This is topic Obamacare, I will miss you. (No I won't because you've unpacked your bags!) in forum Books, Films, Food and Culture at Hatrack River Forum.
"Tomorrow, nine people who get free government healthcare will let us know what the rest of us get." --Andy Borowitz
I'm going with my gut on this, but I think the individual mandate will get scuttled. I was tempted to intrade it as you can still make about $3 per share, but I'm just not much of a gambler. I'm more of an insider trader if I do any trading at all. I like a sure thing.
I would laugh in a schadenfreude kind of way if the part that preempts insurance companies from refusing to cover preexisting conditions remains intact. Of course that probably just means premiums for everybody goes up.
I don't think the individual mandate was a good idea, the precedent is just too disturbing to me. But I do want a public option, if we're going to take a step back for now. The majority of Americans might be against the mandate, but a majority also said they wanted reform a few years back. Going back to the status quo sucks for everybody except those in Congress I suppose.
Of course Boehner has already made noise about cleaning up whatever SCOTUS doesn't strike down. Doesn't surprise me, he represents a clique that is so out of touch with what the average American is dealing with these days.
[ June 28, 2012, 11:30 AM: Message edited by: BlackBlade ]
Posted by Kwea (Member # 2199) on :
You might be surprised to find out who's idea it was in truth.
Posted by Lyrhawn (Member # 7039) on :
I really have no idea how tomorrow will go. Scalia has been on the war path over this issue, and both he and Alito have been scolded by the left wing of the Court, publicly, for their behavior over the last session with regards to judicial overreach and politicization of issues before the Court. It's always been about Anthony Kennedy and how far he was willing to go.
A year ago academia was saying 99% slam dunk it would be safe, but now they're saying flip a coin. Analysts are saying the Q&A from the initial case as it was argued suggests they're leaning toward striking it down, but I've heard others say you can't take Q&A as a sign of what the justices will rule.
My guess?
I'm going to go nuts and say 6-3 decision with Roberts joining the liberal wing. I think if Kennedy votes to keep it and the liberal wing wins, Roberts will jump on board for the sake of trying to save face to keep some semblance of integrity for the Court in a year where their reputation has taken some heavy damage. If you read the decisions Scalia and Alito have written just during this session, and the outrages dissents written by the liberals, it doesn't take a genius to see where most of them fall on current issues.
I'll make another prediction: If it gets knocked down, Obama and the Democrats will curl up into a little ball and throw paper airplanes at the GOP instead of manning up and going to war. It's an issue that could define the election and win reelection for Obama if he was aggressive enough. But he won't be, because it's not his style.
Waiting for tomorrow is like reading the end of a George R. R. Martin novel. You can't trust that everything will work out in the end.
Posted by BlackBlade (Member # 8376) on :
Well wonders never cease!
Posted by odouls268 (Member # 2145) on :
"Tomorrow, nine people who get free government healthcare will let us know what the rest of us get." --Andy Borowitz
hehehe that's funny stuff.
Posted by Blayne Bradley (Member # 8565) on :
I just want Obama to expand the court at this rate, 5-4 decisions are awful and the current size is an historical accident.
Posted by Samprimary (Member # 8561) on :
I wanted Obamacare to be struck down by a nakedly political SCOTUS. My reasoning has been coldly utilitarian; I think our country is idiotic — completely idiotic — when it comes to health care, it is a national embarrassment and a frequent delusion of conservatives that we have a good system or even the 'best healthcare in the world,' and it has always seemed like things have to get worse before they can get better. I wanted the conservatives to get every inch of the system THEY desire, because I want the cold reality of that system's 'functionality' thrust in our faces. I want them to face the ungovernable conclusion of their ideas.
But today I did not get what I want, and I'm not really going to complain too much, because I got the next best thing, and certainly the kinder in the short term:
quote:The Supreme Court upheld the health care law today in a splintered, complex opinion that gives President Obama a major victory.
Basically. the justices said that the individual mandate -- the requirement that most Americans buy health insurance or pay a fine -- is constitutional as a tax.
Chief Justice John Roberts -- a conservative appointed by President George W. Bush -- provided the key vote to preserve the landmark health care law, which figures to be a major issue in Obama's re-election bid against Republican opponent Mitt Romney.
The government had argued that Congress had the authority to pass the individual mandate as part of its power to regulate interstate commerce; the court disagreed with that analysis, but preserved the mandate because the fine amounts to a tax that is within Congress' constitutional powers.
The announcement will have a major impact on the nation's health care system, the actions of both federal and state governments, and the course of the November presidential and congressional elections.
A key question for the high court: The law's individual mandate, the requirement that nearly all Americans buy health insurance, or pay a penalty.
Posted by Derrell (Member # 6062) on :
Does this mean I have to buy insurance? How do I go about doing that? Where do I get the money?
Posted by Blayne Bradley (Member # 8565) on :
If you are under 25 iirc your parents are support to cover you, after that you have to select one of the many many many HMO's and just call and ask.
Otherwise I guess you pay a fine.
Posted by Geraine (Member # 9913) on :
Well, its Constitutional, but not under the Commerce Claus.
It survives by being called a "Tax" which the government has power to do.
I will say that while I do not like the ruling, I understand why the SCOTUS ruled this way.
It also scares the living crap out of me. It effectively means that the government can push through anything they want and then place a tax on the people for non-compliance.
It is a double edged sword for the Obama administration, one that I think hurts him this election cycle more than helps him.
If the mandate was struck down, I don't think it would have really affected Obama's election chances as much as this decision.
Obama has been out there for the past three years saying he wasn't going to raise taxes on the middle class and those making less than 250k a year. The poor won't be affected by this ruling since they will be covered under Medicare. You can bet that the GOP will use this "tax" in their ads against Obama.
Oh, and can we stop calling the SCOTUS an arm of the Republican party now?
Posted by Aros (Member # 4873) on :
quote:Originally posted by Geraine: It also scares the living crap out of me. It effectively means that the government can push through anything they want and then place a tax on the people for non-compliance.
Hyperbole much?
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Derrell: Does this mean I have to buy insurance? How do I go about doing that? Where do I get the money?
Yes! I hope he does this.
Posted by Blayne Bradley (Member # 8565) on :
There has always been a liberal wing and a conservative wing with one or two guys in the middle who are seen as wild cards.
And this is still a problem, especially as some people say that one of them may have ruled this way just because of image issues and public trust.
Having the mandate upheld I believe cements Obama's victory, the republicans can spin it however they like but the fact remains that ObamaCare is now a fact and cannot be ignored. It forces the Republicans to campaign against it, and any successes it will likely result or bring, instead of having the job done for them by the USSC.
It makes it harder not easier for the GOP.
Apparently you are one vote away from having the entire bill tossed out:
quote: The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting States all Medicaid funding. These parts of the Act are central to its design and operation, and all the Act’s other provisions would not have been enacted without them. In our view it must follow that the entire statute is inoperative.
According to dissenting opinion.
Posted by Lyrhawn (Member # 7039) on :
Politically it would have been better for Obama if the measure had been struck down. It would have been a winning campaign issue for him.
It would have been much easier to rail against the GOP for removing protections than it will be to campaign ON the ACA. If he chooses to do so at all.
Posted by Samprimary (Member # 8561) on :
either way it was pretty amazing to me to watch the expected noise outcome of this case
ACA struck down: A BLOW OBAMA WILL NOT RECOVER FROM ACA upheld: A TRAVESTY OBAMA WILL NOT RECOVER FROM
Posted by Blayne Bradley (Member # 8565) on :
Yeah pretty much, I consider it a win because it leaves Obama with something substantial to show the American people that he's been doing his job and Got Stuff Done. If it was struck down people would say he is just being whiny and partisan.
Posted by Xavier (Member # 405) on :
quote:Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by Xavier:
quote:Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
I'm partial to this idea. He needs to own this moment and campaign on it. The Republican party has no alternative for Obamacare. He can get a lot of mileage off that. He needs to stop throwing paper airplanes at the Republicans. It's time to realize he won on this issue and that Congressional Reps lost their seats getting him this victory. He needs to outline what his legacy period would consist of.
[ June 29, 2012, 11:24 AM: Message edited by: BlackBlade ]
Posted by Blayne Bradley (Member # 8565) on :
“Throw them into perilous ground, and they will survive; plunge them into Death Ground, and they will live.” - Sun Tzu.
Posted by Tarrsk (Member # 332) on :
quote:Originally posted by Xavier:
quote:Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
More to the point, the ACA is pretty darn unpopular. Obama would not have been able to use it as a campaign issue the way Lyrhawn describes because there simply wouldn't be sufficient outrage from the electorate at large. On the contrary, Republicans would have a powerful new rhetorical tool: "Obama's signature legislative 'accomplishment' was so radical that it was deemed UNCONSTITUTIONAL by the highest court in the land!!!"
