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

[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 into 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 [STRIKE]by far the highest in the country[/STRIKE] 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.
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.
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.

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]

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:
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 http://www.nytimes.com/2007/11/04/b...773f35bd&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. 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. 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.