View Full Version : Will Obamacare succeed where term limits failed?
This could be the best thing (http://www.politico.com/story/2013/06/obamacare-lawmakers-health-insurance-92691.html?hp=f2) to come from Obamacare....
Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.
The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.This is too delicious. The people that wrote and passed the law are now talking about quitting their jobs to avoid being subject to it....
I would cynically state that they would just amend the bill quietly to keep their privileged status, but that would require them to actually pass something. Unless it was hidden in a larger, unrelated bill it's not politically feasible, and an unrelated bill large enough to hide the amendment isn't going to get passed, because, well, Congress.
LittleGrizzly
06-13-2013, 19:01
Sounds like a good way to get a great health system, force the lawmakers and aides to use the same system as everyone else...
Who's everyone else? The upper-middle-classer who thinks they're struggling because they have to pay a hefty premium?
That would be me. And I spent a ridiculous amount of time this week battling with a hospital that was double-billing my family. Anyone who defends the status quo of our medical system is delusional, probably blinded by ideology.
I remember when the debate over healthcare reform was going on, I kept asking my more rightwing friends, "Show me an example of market-driven healthcare on a national scale that works." Inevitably, they could not. Which tells you everything you need to know. Much like communism, profit-driven national healthcare sounds good in theory. The fact that it's unable to show results in the real world? Don't confuse us with empiricism.
HoreTore
06-13-2013, 19:40
Still, you haven't seen the worst solution, Lemur: New Public Management (NPM) (http://en.wikipedia.org/wiki/New_public_management).
Properly implemented, this brilliant idea captures the positives of both the market-driven system and the government system. Then it decides to shed all of those, and instead focus on combining the worst aspects of both. Brilliant, I say. No freedom, no choice for the patient, an anal adherence to rules and regulations, time wasted on billing other departments and spiraling deficits.
I Love Thatcher and Blair, I really, really do. I love them so much I wish them to go somewhere very warm in the afterlife.
We need a universal option, with universal standards and universal accountability. Its only fair.Since healthcare isn't equal, we need to have government lower the standards until they're equally bad for all. :yes:
I remember when the debate over healthcare reform was going on, I kept asking my more rightwing friends, "Show me an example of market-driven healthcare on a national scale that works." Inevitably, they could not. Which tells you everything you need to know. Much like communism, profit-driven national healthcare sounds good in theory. The fact that it's unable to show results in the real world? Don't confuse us with empiricism. None of this justifies passing Obamacare. It makes healthcare more expensive and doesn't solve any of the problems it set out to address.
Edit:
Here's more...
Coverage may be unaffordable for low-wage workers (http://news.yahoo.com/coverage-may-unaffordable-low-wage-workers-151922273.html)
An interesting take from Ramesh Ponnuru (https://www.nationalreview.com/nrd/articles/349681/chronic-disease):
Conservatives and Republicans in Washington — activists, strategists, politicians — are increasingly embracing a theory about Obamacare: It’s going to collapse of its own weight, and its failure could yield a sharp right turn in the 2014 and 2016 elections. That theory is probably wrong, and dangerously so. To be rid of Obamacare, Republicans will have to do more than just wait for it to go away — and more than they have done so far. [...]
Republicans’ confidence that Obamacare will collapse has contributed to their lassitude in coming up with an alternative. It is a perverse complacency. If the program were going to collapse in the next three years, it would be all the more important for Republicans to build the case for a replacement for it.
Papewaio
06-13-2013, 21:20
Problem with a market model for medical care is that it is not a fair buyer-seller relationship.
Often the buyer has to be healthy to get insurance. Wait months before being eligible for various benefits and a lot of insurance benefits tie your medical procedures to the insurers preferred choice. So you have buyers who spend money to get a delayed benefit as determined by the seller, to deal with scenarios which are not always elective for the buyer.
Also it is a highway mans dilemma "Your money or your life". So the rates get ratcheted up and up as time passes. As you become more at risk your premiums go up. So for a lot of retired people it is not an affordable option.
Universal health care provides a baseline access. With private healthcare mixed in it shortens the wait time for those paying for it and the universal healthcare provides a minimum level of competition and covers any overt or covert private health gaps. Also every person who moves to private health should in theory shorten the queues in the public system. However specialists are a limited resource that in Australia have a quota as set by their own colleges. So it doesn't really shorten the line for public health.
Universal healthcare provides here a free to play option. Private health provides bonuses such as queue jumping and a private room.
Get the combination right and you have a cos efficient synergy. Get it wrong and you double up all that is wrong in both big government and big business.
double up all that is wrong in both big government and big business.
Yeah, that's the hybrid jackalope we managed to create here in the States. It may be hideously expensive and bureaucratic, but at least we get middling to sub-par results.
LittleGrizzly
06-13-2013, 22:37
Who's everyone else?
......................
I was mainly referring to the working/middle classes...
HoreTore
06-13-2013, 23:17
A misleading label, in my opinion. Much of the working class in in poverty, and the middle-class is in fact rich by any standard that isn't coming from a perspective of considerable wealth. If you want Congress to get the point, make them live like the lowest common denominator for a month or so. Hell, that should be like a rite of initiation for politicians--you could even make a reality TV show about it. :creep:
The US has no concept of classes. When a factory worker or plumber can call himself middle class, you know society is on the wrong path... Fear of the reds, I guess.
The US has no concept of classes. When a factory worker or plumber can call himself middle class, you know society is on the wrong path... Fear of the reds, I guess.
Plumbers actually make good money.
HoreTore
06-13-2013, 23:31
Plumbers actually make good money.
Yes, the working class can make good money. As I said, the US has no concept of classes. A plumber is working class, no matter how much money you throw at him.
HoreTore
06-14-2013, 06:13
Every country has a concept of class, we just do it differently than Europeans. To say we don't have a concept of classes is just silly.
A plumber can call himself middle class. That's silly.
You're all terrified of being workers.
Yes, the working class can make good money. As I said, the US has no concept of classes. A plumber is working class, no matter how much money you throw at him.
If a plumber is self-employed and runs his own plumbing business is he still working class or is he a member of the bourgeoisie?
HoreTore
06-14-2013, 11:06
If a plumber is self-employed and runs his own plumbing business is he still working class or is he a member of the bourgeoisie?
Then he's moved up to middle class, the petty bourgeoisie. He owns his own means of production, but he is still forced to sell his labour on the market. If he opens a factory producing plumbing equipment, he's a capitalist.
HoreTore
06-14-2013, 11:17
What kind of car you drive, what kind of neighborhood you live in, how you can afford to raise your family, the standard of medical care you recieve, whether or not eating out as a family at a restaurant is something you can even feasibly do, these are things that would indicate your class. What kind of work you do to achieve your standard of living is something pretty far down the ladder.
I like how your apparently some kind of authority on American society. When did you live here? How many different sides of America have you seen? Who's terrified of being workers? Most of the people I know would kill somebody to get a chance to go to trade school.
The bolded part shows you've got it all turned on its head. The means of production, ie. how you earn your living in your relation to those who contribute or benefit to that income, is what determins your class. Your cultural standing is largely irrelevant, though some like to use those factors to juggle you around your class(like saying "lower, upper, educated, etc" working/middle class).
HoreTore
06-14-2013, 11:27
That you think class is determined by sitting back and calculating some formula is pretty indicative of your class. :shrug:
I'm a teacher, thus working class. Some like to say I'm part of the "educated working class".
I know the brits like to include family and social relations in their class defintions, and I see some sense in that, at least in the British context(not so much for more egaliatrian societies).
My defintions are the marxist definitions of class. I don't know where you got yours, but since they're obviously not marxist, they're wrong ~;)
HoreTore
06-14-2013, 11:49
That's my point. Your definitions come from a book, because you're part of the comfortable classes. Middle or upper middle, whatever. The reality is that class is determined by what you have control over and what you have access to. Wealth passes in and out of middle-class and even many wealthy families so fast that your old definitons of basing it on how they got the means is kind of outdated. Especially in America.
It's based on a tradition, the tradition which created the concept ~;)
Even the poor think they're middle class who just have a temporary low.
It takes the market to break them for several years to maybe perhaps make them declare themselves poor.
But in their hearts they will still think they should be middle class and the world around them is treating them unfairly.
Even the rich want to be middle class but the poor chaps are unable to spend their money as fast as it flows in, after a while they just give up as well.
HoreTore
06-14-2013, 13:09
Even the poor think they're middle class who just have a temporary low.
It takes the market to break them for several years to maybe perhaps make them declare themselves poor.
But in their hearts they will still think they should be middle class and the world around them is treating them unfairly.
Even the rich want to be middle class but the poor chaps are unable to spend their money as fast as it flows in, after a while they just give up as well.
That's the problem with US(and increasingly european) class thinking: you're either poor or you're middle class, the working class has ceased to exist. That's not how it actually is. We've got more and more wage-labourers replacing more independent workers(think the franchise system for shops), so the middle class is smaller, and we've got a record high employment rate meaning that the poor class is smaller.
The working class has become bigger, while the lumpenproletariat and middle class has shrinked(meaning things go according to Marx' predictions).
FoxLeLay
06-14-2013, 13:22
Who's everyone else? The upper-middle-classer who thinks they're struggling because they have to pay a hefty premium? The homeless guy who has to use the Emergency Room? The Soldier who gets all the second-rate dental work he wants (seriously, I got fillings that look like they were done in rural mexico)? Even the rich with their concierge doctors have their downsides--Michael Jackson got killed by his, after all.
We need a universal option, with universal standards and universal accountability. Its only fair.
But are you willing to pay the higher taxes that will come with better, universal healthcare? You don't get anything for free, especially when doctors continue to get paid $400,000 a year.
But are you willing to pay the higher taxes that will come with better, universal healthcare? You don't get anything for free, especially when doctors continue to get paid $400,000 a year.
Does it matter whether you pay 200$ a month in taxes or 4800$ when you see a doctor every two years?
What's easier, to plan your monthly budget or to prepare for something that may happen ten years down the line?
If you have to take a credit every time you get an expensive health care bill then you also have to add the interest that you pay on the credit to the total cost.
And that's assuming everybody gets the treatment they need either way, of course without universal health care you can let hospitals refuse poor people and watch them die on the streets. If they are forced to treat them for free then they will surely add the cost that is incurred on top of the treatment for other patients just like a convenience store has higher prices for everyone to make up for the losses due to theft.
FoxLeLay
06-14-2013, 14:53
Does it matter whether you pay 200$ a month in taxes or 4800$ when you see a doctor every two years?
What's easier, to plan your monthly budget or to prepare for something that may happen ten years down the line?
If you have to take a credit every time you get an expensive health care bill then you also have to add the interest that you pay on the credit to the total cost.
And that's assuming everybody gets the treatment they need either way, of course without universal health care you can let hospitals refuse poor people and watch them die on the streets. If they are forced to treat them for free then they will surely add the cost that is incurred on top of the treatment for other patients just like a convenience store has higher prices for everyone to make up for the losses due to theft.
But that's the problem. Do you really you want to pay higher taxes? I don't think everyone's getting the point. Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....
Then the money will be use for someone else, thus, it be no better if someone is treated for free and the cost is put off on other insured people.
Either way, you will not make out. Only these greedy doctors will make out, that's it.
Papewaio
06-14-2013, 14:57
What is the income tax rate in the US?
I'm paying 40%. You either pay taxes or borrow money from other countries.
Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....
This argument conveniently ignores the documented fact that single-payer healthcare programs are cheaper than our capitalist-socialist jackalope system. By a factor of at least 45% (http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita), if not more, depending on the system chosen for comparison. Our system is the most expensive in the world, by long margins. To argue that other systems yield "no savings" is either ignorant or mendacious.
Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....
You mean there are people who never get sick and then suddenly die? There are also cars and houses that are never set on fire but people tend to get insurances for them.
Then the money will be use for someone else, thus, it be no better if someone is treated for free and the cost is put off on other insured people.
No, why? It's not like other people become sick more often just because you are healthy. If people don't go to the doctor the taxes/fees can be lowered. Especially if the system is operated properly whereas a private insurance will just pay out the excess money to shareholders or pay bonuses to managers.
Either way, you will not make out. Only these greedy doctors will make out, that's it.
Not all doctors are greedy and most single payer systems have a limit on how much 5 minutes at a doctor or certain medications can cost.
I'm not sure whether we handle the doctor thing well here as there seem to be some problems but with medications there are tests and if a cheaper medication yields the same results as a more expensive one then the more expensive one will not have to be covered by basic insurances. It's not that every universal health care system is flawless but they're all better than what the US has now.
To say it's better to do nothing if the result of doing something is "only better but not perfect" is quite weird IMO.
A recent Gallup poll finds the 41% of small businesses have frozen all new hiring because of Obamacare (http://www.cnbc.com/id/100825782).
Forty-one percent of the businesses surveyed have frozen hiring because of the health-care law known as Obamacare. And almost one-fifth—19 percent— answered "yes" when asked if they had "reduced the number of employees you have in your business as a specific result of the Affordable Care Act."
Yeah, I get that our old system was bad- but in the rush to "Do Something", we've made it much worse. This is a complete mess. :no:
That only proves that 41% of "small businesses" are cheap. It is a well-known fact that small business and large businesses have used the economic climate as an excuse for predatory hiring practices. Crying wolf and cutting costs, that's all they're doing.
They're not hiring because of increased regulatory burden from our government. Whatever subjective personal views you wish to attach to it are immaterial to the fact that they're not hiring. As both parties seem fond of pointing out, small businesses account for most of our employment. If 41% have stopped hiring and 19% have reduced staffing due to government action.... that's a problem.
HoreTore
06-21-2013, 21:16
small businesses account for most of our employment.
It doesn't matter how many politicians like to say that, it still isn't true.
Big government and big business are responsible for employment in the US and all other industrialized countries. Also, the US defines "small business" as up to 500 employees... Not exactly your neighborhood bar, now is it?
Pure rhetoric, no substance. Capitalism acting as it usually does.
Also, a job that does not enable you to live a good, healthy life is an irrelevant job and should be cut.
So says you and them. From the point of view of people trying to get and keep minimum wage jobs, it is pure exploitation. It is actually more profitable to be a community college student and survive on student loans than it is to attempt to get and keep a job that pays a living wage. The problem is the attitude of the employers, and the attitude of the country towards a failed system. These businesses aren't victims, they're assholes.
What are you talking about? So says me? It's not a problem if 41% of small businesses have stopped hiring?
Please explain. You've got plenty of rhetoric in there, now add some substance to it.
a completely inoffensive name
06-22-2013, 00:56
It's the same deal with unpaid internships. Businesses spin government regulations as "Now we can't train the next generation of workers" When in reality they are just frustrated that they no longer have free labor anymore.
It's the same deal with unpaid internships. Businesses spin government regulations as "Now we can't train the next generation of workers" When in reality they are just frustrated that they no longer have free labor anymore.
And H1-Bs. ~:rolleyes:
a completely inoffensive name
06-22-2013, 03:49
And H1-Bs. ~:rolleyes:
I'm afraid I don't understand. H1-B is an immigrant visa?
I'm afraid I don't understand. H1-B is an immigrant visa?
Companies are using them to depress wages in tech fields. They post job openings with crazy weird requirements, say no one is qualified when no matches are found, then push for more H1-B slots so they can hire an indentured servant on the cheap.
Yeah, listened to an interview about this on the radio, manufacturer complaining that he couldn't get good robotics integration specialists. So I thought, "Wow, that's sad, I hope lots of kids are studying robotics in school."
Then he's pressed a bit, admits he doesn't' want to pay more than $10–$12 per hour, and doesn't see why he should pay more, and that's why he can't find his specialists. Yeah, by all means, let's get him some visas and some cheap labor.
Grrrrrrrr.
Everyone can find horror stories, but remember "anecdote" isn't the singular form of "data".
A study (http://www.brookings.edu/research/papers/2013/05/10-h1b-visas-stem-rothwell-ruiz) by the Brookings Institute asserts that visa workers actually make significantly more than their American peers in most categories.
