government give him the same premiums as everyone else, even though he climbs it several times or more every year? What do we tell our rock climber, that he's a fool and he's not allowed to climb rock?

[Zefram]

So far I am unable to locate anything in the health bill that actually lays out an enforcement mechanism for the mandate. The mandate itself is in there, but I can not find the words naming the agency that will come round and actually collect the money if one doesn't mail it in. One would expect the IRS but I can't find it.

Look under Section 1501 of Subtitle F (Title I), the section on individual responsibility:

(g) Administration and Procedure-

`(1) IN GENERAL- The penalty provided by this section shall be paid upon notice and demand by the Secretary, and except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68.

This of course refers to the applicable part of the Internal Revenue Code (http://www.law.cornell.edu/uscode/html/uscode26/usc_sup_01_26_10_F_20_68_30_B.html). Yes, it's the IRS.

[jreelawg]

People who rely on a single payer system like medicaid can be considered freeloaders, but in essence, a healthy population is a benefit to the entire society as a whole. If we don't make it possible for the poor to get treatment, we will have a sicker population. You could argue that this should be limited to contagious disease.


I see a big problem on the horizon in that the gap between the rich and poor is ever increasing, and the cost of living is increasing. What this will end up being is a form of economic slavery in where nearly a persons entire income will be spent on mandates, and requirements alone. In the end, people need to buy food before buying health insurance. As jobs get more scarce and scarce, more and more people won't even be able to pay these obligations. With these obligations required of them that they cannot fulfill, the government will have to end up paying anyways, or we will start to see a lot of people starve to death.

The way I see, it, because the gap between the obscenely rich and the poor is increasing, it is ethical to balance this gap through taxation. I also fear however that as populations grow and grow and as the wealthy see the general public as increasingly burdensome, we might see some very serious changes happen regarding our rights. We may see very dark days ahead.

[Nebula815]

One reason pharmaceutical companies make pharmaceuticals cost more is because they are an oligopoly. The industry is extremely regulated by the FDA, and new pharmaceuticals I believe have to go through something like ten to fifteen years of testing by the FDA before being approved. This allows the industry to be dominated by a few enormous, very powerful pharmaceuticals companies we call Big Pharma.

If the industry was deregulated (note deregulated, not unregulated), we would probably see an explosion in terms of drug innovation and competition and prices driven down.

Regarding tort reform, one question, I have read that the CBO calculated tort reform would only reduce overall healthcare expenditures by a very small amount, is this true?? This I know is a response many on the Left give to the argument for tort reform, I'm not sure who is right though.

[Zefram]

Regarding tort reform, one question, I have read that the CBO calculated tort reform would only reduce overall healthcare expenditures by a very small amount, is this true?? This I know is a response many on the Left give to the argument for tort reform, I'm not sure who is right though.

Yes (CBO’s Analysis of the Effects of Proposals to Limit Costs Related to Medical Malpractice (“Tort Reform”) (http://cboblog.cbo.gov/?p=389)). They estimate it would lower spending by one half of one percent (0.2% from reduced medical liability premiums and 0.3% from reductions in "defensive medicine").

[zomgwtf]

One reason pharmaceutical companies make pharmaceuticals cost more is because they are an oligopoly. The industry is extremely regulated by the FDA, and new pharmaceuticals I believe have to go through something like ten to fifteen years of testing by the FDA before being approved. This allows the industry to be dominated by a few enormous, very powerful pharmaceuticals companies we call Big Pharma.


Hmmm, Canada has more regulations on pharmaceuticals than the states but it costs far less here than in America. Americans pay by far the most amount of money for the prescriptions. I think it has to do more with greed in America getting out of control and spawning more greed.

The fact that the pharmaceutical companies in America make rediculously large amounts of money (I've read places it's the most profitable business in all of America) means that it can do research to develop new drugs and get a monopoly on them. Since when those drugs are released other companies can not release similar drugs for a set amount of years. Paying for more research but it's mostly just going in as profits. Greed spawning ways to have more greed, awesome :smile:

[cronxeh]

I'm still of the firmly believe that if the point of this bill was to drive down the cost of health care in this country, and make it more affordable for everyone then the bill missed some big things. Frankly these things should of been addressed before the government took upon its self an expansion of power.

First standardization of coding and billing for all insurance companies. Second Tort reform. Third the AMA limiting the number of doctors that enter the field each year.

Limiting number of doctors is a terrible idea. The more doctors, the more competition, the lesser the cost. We need to flood the market with doctors.. Take away health care from hands of MBAs by making it not-for-profit. Dont give me that 'this is america' b.s. Because whatever 'this' is, is crap.

[Ronnin]

I would love to be able to help everyone with everything but it simply isn't possible. Healthcare is expensive, the doctors are expensive, and the equipment and testing is expensive. The eventual end to a system such as this the two tier, government white box brand, and the premium name brand you pay extra for. Care will have to be rationed in some way in an attempt to keep up with the ever expanding costs. The long and the short of this is we can't afford this as a nation at the present time. It sounds good, feels good, but is not feisable currently looking at the US balance sheet and income statement. Should we do something to help those who need healthcare? Yes, we do need some form of a system because we can't ignore the problem or the increasingly aging population. Is this govenment fix the silver bullet? No, this has bad fiscal policy written all over it and will take years before we really begin to see all the unintended concequences socially and financially.

I honestly we can't even begin to address the healthcare issue (medicare, social security, or anything else primarily fiscal for that matter) until we take a real hard look at our current tax code. Anyone who has had a pulse for the last few years has seen their expenses rise, in some form or another, while revenues have fallen either through inflation or the drying up of oportunities to generate more. This is all happening at a time where we should be deleveraging the massive debts we as consumers have generated thanks to the easy money provided by a flawed fiat system.

As far as a right to healthcare is concerned, such a right does not exist. I do not have the right to be a recipiant of anyone else's labor or property without due compensation. Just because the government provides something, that something is not free. I would even argue it is now at a premium! Your right in this courntry is private property and the freedom to do with it as you please (within reasonable bounds). You have the right to make good financial decisions as well as bad ones. You have the right to take care of yourself and your family or shirk those responsabilities. Can government provide help in the pooling of these rights and resources to use the economies of scale to address major issues by all concered? Sure, but only if everyone is going to have to pay the ante to get in to the game.

Just as an aside to this longwinded answer, I have noticed that both sides (liberal vs conservative) love to spend other people's money. Republicans spent a boat load on engaging in what appears to be a long protracted war effort and now Democrats are getting their share of the pie with healthcare and various other social programs. You can go back for quite a few years and watch this game of see-saw. Does anyone here see a pattern? It looks more like a ponzi scheme than a legitimate well functioning government.

[Evo]

Look under Section 1501 of Subtitle F (Title I), the section on individual responsibility:

(g) Administration and Procedure-

`(1) IN GENERAL- The penalty provided by this section shall be paid upon notice and demand by the Secretary, and except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68.

This of course refers to the applicable part of the Internal Revenue Code (http://www.law.cornell.edu/uscode/html/uscode26/usc_sup_01_26_10_F_20_68_30_B.html). Yes, it's the IRS.What's the punishment for not paying the fine? Jail? Then at least you will get free medical coverage.

[Nebula815]

Hmmm, Canada has more regulations on pharmaceuticals than the states but it costs far less here than in America. Americans pay by far the most amount of money for the prescriptions. I think it has to do more with greed in America getting out of control and spawning more greed.

The fact that the pharmaceutical companies in America make rediculously large amounts of money (I've read places it's the most profitable business in all of America) means that it can do research to develop new drugs and get a monopoly on them. Since when those drugs are released other companies can not release similar drugs for a set amount of years. Paying for more research but it's mostly just going in as profits. Greed spawning ways to have more greed, awesome :smile:

I think they're cheaper in Canada because Canadian pharmaceuticals companies just copy the designs already developed by American pharmaceuticals companies, allowing them to make them for far cheaper. American companies are responsible for something like 50% of the research of all pharmaceuticals in the world I believe, and when you have to do the research yourself, it will drive up the price.

Companies in Europe and Canada and other nations and continents that copy the American-developed drugs can then produce and sell them for a lot cheaper.

[Nebula815]

Limiting number of doctors is a terrible idea. The more doctors, the more competition, the lesser the cost. We need to flood the market with doctors.. Take away health care from hands of MBAs by making it not-for-profit. Dont give me that 'this is america' b.s. Because whatever 'this' is, is crap.

I think he meant he wanted to undo the AMA limiting the number of doctors in the field each year. And healthcare for profit doesn't mean it is in the hands of MBAs. If you become a doctor and want to set up your own private practice, which will have to be for-profit, that is your right to sell your skills on the market.

Nationalizing it leads to things like disincentivizing doctors from being as skilled as they should, waste and inefficiency, and so forth.

I would NOT want to deal with any doctor who is a government employee, where there is little incentive to improve their skills. With a free market, the doctor who can charge the higher price you know has to be good. It's like surgeons. The best surgeon can charge an arm and a leg because they are truly among the best. It would be scary using a government surgeon :eek:

I also would not want to deal with government-run hospitals.

One of the problems with the system is health insurance companies, however health insurance companies are very highly regulated, so it isn't surprising the industry has a lot of problems. Single-payer would replace the health insurance companies with basically Medicare-Medicaid for everyone, but considering both those programs are not sustainable, that is a problem too, and the program would have to reimburse doctors and hospitals and so forth properly (which both of these do not right now).

This current bill creates something like single-payer by proxy, placing the health insurance companies under heavy government regulation and control.

[cronxeh]

You just discovered the concept of "supply and demand".

Wrong. But thanks for playing.

[calculusrocks]

The way I see, it, because the gap between the obscenely rich and the poor is increasing, it is ethical to balance this gap through taxation. I also fear however that as populations grow and grow and as the wealthy see the general public as increasingly burdensome, we might see some very serious changes happen regarding our rights. We may see very dark days ahead.


I don't see anything wrong with wealth in-itself so long as it's attained honorably.

[Greg Bernhardt]

What's the punishment for not paying the fine? Jail? Then at least you will get free medical coverage.

And there will be exceptions given to those in poverty. So those of the 32million who are in poverty will stay uninsured because they still don't want to pay for coverage and they won't pay a fine.

[Zefram]

What's the punishment for not paying the fine? Jail? Then at least you will get free medical coverage.

No. The special rules provided for in paragraph 2 (i.e. immediately after what I quoted above) are:

(2) SPECIAL RULES- Notwithstanding any other provision of law--

`(A) WAIVER OF CRIMINAL PENALTIES- In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.
`(B) LIMITATIONS ON LIENS AND LEVIES- The Secretary shall not--
`(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or
`(ii) levy on any such property with respect to such failure.'.

[Nebula815]

The way I see, it, because the gap between the obscenely rich and the poor is increasing, it is ethical to balance this gap through taxation. I also fear however that as populations grow and grow and as the wealthy see the general public as increasingly burdensome, we might see some very serious changes happen regarding our rights. We may see very dark days ahead.

Why do you see an inequality of outcome as a bad thing? That is part of a free society. Our "poor" are among the richest poor in the world, especially considering obesity is a huge problem amongst our poor. Their standard of living only continues to go up. Economic advancement will lead to a lot of wealthy people.