Speaking as a supporter of the ACA, I'd happily take the desired policy outcome over short-term political gain - but I do think that the SCOTUS decision effectively does both for Obama. Or at least, upholding Obamacare hurts the Democrats a lot less than striking it down would have.
Posted by Samprimary (Member # 8561) on :
It's all about if the Democrats can campaign on it effectively; preferably by cloning General Sherman and sending him south with an army of Zombie Union soldiers under his command.
Apparently South Carolina didn't get the message the first time around.
Here's the go-to explanation about what "obamacare" is in terms about what the bill pretty much, well, does.
quote:What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.
So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
Already in effect:
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)
It increases the rebates on drugs people get through Medicare (so drugs cost less)
It establishes a non-profit group, that the government doesn't directly control, [1] PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( [2] Citation: Page 665, sec. 1181 )
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( [3] Citation: Page 499, sec. 4205 )
It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them.
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths. ( [4] Citation: Page 923, sec. 5000B )
It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( [5] Citation: Page 14, sec. 2711 )
Kids can continue to be covered by their parents' health insurance until they're 26.
No more "pre-existing conditions" for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans.
People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend.
Insurers can't just drop customers once they get sick. ( [6] Citation: Page 14, sec. 2712 )
Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down.
New ways to stop fraud are created.
Medicare extends to smaller hospitals.
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly.
A new website is made to give people insurance and health information. (I think this is it: [7] http://www.healthcare.gov/ ).
A credit program is made that will make it easier for business to invest in new ways to treat illness.
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers.
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover.
Employers need to list the benefits they provided to employees on their tax forms.
8/1/2012
Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.
1/1/2013
If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners.
1/1/2014
This is when a lot of the really big changes happen.
No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history.
If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it.
Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( [8] Citation: Page 14, sec. 2711 )
Make it so more poor people can get Medicaid by making the low-income cut-off higher.
Small businesses get some tax credits for two years.
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
Limits how high of an annual deductible insurers can charge customers.
Cut some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen.
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.
The amount you can deduct from your taxes for medical expenses increases.
1/1/2015
Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in [9] this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.
1/1/2017
If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).
2018
All health care plans must now cover preventative care (not just the new ones).
A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).
Budget analysis and medical systems analysis indicate that it will save literally billions of dollars and cut down significantly on america's 40,000+ people who die due to being too poor to access proper health coverage, so I guess it's a foregone conclusion that republicans are going to despise it utterly.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Tarrsk:
quote:Originally posted by Xavier:
quote:Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
More to the point, the ACA is pretty darn unpopular. Obama would not have been able to use it as a campaign issue the way Lyrhawn describes because there simply wouldn't be sufficient outrage from the electorate at large. On the contrary, Republicans would have a powerful new rhetorical tool: "Obama's signature legislative 'accomplishment' was so radical that it was deemed UNCONSTITUTIONAL by the highest court in the land!!!"
Speaking as a supporter of the ACA, I'd happily take the desired policy outcome over short-term political gain - but I do think that the SCOTUS decision effectively does both for Obama. Or at least, upholding Obamacare hurts the Democrats a lot less than striking it down would have.
That's not as true as you think.
The ACA is unpopular.
But people love most of what's actually in the ACA.
If you poll on individual elements, it's wildly popular. If you call it the ACA, people hate it. It's mostly the individual mandates people are ambivalent about.
He could spent the next four months talking about every individual thing like preventing care, pre-existing conditions, etc that the GOP took from all Americans. Frankly, he still should. And he'd trot out thousands of people helped by parts of the law already enacted who lost that help. He would have had a field day with it.
Striking it down would have energized the hell out of the Democratic base. Now it's ho-hum, move on, but the right gets the energy.
Posted by Samprimary (Member # 8561) on :
Nate Silver's (typically well-reasoned) analysis of the situation indicates otherwise, noting that dissatisfactory public branding of Obamacare is already factored into the energy the right has going for it right now.
Posted by Xavier (Member # 405) on :
quote:Striking it down would have energized the hell out of the Democratic base.
I don't think you realize how downright demoralizing it is to lose.
If this had been struck down, I'd not have been energized, I'd have been deflated. I'd have felt that Obama isn't going to be able to get anything major accomplished in this political climate despite his best intentions.
Posted by Vadon (Member # 4561) on :
quote:Originally posted by Xavier:
quote:Striking it down would have energized the hell out of the Democratic base.
I don't think you realize how downright demoralizing it is to lose.
If this had been struck down, I'd not have been energized, I'd have been deflated. I'd have felt that Obama isn't going to be able to get anything major accomplished in this political climate despite his best intentions.
QFT
Seeing the decision today lit the fire under me and I've applied for more campaign work this cycle. The ACA was just saved by the courts, I do not want to see it taken out next year through a successful repeal attempt. (Even with the prospects of "repeal and replace" I am left to wonder with what would it be replaced? Romney has said he thinks those with pre-existing conditions should be denied coverage.)
Posted by TomDavidson (Member # 124) on :
Speaking as someone living in Wisconsin, defeat is exhausting. Posted by Lyrhawn (Member # 7039) on :
I think it depends on how Obama spun it. If he did his "Gosh we lost" speech like it seems he enjoys doing, it would have been awful.
If he came out with guns blazing, calling for single payer and saying he needs to be reelected to appoint better justices on a wildly reactionary activist Republican Court, I think it would have fired people up.
Part of why the ACA is so unpopular is that no one understands it, mostly because Obama and Democrats don't spend much time explaining it. It's a mystery for most people, and the GOP is filling in the gaps with misdirection and vile lies. If he campaigned on it, that would change. Campaigns aren't about telling you why you should like things you already know. They're about crafting a new narrative.
Posted by Orincoro (Member # 8854) on :
I think you're off your nut on this be, really. What in the history of Obama or the dems in general makes you think they'd be capable of rallying like that? They're not republicans... They care about policy, not just winning and losing.
Plus, he *already* campaigned on the issue, won, and got the legislation. You want to go through that again? While people are suffering the negative consequences of not having these protections? The best part of ACA is that even if Obama loses, people will hate having any of it repealed. Even though they say they won't- when it gets put to them, they will.
Posted by Lyrhawn (Member # 7039) on :
I've already said I'm not sure if they ARE capable of that, just that it could happen of Obama played it right.
And this is EXACTLY how you campaign. You say you want to do something, you win, you do it, then you dance around the ring at the end the fight. So yeah, traditionally people tout their successes in a campaign. The ACA is the crown jewel of Obama's legislative successes. Of course you campaign on it.
Posted by Orincoro (Member # 8854) on :
I meant campaign on getting reform passed, after reform would have already been defeated. I can't see how you could energize people toward doubling down on a cause that has already suffered a major loss. Republicans could, and do, do that, but they do it because they don't actually have to worry about what policies actually work. They don't have to build anything, just double down on the destruction.
That's why this is a wash for Reublicans- when their fight is only against anything constructive, democratic victories just give them more to fight against. The trick is building things that are strong enough to stand up to a constant onslaught of lies and fear mongering.
Posted by Lyrhawn (Member # 7039) on :
Because you're campaigning on what they took away from you.
If the GOP tomorrow passed a law that took away your right to own a car or something, wouldn't that be a campaign issue?
Posted by Orincoro (Member # 8854) on :
But the supreme court would have taken it away. So who are you rallying against? Activists judges? It's just too far of a remove. I understand *you* and *I* would be volunteering at the local campaign office... But it would be a bitter pill for most voters.
Posted by Samprimary (Member # 8561) on :
oh yeah huh romney DID sign the norquist tax pledge.
welp yep
Posted by BlackBlade (Member # 8376) on :
I really have no idea how Norquist got as much pull as he does.
Posted by Lyrhawn (Member # 7039) on :
I dunno, it seems like opinion is turning just a tiny bit on that on the right.
Some GOP congressmen have pulled out of it, some have started to speak in much softer language. There are chinks in the armor.
Posted by BlackBlade (Member # 8376) on :
And I am hopeful that continues but seriously, who does he think he is? Since when is anybody beholden to him? Lindsay Graham speaks out against his pledge and Norquist calls him up and tells him to cool it. It's creepy. His pledge is enforced through money, nothing else. He's in the way of Republicans being able to work with Democrats on fiscal matters, and the timing could't be worse. We need to figure this crisis out not stop to engage in theatrics because this guy likes to feel influential.
