Healthcare ruling:

[Parkbandit]

Mandate is CONSTITUTIONAL.

[Parkbandit]

Wait.. now the mandate survives as a tax?

[Parkbandit]

Entire law is upheld and Constitutional.

Wow, I'm surprised given the questioning and the performance of the Government.

[Warriorbird]

Roberts is leery of political decisions after the clusterfuck of Citizens United.

[Nattor]

wow fail on my part.

[Parkbandit]

Roberts is leery of political decisions after the clusterfuck of Citizens United.

Seriously.. Roberts is the deciding vote FOR it? Kennedy is against.. and Roberts is FOR?

The one thing you can say about the Democrats.. they load the Court with people of their beliefs. You will rarely ever see them as swing votes.. they are solidly liberal.

I have no faith in Romney winning and putting a real Constitutional Conservative on the SCOTUS. We're fucked.

[Liagala]

Romneycare v2.0 was upheld? That's surprising.

[AnticorRifling]

While I believed it would pass I really hoped it wouldn't.

[Warriorbird]

Seriously.. Roberts is the deciding vote FOR it? Kennedy is against.. and Roberts is FOR?

The one thing you can say about the Democrats.. they load the Court with people of their beliefs. You will rarely ever see them as swing votes.. they are solidly liberal.

I have no faith in Romney winning and putting a real Constitutional Conservative on the SCOTUS. We're fucked.

Mandate was originally drafted by multiple conservative think tanks, one of which he was a former part of.

[AbnInfamy]

The one thing you can say about the Democrats.. they load the Court with people of their beliefs. You will rarely ever see them as swing votes.. they are solidly liberal.


That's a bit misleading. Both parties are pretty good at accomplishing this. Otherwise there wouldn't be so many decisions hinging on Kennedy's decision.

This success is a bit disappointing, it would be nice to see some real social medicine like Canada and Europe. Tricare worked great when I had it. Oh, I'm successful enough not to need a hand out, but I still believe this.

[EasternBrand]

This opinion is enormous, there's no way to read this and get actual work done today.

[Parkbandit]

That's a bit misleading. Both parties are pretty good at accomplishing this. Otherwise there wouldn't be so many decisions hinging on Kennedy's decision.

The swing votes are almost always the ones that are appointed by Republican Presidents.



This success is a bit disappointing, it would be nice to see some real social medicine like Canada and Europe. Tricare worked great when I had it. Oh, I'm successful enough not to need a hand out, but I still believe this.

Wait until 2014 when this thing gets going... it will make programs like Social Security and Medicare look like they operate in the black.....

[ClydeR]

http://www.youtube.com/watch?v=Lmihmlb1LBY

Is this an etch-a-sketch?

[Atlanteax]

Well, silver lining, if there is any ... is that it can no longer be denied that Health Insurance *is* a TAX ... as SCOTUS determined it is.

[Suppa Hobbit Mage]

You won't be able to tax the rich enough to pay for this, the middle class is going to get decimated.

[~Rocktar~]

You won't be able to tax the rich enough to pay for this, the middle class is going to get decimated.

You can't tax "the rich" enough to pay for anything, there simply isn't enough money in the world in all the financial markets and all the economies to pay for our current unfunded entitlement mandates.

[Fallen]

Crazy. I honestly didn't see this thing being upheld, especially not in its entirety. As others mentioned, also odd to see Roberts swing left.

[Parkbandit]

You won't be able to tax the rich enough to pay for this, the middle class is going to get decimated.

Yea.. this is the thing that most people don't understand. Rich people have never had a problem paying for insurance.. it's the middle class that struggles with affording it. Do people honestly believe that this will lower their costs?

Go go Bottom Up Poverty!

[Parkbandit]

I honestly believe this isn't a big "win" for Obama. One thing that Obama does well is play the victim. If SCOTUS had found the law unconstitutional, then Obama could have really ramped up is base to get out and vote.. saying the SCOTUS was legislating from the bench and the ones that voted against it are all racists.

I honestly think this helps Romney... who will tout that he will repeal the law once he's in office. Whether he does or not is another story........

[AnticorRifling]

So if it's a tax how to I go about getting tax exempt status :)

[Androidpk]

Sure Romney will use this to get votes but if he got in office he would just flip flop.

[Gelston]

He won't be able to repeal it when he gets in anyways. Congressional Democrats would never allow it.

[ClydeR]

What's the deal with the Medicaid part of the decision? There's practice and there's theory. The Supreme Court deals with theory. I'd like to know the practical impact.


Medicaid is also basically the cheapest health insurance program around. It's for poor people, it's pretty stingy, and it pays providers poorly.

So somewhere in the legislative sausage-making, budget-conscious centrists realized that it would be cheaper to rely heavily on Medicaid expansion to achieve the Affordable Care Act's coverage goals. To an extent this is exactly what liberals have been saying about single-payer all along. But in this case it played as a centrist desire to keep the bill relatively cheap. The problem is that most of the Medicaid expansion that would have to happen would have to come from politically conservative states. So congress' approach was essentially to make Red America an offer it couldn't refuse—expansion could be done on very generous terms with the federal government picking up over 90% of the tab, but failure to expand would come with a hefty financial penalty in terms of lost matching Medicaid grants.

Chief Justice Roberts joined with the other conservatives on the court to argue that this penalty—withdrawing of existing federal money unless states kicked in new money of their own—overstepped the constitutional bounds of the spending power. So now states have the carrot to expand Medicaid but not the stick.

Since your state's citizens have to pay taxes to the federal government one way or the other, you'd have to be pretty crazy to refuse the carrot if you ask me. But ideological zeal may well lead some states to turn it down. In that case, substantially more people than the law's authors expected might find themselves eligible for either hardship waivers from the mandate or subsidies to buy insurance on exchanges. How much of each of those things happened will depend on exactly what states do, and figuring out the budgetary implications of the whole thing is going to require some hard work by the little modeling gnomes at the Congressional Budget Office.

More... (http://www.slate.com/blogs/moneybox/2012/06/28/medicaid_what_s_the_deal_.html)

It sort of looks like that part of the decision will have little practical impact in this case.

[Parkbandit]

So if it's a tax how to I go about getting tax exempt status :)

Quit your job, have your wife quit hers, apply for Welfare, unemployment, HUD, etc... Boom, status achievement!

[Parkbandit]

He won't be able to repeal it when he gets in anyways. Congressional Democrats would never allow it.

You believe that the Democrats will take control of the House and maintain control over the Senate?

[Parkbandit]

What's the deal with the Medicaid part of the decision? There's practice and there's theory. The Supreme Court deals with theory. I'd like to know the practical impact.

It sort of looks like that part of the decision will have little practical impact in this case.

Medicare will morph into the Single Payer system the Progressives have been clamoring for.

[Wrathbringer]

Can't afford health insurance premiums? I'll fix that. I'll force you to afford them. :crutches:

[Gelston]

I don't feel that Republicans are going to take over enough of it to repeal anything, no.

[Drew]

Just another in a long history of justices appointed by conservatives betraying conservative causes.

[Parkbandit]

Just another in a long history of justices appointed by conservatives betraying conservative causes.

Roberts wasn't appointed by a Conservative though.. that was GWB and he's far from a Conservative.

[EasternBrand]

So if it's a tax how to I go about getting tax exempt status :)

You could always go to prison. Prisoners are exempt.

[AnticorRifling]

That's true, and apparently they have to have A/C or it's cruel punishment. AFK robbing a bank.

[crb]

I never had that much problem with a theoretical mandate, done by states. It is totally unconstitutional and the way this court has continued to give the federal government more and more power (Kelo, the older marijuana commerce ruling, now this) alarms me. For those who continue to say it is just like Romneycare, it isn't. The constitution clearly creates a government of limited powers while reserving others to the states. This, essentially, gives unlimited power to the federal government who can apparently tax any activity, or inactivity, and then throw us in prison if we don't pay taxes, or garnish our wages, etc.

The founding fathers did not limit the role of the federal government because they thought George Washington was a bad man and would abuse his power. They did it as a check against future limits to freedom that they knew they couldn't see, and that protection is now all but gone. For the liberals applauding this, what happens when we have a far right group in power and they pass a law mandating you purchase a firearm, or be taxed a penalty? This is much the same issue as the Obama Dream-Act-By-Executive-Order-Manuever. Do we really want a King in this country? If the President can choose to ignore the law, what happens when the other side wins the White House? Obama has just created a precedent for Romney to say "We're not going to enforce any clear air act laws on power companies." How would you feel about that? Giving so much power to one branch of government is a bad idea.

When a power is left to the states, the states can experiment. Who here believes that bureaucrats and political appointees in Washington DC can come up with the best healthcare system? Who believes that 50 states experimenting have a better chance of finding it? I'd rather run 50 different experiments to see which way works out the best myself. Competition breeds excellence, top down decrees do not.

My main problems with Obamacare is that it increased the cost of insurance through the addition of new coverage mandates that were also regressive. Forcing an 18 year old construction worker to pay more for health insurance so a 26 year old rich kid slacker who spent a couple years "finding himself" can get it for free is regressive. When all those mandates went into effect, the very day, my health insurance copay went up by 150% and my deductible doubled.

It also used budgetary gimmicks to pass, such as using 10 years of tax revenue to fund 6 years of benefits. Which will not work in the future unless we take 4 years off every decade.

Instead of doing what every economist says needs to be done (remove the employer deduction on health insurance benefits which unfairly subsidizes people who get insurance at work vs. those who buy it themselves, and tax people with cadillac insurance plans who overconsume healthcare resources - which includes myself to be fair) he instead decided to tax medical device makers (which of course won't raise the prices of medical devises) and investment income (which of course won't lower the availability of capital to businesses).

In short, it does nothing to lower the cost of health insurance, but instead raises it, which is the actual problem. Uninsured people aren't the problem, medical care costing too much is, and uninsured people are just a symptom.

The important work to be done is work to lower medical costs by increasing competition and putting the patient in control of more choices. The reason medical costs for things paid for by insurance have inflated at a much higher rate than costs for things like laser eye removal, cosmetic procedures, etc, is because the purchaser (government, insurance company, employer) is not the consumer (patient). So the patient has no incentive to shop around on price, so they don't. So the provider has no incentive to try to lower costs, so they don't.

What is the other industry with runaway cost inflation? Higher education. Do students pay their own tuition up front? Not usually, so you get the same moral hazard causing the same sort of price inflation.

[Bobmuhthol]

Not a moral hazard.

[WRoss]

I'm betting that this thread will break 500 pages. 10 internet points. Any takers?

[AnticorRifling]

Not a moral hazard.

But would you agree or disagree that it is hazardous?

[Bobmuhthol]

Going to college? Yeah, I could see that being hazardous.

[everan]

I never had that much problem with a theoretical mandate, done by states. It is totally unconstitutional and the way this court has continued to give the federal government more and more power (Kelo, the older marijuana commerce ruling, now this) alarms me. For those who continue to say it is just like Romneycare, it isn't. The constitution clearly creates a government of limited powers while reserving others to the states. This, essentially, gives unlimited power to the federal government who can apparently tax any activity, or inactivity, and then throw us in prison if we don't pay taxes, or garnish our wages, etc.

The founding fathers did not limit the role of the federal government because they thought George Washington was a bad man and would abuse his power. They did it as a check against future limits to freedom that they knew they couldn't see, and that protection is now all but gone. For the liberals applauding this, what happens when we have a far right group in power and they pass a law mandating you purchase a firearm, or be taxed a penalty? This is much the same issue as the Obama Dream-Act-By-Executive-Order-Manuever. Do we really want a King in this country? If the President can choose to ignore the law, what happens when the other side wins the White House? Obama has just created a precedent for Romney to say "We're not going to enforce any clear air act laws on power companies." How would you feel about that? Giving so much power to one branch of government is a bad idea.

When a power is left to the states, the states can experiment. Who here believes that bureaucrats and political appointees in Washington DC can come up with the best healthcare system? Who believes that 50 states experimenting have a better chance of finding it? I'd rather run 50 different experiments to see which way works out the best myself. Competition breeds excellence, top down decrees do not.

My main problems with Obamacare is that it increased the cost of insurance through the addition of new coverage mandates that were also regressive. Forcing an 18 year old construction worker to pay more for health insurance so a 26 year old rich kid slacker who spent a couple years "finding himself" can get it for free is regressive. When all those mandates went into effect, the very day, my health insurance copay went up by 150% and my deductible doubled.

It also used budgetary gimmicks to pass, such as using 10 years of tax revenue to fund 6 years of benefits. Which will not work in the future unless we take 4 years off every decade.

Instead of doing what every economist says needs to be done (remove the employer deduction on health insurance benefits which unfairly subsidizes people who get insurance at work vs. those who buy it themselves, and tax people with cadillac insurance plans who overconsume healthcare resources - which includes myself to be fair) he instead decided to tax medical device makers (which of course won't raise the prices of medical devises) and investment income (which of course won't lower the availability of capital to businesses).

In short, it does nothing to lower the cost of health insurance, but instead raises it, which is the actual problem. Uninsured people aren't the problem, medical care costing too much is, and uninsured people are just a symptom.

The important work to be done is work to lower medical costs by increasing competition and putting the patient in control of more choices. The reason medical costs for things paid for by insurance have inflated at a much higher rate than costs for things like laser eye removal, cosmetic procedures, etc, is because the purchaser (government, insurance company, employer) is not the consumer (patient). So the patient has no incentive to shop around on price, so they don't. So the provider has no incentive to try to lower costs, so they don't.

What is the other industry with runaway cost inflation? Higher education. Do students pay their own tuition up front? Not usually, so you get the same moral hazard causing the same sort of price inflation.

Excellent and well thought out statement. Student loans and the cost of higher education are a topic unto themselves, but you're on the right track there too.

[AnticorRifling]

You have the choice of shouldering the higher education cost and taking on student loans, we're not given much of a choice here.

[Latrinsorm]

The constitution clearly creates a government of limited powers while reserving others to the states.Haven't we learned that that was one part of the Constitution that was flawed? When you say:
When a power is left to the states, the states can experiment. Who here believes that bureaucrats and political appointees in Washington DC can come up with the best healthcare system? Who believes that 50 states experimenting have a better chance of finding it? I'd rather run 50 different experiments to see which way works out the best myself. Competition breeds excellence, top down decrees do not.Some of those experiments turned out to be massively wrong. This isn't a problem if states view them as experiments to be discarded if necessary, but that's not how it turned out. What actually happened was those states calcified, turned intransigent. What do we say to the people in those states? Is it better to have a bell curve, where a couple states are awesome and a couple states are miserable, or is it better to have a flat line, where every state has the same middling level? I would say that if the low end of the bell curve falls below a certain level, our federal government is obligated to intervene, both from basic morality and from its stated philosophy. There is a certain base line under which we promise people will not fall.

Alternatively, should we just do away with the promises? They wrote on paper for a reason, after all.

[Wrathbringer]

In 2014, the penalty will be $285 per family or 1% of income, whichever is greater. By 2016, it goes up to $2,085 per family or 2.5% of income.

[Parkbandit]

The Roberts court hasn't been particularly friendly to this administration: http://www.huffingtonpost.com/adam-winkler/supreme-court-obama_b_1619369.html. Before you dismiss it as "OMG HUFFPOST BIASED!11!lawl!!1!," check out the study they reference.

Both sides have been grabbing for more executive power for decades. Did you not have a problem with, oh, say, Bush unilaterally declaring that our enemies are "unlawful combatants" specifically to circumvent their entitled treatment as prisoners of war under the Geneva conventions? Did you not have a problem with the Bush administration indefinitely detaining those "combatants," denying them habeus corpus, wiretapping citizens without warrants, and so on? Or torturing those said combatants--also violating treaties the US signed in good faith? Or is it just "Tyrannical Obama" that you're now suddenly whining about? Especially bullshit, since the individual mandate was thought up by far-right think tanks, not Obama.

Night and day comparisons... none of those Bush "power grabs" would control such a gigantic sector of the economy like healthcare does.

But I suppose you had no problem with these "power grabs", right? Or the actual similar ones put forth by the current administration, right?


You may think the government is incapable of coming up with the best healthcare system, but it's sure as hell not ideal to have board members of companies with shareholders who care only about stock prices, come up with the system.