There's a guy in my office that's on a worker visa- if you mention any of the stuff being spouted in this thread around him you had better brace yourself to be set straight with a lengthy dissertation from him. Another guy in our office was complaining about the proposed H1-B expansion within earshot and it turned into a 20 minute lecture. I have no problem with people who come into the country legally.
Tellos Athenaios
06-24-2013, 02:01
Everyone can find horror stories, but remember "anecdote" isn't the singular form of "data".
A study (http://www.brookings.edu/research/papers/2013/05/10-h1b-visas-stem-rothwell-ruiz) by the Brookings Institute asserts that visa workers actually make significantly more than their American peers in most categories.
True for "high tech" work, basically US firms will do a lot to avoid hiring Americans and even pay decent wages to tempt foreign workers. Doesn't really apply to the helpdesk drones, airline pilots or the pizza guys, though.
Pizza guys, huh? I'd love to see the job description for a pizza guy that would qualify for a H1B. :laugh4:
Pizza guys, huh? I'd love to see the job description for a pizza guy that would qualify for a H1B. :laugh4:
I could swear that sentence started with "Doesn't really apply to [...]" but maybe that's just me.
Another fun Obamacare fact, people on individual plans can expect to pay up to double (http://www.forbes.com/sites/theapothecary/2013/07/01/wsj-health-insurance-rates-could-double-or-even-triple-for-healthy-consumers-in-obamacares-exchanges/)... or more for the same coverage they have today.
But that’s not exactly right, because as Sam Richardson has shown, Obamacare Bronze plans aren’t that different from what you can buy today on the individual market in terms of co-pays, deductibles, and actuarial value. Richardson found two nearly-identical plans sponsored by Kaiser in Sacramento, with identical networks of hospitals and doctors.
As Richardson’s table to the right illustrates, the Obamacare plan had a higher out-of-pocket maximum and the same actuarial value as the 2013 Kaiser plan. Today’s plan costs $100 a month; the Obamacare version costs $205.
Here's the table(click to see it):10108
Shaka_Khan
07-02-2013, 06:53
Here's What Happens If You Don't Sign Up For Obamacare (http://finance.yahoo.com/news/heres-happens-dont-sign-obamacare-220458373.html)
"According to a recent survey, nearly two-thirds of uninsured Americans say they haven't decided whether or not they'll buy health insurance by the Jan. 1, 2014 deadline (even though they'll have to pay a penalty if they don't)."
The future of health insurance for uninsured Americans (Survey) (http://www.insurancequotes.com/health/health-insurance-for-uninsured#.UdJktJOweM9)
"Only 19 percent said they will get coverage by the deadline, while 10 percent said they plan to stay uninsured and pay the penalty, which in 2014 is the greater of $95 or one percent of income for an adult. For children under 18, the penalty is half the adult amount. The penalty increases each year, up to the greater of $695 or 2.5 percent of household income for an adult in 2016. And a family would pay a maximum of the greater of $2,085 or 2.5 percent of income then, according to the Kaiser Family Foundation."
Republicans came up with most of the ideas that actually got implemented.
Yup, the whole thing is predicated on the Heritage Foundation's 1989 proposals (http://online.wsj.com/article/SB10001424052970204369404577211161144786448.html), enacted by Repub Gov Mitt Romney is 2006 (http://www.usnews.com/news/articles/2013/05/16/study-romneycare-lowered-uninsured-rate-didnt-increase-hospital-costs), etc.
And I love how every evil and ill of our healthcare system is laid at the feet of ACA (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act), which is nothing more than an attempt to flatten the market a bit (in a clumsy manner).
Those who complain loudest have no credible plan for reining in the excesses of our medical/insurance colossus. (Buy insurance across state lines! Malpractice caps! Deregulate everything! Yeah, that's about all they've got. Evidence that any of this would work? We don't need no stinkin' evidence.) But we need to maintain the status quo because FREEDOM AND MURICA (http://wonkette.com/521579/american-babies-cost-three-times-as-much-as-european-babies-for-freedom).
Anyway ...
http://youtu.be/e7cry-4pyy8
I wish people would stop calling it Obamacare. Its a ponzi-scheme that will enrich pharmaceutical companies while lowering the overall standard of care. And Republicans came up with most of the ideas that actually got implemented.Obama doesn't mind people calling it Obamacare... because he does care (https://www.youtube.com/watch?v=I3OnOZOXV_Q&t=29s). ~D
Seriously though, you can try to blame whoever you want for the bill, but it was passed on a largely party-line vote and signed into law by President Obama and it's been championed by him ever since.
Yup, the whole thing is predicated on the Heritage Foundation's 1989 proposals (http://online.wsj.com/article/SB10001424052970204369404577211161144786448.html), enacted by Repub Gov Mitt Romney is 2006 (http://www.usnews.com/news/articles/2013/05/16/study-romneycare-lowered-uninsured-rate-didnt-increase-hospital-costs), etc.
And I love how every evil and ill of our healthcare system is laid at the feet of ACA (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act), which is nothing more than an attempt to flatten the market a bit (in a clumsy manner).
Those who complain loudest have no credible plan for reigning in the excesses of our medical/insurance colossus. (Buy insurance across state lines! Malpractice caps! Deregulate everything! Yeah, that's about all they've got. Evidence that any of this would work? We don't need no stinkin' evidence.) But we need to maintain the status quo because FREEDOM AND MURICA (http://wonkette.com/521579/american-babies-cost-three-times-as-much-as-european-babies-for-freedom).
A few points:
"At least he did something!" isn't a good defense. The status quo was bad. Obamacare is worse. Keeping the status quo isn't a long term solution, but it's better than what we're getting now by almost any measure.
Heritage putting out a proposal does not equal widespread conservative- or even GOP support for a mandate (http://www.forbes.com/sites/aroy/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/).....
"In 1994 Sen. Don Nickles (R., Okla.) and Rep. Cliff Stearns (R., Fla.) turned the Heritage plan into a bill. Peter Ferrara and others, such as Tom Miller at the Cato Institute, rallied other conservatives against the plan. “By endorsing the concept of compulsory universal insurance coverage,” wrote Miller, “Nickles-Stearns undermines the traditional principles of personal liberty and individual responsibility that provide essential bulwarks against all-intrusive governmental control of health care.”
Ferrara convinced 37 leaders of the conservative movement, including Phyllis Schlafly, Grover Norquist, and Paul Weyrich, to sign a petition opposing the bill. “To this day,” Peter writes, “my relationship with Stuart Butler and Heritage has never recovered.”"
Lastly- speaking personally, I would have opposed the Heritage plan (if I wasn't 10 at the time) on the grounds of its individual mandate- but it would have been a vast improvement over Obamacare in that it only mandated catostrophic vs comprehensive plans and it leveled the tax structure between employer-based coverage and individual coverage. The latter was also part of the McCain plan- and is one of the few things proposed that makes some sense.
Kralizec
07-02-2013, 20:41
Big government and big business are responsible for employment in the US and all other industrialized countries. Also, the US defines "small business" as up to 500 employees... Not exactly your neighborhood bar, now is it?
Seriously? Lol...
Businesses are only considered "small" here when they have less than 50 employees and a maximum turnover of 10 million. I think the same norm is used throughout the EU.
Montmorency
07-02-2013, 21:01
the US defines "small business" as up to 500 employees
Isn't 50-500 defined as "medium"?
"At least he did something!" isn't a good defense. The status quo was bad. Obamacare is worse. Keeping the status quo isn't a long term solution, but it's better than what we have now by almost any measure.
The obvious long-term solution is implementing what every other industrialized nation on Earth has, which is some sort of single-payer system (http://en.wikipedia.org/wiki/Single-payer_health_care). I know that's not what Ayn Rand (who wrote the Constitution and gave birth to George Washington) would want, but it's the only system demonstrated to control costs while providing a baseline of health for citizens.
Because Obamacare is entirely derived from a Republican think-tank and Republican politicians, it addresses none of the underlying problems. It's still trying to pretend that national private-sector healthcare can work, a proposition for which there is zero evidence.
It will be interesting to see if a measure as watered-down as Obamacare can be implemented despite the nihilist opposition of Republican governors. Time will tell. You take the fialure and costliness of Obamacare as a given, as a priori truth that only madmen and ideologues might question. I'd suggest there's a bit more divergence of thought on the overall cost of it, coming from sources such as the CBO.
And anyway, you have no positive agenda to put forward, just Obamacare bad bad bad. You can't defend the status quo ante because it is indefensible, and the only changes you can suggest are Randian free-market solutions which have never been demonstrated to work in the real world. They have exactly as much evidence for their efficacy as communist economic theory (https://en.wikipedia.org/wiki/Communism) and crystal-powered healing (https://en.wikipedia.org/wiki/Crystal_healing).
Obamacare is a very mild start on reining in some of the worst practices of health insurance. It doesn't go nearly far enough, but neither does it appear to be the flaming disaster you tangibly yearn for it to be.
And if this amounts to an "At least he did something" defense, I'd say it has more heft than your "Oh no he did something" offense.
The obvious long-term solution is implementing what every other industrialized nation on Earth has, which is some sort of single-payer system (http://en.wikipedia.org/wiki/Single-payer_health_care). I know that's not what Ayn Rand (who wrote the Constitution and gave birth to George Washington) would want, but it's the only system demonstrated to control costs while providing a baseline of health for citizens.There. Isn't that much more pleasant to read? All that's missing is some supporting statements.
Because Obamacare is entirely derived from a Republican think-tank and Republican politicians, it addresses none of the underlying problems. It's still trying to pretend that national private-sector healthcare can work, a proposition for which there is zero evidence.Again, you can try to blame whoever you want for it, but it was passed by a Democrat congress and signed into law by Obama. Let's deal with reality. If the Democrats didn't like it, they need not have passed it.
And anyway, you have no positive agenda to put forward, just Obamacare bad bad bad. You can't defend the status quo ante because it is indefensible, and the only changes you can suggest are Randian free-market solutions which have never been demonstrated to work in the real world. Nor have they been tried. If you had a hangnail and someone suggested sawing off your arm to fix it and I said we shouldn't, would you chastise me for not having a plan??
It's hardly a "Randian" suggestion... whatever that means. Employer-based coverage grew out of FDR era wage controls. That was a major factor in ballooning medical costs. I'm not even claiming it would solve everything- but beginning to separate coverage from employment by breaking down the tax favoritism would make it better than it is now.
I'm not even claiming it would solve everything
You haven't got any evidence suggesting it would solve anything. Nor has any substantial proposal been put forward by the nihilists in Congress.
You appear to have an almost purely negative agenda, with no politically or financially realistic plan for what to do afterwards. See earlier quotes from Ramesh Ponnoru (https://forums.totalwar.org/vb/showthread.php?144540-Will-Obamacare-succeed-where-term-limits-failed&p=2053532859&viewfull=1#post2053532859) to see what I think of this.
Again, you can try to blame whoever you want for it
Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.
If you had a hangnail and someone suggested sawing off your arm to fix it and I said we shouldn't, would you chastise me for not having a plan??
I'd say, "Show me successful hangnail removal, please," and you'd be able to do so. I can reel off dozens of countries that have successfully integrated some form of single-payer healthcare into their economy, and I can link to the overall healthcare results (http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems) and cost savings (http://economix.blogs.nytimes.com/2013/03/29/u-s-health-care-prices-are-the-elephant-in-the-room/?_r=0). Hell, in this thread I already have. These aren't even controversial or contested statistics.
Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."
You haven't got any evidence suggesting it would solve anything. Nor has any substantial proposal been put forward by the nihilists in Congress.
You appear to have an almost purely negative agenda, with no politically or financially realistic plan for what to do afterwards. See earlier quotes from Ramesh Ponnoru (https://forums.totalwar.org/vb/showthread.php?144540-Will-Obamacare-succeed-where-term-limits-failed&p=2053532859&viewfull=1#post2053532859) to see what I think of this.Let's be honest... would it make any difference if a congressional "nihilist" proposed an Obamacare alternative? There have been Republican proposals. The fact that you're seemingly unaware of them illustrates my point. The Republicans are nihilists with no plan of their own... even if they have several plans. There are many reasons they don't get any traction.... that the GOP isn't in power and the GOP electorate feels a far less pressing need for reform than the Democrat base are two big factors.
Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.The "Heritage Plan" never had widespread support among conservatives. If it had, something like it would have passed when the GOP had control of congress and the White House. Yet, it required Democrat control for it to get passed. To me, it doesn't seem fair to describe such that as a "Republican plan".
I'd say, "Show me successful hangnail removal, please," and you'd be able to do so. I can reel off dozens of countries that have successfully integrated some form of single-payer healthcare into their economy, and I can link to the overall healthcare results (http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems) and cost savings (http://economix.blogs.nytimes.com/2013/03/29/u-s-health-care-prices-are-the-elephant-in-the-room/?_r=0). Hell, in this thread I already have. These aren't even controversial or contested statistics.That's the problem with trying something new/innovative. There is no proven track record. A big difference between the recent conservative proposals and Obamacare is that they are incremental and each step could stand alone. Obamacare has popular provisions in it, to be sure- but they are completely unsustainable without the mandate and forcing people into paying for coverage they don't need.
Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."Single-payer... as implemented in some countries... would be an improvement over what we have now. But Obamacare is not such a plan. It adds more expense and bureaucracy to an already bloated system while still trying to call itself "market based".
There have been Republican proposals.
I appreciate that you can say that with a straight face. Yes, proposals were made (http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/27/the-republican-plan-to-overhaul-health-care/), especially around the time Obamacare was being introduced. No, none of them were serious, or intended to do anything but prolong the status quo. (The more recent proposals are ... well, read for yourself (http://www.foxnews.com/politics/2013/04/24/house-gop-withdraws-health-care-proposal-but-vow-to-bring-it-back/).)
The "Heritage Plan" never had widespread support among conservatives. If it had, something like it would have passed when the GOP had control of congress and the White House.
So let's see what sorts of "reforms" the Republicans passed when they had control of the Federal government ... hmmm ... would it look like a massive, unfunded giveaway to seniors and the Pharma industry (http://en.wikipedia.org/wiki/Medicare_Part_D)? Is that the sort of conservative reform we can look forward to?
That's the problem with trying something new/innovative. There is no proven track record.
Two thoughts:
(1) Basing national healthcare on principals and ideology that you self-describe as having "no proven track record" in this context is literally playing with people's lives. If the line where free-market absolutism meets reality is not as smooth as you believe it to be, you will get people killed for your grand theory. (And in such an occurrence you would probably argue that we just didn't apply Free-Market-Everything perfectly or purely enough; after all, a Sacred Truth cannot be wrong, it can only be wrongly applied.) Hence my repeated comparisons to communism in this thread. There really is a disturbing and precise parallel.
(2) Advocates of large-scale, untested, unproven new applications of ideology cannot ever be described as "conservative," unless we want to throw the English language under a large fleet of buses. The correct term is radical.
Major Robert Dump
07-03-2013, 20:56
Delayed a year.
L O Effing L. Republican blame game GOGOGOGOGO
Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.Again, the adoption of a mandate-type plan was an half-hearted response to Hillarycare that never enjoyed widespread support among Republicans or conservatives.
Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."Single-payer, socialized medicine would not be my favored choice. I think it would almost certainly, however, lower the astronomical growth of medical costs. Would it lower them enough to make them sustainable? I doubt it- not without rationing. Regardless, Obamacare != single-payer healthcare. It is increasing costs. And it makes most of our problems worse.
------------
Delayed a year.
L O Effing L. Republican blame game GOGOGOGOGOConveniently, that puts the implementation after the mid-term elections. The Democrats know they're got a big steaming turd on their hands and the last thing they want is a year of suffering under the employer mandate leading up to the elections. :no:
Edit:An exit question.. Under what authority can the administration postpone implementation? I'm not aware of the law having that flexibility in it. Anyone want to set me straight here?
Looks like the new thing will be to blame all healthcare problems on Obamacare. Whih is quite clever—there are a lot of problems. Great summation (http://prospect.org/article/under-obamacare-millions-will-die):
[An anti-Obamacare] ad mentions not being able to choose your doctor, which would be bad. If you chose an insurance plan in an exchange established by Obamacare, that plan will probably have a network of doctors from which you have to choose if you want your care paid for, and if your doctor isn't on it, then you've been prevented from choosing your own doctor.