Posted by Lyrhawn (Member # 7039) on :
When he was on The Daily Show, other than on the pledge, he actually sounded like a pretty reasonable guy.
He wasn't foaming at the mouth like Rush does or anything.
Posted by Rakeesh (Member # 2001) on :
Perhaps that is the difference between the rabble rousing far-right activist/'entertainer' such as Rush who can certainly get people talking but when it comes to specific policy aims is apparently not the silver bullet...and someone who can get individual (and quite a lot of them) major, national politicians to kowtow?
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by Lyrhawn: When he was on The Daily Show, other than on the pledge, he actually sounded like a pretty reasonable guy.
He wasn't foaming at the mouth like Rush does or anything.
I doubt mafia bosses ever raise their voices too. It's still messed up. There's nothing illegal about it of course, but...
Posted by Orincoro (Member # 8854) on :
I saw the Sopranos, and Goodfellas, and Casino. Fair amount of yelling.
Posted by Kwea (Member # 2199) on :
LOL...
Well, Rush said if this passed he would move to Costa Rica. Wonder if he packed yet....
Funny thing though.....Costa Rica has Universal Health Care.
Posted by Orincoro (Member # 8854) on :
There was a nice twitter feed of people proclaiming their intentions to move to Canada.
Posted by dabbler (Member # 6443) on :
The ACA is favorable to 42% of the polled, as of April after the oral arguments and unfavorable to 43%. I know the media likes to say its really hated, but it's not that bad. The split is 70% democrats favor and 7% repubs. So there's a lot of room to educate the repubs on what's on it to see if that changes their minds.
I like that long descrip. I knew most of it, but not all of it (like that congress is going on exchanges).
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by BlackBlade: I really have no idea how Norquist got as much pull as he does.
The neoconservative swell. A whole couple of terms with the country being run under the agenda of a group that really fully trusts in supply side economics, laffernomics, and any other economic hypothesis which posits a benefit to piling favors unto our most well-off and letting everyone else ultimately pay that infrastructural tab.
Posted by Samprimary (Member # 8561) on :
alternate answer: the GOP is broken
Posted by Orincoro (Member # 8854) on :
That's crazy! Youre saying belief in supply side economics is based on the personal interests of oh my GOD!
Posted by Samprimary (Member # 8561) on :
quote:Of course, because so many people are arguing about it, and some of the people arguing about it don't really care whether or not what they're saying is true, there are a lot of things people think the bill does that just aren't true. Here's a few of them:
Obamacare has death panels!: That sounds so cartoonishly evil it must be true, right? Well, no. No part of the bill says anything about appointing people to decide whether or not someone dies. The decision over whether or not your claim is approved is still in the hands of your insurer. However, now there's an appeals process so if your claim gets turned down, you can challenge that. And the government watches that appeals process to make sure it's not being unfair to customers. So if anything the PPACA is trying to stop the death panels. ( Citation: Page 23, sec. 2719 )
What about the Independent Medical Advisory Board? Death Panels!: The Independent Medical Advisory Board is intended to give recommendations on how to save Medicare costs per person, deliver more efficient and effective care, improve access to services, and eliminate waste. However, they have no real power. They put together a recommendation to put before Congress, and Congress votes on it, and the President has power to veto it. What's more, they are specifically told that their recommendation will not ration health care, raise premiums or co-pays, restrict benefits, or restrict eligibility. In other words, they need to find ways to save money without reducing care for patients. So no death panels. In any sense of the (stupid) term. ( Citation: Page 407, sec. 3403 )
Obamacare gives free insurance to illegal immigrants!: Actually, there are multiple parts of the bill that specifically state that the recipient of tax credits and other good stuff must be a legal resident of the United States. And while the bill doesn't specifically forbid illegals from buying insurance or getting treated at hospitals, neither did the laws in the US before the PPACA. So even at worst, illegals still have just as much trouble getting medical care as they used to. ( Citations: Page 122, sec. 1402, Page 123, sec. 1411, Page 125, sec. 1411, Page 132, sec. 1412 )
Obamacare uses taxpayer money for abortions!: One part of the bill says, essentially, that the folks who wrote this bill aren't touching that issue with a ten foot pole. It basically passes the buck on to the states, who can choose to allow insurance plans that cover abortions, or they can choose to not allow them. Obama may be pro-choice, but that is not reflected in the PPACA. ( Citation: Page 64, sec. 1303 )
Obamacare won't let me keep the insurance I have!: The PPACA actually very specifically says you can keep the insurance you have if you want. ( Citation: Page 55, sec. 1251 )
Obamacare will make the government get between me and my doctor!: The PPACA very specifically says that the Secretary of Health and Human Services (who is in charge of much of the bill), is absolutely not to promote any regulation that hinders a patient's ability to get health care, to speak with their doctor, or have access to a full range of treatment options. ( Citation: Page 165, sec. 1554 )
Obamacare has a public option! That makes it bad!: The public option (which would give people the option of getting insurance from a government-run insurer, thus the name), whether you like it or not, was taken out of the bill before it was passed. You can still see where it used to be, though. ( Citation: Page 92, sec. 1323 (the first one) )
Obamacare will cost trillions and put us in massive debt!: The PPACA will cost a lot of money... at first. $1.7 Trillion. Yikes, right? But that's just to get the ball rolling. You see, amongst the things built into the bill are new taxes - on insurers, pharmaceutical companies, tanning salons, and a slight increase in taxes on people who make over $200K (an increase of less than 1%). Additionally, the bill cuts some stuff from Medicare that's not really working, and generally tries to make everything work more efficiently. Also, the increased focus on preventative care (making sure people don't get sick in the first place), should help to save money the government already spends on emergency care for these same people. Basically, by catching illnesses early, we're not spending as much on emergency room visits. According to the Congressional Budget Office, who studies these things, the ultimate result is that this bill will reduce the yearly deficit by $210 billion. By the year 2021, the bill will actually have paid itself and started bringing in more money than it cost.
Obamacare is twice as long as War and Peace!: War and Peace is 587,287 words long. The Patient Protection and Affordable Care Act, depending on which version you're referring to, is between 300,000-400,000 words long. Don't get me wrong, it's still very long, but it's not as long as War and Peace. Also, it bears mention that bills are often long. In 2005, Republicans passed the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users, 2005, which was almost as long as the PPACA, and no one raised a stink about it.
The people who passed Obamacare didn't even read it!: Are you kidding? They had been reading it over and over for a half a year. This thing was being tossed around in debates for ages. And it went through numerous revisions, but every time it was revised, it was just adding, removing, or changing small parts of it, not rewriting the whole thing. And every time it was revised, the new version of the bill was published online for everyone to see. The final time it was edited, there may not have been time to re-read the entire thing before voting on it, but there wasn't a need to, because everyone had already read it all. The only thing people needed to read was the revision, which there was plenty of time to do.
Pelosi said something like, "we'll have to pass the bill before reading it"!: The actual quote is "we have to pass the bill so that you can find out what is in it, away from the fog of controversy", and she's talking about all the lies and false rumors that were spreading about it. Things had gotten so absurd that by this point many had given up on trying to have an honest dialogue about it, since people kept worrying about things that had no basis in reality. Pelosi was simply trying to say that once the bill is finalized and passed, then everyone can look at it and see, without question, what is actually in the thing (as opposed to some new amendment you heard on the radio that they were going to put in).
I think those are some of the bigger ones. I'll try to get to more as I think of them.
Whew! Hope that answers the question!
Posted by Samprimary (Member # 8561) on :
quote:Some conservatives are so upset over the decision that they can only reconcile it by assuming the tie-breaking Justice is mentally incompetent.
OH and apparently also the Mississippi Tea Party is now advocating insurrection over the bill not being struck down by the SCOTUS.
Posted by Lyrhawn (Member # 7039) on :
Mississippi: Taking their ball and going home since 1861.
Posted by kmbboots (Member # 8576) on :
Could we maybe let them this time? We don't really need their ball.
Posted by TomDavidson (Member # 124) on :
Hands up, people who want to keep Mississippi in the union?
Posted by Hobbes (Member # 433) on :
quote:Originally posted by kmbboots: Could we maybe let them this time? We don't really need their ball.
I think we'd make a pretty crappy United States if we did let them.
Hobbes Posted by MattP (Member # 10495) on :
Let's swap them out for Guam or Puerto Rico. Then we don't have to mess with the flag.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by TomDavidson: Hands up, people who want to keep Mississippi in the union?
I think I want it vaguely more than I want Mississippi as a decrepit, poverty-stricken, tea-party Wunderland sharing our borders and deregulating its industry to the point where everywhere around it gets its meth output and blue clouds of coalsmoke
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by TomDavidson: Hands up, people who want to keep Mississippi in the union?