[Ivan Seeking]

We all know, of course, that when you are young and healthy, you pay into the healthcare system and don't use the services, but when you are old and sickly, you get more money out than you pay in. So lets stop pretending everyone is on a level playing field and give people individual health savings plans that let them build-up coverage over a lifetime rather than just getting it when they get old. That will convince the young that they aren't flushing their money down the toilet by buying health insurance they have almost no chance of using.

Catastrophic illness or injury can easily result in medical expenses that far exceed one's ability to pay. That is the point of having insurance and not just a savings plan. Likewise, I have auto insurance, and professional liability insurance for that matter, in the event that I get sued for millions in expenses or damages. I cannot possibily save enough money to cover all possibilities. This is why we have insurance in the first place. You are arguing against the basic logic that lies behind all insurance plans. By spreading the cost of individual catastrophic expenses over many policy holders, the risk to any single holder is reduced to manageable levels. But, in order to this to be possible for medical insurance, everyone must participate.

[Nebula815]

Catastrophic illness or injury can easily result in medical expenses that far exceed one's ability to pay. That is the point of having insurance and not just a savings plan. Likewise, I have auto insurance, and professional liability insurance for that matter, in the event that I get sued for millions in expenses or damages. I cannot possibily save enough money to cover all possibilities. This is why we have insurance in the first place. You are arguing against the basic logic that lies behind all insurance plans.

In a proper free-market health insurance system, you could purchase affordable health insurance, or if you go without it, fine, but you pay out of pocket if anything catostrophic happens (which would probably mean bankruptcy).

[Ivan Seeking]

Have you read the law?

Can you answer the question or not?

[Ivan Seeking]

In a proper free-market health insurance system, you could purchase affordable health insurance, or if you go without it, fine, but you pay out of pocket if anything catostrophic happens (which would probably mean bankruptcy).

But for many people, we don't have affordable health insurance. I don't understand your point.

[Ivan Seeking]

I never agreed to this contract. I only pay taxes because I'd go to jail if I didn't.

Okay, fine. So what is your answer to my question? Are you willing to sign a waiver or accept the terms that allow medical workers to refuse treatment based on credit ratings or credit card limits?

[Ivan Seeking]

And there will be exceptions given to those in poverty. So those of the 32million who are in poverty will stay uninsured because they still don't want to pay for coverage and they won't pay a fine.

What evidence exists to show that given the option for affordable coverage, most of these 32 million would refuse it? I have known [or known of] many families who want insurance but simply can't afford it under the current system. No one wants to face financial ruin due to bad luck, when it could be avoided.

[Ivan Seeking]

As do most Americans, I pay a fee for private medical insurance that in turn pays for any 'extended medical treatment' for my family. Thus, also as most Americans under 65, I demand not a thing from the federal government by way of medical benefits, at least for now. As for emergency 911 services, they are provided by my local county, paid for out of my existing state and local taxes, and depending on the situation reimbursed by insurance. I'd prefer the federal government stay the heck out either domain, thank you very much.

As soon as you get into an ambulance, you are outside of the tax-based emergency services. What seems strange to me is that you apparently have no problem with the tax-based emergency services.

Since you already have insurance and this doesn't affect you, what is the problem? Or is it a matter of saying that you're covered so screw everyone else?

[jreelawg]

Why do you see an inequality of outcome as a bad thing? That is part of a free society. Our "poor" are among the richest poor in the world, especially considering obesity is a huge problem amongst our poor. Their standard of living only continues to go up. Economic advancement will lead to a lot of wealthy people.

I don't think the model is sustainable, something has to give eventually, and we are getting closer to that point.

[turbo]

Mandated health-insurance coverage is an idea that has been around for decades - among Republicans, primarily. Now that it is written into law, Republicans hate the idea.

http://news.yahoo.com/s/ap/20100327/ap_on_bi_ge/us_health_overhaul_requiring_insurance;_ylt=AgJjGh f_NFkaLm.Yb2umQzCs0NUE;_ylu=X3oDMTM3NWp1YjFnBGFzc2 V0A2FwLzIwMTAwMzI3L3VzX2hlYWx0aF9vdmVyaGF1bF9yZXF1 aXJpbmdfaW5zdXJhbmNlBGNwb3MDMwRwb3MDOARzZWMDeW5fdG 9wX3N0b3J5BHNsawNuZXdoZWFsdGhpbnM-

[TurtleMeister]

Our "poor" are among the richest poor in the world, especially considering obesity is a huge problem amongst our poor. Their standard of living only continues to go up.
That is true. If it were not then we would not have an illegal immigration problem.

What evidence exists to show that given the option for affordable coverage, most of these 32 million would refuse it?
On average, the poor are poor for a reason. They make bad choices. I know that's not evidence, just an observation. And if you think it's not true then you probably have not lived around the poor very much.

I have known [or known of] many families who want insurance but simply can't afford it under the current system.
It remains to be seen that the new system will lower costs. If it doesn't then we will simply have a tax on the poor.

No one wants to face financial ruin due to bad luck, when it could be avoided.
Many of the poor are already in financial ruin.

[Ivan Seeking]

There will be a new low-cost pool from which the disadvantaged can purchase insurance. This will not reduce the current cost of standard private insurance, but it does seek to contain those costs, which are rising quickly.

Cadillac plans will be taxed. So those plans become more expensive by design.

[Ivan Seeking]

Also, I should have mentioned in the op that there are exemptions to the penalty, for the poor.

It was not clear if the sliding scale is based on the time of that the law is in effect, or the time that a person has gone without insurance.

I have not read all 2400 pages plus the reconcilation act, yet.

[Nebula815]

Mandated health-insurance coverage is an idea that has been around for decades - among Republicans, primarily. Now that it is written into law, Republicans hate the idea.

http://news.yahoo.com/s/ap/20100327/ap_on_bi_ge/us_health_overhaul_requiring_insurance;_ylt=AgJjGh f_NFkaLm.Yb2umQzCs0NUE;_ylu=X3oDMTM3NWp1YjFnBGFzc2 V0A2FwLzIwMTAwMzI3L3VzX2hlYWx0aF9vdmVyaGF1bF9yZXF1 aXJpbmdfaW5zdXJhbmNlBGNwb3MDMwRwb3MDOARzZWMDeW5fdG 9wX3N0b3J5BHNsawNuZXdoZWFsdGhpbnM-

Establishment Republicans, perhaps. Conservatives have always hated the idea.

[Nebula815]

But for many people, we don't have affordable health insurance. I don't understand your point.

My point was if we had a proper free-market health insurance system, we wouldn't have the problem of health insurance rising so much in cost. However, I do not see government intervention as the solution to bring the cost down, I think we have to identify the various components of the system that increase costs and work to reform them.

Also, when you say one gets into an ambulance, how are they out of the taxpayer-funded services? The ambulances are from the fire services, which are taxpayer-funded.

[Zefram]

Establishment Republicans, perhaps. Conservatives have always hated the idea.

I'm curious, do you consider any of the following to be conservatives: Robert Bennett, Kit Bond, Bob Dole, Chuck Grassley, Dick Lugar, Ted Stevens, John Warner, Orrin Hatch, Mike Crapo, Lindsey Graham, Lamar Alexander, Judd Gregg?

[Nebula815]

Bob Dole and Lindsay Graham most certainly not, I am not up-to-speed on the views of all the others. I recognize the names though.

[russ_watters]

Yes (CBO’s Analysis of the Effects of Proposals to Limit Costs Related to Medical Malpractice (“Tort Reform”) (http://cboblog.cbo.gov/?p=389)). They estimate it would lower spending by one half of one percent (0.2% from reduced medical liability premiums and 0.3% from reductions in "defensive medicine"). Note, that report is for a "typical package of reforms" and so doesn't necessarily represent what could actually be accomplished with proper leglislation.

According to the study linked below, everything about malpractice costs $29 billion a year and defensive medicine is another $100 to $178 billion a year. So the CBO's estimate of a "typical package" reducing that by $10 billion is only a 5-8% of the problem. I have a very hard time believing a good package of legislation couldn't drop that by, say, half: $65-$105 billion a year.

http://www.aaos.org/news/aaosnow/nov08/managing7.asp

Also, what I doubt either of these studies or predictions about Obamacare take into account is the secondary economic effects: supply and demand. By forcing people to buy insurance and forcing insurers to cover everything under the sun, prices will be driven up via supply and demand. Conversely, by reducing unnecessary services, supply and demand will drive the unit cost of services down. These effects will not be insignificant.

[Zefram]

The "typical package" CBO analyzed for Hatch contained:

A cap of $250,000 on awards for noneconomic damages;
A cap on awards for punitive damages of $500,000 or two times the award for
economic damages, whichever is greater;
Modification of the "collateral source" rule to allow evidence of income from
such sources as health and life insurance, workers’ compensation, and automobile
insurance to be introduced at trials or to require that such income be subtracted
from awards decided by juries;
A statute of limitations—one year for adults and three years for children—from
the date of discovery of an injury; and
Replacement of joint-and-several liability with a fair-share rule, under which a
defendant in a lawsuit would be liable only for the percentage of the final award
that was equal to his or her share of responsibility for the injury.

Certainly there are alternative proposals like special medical courts, etc but this is a fairly standard and aggressive prescription.

The Kessler-McClellan study's estimates of the costs of defensive medicine are on the high end and the CBO cast doubt (http://www.cbo.gov/doc.cfm?index=4968&type=0) on the generalizability of their result in 2004:

More recently, some researchers observed reductions in health care spending correlated with changes in tort law, but their studies were based on a narrow part of the population and considered spending for only a few ailments. One study analyzed the impact of tort limits on Medicare hospital spending for patients who had been hospitalized for acute myocardial infarction or ischemic heart disease; it observed a significant decline in spending in states that had enacted certain tort restrictions. [...]

When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.

So there's good reason to be skeptical of the utility of a statement like "If the Kessler and McClellan estimates were applied to total U.S. healthcare spending in 2005, the defensive medicine costs would total between $100 billion and $178 billion per year."

[Argentum Vulpes]

Limiting number of doctors is a terrible idea. The more doctors, the more competition, the lesser the cost. We need to flood the market with doctors.. Take away health care from hands of MBAs by making it not-for-profit. Dont give me that 'this is america' b.s. Because whatever 'this' is, is crap.

Wow if my point was the broad side of a barn, I'd be feeling like Dick Cheney's duck hunting partner right now. Did you even bother looking at the link I provided? My point was that the federal government needs to jump up the AMAs rear end about this artificial limiting of the supply of doctors here in the USA.

[russ_watters]

The "typical package" CBO analyzed for Hatch contained:

Certainly there are alternative proposals like special medical courts.... That helps limit the lawsuits a little, but doesn't directly address the problem of defensive medicine. What I think would help more is specific guidelines protecting doctors against the need for defensive medicine, such as not being able to sue for a misdiangosis of an unusal malady. If there is a 99% chance that based on your symptoms you have a certain problem, it doesn't make sense to immediately test for the malady that is the other 1% and a doctor should not be held responsible for making that call. Heck, even take the decision out of the doctor's hands: for the most common maladies, you can put together a matrix of diagnoses and so just by following procedures, a doctor is protected against being sued for not making that 1 - in - 100 diagnosis.

[TheStatutoryApe]

Wow if my point was the broad side of a barn, I'd be feeling like Dick Cheney's duck hunting partner right now. Did you even bother looking at the link I provided? My point was that the federal government needs to jump up the AMAs rear end about this artificial limiting of the supply of doctors here in the USA.