Of course, that isn't because of Obamacare, it's because of the way insurance works in America; it's how it worked before Obamacare, and it's how it'll work after Obamacare. But it's a lot simpler to say, "Now that we're under Obamacare, I didn't get to choose my doctor!" And did you know that under Obamacare, medications could come with dangerous side effects? Or that under Obamacare, kids who get shots will cry? Not only that, under Obamacare, you could get cancer and die—even if your doctor wanted to save you. In fact, under Obamacare, we're all going to die one day. Thanks for all the misery, pain, and death, Obama.
And what if you need to choose a new insurance plan due to Obamacare and none of the compatible new plans feature your current doctor in their networks?
Is it fair to blame Obamacare then? Think it won't happen?
HoreTore
07-09-2013, 19:00
No, because it was already so that in the event you had to swap insurance for some reason, you wouldn't necessarily get to keep the same doc.
You can't blame the new system for carry-over* faults in a new system, while at the same time praising the old system. You can whine about them both at the same time, but you can't pick and choose. Sorry.
*couldn't find a good word on the spot, suffer my norwenglish....
Ironside
07-09-2013, 19:30
Single-payer, socialized medicine would not be my favored choice. I think it would almost certainly, however, lower the astronomical growth of medical costs. Would it lower them enough to make them sustainable? I doubt it- not without rationing. Regardless, Obamacare != single-payer healthcare. It is increasing costs. And it makes most of our problems worse.
I'll point out that the US are beaten by a lot of countries in life length, child mortality, etc, etc, running around with 50-70% of the costs. To be fair the americans might be sicker than the rest, but that rationing does seem to work better than yours.
And Obamacare looks this way because the Republicans decided to think like you. The earlier versions were quite a bit stronger towards single-payer socialized medicine.
Ironside
07-10-2013, 09:10
Sometimes I like to put on my tin foil hat and consider the possibility that Obama and the entire democratic party are incompetent on purpose, in order to further the Republican agenda of discrediting government in every way possible, to further their own master plan of making us all corporate slave-bitches.
Then I take the tin-foil hat off, cuz those things give you a headache.
That would require the politicians to give up power, for money or something. Now power without purpose and getting payed extra for (ab)using that power, that fits your gloomy view.
Ironside
07-10-2013, 17:20
But the money is the power. After serving in Congress, many politicians go work for lobbyists. The entire system is self-perpetuating. Also, insider-trading laws don't apply to Congressmen, so conflicts of interest are just a-okay. I wouldn't put any level of corruption past our most venerable institution. It takes suspension of disbelief just to take it seriously.
You suggested that it was general party policy, ergo even the ancient ones. Yes the springboard politicians could very well be playing that game, but for the veterans, the pull would rather be to be flattered into appearing very important by changing laws. Bribery is a part of that, but not the main driving force. They would not intentionally outsource their own power though.
Fisherking
07-10-2013, 18:12
I have not followed this, as I live outside the country and hope I am not effected by it.
But I do have a question or two.
If it is so good, why is there a tax penalty for individuals who don’t want to use it?
And, what happens to Doctors who are not employees of a large health care provider?
Most of the rest, I assume is a degree of scare mongering by the Republicans.
The only other thing I have heard that could be alarming is the supposed doubling or tripling of individual plans. This could be more of the scare tactics, I hope, but maybe not.
Also, as everyone is to be insured and everyone must be excepted but smokers pay a higher premium, I find that somewhat disingenuous.
After all, doesn’t someone obese or with another lifestyle related condition, not an equally high risk nonsmoker or not as the smokers who have to pay higher premiums? Just a little social engineering to go along with the program, huh?
If it is so good, why is there a tax penalty for individuals who don’t want to use it?
Because if we are to prop up and nurse along our broken system of private insurance, we have to expand the pool and convince the majority of citizens to buy some sort of coverage. In other words, force the reckless, the healthy, and the young to buy coverage they otherwise might not, thus spreading the pool and market to cover the sick, the lame, and the old.
I believe it's superficially similar to what's implemented in Switzerland (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland).
Of course, I would argue that there is zero evidence that private insurance is the appropriate way to fund healthcare, but that's because I don't see evidence that market forces work properly in healthcare. Market capitalism is great at many, many things. But when there's no evidence that it works in a certain context, it's time to re-think.
For example, I become a screaming socialist state-lover when it comes to the military. I think PMCs (http://academi.com/) are a horrible idea. I don't much like mercenaries or their side-effects. I think the military should be paid for straight outta taxes. I hear that makes me a pinko commie.
Likewise, I simply do not see evidence that national healthcare is best run by market principles—and those who advocate complete privatization and deregulation have nothing but theory and ideology on their side (which should tell you a great deal). But if we need to broaden the market to force our jackalope system to limp along for a bit ... eh, okay.
At least Obamacare sets up state exchanges (http://obamacarefacts.com/obamacare-health-insurance-exchange.php), out of which something useful may grow.
HoreTore
07-10-2013, 18:52
I support government services where that is efficient(healthcare, military).
I support private services where that is efficient(groceries and tv's).
I support a combination of the two above where that is efficient(kindergartens).
The distance from a conservative US republican(Lemur) and a Norwegian socialist(myself) isn't always so huge...
The distance from a conservative US republican(Lemur) and a Norwegian socialist(myself) isn't always so huge...
:laugh4: Lemur comes across more as a 90's moderate, which in this day and age means he's a freedon hating pinko to most of the Republican base.
I'm a bit further to the right, but even I knew this scheme would be a disaster. If true healthcare reform is to happen, we need to go to a single-payer system. As it stands (both pre- and post-Obamacare) the system's main goal is to siphon as much money out of your pockets before your die. As long as healthcare is not non-profit, this will always be the case.
Fisherking
07-10-2013, 21:30
It was passed by Congress, so there is no doubt it is flawed.
Just looking from here, without reading the thing I figure the main beneficiaries of the program are insurance companies, large healthcare providers and government agencies.
It is just an estimation but I think the people will take it in the shorts, and the pocket of course.
The German system works well here, but I have serious doubts that it can work there. I shudder at the thought of a government run healthcare system as it would be under funded and so filled with red tape you would long since have died before you got in to see a government doctor.
My guess is this will be about as good as you can get. You will never find a way of getting back to charging according to the means of the patient to pay. Docs don’t work for a chicken dinner any more.
HoreTore
07-10-2013, 21:40
The need to avoid waste, the number one leading cause of birth among bureaucrats, will always be present, private or public.
Though the extreme number of people who wish to "avoid waste of tax payer money" do seem to have a special ability when it comes to pissing away money on useless levels of red tape.
Yes, I'm looking at you, conservatives.
I figure the main beneficiaries of the program are insurance companies, large healthcare providers and government agencies.
Largely correct. Health Insurance and hospital stocks skyrocketed the moment Obamacare was passed.
It is just an estimation but I think the people will take it in the shorts, and the pocket of course.
Hard to estimate. Our pre-Obamacare system was already outpacing inflation by well over 100%. As economists say, trends that cannot continue ... don't. So something was (is) going to break. I doubt you can blame the deep dysfunction of our healthcare system exclusively or even primarily on an initiative as watered-down and modest as Obamacare. Not that people won't try, bless their little hearts.
I shudder at the thought of a government run healthcare system as it would be under funded and so filled with red tape you would long since have died before you got in to see a government doctor.
If this were true, you would see corresponding health data from single-payer systems, showing less efficiency and worse health results. The opposite is true.
My guess is this will be about as good as you can get.
What are you basing that on? Other nations have enacted objectively better systems than ours, and have decades of documented experience to back it up. I am continually amazed by the empiricism-free and data-free nature of these sorts of objections.
The Lurker Below
07-10-2013, 21:55
I agree with Drone that a single payer system is the best solution, and is long overdue. I wonder though, the more things change, the more they stay the same. It's been implied in posts here that our bureaucratic red tape creators would make our single payer system a dysfunctional system, getting nothing done. People with money would still find the healthcare they want, only at additional expense than the taxes they already pay. Long term, no difference.
At least Obamacare sets up state exchanges (http://obamacarefacts.com/obamacare-health-insurance-exchange.php), out of which something useful may grow.
Currently over half the states have refused to set up the exchanges, and due to laws within their state, might never do so. This means that in those states the federal gov't will set up the exchange, which Obamacare legislation itself declares cannot be done.
Papewaio
07-10-2013, 22:00
This is a strange one.
There are so many healthcare systems in the world.
Why not look at the top ten as rated for infant mortality, life expectancy, emergency queue length, surgery queue length.
Then look at the cost to implement these and how they were implemented.
Pick and choose based on real world results.
Fisherking
07-10-2013, 22:09
I would prefer to be optimistic and say it is only a small problem that can quickly brought under control.
I know other governments have done a decent job of it and single payer systems can work.
My pessimism is based on how the US Government tends to function and how Congress behaves.
I am truly sorry to hear that healthcare has skyrocketed to those levels.
I would prefer to be optimistic and say it is only a small problem
It's a huge problem. Costs in the USA healthcare system are completely out of control (http://www.time.com/time/magazine/article/0,9171,2136864,00.html).
Just in the last few years, healthcare as a percentage of our national gross domestic product (http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS) went from 16.6% (2008) to 17.9% (2011).
Note that healthcare growth as a percentage of the economy slowed during this period. And still managed to leave inflation, and every other national economic sector, in the dust.
Like I said, trends that can't continue, don't. My hope is that we have a soft rather than hard landing.
People with money would still find the healthcare they want, only at additional expense than the taxes they already pay
That's how most single-payer systems work. A national baseline of healthcare, and then more or faster or better service if you have the means to pony up. Seems to work pretty well.
My mother and step-father are obsessive Fox News viewers, and they insist that private healthcare is illegal in Great Britain. Because, you know, socialism and stuff. No matter how many times I explained that this was false, to this day they will tell anyone who will listen how private doctors are illegal in Merry Olde Englande.
Fact-free. So much of this debate is blissfully devoid of data and empiricism. Makes me crazy.
Papewaio
07-10-2013, 23:15
In Aus it works like this:
1.5% Medicare tax
After a certain threshold:
1.5% Medicare tax + Private Health Insurance or 2.5% Medicare tax without Private Health Insurance.
Medicare covers the basic health system and it is the primary one for emergency care.
Private health insurance reduces and/or removes private health costs. The private health system allows either a private room in the same hospitals, more options, quicker access via private hospitals etc. Private health is also the primary way for elective surgery.
If you are really rich you could just pay outright for private health. But if you really are rich you would know how to reduce your cost base in the first place.
So it is similar to a free to play game where you can pay to get better outfits or shorter queue to server.
That's how most single-payer systems work. A national baseline of healthcare, and then more or faster or better service if you have the means to pony up. Seems to work pretty well.
My mother and step-father are obsessive Fox News viewers, and they insist that private healthcare is illegal in Great Britain. Because, you know, socialism and stuff. No matter how many times I explained that this was false, to this day they will tell anyone who will listen how private doctors are illegal in Merry Olde Englande.
Fact-free. So much of this debate is blissfully devoid of data and empiricism. Makes me crazy.
If you was curious, the biggest private providers in the UK are Bupa (http://www.bupa.co.uk/).
I would be interested for you to use their "get a quote" to get a price comparison. To see if it is cheaper or more expensive than typical insurance in the US.
For me by myself, it looks between £41-65 per month. So $61-100 in your money.
This could be cheaper due to the public funding aspects as well.
Papewaio
07-11-2013, 04:25
I am with Bupa here. Costs vary by state and type of cover.
I don't have hospital cover just extras such as optical and dental.
So I pay the 2.5% Medicare rate.
a completely inoffensive name
07-11-2013, 06:12
Eventually the US will move to single payer. It's only a matter of time. The current situation will literally choke us to death financially and it has been, and only then will Americans come kicking and screaming to the same policy that every other industrialized nation has adopted.
Union leaders who helped push Obamacare's passage, now seem to be suffering from buyer's remorse...
Union Letter: Obamacare Will ‘Destroy The Very Health and Wellbeing’ of Workers (http://blogs.wsj.com/corporate-intelligence/2013/07/12/union-letter-obamacare-will-destroy-the-very-health-and-wellbeing-of-workers/)
Can't say we didn't try to warn them....
Fisherking
07-15-2013, 17:36
The link didn’t work!
But here it is: http://blogs.wsj.com/corporate-intelligence/2013/07/12/union-letter-obamacare-will-destroy-the-very-health-and-wellbeing-of-workers/
I do find it disturbing that the Named Representatives are called Leader, regardless of what ever title they may have in Congress.
Smacks too much of Der Führer.
Union leaders who helped push Obamacare's passage, now seem to be suffering from buyer's remorse...
Did we read the same letter? They just want some specific changes made to the implementation, and they're using apocalyptic language in a fit of overstatement. Nowhere do they demand the repeal of Obamacare; rather, like everybody with fingers in this pie, they want bits bent to suit their needs. Seems like perfectly normal lobbying.
Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?
Ironside
07-15-2013, 20:33
Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?
Close. Being aware of his forthcoming death, Jimmy Hoffa decided to conduct a biochemical project, where he implanted his genetical material into a living host, where the specimen grew, to eventually emerge after the incubation period ended. Due to limitation in this process, genetical material from the host were also used, creating only a partial clone, that despite having a diffferent upbringing decided to pursue a similar career.
Or in other words, he had a son.
Fisherking
07-15-2013, 21:19
Did we read the same letter? They just want some specific changes made to the implementation, and they're using apocalyptic language in a fit of overstatement. Nowhere do they demand the repeal of Obamacare; rather, like everybody with fingers in this pie, they want bits bent to suit their needs. Seems like perfectly normal lobbying.
Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?
It sounded concerned enough for me. I have wondered about those 30 hour part time help limits my self.
If employers have incentives to cut work hours to save an expense they will not hesitate.
I would have also thought that existing employer/union plans would have been grandfathered in.
Tax exemptions and subsidies one would think would be based on income and not on whether the plan was a non profit or for profit plan.
Isn’t supposed to be about getting people affordable health care instead of benefiting large Insurance plans and major health care corporations?
If this were a sane world workers and small businesses would have woken up and seen that both established parties were only out to please the big money of corporations and founded a new party.
Instead they just believe the lies of their preferred group and blame the other side. And nothing changes.
Instead they just believe the lies of their preferred group and blame the other side. And nothing changes.
As stated earlier, I expect that something useful might grow out of the exchanges. Example:
Health Plan Cost for New Yorkers Set to Fall 50% (http://www.nytimes.com/2013/07/17/health/health-plan-cost-for-new-yorkers-set-to-fall-50.html?_r=0)
State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.
Supporters of the new health care law, the Affordable Care Act, credited the drop in rates to the online purchasing exchanges the law created, which they say are spurring competition among insurers that are anticipating an influx of new customers. The law requires that an exchange be started in every state.
-edit, yet another example-
Vermont Releases Final Health Insurance Rates (http://newyork.cbslocal.com/2013/07/16/vermont-releases-final-health-insurance-rates/)
The Green Mountain Care Board — the regulatory authority for insurance and hospital rates in Vermont — announced this week that it negotiated 4.3% to 5.3% rate cuts in individual and small-group plans offered by Blue Cross Blue Shield of Vermont and MVP Health Care. The rates go into effect Jan. 1.
Vermont approved six “metal” plans in its health insurance Marketplace, also called an Exchange. There are two bronze, two silver, one gold, and one platinum plan, each with different combinations of copayments, coinsurance rates, and limits on annual out-of-pocket spending.
McClatchy has reported (http://www.mcclatchydc.com/2013/08/02/198432/most-2013-job-growth-is-in-part.html#.Uf_YWXd_53t) that in 2013, 97% of jobs created have been part-time jobs!~:eek:
Ok, so where does Obamacare come in? Here:
“There is something going on if such a large share of the hiring is part time,” Hall said.
He said the overall share of part-time jobs to all jobs, 19 percent, wasn’t a problem – yet.
Hall speculated that the implementation of the Affordable Care Act, shorthanded as Obamacare, might be resulting in employers shifting workers to part-time status to avoid coming health care obligations.