The government is the most inept system for the type of reform that is needed. The problem people have with the current healthcare system (prior to Obamacare) was ever increasing costs. Do you honestly believe that Obamacare will deliver on the promise of lower healthcare costs as well as saving the government money? If so, I have a shit ton of bridges I would like you to buy.



Most people get through coverage from their employer, and have limited, if any, choices.

Giving people a choice would be a good reform in my opinion. Giving insurance companies the ability to compete across state lines would be a gigantic step in the right direction. A government healthcare program will not give anyone any additional choices in the end.. it will be morph into a single payer system that you either take or you get penalized for not taking it.


Viewing Obamacare, in a vacuum, is retarded. "If only Obamacare was done away with, the free market would make everything perfect!" No, it clearly wasn't perfect before-hand, and repealing Obamacare, and replacing it with nothing, doesn't magically fix things by "empowering health insurance companies."

Who is arguing that healthcare needs no reform? I haven't seen that argument yet. Of course it needs reform, but Obamacare isn't the reform we need.

[g++]

I think CRB wrote a decent post about the qualms alot of people have with the healthcare law and everyone carved it up into easy to argue party politics pieces. Does anyone disagree with anything he wrote about it being fiscally regressive before we degenerate into arguing whether its the republican or democrats fault?

[Parkbandit]

I'm betting that this thread will break 500 pages. 10 internet points. Any takers?

I'll take that bet. How many posts per page? I'm using 100. :)

[4a6c1]

trolololoooooooooool

[TheEschaton]

The Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today. But the Court does not express an opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people.

This quote tells me that Roberts is gun shy. I don't know why, maybe it was Citizens United, but I don't think you could call him a liberal now. He clerked for Rehnquist, and has always been a center-right jurist. Keep in mind, J.P. Stevens, perhaps the most liberal member of the Court til Kagan and Sotomayor joined, was appointed by a Republican. So was Kennedy.

Like PB said, every swing vote, and every "unexpected" vote in recent SCOTUS ruling, has been a so-called conservative (or at least Republican-appointed) jurist going left.

Unlike what PB said, perhaps it's not because they're "traitors" to the conservative cause, but because they reasonably applied the Constitution and found themselves not where far-right conservatives think they have to be.

Anyways, afk for 2 days reading the decision, so I can rebut the asinine arguments sure to crop up here.

As for crb's commentary - that goes more to the latter half of Roberts quote. We can argue economics for a long time. The Democratic position has long been unchanging - the cost of this bill will be saved by preventative medicine, recouping losses elsewhere, etc, but even if it isn't, it is something which should be done because all people deserve affordable health care. Let's debate whether that's a valid analysis. Whether it's constitutional or not and whether the Court got it right or not is going to be a long, ridiculous debate where y'all are going to directly defy constitutional interpretation based on ridiculous assumptions of the staticness of the Constitution, and then I'm going to have to bring up decades of conservative interpretation of the Court and it'll be silly and it makes my head hurt just thinking about it.

[TheEschaton]

Also, from a political standpoint, I agree with PB that either way, Obama would have used the decision to his political advantage. What I think this *does* do is give a sense of urgency to the Romney campaign. Whether he can capitalize on that, is another question.

Also, if Romney does get elected, I'd be surprised if he actually did anything about this. For one, I don't think (?) he can just executive order a Congressional Act without suspending some pretty serious balance-of-powers things - but my knowledge of the extent and power of executive orders is not that great. He'd have to have Republicans introduce a bill to repeal it, and that might not be a political fight he'll want to spend his first 2 years on, especially if the GOP doesn't have a supermajority.

[Suppa Hobbit Mage]

I like the affordable healthcare concept. In 2 years of Obamacare, we haven't seen how it will be paid for - and there really is only one way it can be now - taxes. Taxes are going up, I don't care who you are or who's elected. They have to go up.

[Bobmuhthol]

Or we can just add to the national debt some more, since some presidents (OBAMA) think that's a fun way to pay for things.

[Archigeek]

The important work to be done is work to lower medical costs by increasing competition and putting the patient in control of more choices. The reason medical costs for things paid for by insurance have inflated at a much higher rate than costs for things like laser eye removal, cosmetic procedures, etc, is because the purchaser (government, insurance company, employer) is not the consumer (patient). So the patient has no incentive to shop around on price, so they don't. So the provider has no incentive to try to lower costs, so they don't.

Unfortunately health care is a poor example of the shining beacon of capitalism. Why? Because first and foremost, when you are badly in need of healthcare, you are most often in no position to sit at the bargaining table. I love capitalism. I'm a business owner and have worked to increase my own capital for a long time, but when you're in need of healthcare, you're just not in a position to go shopping and be making a lot of good fiscal choices. This is why there has to be a socialist element to healthcare reform in order for it to succeed. I didn't really fully understand this until I went through a couple of instances where I was in that boat, and now I believe that capitalism can't be the fix for healthcare.

But fear not, some patient protection doesn't mean we need to have continued rampant healthcare cost increases. I'm hopeful that there are solutions out there that allow for patient protection and still do something about the costs, which are and have been out of control for decades. Health care costs have outstripped inflation since it was deregulated, so I think the "sky is falling" chorus here is going to find that it was falling and it's still falling and will continute to fall until we implement some additional reforms. I think this bill could have been much better, but unfortunately, our congress is so fucked up that they'd rather go back to duels at 10 paces than find something they can agree on... as a result they can't pass a strong bill on much of anything, for fear it would give the other guys some political capital. It's idiotic.

Those procedures you refered to such as "laser eye removal" (I think you meant surgery, not removal?) and cosmetic procedures are subject to competitive market forces because when you're going to have one done, you can take your time and go shopping, and market forces apply. Conversely, when you need heart surgery or cancer treatment, you aren't really in a position or mindset to go shopping. And even when it's a procedure you can take your time on a little bit, such as hip surgery, (been there, done that), you still aren't really going to go shopping for the cheapest surgeon, anesthesiologist(s), nurses, etc. It just doesn't work that way. And woe be to you if you try to make good decisions after the surgery and you're high on oxycodone. It just isn't going to happen. Those are the situations where patient protection needs to step in. We need that.

I'm all for increased transparency and insurance plan portability by the way, as I do think more information up front is very helpful. Some things you can shop for, and some things you just don't need and if it were your dollar you'd probably take a pass, but the way the system is now, far too many people (like me) end up buying drugs in Mexico and Canada when they make their "capitalist" choices, because that's where the best prices are. That part of the system is broken too.

[Bobmuhthol]

Those procedures you refered to such as "laser eye removal" (I think you meant surgery, not removal?)

This needs its own post because I laughed so hard.

[Latrinsorm]

Conversely, when you need heart surgery or cancer treatment, you aren't really in a position or mindset to go shopping.For illustration, the first thing my father heard after waking up in the cath lab was "you need to sign this or you die", regarding a consent form for heart surgery.

[Suppa Hobbit Mage]

What is a cath lab?

[Latrinsorm]

It's this place you go to and they knock you out and do some kind of diagnostics, then you wake up and they tell you you're going to die.

I just looked it up and there's a real explanation here (http://en.wikipedia.org/wiki/Cath_lab) if you want.

[AnticorRifling]

What is a cath lab?

Heart cath, not pee pipe into bag kind of cath.

[Parkbandit]

For illustration, the first thing my father heard after waking up in the cath lab was "you need to sign this or you die", regarding a consent form for heart surgery.

Don't worry.. when Obamacare gets going, your father won't have to worry about those annoying life saving procedures.

[AnticorRifling]

Conversely, when you need heart surgery or cancer treatment, you aren't really in a position or mindset to go shopping. And even when it's a procedure you can take your time on a little bit, such as hip surgery, (been there, done that), you still aren't really going to go shopping for the cheapest surgeon, anesthesiologist(s), ...

Probably because you don't want the cheapest, you want the best.

[TheEschaton]

So, just from reading the syllabus, the conservatives will be happy to know that Roberts:

1) Said that the individual mandate is not a valid use of the Commerce clause
2) Said that the individual mandate is not a valid interpretation of the Necessary and Proper Clause
but
3) Said that the individual mandate can be validly interpreted as a Taxation power of Congress, which was an alternate argument of the government. Because of the way our judicial system works, if legislation can be judged to have a valid interpretation (even if not wholly intended by the authors of the legislation) SCOTUS has a duty to preserve legislation, not destroy it.

It'll be interesting to see what the dissent says about Roberts analysis of the "penalty" as a tax on people without health care.

[Archigeek]

Probably because you don't want the cheapest, you want the best.

That might be the case, or since you are in need of heart surgery, it might also be because you are too out of it to make good decisions, or perhaps transporting you is a bad idea, etc, etc. Aquiring good healthcare is not like shopping for a new car. It just isn't and shouldn't be. Try going shopping for a car when your life depends on it and watch yourself pay through the nose then too. Our system is broken, but going whole-hog capitalist healthcare isn't the answer either.

[AnticorRifling]

That might be the case, or since you are in need of heart surgery, it might also be because you are too out of it to make good decisions, or perhaps transporting you is a bad idea, etc, etc. Aquiring good healthcare is not like shopping for a new car. It just isn't and shouldn't be. Try going shopping for a car when your life depends on it and watch yourself pay through the nose then too. Our system is broken, but going whole-hog capitalist healthcare isn't the answer either.

Going hog wild isn't the issue but going full socialist and how many kids are going to want to take out the loans needed for school only to not repay them until they are 50? F that I'll go be an engineer.

We're in the funny position that we can bitch about the cost of healthcare because we do have access to such good healthcare where other people in the world would pay anything for the quality we've got...that quality didn't come about because it was cheap and it didn't come about because the inventive spirit just loves doing research without getting paid.

[TheEschaton]

I took out a law school loan which I won't pay off for probably more than a decade because I work in the public sector. IMO, doctors (and public sector lawyers) shouldn't be in it for the money, but out of a desire to actually make people better.

[AnticorRifling]

You won't be 50 in a decade. LAYWERED.

Since you're saying private law can be in it for the money then private medicine can follow the same path?

You get what you pay for, welcome to your public defense attorney lvl doctor (ps you can't plead guilty or get a bargain for community service with a public defender doctor...you just gonna die).

[Bobmuhthol]

LAYWERED.


We're in the funny position that we can bitch about the cost of healthcare because we do have access to such good healthcare where other people in the world would pay anything for the quality we've got

I'm pretty sure they'd just riot.

[crb]

I like the affordable healthcare concept. In 2 years of Obamacare, we haven't seen how it will be paid for - and there really is only one way it can be now - taxes. Taxes are going up, I don't care who you are or who's elected. They have to go up.

Ron Paul says taxes aren't the tax. Spending is the true tax. He is right.

Government spending is a tax on citizens. If they only tax enough to pay for half their spending, citizens still pay for the other half through lower economic growth, debased currency, etc. The piper must be paid eventually, and the only people who can pay him is all of us, and our children. You might pay for it with a lower wage, weakened buying power, and just some taxes, but you'll pay for it.

Why didn't our founders put an article into the Constitution requiring a 3/4th majority of both houses to push spending above a certain level of GDP?

[Archigeek]

Going hog wild isn't the issue but going full socialist and how many kids are going to want to take out the loans needed for school only to not repay them until they are 50? F that I'll go be an engineer.

Really? We're a long ways from going full socialist, in spite of the hysteria. CRB made the case that capitalist forces could take care of the problems with healthcare, and I argued that healthcare doesn't work that way.


We're in the funny position that we can bitch about the cost of healthcare because we do have access to such good healthcare where other people in the world would pay anything for the quality we've got...that quality didn't come about because it was cheap and it didn't come about because the inventive spirit just loves doing research without getting paid.

I spent about a year unemployed, and if it wasn't for the current healthcare plan, I wouldn't have been able to get insurance due to pre-existing conditions, and thus I would have been put on one of the state emergency plans. Because of this healthcare bill, I was able to get coverage that I could pay for myself.

Do you think the inventive spirit was dead prior to healthcare costs start on its meteoric rise? Was there no inventive spirit prior to the 90's? There's compensation and protection for invention and then there's overkill. Case in point: Embrel, a drug that is a great drug for some people with different forms of arthritis or psoriasis or ankylosing spondilitis. By most accounts it's a great drug and has been since its release in 1998. Unfortunately, due to our F'd up patent system, its official patent protection was provided just this year (prior to that it was "patent pending"), and will go for another 12 years. So it will have protection in the US for a sum total of 26 f'ing years? Last year the US manufacturers made 3.5 billion dollars off of that one drug, at in excess of $1000 a dose (required dosage is between 1 and 4 shots a month). That's just US sales mind you. Do you think that "the inventive spirit" should have protection for 26 years? Amounting to many billions of dollars? The patent sytem was never intended to provide that level of protection, and believe me, the pursuit of $1 billion is just as hard core as the pursuit of $100 billion.

Meanwhile, those folks in countries that aren't "in the funny position that we can bitch about the cost of healthcare because we do have access to such good healthcare" just look at us and chuckle. I'm sure they're thankful that our awesome system developes some kick ass drugs, but then they put price controls in place, and the drug companies still have no problem making a fortune selling the same drug for a still very profitable fraction of the cost in Canada or just about any other country. Yet in this country there are a shit-ton of people with no insurance coverage or with crappy insurance coverage that won't cover our over-priced drugs anyway. The US healthcare system is broken.

[Back]

So do I have to start liking Nutella now? Are we switching to the eurodollars?

[crb]

Unfortunately health care is a poor example of the shining beacon of capitalism. Why? Because first and foremost, when you are badly in need of healthcare, you are most often in no position to sit at the bargaining table. I love capitalism. I'm a business owner and have worked to increase my own capital for a long time, but when you're in need of healthcare, you're just not in a position to go shopping and be making a lot of good fiscal choices. This is why there has to be a socialist element to healthcare reform in order for it to succeed. I didn't really fully understand this until I went through a couple of instances where I was in that boat, and now I believe that capitalism can't be the fix for healthcare.

But fear not, some patient protection doesn't mean we need to have continued rampant healthcare cost increases. I'm hopeful that there are solutions out there that allow for patient protection and still do something about the costs, which are and have been out of control for decades. Health care costs have outstripped inflation since it was deregulated, so I think the "sky is falling" chorus here is going to find that it was falling and it's still falling and will continute to fall until we implement some additional reforms. I think this bill could have been much better, but unfortunately, our congress is so fucked up that they'd rather go back to duels at 10 paces than find something they can agree on... as a result they can't pass a strong bill on much of anything, for fear it would give the other guys some politicla capital. It's idiotic.

Those procedures you refered to such as "laser eye removal" (I think you meant surgery, not removal?) and cosmetic procedures are subject to competitive market forces because when you're going to have one done, you can take your time and go shopping, and market forces apply. Conversely, when you need heart surgery or cancer treatment, you aren't really in a position or mindset to go shopping. And even when it's a procedure you can take your time on a little bit, such as hip surgery, (been there, done that), you still aren't really going to go shopping for the cheapest surgeon, anesthesiologist(s), nurses, etc. It just doesn't work that way. And woe be to you if you try to make good decisions after the surgery and you're high on oxycodone. It just isn't going to happen. Those are the situations where patient protection needs to step in. We need that.

I'm all for increased transparency and insurance plan portability by the way, as I do think more information up front is very helpful. Some things you can shop for, and some things you just don't need and if it were your dollar you'd probably take a pass, but the way the system is now, far too many people (like me) end up buying drugs in Mexico and Canada when they make their "capitalist" choices, because that's where the best prices are. That part of the system is broken too.

You have a point, but not a good one. Not all healthcare is emergent, even cancer and heart disease. Many people live for years with disease and spend plenty of time visiting specialists or going for second opinions. They also have to have numerous scans, repeatedly. If there was price competition maybe they'd get their PET scan at Discount Dave's Medicalrama which advertises radiology services at low low prices during your evening news broadcasts. Educating you before you get sick, so you go to him. Not to be outdone, Crazy Larry's Radiological Wonderland opens up across the street, advertising a 10% price match. You may not have time to shop around, but you would have known about the businesses prior to needing them, like you do for most other businesses you encounter in your life.

But even if you didn't know about these businesses before hand, others did, people with non-emergent needs. Larry and Dave compete for these customers, like laser eye surgeons and laser hair removal places do. When you walk in with your emergent need, they don't say "Hey, look at this sucker, we can gouge him." it isn't as if McDonalds charges more for a bigmac when you're literally starving. You get the same low price the invisible hand of the market created through competition.