Pretty sure we covered this in the 1860s.
Posted by TomDavidson (Member # 124) on :
quote:I think I want it vaguely more than I want Mississippi as a decrepit, poverty-stricken, tea-party Wunderland sharing our borders and deregulating its industry to the point where everywhere around it gets its meth output and blue clouds of coalsmoke.
Does keeping it in the Union mean this doesn't happen?
Posted by SteveRogers (Member # 7130) on :
I want to applaud who ever is running that article on Reddit.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by TomDavidson:
quote:I think I want it vaguely more than I want Mississippi as a decrepit, poverty-stricken, tea-party Wunderland sharing our borders and deregulating its industry to the point where everywhere around it gets its meth output and blue clouds of coalsmoke.
Does keeping it in the Union mean this doesn't happen?
Plus they get Senators and Congresspeople and electoral college votes that can screw things up for the rest of us.
Posted by Darth_Mauve (Member # 4709) on :
If Mississippi left, then people from Mississippi would not be American Citizens. They could not hold down jobs in neighboring states such as Alabama.
Wait...
How would Alabama's strict illegal alien laws work if you couldn't tell the illegal aliens from the real American's by their skin color?
Everyone would need to have their papers on them at all times.
Posted by Kwea (Member # 2199) on :
You already can't, so no change in the laws. No change in enforcement either.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by TomDavidson:
quote:I think I want it vaguely more than I want Mississippi as a decrepit, poverty-stricken, tea-party Wunderland sharing our borders and deregulating its industry to the point where everywhere around it gets its meth output and blue clouds of coalsmoke.
Does keeping it in the Union mean this doesn't happen?
To enough of an extent that it doesn't start looking like a new northern mexico
Posted by Samprimary (Member # 8561) on :
I wish I could believe Mitt Romney would be like Teddy Roosevelt in that he surprised everybody with how diametrically opposed his campaign rhetoric was with policy as president. But I'm not taking that risk. I certainly don't believe his personal beliefs mirror what he's currently saying but that just means I know less about him not more.
Posted by Samprimary (Member # 8561) on :
He is saying that the individual mandate is "the ultimate conservatism." Direct quote.
quote:
Romney:
"When they show up at the hospital, they get care, they get free care, paid for by you and me. If that's not a form of socialism, I don't know what is. So my plan did something quite different. It said, you know what, if people can afford to buy insurance, if they can afford to buy insurance, or if they can pay their own way, then they either buy that insurance or pay their own way, but they no longer look to government to hand out free care. And that, in my opinion, is ultimate conservatism. That's why the Heritage Foundation worked with us and was at the celebration of the signing. The Heritage Foundation, as you know, a quintessentially conservative group, recognized that the principles of free enterprise and personal responsibility were at work."
At least he had indeed correctly tagged the fact that it is indeed socialism of a sort to not literally leave someone outside the hospital to die if they cannot pay for emergency care.
Posted by Blayne Bradley (Member # 8565) on :
Argument I've found made by Embittered Old People and Nihilist Synchophants:
quote: Legally, the big Federal stick over the states - ability to pull existing funding to make the states bend to their will - is gone. Kaput. Verboten. You may condition new money, but you cannot put new stings on existing money to force the states to do as you wish. With a 7-2 majority, the states now have carte blanche from the liberal wing to tell the Feds to shove it if the Feds do something they don't like. The Tenth Amendment reached up and just ripped the heart out of Big Government right there.
This "gold trim on the flag" levels of bs where the Federal gov't is just going to say "lol no."?
Posted by Samprimary (Member # 8561) on :
Ladies and gentlemen I give you: florida governor rick scott, one of the most charming individuals in government today.
Rick, I hear you really like the old model of healthcare and hate the new one, please show us how to do it RIGHT for once please
quote:According to the Post, the coverup began as early as last February, “when Duval County Health Department officials felt so overwhelmed by the sudden spike in tuberculosis that they asked the U.S. Centers for Disease Control and Prevention to become involved. Believing the outbreak affected only their underclass, the health officials made a conscious decision not to not tell the public, repeating a decision they had made in 2008, when the same strain had appeared in an assisted living home for people with schizophrenia.”
That decision now appears to have gone terribly awry, partly because the disease appears to have already spread into the general population but also because just nine days before the CDC warning was issued, Florida Governor Rick Scott had signed a bill downsizing the state’s Department of Health and closing the A.G. Holley State Hospital that had treated the most difficult tuberculosis cases for over 60 years.
we are so dysfunctional at health care, we are really trying to turn ourselves into a russia or india, where itinerant and homeless populations turn into unchecked breeding grounds for drug resistant TB because our system is so averse to proactive coverage.
solution: hide it, they're just homeless people, plus let's close this hospital we need now more than ever hurrr
Posted by Darth_Mauve (Member # 4709) on :
Welcome to Survival of the Richest
Posted by Lyrhawn (Member # 7039) on :
And we still have to listen to American politicians crow about American Exceptionalism every day and excoriate each other for flag pin faux pas.
How the rest of the world keeps a straight face when they talk about us is beyond me.
Posted by Orincoro (Member # 8854) on :
Well, they don't, generally.
Posted by Geraine (Member # 9913) on :
quote:Originally posted by Samprimary: I HATE TO BELABOR THE POINT (well maybe I dont) but good lord people, this is exactly the sort of thing we need to pay attention to.
quote:According to the Post, the coverup began as early as last February, “when Duval County Health Department officials felt so overwhelmed by the sudden spike in tuberculosis that they asked the U.S. Centers for Disease Control and Prevention to become involved. Believing the outbreak affected only their underclass, the health officials made a conscious decision not to not tell the public, repeating a decision they had made in 2008, when the same strain had appeared in an assisted living home for people with schizophrenia.”
That decision now appears to have gone terribly awry, partly because the disease appears to have already spread into the general population but also because just nine days before the CDC warning was issued, Florida Governor Rick Scott had signed a bill downsizing the state’s Department of Health and closing the A.G. Holley State Hospital that had treated the most difficult tuberculosis cases for over 60 years.
we are so dysfunctional at health care, we are really trying to turn ourselves into a russia or india, where itinerant and homeless populations turn into unchecked breeding grounds for drug resistant TB because our system is so averse to proactive coverage.
solution: hide it, they're just homeless people, plus let's close this hospital we need now more than ever hurrr
So wait... The CDC along with other health officials decide not to tell the people, but hey, let's blame it on a bill Rick Scott passed! How does that even make sense?
Health officials and the CDC decide not to tell people about an outbreak, more people get infected. Damn, I'm so happy we are giving more power over the health care system to them!
Posted by Darth_Mauve (Member # 4709) on :
Germaine, reading the article it is clear the CDC did not decide to tell people. They tried several times to get the word out. It was the state level health department officials who decided to keep it quiet.
We are not blaming Rick Scott for trying to keep it quiet. We are blaming him for cutting back the state health care funding to the point that the state officials felt the need to keep it quiet, and were able to do so to save money.
Posted by Lyrhawn (Member # 7039) on :
Based on the article it actually looks like Gov. Scott had no clue what was happening. It was more a result of his terrible policies than an intentional cover-up.
Posted by Orincoro (Member # 8854) on :
As is often the case. Culpability is often unsatisfyingly allocated to the policy level. These types of things are rarely the result of discrete, individual choices, but overall approaches that carry these as consequences.
Posted by Lyrhawn (Member # 7039) on :
Scott isn't the only Rick out there saying he won't implement Obamacare.
quote:Asked Monday about a new report by the federal Agency for Healthcare Research and Quality, which ranked Texas dead last in terms of delivering health services, Perry forcefully hit back against the new study.
So is there a direct correlation between states with terrible health care and refusal to upgrade quality of service, or is it just a coincidence?
Posted by Orincoro (Member # 8854) on :
I would say its abut as coincidental as states that refuse to teach contraception and family planning having high rates of stds and illegitimacy.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Darth_Mauve: Welcome to Survival of the Richest
Sorry, richie rich, if we sit back and let the poor breed new strains of tuberculosis out of sheer incompetent neglect of our dysfunctional systems and its perverse incentives, y'all gonna get consumption too
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Lyrhawn: So is there a direct correlation between states with terrible health care and refusal to upgrade quality of service, or is it just a coincidence?
The selfsame slavish adherence to the very programs and ideologies which have left their healthcare systems in absolute, godawful shambles are all very well associated with loathing obama
(and, just for fun, you can note they tend to be net federal dollar consumers rather than producers, too.)
Posted by Orincoro (Member # 8854) on :
Shocker, that one.