“There’s been so much talk about the effects of Obamacare on part-time work,” he said. “This is such an unusual thing to see.”
So who's "Hall" you're thinking? From the article...
Hall is no ordinary academic. He ran the Bureau of Labor Statistics, the agency that puts out the monthly jobs report, from 2008 to 2012.
Assuming just a straight hourly wage, companies would prefer to hire full-time over part-time. It would mean less people to train up, less people to manage, and less schedules to coordinate. Any disincentives for full-time employees are going to be attributable to government interference- some necessary.... some not.
Obamacare is saying that if you have employees work for more than 30 hours a week, it's going to cost you more money. So what do you do? Hire as many people at under 30 hours a week as you can. I don't get where you're seeing this as something nefarious on the part of business owners. They're trying to save money- the same as most anyone would.
Fisherking
08-05-2013, 20:33
You still have that two party mind set GC. There are plenty of Rich Corporate Types that pay tribute to the DNC and their candidates. McDonald’s got a government exemption from Obamacare and no one screamed.
Then there are guys like the owner of Obama’s next vacation home. David M. Schulte http://www.chilmarkpartners.com/david-m--schulte-pages-18.php
http://newsbusters.org/blogs/michelle-malkin/2013/08/01/malkin-column-vacationer-obamas-favorite-vineyard-vulture
Personally, I still think the plan is more about helping Insurance Companies than people. But hay, that is just me.
I still think the plan is more about helping Insurance Companies than people. But hay, that is just me.
You're not wrong.
To look at it from a genealogical/Biblical perspective:
Swisscare (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland) begat Heritage Foundationcare (http://youtu.be/6Fsm7em3WWY), which begat Romneycare (http://en.wikipedia.org/wiki/Massachusetts_health_care_reform), which begat Obamacare (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act).
But what got lost pretty much the moment the plan left Switzerland was the deep governmental (and therefore public, and publicly debated) involvement in the foundation-level, minimum insurance. That was tossed out from Heritagecare on (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland#Compulsory_coverage_and_costs).
Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Federal Act. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.
Regulations also restrict the allowable policies and profits that a private insurer may offer, as noted by healthcare economics scholar Uwe Reinhardt in a review in the Journal of the American Medical Association:
"To compete in the market for compulsory health insurance, a Swiss health insurer must be registered with the Swiss Federal Office of Public Health, which regulates health insurance under the 1994 statute. The insurers were not allowed to earn profits from the mandated benefit package, although they have always been able to profit from the sale of actuarially priced supplementary benefits (mainly superior amenities).
Regulations require "a 25-year-old and an 80-year-old individual pay a given insurer the same premium for the same type of policy.... Overall, then, the Swiss health system is a variant of the highly government-regulated social insurance systems of Europe... that rely on ostensibly private, nonprofit health insurers that also are subject to uniform fee schedules and myriad government regulations."
The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.
Papewaio
08-05-2013, 22:46
I take it that the Swiss fees are flat given the example of a 25 yr old paying the same as an 80 yr old.
So I assume the 8% of your income is to cover low wage earners.
Maybe I'm just a poor capitalist because I don't sympathize with them at all, nor do I think they should be doing it. Its not really nefarious, its just lazy and greedy. If our pitiful attempt at subsidized healthcare is going to fail because business owners are cheap, then we should have just fought for true universal healthcare to begin with. The healthcare act, as it is, is a gentle nudge in the right direction for businesses. Chambers of commerce and small business associations can be major republican lobby bases, and I wouldn't be surprised if there was a lot of pressure coming from those places to put the blame on Obamacare and make a public stink about it all. Either way, their reaction proves that they need a harsher prodding instead.Do you go out of your way to pay more for American made products? If not that, do you make sure you only buy FairTrade produce? Do you shop small, local businesses instead of big box stores? If not, can I call you lazy and greedy?
a completely inoffensive name
08-06-2013, 06:15
I remember when I lived in Santa Cruz, they heavily restricted the amount of chain stores coming in. I couldn't find a single McDonalds and I am pretty sure they banned Wal-Mart from coming in entirely.
They had to cave in to the college students though and let about 4 Taco Bells into town.
An interesting historical note from a blogger (http://dish.andrewsullivan.com/2013/08/05/since-when-was-free-loading-a-conservative-value/): Socialized medicine came to the USA in 1986, and was signed into law by Saint Reagan the Immaculate (http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act):
[S]ince 1986, hospitals have been legally required to treat anyone seriously ill who presents himself at an emergency room, with clear medical needs. In the most fundamental way, that was the moment the US socialized medicine – and Ronald Reagan signed the bill. Alas, like so many Reagan domestic initiatives, there was no federal money provided to pay for this. And we all know what happened next: all those extra costs for the uninsured drove up premiums for everyone else, drove up hospital costs, giving them a reason to raise prices even further, and played a role in rendering healthcare unaffordable for many others.
What Obamacare does, like Romneycare before it, is end this free-loading.
The law is telling these young adults that if you want to go without insurance, you are not going to make everyone else pay for it if your risk-analysis ends up faulty. You have to exercise a minimum of personal responsibility to pay for your own potential healthcare. In other words, rights come with responsibilities in a liberal democracy. At least that is what I always understood the conservative position to be.
Kralizec
08-06-2013, 15:47
As far as I know, the Dutch system is superficially similar to the Swiss, in that:
1) health care insurance is mandatory
2) as far as the "base package" is concerned, a government defined group of medical procedures, insurance companies are not allowed to refuse clients. For stuff that's not included, like dental care or eyeglasses, they're a lot more free in what they offer and at which cost.
The insurance obligation lies on the individual; however many employers in the Neth's have brokered deals with insurance companies that allow the employees to apply there at lower rates.
To be clear, is this how Obamacare works (?):
- an individual obligation to get insured
- companies with >X full time employees must offer a collective package for their workforce
Strike For The South
08-06-2013, 15:51
Obamacare is terrible legislation that does nothing but deliver a fat payday to insurance companies. The best healthcare in America is still "Don't get sick, asshole"
The part time jobs thing seems counter intuitive to me. The company I work for is raising wages and making more people full time but hiring less. This seems to be the same course of action other business are taking, based on my conversations. Perhaps this is selection bias.
Companies are going to cut costs. Why let a good crises go to waste? Cut some fat and endear half the country towards you in the process. I feel the same way about the companies that I do the goverment, don't hate them for doing what they were made to do.
To be clear, is this how Obamacare works (?):
- an individual obligation to get insured
- companies with >X full time employees must offer a collective package for their workforce
Yup, that's about the size of it. Major difference is that the controls on the "basic" health insurance aren't nearly as broad or well-defined as the Swiss/Dutch model. And the "X" number is 50, I believe.
It's the best we could do under the circumstances, which is a long way from saying it's good.
If the Republicans ever undo their cranial-rectal inversion (http://www.npr.org/blogs/thetwo-way/2013/05/16/184611542/house-republicans-vote-again-to-defund-obamacare) on the subject, they could be rather helpful in debating it like grownups, and ultimately making its implementation less worse.
Unfunded giveaway to big pharma and seniors? Yes please (http://en.wikipedia.org/wiki/Medicare_Part_D)! Private-insurance-based reform modeled on the Swiss/Dutch model? SOCIALISMO!
If the Republicans ever undo their cranial-rectal inversion (http://www.npr.org/blogs/thetwo-way/2013/05/16/184611542/house-republicans-vote-again-to-defund-obamacare) on the subject, they could be rather helpful in debating it like grownups, and ultimately making its implementation less worse.
Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.
Fisherking
08-06-2013, 17:26
Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.
That is nothing new, just the Out of Power Syndrome.
That is nothing new, just the Out of Power Syndrome.
Actually, by any objective metric you care to choose (http://www.washingtonmonthly.com/political-animal/2011_12/unprecedented_obstruction_and033982.php), the Republican congressional members under the Obama admin have taken obstructionism to new and uncharted heights. Among other achievements, they've pretty much wrecked the filibuster (http://tpmdc.talkingpointsmemo.com/2013/08/gop-telegraphs-mass-filibuster-of-top-judicial-nominees.php).
To say they're just experiencing Out of Power Syndrome is willfully ahistorical.
Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.I'm morally opposed to the mandate, but it'd be a lot easier to swallow if it allowed for low-priced catastrophic / high deductible plans. From what I've seen, even the bronze level plans are required to offer comprehensive coverage. But then, making young, healthy people pay for coverage they don't need is how Obamacare gets the numbers to add up...
Any real healthcare insurance reform (let's face it, that's what it is- not healthcare reform, but insurance reform) needs to decouple coverage from employment. I don't know that Obamacare helps much in that regard.
Fisherking
08-06-2013, 19:26
Actually, by any objective metric you care to choose (http://www.washingtonmonthly.com/political-animal/2011_12/unprecedented_obstruction_and033982.php), the Republican congressional members under the Obama admin have taken obstructionism to new and uncharted heights. Among other achievements, they've pretty much wrecked the filibuster (http://tpmdc.talkingpointsmemo.com/2013/08/gop-telegraphs-mass-filibuster-of-top-judicial-nominees.php).
To say they're just experiencing Out of Power Syndrome is willfully ahistorical.
Seems just like what the Democrats did with W. I guess they are still learning. They both play this little games. I thought ‘what comes around goes around’ was rich because she was there when it was them holing up nominations. But I expect most people may have covalently forgotten that.
Fisherking
08-06-2013, 21:25
Its all in the numbers dude. This congress has accomplished less than any other congress. They've accomplished much less than half of a particular congress that was actually dubbed the "Do-Nothing" congress.
Judging form what gets passed when they work, I would count that as a big plus.
:laugh4:
Its all in the numbers dude. This congress has accomplished less than any other congress. They've accomplished much less than half of a particular congress that was actually dubbed the "Do-Nothing" congress.
Why is that a bad thing? When everything they do is a screwup, maybe nothing is better. What happened to the people who used to wish for gridlock?
Personally, I think number of bills passed is a very poor metric for success...
As to the filibuster, it's been wrecked ever since they decided you could have endless debate without actually having to debate (or speak). :yes:
Seems just like what the Democrats did with W. I guess they are still learning. They both play this little games. I thought ‘what comes around goes around’ was rich because she was there when it was them holing up nominations. But I expect most people may have covalently forgotten that.
The difference between the Dems with W and the GOP with Obama is huge. The Dems would whine and complain for a while, then cave in when the right-wingers started calling them freedom-hating pinkos. Pelosi and Reid were spineless and naive as party leaders, and it never even occured to them to shut things down like the GOP is doing at the moment. And now they only have themselves to blame, since Reid is the one responsible for shutting down the Senate with the 60-vote rule. Self-serving idiots, the both of them.
Halting nominations is child's play compared to the current situation.
Kralizec
08-07-2013, 01:01
I'm morally opposed to the mandate, but it'd be a lot easier to swallow if it allowed for low-priced catastrophic / high deductible plans. From what I've seen, even the bronze level plans are required to offer comprehensive coverage. But then, making young, healthy people pay for coverage they don't need is how Obamacare gets the numbers to add up...
That really depends on...which way you look at it, or something.
Young people not wanting to be in the same insurance scheme as old people is an example of negative selection. Meaning; you think that being in the same pool as some old guy (more prone to disease) is a bad choice, and so you refuse. As a result, the insurance payments of all the old people will rise.
As a young person, I'm in effect paying for the medical care of the elderly. But since I hope and expect to become old too, I don't think it's unfair. Besides, the scheme also covers a lot of treatments that could theoretically befall me too and which I can't possibly afford on my own. Insurance is a form of solidarity.
There will always be questions: in one case, I remember looking at the optional choices of one insurance company and noticed that the only way I could get dental coverage with that company was to buy Package A which included dental care but also various forms of bull****, sometimes called "alternative medicine". I refused out of principle, which is another form of negative selection I suppose.
If you accept that it's morally undesirable to deny a patient treatment for a certain condition, then mandatory insurance is pretty much inevitable.
NBC realizes the obvious (http://investigations.nbcnews.com/_news/2013/08/13/20010062-businesses-claim-obamacare-has-forced-them-to-cut-employee-hours?lite)...
Employers around the country, from fast-food franchises to colleges, have told NBC News that they will be cutting workers’ hours below 30 a week because they can’t afford to offer the health insurance mandated by the Affordable Care Act, also known as Obamacare.
“To tell somebody that you’ve got to decrease their hours because of a law passed in Washington is very frustrating to me,” said Loren Goodridge, who owns 21 Subway franchises, including a restaurant in Kennebunk. “I know the impact I’m having on some of my employees.”
Many of us have been pointing this out since the law was passed- better late than never NBC.
Papewaio
08-15-2013, 09:27
Really poorly implemented. Just pick any other first world country and implement their health system. It will be better, faster and cheaper then what this monstrosity will get you.
I cannot point to a more expensive, less effective health system then that in the US.
NBC realizes the obvious (http://investigations.nbcnews.com/_news/2013/08/13/20010062-businesses-claim-obamacare-has-forced-them-to-cut-employee-hours?lite)...
Many of us have been pointing this out since the law was passed- better late than never NBC.
Perhaps less regulation would fix the issue?
a completely inoffensive name
08-16-2013, 00:37
The free market stinks at organizing the distribution of anything that is not a non-essential, consumable product. How long until the US figures that out?
Obama's hometown newspaper takes a dump (http://my.chicagotribune.com/#section/-1/article/p2p-77808576/) on Obamacare.
If you've tried to sign up online for health coverage under the problem-plagued Obamacare exchange, our sympathies. Many people have tried to create accounts and shop for insurance under the new law. Few have succeeded. Those that have enrolled have found that the system is prone to mistakes. Some applications have been sent to the wrong insurance company.
Wait. It gets worse. Those who have managed to browse the marketplace have often been hit by sticker shock. Take Adam Weldzius, a nurse practitioner and single father from Carpentersville. He sought the same level of coverage on the exchange as he and his 7-year-old daughter have now, with the same insurer and the same network of doctors and hospitals. At best, Weldzius found, his monthly premium of $233 would more than double. If he chose a plan priced at the same level, the annual deductible would be $12,700, more than three times his current $3,500 deductible.It goes on, but you can read it yourself.
If you like your insurance you probably won't get to keep it. If you like your doctor, you might not keep him. Higher premiums, higher deductibles. None of it should be a surprise to anyone.
For giggles, here's a DailyKos blogger (http://www.dailykos.com/story/2013/09/30/1242660/-Obamacare-will-double-my-monthly-premium#) who is shocked- shocked that his insurance premiums are going to double...
My wife and I just got our updates from Kaiser telling us what our 2014 rates will be. Her monthly has been $168 this year, mine $150. We have a high deductible. We are generally healthy people who don't go to the doctor often. I barely ever go. The insurance is in case of a major catastrophe.
Well, now, because of Obamacare, my wife's rate is gong to $302 per month and mine is jumping to $284.
I am canceling insurance for us and I am not paying any fucking penalty. What the hell kind of reform is this?
Oh, ok, if we qualify, we can get some government assistance. Great. So now I have to jump through another hoop to just chisel some of this off. And we don't qualify, anyway, so what's the point?
I never felt too good about how this was passed and what it entailed, but I figured if it saved Americans money, I could go along with it.
I don't know what to think now. This appears, in my experience, to not be a reform for the people.
What am I missing?
The theme seems to be that if you are young and relatively healthy, you can expect to pay a lot more for healthcare.
So basically you're unable to fix a broken system?
So basically you're unable to fix a broken system?
Nobody has asked me to. :shrug:
Personally, were I to replace the old broken system with a new broken system, I'd try to make sure it's not worse. I know that's a high standard for politicians though.....
Nobody has asked me to. :shrug:
Personally, were I to replace the old broken system with a new broken system, I'd try to make sure it's not worse. I know that's a high standard for politicians though.....
Not you personally, your country.
Seamus Fermanagh
10-16-2013, 16:12
The higher rates are a necessity. Adverse selection under the must-insure clause of the ACA guarantees participation by those in greatest need. Costs to insure must be passed on to the broader population or the whole system goes teats up in a hurry. If they truly wish for this new system to work, they are going to have to ramp up the penalties to a level at or near the cost of the least expensive exchanges. Otherwise, the very folks required to make the new system fiscally sound by putting in their higher premiums for relatively little service will opt out, pay the small fine, and self-insure their limited risk until they become chronically ill and the exchange represents an economic windfall.