I've been looking and can not find a nonpartisan or official AMA source on this policy of limiting the number of physicians. There are apparently a limited number of medical schools which is maintained by the AMA but this does not necessarily seem unreasonable as it ought to help maintain a proper standard in the field. Your link also cites high rejection rates for applicants to medical school but does not seem to include any idea of whether or not those rejected were at all qualified.

[Shackleford]

So, in order to eliminate or greatly reduce taxpayer subsidy for uncompensated health care services ($40 billion/year), we're going to subsidize millions of people who cannot afford their health care insurance.

Hm.

Also, premiums for health care insurance will invariably rise thus making it less affordable for people and requiring a greater government subsidy for the poor so they can get health care insurance.

This corporate fascism is simply the first step toward a single-payer system. The next step is price controls and such. This unconstitutional bill will do nothing to increase access to health care insurance. There are a myriad things to do that would through the market-driven system reduce cost to both the health care providers and the health care insurers. The DemonCats of course didn't do any of this.

Remember, health care service and health care insurance (a privately-offered product) are privileges, not rights. There's a big difference between social safety nets that we want (e.g. emergency service, fire, etc.) and socialism/fascism. We are very fortunate to have built a nation and an economic system that give us near-instantaneous life-giving aid. This was done through capitalism and the free market. Health care service is very valuable. The training involved requires years of commitment and a lot of money. You are paid by the problem you solve. People in health care solve problems we all have.

[calculusrocks]

Okay, fine. So what is your answer to my question? Are you willing to sign a waiver or accept the terms that allow medical workers to refuse treatment based on credit ratings or credit card limits?

I don't condone the government's efforts in the health insurance at all, except for laws and enforcement that prevent fraud. I don't expect government to steal treatment for me any more than I expect to steal treatment from the doctor himself. The government is completely in bed with the corporations (and the lawyers) as far as I'm concerned. Did the health insurance industry take losses in the stock market after the bill signed? No. It carried the DOW because now the health insurance industry knows that they can force people to buy their product, thanks to government. We already have limited choice because I'm not allowed to buy insurance across state lines.

More entitlements, more taxes, more spending, more laws. No matter what the problem is, the solutions presented by the politician is more entitlements, more taxes, more spending more laws. It doesn't matter if it spawns more and more problems. The solution presented is more entitlements, more taxes, more spending, more laws. If it worked, wouldn't we see the positive results of this approach by now? To what success?

All I see is my choice, my freedom, being offloaded into Washington because they think they somehow know (because their own narcissism prevents them from seeing their own track record) what is best for me. I won't willingly sign anything that gives the impression that I condone any of this.

As far as this contract with the government goes, yeah that's a bunch of nonsense since they are able to erase the contract and make changes as they go along meanwhile they hold my signature in ink.

[mheslep]

As soon as you get into an ambulance, you are outside of the tax-based emergency services. What seems strange to me is that you apparently have no problem with the tax-based emergency services.Hard to do privately without a monopoly.

Since you already have insurance and this doesn't affect you, what is the problem?
You seemed to be addressing everyone above when you stated:
There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured.but I see you were referring only to the uninsured. Even so, I challenge several assertions made in that first post: that there is any 'implicit contract' between the individual and the federal government for any 'extended' medical service. The mandate at hand is federal law. After some limited emergency care enforced by EMTALA, medical providers do have the right to deny service. Often one is not 'all alone'. There are numerous charitable organizations that help pick up the tab for the unfortunate.

Or is it a matter of saying that you're covered so screw everyone else?Well in response I won't get into my charitable habits here. However, given that the US spends $500B/year in taxpayer based Medicare and Medicaid services, which I pay into handsomely via taxes, I find that a silly proposition.

[mheslep]

Mandated health-insurance coverage is an idea that has been around for decades - among Republicans, primarily. Now that it is written into law, Republicans hate the idea.

http://news.yahoo.com/s/ap/20100327/ap_on_bi_ge/us_health_overhaul_requiring_insurance;_ylt=AgJjGh f_NFkaLm.Yb2umQzCs0NUE;_ylu=X3oDMTM3NWp1YjFnBGFzc2 V0A2FwLzIwMTAwMzI3L3VzX2hlYWx0aF9vdmVyaGF1bF9yZXF1 aXJpbmdfaW5zdXJhbmNlBGNwb3MDMwRwb3MDOARzZWMDeW5fdG 9wX3N0b3J5BHNsawNuZXdoZWFsdGhpbnM-For individual mandates, that's in the STATES, where the US constitution has nothing to say on the matter. There was one Republican co-sponsored bill - Wyden-Bennett - that called for federal mandates. I don't see a reversal of Republican opinion anywhere.

[TheStatutoryApe]

I would like to see nationalized health care. This though just seems like some ridiculous bastard hybrid. It would appear as though the idea is for people to get a taste of better access to health care but not appreciate the aftertaste the system leaves leading to more and more reforms that will eventually lead to nationalized healthcare. A foot-in-the-door bill.

[russ_watters]

I agree that it is a "foot-in-the-door bill", but I'm glad the "public option"/fully nationalized healthcare piece was defeated by the Republicans (I consider the republicans more winners here than democrats). I simply can't believe that the government can do something like health care more efficiently than the priate market. Further, I went to college, work hard, and make good money. In a free society, people are supposed to be allowed to enjoy the benefits of their success. It is therefore against the principles of a free society to take those benefits away.

Caveat: Right now, the super-rich in those countries with nationalized healthcare still do somewhat have the right to use their success to improve their medical care: they can just fly to the US for treatment! (And many do!)

[mheslep]

I would like to see nationalized health care.Since the current bill is a form of nationalized health care, I assume you mean you want either single payer by the government (Canada), or you want the government to actually run the medical system, docs, hospitals and all (UK). Why?

[mheslep]

[...]When CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts

[...]So there's good reason to be skeptical of the utility of a statement like "If the Kessler and McClellan estimates were applied to total U.S. healthcare spending in 2005, the defensive medicine costs would total between $100 billion and $178 billion per year."Last I looked at the Texas malpractice reforms, one finds the results reflected in the malpractice premiums charged to physicians, and it was overwhelmingly clear they had dropped dramatically post reform. If we believe that is true, as well as the CBO report above, then possibly that means that hospitals and doctors have not been passing on the cost reductions, i.e., prices are 'sticky' as they say in economics.

[edward]

For individual mandates, that's in the STATES, where the US constitution has nothing to say on the matter. There was one Republican co-sponsored bill - Wyden-Bennett - that called for federal mandates. I don't see a reversal of Republican opinion anywhere.

Republicans were for mandatory health insurance care before they were against it.

But Hatch's opposition is ironic, or some would say, politically motivated. The last time Congress debated a health overhaul, when Bill Clinton was president, Hatch and several other senators who now oppose the so-called individual mandate actually supported a bill that would have required it.

http://www.wbur.org/npr/123670612

http://blondesense.blogspot.com/2010/03/wow-mandatory-health-care-insurance-is.html

[mheslep]

Republicans were for mandatory health insurance care before they were against it.Some supported it, maybe they still do. So? Nixon supported wage and price controls. Does that mean 'Republicans' support wage and price controls? The thesis proposed in this thread is that 'Republicans' have reversed themselves on individual health mandates at the federal level. Yeah? Who? Hatch?

[BoomBoom]

My problem with the mandate is that you are required to purchase a product from a private company that will make a profit from it. It would be OK I think if there were a public option or some other non-profit provider, but I am not a fan of making insurance companies richer than they already are as mandated by government.

I suspect the insurance companies will make bank on this and after reaping the benifits for awhile and posting record profits, we may have to revisit the public option idea in the future.

[turbo]

I suspect the insurance companies will make bank on this and after reaping the benifits for awhile and posting record profits, we may have to revisit the public option idea in the future.Probably sooner than later, too. The insurance companies will take all they can get until the more restrictive (read "fair") regulations regarding coverage for adults begins in 2014, and then who knows what they can pull off? Barring a wholesale takeover by the GOP in 2012, we will be fighting the public option fight all over again.

If the GOP takes the WH in 2012, the public option is dead. Possibly for a very long time.

[mheslep]

BTW, the individual federal insurance mandate is not high on my list of objections to this new Obamacare law, per se. I'm mainly concerned that it sets a precedent for federal the government mandating anything, like mandating that I buy a Government Motors automobile. If I could find a good legal argument, I'd have much less objection, though I still not favor it.

[Ivan Seeking]

Some supported it, maybe they still do. So? Nixon supported wage and price controls. Does that mean 'Republicans' support wage and price controls? The thesis proposed in this thread is that 'Republicans' have reversed themselves on individual health mandates at the federal level. Yeah? Who? Hatch?

Obama's plan has been called "right of Nixon". I would expect that you are too young to fully appreciate the siginficance of that statement. It is yet another example that America's right has gone right over a cliff.

Here was Nixon's proposal
President Richard Nixon's Special Message to the Congress Proposing a Comprehensive Health Insurance Plan

February 6, 1974...
http://www.kaiserhealthnews.org/Stories/2009/September/03/nixon-proposal.aspx

...The flat truth is that in February 1974, with the hounds of hell baying at him about Watergate, with a national trial by shortage under way after the Arab Oil Embargo, with the economy in extremely rocky shape, and with large Democratic majorities in both houses of Congress, Republican Richard M. Nixon submitted to Congress a national health care bill in many ways more comprehensive than what Mr. Obama achieved.

Mr. Nixon's health care plan would have covered all employed people by giving combined state and federal subsidies to employers. It would have covered the poor and the unemployed by much larger subsidies. It would have encouraged health maintenance organizations. It would have banned exclusions for pre-existing conditions and not allowed limits on spending for each insured.

I know a bit about this because I, your humble servant, as a 29-year-old speech writer, wrote the message to Congress sending up the bill.

In many ways, the bill was far more "socialist" than what Mr. Obama has proposed...
http://www.aolnews.com/opinion/article/opinion-giving-nixon-his-due-on-health-care-reform/19414702

[calculusrocks]

BTW, the individual federal insurance mandate is not high on my list of objections to this new Obamacare law, per se. I'm mainly concerned that it sets a precedent for federal the government mandating anything, like mandating that I buy a Government Motors automobile. If I could find a good legal argument, I'd have much less objection, though I still not favor it.

Or government bonds, perhaps?

[calculusrocks]

Ivan, if by "to the right" you mean nationalizing Amtrak and central planning, then yeah? But that doesn't make very much sense. If we're going to use this left-right paradigm, we might as well start with some definitions. Otherwise it just becomes a food fight between partisans who want to paint every control freak as a member of the other team.

Right - smaller gov't
Left - bigger gov't

[Ivan Seeking]

Ivan, if by "to the right" you mean nationalizing Amtrak and central planning, then yeah? But that doesn't make very much sense. If we're going to use this left-right paradigm, we might as well start with some definitions. Otherwise it just becomes a food fight between partisans who want to paint every control freak as a member of the other team.

Right - smaller gov't
Left - bigger gov't

I don't think you can break down "left" and "right" that simply, but I tend to agree with the notion that the role of government in solving problems is a key element of the distinction between the two views. My point is that the "right" has not always been driven entirely by ideology. Amtrak is another example of this. One cannot run a nation while wearing ideological blinders.