Like when you go to the hospital in an emergency, they wouldn't put you in an extra expensive hospital bed and hook you up to extra expensive monitoring equipment just because you don't have time to shop around. Since the hospital needed to compete on price to attract all those elective surgeries (hips, knees, whatever) they needed to save money to offer you, the customer, savings. So they shopped around for equipment, and that forced their suppliers to compete on price, so they could offer the hospital savings. So the supplier goes to the manufacturer and shops around, and this forces the manufacturer to innovate. To win market share and compete they need to provide that equipment at lower prices. They innovate, they optimize, and they succeed. Everyone benefits, not just those who shop around. Competition works, but competition can only happen if the person buying something is the one paying for it.

Sometimes cancer patients need boob jobs too. They benefit from the price competition in that industry. It is the same thing you'd see if everything was open to competition.

Think about things like dialysis, that isn't an emergent need usually, and is one of the single most expensive medical needs ever. If you need dialysis, you need dialysis, regularly, for the rest of your life. Surely there is possibility for competition there? Then again.. if Medicare is paying for it... what do you care what the bill is? Where is the incentive for the provider to innovate?

[crb]

Really? We're a long ways from going full socialist, in spite of the hysteria. CRB made the case that capitalist forces could take care of the problems with healthcare, and I argued that healthcare doesn't work that way.



I spent about a year unemployed, and if it wasn't for the current healthcare plan, I wouldn't have been able to get insurance due to pre-existing conditions, and thus I would have been put on one of the state emergency plans. Because of this healthcare bill, I was able to get coverage that I could pay for myself.
.


Never heard of COBRA? Or is that the program you're talking about?

Also... had you lived in Michigan you could have. We have had an insurer, through their own choice, offer guaranteed coverage and community ratings for as long as I can remember. Biggest insurer in the state in fact.

Imagine if you could have bought insurance across state lines... but thats just a silly competitive capitalist thing.

[TheEschaton]

Last I checked, boob jobs aren't covered by health insurance anyways...


...at least not my health insurance, judging from the women in my office.

You keep talking about quality-of-life/cosmetic care as if basic health care covers these things...

[Warriorbird]

Crazy. I honestly didn't see this thing being upheld, especially not in its entirety. As others mentioned, also odd to see Roberts swing left.

Like many Obama plans, this is all Republican.

[Bobmuhthol]

it isn't as if McDonalds charges more for a bigmac when you're literally starving. You get the same low price the invisible hand of the market created through competition.

There is room for competition in food within a geographical area. There is not room for competition in healthcare. I'm sure we all read On the Wealth of Nations, but apparently you and I took very different messages from it, Mr. Smith.

[Parkbandit]

That might be the case, or since you are in need of heart surgery, it might also be because you are too out of it to make good decisions, or perhaps transporting you is a bad idea, etc, etc. Aquiring good healthcare is not like shopping for a new car. It just isn't and shouldn't be. Try going shopping for a car when your life depends on it and watch yourself pay through the nose then too. Our system is broken, but going whole-hog capitalist healthcare isn't the answer either.

Huh? I don't get your analogy. You don't go shopping for health insurance when you are sick.. you are already supposed to have health insurance... which is why you buy health insurance to begin with.

[Reliel]

Last I checked, boob jobs aren't covered by health insurance anyways...


In the military they are. At least for military wives.

[Warriorbird]

Just another in a long history of justices appointed by conservatives betraying conservative causes.

Except this is a conservative cause.

[Parkbandit]

I took out a law school loan which I won't pay off for probably more than a decade because I work in the public sector. IMO, doctors (and public sector lawyers) shouldn't be in it for the money, but out of a desire to actually make people better.

Isn't that is your decision not to get a job that pays you enough to help repay your loans?

[TheEschaton]

Isn't that is your decision not to get a job that pays you enough to help repay your loans?

Yep. Lawyers are different than doctors though, lawyers aren't de facto about making people's lives better. ;)

[Archigeek]

Like I said, I'm all for increased transparency, and in some cases it would bring improved pricing. But you're wrong, I do have a point and it is a good one. Price competition just doesn't work in a lot of healthcare situations, because even when we have the time and cognitive sense to make our healthcare decisions, we still aren't making them based on price, and I don't think we want a purely capitalistic model where the quality of care is entirely based on how much you can pay, and only the wealthiest have access to the best medical care.

I think there are some ways to make it work in areas where it doesn't, and I'm all for that, but the truth is that even when heart surgery isn't an emergency situation, it's still a situation that's urgent most of the time, and one where people can't make effective capitalistic decisions.

Where I think you're right are things like repeat drug purchases, or perhaps the dialasis that you mentioned, but as I stated in my other post, unfortunately drug production is so centralized in a few companies, and given such long term price protection that the best way to make your priced-based decision is to take your business out of the USA. If drug companies actually had to compete more often I do believe that prices would come down, and they'd still make a solid profit.

[Parkbandit]

Yep. Lawyers are different than doctors though, lawyers aren't de facto about making people's lives better. ;)

Just the opposite, am I right? AM I RIGHT!?!?!?!??!

[msconstrew]

We're in the funny position that we can bitch about the cost of healthcare because we do have access to such good healthcare where other people in the world would pay anything for the quality we've got...that quality didn't come about because it was cheap and it didn't come about because the inventive spirit just loves doing research without getting paid.

I think this is an assumption on your part that we've got good-quality healthcare. There was a study done in 2010 by the Commonwealth Fund that compared the quality of the healthcare available in the US to seven other countries (Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom) and ranked the quality according to five criteria (quality, access, efficiency, equity, and healthy lives).

Although the US certainly has the most expensive healthcare out of the eight total countries surveyed, it ranked last or next-to-last in all five categories. In addition, according to the WHO, the US lags behind 40 other countries when it comes to the maternal mortality rate.

It's incorrect to blindly assert that we've got the best healthcare in the world. We don't. We do have good specialty doctors, but so do Germany and Japan, to name two. But we've got terrible access to healthcare, especially for the most vulnerable populations and apparently that's what the ACA aims to fix, at least in part.

[TheEschaton]

That is an issue that people on the right side of the spectrum don't really argue about. You want the competition, but you also want to protect the profit of these big companies. It has been a rightward policy of big pharmaceuticals to control prescription medicine costs to astronomical proportions, supposedly to trim the cost of R&D. Yet if they were truly competitive, they'd be open to competing with generics from Canada and India.

Case in point: Bush appointed to the Office of the Global AIDS Coordinator the former chair of Eli Lilly, who's main goal was stated to be to pursue 15bn dollars in drug procurement for combating HIV. What they didn't say is that the way they set this whole scam up was that you could only buy brand name drugs, so poor countries who wanted the aid were forced into paying for drugs they could have gotten for a fraction of the cost elsewhere. 15bn, and all of it went to Big Pharm, including - you guessed it - Eli Lilly.

[Archigeek]

Huh? I don't get your analogy. You don't go shopping for health insurance when you are sick.. you are already supposed to have health insurance... which is why you buy health insurance to begin with.

Allow me to clarify so that hopefully you can understand: insurance is a way of spreading out the cost of healthcare, the high cost of healthcare is reflected in the high cost of insurance, not the other way around. So sure, you may have insurance and hopefully it's reasonably good, but knowing what's really covered and making health care choices happens mostly when you need the care itself, not when you buy the insurance. Yes buying the insurance is an important part of the equation, but it's just one part of many. So when you get sick and have to make choices, you aren't in a position to make those choices based on price. You aren't done making decisions after purchasing your insurance.

[Parkbandit]

That is an issue that people on the right side of the spectrum don't really argue about. You want the competition, but you also want to protect the profit of these big companies.

I have never heard of a conservative wanting to "protect the profit" of any company. That is the company's responsibility.


It has been a rightward policy of big pharmaceuticals to control prescription medicine costs to astronomical proportions, supposedly to trim the cost of R&D. Yet if they were truly competitive, they'd be open to competing with generics from Canada and India.

Do you know how generics are created?

[Parkbandit]

Conservatives won a substantial victory (http://www.washingtonpost.com/politics/supreme-court-to-rule-thursday-on-health-care-law/2012/06/28/gJQAarRm8V_story.html?hpid=z1) Thursday. The physics of American politics — actions provoking reactions — continues to move the crucial debate, about the nature of the American regime, toward conservatism. Chief Justice John G. Roberts Jr. (http://www.washingtonpost.com/opinions/liberals-put-the-squeeze-to-justice-roberts/2012/05/25/gJQANa4hqU_story.html) has served this cause.
The health-care legislation’s expansion of the federal government’s purview has improved our civic health by rekindling interest in what this expansion threatens — the Framers’ design for limited government. Conservatives distraught about the survival of the individual mandate (http://www.washingtonpost.com/opinions/the-supreme-court-and-the-health-care-mandate-muddle/2011/03/10/AB30N5Q_story.html) are missing the considerable consolation prize they won when the Supreme Court rejected a constitutional rationale for the mandate — Congress’s rationale — that was pregnant with rampant statism.
The case challenged the court to fashion a judicially administrable principle that limits Congress’s power to act on the mere pretense of regulating interstate commerce. At least Roberts got the court to embrace emphatic language rejecting the Commerce Clause rationale for penalizing the inactivity of not buying insurance:
“The power to regulate commerce presupposes the existence of commercial activity to be regulated. . . . The individual mandate, however, does not regulate existing commercial activity. It instead compels individuals to become active in commerce by purchasing a product, on the ground that their failure to do so affects interstate commerce. Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority. . . . Allowing Congress to justify federal regulation by pointing to the effect of inaction on commerce would bring countless decisions an individual could potentially make within the scope of federal regulation (http://www.washingtonpost.com/opinions/taxing-jobs-out-of-existence/2012/05/09/gIQA75D2DU_story.html), and — under the government’s theory — empower Congress to make those decisions for him.”
If the mandate had been upheld under the Commerce Clause, the Supreme Court would have decisively construed this clause so permissively as to give Congress an essentially unlimited police power — the power to mandate, proscribe and regulate behavior (http://www.washingtonpost.com/opinions/obamacares-rewriting-of-contract-law/2012/03/23/gIQAVuFmWS_story.html)for whatever Congress deems a public benefit. Instead, the court rejected the Obama administration’s Commerce Clause doctrine. The court remains clearly committed to this previous holding: “Under our written Constitution . . . the limitation of congressional authority is not solely a matter of legislative grace.”
The court held that the mandate is constitutional only because Congress could have identified its enforcement penalty as a tax. The court thereby guaranteed that the argument ignited by the mandate will continue as the principal fault line in our polity.
The mandate’s opponents favor a federal government as James Madison fashioned it, one limited by the constitutional enumeration of its powers. The mandate’s supporters favor government as Woodrow Wilson construed it, with limits as elastic as liberalism’s agenda, and powers acquiring derivative constitutionality by being necessary to, or efficient for, implementing government’s ambitions.
By persuading the court to reject a Commerce Clause rationale for a president’s signature act, the conservative legal insurgency against Obamacare has won a huge victory for the long haul. This victory will help revive a venerable tradition of America’s political culture, that of viewing congressional actions with a skeptical constitutional squint, searching for congruence with the Constitution’s architecture of enumerated powers. By rejecting the Commerce Clause rationale, Thursday’s decision reaffirmed the Constitution’s foundational premise: Enumerated powers arenecessarily limited because, as Chief Justice John Marshall said, “the enumeration presupposes something not enumerated.”
When Rep. Nancy Pelosi (D-Calif.), asked where the Constitution authorized the mandate, exclaimed, “Are you serious? (http://cnsnews.com/news/article/flashback-pelosi-obamacares-constitutionality-are-you-serious) Are you serious?,” she was utterly ingenuous. People steeped in Congress’s culture of unbridled power find it incomprehensible that the Framers fashioned the Constitution as a bridle. Now, Thursday’s episode in the continuing debate about the mandate will reverberate to conservatism’s advantage.
By sharpening many Americans’ constitutional consciousness, the debate has resuscitated the salutary practice of asking what was, until the mid-1960s, the threshold question regarding legislation. It concerned what James Q. Wilson called the “legitimacy barrier”: Is it proper for the federal government to do this? Conservatives can rekindle the public’s interest in this barrier by building upon the victory Roberts gave them in positioning the court for stricter scrutiny of congressional actions under the Commerce Clause.
Any democracy, even one with a written and revered constitution, ultimately rests on public opinion, which is shiftable sand. Conservatives understand the patience requisite for the politics of democracy — the politics of persuasion. Elections matter most; only they can end Obamacare. But in Roberts’s decision, conservatives can see that the court has been persuaded to think more as they do about the constitutional language that has most enabled the promiscuous expansion of government.

http://www.washingtonpost.com/opinions/george-will-supreme-court-gives-conservatives-a-consolation-prize/2012/06/28/gJQAWyhY9V_print.html

[Androidpk]

http://sphotos.xx.fbcdn.net/hphotos-ash3/562684_362957240443940_964017517_n.jpg

[Bobmuhthol]

I have never heard of a conservative wanting to "protect the profit" of any company. That is the company's responsibility.

That's weird, because I have never heard a person both identify as a conservative and not throw a huge fit about how businesses are God's gift to man and we need to stop all evil laws meant to tax them properly.

[Parkbandit]

That's weird, because I have never heard a person both identify as a conservative and not throw a huge fit about how businesses are God's gift to man and we need to stop all evil laws meant to tax them properly.[/COLOR]

It's because you have spent your entire adult life in the Progressive Utopia known as a University.

[Parkbandit]

http://sphotos.xx.fbcdn.net/hphotos-ash3/562684_362957240443940_964017517_n.jpg


STEPHANOPOULOS: You were against the individual mandate…

OBAMA: Yes.

STEPHANOPOULOS: …during the campaign. Under this mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?

OBAMA: Well, hold on a second, George. Here — here’s what’s happening. You and I are both paying $900, on average — our families — in higher premiums because of uncompensated care. Now what I’ve said is that if you can’t afford health insurance, you certainly shouldn’t be punished for that. That’s just piling on. If, on the other hand, we’re giving tax credits, we’ve set up an exchange, you are now part of a big pool, we’ve driven down the costs, we’ve done everything we can and you actually can afford health insurance, but you’ve just decided, you know what, I want to take my chances. And then you get hit by a bus and you and I have to pay for the emergency room care, that’s…

STEPHANOPOULOS: That may be, but it’s still a tax increase

.OBAMA: No. That’s not true, George. The — for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase. What it’s saying is, is that we’re not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that if you hit my car, that I’m not covering all the costs.

STEPHANOPOULOS: But it may be fair, it may be good public policy…

OBAMA: No, but — but, George, you — you can’t just make up that language and decide that that’s called a tax increase. Any…

STEPHANOPOULOS: Here’s the…

OBAMA: What — what — if I — if I say that right now your premiums are going to be going up by 5 or 8 or 10 percent next year and you say well, that’s not a tax increase; but, on the other hand, if I say that I don’t want to have to pay for you not carrying coverage even after I give you tax credits that make it affordable, then…

STEPHANOPOULOS: I — I don’t think I’m making it up. Merriam Webster’s Dictionary: Tax — “a charge, usually of money, imposed by authority on persons or property for public purposes.”

OBAMA: George, the fact that you looked up Merriam’s Dictionary, the definition of tax increase, indicates to me that you’re stretching a little bit right now. Otherwise, you wouldn’t have gone to the dictionary to check on the definition. I mean what…

STEPHANOPOULOS: Well, no, but…

OBAMA: …what you’re saying is…

STEPHANOPOULOS: I wanted to check for myself. But your critics say it is a tax increase.

OBAMA: My critics say everything is a tax increase. My critics say that I’m taking over every sector of the economy. You know that. Look, we can have a legitimate debate about whether or not we’re going to have an individual mandate or not, but…

STEPHANOPOULOS: But you reject that it’s a tax increase?

OBAMA: I absolutely reject that notion.



So much for not taxing 95 percent of Americans....

[Bobmuhthol]

I'm as anti-Obama as any reasonable person could be, and Obama was clearly on point in that exchange.

That said, I don't like mandated health insurance.

But I also don't like burdens to the system, so if that's the alternative...

[zzentar]

I don't think people see the far reaching results from this SCOTUS ruling, now congress can FINE any citizens for for not following their mandate. Do what we want or pay a fine, now that's called a tax.