Montmorency
10-16-2013, 16:20
I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.
The higher rates are a necessity. Not just for the reasons you mention. What happens to prices when you increase demand for a good or service while having the same or decreased supply?
Seamus Fermanagh
10-16-2013, 17:24
I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.
The total cost of care cannot be lower and must be significantly higher. Government figures suggest roughly 15% of all Americans are uninsured. 70% of that figure is uninsured for economic reasons -- coverage being too costly. Another portion cannot get insurance because they have been denied coverage due to pre-existing conditions that generate a high morbidity risk (these people were screened out of coverage by Insurance companies because insuring them, with their high likelihood of high costs, would have jacked up the overall rates of the coverage more.
Thus, in trying to cover everybody, we are increasing the number of people to be insured by 15-17 percent (depending on illegals). Moreover, some of those 15% include high morbidity cost individuals who are likely to create a greater cost vector than the "average" person. Let us assume that, all things being equal, aggregate cost of healthcare increases by 16% solely on volume (I would actually presume it to be more).
Some of this is supposed to be "headed off at the pass" by a greater reliance on preventive medicine to minimize the need for more costly interventions later. Recent projections put this savings at less than one quarter of one percent...but let's be perky and assume that over time we can make that a full 5%.
That takes our 116% total health costs and drops it back to 110% of current (again, I think I am being kind). However, 60% of that increased medical need (the uninsured) are because they cannot afford it NOW (poor, working poor, above poverty level but no room for frills). So that cost factor MUST be shoved onto those who are already paying (directly or indirectly) for their own insurance. If it isn't, it must be absorbed as additional debt by the Government.
In addition to those for whom the health care exchange packages must be more or less fully subsidized, other groups are being subsidized by the government as well, particularly for those in what we label our "lower middle class," to make their care "affordable." Those subsidies too must be passed on to the full price paying customers or absorbed as debt.
Costs for health care cannot go down and must go up. TANSTAAFL.
Montmorency
10-16-2013, 17:35
The total cost of care cannot be lower and must be significantly higher.
Nonsense. The list of treatments, tests, medications, etc. that are identical from country to country yet 5, 10, 20, or more times as expensive in the United States is of untold length. The fact of the matter is that there is a price-race between hospitals and insurance agencies and that obliterating the highly-inflated costs of the medical sector would easily permit the underfunded individuals that ACA purports to service to obtain affordable insurance on their own initiative.
Costs for health care cannot go down and must go up.
No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:
No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:That's the whole premise of insurance. Who cares what it costs? It's not my money!
It's not surprising that costs spiral upwards when you setup perverse incentives like this....
Seamus Fermanagh
10-16-2013, 18:43
Nonsense. The list of treatments, tests, medications, etc. that are identical from country to country yet 5, 10, 20, or more times as expensive in the United States is of untold length. The fact of the matter is that there is a price-race between hospitals and insurance agencies and that obliterating the highly-inflated costs of the medical sector would easily permit the underfunded individuals that ACA purports to service to obtain affordable insurance on their own initiative.
....
No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:
My comments were directed at the current system as modified by the ACA. What you are suggesting would involve a far more sweeping alteration than what is scheduled to occur. Perhaps we will head that way in time, but that is not the impact this law, as currently constituted, will have.
Montmorency
10-16-2013, 18:48
Fair enough, though I don't see why
Costs for health care cannot go down and must go up.
would be justified even in a narrow context.
It really is an alarming thought.
Seamus Fermanagh
10-16-2013, 19:25
Of course it is alarming. That's one of the reasons so many on the political right in the USA oppose it -- and I am not talking about the fruit bat fringe.
The basic idea is that more people will be provided service (the purpose of the act in the first place). That greater total amount of service will require more health care spending overall, even if there is somewhat less spending on a per capita basis (which is being argued).
Can that be altered? Yes.
To alter it in a substantial way would require:
1) A decrease in services.
2) An alteration in the services provided (shift to preventative for example).
3) An alteration in the population's behavior (overeating, under-exercising, & tobacco use).
4) Price controls on various elements of the health care system, notably salaries for medical licensed health care providers.
or some combination of 1-4.
#1 runs counter to the stated goal of making health care better for all, while 3 & 4 are problematic in implementation under our current system of governance. 3 & 4 would really only become possible under a full-on national health care system.
I should note here that any number of those on America's political left, along with some issue-by-issue types among the moderates, are angry with the situation and with the ACA precisely because it does NOT take the necessary steps to shift us to a true national health care system. I suspect that they're frustrated as well precisely because they believe that nothing less than such a system could truly influence the largest components of American Health Care costs: Poor lifestyle choices, Physician and specialist salaries, and Medical malpractice/insurance therefrom.
Poor lifestyle choices, Physician and specialist salaries, and Medical malpractice/insurance therefrom.
To which I would add the biggest rotting apple in the barrel: Unrealistic pricing.
You don't see many $500 hammers like you did in the old days of government contracting, but now you see plenty of $800 bags of saline solution that cost $1 to manufacture and distribute.
Price gouging, like so many government functions, has been privatized.
Montmorency
10-16-2013, 19:59
Unfortunately I doubt that the long-term trend would look much different with a continuation of the (former) status quo. The ACA isn't enough, but it's conceivable that overall the net is at least a little benefit. It could also be argued for as a component of a minimalist program - after all, the TPers weren't just spontaneously generated by the mooting of health-care reform...
notably salaries for medical licensed health care providers.
First, get at the chargemasters and the admin layers. If services rendered become much cheaper, insurers will in turn be left without an excuse to maintain high premiums. Physician and specialist salaries are not so harmful as the rest.
An alteration in the services provided (shift to preventative for example).
Simultaneously with discouragement of reflexive recourse to maximalist end-of-life care.
Consider not commissioning 6-figures in services to keep gramps vegging along for another few weeks or months.
Montmorency
10-16-2013, 20:23
Furthermore: Get providers to treat tried-and-true technologies and procedures with more respect, as opposed to pushing the latest pricy-yet-ineffective 'device of wonder' on credulous or bewildered patients. It makes no sense to invest hugely in expensive-but-unproven techs, especially with short-term obsolescence being the norm, unless it's all just a marketing trick on the part of hospitals, far closer to rock-walls and multimedia centers at colleges than anything else...
This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'
Seamus Fermanagh
10-16-2013, 20:42
To which I would add the biggest rotting apple in the barrel: Unrealistic pricing.
You don't see many $500 hammers like you did in the old days of government contracting, but now you see plenty of $800 bags of saline solution that cost $1 to manufacture and distribute.
Price gouging, like so many government functions, has been privatized.
Most of which is nothing but a game. The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels. Insurance pays 32. The whole thing is a damn shell game.
Seamus Fermanagh
10-16-2013, 20:44
...This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'
Now you're calling on a full-on alteration of a culture. Such changes rarely happen swiftly and virtually never by fiat. In fact, that last statement -- I deserve the best -- is much of the practical motivation behind the ACA, at least as far as creating the political support for it.
Montmorency
10-16-2013, 20:52
Heh, maybe there could be workarounds that don't entail tackling it head-on?
I'm just outlining detrimental elements of the system; of course I lack the ability to compel them out of existence by "fiat".
I'm just one of the tourists. :shrug:
a completely inoffensive name
10-16-2013, 20:58
This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'
Nonsense. Science and technology will deliver unto us all, heaven on Earth. Who are you to decide that my grandma should not get as many procedures and machines as possible?
DEATH PANELS
The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels.
There's truth in what you say, but the bolded bit is ... shall we say an extremely generous interpretation of hospital behavior.
Seamus Fermanagh
10-17-2013, 00:26
There's truth in what you say, but the bolded bit is ... shall we say an extremely generous interpretation of hospital behavior.
Well, one of the costs they are offsetting is that of indigents and illegals receiving primary care in hospital emergency rooms on a (like it or not) pro bono basis. It must mount up somewhere, because as a sector (http://www.yardeni.com/pub/sp500margin.pdf) health care facilities don't show huge profit margins compared to pharmaceuticals (license to print money) or biotechnology (license to print money in large denominations).
Still, it must be noted that the ACA is an attempt (how effective we shall see) to stop the entirely pro bono care in emergency rooms in favor of complete health coverage and increased preventative care.
Kralizec
10-17-2013, 01:06
Out of random curiosity...
Mandatory insurances have existed in the Neth's for a considerable time now in some form or another. There is a group of people here, which was never that big and is considerably diminished today, which is opposed to the very concept of insurance on religious grounds. I gather that their idea is that random misfortunes are not random at all, but the Will of God, and that it's blasphemy or at least hubris to try to avoid the consequenses.
Is this line of thought at all common in the US?
Seamus Fermanagh
10-17-2013, 05:27
Out of random curiosity...
Mandatory insurances have existed in the Neth's for a considerable time now in some form or another. There is a group of people here, which was never that big and is considerably diminished today, which is opposed to the very concept of insurance on religious grounds. I gather that their idea is that random misfortunes are not random at all, but the Will of God, and that it's blasphemy or at least hubris to try to avoid the consequenses.
Is this line of thought at all common in the US?
No. Those who believe in full and complete pre-ordination are quite rare.
The Lurker Below
10-17-2013, 22:06
I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.
Not sure if serious. I enjoyed the chuckles anyhow. Liberals feel less miserable only when everybody feels some of the misery.
Papewaio
10-17-2013, 22:09
Not just for the reasons you mention. What happens to prices when you increase demand for a good or service while having the same or decreased supply?
Increased demand causes increased cost.
However you need to do a couple more iterations on this one or all you will do is prove firemen cause fires.
There is also the reduced cost in supplying something that is mass manufactured particularly designed once electronically manufactured many times.
There is no overall increased demand for being ill. People get sick regardless of having insurance or not. The overall healthcare system ie private and public has to care for the people and with chronically ill rarely if ever recovers any money.
What is increasing is demand for the insurers product. Which is highly scalable. What isn't is the doctors and hospitals so the insurers will be in a bidding war and/or build their own training hospitals to provide sufficient coverage. If anything they will make it scalable by trading between each other at a pittance and making the patients pay a significant markup ie ATMs
Papewaio
10-17-2013, 22:13
Nonsense. Science and technology will deliver unto us all, heaven on Earth. Who are you to decide that my grandma should not get as many procedures and machines as possible?
Given how much Monty spanks your butt I always assumed Monty was your grandma...
Montmorency
10-18-2013, 00:34
Given how much Monty spanks your butt
???
...
Oh.
OOOOHHHHH
...
How much do you want?
Proletariat
10-18-2013, 03:38
But the loser of the game is the self covered or out of pocket customer. They get the full 800$ charge for salt water in a plastic wrap and are charged 2 dollars each Tylenol administered when a bottle of hundreds costs under a few dollars at Costco. The problem of the insane pricing and the 'charge list' charade was examined in Time magazine a year back really well. It's what's wrong with healthcare and no one gets into it. Much more important than tort reform second maybe only to national health care or public option decision. That its just standard to not be told what any of the arbitrary or jacked up charges are being leveled at you by your healthcare provider is maddening. No one would accept buying software or food this way. So the freemarket works there in a way it can't in healthcare.
What I've learned as a therapist in the US army, some hospitals and some nursing centers for ten years. We're all being fleeced.
Most of which is nothing but a game. The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels. Insurance pays 32. The whole thing is a damn shell game.
I few years ago I had to get a chest x-ray and I didn't have insurance coverage. I called several hospitals... and none of them could tell me what a chest x-ray would cost me out of pocket. They honestly did not know. I was transferred to different departments, talked to different people, I never got a clear answer. Basically, I would have to come get the x-ray and they'd bill me- then I'd know what it costs.
Finally I found an outpatient surgery center in the phone book and they told me- $80. So guess where I went?
The point is- healthcare providers and consumers are both far isolated from the actual costs of their services. There is zero incentive on either side to keep costs low. If you want to see costs go down, you have to make people care what their healthcare costs.
If my car needs work done, I shop around for the best deal. People need to do the same for healthcare. For emergencies, you don't have much choice- but for everything else, there should be a price incentive.
There is no overall increased demand for being ill. People get sick regardless of having insurance or not. The overall healthcare system ie private and public has to care for the people and with chronically ill rarely if ever recovers any money.This is a gross oversimplification. The threshold at which people seek treatment can vary greatly. If you have costly coverage or no coverage, you're less likely to go to a doctor for less serious problems.
Seamus Fermanagh
10-18-2013, 16:45
But the loser of the game is the self covered or out of pocket customer. They get the full 800$ charge for salt water in a plastic wrap and are charged 2 dollars each Tylenol administered when a bottle of hundreds costs under a few dollars at Costco. The problem of the insane pricing and the 'charge list' charade was examined in Time magazine a year back really well. It's what's wrong with healthcare and no one gets into it. Much more important than tort reform second maybe only to national health care or public option decision. That its just standard to not be told what any of the arbitrary or jacked up charges are being leveled at you by your healthcare provider is maddening. No one would accept buying software or food this way. So the freemarket works there in a way it can't in healthcare.
What I've learned as a therapist in the US army, some hospitals and some nursing centers for ten years. We're all being fleeced.
When I've insisted on paying out of pocket, or when the mother in law goes out of pocket to her dentist, there are different prices available. One can even negotiate a bit on them (the mother in law has few teeth left of her own, getting her cleanings done at the pediatric rate by arrangement).
On the other hand, prole', I do not doubt that many (most? all?) of us ARE being over-charged. As you have direct industry experience and I have not, your points carry weight with me. I've argued before that the current system is, in some ways, the proverbial camel (horse designed by committee) with too many in-built gaffes and shenanigans. It is neither a fee-for-service with insurance negotiated to suit each client situation NOR a government mandated and controlled system that is applied equally to all. It is a Frankenstein of both.
My thrust here has been to argue that the ACA is not going to get the job done in terms of making things better.
As the reports come in documenting the logistical train wreck that has been the Obamacare exchanges, we're beginning to hear murmurs that suggest that it may be postponed anyway, lest it collapse under it's own fail.
Obamacare Website Failure Threatens Health Coverage For Millions Of Americans (http://www.huffingtonpost.com/2013/10/18/obamacare-train-wreck_n_4118041.html?utm_hp_ref=politics&ir=Politics)
Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need, Laszewski said. That would make the pool of people covered very costly, causing health insurers to lose money and likely rethink whether they want to participate in the exchanges, he said. "The fundamental threat to Obamacare is we don't get enough healthy people in the pool to keep the rates reasonable, and they are in grave danger of that problem," he said.
If these problems persist longer -- weeks, months, a whole year -- the entire Obamacare project falls apart, Laszewski said: "It's a holy shit moment."
"Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need"—yup, that's the scariest part.
Interesting that the Obama campaign was a best-practices model of how to do web, but once normal federal procurement is the basis, it all breaks down. Ah, dysfunction. Good article about it here (http://www.npr.org/2013/10/17/235739367/if-a-tech-company-had-built-the-federal-health-care-website).
The launch of the federal Obamacare website has been unforgivable, for a variety of reasons. Just a shocking mess. And I suspect it was preventable.
"Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need"—yup, that's the scariest part.Are you being serious? .....I cant tell. :inquisitive:
Of course I'm being serious. The whole Swiss (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland)/Heritage Foundation (http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html)/Romneycare (http://en.wikipedia.org/wiki/Massachusetts_health_care_reform)/Obamacare (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act) premise is based on the idea of broadening the insurance pool so that the high-risk, high-usage patients are balanced out by healthy people. A system that (through incompetence) encourages only the high-risk people to enroll is broken, utterly broken. It's bad news. It flips the bird at the whole let's-do-universal-insurance-with-private-insurers concept. It's nine or ten shades of bad.
a completely inoffensive name
10-18-2013, 21:15
Given how much Monty spanks your butt I always assumed Monty was your grandma...
https://i.imgur.com/BBjlvOJ.jpg
Well, October is drawing to a close, and Healthcare.gov is still a virtually unusable mess (http://www.cbsnews.com/8301-250_162-57609316/healthcare.govs-problems-technical-and-political-run-deep/).