If your point is that Nixon was a liberal, good luck in defending that one!

[edpell]

right - higher taxes
left - higher taxes

right - foreign wars for resources
left - foreign wars for resources

right - amnesty for 30 million illegal immigrants
left - amnesty for 30 million illegal immigrants

right - annual federal debt >1 trillion dollars
left - annual federal debt >1 trillion dollars

I fail to see the difference.

[mheslep]

Nixon was a creature of the big government 60s and 70s, instituted wage and price controls, vastly increased the power of government and its regulation in numerous ways (e.g. EPA). He had almost nothing in common with what's considered a Reagan conservative of today.

[calculusrocks]

If your point is that Nixon was a liberal, good luck in defending that one!


Nixon wasn't a liberal. He was a socialist. He's not the first socialist to reside in the Republican party, and he won't be the last. This whole notion that is repeated ad nausium that if X is a republican, and X supports socialist proposition Q, then all republicans are therefore hypocrites is really quite bizarre, especially considering Obama was the one saying that it was "guilt by association" when his ties to the radical terrorist Bill Ayers and the Woods foundation were revealed.

[BoomBoom]

Nixon was a creature of the big government 60s and 70s, instituted wage and price controls, vastly increased the power of government and its regulation in numerous ways (e.g. EPA). He had almost nothing in common with what's considered a Reagan conservative of today.

Reagan, who re-wrote the book on extravagant deficit spending...and Bush followed suit perfectly. That must be 'Reagan conservatism'...as long as the spending is on the military, it doesn't count?

[mheslep]

Nixon wasn't a liberal. He was a socialist.
He had some awful socialist policies.

[turbo]

He had some awful socialist policies.Including that nasty Head-Start program. What a Commie! Johnson started it, and Nixon expanded it. What a traitor.

When I was a kid in grade school in the 50s, we were heavily tracked because the federal government had figured out that we would lose our technological edge to the Soviets if we continued to allow children to be under-educated, and not allowed to track into harder science courses. My parents must have struggled awfully, financially, but they managed to buy me a Sears newtonian one year, and an Edmund microscope the year after. I had been scoring off the charts in sciences and math and my teachers gave me LOTS of extra work, and must have urged them to get me some more "tools" at home.

[mheslep]

Reagan, who re-wrote the book on extravagant deficit spending...and Bush followed suit perfectly. Wrote the book? What do you call what's going on now?

1. Spending is also a function of the Congress, so include, say, Tip O'neil in the 1980s calculus.
2. Entitlements are the real problem, not military spending which can be and was dramatically reduced after the cold war. Reagan didn't sign any new entitlements.
3. The deficits in the Reagan era peaked in '86 at 5% of GDP; today's deficit doubles (http://www.usgovernmentspending.com/downchart_gs.php?year=1900_2010&view=1&expand=&units=p&fy=fy11&chart=G0-total&bar=0&stack=1&size=m&title=&state=US&color=c&local=s) that figure.

[calculusrocks]

The food fighters just don't get it. The CBO, the government's own self-serving measurements, projects that it's going to take 90% of GDP to service the debt by 2020. The goal now is to convince as many stupid countries as possible to invest in our economy to serve our addiction to spending.

ADD: http://www.washingtontimes.com/news/2010/mar/26/cbos-2020-vision-debt-will-rise-to-90-of-gdp/

[calculusrocks]

1) Deficits != Spending
2) LOL @ comparing nonsense programs like "Cash for Clunkers" to spending on military for the Cold War.

[BoomBoom]

1) Deficits != Spending
2) LOL @ comparing nonsense programs like "Cash for Clunkers" to spending on military for the Cold War.

Umm, not quite sure if this comment was directed towards me or not? (I'll respond anyway)

Personally, I would much rather my tax dollars go towards providing all with health coverage, than fund a useless war for no other reason than, "we're afraid of them", or building bombs to make others afraid of us...etc.
It's just a matter of allocation of 'values'. So if you are really sincere in your 'disgust' of deficit spending, you should be equally against it when it comes to military spending by republican presidents. But you do not seem to be, which makes your argument seem a bit disingenuous.

[edward]

Some supported it, maybe they still do. So? Nixon supported wage and price controls. Does that mean 'Republicans' support wage and price controls? The thesis proposed in this thread is that 'Republicans' have reversed themselves on individual health mandates at the federal level. Yeah? Who? Hatch?

You can add Romney to that list, also Scottt Brown.

http://seattletimes.nwsource.com/html/nationworld/2011431814_healthmandate25.html?prmid=obnetwork

http://dailycaller.com/2010/01/13/republican-scott-brown-defends-his-vote-for-mitt-romneys-massachusetts-health-care-plan/

[calculusrocks]

Umm, not quite sure if this comment was directed towards me or not? (I'll respond anyway)

Personally, I would much rather my tax dollars go towards providing all with health coverage, than fund a useless war for no other reason than, "we're afraid of them", or building bombs to make others afraid of us...etc.
It's just a matter of allocation of 'values'. So if you are really sincere in your 'disgust' of deficit spending, you should be equally against it when it comes to military spending by republican presidents. But you do not seem to be, which makes your argument seem a bit disingenuous.

First, the tax dollars don't go directly to health coverage. Money changes hands between many bureaucrats in between. If you wanted a more direct approach, try private charity.

Second, I don't like war, and I don't think we should be in Iraq or Afghanistan. But, the Cold War, you must admit that was a good result. The problem is that you're confusing "war" and "military spending". We spent money on the military to avoid war. If you don't like war, then why would you oppose a course of action that avoided a real war? Because it costs too much money?

Third, Reagan ran deficits. BUT, he ran deficits on a budget that actually made sense! We have to look how much we actually spend in total, not just whether or not we're over budget.

Forth, I think Reagan had a great idea with a missile defense system. That's something the gov't should do, defend us from our enemies. Instead we have tons of military bases all over the globe, and I don't think that's helpful. I think we need to cut-out a more modest foreign policy.

Fifth, how did we get into a war debate anyway? I thought you wanted to discuss health care?

[mheslep]

You can add Romney to that list, also Scottt Brown.

http://seattletimes.nwsource.com/html/nationworld/2011431814_healthmandate25.html?prmid=obnetwork

http://dailycaller.com/2010/01/13/republican-scott-brown-defends-his-vote-for-mitt-romneys-massachusetts-health-care-plan/No, no, no. They supported STATE mandates. I don't have any a priori problem with state mandates either, as the US constitution is not material.

[mheslep]

It's just a matter of allocation of 'values'. So if you are really sincere in your 'disgust' of deficit spending, you should be equally against it when it comes to military spending by republican presidents. But you do not seem to be, which makes your argument seem a bit disingenuous.I pointed out above that are no comparisons for the current deficit spending under any President/Congress unless one goes back to WWII. Second, given the position of the current administration on Afghanistan, I think it is unfair to point to only Republican presidents for deficit military spending.

[Ivan Seeking]

The topic of this thread is the mandate for health insurance for all who are not eligible for medicare or medicaid. This is clearly not a redistribution of wealth as it penalizes those who, in the event of a serious injury or illness, would require medical care that they cannot afford. Please keep all other health care debates in the appropriate thread.
http://www.physicsforums.com/showthread.php?t=387789

Has anyone indicated that they would accept the terms suggested in the op?

[calculusrocks]

The topic of this thread is the mandate for health insurance for all who are not eligible for medicare or medicaid. This is clearly not a redistribution of wealth as it penalizes those who, in the event of a serious injury or illness, would require medical care that they cannot afford. Please keep all other health care debates in the appropriate thread.
http://www.physicsforums.com/showthread.php?t=387789

Has anyone indicated that they would accept the terms suggested in the op?

Sen. Max Caucus and Sen. Howard Dean both say that it is about Redistribution of Wealth.

http://www.youtube.com/watch?v=rY4Qbv7gPbo&feature
http://www.youtube.com/watch?v=LQy_XpzwRn0

Rep. Dingell says it's going to take a while before the law controls the people.

bK62MQ_OIEI

[Al68]

Okay, fine. So what is your answer to my question? Are you willing to sign a waiver or accept the terms that allow medical workers to refuse treatment based on credit ratings or credit card limits?What possible reason would he need to sign a waiver releasing someone else from an obligation he never suggested they had to begin with?There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured.I've made no such demand or agreement (contract).

The words "implied contract" contradict each other. A contract is an agreement between people by definition, which logically precludes the use of the word to describe an involuntary obligation.

How about this: Nobody needs to sign such a waiver because we all have implied waivers. :bugeye:

[edpell]

I have medical insurance even before this all started. So my credit rating is irrelevant and I have no reason to sign any waivers.

Would I let others die in the gutter? No and yes. I would like a LIMITED universal health coverage at say 1% of GDP and then after that you are on your own or on the charity of others and when those both run out you die.

[Zefram]

I would like a LIMITED universal health coverage at say 1% of GDP and then after that you are on your own or on the charity of others and when those both run out you die.

Does that 1% include care for the elderly and poor (the niches currently carved out for Medicare and Medicaid) or is it aimed at everyone outside of those programs?

[edpell]

I am often a Libertarian so that would be 1% GDP for all federal government provided health care to all Americans and visitors. Clearly many things now paid for by the federal government would no longer be covered by the federal government. I favor a greatly reduced federal government.

[Ivan Seeking]

What possible reason would he need to sign a waiver releasing someone else from an obligation he never suggested they had to begin with?I've made no such demand or agreement (contract).

The words "implied contract" contradict each other. A contract is an agreement between people by definition, which logically precludes the use of the word to describe an involuntary obligation.

How about this: Nobody needs to sign such a waiver because we all have implied waivers. :bugeye:

Okay, so you would not agree to sign a waiver but you expect to be treated even if you can't afford it and have no insurance; or at the least, you believe that other people should have this right, for free? If not, then do you believe that anyone who can't pay for medical treatment on the spot, and who has no insurance, should be refused treatment and sent home, or left on the highway to die [as in the example used earlier]?

There are only two choices here: Either you or others get something for nothing, or you don't. Which is it?

How about it we call it a waiver of liability? That is easily justified. One can be excluded from the insurance mandate if they sign a waiver of liability in the event that medical treatment is ever refused due to a lack of insurance or the means to pay.

Also, I take it that you don't recognize that Congress has the right to make laws; nor that we have a representitive democracy? If you don't recognize the mandate that emergency treatment cannot be refused, then you must not recognize the power of Congress as defined under the US Constitution, or that this was done in your name as well as mine.

If you don't believe in our system of government, then your objections are outside of the bounds of this discussion. We are discussing the limits of power of the government as it stands now - according to Constitutional law.

[TheStatutoryApe]

We are discussing the limits of power of the government as it stands now - according to Constitutional law.

Passage of a Bill of Attainder is prohibited by the constitution. Can you demonstrate how this is not a Bill of Attainder?

[calculusrocks]

Ivan, what I'm saying is that the government should abide by its own laws. If the government's own laws mandate that they treat me every time I get small fever, then I'll seek treatment for the small fever (provided the line is not too long, then I'll just tough it out).

No where in the Constitution does it grant authority to Congress to do this. Rights in this country are retained by the People, not the State. We the people tell government what it can do, not vice-versa. The Constitution is the law in the land, and this bill might as well be a defacto 28th Amendment it is so patently unconstitutional.