Posted by Rakeesh (Member # 2001) on :
quote:So wait... The CDC along with other health officials decide not to tell the people, but hey, let's blame it on a bill Rick Scott passed! How does that even make sense?
Health officials and the CDC decide not to tell people about an outbreak, more people get infected. Damn, I'm so happy we are giving more power over the health care system to them!
According to the story, the disease had *already* spread, so the decision to downsize hospital space would've been a bad one regardless. Furthermore, the initial county health officials who turned to the CDC said they felt overwhelmed...I wonder why that was? Lack of staff, funding, resources perhaps?
Who is one of the leading figures in the state behind cutting services, Geraine? Do you think that might have had *some* impact on this matter? Is there *any* failure in our civic infrastructure for which the immediate answer isn't 'strangle their funding off to kill it'? Because if your solution to every problem is the same, chances are it's not that all the problems have the same solution.
*TB* outbreaks in the 21st century United States among the most poor and desperate. Is not even THAT a situation in which we say 'ok, government can do some good here'. Isn't something like taking steps to mitigate the outbreak of dangerous diseases when they flare up one of those fundamental, universally agreed purposes of government?
Posted by Samprimary (Member # 8561) on :
quote:Is there *any* failure in our civic infrastructure for which the immediate answer isn't 'strangle their funding off to kill it'?
Can we classify military contracts as civic infrastructure?
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by Rakeesh: [QUOTE] Isn't something like taking steps to mitigate the outbreak of dangerous diseases when they flare up one of those fundamental, universally agreed purposes of government?
... No?
Wait wait! I can get this one.... No? AWW CRAP.
Posted by Foust (Member # 3043) on :
Why haven't any Hatrack conservatives responded to any of this? My popcorn is getting cold.
Posted by Blayne Bradley (Member # 8565) on :
We don't have that many remaining, also they're less inclined to deliberately be people's entertainment.
Posted by Orincoro (Member # 8854) on :
Because eventually even the thickest partisan hack realizes his party is just blatantly ****ing him about for money. And these weren't even the thickest of partisans. The republicans have gotten bad enough, I think, that a fair few of their base have cooled on them- possibly for good.
Posted by Blayne Bradley (Member # 8565) on :
They'll still vote for what they perceive to be the lesser of two evils out of tribalism.
Posted by Orincoro (Member # 8854) on :
Meh. I'm not terribly worried about any of that. You can't really change the tide of history, and right now American conservatism is so far on the wrong side of the tide, it may nt recover in anything like the present form.
Posted by Rakeesh (Member # 2001) on :
I really am interested in the question of why what appears to be (but that's simply my opinion) a reflexive irritation with this situation leads to 'we need to give them less power, less ability, less resources-this would be better if they were smaller'. That is what Geraine appeared to me to be getting at, but it's quite possible I'm wrong-I'm operating from a position of irritation too.
Related to the topic, 'small government' just seems to be such a double-standard. Social services, taxation, infrastructure, regulation-it appears to me more often than not the answer either starts with or includes 'it would all be better if it were gone or smaller'. They cannot be trusted-they'll be either inefficient or wicked in their use of what power we give them.
But then if we mosey on down to military, law enforcement, a few key social and religious issues, and intelligence services...we mustn't pry. They know what they're doing. Trust the leaders on the ground. We're a Christian nation. Ticking time bomb.
If we cannot be trusting government to effectively manage something as straightforward as infrastructure, why in heaven are we to then say government needs to legislate which adults can sleep with which, and we need to trust our generals with power over life and death of our soldiers and others and trillions of dollars?
I can certainly see why Geraine wouldn't want to talk about that here-not exactly a friendly audience, or even a neutral one. But this contradiction seems very real to me, and it's both troubling and interesting
Posted by Orincoro (Member # 8854) on :
Rakeesh, it all hinges on a few popular fallacies. The first is basically a post hoc ergo proper hoc error that attributes perceived failures of modern institutions and governments to the existance of these institutions, rather than to the actual causes: namely industrialization.
It is no accident, for example, that American conservatism had its bastion in the industrializing North and West where the most people in power stood to gain from unregulated industry in the 19th and early 20th centuries, before these areas became socially egalitarin, and education the middle class smoothed the playing field Whereas, conservatism finds its modern roots in the south, where the same thing is happening again- a few stand to benefit from weak regulation and poor infrastructure, while the populous is socially immobile and poorly educated.
So the fallacy that gets sold to poor and uneducated people is that the government that arose to regulate the forces bringing such imbalance into their lives was in fact the source of the imbalance. To someone who has a poorly informed picture of how national or even state government operates, the functioning of national institutions, especially social institutions, can easily be made to appear perverse. And while the forces of conservatism labor to retard and dismantle these systems, their actual utility becomes legitimately questionable. Whereas, with certain other systems, such as defense, intelligence, and etc, the same fallacy applies in a reciprocal fashion: American might and American Exceptionalism, actually based on the industrialization of America and the strength of social institutions, is credited entirely to military strength--- strength which was actually developed of necessity to defend the borders of a trading empire that was not won by conquest at all, but by trade competitiveness. (this is not to say our military might doesn't ensure ascendancy, but it wasn't developed *in order to conquer*. It was built to protect gains made in other ways).
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Rakeesh: I really am interested in the question of why what appears to be (but that's simply my opinion) a reflexive irritation with this situation leads to 'we need to give them less power, less ability, less resources-this would be better if they were smaller'. That is what Geraine appeared to me to be getting at, but it's quite possible I'm wrong-I'm operating from a position of irritation too.
Related to the topic, 'small government' just seems to be such a double-standard. Social services, taxation, infrastructure, regulation-it appears to me more often than not the answer either starts with or includes 'it would all be better if it were gone or smaller'. They cannot be trusted-they'll be either inefficient or wicked in their use of what power we give them.
But then if we mosey on down to military, law enforcement, a few key social and religious issues, and intelligence services...we mustn't pry. They know what they're doing. Trust the leaders on the ground. We're a Christian nation. Ticking time bomb.
If we cannot be trusting government to effectively manage something as straightforward as infrastructure, why in heaven are we to then say government needs to legislate which adults can sleep with which, and we need to trust our generals with power over life and death of our soldiers and others and trillions of dollars?
I can certainly see why Geraine wouldn't want to talk about that here-not exactly a friendly audience, or even a neutral one. But this contradiction seems very real to me, and it's both troubling and interesting
The argument I usually hear isn't so much an issue of large or small government, but federalism. It's up to the states to take care of stuff like this, not the federal government. Though I can't ever remember reading about conservatives bashing the CDC, I guess it wouldn't surprise me, they've bashed the NIH before.
But I think the conservative argument would be that this is the way Florida wants it, and if they want to pour gasoline all over their state and light it on fire, it's not really our business until the fire starts jumping state lines. Then it's Georgia's problem.
Posted by Darth_Mauve (Member # 4709) on :
Do you know who loves State powers and States rights? The corrupt and the interstate corporations. Its so much easier to bribe a state legislator than a federal one.
Posted by Orincoro (Member # 8854) on :
Youre not saying that congressional Reublicans would try to retard the federal government's ability to regulate so that they could OH MY GOD!
Posted by GaalDornick (Member # 8880) on :
I don't understand why everyone needs to buy health care or pay a tax if you don't. The argument I've heard is that people who don't buy hc insurance and then become ill end up costing every other taxpayer more money since their bills end up getting sent to the government anyways. The way I see it, if someone chooses not to buy hc insurance and can afford it, then they should be allowed to live with the consequences of their own choice, i.e. the government doesn't need to cover their bills. I know it's considered heartless, but they made a decision to spend their money on something else other then hc, so why should the rest of society be responsible for their poor priorities?
If they can't afford it and qualify for medicaid, then it's a different story. But for people that aren't low income and choose not to buy insurance, then I don't see why the government needs to baby them and protect them from their own decisions. If people want individual liberty to make their own decisions then they should live with the individual responsibility for their decisions.
Posted by Samprimary (Member # 8561) on :
quote: then they should be allowed to live with the consequences of their own choice, i.e. the government doesn't need to cover their bills. I know it's considered heartless, but they made a decision to spend their money on something else other then hc
I'd like to see the 'decisions' many of my friends have made not to be able to afford healthcare. Have it explained to them that it is 'poor priorities' like making rent or having formula that, yanno, means that they should be left outside a hospital to die in an emergency event if the hospital is able to figure out that they make more than X dollars a year individually or as a family unit.
Posted by GaalDornick (Member # 8880) on :
I addressed that when I said that if a person can't afford it, it's a different story. If that's the case, then they should be given government aid.