The administration is now promising that the site's problems will be, for the most part, resolved by the end of November. Yet even if the technical glitches on HealthCare.gov are resolved, this week revealed that the new insurance marketplaces the site serves still need to overcome huge hurdles, both technically and politically, to succeed.
The end of Novermber? Awesome.
Now we're also learning that at least part of the reason for the website's failed rollout was due to political concerns...
CBS News' Sharyl Attkisson has been digging into the cause of the delays in preparing the website for the government's health insurance market and has learned was a major interruption in the months before President Obama's re-election. At the height of the 2012 presidential election campaign, it was crunch time for the Obama administration to release key instructions so contractors could work toward the October 2013 deadline.
But a Health and Human Services official who was closely involved tells CBS News that in late summer, the administration stopped issuing proposed rules for the Affordable Health Care Act until after the election.
The result was what many viewed as a serious delay as contractors, states and insurance companies awaited crucial guidance to move forward.
And at the risk of beating a dead horse, if you like your insurance.... no, you can't keep it. :no:
Gerry Kominski, director of public health policy at UCLA said: "About half of the 14 million people who buy insurance on their own are not going to be able to keep the policies that they had previously."
Lastly, the administration has been trying to point to the state-run exchanges as an Obamacare success. Some of them aren't experiencing the same level of technical glitches, but not everything is unicorns and rainbows there either- new Medicaid enrollments (expanded under Obamacare) are far outpacing actual insurance registrations....
a CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there's concern there won't be enough healthy people buying health insurance for the system to work.
As the Obamacare website struggles, the administration is emphasizing state-level success. President Obama said Monday, "There's great demand at the state level as well. Because there are a bunch of states running their own marketplaces."
But left unsaid in the president's remarks: the newly insured in some of those states are overwhelmingly low-income people signing up for Medicaid at no cost to them.
Matt Salo, executive director of the National Association of Medicaid Directors, said, "We're seeing a huge spike in terms of Medicaid enrollments."
He says the numbers have surprised him and state officials.
The technical incompetence of the web portal, at least, could have been avoided. However, all these other "unforseen" problems have been pointed out repeatedly- before, during, and since the law's passage.
According to an NBC investigation (http://investigations.nbcnews.com/_news/2013/10/28/21213547-obama-admin-knew-millions-could-not-keep-their-health-insurance?lite), Obama knew he was lying when he repeatedly stated "If you like your heath insurance, you can keep it.", and the law was written in such a way to make it almost impossible for a plan to get 'grandfathered' in.
President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.
Here's the real money shot from the article:
George Schwab, 62, of North Carolina, said he was "perfectly happy" with his plan from Blue Cross Blue Shield, which also insured his wife for a $228 monthly premium. But this past September, he was surprised to receive a letter saying his policy was no longer available. The "comparable" plan the insurance company offered him carried a $1,208 monthly premium and a $5,500 deductible.
And the best option he’s found on the exchange so far offered a 415 percent jump in premium, to $948 a month.
"The deductible is less," he said, "But the plan doesn't meet my needs. Its unaffordable."
"I'm sitting here looking at this, thinking we ought to just pay the fine and just get insurance when we're sick," Schwab added. "Everybody's worried about whether the website works or not, but that's fixable. That's just the tip of the iceberg. This stuff isn't fixable." And that, folks, will be why the ACA fails.
ICantSpellDawg
10-29-2013, 01:28
Of course I'm being serious. The whole Swiss (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland)/Heritage Foundation (http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html)/Romneycare (http://en.wikipedia.org/wiki/Massachusetts_health_care_reform)/Obamacare (http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act) premise is based on the idea of broadening the insurance pool so that the high-risk, high-usage patients are balanced out by healthy people. A system that (through incompetence) encourages only the high-risk people to enroll is broken, utterly broken. It's bad news. It flips the bird at the whole let's-do-universal-insurance-with-private-insurers concept. It's nine or ten shades of bad.
I've been as patient as an ideological opponent can possibly be. When a law passes called "the affordable care act" is it ignorant to believe that at least someone wants it to make care more affordable? It is now less affordable for everyone I've spoken to, blue collar, white collar, no collar.
My healthy brother had a $98 catastrophic policy. It cancels in January because it fails to adhere to new insurance guidelines and has been replaced by a $260 per month catastrophic policy which he intends to drop and instead pay the $300 per year penalty (approx 1% of his income). His unhealthy brother (me) had a $510 policy which cancels in January and is replaced by a $628 per month policy. Additionally, my gastroenterologist is not covered under this plan.
My idiotic friend who loves everything Barack Obama and is an environmental science major and started his own business is super excited to find a policy that he can finally afford. The site doesn't work. If he couldn't afford the $98 per month policy that my brother had, what makes him think that he can suddenly afford the $300 policy that may or may not be available if the website starts working?
The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.
Personally, I would like to see itemized and standard deductions on tax returns for health costs eliminated and see HSA's open up to everyone regardless of the deductible size of their health plans, for starters. I'm open to mandating that employers make an HSA available to all employees for pre-tax deduction of income. Likewise, I'm open to forcing employers to make health insurance portable, pre-tax for employee the and cutting employer benefit. These are things that shouldn't cost the employer money, but will merely give all employed individuals access to these things and allow individuals to get the tax relief. It will also allow the individual to shop around and simply let his employer know when he or she has signed a contract with a new company. This will also help avoid individuals lapsing coverage. This type of competition has led to low cost of car insurance and has never thrived in the health insurance market.
As a former insurance agent and claims adjuster, irresponsible people will NEVER fail to lose coverage through non-pay termination. This is because poor people are too physically or mentally I'll, or are morons (by nature, culture, or opportunity). Something as important as health insurance cannot be allowed to expire like a morons car insurance.
Seamus Fermanagh
10-29-2013, 04:55
I've been as patient as an ideological opponent can possibly be. When a law passes called "the affordable care act" is it ignorant to believe that at least someone wants it to make care more affordable? It is now less affordable for everyone I've spoken to, blue collar, white collar, no collar.
My healthy brother had a $98 catastrophic policy. It cancels in January because it fails to adhere to new insurance guidelines and has been replaced by a $260 per month catastrophic policy which he intends to drop and instead pay the $300 per year penalty (approx 1% of his income). His unhealthy brother (me) had a $510 policy which cancels in January and is replaced by a $628 per month policy. Additionally, my gastroenterologist is not covered under this plan.
My idiotic friend who loves everything Barack Obama and is an environmental science major and started his own business is super excited to find a policy that he can finally afford. The site doesn't work. If he couldn't afford the $98 per month policy that my brother had, what makes him think that he can suddenly afford the $300 policy that may or may not be available if the website starts working?
The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.
Personally, I would like to see itemized and standard deductions on tax returns for health costs eliminated and see HSA's open up to everyone regardless of the deductible size of their health plans, for starters. I'm open to mandating that employers make an HSA available to all employees for pre-tax deduction of income. Likewise, I'm open to forcing employers to make health insurance portable, pre-tax for employee the and cutting employer benefit. These are things that shouldn't cost the employer money, but will merely give all employed individuals access to these things and allow individuals to get the tax relief. It will also allow the individual to shop around and simply let his employer know when he or she has signed a contract with a new company. This will also help avoid individuals lapsing coverage. This type of competition has led to low cost of car insurance and has never thrived in the health insurance market.
As a former insurance agent and claims adjuster, irresponsible people will NEVER fail to lose coverage through non-pay termination. This is because poor people are too physically or mentally I'll, or are morons (by nature, culture, or opportunity). Something as important as health insurance cannot be allowed to expire like a morons car insurance.
Gelcube will get his wish and you will not get yours.
As the adverse selection bias by higher risk insureds magnifies the functional cost of the plan -- since it will be cheaper to pay the penalty than the premiums -- the strain on the insurance industry will force the government to make changes to maintain healthcare affordability and rescue the system.
In fairly rapid stages, this will lead us to a national health system. This has been a major goal among numerous democratic party leaders for a generation. This is simply a step on the path.
Establishment of a national health care system will bring us in line with the developed countries and will almost complete the social safety network that is expected in a developed country (Old Age Pension, minimum subsistence allowance for the indigent, healthcare, education [partial]). Once undergraduate education is placed under government control the support network will be complete. The current administration has already begun that part of the process (http://articles.washingtonpost.com/2013-08-22/politics/41435414_1_molly-corbett-broad-president-obama-tuition)as well.
ICantSpellDawg
10-29-2013, 05:26
We'll see what happens. Who knows. I don't believe in pre-destination and I don't believe that Democrats are particularly competent. I know that Republicans aren't competent, they don't even pretend to be. They just want to take the power away from the incompetent narcicists.
One could say; if they can't be trusted to put out a website, why should we just ante up and put something so important in the hands of fools?
Republican strategy is to throw a monkey wrench in government. If the Democrats think that ruining government will make people want more, I would suggest that they are mistaken.
Reality has a liberal bias.
The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.
"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."
It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.
Seamus Fermanagh
10-29-2013, 13:28
"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."
It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.
Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.
Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.
The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.I agree insofar as the website not being the "big" story, but the magnitude of the technical failure that is heathcare.gov is most definitely not being overblown....
They didn't begin any actual testing of the site until just a couple weeks before launch- far too late to make any significant changes. But, even with the testing they did, the website was crashing under a load of just a few hundred users (http://www.cnn.com/2013/10/22/politics/obamacare-website-problems/)- on a website that was expecting to receive millions. Some problems are to be expected when you roll out a major e-commerce portal. The problems with heathcare.gov go far beyond that. It was essentially non-functional on its go-live date.
The President's healthcare sign-up web page was supposed to handle tens of thousands of people at once. But in a trial run days before its launch, just a few hundred users flatlined the site.
Despite the problems, federal health officials pushed aside the crash cart and rolled out HealthCare.gov on October 1 as planned, The Washington Post reported.
As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan. Either we achieve something similar to the Swiss model, which is what all of these plans are based on, or we fall back into the Reagan-created (http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act) jackalope socialist/crony capitalist hybrid.
As a tonic and corrective, have a quick read about Ron Paul's campaign manager, who died of pneumonia with massive debt (handed on to his surviving mom), because the jackalope insurance system ratcheted up his rates due to a pre-existing condition.
This is what Randian freedom looks like (http://gawker.com/5840024/ron-pauls-campaign-manager-died-of-pneumonia-penniless-and-uninsured), folks. Drink it in.
Back in 2008, Kent Snyder — Paul's former campaign chairman — died of complications from pneumonia. Like the man in Blitzer's example, the 49-year-old Snyder was relatively young and seemingly healthy* when the illness struck. He was also uninsured. When he died on June 26, 2008, two weeks after Paul withdrew his first bid for the presidency, his hospital costs amounted to $400,000. The bill was handed to Snyder's surviving mother, who was incapable of paying. [...]
After Snyder's death, Paul posted a message to the website for his Campaign for Liberty — a pre-Tea Party organization which served Paul as both presidential marketing tool and platform to promote his non-interventionist, free market ideals.
He wrote:
"Like so many in our movement, Kent sacrificed much for the cause of liberty. Kent poured every ounce of his being into our fight for freedom. He will always hold a place in my heart and in the hearts of my family."
And that, friends, is what freedom is really all about.
The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.
Single-payer is the only way we are going to get through the baby boomer termination years without the medical industrial complex taking all our money (either via insurance or inherited debt). Having the most selfish generation cling to life regardless of cost and quality will surely bankrupt us otherwise.
As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan. The ACA isn't realistic. :no:
The ACA isn't realistic. :no:
If "realistic" equals X, then give X value of, "Coherent plan based on real-world model that has some chance of being enacted in current dysfunctional political climate."
Obviously there are other plans that are implemented by other industrialized nations, some of which are far superior to the Swiss model. None would make it through the toxic swamp we call Congress.
Your free-market-everything notions are no more likely to be enacted than a Norwegian-style single-payor system.
I realize that sitting in a padded, wing-backed chair made entirely of radical ideology is, if nothing else, comfy—but on this issue I would appreciate seeing you step outside of your comfort zone and address what is possible, all things considered.
The Swiss model (as mutated through HeritageCare, RomneyCare, and Obamacare) can be made to work. It does not need to evolve into single-payor, or national insolvency, or any of the other apocalyptic tropes that appear to give such visceral pleasure when forecast.
The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.
The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.Kent, as an obvious Ron Paul supporter, chose to work for the Ron Paul campaign knowing it did not provide insurance. I'm pretty sure, as a Paul supporter, he would not have supported Obamacare or socialized medicine. I don't think he would want to be used as a political football by Obamacare supporters. You should probably stop.
I don't think he would want to be used as a political football by Obamacare supporters. You should probably stop.
You can choose to read "blatantly ironic example" as "political football," but coming from someone who rubs Benghazi like a magical fetish item, your sudden outbreak of don't-use-the-dead-for-political-purposes is a bit rich.
I think Kent is a very good example of where libertarianism leads—one of many such examples.
Any Rand took social security (http://www.alternet.org/story/149721/ayn_rand_railed_against_government_benefits%2C_but_grabbed_social_security_and_medicare_when_she_nee ded_them), for example.
Even when libertarians get handouts, they rarely recognize them as such. Ted Cruz doesn't believe the tax breaks he gets through his wife's medical insurance (http://talkingpointsmemo.com/livewire/ted-cruz-s-wife-confirms-he-s-covered-under-her-blue-chip-health-plan) have anything to do with tax or revenue. Assuming you have a mortgage, I'm willing to bet you don't see your mortgage deduction as a middle-class payoff (http://www.bloomberg.com/news/2012-03-01/middle-class-welfare-state-invisible-by-design-commentary-by-ezra-klein.html), even though that is precisely what it is.
You state, with absolutely nothing to back it up, that Kent "would not have supported Obamacare or socialized medicine." Yeah, not so sure about that, especially when he was dying, and possibly aware of the bills he was leaving to mama. Libertarians tend to see the value of collective risk management (i.e., "society") once the repercussions of their peculiar notion of freedom come knocking at the door.
Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.
Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.
:inquisitive: That's exactly what I said when I said it's funny that people compare a huge database with a myspace site.
And our country is quite a bit behind when it comes to utilizing technology in the public and some other sectors, I wasn't claiming that we're better. In fact we are worse. Just because I may have successfully acquired a reputation of being an Anglo-hater, that doesn't have to be true. :stare:
ICantSpellDawg
10-30-2013, 04:24
Lemur, are you suggesting that insurance would have saved his life?
Because from what you are suggesting, the guy lived his life without paying into insurance and died of a fast illness that would have killed him anyway. Sounds to me like he got away with 400k.
Lemur, are you suggesting that insurance would have saved his life?
Last I checked, pneumonia was treatable (http://www.webmd.com/lung/tc/pneumonia-treatment-overview), if you get to it quickly enough.
why are we disparaging the dead guy?
Noting that the essential supporter of a libertarian candidate died of preventable causes, uninsured, leaving his mom with $400k in medical bills, is somehow off-limits? Please.
The real-world results of libertarianism are relevant, especially when the only alternatives posited to Obamacare are (a) the status quo ante, or (b) an untested libertarian experiment in national-scale free-market healthcare provision.
ICSD, you clearly didn't read even the bit of the article I snipped. GC ... really? You're falling for this?
ICantSpellDawg
10-30-2013, 12:33
I don't understand your point then, Lemur. A friend of mine passed away within 24 hours from pneumonia and a rare blood toxicity. He had a Cadillac plan. Anyone, for any reason, can go into a hospital and get life saving treatment.the bills come later. I read your article and your point seems less clear to me,
All I'm reading is "libertarian, no insurance, died, debt, sucker"
This guy died penniless and with 400k in medical debt. That is how I would like to die because it means that I've cycled out all of my assets and defrauded the corrupt and usurous medical system. His mom doesnt have to pay those bills if she isnt trying to keep anything valuable in his estate. Honestly, though, I have always kept health insurance - I believe in trying to carry my own weight and don't want society spend a minute thinking about my health.
You are using a convoluted argument to suggest that this guy was some ignorant pauper who fell for libertarianism and suffered pneumonia because he couldn't afford a few $50 PCP visits and low cost medicine. The emergency aspect would not have turned him away either.