Why should I sign waivers denying myself treatment simply because I do not appreciate your malicious interpretation of the law?

[calculusrocks]

I am often a Libertarian so that would be 1% GDP for all federal government provided health care to all Americans and visitors. Clearly many things now paid for by the federal government would no longer be covered by the federal government. I favor a greatly reduced federal government.

That I'd support, and I'd hope the citizenry would appreciate such a system as to not to abuse it.

[Al68]

Okay, so you would not agree to sign a waiver but you expect to be treated even if you can't afford it and have no insurance; or at the least, you believe that other people should have this right, for free?No and no. If not, then do you believe that anyone who can't pay for medical treatment on the spot, and who has no insurance, should be refused treatment and sent home, or left on the highway to die [as in the example used earlier]? Nope.There are only two choices here: Either you or others get something for nothing, or you don't. Which is it?Those are obviously not the only choices, and I won't bother elaborating further, since you already know this.How about it we call it a waiver of liability?Since I am not a party to any contract containing any such liability, that makes no sense. If I were, I would need a reason to sign the waiver, such as compensation for waiving my entitlements in such a contract. That is easily justified. One can be excluded from the insurance mandate if they sign a waiver of liability in the event that medical treatment is ever refused due to a lack of insurance or the means to pay. Again, since I'm not a party to any such contract, no need for a waiver. How about having anyone interested in being part of this system sign a contract, and leave the rest of us alone. The idea that people who don't want to participate should be the ones signing anything is absurd.Also, I take it that you don't recognize that Congress has the right to make laws;Obviously false. Congress does have limited delegated power to make laws. If you don't recognize the mandate that emergency treatment cannot be refused, then you must not recognize the power of Congress as defined under the US Constitution, or that this was done in your name as well as mine.The current US Constitution prohibits involuntary servitude.If you don't believe in our system of government, then your objections are outside of the bounds of this discussion. We are discussing the limits of power of the government as it stands now - according to Constitutional law.My objections are based on the US Constitution, as should be obvious. As StatutoryApe pointed out, Bills of Attainer are prohibited, as is involuntary servitude. Not to mention the ninth and tenth amendments. This law clearly violates the constitution many times over.

The only question is, are you knowingly an enemy of the US Constitution, or do you simply not know what it says like most Americans?

[mheslep]

No where in the Constitution does it grant authority to Congress to do this. Rights in this country are retained by the People, not the State. It is not at all clear that holds up. Some would say the Supreme Court wiped out the 10th amendment in the new deal decisions National Labor Relations Board v. Jones & Laughlin Steel Corporation 1937, and US v Darby Lumber Co 1941:
(I'm am not one of the some.)

[...]in United States v. Darby Lumber Co., 312 U.S. 100 (1941), the Court said the 10th Amendment "is but a truism" and was not considered to be an independent limitation on Congressional power.
http://www.answers.com/topic/national-labor-relations-board-v-jones-laughlin-steel-corporation
http://www.answers.com/topic/commerce-clause
For a real case of tossing out 100 years of precedent, those cases dam sure qualified.

[calculusrocks]

Well, I'm not getting my hopes up on the Supreme Court.

[Al68]

Some would say the Supreme Court wiped out the 10th amendment in the new deal decisions National Labor Relations Board v. Jones & Laughlin Steel Corporation 1937, and US v Darby Lumber Co 1941:
(I'm am not one of the some.)Yeah, that was the beginnings of a corrupt politicized Supreme Court. But the fact still remains that nothing the courts do ever actually change what the constitution says.

There are two ways to legitimately amend the constitution, and that isn't one of them.

[Kerrie]

Stepping back from emergency services, I went about 3 years without health insurance when I was in my 20s, then had individual insurance (I was self-employed) for another 5. In that time, I went to the dentist once, had my wisdom teeth out and had a hernia operation. Both surgeries were payed for mostly out of pocket because I had a high deductable, so while I paid $8000 or so for insurance over that time, I still payed about $6000 out of pocket for the services I got. I'm glad I went without insurance for a few years, but I would have been better off going without insurance another few years. Regardless, as a person living in a supposedly free society, I should have the right to make such choices for myself.

Russ, you were one of the lucky ones who had the disposable income to pay for your medical bills-whether it came in the form of premiums or a direct bill. Not only did you have the disposable income to pay for it, but you also chose to pay it. Many people can't or simply won't pay for medical costs incurred, therefore you (and everyone else with the ability and choice to fork out their hard earned cash) end up paying more than you should.

Just 3 years ago I was denied individual coverage for a minor and common condition that many doctors told me was nothing to worry about. The denial letter was signed by a nurse-not a doctor. I am personally glad the government is stepping in to stop insurance companies from denying coverage. Also in the letter was an offer to apply for the state's high risk medical insurance pool, and of course, that insurance company was the carrier for the high risk pool and more expensive. So in these instances, insurance companies have too much power over who they accept and don't accept, and this is where big brother government can help the people.

[Ivan Seeking]

Kerrie!!!! Why don't you post in GD and tell us what you've been doing.

[Kerrie]

I sure will Ivan.

And I am in 100% agreement with our government stepping in for the people who are slipping off the cliff of health insurance coverage. Those who have coverage today may not have it tomorrow because of rising costs.

The law mandates that we have liability coverage for driving and in general, we just pay it and carry on. As long as we avoid tickets and accidents, we pay the lowest rate possible and have a choice of our carrier. Our rates stay competitive because the law requires everyone who chooses to drive to have liability insurance (and of course full coverage if financing the car).

Could it be that the government is stimulating a new market for health insurance policies that will-over time of course-drive down outrageous costs and give this market a healthy competitive drive? Currently, costs are so vague that Americans have no idea how much they are overpaying; would an awareness of these costs by Americans help the competition so that everyone can have access to our fantastic health care?

I don't know if there has been any mention in this reform about the health habits of Americans (obesity as an example), but I would welcome any sort of incentive plan that kept my rates down for making healthy choices.

[Ivan Seeking]

The law mandates that we have liability coverage for driving and in general, we just pay it and carry on. As long as we avoid tickets and accidents, we pay the lowest rate possible and have a choice of our carrier. Our rates stay competitive because the law requires everyone who chooses to drive to have liability insurance (and of course full coverage if financing the car).

Could it be that the government is stimulating a new market for health insurance policies that will-over time of course-drive down outrageous costs and give this market a healthy competitive drive? Currently, costs are so vague that Americans have no idea how much they are overpaying; would an awareness of these costs by Americans help the competition so that everyone can have access to our fantastic health care?

I don't know if there has been any mention in this reform about the health habits of Americans (obesity as an example), but I would welcome any sort of incentive plan that kept my rates down for making healthy choices.

Yes, while naysayers point and accuse Obama of cutting dirty deals with the insurance industry, the reality is that by expanding the base significantly, companies can reduce rates for everyone. There is no way for insurance companies to survive if a good percentage of Americans only get insurance when they get sick or old. It doesn't take a genius to figure that one out.

There are of course limits on what we can hope to gain or save, but the goal was to contain the runaway costs. Broadly expanding the base of the insured was one strategy needed to achieve containment.

[TheStatutoryApe]

The law mandates that we have liability coverage for driving and in general, we just pay it and carry on. As long as we avoid tickets and accidents, we pay the lowest rate possible and have a choice of our carrier. Our rates stay competitive because the law requires everyone who chooses to drive to have liability insurance (and of course full coverage if financing the car).

If I get pulled over and it is believed that I am driving without insurance I will be given a ticket. I go to court and the court decides whether or not I broke the law and then fines me.
Apparently in a few years if it is believed that I do not have health insurance the IRS will simply tell me that I owe them more money. No court, no due process, just "fork it over pal". This allows congress to legislate de jure guilt for not doing what they want, you are guilty because their law (not a court) says so. It goes against the principles of the constitution and is, at the least, borderline illegal.

I'm for Universal Healthcare and do not mind the general aim of the bill, but they need to do it right.

[mheslep]

Yes, while naysayers point and accuse Obama of cutting dirty deals with the insurance industry, the reality is that by expanding the base significantly, companies can reduce rates for everyone. There is no way for insurance companies to survive if a good percentage of Americans only get insurance when they get sick or old. It doesn't take a genius to figure that one out.

There are of course limits on what we can hope to gain or save, but the goal was to contain the runaway costs. Broadly expanding the base of the insured was one strategy needed to achieve containment.Real reality: Massachusetts has a mandate that attempts to pull in all state residents into the paying base, yet its rates are by far the highest in the country far higher than the US average and continue to rise since implementation in 2006.

[Kerrie]

If I get pulled over and it is believed that I am driving without insurance I will be given a ticket. I go to court and the court decides whether or not I broke the law and then fines me.
Apparently in a few years if it is believed that I do not have health insurance the IRS will simply tell me that I owe them more money. No court, no due process, just "fork it over pal". This allows congress to legislate de jure guilt for not doing what they want, you are guilty because their law (not a court) says so. It goes against the principles of the constitution and is, at the least, borderline illegal.

I'm for Universal Healthcare and do not mind the general aim of the bill, but they need to do it right.

When you go to court to prove your innocence because you did have the required auto liability coverage (but perhaps the lack of proof on hand after getting pulled over earned you a ticket), technically you will get out of the fines imposed by court, correct?

If you prove to the IRS that you have health insurance, you should be able to get out of the fines the IRS collects, correct? IRS doesn't make the law, it only collects the fines and fees if the law is broken.

Both mandatory insurances (auto liability and health) stem from a law made our freely elected government representatives. Who collects the fines is not relevant in this thread, and in time the process of carrying out the law may be refined as needed. The lack of coverage for a portion of Americans becomes everyone's liability-whether we feel it today or not, it will become a disaster if government intervention is not taken today.

I think Americans in general take for granted and expect the best in a standard of living for next to nothing even as costs rise. Our government (that we as a free people have a choice in electing as many nations do not) must take action to ensure that American citizens have affordable access to adequate coverage over time; otherwise health coverage will become a luxury for the elite. Everyone having the ability to get heath care greatly benefits the nation as a whole.

[Kerrie]

Real reality: Massachusetts has a mandate that attempts to pull in all state residents into the paying base, yet its rates are by far the highest in the country and continue to rise since implementation in 2006.

Could it be that MA's population is roughly only 2% of the American population? The high costs are collective over the entire United States.

[mheslep]

Could it be that MA's population is roughly only 2% of the American population? So? The theory on the table is that expanding the insurance base by mandating health insurance purchases will, without considering other factors, reduce premiums. If it did not lower premiums for the 6.5 million residents of Mass, why do you think it will somehow work for 300 million US residents?

The high costs are collective over the entire United States.<shrug> The numbers say otherwise.
Average 2009 family plan costs (table 3) (http://healthinsurance.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=healthinsurance&cdn=health&tm=151&f=10&su=p736.9.336.ip_&tt=2&bt=1&bts=1&st=24&zu=http%3A//www.ahipresearch.org/pdfs/2009IndividualMarketSurveyFinalReport.pdf):
Mass: $13,288.
Virginia: $6,383
Iowa: $5,609

[Kerrie]

So? The theory on the table is that expanding the insurance base by mandating health insurance purchases will, without considering other factors, reduce premiums. If it did not lower premiums for the 6.5 million residents of Mass, why do you think it will somehow work for 300 million US residents?