[Tgo01]

I don't think people see the far reaching results from this SCOTUS ruling, now congress can FINE any citizens for for not following their mandate. Do what we want or pay a fine, now that's called a tax.

I think the government has always had powers to say "do what we want or we fine you."

[~Rocktar~]

Last I checked, boob jobs aren't covered by health insurance anyways...


...at least not my health insurance, judging from the women in my office.

You are a moron. There are other reasons to get a boob job and several other cosmetic surgeries than vanity and they do fall into the "medical necessity" catagory and thus are covered by medical insurance. Please do try and educate yourself even a little before spewing.

[Bobmuhthol]

You are a moron. There are other reasons to get a boob job and several other cosmetic surgeries than vanity and they do fall into the "medical necessity" catagory and thus are covered by medical insurance. Please do try and educate yourself even a little before spewing.
Heart transplants are covered by insurance, but that doesn't mean that I can walk in and ask for a heart transplant I don't need. You're making a totally irrelevant argument and having an apparent rage attack in the process.

Also category.

[Jarvan]

So if it's a tax how to I go about getting tax exempt status :)

It's a tax, but currently there is nothing in place where they can do anything if you fail to pay it.

No Wage garnishment. No fines, No jail time.

Basically, it's the "Honor System"

Yeah.... the honor system of paying a tax in a country where the lights go out, your team wins/loses, there is a natural disaster, or it's a day of the week with a vowel is justification for looting.

[Jarvan]

So, just from reading the syllabus, the conservatives will be happy to know that Roberts:

1) Said that the individual mandate is not a valid use of the Commerce clause
2) Said that the individual mandate is not a valid interpretation of the Necessary and Proper Clause
but
3) Said that the individual mandate can be validly interpreted as a Taxation power of Congress, which was an alternate argument of the government. Because of the way our judicial system works, if legislation can be judged to have a valid interpretation (even if not wholly intended by the authors of the legislation) SCOTUS has a duty to preserve legislation, not destroy it.

It'll be interesting to see what the dissent says about Roberts analysis of the "penalty" as a tax on people without health care.

I read #3 to me to mean that the Congress can now tax us to do anything they want.

Lose weight, or be taxed, buy a new car with better mileage, or be taxed.

Anyone else wonder if this law would have passed at ALL if the dems had claimed it was a tax?

[Androidpk]

Heart transplants are covered by insurance, but that doesn't mean that I can walk in and ask for a heart transplant I don't need. You're making a totally irrelevant argument and having an apparent rage attack in the process.

Also category.

He rages in every post if you hadn't noticed.

[Bobmuhthol]

Lose weight, or be taxed, buy a new car with better mileage, or be taxed.

The government does that all the time. Taxes on tobacco, alcohol, gasoline, telephones, whatever they want. This is (likely) a unique example of being taxed for failing to be proactive, where most of the existing taxes are for consuming unfavorable things.

[Jarvan]

I think this is an assumption on your part that we've got good-quality healthcare. There was a study done in 2010 by the Commonwealth Fund that compared the quality of the healthcare available in the US to seven other countries (Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom) and ranked the quality according to five criteria (quality, access, efficiency, equity, and healthy lives).

Although the US certainly has the most expensive healthcare out of the eight total countries surveyed, it ranked last or next-to-last in all five categories. In addition, according to the WHO, the US lags behind 40 other countries when it comes to the maternal mortality rate.

It's incorrect to blindly assert that we've got the best healthcare in the world. We don't. We do have good specialty doctors, but so do Germany and Japan, to name two. But we've got terrible access to healthcare, especially for the most vulnerable populations and apparently that's what the ACA aims to fix, at least in part.


And yet when alot of the world leaders and the super rich need life saving surgery or treatment, then come here. We have the best healthcare. Your looking at the average over all not the best itself. It would be like saying a school has no good students cause the average is a 2.0 GPA when there are 100 or so 4.0 students there.

[Jarvan]

The government does that all the time. Taxes on tobacco, alcohol, gasoline, telephones, whatever they want. This is (likely) a unique example of being taxed for failing to be proactive, where most of the existing taxes are for consuming unfavorable things.[/COLOR]

The government taxes you for using those things, not for NOT using them.

If the feds tried to pass a law taxing me 500 bucks a year for not smoking, I would shit in the capital.

[TheEschaton]

I read #3 to me to mean that the Congress can now tax us to do anything they want.

Lose weight, or be taxed, buy a new car with better mileage, or be taxed.

Anyone else wonder if this law would have passed at ALL if the dems had claimed it was a tax?

I don't think that's an unfair reading, actually. An eco-friendly law, be taxed if you buy a car that gets less than 30 mpg highway, etc. That sort of thing already exists in sin taxes on cigarettes, etc.

The contention here is whether the government can penalize someone as a tax for NOT doing something. Apparently Roberts thinks so, as long as (from what I can tell) the penalty isn't so restrictive as to force people to buy insurance because it would be financially ruinous to do so otherwise.

[TheEschaton]

And yet when alot of the world leaders and the super rich need life saving surgery or treatment, then come here. We have the best healthcare. Your looking at the average over all not the best itself. It would be like saying a school has no good students cause the average is a 2.0 GPA when there are 100 or so 4.0 students there.

Because they can afford it. If we have the best, but only the top 0.1% of our country can afford it, that's not really a great metric for determining the quality of our health care. I think an average (based on access vs. quality) is a legitimate comparison. Why do you think having the outright best (however unavailable) is a better metric?

Edit: Your analogy is also ridiculous. No one on the left is saying "a school has no good students cause the average is a 2.0 GPA", we're saying everyone should have the ability to attend school and be able to access the same education everyone else does (in your silly analogy).

[Bryft]

So what you are all pretty much telling me is... if I don't get health insurance... I have to pay them... and I still won't have health insurance I'll just be a little more poor. Sounds like a great plan to me.

[~Rocktar~]

Heart transplants are covered by insurance, but that doesn't mean that I can walk in and ask for a heart transplant I don't need. You're making a totally irrelevant argument and having an apparent rage attack in the process.

Also category.

When theE makes an intellectually vapid statement of absolutes, I enjoy calling him on it. Kind of like how you enjoy adding nothing of relevance to a conversation. Keep up the good work Bob. Oh, and thanks for the spell check, typically academic, 100% accurate and yet still has no value.

[Latrinsorm]

And yet when alot of the world leaders and the super rich need life saving surgery or treatment, then come here. We have the best healthcare. Your looking at the average over all not the best itself. It would be like saying a school has no good students cause the average is a 2.0 GPA when there are 100 or so 4.0 students there.No disagreement, simple pronoun trouble. If LeBron James says "we live in a mansion", that is true for his family. If someone says "we do not live in mansions" in the context of the average American, that is also true. Obviously msconstrew was referring to the average American; two giveaways were "access" and "equity".

[Bobmuhthol]

When theE makes an intellectually vapid statement of absolutes, I enjoy calling him on it.

The problem is that to anyone who read it not looking for an excuse to rage out on TheE, there were no absolutes.

[~Rocktar~]

The problem is that to anyone who read it not looking for an excuse to rage out on TheE, there were no absolutes.[/COLOR]

I am so glad you are not an English major. The statement that boob jobs are not covered by insurance is a pretty clear absolute. Nice try though. Please go fail elsewhere.

[TheEschaton]

....except it was a joke, as referenced by the line about the women in my office, which I presume you also read, seeing as it's in the bit you quoted. Then, I even went on to refer to cosmetic/quality of life health care as not being part of basic health care. Nowhere, not once, did I say "all boob jobs are cosmetic."

Here's an absolute statement: You're a fucking astronomical idiot.

[TheEschaton]

P.S. When a boob job becomes "medically necessary" it tends to be called a masectomy. If crb was referring to masectomies in his post, not only did I read that wrong, but he's an idiot, as "competition" for boob jobs doesn't have any correlation to actual medical procedures, like a masectomy.

[Jarvan]

I don't think that's an unfair reading, actually. An eco-friendly law, be taxed if you buy a car that gets less than 30 mpg highway, etc. That sort of thing already exists in sin taxes on cigarettes, etc.

The contention here is whether the government can penalize someone as a tax for NOT doing something. Apparently Roberts thinks so, as long as (from what I can tell) the penalty isn't so restrictive as to force people to buy insurance because it would be financially ruinous to do so otherwise.

Yes, you didn't read my words as I felt I wrote them.

If I refuse to buy a car with better mileage, and keep the car I have, the government could then tax me. The key here is the tax is not for buying something they don't approve of, it's for NOT buying something to begin with. Also, as stated, as it stands, it's a tax with no means to collect. Basically, it was added to balance the numbers. They could have just as easily put in "Little green aliens will give us 50 trillion dollars for healthcare for 100 years" and achieved the same results as a tax for not doing something that they have way to collect.

Or better yet, They could tax me for not buying my monthly quota of spinach or some such.

[Jarvan]

Because they can afford it. If we have the best, but only the top 0.1% of our country can afford it, that's not really a great metric for determining the quality of our health care. I think an average (based on access vs. quality) is a legitimate comparison. Why do you think having the outright best (however unavailable) is a better metric?

Edit: Your analogy is also ridiculous. No one on the left is saying "a school has no good students cause the average is a 2.0 GPA", we're saying everyone should have the ability to attend school and be able to access the same education everyone else does (in your silly analogy).

Everyone can't have a new heart either. Nor can everyone have the world's best heart surgeon work on them. The left is saying by doing this all is equal... it's never equal. Plain and simple. Even healthcare in Europe, the best healthcare is PAID for by the rich. it's not given FREE to the poor.

[Jarvan]

No disagreement, simple pronoun trouble. If LeBron James says "we live in a mansion", that is true for his family. If someone says "we do not live in mansions" in the context of the average American, that is also true. Obviously msconstrew was referring to the average American; two giveaways were "access" and "equity".

Show me one country in the world where the rich get EXACTLY the same healthcare and access as someone without a single -insert lowest coin value of said country here- to their name?

No such thing.

is their average better? maybe, but then ask yourself why. Or better yet, Ask yourself if Access to DR's will be easier in the US when every single person can go for free? 3 week wait now for a DR? try 7 weeks when that happens.

[Rinualdo]

Why are you bothering to debate with Rocktar?

[Parkbandit]

Show me one country in the world where the rich get EXACTLY the same healthcare and access as someone without a single -insert lowest coin value of said country here- to their name?

No such thing.


Easy. Fantasyland.

[Warriorbird]

http://i.imgur.com/8pXAv.jpg

[Warriorbird]

Show me one country in the world where the rich get EXACTLY the same healthcare and access as someone without a single -insert lowest coin value of said country here- to their name?

No such thing.

is their average better? maybe, but then ask yourself why. Or better yet, Ask yourself if Access to DR's will be easier in the US when every single person can go for free? 3 week wait now for a DR? try 7 weeks when that happens.

There's countries that pay much less of their money for healthcare and who have better access.

[Bobmuhthol]

Those countries also have lower life expectancies and higher mortality rates from just about every treatable disease.

[TheEschaton]

Yes, you didn't read my words as I felt I wrote them.

If I refuse to buy a car with better mileage, and keep the car I have, the government could then tax me. The key here is the tax is not for buying something they don't approve of, it's for NOT buying something to begin with. Also, as stated, as it stands, it's a tax with no means to collect. Basically, it was added to balance the numbers. They could have just as easily put in "Little green aliens will give us 50 trillion dollars for healthcare for 100 years" and achieved the same results as a tax for not doing something that they have way to collect.

Or better yet, They could tax me for not buying my monthly quota of spinach or some such.

Except you not buying a new car is a question of luxury and convenience, as long as your current car conforms to whatever standards we've set out for "acceptable car ownership/usage" is. In health care, this bill has said that it isn't acceptable, from a General Welfare sort of angle, for people to be uninsured and be more expensive medically when/if they do get ill, when they can be insured, either privately or publicly. That's a legislative decision, and it's one that went through due process and proper procedure, whether you like the decision or the procedure notwithstanding.

As for your second post, I don't quite see the argument you're trying to make. If you need a heart transplant in Europe, you get one without it being a financial burden. Quality does increase with payment, if you go privately, but if you have no money, you get one. If you need one in the U.S., you'll get one (or be put on the list, same as Europe) when it becomes an emergency care issue, even if you can't afford it, but you'll be strapped with a quarter million dollar bill. Of course the majority will subsidize the poor minority who can't afford health care in this system, but I suppose the difference is that we don't think the rich's right to their money supercedes the poor's right to health care.

[Warriorbird]

Those countries also have lower life expectancies and higher mortality rates from just about every treatable disease.

Uh, no.

What countries are you talking about?

Are you not looking at first world capitalist democracies?

[Bobmuhthol]

Given the United States has the lowest mortality rates in the world for the most common cancers, uh, yes.

[Warriorbird]

Given the United States has the lowest mortality rates in the world for the most common cancers, uh, yes.

That would be a different figure than for "just about every treatable disease." You can also note that we still manage to have lower life expectancies than those folks.

EDIT:

You can also look at the total disaster of our infant mortality rate.

[EasternBrand]

A lot of people are upset because it appears that the Supreme Court has authorized the constitutionality of a "tax on inactivity." If you don't purchase minimum essential coverage, you are subject to a tax of a lesser amount. The Court said that this structure was constitutional. But one of the more interesting parts of today's decision--and one that I have not seen covered in any reporting I've read--is that Alito's dissent never says that the federal government lacks the authority to tax inactivity. Indeed, the distinction the dissent draws is "not whether Congress had the power to frame the minimum-coverage provision as a tax, but whether it did so." (Alito Dissent at 17-18.) Alito comes to the conclusion that, the way the statute is authored, the mandate is not a tax at all, but an "exaction . . . imposed for violation of the law." (Alito Dissent at 19.) Because an exaction imposed as a penalty is outside the scope of the federal tax power, the mandate is unconstitutional.

So what does this mean for the ability to tax you if you didn't buy your broccoli quota? It means that the dissent would find the statute unconstitutional if it were written like this: "All citizens must purchase 100 lbs. of broccoli in each fiscal year. Anyone who does not so purchase will be subject to a penalty equal to the average market price of 25 lbs. of broccoli for that given year." Arguably such a statute is now constitutional under today's precedent. But consider the following statute: "All tax brackets are hereby increased by two percentage points. This tax increase is not applicable to any citizen who purchases 100 lbs. of broccoli during the fiscal year." Likely, the majority opinion today would cover this too. It's pretty clearly a tax. But here is the most important part: Alito's dissent does not attack the constitutionality of this second statute. Yes, Alito does raise the question "whether this [would be] a direct tax that must be apportioned among the States according to their population." (Alito Dissent at 25.) This is a reference to the Capitation (or Direct Tax) Clause of Article I, the meaning of which Alito calls "famously unclear." But he does not say that it would be unconstitutional. Instead, he says that such a question would need to be fully briefed and argued before the Court could make any decision about the Capitation Clause.

The dissent's problem is not with a "tax on inactivity." Not even Alito, Scalia, Thomas, or Kennedy say that a tax because you didn't buy your vegetables would be unconstitutional. What this means is that the question would be entirely different for the minority if the mandate were rewritten more clearly as a tax. It is not a question they answer one way or the other, and it's not the issue. We can argue about whether a tax on inactivity is good policy (and, well, we are). But no one on the Court said today that that would be unconstitutional.

[Bobmuhthol]

That would be a different figure than for "just about every treatable disease." You can also note that we still manage to have lower life expectancies than those folks.

The conditional life expectancy of a United States citizen who lives to be 65 is higher than that of European countries. I don't know what other treatable diseases are killing more Americans than cancer, but if you name a few I'll try to get the statistics for you.

http://2.bp.blogspot.com/_djgssszshgM/RzXsjYF141I/AAAAAAAAALw/wr1i0L-zl8I/s400/life+expectancy.jpg

[TheEschaton]

I don't think that's an unfair reading, actually. An eco-friendly law, be taxed if you buy a car that gets less than 30 mpg highway, etc. That sort of thing already exists in sin taxes on cigarettes, etc.

The contention here is whether the government can penalize someone as a tax for NOT doing something. Apparently Roberts thinks so, as long as (from what I can tell) the penalty isn't so restrictive as to force people to buy insurance because it would be financially ruinous to do so otherwise.