You usually have better and more poignant arguments than this. Let's get back to talking about how a guy like this is even less likely to have health insurance since Obamacare has spiked the price. He planned to game the system when the prices were lower, now they are all higher for everyone and he can get the same emergency treatment by only paying a miniscule tax penalty instead of Signing up for a crappy insurance policy that costs a months rent every month.
Again, I stress having health insurance, but this law is a stupid mess, as you yourself have stated. The effects of the multi-thousand pages of regulations are now becoming clear. None of this is to say that our evil health insurance market works, just that all of this regulation and expense does little other than exacerbate the problem.
Honestly, though, I have always kept health insurance - I believe in trying to carry my own weight and don't want society spend a minute thinking about my health.
Well, the entire society of people in your health insurance is actually caring about your health. Not having health insurance is more akin to carrying your own health since the entire point of insurance is to distribute a risk and carry it together with a group/society of people. It's a business model because people love to distribute risks. The real question is whether a non-profit organization could maybe provide the same thing cheaper since they wouldn't have to add a profit margin onto the monthly bill. In return one might then also add people who are refused by private insurers since they would not be profitable customers.
One could also say that private insurers try to accept only people who most likely do not ever or just very rarely need the insurance because these are more profitable given that they pay more into it during their lives than they ever get back/use. And insurances make money from that while the people who actually need the services provided get nothing out of it. This leaves both extremes of the spectrum "scammed" by the system, since the needy do not get what they need and the less needy pay for something they do not need.
In a unified system at least the needy get what they need and if you include some proper safeguards, the less needy won't pay overhead to line the pockets of investors and know that at least their money goes to helping those in need.
The last bit is of course hard to manage and I'm not claiming our system here is perfect, our insurances are vultures as well but kept somewhat in check by the government. I wouldn't mind a change of our system away from for-profit either, as it is they like to beg the government for more money and then use that to increase top management salaries and to celebrate bunga-bunga parties in other countries...
Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"
In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"
In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"
Seamus Fermanagh
10-30-2013, 18:30
Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"
In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"
In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"
T:
There are plenty who make such a choice about all forms of insurance (life, health, auto) under the present system. The large majority of those under age 45 get away with it too. Most folks under 45 do not end up dead, and most do not get seriously ill or injured. A hefty slice of that age group looks at both life and health insurance and says "fugetaboutit, I would rather buy X."
Under the ACA, we're all mandated to buy insurance....but with the penalties as is, it will be more costly for many of the under 45's to buy insurance than to pay the fines, and they ALREADY have the least sense of need of any group in the market.
I think it is the responsible choice to protect your family. So, obviously, do you. But there is a significant minority who just aren't motivated at all -- they KNOW they aren't going to die, get injured, or fall sick. And with the latter, they now know they can buy the insurance then, when they need the discounted services.
ICantSpellDawg
10-30-2013, 18:41
Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"
In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"
In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"
Clearly health insurance is no joke. I've worked consistently at points solely to keep health insurance. I am intimately involved with the balance between the need for collective action to avoid massive individual costs and the importance of individual responsibility to ensure that care is appropriate, paid for with incentives for sound treatment and medical development.
The current system doesn't work because it allows costs to run rampant, which encourages adverse selection. The new system does not address this in the right ways. Individuals saving money in an HSA with high deductibles will allow individuals to determine which treatments are appropriate for their situation under the guidance of their Dr, but leaves the impoverished out in the cold (or leaves their care in the hands of other insured peoples and tax payers)
Some combination is needed. Possibly a more thorough review of who should qualify for medicaid, more reliance on individual HSA's to fund the majority of health care, and some catastrophic risk pooling to be done by either tax payers or the masses of insured individuals or both. This, I believe, is the solution that will allow healthcare to grow at a healthy rate without undue burden on healthy people while protecting everyone from catastrophe and rampant costs.
This is a moderate approach and is not the position of "libertarians" genrally, as was suggested in Lemur's annual "death of the GOP is imminent" thread.
I believe that it is an honest and balanced approach - coming from someone who truly would benefit by just passing the buck to someone else. I refuse to do that in good conscience. I have taken a more sensible approach than the aforementioned deceased; to avoid simply defaulting on my obligations, most likely because I am responsible and have a wife whom I would leave behind.
Montmorency
10-30-2013, 18:45
A deepening of the status quo is a moderate position only in the sense that a coma is the moderate answer to the question, "To be or not to be"...
ICantSpellDawg
10-30-2013, 18:48
Brilliant.
We have the most advanced medical system in the world, it is just wildly overpriced and people are left out.
We want to keep the most vibrant system in the world, stabilize prices without relying on a command economy, and bring more people in from the cold. This isn't like putting gum in a leaky boat, it's like saying we don't want to risk sinking an amazing ship because some people travel cargo.
I don't know if that is a good analogy because it needs to sink in. Probably not, as I am not great at analogies.
I think it is the responsible choice to protect your family. So, obviously, do you. But there is a significant minority who just aren't motivated at all -- they KNOW they aren't going to die, get injured, or fall sick. And with the latter, they now know they can buy the insurance then, when they need the discounted services.
If I am honest, the way your healthcare system is set-up, it truly scares me, Seamus. Whilst I might make little pokes here and there, if I actually imagine being under system tomorrow, I would be mortified. Perhaps to you who grew up with the system, it is different, but for me, the actual concept of if I get ill, knowing I would be able to have treatment is a complete load off my mind. Knowing if I get some disease, cancer or involved in a traffic accident, I would be cared for and stand a good chance of getting better.
You say "All is fine" for the age group, but perhaps I have been unlucky, but I know this is false and under reported. Everyone of my cousins have had medical emergencies, about half of my siblings too. All different kinds due to various reasons. I got a cousin who was really into sports, working out everyday, really watching their diet, even in Oxford Rowing team, ended up with a heart attack and rushing to hospital where they discovered he had a heart defect. I had another cousin (his brother) who was a gym instructor turned police officer , who had pancreatitis and had to be rushed to hospital. Another cousin had a very severe allergic reaction who was in hospital for a week. I got a brother who had kidney failure and is terminally ill (hit the point where transplant is no longer an option), only reason he is still alive is because he is still having some treatments which only there to prolong his life. I could go on with this, by even bringing in older generations and the c-word.
Just imagining my family in the American system.. they would all be bankrupt and perhaps dead. Their families and children without fathers simply because of the system in place.
I read all these stories including how people try to raise money to pay for medical bills, most likely going to end up in the afterlife they believe in, hearing how people are suffering from issues, saying they won't seek a doctor because of the costs that might be involved, it is truly insane from my point of view. How can a system be so barbaric which lets the populace suffer and die ?
You might see this as 'Liberal Whining' or similar, but I am being honest, I am glad to have my healthcare system. I am happy for the money to come out of my taxes. I am happy to know when those worse times come, there is someone there to hold my hand and attempt to make things better for me.
We have the most advanced medical system in the world, it is just wildly overpriced and people are left out.
Hybrid system, like in the UK.
"What do you mean?"
In the UK, Healthcare is paid through taxes, this provides healthcare to everyone in the country, so no one is left out in the wild. However, there is also a private sector, this is mostly paid for by the rich (or they sometimes go to countries like America). These people obviously have the money to waste on such things and pay those overpriced amounts. Implementing a bottom-line in the United States, like an AHS (American Health Service) would supply that, whilst also keeping the private sector in place to keep that innovation you desire.
Montmorency
10-30-2013, 19:05
We want to keep the most vibrant system in the world, stabilize prices without relying on a command economy, and bring more people in from the cold. This isn't like putting gum in a leaky boat, it's like saying we don't want to risk sinking an amazing ship because some people travel cargo.
It's like the ship is sinking already and you want to save it by tossing the crew overboard and waiting for the quarterdeck to head down and work shifts to evacuate the growing pool. It's silly, plain and simple.
Seamus Fermanagh
10-30-2013, 19:07
If I am honest, the way your healthcare system is set-up, it truly scares me, Seamus. Whilst I might make little pokes here and there, if I actually imagine being under system tomorrow, I would be mortified. Perhaps to you who grew up with the system, it is different, but for me, the actual concept of if I get ill, knowing I would be able to have treatment is a complete load off my mind. Knowing if I get some disease, cancer or involved in a traffic accident, I would be cared for and stand a good chance of getting better.
You say "All is fine" for the age group, but perhaps I have been unlucky, but I know this is false and under reported. Everyone of my cousins have had medical emergencies, about half of my siblings too. All different kinds due to various reasons. I got a cousin who was really into sports, working out everyday, really watching their diet, even in Oxford Rowing team, ended up with a heart attack and rushing to hospital where they discovered he had a heart defect. I had another cousin (his brother) who was a gym instructor turned police officer , who had pancreatitis and had to be rushed to hospital. Another cousin had a very severe allergic reaction who was in hospital for a week. I got a brother who had kidney failure and is terminally ill (hit the point where transplant is no longer an option), only reason he is still alive is because he is still having some treatments which only there to prolong his life. I could go on with this, by even bringing in older generations and the c-word.
Just imagining my family in the American system.. they would all be bankrupt and perhaps dead. Their families and children without fathers simply because of the system in place.
I read all these stories including how people try to raise money to pay for medical bills, most likely going to end up in the afterlife they believe in, hearing how people are suffering from issues, saying they won't seek a doctor because of the costs that might be involved, it is truly insane from my point of view. How can a system be so barbaric which lets the populace suffer and die ?
You might see this as 'Liberal Whining' or similar, but I am being honest, I am glad to have my healthcare system. I am happy for the money to come out of my taxes. I am happy to know when those worse times come, there is someone there to hold my hand and attempt to make things better for me.
The choice to opt out of health coverage would be VERY scary for me as well. To my mind it is one of the first benefits of employment that you procure for yourself and your family. Life insurance and retirement planning following immediately after.
You are correct in that, having grown up under our needlessly byzantine system, I am not inherently terrified that I will fall ill during that one or two months between jobs with benefits or other small gap. On the other hand, those folks who blithely assume that "noting can happen to me" and who therefore don't secure any health coverage, life insurance, or the like...well, the technical term for them would be "fools."
[F]olks who blithely assume that "noting can happen to me" and who therefore don't secure any health coverage [...] well, the technical term for them would be "fools."
I'm not sure how fools and idiots are relevant. They will always be with us, most will get sick, all will die. And under our current system, you and I pay for them in the least efficient manner possible (http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act).
Is it not preferable to get as many of those fools and idiots into some sort of insurance pool? Isn't that both more practical and more humane?
ICantSpellDawg
10-30-2013, 20:41
Yes, what is your point?
Yes, what is your point?
What is the premise of SwissCare/HeritageCare/RomneyCare/Obamacare?
As for the people who would rather pay the penalty since it is cheaper, that's a very weird decision.
It is cheaper if you never fall sick, but given that you have to pay at minimum the penatly, the actual full health insurance coverage actually costs only the difference between the penalty and the insurance fee. And if you just do not want to contribute the fee to crash the system, consider that with the penalty you pay less, but you still contribute the penalty, yet for zero return in case you do need the healthcare system one day. People who pay the penalty simply provide free money to the system at a 100% profit for every insured person. To me it makes a lot more sense to pay the additional money which also provides the full benefits of the system in case you actually need it.
Kadagar_AV
10-30-2013, 21:42
USAnians commenting on this are like zebras and giraffes arguing on what the most apple-like construction one could get from a cone :dizzy2:
WHAT!?!?
You can afford an all-inclusive health plan for your population.
...
...
...
And yeah, that's pretty much it.
Sorry if you think Doctors are better of drugging some artist or perfecting some celebrities boobs, but REALLY??
You can afford an all-inclusive health plan for your population.
But there is no money in that. :crazy:
Tellos Athenaios
10-30-2013, 21:51
I think the radical libertarian was well aware of the consequences of his ideology. It's nothing remarkable either way.
Yes, I can see it now: "when you tire of responsibility, when you just wanna be a teenager again there's always libertarianism".
Basically you're saying he fully endorsed the notion of intentionally racking up $400K of debt, going all "oh, well, let's see who I can sucker into paying for me; oh hi, mum, long time no see!"
ICSD seems to think it's a valid way of life, too.
ICantSpellDawg
10-30-2013, 22:21
Yes, I can see it now: "when you tire of responsibility, when you just wanna be a teenager again there's always libertarianism".
Basically you're saying he fully endorsed the notion of intentionally racking up $400K of debt, going all "oh, well, let's see who I can sucker into paying for me; oh hi, mum, long time no see!"
ICSD seems to think it's a valid way of life, too.
It is a "valid" way of life, as the guy who used it for the entirety of life proved by dying. Is it the best? Read my post which states my opinion that "no, it is not". You're post is incorrect.
Papewaio
10-30-2013, 23:34
Leaving the bill to your parents isn't libertarian it is called being a minor.
With freedom comes responsibility. Your choices have consequences and you should be footing the bill for all of these if you are a true libertarian. The moment your mum or your friends have to fund raise for your existence you cross the line from do it by yourself libertarian to member of society.
It is just another example of ideals meeting reality. Most don't pass the pressure test.
As a campaign worker for Ron Paul he probably believed in serious reform of the healthcare system that would also have completely nuetered the ability of collections to go after his mother for something she was totally not a party to. Libertarians have their own problems with the status quo.
But then what? Who would pay for the bill then? The doctor? And what happens on a free market then? Healthcare only for people who can pay up front? And what would that goal make him considering he got healthcare he couldn't pay for? A fraudster or just a hypocrite? And why would I respect the values of such a person?
Montmorency
10-31-2013, 01:06
Didn't Ayn Rand herself say that one should take advantage of every government benefit possible, even if they should all be eliminated ultimately?
The idea was that you're looking out for your own self-interest and technically getting back your taxes anyway.
A fraudster or just a hypocrite?
The first, yes. The second, no.
https://i494.photobucket.com/albums/rr309/desertSypglass/cryptkeeper.gif
Didn't Ayn Rand herself say that one should take advantage of every government benefit possible, even if they should all be eliminated ultimately?
The idea was that you're looking out for your own self-interest and technically getting back your taxes anyway.
Ayn Rand is not part of my self-interest, so I do not care.
The first, yes. The second, no.
The point about being a hypocrite was that when you think society shouldn't foot the bill, yet unload it onto others because you cannot pay, well...
As for self-interest, it is the reason insurance exists. People who can think further than the tip of their own nose realize that they may not be able to pay a huge bill one day so they share the risk with others. There is no huge necessity for altruism.
But then what? Who would pay for the bill then? The doctor? And what happens on a free market then? Healthcare only for people who can pay up front? And what would that goal make him considering he got healthcare he couldn't pay for? A fraudster or just a hypocrite? And why would I respect the values of such a person?
Ron Paul is a doctor himself and if I remember correctly he had some specific ideas for health care reform, but I can't remember what they are and I'm guessing his campaign website is now defunct. I think a lot of his ideas hinged on charities helping out the less fortunate with their medical bills.
Ron Paul is a doctor himself and if I remember correctly he had some specific ideas for health care reform, but I can't remember what they are and I'm guessing his campaign website is now defunct. I think a lot of his ideas hinged on charities helping out the less fortunate with their medical bills.
Socialism by bad conscience? Or simply an incredibly unreliable insurance?
Socialism by bad conscience? Or simply an incredibly unreliable insurance?
I think it was "They should work for cheaper" and he apparently offers a lowish rate and sometimes does free work. Don't quote me on that, would need to googlefu to confirm.
Kadagar_AV
10-31-2013, 02:08
Socialism by bad conscience? Or simply an incredibly unreliable insurance?
Made my day, cheers :bow:
Socialism by bad conscience? Or simply an incredibly unreliable insurance?
The latter, I think.
Don't ask me. I just don't see what this person's informed beliefs have to do with anything at all.
I know, I was just saying that they are not exactly coherent or respectable either unless you find being a parasite who says people should be self-sufficient very respectable.
I thought I managed to make my views on the wider issue somewhat clear as well.