<shrug> The numbers say otherwise.
Average 2009 family plan costs (table 3) (http://healthinsurance.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=healthinsurance&cdn=health&tm=151&f=10&su=p736.9.336.ip_&tt=2&bt=1&bts=1&st=24&zu=http%3A//www.ahipresearch.org/pdfs/2009IndividualMarketSurveyFinalReport.pdf):
Mass: $13,288.
Virginia: $6,383
Iowa: $5,609

Did you factor in the cost of living between Iowa and Massachusetts? I am sure a house in Des Moines Iowa is nothing in comparison to a house in Boston Mass.

My point in my previous post was that only 2% of the entire US population is required to have insurance, therefore the costs will be "high" (partly due to cost of living?) and residents of MA won't see a decrease until the other 98% of the population of the country contributes to these costs as a whole. The larger the pool of insurance premiums, the more affordable it will become. Put in the other 300 million citizens contributing to these rates, and I have a good guess they will come down.

[mheslep]

[...]
My point in my previous post was that only 2% of the entire US population is required to have insurance, therefore the costs will be "high" (partly due to cost of living?) and residents of MA won't see a decrease until the other 98% of the population of the country contributes to these costs as a whole. The larger the pool of insurance premiums, the more affordable it will become. Put in the other 300 million citizens contributing to these rates, and I have a good guess they will come down. Sorry I'm not sure what you mean. Clearly most of the rest of the US population does have insurance. About 85% of Americans have insurance of some kind. Maybe another 5-8% can afford insurance but choose not buy it, and they would be indeed forced to buy insurance with the new mandate. Even so, that won't change a thing about the current demographics of Mass., as all the insurers operating there only deal with Mass. residents, just like everywhere else in the US (unfortunately).

[Kerrie]

According to the Census Bureau, about 46 million people-more than 5-8% of the population-are uninsured, and those are just the citizens.

A family member of mine who is a nurse says she treats a lot of uninsured illegals everyday, which is also not helping our situation. Now, I don't have a suggestion for that fix, that is certainly a whole other topic, but the fact and reality is, the number of uninsured is growing, and it should make those who are insured concerned about the future of affordability of theirs.

What will happen when your health insurance premiums cost as much as your mortgage? Will you forgo your house or your health insurance? My entire family is currently uninsured because we cannot afford the $950 monthly premiums (I was laid off in January), I think I have more reason to be scared of this bill then those who are complaining about it and have excellent coverage. Am I going to forgo paying my rent to pay for those rates of health insurance? Absolutely not!

To clear up my last statement-if MA is the only state that requires health insurance, then that is just 2% of the entire US population. If, say 95% of the US population is putting in, then costs come down and competition is stimulated among health care providers and insurers. Hope that helps clear up my point.

[mheslep]

According to the Census Bureau, about 46 million people-more than 5-8% of the population-are uninsured, and those are just the citizens. Yes, exactly so, about 15% of the population. But only half or less of those are in the group that can afford insurance but choose not to buy it - the ones effected by the mandate. The rest either can not afford insurance and don't qualify for Medicaid, can not afford insurance and don't sign up for Medicaid even though they qualify, can not get it for some condition, or are here illegally. None of those latter groups are going to 'contribute' to the base via a health insurance mandate. So as I said, the new federal mandate is going to add 5-8% more payers on the rolls, assuming those people go along, and they very well may not.

To clear up my last statement-if MA is the only state that requires health insurance, then that is just 2% of the entire US population. If, say 95% of the US population is putting in, then costs come down and competition is stimulated among health care providers and insurers. Hope that helps clear up my point.Ok, I understand. Here's the problem. We won't have 95% of the US population paying in. That's not intended in this bill. The bill authors claim it will insure 95% of the population. We will theoretically have an increase from 85% paying to roughly 90-92% paying (via mandates), and then another 5% (10 million people) will essentially get coverage they don't have now for which they do not pay (pre-existing conditions, not quite poor enough for Medicaid, etc). Thus while some more people will be paying in, there will also be more people receiving benefits. That is what happened in in Mass (they're also 95% insured now), yet the premiums have gone up faster than the national average.

[Kerrie]

I don't believe the census can accurately count illegals, therefore that could be a bigger problem than what is actually visible, perhaps a problem blindly contributing to the rising costs.

As for your numbers, I see that is pure personal speculation unless you are citing a valid source? Isn't the health mandate intended to require everyone have insurance, with subsidies to those who cannot afford current rates? Therefore, if more are required to pay it, your premiums have a higher likelihood of not rising as quickly? Premiums everywhere have gone up faster than they should, not just in MA, which is why there is a growing percentage of those who are losing insurance everyday.

According to SCORE, small businesses employ about half of the American population. Small businesses are losing the ability to carry coverage for their employees due to rising group health coverage costs. If you are one of the lucky people who work for huge corporations or government establishments, you don't have to worry as much because of the purchasing power of group coverage that the large corporation or government can negotiate. And the bill specifically states that those who already have coverage will not have to change anything about their current plan, doesn't it?

So, really, those who are uninsured (such as myself) have a lot more to fear of this bill than most, yet I am relieved of the government intervention of the insurance reform itself. As for the actual health care quality we receive, do you speculate this quality will come down with the standard of living we demand in our country even with health insurance coverage as a requirement?

[turbo]

My last post was lost. Trying again:

We must acknowledge that many of the people that are "insured" are self-insured. There are countless people who choose to be "insured" but they are priced out of policies that pay for basic medical care, and have deductibles of $10-20K or more. If the "insured" come down with a really expensive disease, they are dropped like hot potatoes, and have NO coverage. This is a sick system, and it has to be stopped.

[Choronzon]

My last post was lost. Trying again:

We must acknowledge that many of the people that are "insured" are self-insured. There are countless people who choose to be "insured" but they are priced out of policies that pay for basic medical care, and have deductibles of $10-20K or more. If the "insured" come down with a really expensive disease, they are dropped like hot potatoes, and have NO coverage. This is a sick system, and it has to be stopped.

:rolleyes:

I have one of those plans, and many of my friends and family do as well. Some of them have gotten seriously sick, and no one was "dropped like hot potatoes." I (and many like myself) was careful when I shopped for my health insurance, and I'm also not a push over—if someone breaks my contract I don't just whine about it—I take action.

I like having high deductible insurance. It allows me to talk to my doctor like a man—because when I need something done he isn't worried about getting paid by my insurance company. He works directly for me.

I understand that many people can't afford this—but so what? That's life. Poor people don't get to enslave the rest of us so that they can have health insurance.

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

[Kerrie]

:rolleyes:

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

Until you have to file bankruptcy due to medical collections garnishing your wages.

[Choronzon]

Until you have to file bankruptcy due to medical collections garnishing your wages.

Yeah, I have a pretty good method to avoid that situation—I pay my bills.

[Evo]

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.I work, so I have a no deductible insurance that pays 100% after the first $20.

I'm not saying that you are a loser because you have to pay a fortune for your insurance. I'm just saying that one size does not fit all.

[mheslep]

Hi Kerrie -
[...]As for your numbers, I see that is pure personal speculation unless you are citing a valid source?
They're commonly available from quick googling, have been repeatedly cited by proponent legislators so I take them as public knowledge. Anyway:
Democratic Summary of the health bill (http://dpc.senate.gov/healthreformbill/healthbill95.pdf)
The Congressional Budget Office (CBO) has determined that the two bills [...] ensure that more than 94 percent of Americans have access to quality, affordable health insurance

Breakdown of the 47 million uninsured figure you cited is here (http://www.nytimes.com/2007/11/04/business/04view.html?ex=1351828800&en=7ebf86b6773f35bd&ei=5090&partner=rssuserland&emc=rss) (Statement 2) which pulls from the Census:
o 10 million not US citizens, many illegal
o 18 million have household income over $50k (i.e. 6% of the population)
o 1/4 have been offered employer-provided insurance but declined it.

Isn't the health mandate intended to require everyone have insurance, with subsidies to those who cannot afford current rates? Therefore, if more are required to pay it, your premiums have a higher likelihood of not rising as quickly?Yes everyone has a mandate to buy if they can afford it. Yes some more will get subsidies. But also, as I'm sure you've heard, the insurance companies will no longer be able to reject anyone with expensive pre-existing and chronic conditions - they have to suck all those people up into the system, paid for by the premiums of others. The CBO balanced those - the new payers vs the new chronic/pre-existing - and given the rules levied on the CBO they found on average that premiums would fall ~1%. That has not been the reality in Mass.

[...]And the bill specifically states that those who already have coverage will not have to change anything about their current plan, doesn't it?The President has promised that several times. My read is he's wrong. You'll have coverage, but not necessarily the same. As the bill summaries above will show you, or some of the fact checker sites, the bill creates health insurance 'exchanges', which offer only 'Qualified Plans' specified by the government. For the moment everyone can keep their employer plans, but eventually all health insurance companies will be prohibited from offering anything but those plans on the exchanges.

As for the actual health care quality we receive, do you speculate this quality will come down with the standard of living we demand in our country even with health insurance coverage as a requirement?I don't know. I have spent a lot of time looking at the quality issue, and I'm absolutely convinced that the US medical system on the whole produces the best or close to the best medical outcomes in the world, along with the highest costs per person. My speculation is that in moving closer to some of the European centrally controlled models either the costs will escalate, or the quality will decrease.

Here's what I think should have been done instead.
http://www.roadmap.republicans.budget.house.gov/Issues/Issue/?IssueID=8516

[mheslep]

I work, so I have a no deductible insurance that pays 100% after the first $20.
.Holly smokes. :surprised No deductible for anything? Well that must be what they mean by Cadillac plan.

[brainstorm]

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured. If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.

Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives you the right to treatment that you can't possibly afford?

The problem is that medical costs are seen as fixed, and the assumption is that they can't be provided for less than the current fees. This simply isn't true. The reason why medical costs are so high is the large number of people who want to work and make good money in some aspect of medical service, administration, supply, etc.

The people who don't want to pay the high costs are those who make relatively little money in low wage jobs, for whom medical costs are a much higher proportion of their income than people who work in the medical field. Basically these people think they have a right to medical care without being slaves to medical personnel - which is probably true.

[Evo]

Holly smokes. :surprised No deductible for anything? Well that must be what they mean by Cadillac plan.
The way it works is that I have a $20 co-pay for my first visit and any tests done as a result are free. I had two cat scans, extensive bloodwork (3 times because of high results), x-rays and an MRI. All at no cost.

That's how insurance works for people that work for large companies. That's why you see so much opposition to universal healthcare. My plan covers unlimited dependants also, but my kids can't be covered after they turn 24, which is why there needs to be some sort of universal plan. I am willing to give up some of my benefits to cover these people, but I don't want to go broke either.

[mheslep]

Until you have to file bankruptcy due to medical collections garnishing your wages.The bankruptcies don't (largely) come from high deductibles. They come from no coverage or loss of coverage.

[mheslep]

The way it works is that I have a $20 co-pay for my first visit and any tests done as a result are free. I had two cat scans, extensive bloodwork (3 times because of high results), x-rays and an MRI. All at no cost.Hope all is well.