I got neg rep for this saying "And your credibility is still next to nothing." Frankly, I'm confused. I agreed with Jarvan that it's not an unfair way to read the ruling, and that today's ruling is an extension of other government efforts to promote certain behaviors, like sin taxes. Methinks someone has a reading comprehension problem.

[Warriorbird]

The conditional life expectancy of a United States citizen who lives to be 65 is higher than that of European countries. I don't know what other treatable diseases are killing more Americans than cancer, but if you name a few I'll try to get the statistics for you.

http://2.bp.blogspot.com/_djgssszshgM/RzXsjYF141I/AAAAAAAAALw/wr1i0L-zl8I/s400/life+expectancy.jpg

You're sort of sticking your fingers in your ears here about infant mortality and a tremendous amount of the population who's below 65. Healthcare doesn't begin when you retire. We've got relatively decent coverage for folks over 65. The total life expectancy of America is lower than that series of capitalist democracies who pay less than we do for healthcare, not some arbitrary point in which all American have 80% coverage.

This isn't an "old people" issue.

[Bobmuhthol]

Bitch you think you credible? Your credibility is next to nothing!

[Bobmuhthol]

You're sort of sticking your fingers in your ears here about infant mortality and a tremendous amount of the population who's below 65. Healthcare doesn't begin when you retire. We've got quality coverage for folks over 65. The total life expectancy of America is lower than that series of capitalist democracies who pay less than we do for healthcare, not some arbitrary point in which all American have 80% coverage.

Hi the standardized mean applies to everyone. Two different statistics: elderly people fare better in the US (because of better healthcare), and standardized life expectancy at birth is better in the US (because of better healthcare).

[Warriorbird]

Hi the standardized mean applies to everyone. Two different statistics: elderly people fare better in the US (because of better healthcare), and standardized life expectancy at birth is better in the US (because of better healthcare).

Of course it applies to everyone... and its lower than a long list of countries.

Infant mortality is higher and standardized life expectancy is lower. Your whole set of claims before was based on a period of time in which we have 80% coverage for every American.

[Bobmuhthol]

IT IS THE HIGHEST NUMBER.

[Warriorbird]

IT IS THE HIGHEST NUMBER.

This isn't some sort of debate on Social Security or Medicare. The baby boom will do just fine (on our backs).

Life expectancy lower than: Japan, Germany, Switzerland, Denmark... the list goes on...

[Bobmuhthol]

Okay you're obviously fucking ignoring the numbers in front of you and pretending that I'm making claims that I'm not, so whatever. I can't change the fucking table. It's right there. Look at it.

[Warriorbird]

Okay you're obviously fucking ignoring the numbers in front of you and pretending that I'm making claims that I'm not, so whatever. I can't change the fucking table. It's right there. Look at it.

And I'm using current oecd figures, rather than a manipulated average from 1980-1999.

[Alfster]

While I didn't bother to read most of the thread...

This ruling certainly made my current job much more interesting. Nothing like being in the health insurance business right now...Giant clusterfuck all around.

[Bobmuhthol]

The study was not conducted using "current" figures so no you're not.

[Archigeek]

Never heard of COBRA? Or is that the program you're talking about?

Also... had you lived in Michigan you could have. We have had an insurer, through their own choice, offer guaranteed coverage and community ratings for as long as I can remember. Biggest insurer in the state in fact.

Imagine if you could have bought insurance across state lines... but thats just a silly competitive capitalist thing.

I was speaking of at the end of COBRA eligibility. And assuming you read my post, I am for insurance portability, AKA: buying insurance across state lines. I'm not anti-capitalism, I just don't view capitalism through the lense of idealistic furvor that you do.

[Warriorbird]

The study was not conducted using "current" figures so no you're not.

I'm sorry that the current listed oecd figures have no bearing on what you're attempting to argue from and don't really reference current spending at all. The WHO disagrees with you too if that matters.

We're dealing with right now.

Here's a description of the study you're dealing with:


Two University of Iowa researchers, Robert L. Ohsfeldt and John E. Schneider, reviewed the data for the nations of the OECD to statistically account for the incidence of fatal injuries for the member countries. The dynamic table above presents their findings, showing both the average life expectancy from birth over the years 1980 to 1999 without any adjustment (the actual "raw" mean), and again after accounting for the effects of premature death resulting from a non-health-related fatal injury (the standardized mean).

Without accounting for the incidence of fatal injuries, the United States ties for 14th of the 16 OECD nations listed. But once fatal injuries are taken into account, U.S. "natural" life expectancy from birth (76.9 years) ranks first among the richest nations of the world.

Which points out that gosh, gee, our infant mortality rate totally fucking blows. Given better pre-natal care and a number of things tied into actual access to care for young parents, that manipulated number might not have to be manipulated.

Notably, it's not 1999. We're not dealing with senior citizens, the other point you used to make your case. There's a lot more than 16 OECD countries and tremendous strides in care have been made in the 13 years since this study (with some notable biases associated) occurred which are reflected in those OECD countries now kicking our ass.

It's certainly interesting reading though.

[Bobmuhthol]

If at any point you said, "What is the standardization?" you might feel differently about the numbers, but you never did so I just assumed you were a fucking moron who didn't know which number was bigger.

Maybe this will help: WHEN YOU DO NOT INCLUDE NON-HEALTH-RELATED DEATHS IN THE MORTALITY RATE, THE UNITED STATES, ON A HEALTH-RELATED-DEATH ONLY BASIS, HAS THE HIGHEST LIFE EXPECTANCY. OECD INCLUDES ALL DEATHS. ALL OF THEM. THE ONES THAT HAVE NOTHING TO DO WITH HEALTH CARE. NO ONE HAS PUBLISHED THE SAME STUDY FOR FIGURES MORE RECENT THAN 1999.

For fuck's sake.

[Bobmuhthol]

The infant mortality rate is the result of health related deaths and is included in the numbers, unless it was the result of an accident or homicide. Please make up another reason why the numbers should be changed arbitrarily so that your argument can be better.

[Warriorbird]

The infant mortality rate is the result of health related deaths and is included in the numbers, unless it was the result of an accident or homicide. Please make up another reason why the numbers should be changed arbitrarily so that your argument can be better.

That's actually what they're doing and what you're doing. Related to the specific study I liked this comment:

"Simplistically removing specific causes of death to achieve the longest life span for the U.S. smacks of the worst kind of intellectual dishonesty."

Might the poor not get good healthcare in accidents? Might accidental death of children (preventable with better care) really be a huge factor? Sure might.

It's also manipulated to only include certain OECD countries.

[Darkwynde]

Bob... as your list is from 1980-1999, I thought I might update. From the CIA site:

Rank
country (years) Date of Information (all est. 2011 except for 2010 for the European Union)
1 Monaco 89.68
2 Macau 84.43
3 Japan 83.91
4 Singapore 83.75
5 San Marino 83.07
6 Andorra 82.50
7 Guernsey 82.24
8 Hong Kong 82.12
9 Australia 81.90
10 Italy 81.86
11 Liechtenstein 81.50
12 Canada 81.48
13 Jersey 81.47
14 France 81.46
15 Spain 81.27
16 Sweden 81.18
17 Switzerland 81.17
18 Israel 81.07
19 Iceland 81.00
20 Anguilla 80.98
21 Netherlands 80.91
22 Bermuda 80.82
23 Cayman Islands 80.80
24 Isle of Man 80.76
25 New Zealand 80.71
26 Ireland 80.32
27 Norway 80.32
28 Germany 80.19
29 Jordan 80.18
30 United Kingdom 80.17
31 Greece 80.05
32 Saint Pierre and Miquelon 80.00
33 Austria 79.91
34 Malta 79.85
35 Faroe Islands 79.85
36 European Union 79.76
37 Luxembourg 79.75
38 Belgium 79.65
39 Virgin Islands 79.47
40 Finland 79.41
41 Korea, South 79.30
42 Turks and Caicos Islands 79.26
43 Wallis and Futuna 79.12
44 Puerto Rico 79.07
45 Bosnia and Herzegovina 78.96
46 Saint Helena, Ascension, and Tristan da Cunha 78.91
47 Gibraltar 78.83
48 Denmark 78.78
49 Portugal 78.70
50 United States 78.49

Our elderly health care is staggeringly bad, as is our infant mortality rate. While we do have major R&D funded by major Pharma, certain groups STILL go to Germany, for example, for lower cost spinal/neck surgery. And they are not just the rich.

On a side note, when I fell ill in France, I was taken care of fabulously. Without proof of anything except that I was ill. In the pharmacies, there were doctors behind the counter. So I would venture that 'we are the highest-level of healthcare available anywhere' should be taken on a case-by-case basis.

Of course, we probably have a lower life span because we tend to be larger creatures than most, but that is another thread entirely.

I'm going to live to be 100. While in Monaco. :crutches: Been there. Is nice.

[Bobmuhthol]

Holy shit I can't handle it. You're literally making the claim that people dying in car accidents or being murdered reflects poorly on our health care. I'm done.


Bob... as your list is from 1980-1999, I thought I might update. From the CIA site:

Again, I'm not using "all deaths" as a basis for health care, I'm using deaths as a result of a health issue. The CIA does not include those numbers.

[Latrinsorm]

Show me one country in the world where the rich get EXACTLY the same healthcare and access as someone without a single -insert lowest coin value of said country here- to their name?

No such thing.I'm not totally sure what this has to do with anything, but it is correct.
is their average better? maybe, but then ask yourself why. Or better yet, Ask yourself if Access to DR's will be easier in the US when every single person can go for free? 3 week wait now for a DR? try 7 weeks when that happens.It looks like this was also taken into account in the study, it could go under efficiency or access.

If I ask myself, my answer is that a healthcare system is better at providing healthcare when it aims to provide healthcare, and better at making a profit when it aims to make a profit. That seems pretty straight forward to me. You could make the argument, as I believe crb is getting at, that a provider that was best at providing healthcare would therefore have more customers and therefore make the most profit, but that's just not realistic for any number of reasons.

[Warriorbird]

Holy shit I can't handle it. You're literally making the claim that people dying in car accidents or being murdered reflects poorly on our health care. I'm done.

I'm sorry that you can't grasp accidents happening to children and access to emergency care being a health issue. An economist with an agenda massaged numbers.

That sort of thing makes up a large amount of our still disgusting infant mortality rate.

[Tgo01]

On a side note, when I fell ill in France, I was taken care of fabulously. Without proof of anything except that I was ill.

I hear this argument a lot when people try to say the health care in the US sucks. Are people seriously suggesting that in the US if you fell really ill the hospitals would just spit on you and kick you in the head unless you showed them money first or something?

[Tgo01]

Might the poor not get good healthcare in accidents?


I'm sorry that you can't grasp accidents happening to children and access to emergency care being a health issue.

Come on Warriorbird you're really stretching things here. Are you seriously trying to make the argument that if someone is in a horrible car accident they are going to fish through their wallet for a health insurance card or for a credit card before giving them care?

[Bobmuhthol]

I don't know if this link is visible outside of the MIT network but "an economist massaging numbers" seems a little far-fetched when it's really "two economists who wrote a book on health care."

http://mit.worldcat.org/title/business-of-health-the-role-of-competition-markets-and-regulation/oclc/70232338&referer=brief_results

[Darkwynde]

I hear this argument a lot when people try to say the health care in the US sucks. Are people seriously suggesting that in the US if you fell really ill the hospitals would just spit on you and kick you in the head unless you showed them money first or something?

I wasn't saying it sucked at all. I am in the middle of health scare(s) at the moment and am in the system entirely. I think my point was on the other end of the spectrum in response to the US is the BEST at everything healthcare related.

Easy...

[Warriorbird]

Come on Warriorbird you're really stretching things here. Are you seriously trying to make the argument that if someone is in a horrible car accident they are going to fish through their wallet for a health insurance card or for a credit card before giving them care?

Why would I ever claim that? That they're less likely to get treated on time, that they might not have been given the proper counseling on safety, that they might not even be treated at all (no one to even call a doctor for them), that they might not have appropriate medication access, there's a number of other less ridiculous notions than the standard trotted out idea of people being denied care (though, notably, that did happen in America during the 20th century I'm not going to claim it does now).

Pitch on more affluent areas having better emergency care too once people are in a hospital.

[thefarmer]

I hear this argument a lot when people try to say the health care in the US sucks. Are people seriously suggesting that in the US if you fell really ill the hospitals would just spit on you and kick you in the head unless you showed them money first or something?

http://www.imfdb.org/w/images/thumb/4/43/JohnQ002.jpg/800px-JohnQ002.jpg

[Tgo01]

Easy...

/snarl

Never!

Okay my bad, it was just before that you said the US elderly health care and infant mortality rate was "staggeringly bad" and mentioned that the US is in 50th place as far as life expectancy goes. Just figured you were trying to make the point that compared to other Western countries the US sucks.

[Darkwynde]

Not at all. I was making a failed attempt to update Bob's statistics with other statistics with the chart. As my mother works as an ombudsman representative for certain nursing homes, I do get elderly health statistics for the Southern Region, and they are not that great in that particular sector.

But no, no, no. I am fortunate that I do have moderately good health insurance, and I am seeing wonderful specialists. I am not knocking our system as a whole in comparison to the world.

:hands you a cup of herbal tea:

[Warriorbird]

I don't know if this link is visible outside of the MIT network but "an economist massaging numbers" seems a little far-fetched when it's really "two economists who wrote a book on health care."

http://mit.worldcat.org/title/business-of-health-the-role-of-competition-markets-and-regulation/oclc/70232338&referer=brief_results


The role of government in the health sector should be reduced.

Do “Any Willing Provider” and “Freedom of Choice” Laws Affect HMO Market Share? by Michael A Morrisey; Robert L Ohsfeldt

State Regulation and Hospital Costs Author: John J Antel; Robert L Ohsfeldt; Edmund R Becker

far more damning:

Produced by the AEI Press

http://www.aei.org/

http://en.wikipedia.org/wiki/American_Enterprise_Institute

[Bobmuhthol]

State Regulation and Hospital Costs was published in The Review of Economics and Statistics. Ohsfeldt has also been published in Public Choice, Medical Care, Health Services Research, American Journal of Economics and Sociology, Archives of Internal Medicine, Value in Health, American Journal of Epidemiology, The American Economic Review, Journal of Economic History, Industrial and Labor Relations Review, Land Economics, Journal of Human Resources...

[Warriorbird]

State Regulation and Hospital Costs was published in The Review of Economics and Statistics. Ohsfeldt has also been published in Public Choice, Medical Care, Health Services Research, American Journal of Economics and Sociology, Archives of Internal Medicine, Value in Health, American Journal of Epidemiology, The American Economic Review, Journal of Economic History, Industrial and Labor Relations Review, Land Economics, Journal of Human Resources...

He's done a lot of work without any political touches. He's certainly making policy claims with this (admittedly interesting) article and getting money from a think tank that generated a whole lot of the Bush Administration.

Economists, like Supreme Court justices, are often unwilling to admit their political sides.

[Jarvan]

That's actually what they're doing and what you're doing. Related to the specific study I liked this comment:

"Simplistically removing specific causes of death to achieve the longest life span for the U.S. smacks of the worst kind of intellectual dishonesty."

Might the poor not get good healthcare in accidents? Might accidental death of children (preventable with better care) really be a huge factor? Sure might.

It's also manipulated to only include certain OECD countries.

So what your saying is if someone goes around and murders ever person under say.. 50 in the US. That should count in Life expectancy?

Are you Daft man?

[Jarvan]

Small Business question here. Wondering if anyone can help determine if this would be a possibility.

My boss owns two locations and has about 30 employee's at each. His manager's get insurance. Really good insurance and he pays the portion that most employer's would require them to pay. For me for example he covers the $532 a month it would cost me for my insurance. I pay nothing, and it's awesome.

Together with both his locations he is put over the 50 employee mark which means he would have to provide health insurance to all his employee's. At least make a plan available to them from what I understand regardless if they choose to accept it or not. Is it possible that instead of choosing a low tier plan that would be affordable, that he could chose to only offer top tier plans which would be out of the range of affordability of any of his employee's?

One of the reasons I ask is cause it's possible he could request of his managers to keep staff under 24 employee's at each locations and dish out overtime to the ones we keep instead of offering insurance. Most of the employee's are at minimum wage. $8/hr. It would be like offering each of the remaining employee's 10 more hours a week, or $120 more a week before taxes. Or close to $23,000 in extra payroll a month between the two locations. Offering a lower tier insurance plan would run him probably 10-30% more than that.