Also, if your friends can't afford it, is the government mandating everyone needs to buy insurance or face an extra tax a better solution? They still can't afford it but now they have to buy it anyways.
Posted by Rakeesh (Member # 2001) on :
quote:Also, if your friends can't afford it, is the government mandating everyone needs to buy insurance or face an extra tax a better solution? They still can't afford it but now they have to buy it anyways.
The mechanism by which this whole slew of new systems and regulations and laws operates isn't, in fact, "Everyone who can't afford it must still buy it, or face an additional tax/penalty/assessment/fee/hastheRomneycampaigndecidedyet?." That you describe it that way points to a pretty thorough ignorance as to what has actually changed, or rather will change.
Samprimary, don't forget we can leave their children to die too!
Posted by Parkour (Member # 12078) on :
quote:Originally posted by GaalDornick: I addressed that when I said that if a person can't afford it, it's a different story. If that's the case, then they should be given government aid.
Also, if your friends can't afford it, is the government mandating everyone needs to buy insurance or face an extra tax a better solution? They still can't afford it but now they have to buy it anyways.
How are the hospitals supposed to know who to leave out on the street to die? Is there some sort of armband you can wear to let the paramedics know you didn't get a raise last year and haven't 'decided' to not have 150 grand ready for when you got plowed by a drunk driver?
Posted by GaalDornick (Member # 8880) on :
Sure. Because there's no such thing as a health care insurance card. What are you even talking about? 150 grand ready? That's the purpose of health care insurance.
Posted by Rakeesh (Member # 2001) on :
So, no bothering to check on what these laws actually do, Gaal? Alright, then, back to silliness: what happens to the person who is injured without ID on them? Do we wait until they come to to gife us their numbers? Or maybe treat them to barely-alive until they cough up the money? Or...what, exactly, shall we do in the name of 'individuaul responsibility' which is so often doublespeak for 'eff the poor'
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by GaalDornick: Also, if your friends can't afford it, is the government mandating everyone needs to buy insurance or face an extra tax a better solution? They still can't afford it but now they have to buy it anyways.
Yes. The mandate and the consumer protections lock both the individuals and the insurers into a systemic deal that cannot be wriggled out of for enhanced profits. That being the current system, where you can welch on 5 or 6 digit medics bills if you need to, and the insurance companies can do basically the same thing. Oh, but since you're an individual, before you declare bankruptcy, we'll just need to zero out everything you have ever saved in your life.
Forcing everyone to buy insurance is the key to stabilizing and regulating the market. Without the mandate, the Feds have no skin in the regulation game. With it, they will be on the ball, making sure standards re kept.
Posted by Blayne Bradley (Member # 8565) on :
quote:Originally posted by GaalDornick: I don't understand why everyone needs to buy health care or pay a tax if you don't. The argument I've heard is that people who don't buy hc insurance and then become ill end up costing every other taxpayer more money since their bills end up getting sent to the government anyways. The way I see it, if someone chooses not to buy hc insurance and can afford it, then they should be allowed to live with the consequences of their own choice, i.e. the government doesn't need to cover their bills. I know it's considered heartless, but they made a decision to spend their money on something else other then hc, so why should the rest of society be responsible for their poor priorities?
If they can't afford it and qualify for medicaid, then it's a different story. But for people that aren't low income and choose not to buy insurance, then I don't see why the government needs to baby them and protect them from their own decisions. If people want individual liberty to make their own decisions then they should live with the individual responsibility for their decisions.
If you are not presumably a shill, than it should be sufficient enough, as others have already explained to explain to you that this is about economics of scale. Prices can only effectively be kept down if everyone contributes, the only way to do so in a private system is to get everyone to buy insurance, and then expand medicaid to cover the ones who can't afford insurence (up to 133% of the poverty line iirc).
The :bootstraps: neocalvinist mentality of FYIGM of where everyone has a moral obligation to lie in the bed they made is utter absurdity as it completely ignores the extant that both luck and circumstance beyond the control of the individual plays in people's lives.
Posted by BlackBlade (Member # 8376) on :
Ah yes the if you don't agree with me you must be a shill, or at the very least hate babies/poor bit. I'm quite fond of that line of argument.
Posted by kmbboots (Member # 8576) on :
BlackBlade, when someone is suggesting letting people die on the ER steps, assuming they are a shill is the least offensive conclusion one can reach.
Posted by Orincoro (Member # 8854) on :
Blayne makes the appeal to fairness, but that line of argument isn't even necessary here. The economic argument is sound. Whether you do believe in the fallacy of absolute personal agency in success or not, the facts of the situation are that the system will function more effectively and with better efficiency this way.
The mistake of calling what we currently have a "free market" approach is common enough. But the market is not actually free if actors within it are endowed with the power to exclude undesireable participants. The mandate and consumer protections, in reality, create a freer market, where more actors can participate without exclusion. There's nothing free about a market where the producers set the rules for participation, and then actively exclude competition by cornering the market on care.
Posted by MrSquicky (Member # 1802) on :
I don't see where Gaal suggested keeping people without health insurance out of hospitals. From what I read, he is saying that they should be held liable for the cost of their care and that this should not be passed on to other parties, here specifically the government. I think that you are being extremely unfair to him.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by MrSquicky: I don't see where Gaal suggested keeping people without health insurance out of hospitals. From what I read, he is saying that they should be held liable for the cost of their care and that this should not be passed on to other parties, here specifically the government. I think that you are being extremely unfair to him.
Here is what Gaal wrote:
quote: The argument I've heard is that people who don't buy hc insurance and then become ill end up costing every other taxpayer more money since their bills end up getting sent to the government anyways. The way I see it, if someone chooses not to buy hc insurance and can afford it, then they should be allowed to live with the consequences of their own choice, i.e. the government doesn't need to cover their bills.
It isn't like people who can't pay their hospital bill now aren't being held liable for them. Of course they are. If expensive treatment is provided, they are on the hook for it whether they end up paying for it or not. If they can't pay, not only are they liable, the costs get passed on to us. They only way to not end up with costs is to not provide the service.
If this isn't what Gaal meant, I would think he had an opportunity to clarify after Samprimary's post.
Posted by Rakeesh (Member # 2001) on :
On the one hand, Gaal didn't explicitly say 'keep the sick out of hospitals'-though that is not an uncommon accompaniment to the 'let them suffer the consequences' rhetoric at all. On the other hand, he did speak as though it were somehow unjust that when we do let the unpaying sick into hospitals, we let them have services without paying which isn't true either but rather the status quo.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by GaalDornick: Sure. Because there's no such thing as a health care insurance card.
And so if you're robbed and shot, and the paramedics who haul you in have frisked you but didn't find a wallet, you're just S.O.L, right?
quote:What are you even talking about? 150 grand ready? That's the purpose of health care insurance.
I am assuming you don't know either how many people are really insured enough that it would bear the brunt of the real costs of livesaving surgery, nor do you really know what real medical costs really in general tend to be when you are cut open by surgeons.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by GaalDornick: Sure. Because there's no such thing as a health care insurance card. What are you even talking about? 150 grand ready? That's the purpose of health care insurance.
The ER can't always get verification of everyones identity before taking them on as an expense. It would be monumentally retarded if we put in that kind of a roadblock to vital care just to satisfy the tiny quantity of people who just want to say "bootstraps, buddy"! And throw everyone out who made the "decision" to be unable to shoulder rapidly rising healthcare costs.
And yes, 150 g's... can we anecdote yet?
Posted by GaalDornick (Member # 8880) on :
ER is different than long-term medical treatment. Emergency Room is immediately saving someone's life. Like I said, if someone can't afford healthcare insurance, then they should be given government help. All others, it's your choice whether to buy insurance or not, but don't expect others to subsidize your risk if you choose not to.
Here's an anecdote: My father is a taxi driver and my mother is a paralegal. I have three siblings, one of whom suffers from Crohn's disease and I have been seeing a gastroenterologist for three years now. We have never once been told we can't see a doctor because we can't afford it. All four of us have either attended or are attending college. From my experience, it's not as difficult as people complain about to make a comfortable living with limited money. I live in Miami and I know people that complain about healthcare costs but managed to afford tickets to all three Miami Heat NBA Finals games here. I don't think the rest of society needs to cover their healthcare costs.
Posted by GaalDornick (Member # 8880) on :
My main point is that I think people feel too entitled now to that point that they should be able to do what they want and society still owes them a living. The government only needs to do for the people what they can't do for themselves. Regulation against corruption is one of them , so yes the government needs to be involved in healthcare to a certain extent but we are far beyond that now.