That's how insurance works for people that work for large companies. That's why you see so much opposition to universal healthcare. My plan covers unlimited dependants also, but my kids can't be covered after they turn 24, which is why there needs to be some sort of universal plan. I am willing to give up some of my benefits to cover these people, but I don't want to go broke either.I work for a BigCo, and have what'd I'd call an excellent PPO plan. Much of the critical care coverage is also no deductible, but much of the rest - psych care, fertility, yaddah yaddah, has non trivial deductibles. I also provide health insurance to the employees of my partnership - its good but not as good as BigCo.

[mheslep]

..., and have deductibles of $10-20K or more. I don't think there any plans with single coverage deductibles above $6k. $12k for a family, max.
http://en.wikipedia.org/wiki/High-deductible_health_plan

[Choronzon]

I work, so I have a no deductible insurance that pays 100% after the first $20.

I'm not saying that you are a loser because you have to pay a fortune for your insurance. I'm just saying that one size does not fit all.

I don't pay a fortune for Health Insurance. My premiums are actually quite low. As a matter of fact, I pay less for my Health Insurance than I do for my cell phone.

As for Health Care—I'd still rather pay for it myself. Even if I go over my deductible, I would pay for my care myself and then get reimbursed by my Insurance company. Even if I had to mortgage out my house. I want no one between my doctors and myself. No private corporation, and most certainly no Government.

[Evo]

I don't pay a fortune for Health Insurance. My premiums are actually quite low. As a matter of fact, I pay less for my Health Insurance than I do for my cell phone.

As for Health Care—I'd still rather pay for it myself. Even if I go over my deductible, I would pay for my care myself and then get reimbursed by my Insurance company. Even if I had to mortgage out my house. I want no one between my doctors and myself. No private corporation, and most certainly no Government.
I don't have anyone between my doctors and myself. I am not restricted to my choice of doctor, I do not need referals or pre-authorizations, I know this because the doctor's office calls me and tells me they checked with my insurance and I have no restrictions.

You must have sucky insurance. I feel sorry for you, but it's not unusual that people like you have to pay so much. Hopefully that will change.

[Kerrie]

The bankruptcies don't (largely) come from high deductibles. They come from no coverage or loss of coverage.

Or the co-insurance that the patient must end up paying, which can be 20-30% of the final bill. Regardless of the details, a lack of coverage and affordability drives up the bankruptcy tendencies, thus driving up costs to those who are still "in" the insurance circle.

From your link:

"The plan ensures universal access to affordable health insurance by restructuring the tax code, allowing all Americans to secure affordable health plans that best suit their needs, and shifting the ownership of health coverage away from the government and employers to individuals.

* Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
* Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
* Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
* Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
* Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
* Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation."

This sounds all similar to what has been passed with the exception of the tax credit vs tax fine. Perhaps however, the situation is dire enough to have to force people to purchase insurance because the incentive doesn't work for low wage workers-which are the majority of the under-insured. If I had the tax incentive to purchase insurance in my current situation, I wouldn't take it (and I have had health issues too). If I am being forced to, I am much more likely to do what is required to avoid a hassle with the IRS (especially being an accounting student!).

I am also in agreement with the medical malpractice problem, as I have read that doctors order all sorts of tests (which of course drive up costs) because they operate out of fear of getting sued over actually being a doctor. The transparency issue of what we actually pay for every little service, pill, or kleenix box definitely needs highlighting-Americans will stimulate competition when they are more aware of their options.

[Choronzon]

I don't have anyone between my doctors and myself. I am not restricted to my choice of doctor, I do not need referals or pre-authorizations, I know this because the doctor's office calls me and tells me they checked with my insurance and I have no restrictions.

You must have sucky insurance. I feel sorry for you, but it's not unusual that people like you have to pay so much. Hopefully that will change.

:rolleyes:

I'd say you were presuming a bit much—but I know you're not. You know for a fact that someone pays for your health insurance, and that even if it is entirely provided by your employer, it's just another type of wage that they're paying you, wages that you perhaps would have been paid directly if your employer values you enough.

Again, why am I telling you something I'm quite certain you already know? I 've had insurance policies similar to yours as well—including a posh plan provided by the government what I worked for the Department of Homeland Security. I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are whats wrong with health care in this country. People don't care what burden is being borne by others around them, they only care what has to come directly from their wallet, and eventually when they look around and there's no one else providing for them anymore, they get all indignant.

But, hey, maybe you do get a better deal then I do—you wouldn't be the only one in this country who does. Unlike most other people in this country, however, I don't feel like I'm entitled to a portion of your success. You enjoy it, and maybe I'll be inspired by your example and try and be more like you. Not today, though.

[TheStatutoryApe]

When you go to court to prove your innocence because you did have the required auto liability coverage (but perhaps the lack of proof on hand after getting pulled over earned you a ticket), technically you will get out of the fines imposed by court, correct?

If you prove to the IRS that you have health insurance, you should be able to get out of the fines the IRS collects, correct? IRS doesn't make the law, it only collects the fines and fees if the law is broken.

Both mandatory insurances (auto liability and health) stem from a law made our freely elected government representatives. Who collects the fines is not relevant in this thread, and in time the process of carrying out the law may be refined as needed. The lack of coverage for a portion of Americans becomes everyone's liability-whether we feel it today or not, it will become a disaster if government intervention is not taken today.

I think Americans in general take for granted and expect the best in a standard of living for next to nothing even as costs rise. Our government (that we as a free people have a choice in electing as many nations do not) must take action to ensure that American citizens have affordable access to adequate coverage over time; otherwise health coverage will become a luxury for the elite. Everyone having the ability to get heath care greatly benefits the nation as a whole.
The only reason the IRS has authority is because Congress can not legislate criminal guilt. So instead of saying that you are a criminal and will be fined for not doing what they want you to do they say you will be taxed. This allows them to side step the legal system and due process. Since you are not defined as a criminal you do not get your day in court. You will have to pay the tax. You get no defense. According to tax codes you must pay the tax and only then will you be allowed to dispute the taxation on the grounds that you do not owe it per tax code. You are only allowed to dispute the tax on the grounds that according to code you do not owe it. If you attempt to dispute a tax on the basis that you should not be made to pay it your hearing will be denied and you will be fined $5000 for submitting a frivolous dispute. There is no presumption of innocence and no right to a trial. You may only request, after the determination of your 'guilt', a hearing where you may attempt to prove that you have mistakenly been categorized as 'guilty'. In essence the law it self says that you are 'guilty' and will be 'fined'. It sidesteps the separation of powers on a technicality, denies due process, and comes incredibly close to being a bill of attainder.

[Evo]

:rolleyes:

I'd say you were presuming a bit much—but I know you're not. You know for a fact that someone pays for your health insurance, and that even if it is entirely provided by your employer, it's just another type of wage that they're paying you, wages that you perhaps would have been paid directly if your employer values you enough.

Again, why am I telling you something I'm quite certain you already know? I 've had insurance policies similar to yours as well—including a posh plan provided by the government what I worked for the Department of Homeland Security. I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are whats wrong with health care in this country. People don't care what burden is being borne by others around them, they only care what has to come directly from their wallet, and eventually when they look around and there's no one else providing for them anymore, they get all indignant.

But, hey, maybe you do get a better deal then I do—you wouldn't be the only one in this country who does. Unlike most other people in this country, however, I don't feel like I'm entitled to a portion of your success. You enjoy it, and maybe I'll be inspired by your example and try and be more like you. Not today, though.Funny the DHS is my customer.

My insurance is definitely a perk, on top of my pay. It's one of the things that you look for when you seek employment. But you say that "my" copay, the amount I personally pay is what is wrong. You're forgetting that as part of my contract that my company pays over $16,000 a year for my health insurance. They pay, not me, but it's paid.

That's why it's important to have a system in this country that takes care of those that don't have the ability to get insurance.

It also explains why many people that get free insurance now from their employers are upset. The government's plan to reimburse me $2,500 towards a $16,000 insurance plan is not a good thing. There has to be some way to allow for what people already have in place.

[mheslep]

Here again is Ryan's list:
* Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
* Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
* Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
* Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
* Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
* Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.

There are a couple of similarities between Rep Ryans health roadmap and the current health reform law, but otherwise they are not alike, and approach the problem entirely differently. The similarities include, for example, a path to cover those with pre-existing conditions and an increased use of information technology. Otherwise, the current health reform law:

Does not allow small businesses to pool, so that, for example, the US association of restaurants could set up a plan well suited for every waitor/waitress in the US. Instead the current law has the federal government set up a single pool, and even that eventually goes away.
Does not enforce a policy that would allow you to buy and take your current policy to any new job, and to any state. The current law gives the states the option to set up cooperative agreements, which means nothing will happen.
Does not do anything until 2018 (and then not much) to balance the current employer - self-employed tax law, as Ryan does in that first bullet with his tax credit, so that individuals get ~ the same tax breaks as those working for BigCo.
Sets up a federally run health exchange which every health insurance company will eventually have to use. Ryan's plan sets up state exchanges.
Uses the IRS enforced mandate to have everyone who can buy insurance. Ryan's plan has no mandate, but does do things that nudge the uninsured-but-can-afford-it to get insurance (auto-enrolment).
Does almost nothing about malpractice costs. Ryan's plan does. It caps non-economic damages.


Long version
http://www.roadmap.republicans.budget.house.gov/plan/#Healthsecurity

[Choronzon]

My insurance is definitely a perk, on top of my pay. It's one of the things that you look for when you seek employment.

That's why it's important to have a system in this country that takes care of those that don't have the ability to get insurance.


I don't follow—how does the fact that your insurance is a perk which is given to you in exchange for your labor somehow imply that we should provide that perk to people who can't earn it?

[mheslep]

....

It also explains why many people that get free insurance now from their employers are upset.Nobody gets free anything from their employer. For every benefit received, another one, probably additional salary, is taken away. If realized health insurance premiums are less because of the employer tax break, that break comes from the government and of course that's not free either.

[mheslep]

: I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are whats wrong with health care in this country. Oh hell yes. You'd save the country a lot of trouble if you could convince some more folks.

[Evo]

I don't follow—how does the fact that your insurance is a perk which is given to you in exchange for your labor somehow imply that we should provide that perk to people who can't earn it?You made the silly statement that insurance was paid by my company instead of wages. No, it was a perk on top of wages.

I'm saying that many people aren't able to get insurance from their employers and we need to do something about it. But we need to to do it in a way that doesn't hurt the companies that already pay for their employees. And poeple shouldn't have to pay through the nose for it as you suggested that people pay high deductables for insurance like you.

You said :rolleyes:

I understand that many people can't afford this—but so what? That's life. Poor people don't get to enslave the rest of us so that they can have health insurance.

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.Uh huh, American's that don't get employer benefits are losers. Nice.

[Choronzon]

You made the silly statement that insurance was paid by my company instead of wages. No, it was a perk on top of wages.

I'm saying that many people aren't able to get insurance from their employers and we need to do something about
it. But we need to to do it in a way that doesn't hurt the companies that already pay for their employees. And poeple shouldn't have to pay through the nose for it as you suggested that people pay high deductables for insurance like you.

You said

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.

And I'm not trying to be nice. I also feel no obligation to be kind to people who can't provide for themselves and thus believe that they are entitled to a portion to what I've earned. I don't think it's nice to be a burden to everyone else either.

[Evo]

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.I get $250,000 salary, and they throw in free insurance. Does it matter if I pay it or my employer pays it? It gets paid. It just doesn't come out of my pocket.

What's your problem with that?

My problem with what you are saying is that less fortunate people shouldn't get compensated for insurance costs. I *do*, unlike you, feel responsible for people that don't get these perks and I am willing to help them out.