I'm just trying to get a grasp on what exactly I'm in for.

Yes he Could. It's also likely he will.

Why pay for something when you don't have to?

Also. Your wrong on the insurance end of it. The minimum allowed plans in 2014 will likely run him a heck of alot more due to the nature of the required plans. Altho at this time it is speculation mostly.

And it won't happen till 2014, unless Romney wins in Nov. He has a few options he can do if he does win to slow/stall/stop the law. Even without repealing.

[~Rocktar~]

Holy shit I can't handle it. You're literally making the claim that people dying in car accidents or being murdered reflects poorly on our health care. I'm done.



Again, I'm not using "all deaths" as a basis for health care, I'm using deaths as a result of a health issue. The CIA does not include those numbers.[/COLOR]


Don't argue with WB, he will just drag you down to his level and drown you in the shit he spews. Quite literaly, he is immune to facts and is trolling the fuck out of you.

[Warriorbird]

So what your saying is if someone goes around and murders ever person under say.. 50 in the US. That should count in Life expectancy?

Are you Daft man?

Our troublingly high rate of murder should certainly count into life expectancy. I didn't argue that it was a health issue though.

[Warriorbird]

He has a few options he can do if he does win to slow/stall/stop the law. Even without repealing.

I'm totally confident he'll slow/stall/stop his law.

[Parkbandit]

Our troublingly high rate of murder should certainly count into life expectancy. I didn't argue that it was a health issue though.

Why should murder / auto accident deaths / suicides / drug ODs / shark attacks / etc... be included in the mortality statistics concerning the healthcare system though? Like you agreed, they aren't health issues that can suddenly be fixed with Obamacare.

[Atlanteax]

Why should murder / auto accident deaths / suicides / drug ODs / shark attacks / etc... be included in the mortality statistics concerning the healthcare system though? Like you agreed, they aren't health issues that can suddenly be fixed with Obamacare.

Because WarriorBird *THRIVES* on obfuscating the facts ... it is his patented MO.

[Atlanteax]

In 2014, the penalty will be $285 per family or 1% of income, whichever is greater. By 2016, it goes up to $2,085 per family or 2.5% of income.

http://media.caglecartoons.com/media/cartoons/205/2012/06/28/114272_600.jpg

[Warriorbird]

Why should murder / auto accident deaths / suicides / drug ODs / shark attacks / etc... be included in the mortality statistics concerning the healthcare system though? Like you agreed, they aren't health issues that can suddenly be fixed with Obamacare.

Given a more effective healthcare system, murder, death from an auto accident pre reaching the ER, hell, even suicide, most certainly drug overdoses (treatment programs are healthcare), and potentially shark attack (though that's heavily observed and dealt with well) could all factor in the healthcare system.

It's intellectually dishonest to try to throw things out with the potential application of our healthcare system to pretend our life expectancy is better than that of other countries that pay less for care and have more coverage.

Would Alex and others have a point in deaths related to societal obesity and things like that? Maybe, but you could argue that us taking poor care of ourselves as a country could be related to the healthcare system and health education too.

Our current life expectancy is lower than countries that spend less and have more coverage. This is simple fact. You could use WHO or OECD numbers.

(Notably, I'm also not claiming that the Romney/Obama plan will really alter that. I do think greater availability and the pre-existing conditions coverage are good things, however.)

[AnticorRifling]

Which countries, from your research, have better coverage and spend less? And what is your definition of better coverage is it better overall tech/research/meds/facilities or everyone has the chance to see a saw bones.

My next question would be do you think those countries would be able to keep those costs low if they had to absorb the costs of R&D and testing of the meds they are using?

[Warriorbird]

Which countries, from your research, have better coverage and spend less? And what is your definition of better coverage is it better overall tech/research/meds/facilities or everyone has the chance to see a saw bones.

My next question would be do you think those countries would be able to keep those costs low if they had to absorb the costs of R&D and testing of the meds they are using?

Do you really think we're spending 17+% of our GDP on healthcare solely for R&D? You are much less naive than that.

I already listed a few of them. Many other OECD countries would qualify.

[ClydeR]

Consumer Reports president Jim Guest is traveling abroad but we tracked him down for his reaction to this morning's Supreme Court ruling upholding health reform. Here's what he had to say.

"This is a victory for consumers. Health reform is alive and well and will benefit all of us. But today we are especially thinking of the seriously ill children who will continue to be able to get critical care, the young adults who can stay on their parent's insurance, and the seniors who can better afford the prescription drugs they need. For these people and the millions of Americans with pre-existing conditions, the uncertainty is over."

More... (http://news.consumerreports.org/health/2012/06/supreme-court-health-care-ruling-a-statement-from-crs-president.html)

Consumer Reports should stick to rating toasters.

[~Rocktar~]

Which countries, from your research, have better coverage and spend less? And what is your definition of better coverage is it better overall tech/research/meds/facilities or everyone has the chance to see a saw bones.

My next question would be do you think those countries would be able to keep those costs low if they had to absorb the costs of R&D and testing of the meds they are using?


Do you really think we're spending 17+% of our GDP on healthcare solely for R&D? You are much less naive than that.

I already listed a few of them. Many other OECD countries would qualify.

Do you really think you could answer the question put to you instead of attempting yet another sidestep in the face of facts? Oh wait, no, no you can't.

[AnticorRifling]

Do you really think we're spending 17+% of our GDP on healthcare solely for R&D? You are much less naive than that.

I already listed a few of them. Many other OECD countries would qualify.

No where did I say we were spending 17+% of our GDP on healthcare solely for R&D. You didn't answer any of my questions though...

[Warriorbird]

No where did I say we were spending 17+% of our GDP on healthcare solely for R&D. You didn't answer any of my questions though...

Greater access to care/a reasonable standard of care would be the standard I'd look at.

Switzerland, Germany, Japan, Denmark, and Australia would be examples.

And of course they take advantage of American R&D, but simultaneously there's quite a lot of profit seeking here without equivalent care access.

The costs wouldn't be quite as low. They wouldn't be quite as high, either.

Your questions still are working to rationalize away our lower life expectancy and lesser access to care, which is shameful in the greatest country in the world.

[AnticorRifling]

There you go. Why did you first have to try and put some weird spin on my questions?

[Jarvan]

Given a more effective healthcare system, murder, death from an auto accident pre reaching the ER, hell, even suicide, most certainly drug overdoses (treatment programs are healthcare), and potentially shark attack (though that's heavily observed and dealt with well) could all factor in the healthcare system.

It's intellectually dishonest to try to throw things out with the potential application of our healthcare system to pretend our life expectancy is better than that of other countries that pay less for care and have more coverage.

Would Alex and others have a point in deaths related to societal obesity and things like that? Maybe, but you could argue that us taking poor care of ourselves as a country could be related to the healthcare system and health education too.

Our current life expectancy is lower than countries that spend less and have more coverage. This is simple fact. You could use WHO or OECD numbers.

(Notably, I'm also not claiming that the Romney/Obama plan will really alter that. I do think greater availability and the pre-existing conditions coverage are good things, however.)

So... just as an example under your statement.. Someone taking a shotgun and blowing.. say.. your brain's out would be preventable under an effective healthcare system...... Right. I suppose a Meteor strike that killed thousands of people would be preventable under a more effective healthcare system.

[Warriorbird]

So... just as an example under your statement.. Someone taking a shotgun and blowing.. say.. your brain's out would be preventable under an effective healthcare system...... Right. I suppose a Meteor strike that killed thousands of people would be preventable under a more effective healthcare system.

If that person didn't immediately die, treatment of a shotgun wound would certainly fall under it. Your mysterious fictional meteor strike would certainly fall under the healthcare system. We've had some bad responses to natural disasters in this country. But, by all means, keep trying to charge down the slope.

[Tgo01]

Deaths from a meteor strike fall under the health care system. Now I've heard it all, thanks Warriorbird.

[Warriorbird]

There you go. Why did you first have to try and put some weird spin on my questions?

My apologies. I think I'm still intellectually bothered by people trying to pretend our life expectancy is higher than other places. I shouldn't be though.

[Warriorbird]

Deaths from a meteor strike fall under the health care system. Now I've heard it all, thanks Warriorbird.

Not immediate deaths. In Jarvan's cheesy slippery slope example, some people would likely survive the meteor strike that mysteriously hit our country. Our response to it would certainly be conducted by, guess what, our healthcare system.

Hell, take his shotgun example. Due to HPAA and our dubious mental health system, we had Cho wandering around Virginia Tech with guns. Jared Loughner found it exceptionally easy to pack heat.

In spite of his obvious reaches it all fits.

[Tgo01]

You're one of those people who make the argument that murders should fall under our health care system because if we had better health care we could have treated these murderers before they killed someone. Not quite as good as your meteor bit but still funny

[Parkbandit]

Given a more effective healthcare system, murder, death from an auto accident pre reaching the ER, hell, even suicide, most certainly drug overdoses (treatment programs are healthcare), and potentially shark attack (though that's heavily observed and dealt with well) could all factor in the healthcare system.

It's intellectually dishonest to try to throw things out with the potential application of our healthcare system to pretend our life expectancy is better than that of other countries that pay less for care and have more coverage.

Would Alex and others have a point in deaths related to societal obesity and things like that? Maybe, but you could argue that us taking poor care of ourselves as a country could be related to the healthcare system and health education too.

Our current life expectancy is lower than countries that spend less and have more coverage. This is simple fact. You could use WHO or OECD numbers.

(Notably, I'm also not claiming that the Romney/Obama plan will really alter that. I do think greater availability and the pre-existing conditions coverage are good things, however.)

Who doesn't currently have access to the emergency room that will suddenly have access under Obamacare? I had not heard that there is such a big problem with ERs that they single handedly increase the mortality rates of things like murder and suicide.. and that Obamacare will fix the problem.

I think you are just pulling a Tsa'ah here...

[Warriorbird]

Who doesn't currently have access to the emergency room that will suddenly have access under Obamacare? I had not heard that there is such a big problem with ERs that they single handedly increase the mortality rates of things like murder and suicide.. and that Obamacare will fix the problem.

I think you are just pulling a Tsa'ah here...

Did you miss the entire bold part of that post?

[crb]

Greater access to care/a reasonable standard of care would be the standard I'd look at.

Switzerland, Germany, Japan, Denmark, and Australia would be examples.

And of course they take advantage of American R&D, but simultaneously there's quite a lot of profit seeking here without equivalent care access.

The costs wouldn't be quite as low. They wouldn't be quite as high, either.

Your questions still are working to rationalize away our lower life expectancy and lesser access to care, which is shameful in the greatest country in the world.

For every study showing that the US has worse outcomes, or whatever random statistic you want to choose, there is one showing we have better.

I am of the opinion of course that most of the studies your side would cite have poor methodology and often fail to account for additional uncontrolled variables.

Things like infant mortality for instance are self reported and each country defines it differently. Some countries for instance count a death within 2 or 3 days of life as a stillbirth, and it isn't added to infant mortality statistics. In the US it is.

As far as I know, when factoring out murders, car accidents, and the like, and adjusting for lifestyle/genetics otherwise, life expectancy in the US is higher than most other places. I know our cancer survival times post diagnosis are higher. Wait times tend to be much shorter, access to care is also much better. You can look at statistics like MRI machines per capita, doctors/surgeons/specialists per capita, we have pretty good access to care - if you have insurance. If you don't, well, don't complain about a lack of available services, they exist, complain that lack of competition through a poor payment model and bad regulation raising medical costs unnecessarily which prices you out of the insurance market.

You mention Germany and Switzerland in your remarks, I actually like their healthcare systems too. I believe both countries use the system McCain ran on in 2008. Everyone gets a tax credit to buy health insurance in the private market, the hated voucher system. Of course, Germany and Switzerland have a less progressive tax system than we do, there aren't so many people paying 0 taxes. I think also, though I do not know for sure, the voucher is the same size for everyone, like a public school voucher would be. So you can pay up to get better coverage than what the voucher alone would cover. I totally favor this system. Lets get rid of all insurance coverage mandates, let insurance companies innovate and experiment and create their own options. The role of the government is not to set options (one option for the entire country more or less, which is so blatantly stupid I can't believe anyone would argue otherwise) but to educate consumers on options. Then give every citizen a voucher to purchase said insurance. Index it to inflation. If your employer provides coverage, the value of the coverage is tax free up to the value of the voucher, above that is considered taxable income (and of course, no additional voucher for you).

Let there be 300,000,000 million people shopping individually (with government education, PSAs, and the like, on what plan to look for, and yes the government can regulate to make sure companies follow through on coverage, but the government should not set minimum coverage options other than setting the voucher price which obviously can buy X amount of coverage.... AND really, with 300,000,000 million shoppers you don't think Google or Amazon or some other company isn't going to set up a marketplace with reviews, statistics, comparisons, and reviews? Educating the public without costing taxpayers a dime?). 300,000,000 people shopping will create competition for their business.

That is the system we need. I'm really quite okay with people buying it with public funds (though, we have to reform our tax policy to give it a broader base), but there has to be competition. You will never lower cost inflation without competition, unless you just use rationing and force prices down soviet style. Reform the tax system to flat rate of near flat rate (5, 10, 15). Remove every single deduction and credit except a standard deduction for dependents on a head of household return (which is fair, since one return can cover 2 3 4 5 6 citizens etc). Then just give this single voucher for purchasing healthcare. This is the safety net, it doesn't have to be generous, or gold plated, make the voucher enough to purchase a minimum level of coverage. Meanwhile you can probably get rid of medicaid and medicare and put it on this system too. Suppose it was $5000 per person per year, of $20,000 a year for a family of four. That'd cost us around 1.5 trillion a year. Which, since it is covering every citizen and getting rid of medicare and medicaid and the unfair tax exemption for cadillac employer provided health insurance (which as I recall is nearly half a trillion or something like that), is probably a wash for the budget. And of course, if employers then dumped their insurance, they could raise wages, which raises income tax receipts, and gives people more money to pay up for better coverage if they want to. The employee buys their own policy from a huge market of options, instead of a one-size-fits-all top down plan, and they own the policy. They take it with them if they switch jobs or whatever else.

The voucher of course wouldn't be a refundable credit, if you don't spend it all, you don't get a check for the balance. Any left unclaimed funds in the voucher system due to people underspending or not buying free insurance for themselves goes into a fund providers can apply to for uncompensated care.

Index it to core inflation.

Socialized? Kinda, the taxpayers pay for it all, but the money is then used in a private marketplace with the maximum amount of competition.

[Warriorbird]

You're one of those people who make the argument that murders should fall under our health care system because if we had better health care we could have treated these murderers before they killed someone. Not quite as good as your meteor bit but still funny

Nah, in that case I was suggesting they be locked away in a mental hospital and/or denied access to guns.. I don't think either of those fellows could've been "prevented." Nice attempt to label me though.

[Tgo01]

Nah, in that case I was suggesting they be locked away in a mental hospital and/or denied access to guns.. I don't think either of those fellows could've been "prevented." Nice attempt to label me though.

Well obviously, is anyone really making the argument that mentally unstable people have a legal right to own guns?

[AnticorRifling]

How, pre crime, would you lock them away or deny them access?

[Liagala]

How, pre crime, would you lock them away or deny them access?
http://upload.wikimedia.org/wikipedia/en/thumb/4/44/Minority_Report_Poster.jpg/220px-Minority_Report_Poster.jpg

[Warriorbird]

Life expectancy isn't a random statistic. Choosing to eliminate a bunch of things to get to a better one is disengenuous, crb.

I like Germany and Switzerland's systems as well as Denmark's. I disagree with a lot of the extra stuff you tacked on, but the upshot is there's more efficient systems by quite a lot.

[Warriorbird]

How, pre crime, would you lock them away or deny them access?

The reintroduction of the American mental hospital would be convenient, as would elimination of HPAA applying to firearms background checks.

But also...

Tom Cruise's got this

http://www.virginmedia.com/images/psychics-minorityreport-590x350.jpg

[Warriorbird]

Well obviously, is anyone really making the argument that mentally unstable people have a legal right to own guns?

The NRA does.

[Tgo01]

The NRA does.

Really? The NRA thinks people with mental problems who killed a bunch of people have a legal right to own guns? Source?

[Warriorbird]

Really? The NRA thinks people with mental problems who killed a bunch of people have a legal right to own guns? Source?