If we don't want Obamacare to force us to buy healthcare insurance, then accept the consequences if you don't buy healthcare insurance. If people want individual liberty then they need to accept individual responsibility.
Posted by Rakeesh (Member # 2001) on :
Well, your anecdote proves it! To hell with, for example, what the law does or doesn't actually say-you know a guy who spends money on basketball games instead of health care.
If that is actually a compelling foundation for national policy for you, then there's simply no discussing the matter. Nothing will ever be able to trump that burning sense of righteous indignation.
Posted by GaalDornick (Member # 8880) on :
I didn't say my anecdote proves anything. Parkour asked if we can anecdote yet and I supplied one.
Posted by GaalDornick (Member # 8880) on :
For the record, I think Obamacare is better than what we had before. But I think a libertarian policy would be more effective than either.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by GaalDornick: For the record, I think Obamacare is better than what we had before. But I think a libertarian policy would be more effective than either.
What would that look like, and what basic criteria do you believe need to be met?
Often in the health care debate people argue over the best way to provide health care, but never have the discussion on what they think health care should actually do, so they argue past each other. So what do you think it should do, and how does libertarian health care do it better?
Posted by GaalDornick (Member # 8880) on :
The government should set the safety net for those that can't afford health care insurance and provide enough funds for emergency services. Also, regulate the healthcare providers and insurance companies to the extent that it keeps prices fair (the specifics of how to do this are above my experience/knowledge). Beyond that, you are on your own.
I know this is considered a cruel solution, but I think our current policy of paying for things we can't afford is even more cruel since it will eventually have worse results. The population is becoming too large for the government to try to help everyone. A government that tries to help everyone will end up helping no one, as evidenced by the majority of world governments in large amounts of debt.
With a system like this, there will of course be people who fall through the cracks and need extra help. I think the willing generosity of society will be able to cover most of these cracks. On top of that, I think people would be more generous if they didn't believe that the government was always behind everyone for them to fall back on. Also, a policy like this would be far less expensive, requiring far less money from taxpayers, leading to further generosity. No one feels generous after April 15.
Posted by Blayne Bradley (Member # 8565) on :
quote:Originally posted by GaalDornick: The government should set the safety net for those that can't afford health care insurance and provide enough funds for emergency services. Also, regulate the healthcare providers and insurance companies to the extent that it keeps prices fair (the specifics of how to do this are above my experience/knowledge). Beyond that, you are on your own.
I know this is considered a cruel solution, but I think our current policy of paying for things we can't afford is even more cruel since it will eventually have worse results. The population is becoming too large for the government to try to help everyone. A government that tries to help everyone will end up helping no one, as evidenced by the majority of world governments in large amounts of debt.
With a system like this, there will of course be people who fall through the cracks and need extra help. I think the willing generosity of society will be able to cover most of these cracks. On top of that, I think people would be more generous if they didn't believe that the government was always behind everyone for them to fall back on. Also, a policy like this would be far less expensive, requiring far less money from taxpayers, leading to further generosity. No one feels generous after April 15.
This isn't true, again it's fyigm.
Also, pssst, since you didn't get the memo, but libertarianism is even more discredited than communism.
Posted by Rakeesh (Member # 2001) on :
Politically, in this country? Not by a long shot, for better or worse.
I remain deeply skeptical of the oft-claimed generosity of society among libertarians, if only the tax rate did this and the government did that and charitable groups did the other thing. We're a species that has some demonstrated pretty bad problems giving a crap what happens to strangers, and it's been tested and observed in many different ways. Especially when libertarians start in with the talk about bootstraps and letting people deal with their own mistakes, so and so forth. That's a constant refrain among libertarians, but one thing it isn't is the language of charity. It's simply not what people say when they have a serious priority of helping others, and there simply isn't any evidence, past or present, that human beings just behave more charitably if left alone.
Doesn't stop libertarians from speaking as though it were a given, though.
Posted by Darth_Mauve (Member # 4709) on :
Gaal, I greatly appreciate that you have a solution instead of the throng who say, "Just kill Obamacare is all I care about."
However, there are shortcomings in your solution.
quote: The government should set the safety net for those that can't afford health care insurance and provide enough funds for emergency services.
With the cost of insurance and healthcare far outstripping the cost of inflation the question quickly becomes, "Who can afford insurance." Right now insurance for my family every month is 50% higher than the cost of the mortgage on our house. We are not in the upper middle class, more close to the lower middle class, would we qualify?
Would all emergency room visits be covered under your "emergency services"? If Joe gets rushed to the hospital without his wallet he might need not only the emergency room doctor sewing up cuts and setting bones, but specialists to take care of brain injuries, burns, or cardiac problems for example. You are suggesting that the bill on these services will wait until after the emergency. Then the hospital would bill his insurance if he has any, or him if he doesn't have insurance.
quote: Also, regulate the healthcare providers and insurance companies to the extent that it keeps prices fair (the specifics of how to do this are above my experience/knowledge).
This is actually what a lot of "Obamacare" does. Every bit of regulations to help keep companies fair is fought as being "Anti-business" though.
quote: Beyond that, you are on your own.
This is how healthcare was for most of our history. It is why so many 18th and 19th century dramas and stories have people sacrificing their own safety, productivity, and morality to "make enough money so Mama could get her operation." It is why Tiny Tim had a crutch. The doctors could fix him, but it took money. Bob Cratchet was not poor, but because he couldn't afford a doctor bill then, Tiny Tim was doomed to die.
Tiny Tim had a pre-existing condition, so no insurance company would cover him.
Only Scrooge's money could allow for his healthcare.
Enough real instances of similar circumstances led to the people demanding change.
quote: I know this is considered a cruel solution, but I think our current policy of paying for things we can't afford is even more cruel since it will eventually have worse results. [/cruel]
What could be worse results than people dieing who could be healed? For you there may be worse results than other people who can not get, or are in between health care dieing for lack of help. For them, there isn't.
[cruel] The population is becoming too large for the government to try to help everyone. A government that tries to help everyone will end up helping no one, as evidenced by the majority of world governments in large amounts of debt. [/cruel]
Who decides whom to help? Your solution is "Survival of the richest, pity for the poor, the rest fight it out for yourself". If we can't help everyone, are we then a government of the people, or only of the special people?
Lots of countries are in debt. The debt is not caused by health care costs, but by other broader problems. In Greece paying taxes for the wealthy became almost an option, cheating on it was the standard. In Spain and Iceland it was the banks that goofed on greed and cost billions.
[quote] With a system like this, there will of course be people who fall through the cracks and need extra help. I think the willing generosity of society will be able to cover most of these cracks. On top of that, I think people would be more generous if they didn't believe that the government was always behind everyone for them to fall back on.
History, alas, proves you wrong. We would not have gone to the system we have if the local community could and would afford to help those who fall between the cracks.
Sure everyone loves to donate to the little kid with the bad disease. What they don't donate too is the drug addict who catches Lukemia. I've seen those fund raisers as well. They gather $5 or $6,000 to help pay medical bills. The medicine for the
quote: Also, a policy like this would be far less expensive, requiring far less money from taxpayers, leading to further generosity. No one feels generous after April 15.
My tax bill is far less than my health insurance bill. Cutting the Medicare part out of my tax bill will not make me more generous, since it will just disappear into ever growing insurance bills.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Rakeesh: Doesn't stop libertarians from speaking as though it were a given, though.
The shortfall in generosity needed to cover the uninsured and underinsured here, even WITH essentially free ER care for indigent people and with medical bankruptcy as a frequently used outcome, is much too extraordinarily high to expect to be covered even if we halved tax rates (which would, well, implode the country). The savings of such a plan would be dwarfed by the additional generosity we would have to expect to be put back into the system to cover the uninsured, so it would only make the problem worse. 40,000 people in this country die due to a lack of access to proper health coverage, yearly. There is nothing to suggest that the shortfall in coverage would be covered up for, especially when it comes to individuals with critical care issues like wreck surgery or blood cancer or god knows what else.
quote:The population is becoming too large for the government to try to help everyone
This kinds of reeks of a made-up idea that I think you've been fed. What makes this true? What data is it based on? Why does total population matter more than GDP per capita? Does this idea take into consideration the fact that dense populations are easier to provide effective care to, and cheaper?
Posted by GaalDornick (Member # 8880) on :
"This isn't true, again it's fyigm."
What exactly do you think isn't true? I had no idea what fyigm is until I googled it, but I said nothing like that in any way.
"We're a species that has some demonstrated pretty bad problems giving a crap what happens to strangers, and it's been tested and observed in many different ways."
I agree. We're also a society that has shown remarkable altruism and charitable actions in many different ways.