As long as I do not give up what I already have. That wouldn't be fair, unless the loss of insurance was paid back to me as an equal payraise to allow me to buy back that policy.

[NeoDevin]

I don't think it's nice to be a burden to everyone else either.

It's a bigger burden when people go to ER for frivolous things because they couldn't afford primary care.

[NeoDevin]

I'm also not a push over—if someone breaks my contract I don't just whine about it—I take action.

Now try doing that as a single person who's just been crippled by a disease or an accident.

[Choronzon]

I get $250,000 salary, and they throw in free insurance. Does it matter if I pay it or my employer pays it? It gets paid. It just doesn't come out of my pocket.

What's your problem with that?

My problem with what you are saying is that less fortunate people shouldn't get compensated for insurance costs. I *do*, unlike you, feel responsible for people that don't get these perks and I am willing to help them out.

As long as I do not give up what I already have. That wouldn't be fair, unless the loss of insurance was paid back to me as an equal payraise to allow me to buy back that policy.

I don't have the slightest problem with what you get—you've earned it.

Let me put it another way. The first thing I did after I left my parents home as a teenager was join the military. I had health my health care covered. When I left the Army, I worked for DHS—health insurance came with that. Then I worked for a small business in Detroit. I had to pay a pretty hefty premium with a bit higher premiums and my employer pitched in, but I had health insurance. Right now, I own a bar and buy my own insurance. From the age of my majority I've had health coverage in one form or another by working for it.

Now people want to give away for free what I've had to work for the past 10 years. Thats my problem. What was the point of going to war if all that I earned while there is what many people believe is a right that should be provided for everyone?

If you feel charitable and want to help someone else out, that's very commendable and I hope they appreciate it. I've done the same in the past, and I will do it again in the future. But if I feel like being a little less charitable this month and instead buy an IPad, that should be my right.

[Choronzon]

It's a bigger burden when people go to ER for frivolous things because they couldn't afford primary care.

Now try doing that as a single person who's just been crippled by a disease or an accident.

I'm unconvinced of that. While it is wasteful if an uninsured person takes advantage of ER services, it still doesn't entitle them to all the drugs, tests, and treatments they may need.

As for your second post—so what? Even if I had been crippled by a disease or accident, it doesn't mean that I'm then magically entitled to enslave doctors and force them to treat me, nor am I then entitled to take my neighbors property to pay for my needs. It's called life—we might die at any moment and we might waste our lives with bad decisions or fall upon bad fortune. How does that make your property mine?

[zomgwtf]

How does that make your property mine?

It doesn't, it just shows that you care for others well-being. (which I understand that you don't)

[NeoDevin]

As for your second post—so what? Even if I had been crippled by a disease or accident, it doesn't mean that I'm then magically entitled to enslave doctors and force them to treat me, nor am I then entitled to take my neighbors property to pay for my needs. It's called life—we might die at any moment and we might waste our lives with bad decisions or fall upon bad fortune. How does that make your property mine?

My reply there wasn't intended to support universal health care, but rather to point out that, in many cases, people who are dropped by their insurers are unable to fight back. This is a separate issue.

[Choronzon]

It doesn't, it just shows that you care for others well-being. (which I understand that you don't)

I care for plenty of people—like my friends and family. I work hard to provide for them, and I give to various causes that are important to me. And to be honest, I do think that some people should be given free health care—children with no one to support them, and the disabled, whether mentally or physically. But resources are in fact limited, and when it comes down to it I'd rather send my daughter to a better school or even buy her some meaningless luxuries than give my able-bodied neighbor health-insurance.

[zomgwtf]

@ Choronzon. I'm wondering exactly how much of what 'you earned' is being or will be taken away from you? It seems to me more or less that your 'angry' or 'jealous' over the fact that you've worked hard to attain what you have and other people will get it without working as hard as you. Is that really something to be angry over though???

I didn't see your reply to my other post. So with the resources that you're going to be losing you would be able to send your daughter to a better school???

[Choronzon]

My reply there wasn't intended to support universal health care, but rather to point out that, in many cases, people who are dropped by their insurers are unable to fight back. This is a separate issue.

Well I would absolutely support stronger consumer protection laws, both in health care and other industries.

[Choronzon]

@ Choronzon. I'm wondering exactly how much of what 'you earned' is being or will be taken away from you?

Well, I'll tell you. Out of every $10 of profit my bar brings in, the government takes $6.50 in various taxes and fees. If you're interested in my personal income taxes, I paid just over a third of it in Federal and State taxes. That doesn't include what I've paid in FICA and medicare, which I doubt I will see in 40 years.

As for sending my daughter to a better school, no, I just used that as an example. I was trying to illustrate that we all are at least a bit selfish. While my daughter goes to a public school (a good one!), I spent over $3000 last year so she could do various extracurricular activities (i.e. Dance, Gymnastics, Camp, Chess, etc..). I suppose I could have taken that money and used it help pay some of my struggling neighbor's mortgage, but I didn't. I expect others here have made the same choice. Should I be excited that the government may want to take another thousand of that next year?

To be honest, I don't know exactly how this bill will affect my tax bill. I don't believe those that say it will save money—the very idea that it will is absurd.

[zomgwtf]

Well, I'll tell you. Out of every $10 of profit my bar brings in, the government takes $6.50 in various taxes and fees. If you're interested in my personal income taxes, I paid just over a third of it in Federal and State taxes. That doesn't include what I've paid in FICA and medicare, which I doubt I will see in 40 years.

Ok but how much of this exactly do you suppose is going towards giving a helping hand to those that don't have insurance? Ball park figure if you can. Or are you just against paying taxes altogether and everyone should keep every penny of what they've earned? Maybe you live in the wrong country???

[Choronzon]

Ok but how much of this exactly do you suppose is going towards giving a helping hand to those that don't have insurance? Ball park figure if you can. Or are you just against paying taxes altogether and everyone should keep every penny of what they've earned? Maybe you live in the wrong country???

I've got no idea how much of my tax bill will go to this new health care program. To be honest, even if it lowered my taxes AND gave me personally awesome free healthcare, I'd still hate it on principle alone. To me, the very idea that health care is a right that should be provided to everyone is absurd.

And no, I'm not against paying taxes. I just wish our tax dollars were more localized. I absolutely hate it how the Federal Government takes such a large share of it that makes the sates and local government beg for it back on bended knee with hat in hand.

[TheStatutoryApe]

To me, the very idea that health care is a right that should be provided to everyone is absurd.
I believe in universal health care. I do not feel that it is a right per se but rather that doctors and those in the medical profession have a duty to their community and to do what they can to help those in need. I feel that the government ought to implement any possible means of supporting the medical community in discharging this duty as it is vital to the stability, health, productivity, and wellbeing of the nations citizens.

[brainstorm]

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.

And I'm not trying to be nice. I also feel no obligation to be kind to people who can't provide for themselves and thus believe that they are entitled to a portion to what I've earned. I don't think it's nice to be a burden to everyone else either.

I agree that I don't want to subsidize other people, but I don't think some people understand how prices are set economically that makes subsidies necessary for some people to get certain things. Here's a simple example:

Let's say I make 100k/year and you make 10k/year and, for simplicity's sake we are the only two people in our health care market with one physician. If I decide that my health is worth a lot, then I will be willing to pay higher cost. My doctor, of course, wants to make the maximum amount of money possible, so she will accept as much as I am willing to pay her. I decide 20% of my income is not extravagant, especially since that still leaves me with 80k/year for other things.

Now, the fact that I am spending $20k/year on healthcare means that my doctor's business managers and advisors need to set her fees to get the full $20k. Once these fees are set, they seem like "THE cost" of health care. No one remembers that it was the highest income in town that set the bar to make the fees what they are in the first place.

Then, because I feel bad for you making 10k/year and not having health care, I vote to subsidize your insurance so you can gain access to the same health care that I have. What a good person I am! Only, in order to get the insurance you have to fulfill certain criteria, the most important of which is that you get a job, because I need employees for my investments to keep my 100k/year income growing.

So the problem is that health care costs are relative to the highest incomes instead of the lowest. If they were indexed according to the lowest incomes, no subsidies would be necessary, and health care benefits would not longer be an incentive to work for businesses where people invest more money to make more profit so they can pay more for health care.

[Alfi]

$250,000

Holy crap !!

I make 10% of that as a Electronics Technician fixing computer motherboards.
I guess I move in the wrong crowd.
Sure glad I'm Canadian and have nothing to do with this debate.


It's been a very good read. Thanks to all who contributed to it thus far.

[Al68]

Or are you just against paying taxes altogether and everyone should keep every penny of what they've earned? Maybe you live in the wrong country???Uhh, which country would be the right one?

[brainstorm]

$250,000

Holy crap !!

I make 10% of that as a Electronics Technician fixing computer motherboards.
I guess I move in the wrong crowd.
Sure glad I'm Canadian and have nothing to do with this debate.


It's been a very good read. Thanks to all who contributed to it thus far.

Yes, it's amazing how national pride in comparing one's blessed welfare state with the "big bad capitalist US" works to motivate the world's masses to accept relatively low salaries without realizing that the money they're not getting is going into the pockets of those who underpay them.

[Alfi]

relatively low salaries without realizing that the money they're not getting is going into the pockets of those who underpay them. uh ..ya ...That would be an American company outsourcing jobs.

But at least I'm in good health :)

[brainstorm]

uh ..ya ...That would be an American company outsourcing jobs.

But at least I'm in good health :)

Look, I'm not the least bit nationalistic, but it seriously irritates me when people are and they're not even critical enough to see how it can be used against them.

Investors living in socialized post-industrial economies invest money in economies that are favorable for them to make lots of money so they can afford the high taxes and cost of living in the socialized post-industrial cities where they live.

Otherwise put, investors globally put their money in US-based companies to take advantage of low corporate taxes. You can call such companies "an American company" but there's a good chance there are global interests behind them with the goal of making profit to fund a well-isolated socialized post-industrial economy (WISPIE) somewhere else. In case you don't like the term, WISPIE (which I made up), you could just call such economies NSIs (national-socialist islands).

Anyway, the point is that one of the ways that these investors can channel money into their WISPIE NSI of choice is to out-source choice jobs to people living there. That reduces unemployment and reduces the cost of socialized benefits of those governments.

Then, you can pay people very little and tell them it's because a "mean American company" is their employer, plus they should be happy that they live in a nice socialized non-US country where everyone loves each other and would never exploit each other cruelly as happens in that "big bad capitalism over there."

In reality, the "American company" that "out-sources" jobs to you is probably a company funded and dedicated to the interest of serving you and others in the socialized paradise you live in. Then you all talk about how bad the US and capitalism are to relieve your guilt of being some of the most privileged people in all of capitalism.

Finally get it people. The global economy is totally interconnected. Everyone is part of the US economy and the US economy is part of every other economy. You're not separate. You can't be separate. The only reason you want to be separate is because it fuels your thirst for ethno-national differentiation and superiority. That way you can basically live in segregation among only the people who meet your standards, and everyone else has to go live in a poor or otherwise inferior region because they're not allowed to migrate to a post-industrial socialized paradise.

[cheae]

The following article compares medicaid and public option, may give some insight about the public option

http://www.differencebetween.net/science/health/difference-between-medicaid-and-public-option/