They opposed the attempt to wave HPAA related to firearms background checks in Virginia as "Unnecessary gun control."

Notably, I'm still a member (I really respect the firearms education they do), but yeah. They're against any firearms regulations much like Grover Norquist is against any taxes.

[Tgo01]

I find it very hard to believe that the NRA thinks murderers should be able to own guns.

[Warriorbird]

I find it very hard to believe that the NRA thinks murderers should be able to own guns.

Not murderers (unless you're purpousefully misunderstanding me) but they think that the law that says that people's medical and mental health history shouldn't be revealed in firearms background checks should stay.

[Latrinsorm]

Let there be 300,000,000 million people shopping individually (with government education, PSAs, and the like, on what plan to look for, and yes the government can regulate to make sure companies follow through on coverage, but the government should not set minimum coverage options other than setting the voucher price which obviously can buy X amount of coverage.... AND really, with 300,000,000 million shoppers you don't think Google or Amazon or some other company isn't going to set up a marketplace with reviews, statistics, comparisons, and reviews? Educating the public without costing taxpayers a dime?). 300,000,000 people shopping will create competition for their business.I have two sites I would like you to peruse...

This (http://health.usnews.com/health-plans/national-insurance-companies) site lists the top insurance companies by market share.
This (http://www.consumerreports.org/health/insurance/private-hmo-1.htm) site ranks insurance companies (note the 5 categories), with an explanation of the ranking system here (http://www.consumerreports.org/health/insurance/health-insurance/health-insurance-rankings-data/index.htm).

Of the top 5 by market share, only 1 (Kaiser) rates highly. Aetna barely cracks the top 50, and the other three range from the 20s to the 40s.

.

From this data, we can only conclude that the best insurance companies are not necessarily the most popular and vice versa. I think we can create a comprehensive list of possible explanations:
1. Insurance is not accurately modeled by the classic free market.
2. The data is wrong.
3. Blame it on LeBron.

If it is (1), what evidence do you have that indicates the fundamental problem is regulation (et al) rather than the theory's application itself?

[Tgo01]

So now you're arguing gun control laws? Why exactly? What does gun control law have to do with anything? I realize Jarvan brought up guns but his post was still pertaining to health care.

[Parkbandit]

Life expectancy isn't a random statistic. Choosing to eliminate a bunch of things to get to a better one is disengenuous, crb.

I like Germany and Switzerland's systems as well as Denmark's. I disagree with a lot of the extra stuff you tacked on, but the upshot is there's more efficient systems by quite a lot.

I agree, it's not a random statistic, but including such occurrences like the ones I previously mentioned has nothing to do with the topic at hand: the healthcare system. Especially when Obamacare does nothing to address those deaths.

In before "I wasn't talking to you, I was talking to crb.

[Atlanteax]

Part of the concept behind not including accidents/murders/etc in life expectancy assessments (besides what is obvious to everyone but WB) is that such variables are heavily influenced by the composition of a nation's population.

One could argue that other nations have far more homogeneous populations than what we have in the U.S., of which Japan is the pristine example for a large nation, and Switzerland/Sweden for smaller nations. This would suggest a bias for far less internal racial strife (a factor in serious crimes like murder). Then we have difference in gun control laws & etc effecting murder statistics. Then we also have the fact that the U.S. is far less urbanized than Europe & Japan, indicating auto-related deaths would be of higher bias in the U.S.

So if we are to evaluate how effective a health care system ... we need to measure (a) the physical ease of anyone with an injury/illness obtaining healthcare (access to hospitals and physicians), (b) the monetary ease of doing so (how much does an individual get with a less than $1k/yr healthcare budget, a $2k/yr, a $5k/yr plus), (c) the *success rate* of injuries/illness being treated, and (d) the health longevity provided by successful treatment and by preventive care.

You just do not muck that criteria up by including variables of minor correlation to the above. Excessive variables only cloud the ability to assess.

[Warriorbird]

I agree, it's not a random statistic, but including such occurrences like the ones I previously mentioned has nothing to do with the topic at hand: the healthcare system. Especially when Obamacare does nothing to address those deaths.

In before "I wasn't talking to you, I was talking to crb.

It has quite a lot to do with the healthcare system as was listed in countless examples. I already suggested that Romney/Obamacare wasn't going to solve all the problems with our system but would increase access and keep people from being denied the chance to buy any insurance, both of which are good things. This was pointed out to you, oh, 20-25 posts ago, but you're going to obsess.

EDIT:

LOL to misspelled Rep insults.

[crb]

Life expectancy isn't a random statistic. Choosing to eliminate a bunch of things to get to a better one is disengenuous, crb.

I like Germany and Switzerland's systems as well as Denmark's. I disagree with a lot of the extra stuff you tacked on, but the upshot is there's more efficient systems by quite a lot.

It is if you're using life expectancy as a basis for a healthcare system overhaul. In case you didn't realize this patently obvious fact. Life expectancy != healthcare. Genes matter, lifestyle matters, the percentage risk of you being shot or hit by a car matters. These are all factors in life expectancy, but healthcare can't do shit about them.

http://reason.com/archives/2008/06/17/accidents-murders-preemies-fat
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900567/
http://www.bloomberg.com/news/2012-01-11/u-s-life-expectancy-climbs-as-homicide-cancer-deaths-decline.html
http://www.outsidethebeltway.com/us_life_expectancy_were_number_1/
http://www.angrybearblog.com/2009/07/per-capita-spending-and-life-expectancy.html

And we're not talking about big differences either. Life expectancy of 77.3 vs 77.6 or 78.1, even with factoring in homicides. The US isn't far behind and that probably has to do with our genetic makeup. I would bet than comparison based on one ethnic group vs. the same ethnic group living in two different countries would show even closer statistics.

http://4.bp.blogspot.com/_RPTAaOI4RN8/Sm2TOta-s3I/AAAAAAAAAkA/roEZD_VIujo/s400/graph_3.JPG

In the US, our healthcare system is very very good. Our healthcare payment system is what needs work.

[Atlanteax]

So which militia did you join, Bell Curve Guy? And you wonder why I accuse you of racism when you talk about how homogeneous a population these countries have?

Heh, classic WB.

[crb]

Oh, by the way, the proper way to measure healthcare efficiency, is disease mortality. Even then you should still account for differences in population, but it is the proper place to start.

What is the life expectancy of a person with a BMI of X with stage 4 breast cancer in each country. Something like that.

I think in general, except maybe Britain, most first world countries probably have healthcare systems that compare like olympic sprinters, sure, someone wins, and someone is in last place, but they're all within a second of each other. Britain of course sucks.

[Warriorbird]

Heh, classic WB.

You blamed our healthcare problems on the racial composition of our country. Sit back, take a deep breath, and ponder that.

[Warriorbird]

In the US, our healthcare system is very very good. Our healthcare payment system is what needs work.

Our infant mortality is ridiculously bad. I don't think our system is awful. I do think that it's not as good as those countries that I listed which pay less of their GDP for theirs, and in that, that we pay too much, we're in agreement.

[Parkbandit]

You blamed our healthcare problems on the racial composition of our country. Sit back, take a deep breath, and ponder that.

Re-read what he posted again. You aren't even close to it yet...

[Atlanteax]

You blamed our healthcare problems on the racial composition of our country. Sit back, take a deep breath, and ponder that.

I did no such thing.

I suggest you follow your suggestion about your predisposition to take leaps to the moon in extrapolating ludicrous conclusions.

[Allereli]

People moving to Canada because of Obamacare... (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)

Lulz

[Atlanteax]

People moving to Canada because of Obamacare... (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)

Lulz

Particularly considering that Canada has a full-fledged Obamacare in place...

[Warriorbird]

I did no such thing.

I suggest you follow your suggestion about your predisposition to take leaps to the moon in extrapolating ludicrous conclusions.

Right, right. That racial tension and lack of homogeneity are reducing life expectancy! Keep it up, Mr. Eugenics + your trusty defender.

[Atlanteax]

Right, right. That racial tension and lack of homogeneity! Keep it up, Mr. Eugenics + your trusty defender.

It was an illustration that the countries' demographics are different from each other... prompting an apples & oranges comparison... hence why you need to exclude that as a 'noise variable' when attempting to assess quality of healthcare systems on a relative basis.


My apologies. I think I'm still intellectually bothered by people trying to pretend our life expectancy is higher than other places. I shouldn't be though.

Your level of intelligence must clearly be dismal then, since you are unable to comprehend how to astutely assess differences in the quality of separate health care systems.

[Warriorbird]

It was an illustration that the countries' demographics are different from each other... prompting an apples & oranges comparison... hence why you need to exclude that as a 'noise variable' when attempting to assess quality of healthcare systems on a relative basis.



Your level of intelligence must clearly be dismal then, since you are unable to comprehend how to astutely assess differences in the quality of separate health care systems.

Whatever keeps you and David Duke warm at night. At least the ACLU will defend you now.

You cited lack of racial homogenity and racial tension as explanations of lower life expectancy

[TheEschaton]

Particularly considering that Canada has a full-fledged Obamacare in place...

I think that's why she said Lulz, dumbass.

I have to wonder how many of those are ironic, smug leftie hipsters and how many are just dumb idiots.

[Atlanteax]

You cited lack of racial homogenity and racial tension as explanations of lower life expectancy

Nope, try again.

[Atlanteax]

I have to wonder how many of those are ironic, smug leftie hipsters and how many are just dumb idiots.

These two categorizations are probably not mutually exclusive...

[TheEschaton]

Generally no, but more specifically I wonder who was trying to be funny by suggesting moving to Canada, and how many actually were upset and thought it was a good idea.

[Warriorbird]

Nope, try again.

http://deploreibol.files.wordpress.com/2012/05/illinois-nazis.jpg

Maybe if you clap your hands and shout out "I'm not a racist!" you'll even believe it.

[Atlanteax]

Heh, keep on projecting, WB.

[Androidpk]

http://sphotos.xx.fbcdn.net/hphotos-snc7/s720x720/399433_10150999619914658_1371483633_n.jpg

Love this!

[Warriorbird]

Heh, keep on projecting, WB.

http://www.play.net/simucon/memory/2005/originals/thu16.jpg

http://www.bluesbrotherscentral.com/images/profiles/characters/henry-gibson.jpg

Not too far off.

[Back]

I hold no law degree. I am not in the healthcare industry. I pay $145 a month out of pocket to CareFirst and also whenever I visit a doctor who accepts their insurance plan. I am not happy with how things are currently.

I'd like to know in plain and simple terms how what happened yesterday is going to affect me? Explain how what happened yesterday is good for the majority of Americans or how its bad for the majority of Americans?

I understand checks and balances. If we get to the core of this we have an executive branch pushing to make a law, it being made a law by congress, and then upheld by the supreme court. Strip away what the law was about and this is the basics of what happened, correct?

So now we have a law that says if you don't pay for healthcare you pay a penalty?

[AnticorRifling]

Those explainations won't happen Back, they can't explain them because they don't know.

[Androidpk]

In a nutshell yes.

[Androidpk]

Those explainations won't happen Back, they can't explain them because they don't know.

Your typos of late have me concerned.

[AnticorRifling]

No cause for alarm, I'm healing an instance while I type on the boards.

[Warriorbird]

I hold no law degree. I am not in the healthcare industry. I pay $145 a month out of pocket to CareFirst and also whenever I visit a doctor who accepts their insurance plan. I am not happy with how things are currently.

I'd like to know in plain and simple terms how what happened yesterday is going to affect me? Explain how what happened yesterday is good for the majority of Americans or how its bad for the majority of Americans?

I understand checks and balances. If we get to the core of this we have an executive branch pushing to make a law, it being made a law by congress, and then upheld by the supreme court. Strip away what the law was about and this is the basics of what happened, correct?

So now we have a law that says if you don't pay for healthcare you pay a penalty?

If you didn't pay for care you'd suffer a penalty. If, for instance, you've taken blood thinners, you wouldn't be rejected for a pre-existing condition if you tried to acquire insurance. If you had a child, they could stay on your policy till the age of 26. You might have some additional relatively low cost insurance options available.

Certain employers might be obligated to provide health insurance that didn't previously.

It's pretty similar to what they have in Mass. (and a product of Romney) right now. The world didn't end there or even change much. What's basically a Republican plan has been attacked as "the greatest bit of evil socialism ever!"

[Archigeek]

You mention Germany and Switzerland in your remarks, I actually like their healthcare systems too. I believe both countries use the system McCain ran on in 2008. Everyone gets a tax credit to buy health insurance in the private market, the hated voucher system. Of course, Germany and Switzerland have a less progressive tax system than we do, there aren't so many people paying 0 taxes. I think also, though I do not know for sure, the voucher is the same size for everyone, like a public school voucher would be. So you can pay up to get better coverage than what the voucher alone would cover. I totally favor this system. Lets get rid of all insurance coverage mandates, let insurance companies innovate and experiment and create their own options. The role of the government is not to set options (one option for the entire country more or less, which is so blatantly stupid I can't believe anyone would argue otherwise) but to educate consumers on options. Then give every citizen a voucher to purchase said insurance. Index it to inflation. If your employer provides coverage, the value of the coverage is tax free up to the value of the voucher, above that is considered taxable income (and of course, no additional voucher for you).

Let there be 300,000,000 million people shopping individually (with government education, PSAs, and the like, on what plan to look for, and yes the government can regulate to make sure companies follow through on coverage, but the government should not set minimum coverage options other than setting the voucher price which obviously can buy X amount of coverage.... AND really, with 300,000,000 million shoppers you don't think Google or Amazon or some other company isn't going to set up a marketplace with reviews, statistics, comparisons, and reviews? Educating the public without costing taxpayers a dime?). 300,000,000 people shopping will create competition for their business.

That is the system we need. I'm really quite okay with people buying it with public funds (though, we have to reform our tax policy to give it a broader base), but there has to be competition. You will never lower cost inflation without competition, unless you just use rationing and force prices down soviet style. Reform the tax system to flat rate of near flat rate (5, 10, 15). Remove every single deduction and credit except a standard deduction for dependents on a head of household return (which is fair, since one return can cover 2 3 4 5 6 citizens etc). Then just give this single voucher for purchasing healthcare. This is the safety net, it doesn't have to be generous, or gold plated, make the voucher enough to purchase a minimum level of coverage. Meanwhile you can probably get rid of medicaid and medicare and put it on this system too. Suppose it was $5000 per person per year, of $20,000 a year for a family of four. That'd cost us around 1.5 trillion a year. Which, since it is covering every citizen and getting rid of medicare and medicaid and the unfair tax exemption for cadillac employer provided health insurance (which as I recall is nearly half a trillion or something like that), is probably a wash for the budget. And of course, if employers then dumped their insurance, they could raise wages, which raises income tax receipts, and gives people more money to pay up for better coverage if they want to. The employee buys their own policy from a huge market of options, instead of a one-size-fits-all top down plan, and they own the policy. They take it with them if they switch jobs or whatever else.

The voucher of course wouldn't be a refundable credit, if you don't spend it all, you don't get a check for the balance. Any left unclaimed funds in the voucher system due to people underspending or not buying free insurance for themselves goes into a fund providers can apply to for uncompensated care.

Index it to core inflation.

Socialized? Kinda, the taxpayers pay for it all, but the money is then used in a private marketplace with the maximum amount of competition.

I think there's some value in your idea, but there are some problems. For starters, how do you make indexing to core inflation work when healthcare costs have outstripped core inflation for 3 decades by a wide margin? I think you could bring some cost down if you included the cost transparency that you've lobbied for, but that only solves part of the problem.

One of the big problems with insurance is that when you buy it, you aren't usually in need of immediate health care. On the one hand that's great, but on the other hand, you don't know what care it is you're going to be needing, so picking out a plan based on the 100 or so pages that constitute your insurance contract is just about impossible. We need to make an effort to make sure what is covered is clear.