"Especially when libertarians start in with the talk about bootstraps and letting people deal with their own mistakes, so and so forth. That's a constant refrain among libertarians, but one thing it isn't is the language of charity."
If you're debating with me, can you address me and not libertarians? I'm not claiming to speak for others and having other libertarian ideas assigned to me. I have no idea what talking about bootstraps means, nor how it applies to what I proposed.
Also, I noticed that this post was less condescending and dismissive of my ideas than your previous posts. Is this because you decided to give up refuting my perspective because it's not worth it or that you have a little bit more respect for them after I clarified what I meant? I wanted to write out my opinion on this issue because it's something I have been thinking about for awhile, but none of my friends IRL care enough about issues like these to have discussions about them, so I wanted to write them here to test them out, so to speak.
Darth Mauve, thank you for writing that out. I'm still reading/thinking about it and I'll respond to it if I have a rebuttal.
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by GaalDornick: The government should set the safety net for those that can't afford health care insurance and provide enough funds for emergency services. Also, regulate the healthcare providers and insurance companies to the extent that it keeps prices fair (the specifics of how to do this are above my experience/knowledge). Beyond that, you are on your own.
I know this is considered a cruel solution, but I think our current policy of paying for things we can't afford is even more cruel since it will eventually have worse results. The population is becoming too large for the government to try to help everyone. A government that tries to help everyone will end up helping no one, as evidenced by the majority of world governments in large amounts of debt.
With a system like this, there will of course be people who fall through the cracks and need extra help. I think the willing generosity of society will be able to cover most of these cracks. On top of that, I think people would be more generous if they didn't believe that the government was always behind everyone for them to fall back on. Also, a policy like this would be far less expensive, requiring far less money from taxpayers, leading to further generosity. No one feels generous after April 15.
What would happen to Medicare and Medicaid? Gone?
Posted by Blayne Bradley (Member # 8565) on :
The assertion that there's some magical point where healthcare is unaffordable to provide for all citizens I feel is completely untrue. The whole point of programs like Social Security is that people pay into it, with healthcare if everyone has access to it, prices go down. Prices going up right now is due to the broken semiclosed market environment that conspires to keep prices up.
The status quo, even with Obamacare is unsustainable in the long run, true singlepayer is significantly more sustainable.
You know what happens when the population increases? The economy also tends to grow as well, growth in GDP outpacing costs is the foundation of modern economics.
Posted by Orincoro (Member # 8854) on :
In a very essential way, the status quo system conspires, through various convolutions, to provide the lowest standard of care for the higher cost. Essentially the opposite how a free-market system usually works. A lot of that has to do with regulation: particularly regulation puppateered by the neuter itself to the point where it is providing a demonstrably substandard service at a cost of easily 200% of the average.
It's rather elegant proof that medical care doesn't follow the rules of a free market, for many reasons. For one thing, medical care as a product is not fungible. Imagine Americans today walking around with giant crappy cell-phones with technology 15 years out of date, while the rest of the world had smartphones, and we were paying 1000 dollars for the equivalent of a Nokia 5150. It would never happen. But it happens with health care. It is happening right now.
Posted by Rakeesh (Member # 2001) on :
quote:In a very essential way, the status quo system conspires, through various convolutions, to provide the lowest standard of care for the higher cost. Essentially the opposite how a free-market system usually works. A lot of that has to do with regulation: particularly regulation puppateered by the neuter itself to the point where it is providing a demonstrably substandard service at a cost of easily 200% of the average.
It seems to me that this is the way a free market system works-if it can. The intent on the part of whoever is providing the goods or services isn't, common rhetoric notwithstanding, to provide the most or the best for the least. The very idea that they would runs contrary to one of the primary principles of capitalism, self interest.
So when they can get away with offering less or worse for more, they will, over the long run. It's not the March of Dimes, and helping others is not the first reason nearly anyone becomes a big businessperson. It turns a profit.
The reason things work differently for most other free market systems is, as you say, because they're different. Competition exists in ways for other goods and services that it doesn't for health care. You can price shop for TVs, landscapers, designers, cars, and nectarines in ways you can't for medical care. Very often there you have to take what you are offered by your health insurance, and those decisions aren't made by consumers very often it seems to me.
But, yknow, just say socialism enough and it's bad, I guess.
Posted by Lyrhawn (Member # 7039) on :
I second everything Rakeesh just said.
Every time I use that argument against someone who wants a "government-free free market health care system" they're flummoxed to find a response. It's like they don't actually understand what sort of system they propose and what it entails. Insurance companies make money by DENYING care. Hospitals make money by charging as much as humanly possible, and so much of the cost is so amorphous and shrouded in mystery that a customer couldn't possibly begin to guess how to figure it out, to say nothing of the fact that it's hard to price shop and compare when you're lying on a gurney.
Health care is a fundamentally different service than any other on the market, and shouldn't be treated by the same rules, nor should we expect the same outcomes, as other areas of the market.
Posted by Rakeesh (Member # 2001) on :
quote:Hospitals make money by charging as much as humanly possible, and so much of the cost is so amorphous and shrouded in mystery that a customer couldn't possibly begin to guess how to figure it out, to say nothing of the fact that it's hard to price shop and compare when you're lying on a gurney.
I wouldn't say health care providera are in the business of denying or minimizing care (nor did you, I know), but that's where the money is. As long as people like to make more money, the impulse to offer less quality and quantity will always be there.
If it were the kind of thing people could compare in very straightforward ways, it would be one thing. You can, without needing much in the way of training or expertise, make a pretty informed decision about which car you want to buy. The dozens of factors influencing that decision are easily compared to one another, and there's a single dollar amount attached to each choice, and the only complication there is the length and type of payments. Plus, there are plenty of used cars around as well, and a lot of flexibility overall as far as getting that money together.
Contrast that with health care. Even if someone goes to the trouble of becoming well informed in their regional ins and outs of the system-and that knowledge will be very regional-there will still be so very much they don't know. Perhaps their health care doesn't cover the doctors they know are reliable, or perhaps it does but only if you know to ask-you've got to know the ins and outs of health insurance, and it's not as though 'easy to understand' is a first-tier priority for any provider I've ever seen.
In the quite likely event that your otherwise good or even excellent job doesn't provide adequate care in your eyes, well, what are you to do exactly? Upend careers? Ask a prospective employer to let you know what their benefits will be in ten years when you're having children of your spouse is getting sick?
The single thing that others have pointed out that makes the free market system so compelling simply doesn't exist in health care. If I found out I got screwed on that car, I can simply avoid that dealer or brand in the future, and in the meantime as unhappy as I might be my car will probably drive. If it turns out I got screwed on that major surgery I needed after a car accident, well, what can I do really? Spend the next few years minimum wrangling in court? Switch health care (somehow) for the next time I need major surgery? Customers don't have the kind of quick, easily used power they need for the free market to work.
---------
Gaal,
quote:I agree. We're also a society that has shown remarkable altruism and charitable actions in many different ways.
I really don't think so. Look, I love my country, and I'm proud of it, particularly many of its founding principles. But altruism must be measured by capacity to determine just how large and impressive it is, and I don't think you could acurately say that charity is one of our hallmarks. Especially not in our tax code. Remember, if you intend to provide examples: you cannot simply cherry pick the good and hold them up to stand alone, and 'better than other nations' is a poor measurement indeed for altruism.
quote:If you're debating with me, can you address me and not libertarians? I'm not claiming to speak for others and having other libertarian ideas assigned to me. I have no idea what talking about bootstraps means, nor how it applies to what I proposed.
Well you did use the word yourself, Gaal, and along with your rhetoric it really seemed to fit. As for bootstraps, I was referring to the idealized notion that society is best served when government helps them as little as possible, and they are forced to pull themselves up by their bootstraps.
quote:Also, I noticed that this post was less condescending and dismissive of my ideas than your previous posts. Is this because you decided to give up refuting my perspective because it's not worth it or that you have a little bit more respect for them after I clarified what I meant?
I'm afraid you gave up defending your own perspective. It was pointed out to you that the objections you were raising about these laws were strange, either because the laws simply didn't do what you claimed, or that the system as it is contained the flaws you were criticizing. This seemed to make no impact, and you offered your points in traditional conservative talking point format, no less. So I took those things to mean you weren't serious, so I shouldn't take your remarks as seriously-which I was initially.
I'll try again: it is an article of faith that our society would, from the private sector, provide an equal or better safety net than what we currently have among conservatives. Can you provide any reason that doesn't rebound back to that faith as to why we should think this is true? Can you point to a society that has done so, charitable output increasing in proportion to tax decrease, a regular outpouring of the importance of charity and community support among the middle and upper class and business community?
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