Case in point, I have an insurance policy that for drugs mostly just covers generic drugs. I'm cool with that, except that some drugs don't have generic equivalents. I checked the fine print, even though I didn't need any non-generic drugs when I bought the policy, and saw that one drug there was an outside chance I could possibly need was on the formulary list, with a statement that the drug would be covered "with a higher co-pay". Turned out I did end up in a position where that drug was prescribed by my physician, and that "higher copay" meant I pay all of it. So you see, there's more work to do with insurance than just helping to provide a freemarket for that initial purchase. When you need to collect on your policy because you've been injured or are sick, you practically need a frickin' lobbying agency to get them to agree to cover anything. They make an effort to fight you, and I firmly believe that their decision to cover/not cover some elements of care is based on how much of a pain in the ass you are, (ie: how much it costs them to deal with you). Something needs to be done to make this part of insurance work more smoothly, because people in need of care are not generally in shape to do hard nosed bargaining. To a degree we can look to auto insurance for the answer to this, but to a degree we can't as well. When you're in a car accident, there are limits of coverage that are generally fairly low, and even if you total your car, that's the end of the cost for the insurance company, (barring injury). So it isn't quite the same as healthcare, where a large percentage of the population is dealing with 1 or more chronic problems.

Additionally, as I said in an earlier post, the cost of insurance is reflective of the cost of health care, not the direct cause of most of the cost. Sure there's a profit margin that the insurance companies are making plus administration etc, but the lion's share of the cost of healthcare is in the application of care, not in the insurance against the need for care. Insurance should really be just a form of spreading risk. It is in effect socialism in itself, in that the healthy pay for the poor.

From a purely objective point of view, we've got to figure out a way to make people more cost concious, or regulate cost to the point where the decision on cost has already been made.

[Back]

If you didn't pay for care you'd suffer a penalty. If, for instance, you've taken blood thinners, you wouldn't be rejected for a pre-existing condition if you tried to acquire insurance. If you had a child, they could stay on your policy till the age of 26. You might have some additional relatively low cost insurance options available.

Certain employers might be obligated to provide health insurance that didn't previously.

It's pretty similar to what they have in Mass. (and a product of Romney) right now. The world didn't end there or even change much. What's basically a Republican plan has been attacked as "the greatest bit of evil socialism ever!"

Your response has the phrases "might be", "might have", "for instance", and a lot of "if" in it. It really does sound like a liberal activist's description of things that really don't apply to me but sound good on the surface.

Paragraphs of obscure economic terms also don't mean a whole hell of a lot to me and I am certain millions of Americans out there feel the same way.

Hamticor really nailed it. We don't know yet.

What I would also like to know is if everyone has to get healthcare why don't the make the penalty for not getting it like $1 less so people just get it?

[Tgo01]

You feeling okay Back? You actually seem to be wanting real answers to real questions. This is so different than your usual "A Democrat signed off on it therefore it's automatically good!"

[TheEschaton]

A tax which is less than the cost of the health care isn't an incentive to buy it if you think you don't need health care.

[Warriorbird]

Your response has the phrases "might be", "might have", "for instance", and a lot of "if" in it. It really does sound like a liberal activist's description of things that really don't apply to me but sound good on the surface.

Paragraphs of obscure economic terms also don't mean a whole hell of a lot to me and I am certain millions of Americans out there feel the same way.

Hamticor really nailed it. We don't know yet.

What I would also like to know is if everyone has to get healthcare why don't the make the penalty for not getting it like $1 less so people just get it?

Of course a request for a general description will get something general.

More concrete info:

http://www.healthcare.gov/law/features/index.html

http://www.healthcare.gov/law/timeline/index.html

[Alfster]

In the US, our healthcare system is very very good. Our healthcare payment system is what needs work.

The payment system is a disaster and a giant clusterfuck.

Agreed 100% - simplify the payment system. Cost shares, dual eligible plans, medicare/caid plans are a disaster. Provider's are forced to bill a certain way - and rarely, if ever bill correctly.

[Bobmuhthol]

A tax which is less than the cost of the health care isn't an incentive to buy it if you think you don't need health care.

But any expected out of pocket expenses might have cost less than health care before, and will cost more than health care if you include a penalty, so now buying health care will make sense for a lot of people that otherwise wouldn't.

[Parkbandit]

Whatever keeps you and David Duke warm at night. At least the ACLU will defend you now.

You cited lack of racial homogenity and racial tension as explanations of lower life expectancy

You are an idiot. If you got "OMG U R A RACIST" out of Bad Tie's post, you are either too fucking clueless to understand what he wrote or you are simply doing what you typically do: when someone non-liberal mentions race, you call them a racist.

You are the Cynthia Mckenny of the PC.

[Atlanteax]

A tax which is less than the cost of the health care isn't an incentive to buy it if you think you don't need health care.

It can be, if the tax is large enough to eliminate whatever "profit" an individual feels that they are gaining by not gaining health insurance. A large enough tax will prompt said individual to reassess and decide to get insurance anyways.

Example:
Let's say Taxpayer feels that the best available (cost-effective) plan for him, gives $1k in prescription benefits and $25k in 'god-forbid-I-get-hurt' coverage.
Policy costs $4k a year.
So Taxpayer gets $1k "back" on the Policy (the prescription benefits) ... but decides it is not worth paying $3k for $25k coverage for 'if something bad really happens' (lives a low-risk life-style or whatever).
The government decides that the no-insurance Tax is $2k
Taxpayer "savings" from not getting insurance would only be $1k (3k minutes 2k).
Taxpayer then decides that $25k 'god-forbid' coverage is justified for the $1k in additional cost ($4k policy minus $2k tax minus $1k 'rebate' on prescriptions).

Economics theory is all about government via taxation inducing people to behave differently (ie cigarette taxation).

[TheEschaton]

All well and true, if the average American actually thought about shit like that.

Americans are hopelessly optimistic. They think that their out of pocket costs will be zero unless they already have actual, ongoing medical issues. Thus, under your system, it'll be profitable to not buy it and pay the penalty every time.

[Atlanteax]

All well and true, if the average American actually thought about shit like that.

Americans are hopelessly optimistic. They think that their out of pocket costs will be zero unless they already have actual, ongoing medical issues. Thus, under your system, it'll be profitable to not buy it and pay the penalty every time.

No ... Taxpayer thought paying $3k is not worth for $25 oh-shit coverage. His threshold was actually $1.5k would be worth it. Since due to the Penalty Tax, he is paying an additional $1k in actuality (see prior math), it is then worthwile getting the Policy.

Bobmuthol probably have economic graphs handy that will better illustrate this than words.

It *IS* a 'profit' to forgo the Policy in strictly financial terms.... but Taxpayer's decision (and RL people in general) evaluate the *Utlity* value of what is gained / missed-out-on ... the $25k 'oh-shit' coverage is of $1.5k Utility in this example.

Editted to clarify:
Pre-Gov't-Penalty-Tax ... $1.5k Utility < $3k additional cost ($4k minus $1k 'rebate') ... Taxpayer does not buy Policy
Post-Penalty-Tax ... $1.5 Utility > $1k additional cost ($4k minutes $1k 'rebate' minus $2k penalty tax) ... Taxpayer *does* buy the Policy.

[Drisco]

Somewhere, in the south, there is a fat lady smoking a cig on her scooter complaining that insurance companies can't turn her away now.

[TheEschaton]

It *IS* a 'profit' to forgo the Policy in strictly financial terms.... but Taxpayer's decision (and RL people in general) evaluate the *Utlity* value of what is gained / missed-out-on ... the $25k 'oh-shit' coverage is of $1.5k Utility in this example.


That's just it, I don't think they do.

[TheEschaton]

Somewhere, in the south, there is a fat lady smoking a cig on her scooter complaining that insurance companies can't turn her away now.

And then she's gonna move to Canada just to piss you off.

[Tgo01]

People moving to Canada because of Obamacare... (http://www.buzzfeed.com/daves4/people-moving-to-canada-because-of-obamacare)


And then she's gonna move to Canada just to piss you off.

That's what really makes me laugh at people who say shit like that, like Canada just allows anyone to move into their country or something.

[Drisco]

That's what really makes me laugh at people who say shit like that, like Canada just allows anyone to move into their country or something.

Yeah, we put you guys through intense speaking seminars. If you can't do the Eh right, you aren't getting in.

[Wrathbringer]

I hold no law degree. I am not in the healthcare industry. I pay $145 a month out of pocket to CareFirst and also whenever I visit a doctor who accepts their insurance plan. I am not happy with how things are currently.

I'd like to know in plain and simple terms how what happened yesterday is going to affect me? Explain how what happened yesterday is good for the majority of Americans or how its bad for the majority of Americans?

I understand checks and balances. If we get to the core of this we have an executive branch pushing to make a law, it being made a law by congress, and then upheld by the supreme court. Strip away what the law was about and this is the basics of what happened, correct?

So now we have a law that says if you don't pay for healthcare you pay a penalty?

I'm also trying to understand how this is a positive thing for the poor, since those in opposition were painted as hating poor people. Medical care and insurance is still expensive. Those with no ability to pay were already not being turned away from emergency rooms. It seems the only thing that has changed is that everyone is now required to become a customer of the insurance companies whether they can afford it or not. If you can't afford insurance, then the government takes your money whether you can afford it or not. Can anyone explain how this program will be paid for? Is the "tax" penalty the only revenue supporting the program? If so, then this program is to be funded on the backs of the poor? Is that correct? Seems like the only people benefiting are the hospitals and insurance companies. Surely I'm misunderstanding something.

[Liagala]

I'm also trying to understand how this is a positive thing for the poor, since those in opposition were painted as hating poor people. Medical care and insurance is still expensive. Those with no ability to pay were already not being turned away from emergency rooms. It seems the only thing that has changed is that everyone is now required to become a customer of the insurance companies whether they can afford it or not. If you can't afford insurance, then the government takes your money whether you can afford it or not. Can anyone explain how this program will be paid for? Is the "tax" penalty the only revenue supporting the program? If so, then this program is to be funded on the backs of the poor? Is that correct? Seems like the only people benefiting are the hospitals and insurance companies. Surely I'm misunderstanding something.
A large portion of this program is modeled after the one already in place in Massachusetts. Here, if you did not have insurance coverage during the year, you pay a tax penalty (actually lose a portion of your personal exemption) in proportion to the number of months you were without coverage. If you had no coverage for the entire year, you lose your entire personal exemption. If your income falls below a certain threshhold (I'm not sure exactly what, but I know it's greater than 300% of federal poverty level) that penalty is not assessed, and you retain your personal exemption regardless of insurance status.

So no, the burden is not shouldered by the poor. The poor are exempt from the tax penalty.

[Wrathbringer]

A large portion of this program is modeled after the one already in place in Massachusetts. Here, if you did not have insurance coverage during the year, you pay a tax penalty (actually lose a portion of your personal exemption) in proportion to the number of months you were without coverage. If you had no coverage for the entire year, you lose your entire personal exemption. If your income falls below a certain threshhold (I'm not sure exactly what, but I know it's greater than 300% of federal poverty level) that penalty is not assessed, and you retain your personal exemption regardless of insurance status.

So no, the burden is not shouldered by the poor. The poor are exempt from the tax penalty.

Thank you.

Edit: so the poor still go without health insurance... Again, I see the benefit to the hospitals and insurance companies, but where is the benefit for the poor? Or was this never about poor people getting health coverage? Is the main good being done here the requirement of insurance companies to accept those with pre-existing conditions then?

[Bobmuhthol]

It's about insurance being affordable (hence Affordable Care Act), not free. If everyone has health insurance, premiums go down, and less expensive things are more affordable. I am not stroking out over this act, but I definitely would if it turned into universal health care.

[Liagala]

Thank you.

Edit: so the poor still go without health insurance... Again, I see the benefit to the hospitals and insurance companies, but where is the benefit for the poor? Or was this never about poor people getting health coverage? Is the main good being done here the requirement of insurance companies to accept those with pre-existing conditions then?
I didn't include this part because I don't know how it's being handled on the federal level, but MA also has a system of subsidized health insurance for the poor. It's on a sliding scale based on your income, topping out at 300% of the federal poverty level. If you earn less than that, there are several plans to choose from, all with fixed premiums and coverage (minor differences, like this one paying you back for a gym membership, that one allowing you to get a 90-day supply of meds at Walgreens instead of a mail order, etc). Premiums are extremely reasonable even at the top end, and coverage is good. The poor do not go without medical coverage, unless they choose not to take advantage of the free (or extremely cheap) plan sitting there waiting for them.

[Wrathbringer]

Thanks again. Appreciate the comments.

[ClydeR]

Big news..


(CBS News) Chief Justice John Roberts initially sided with the Supreme Court's four conservative justices to strike down the heart of President Obama's health care reform law, the Affordable Care Act, but later changed his position and formed an alliance with liberals to uphold the bulk of the law, according to two sources with specific knowledge of the deliberations.

Roberts then withstood a month-long, desperate campaign to bring him back to his original position, the sources said. Ironically, Justice Anthony Kennedy - believed by many conservatives to be the justice most likely to defect and vote for the law - led the effort to try to bring Roberts back to the fold.

"He was relentless," one source said of Kennedy's efforts. "He was very engaged in this."

But this time, Roberts held firm. And so the conservatives handed him their own message which, as one justice put it, essentially translated into, "You're on your own."

The conservatives refused to join any aspect of his opinion, including sections with which they agreed, such as his analysis imposing limits on Congress' power under the Commerce Clause, the sources said.

Instead, the four joined forces and crafted a highly unusual, unsigned joint dissent. They deliberately ignored Roberts' decision, the sources said, as if they were no longer even willing to engage with him in debate.

More... (http://www.cbsnews.com/8301-3460_162-57464549/roberts-switched-views-to-uphold-health-care-law/)

[Tgo01]

I don't really feel like making another thread for this so I'll just hijack this thread since it's sort of related.

Obama begging donors for more money. (http://www.huffingtonpost.com/2012/07/01/obama-fundraising-plea_n_1641419.html?icid=maing-grid7|main5|dl1|sec1_lnk1%26pLid%3D174903)

[Rinualdo]

begging?

[Tgo01]

begging?

Begging.

[Bryft]

3681

[Back]

I don't really feel like making another thread for this so I'll just hijack this thread since it's sort of related.

Obama begging donors for more money. (http://www.huffingtonpost.com/2012/07/01/obama-fundraising-plea_n_1641419.html?icid=maing-grid7%7Cmain5%7Cdl1%7Csec1_lnk1%26pLid%3D174903)

Thats one third of a politician's job to get (re)elected. Guess what the other two are?

[Lulfas]

Thats one third of a politician's job to get (re)elected. Guess what the other two are?

Sucking dick and kissing babies. Not necessarily in that order.

[ClydeR]

Florida Gov. Rick Scott now says Florida will do nothing to comply with President Barack Obama's health care overhaul and will not expand its Medicaid program. The announcement is a marked changed after the governor recently said he would follow the law if it were upheld by the U.S. Supreme Court.

More... (http://www.nbcmiami.com/news/local/Gov-Scott-Says-Fla-Wont-Comply-with-Health-Care-Law-160943495.html)

If states elect to participate in the Medicaid expansion, then the federal government will pay 100% of a state's increased Medicaid costs for three years. Thereafter, the federal government will pay 90 cents for each ten cents spent by the state. No matter whether or not a state decides to participate in the Medicaid expansion program, its citizens will still be required to pay federal income taxes that will be used to fund the program in participating states.

[ClydeR]

More on the leak.

We should put Darrell Issa in charge of finding out exactly who did the leaking.


As Crawford says, “the justices are notoriously close-lipped, and their law clerks must agree to keep matters completely confidential”. And yet, we’re now seeing these coordinated and perfectly-timed leaks from within the Court, detailing information known only to the justices themselves. The conservative justices are leaking, and although Crawford talks about “law clerks, chambers’ aides and secretaries” who have been gossiping internally about Roberts’s change of mind, it’s pretty clear that her sources were impeccable and that if they weren’t the conservative justices themselves, they were sources who had the explicit consent of those justices to start talking to the press.

Carter’s article bemoaned the ubiquity of leaking in Washington, describing it as “despicable”, and saying that “one reason to admire the court, even when one disagrees with it, is its ability to withstand the temptation to which other government bodies regularly yield.” He concludes his column by saying that “the rest of Washington would do well to learn from the court’s example”.

Instead, it seems, the Supreme Court has become infected by exactly the same partisanship which has corroded civic life everywhere else in DC. Maybe that was inevitable. But this story is still a signal journalistic accomplishment — and it was written at law-geeky length by a TV reporter. Crawford deserves all credit for getting this scoop — and for showing that there is life yet in broadcast journalism.

More... (http://blogs.reuters.com/felix-salmon/2012/07/02/when-the-supreme-court-leaks/)