Evolutionary speaking working only for, by and with yourself would probably fit the lizard brain or people who are in a constant state of animalistic panic and do not use the more advanced parts of their brain. If you exist somewhere beyond the evolutionary step of monkeys you should be a herd animal and see the value of cooperation. :sweatdrop:
I never heard of a part of our brain called the tiger brain that could make us successful loners.
Last I checked, pneumonia was treatable (http://www.webmd.com/lung/tc/pneumonia-treatment-overview), if you get to it quickly enough.The guy had a pre-existing condition, a un-named"blood disorder" and died from pneumonia. Kinda sounds like HIV to me. But we're both talking about a dead man and trying to attribute motives that we neither know nor understand. We should probably stop.
Noting that the essential supporter of a libertarian candidate died of preventable causes, uninsured, leaving his mom with $400k in medical bills, is somehow off-limits? Please.You don't inherit debt. Debts are paid from the deceased's estate. If there isn't enough value in the estate to cover it... the lender takes a haircut. The only way she could be "left with his debts" is if she was the payer in the first place. In which case, they were her debts all along.
Lastly, I'd like to address the hypocrisy accusation over people who take tax deductions they aren't in favor of or receive benefits from programs that they don't like the structure of.....
I don't have a mortgage, but you can bet I'd take the tax deduction if I did. Also, if Social Security is still paying out when I'm old enough to get benefits- I will most certainly take any benefits that I am eligible for. I don't think Social Security is sustainable as it's currently constituted, nor do I think it is a good investment. Were I to take the 12% of my income the federal government is taking from me and invest it into an IRA- I could get a much better ROI than I will get thru Social Security. That does not change the fact that the government has been taking 12% of my income for this program my entire working life. Therefore, if I get the chance to get any of that money back- I'm going to take it.
Tellos Athenaios
10-31-2013, 20:51
It is a "valid" way of life, as the guy who used it for the entirety of life proved by dying. Is it the best? Read my post which states my opinion that "no, it is not". You're post is incorrect.
As long as this is a free country that's a valid way of life. It is not ideal and is not something I would ascribe to, but there it is
Not it is not a valid way of life: taking your previous post before I replied literally we are dealing with plain and simple theft.
The Inuit used to push that kind of folk off the nearest convenient ice sheet, just to be rid of them, for a good reason: in their extreme situation, such people who defrauded the community of scarce resources were a plain and simple threat to the continued survival of the whole community.
Such a way of life is nothing but a trail of destruction, which innocent people will have to repair.
Other words for the same class of people: frauds, thieves, hustlers, conmen, scammers, mediums.
I see lots of pontificating but no argument. This is America, theft is our mission statement. His choices were valid, that doesn't mean I agree.
Is that why you are allowed to shoot people in the back if they run away with your TV?
Nothing wrong with that. Don't steal TV's.
You just said theft is your mission statement....
Is that what I said? Are you sure?
I think so, yes.
This is America, theft is our mission statement.
Our mission statement. This is America.
Our unspoken and spoken cultural values are not necessarily my values... but anyone shot trying to steal a TV from someone's home gets no sympathy from me.
My point was that if theft is your mission statement then it makes little sense to shoot people for theft. Or maybe it just makes little sense to claim that theft is your mission statement when you shoot people for theft.
Whether this has anything to do with you personally is beside the point.
ICantSpellDawg
11-01-2013, 03:42
Is that why you are allowed to shoot people in the back if they run away with your TV?
To jump off of topic.
Depends on the jurisdiction. In my jurisdiction, you might be arrested for shooting a thief who is running away, but since you are shooting to end the commission of - likely - burglary, you may win that case. Personally, I am not interested in shooting people for theft. I am ok with shooting someone who enters your home illegally for any reason whatsoever, as they don't tend to come in with a business card letting you know of their intentions. You are left to guess. Even if they did, you would then be trusting the word of someone intent to harm you physically and/or financially, so how you'd come to the conclusion that they are trustworthy is anybody's guess. In this situation, I will shoot to eliminate the threat, by incapacitating the criminal and stopping the crime. Shoot center mass, multiple times, with as much ballistic stopping power as possible. Light detached from gun at night as it makes the light source (you) a target. Do not leave your room unless you have other people in the house to protect. This is my plan of action. It will effectively insulate me from having to shoot someone for burglarizing my home, which I would rather not do even though I would be legally justified in doing so, and ensures that lethal force is only used when the personal safety of myself and my wife are at risk in our bedroom.
You can kill with a .22. The point is not to kill, but to stop.
Back on topic
The type of "fraud" that the late individual was guilty of was not fraud in the true sense. It was merely one man refusing to pay a bill which was unconscionably high. You wouldn't charge him with fraud, you (as the provider) would enter litigation to sue him for services rendered unpaid. If the taxpayer or insured's are kind enough to extend credit to him unsolicited, that is their own kindness/foolishness. The coldly bureaucratic arguments which suggest that people should be hauled off for insulting the thought police or daring not to purchase a product which is optional and wildly overpriced is just vacuous, hyperbolic, claptrap. All valid political beliefs for a German to hold, at any given point in history.
ICantSpellDawg
11-01-2013, 04:02
The guy had a pre-existing condition, a un-named"blood disorder" and died from pneumonia. Kinda sounds like HIV to me. But we're both talking about a dead man and trying to attribute motives that we neither know nor understand. We should probably stop.
My friend died from almost exactly the same thing. Healthy, fit as a fiddle, just bought a BMW, started job with a new firm as a financial analyst in Manhattan (at 24 years old) , 95k per year, met a girl. He began complaining of chest pain on Friday night, was dead by 1 pm the next day in a hospital in the NY metropolitan area. Fully insured, Cadillac plan, asymptomatic up to 24 hours prior. Some childhood anemia diagnosis which never gave him a problem, coupled with walking pneumonia was the cause of his total body toxicity and organ failure.
I don't mind that Lemur is vilifying and using as political cudgel a man who died from a serious form of pneumonia who happened, also,to refuse to buy into the absolutely broken medical insurance system; but I'm not sure that it is the kind of argument that someone who wasn't solely trying to rationalize his own tacky argument would continue to make. It's ok to back down sometimes - or to press on instead, like the reasonable moderate who never backs down from firmly held positions which lampoon the "right" that he is.
I'm not sure that it is the kind of argument that someone who wasn't solely trying to rationalize his own tacky argument would continue to make.
This sentence is kinda beautiful. It's like a serpent eating its own tail.
I haven't brought up the subject of your high dudgeon in about a day and a half, so by all means, keep going back to that well.
As a governing philosophy, libertarianism is exactly as realistic as communism. Both suffer from good intentions and starry-eyed idealism, neither works once you scale past the family level. The similarities between the two are quite striking.
Note the mushiness and emptiness (http://www.lp.org/issues/healthcare) of the libertarian answers to our troubled healthcare system. Note the real-world consequences of this sort of adolescent thinking, and the hostility its acolytes express when confronted with same.
Much like communism, libertarianism can never be wrong, because it is a complete, perfect theory. It can only be misapplied or misunderstood.
Feh.
Tellos Athenaios
11-01-2013, 10:44
The type of "fraud" that the late individual was guilty of was not fraud in the true sense. It was merely one man refusing to pay a bill which was unconscionably high. You wouldn't charge him with fraud, you (as the provider) would enter litigation to sue him for services rendered unpaid.
Please reread the original post of Gelatinous Cube. Being fully aware of the consequences, i.e. being fully aware of (at least the order of) the magnitude of the bill prior to deciding to consume the service anyway implies something else, something much less benign than a simple conflict over costs. What it would imply is a cynical exploitation of the assumption that people pay their bills: instead of making sure you, or your insurer, could pay your hospital bill you would bank on the fact that you would be treated first and only asked to pay later so you could then claim to be unable to and leave the hospital and by extension everyone else with costs. In the meantime you of course enjoyed the fact that you never paid an insurance bill. I.e. you are free riding, or mooching, or sucking the teat of society or whatever welfare queen type analogy you'd care to make. Quite the cynical interpretation of the chain of events.
Alternatively, the man did not know or appreciate the consequences of the stupidity of his own dogma nor of the limits of that dogma.
Libertarianism doesn't work because we want things that none of us can afford for ourselves by ourselves alone. It also doesn't work because it doesn't scale, as Lemur pointed out. The welfare state is not, in fact, a modern chain of ever more entitlements being paid for by hard working tax payers. The welfare state is the result of people trying the libertarian and charity approach and finding it wanting. It is the most efficient and most realistic option you have at eradicating absolute poverty, malnutrition, and providing education, basic healthcare etc. through economies of scale and the fact that the reach of the programme is nationwide so even the most backwards poverty stricken regions can benefit from the economic successes of the wider nation.
Ironside
11-01-2013, 11:05
Back on topic
The type of "fraud" that the late individual was guilty of was not fraud in the true sense. It was merely one man refusing to pay a bill which was unconscionably high. You wouldn't charge him with fraud, you (as the provider) would enter litigation to sue him for services rendered unpaid. If the taxpayer or insured's are kind enough to extend credit to him unsolicited, that is their own kindness/foolishness. The coldly bureaucratic arguments which suggest that people should be hauled off for insulting the thought police or daring not to purchase a product which is optional and wildly overpriced is just vacuous, hyperbolic, claptrap. All valid political beliefs for a German to hold, at any given point in history.
You sure you want the health industry to only accept payments in advance and that they always stop the treatment if things get more expensive than expected? Companies are usually neither openly kind or foolish you know.
Note the mushiness and emptiness (http://www.lp.org/issues/healthcare) of the libertarian answers to our troubled healthcare system. Note the real-world consequences of this sort of adolescent thinking, and the hostility its acolytes express when confronted with same.
... Point 2 openly contradict their own goal (it's on the top of the page) and point 3 is in lala land when it comes to medical safety. I'll be very surprised if they do know the origin of FDA and are aware on what type of corruption scandals FDA has been involved in (hint, getting disaproval on a dangerous, non-funtional drug is still as expensive as getting an approval on a functional one).
As a governing philosophy, libertarianism is exactly as realistic as communism. Both suffer from good intentions and starry-eyed idealism, neither works once you scale past the family level. The similarities between the two are quite striking.
I haven't red it in full, but the description of John Galt land have struck me as pretty close to a communist ideal (From each according to his ability, to each according to his need), only inhabitated by supermen, all with very high abillities, with a thin capitalistic veil to cover it up. Not sure if the impression changes by a detailed description.
The type of "fraud" that the late individual was guilty of was not fraud in the true sense. It was merely one man refusing to pay a bill which was unconscionably high. You wouldn't charge him with fraud, you (as the provider) would enter litigation to sue him for services rendered unpaid. If the taxpayer or insured's are kind enough to extend credit to him unsolicited, that is their own kindness/foolishness. The coldly bureaucratic arguments which suggest that people should be hauled off for insulting the thought police or daring not to purchase a product which is optional and wildly overpriced is just vacuous, hyperbolic, claptrap. All valid political beliefs for a German to hold, at any given point in history.
Not really. We do believe that such a vital (since when is healthcare considered optional?) product should not be overpriced in the first place. It may be true that the lender has a problem if the customer does not pay but that does not justify the actions of the customer at all. If you want a community where fooling others and not paying bills is perfectly acceptable then you may have to buy your own island, because clearly most people don't want that.
And who mentioned hauling people off? Are you making things up now?
ICantSpellDawg
11-01-2013, 13:24
Libertarianism is equal in it's utopian absurdity to Communism? Libertarian is the opposite of Communism. Where communism is revolutionary in eliminating individual rights, libertarianism is an erosion of the demands of government. Libertarianism, in my application of it, is focused on peeling the stranglehold of statism off of our necks, finger by finger.
(A guy was just arrested in upstate NY. His license was suspended because his wife failed to pay a speeding ticket, which he had no idea about - he was then questioned about weapons. They saw his licensed carry handgun, checked the mag and -oh my God!- the 10 round mag had 9 rounds in it! He was charged with a misdemeanor under the brand new safe act which requires all 10 round mags to have only 7 rounds in them. The misdemeanor charge caused the licensing bureau to revoke his permit as a matter of course, unconnected to the Safe act. Swat was sent to his home to secure all firearms and seize them, ending his right to keep and bear arms forever) - this is the effect of stupid laws. They cascade and funnel into other badly applied laws making for an awful system of arbitrary law, which few understand and even fewer respect. The national legal system is a disgrace, enacted by people long ago, who have no right to govern me or you from their ignorant graves. Our system needs to be cleaned up everywhere, no with new text, but by eliminating codes and cleaning up the good ones.
Lemur, you are equating libertarianism with anarchism. Libertarians are not anarchists generally. They believe in some degree of government, just much less than currently exists. You misunderstand it basically, and it shows in your own political philosophy. Husar - you recognize that healthcare is important, as do I. You are suggesting that command control of the health care system effectively "controls" prices. Do you really believe this? Why shouldn't the government also control food production and determine pricing, among many other things?
So, the numbers have leaked out about healthcare.gov's launch day. CBS reports (http://www.cbsnews.com/8301-18563_162-57610328/obamacare-early-enrollment-numbers-very-small-documents-show/):
The website launched on a Tuesday. Publicly, the government said there were 4.7 million unique visits in the first 24 hours. But at a meeting Wednesday morning, the war room notes say "six enrollments have occurred so far."Six enrollments, huh? I can see why the White House wasn't too eager to talk about the numbers on this one....
ICSD, what I do not approve is that you think your current laws in the US have anything to do with a sane democratic system, remember that the USA are exceptional. So just because you do not like your particular laws there is no reason to think that government is a bad thing in general by taking the example of a country that sees itself as an exception anyway.
What I do like and find quite funny is this:
The national legal system is a disgrace, enacted by people long ago, who have no right to govern me or you from their ignorant graves.
So the next time someone brings up the founding fathers in a gun or any other debate I may bring this up. :2thumbsup:
As for which markets the government should dabble with: the ones that do not work.
Markets cannot work for example when there is an information imbalance where for example the sellers know far more about their product than the customers. Take food ingredients for example, I could spend months trying to figure out what is in the food I buy, it's a good thing when producers are forced to print it onto the package so I can make a better decision about what food to buy. Generally the food market is different from the healthcare market however because of the nature of the product. With healthcare it's often hard to choose a different supplier, if you're about to bleed out you probably won't choose a hospiteal 200 miles away simply because they offer more new blood for a buck. When you consult a doctor you cannot usually rate the quality of his diagnosis as easily as you can rate the quality of a liter of milk. You also cannot return a service easily if it is broken. Furthermore there is a difference between needing a certain medicine without which you will die and needing kaviar, which is a purely optional food. The healthcare market is supposed to make people healthy but the suppliers actually make money and profit with people who are not healthy, if you deregulate the market completely, what will stop companies from trying to introduce medicine that is addictive or makes people healthy slower than it could so they have to take more? Some of this is done in the food industry as well but it's still easier for the customer to make a somewhat informed decision there.
Seamus Fermanagh
11-01-2013, 21:51
Libertarianism is equal in it's utopian absurdity to Communism? Libertarian is the opposite of Communism. Where communism is revolutionary in eliminating individual rights, libertarianism is an erosion of the demands of government. Libertarianism, in my application of it, is focused on peeling the stranglehold of statism off of our necks, finger by finger.
No "true" communist, libertarian, or Marxist. Actual anarchies have been short-lived and quickly replaced. True democracies have been tried and found wanting at anything past the large town level.
The only forms of government to rack up any real tenure have been: Oligarchic Republics (Roman Republic, Pre 1850 England), Democratic Republics (UK, USA, numerous others since), and Despotisms (Dictatorships, Monarchies, Imperial Bureaucracies, Warlordism).
Of these, A Democratic Republic comes closest to Libertarianism.
ICantSpellDawg
11-02-2013, 00:09
No "true" communist, libertarian, or Marxist. Actual anarchies have been short-lived and quickly replaced. True democracies have been tried and found wanting at anything past the large town level.
The only forms of government to rack up any real tenure have been: Oligarchic Republics (Roman Republic, Pre 1850 England), Democratic Republics (UK, USA, numerous others since), and Despotisms (Dictatorships, Monarchies, Imperial Bureaucracies, Warlordism).
Of these, A Democratic Republic comes closest to Libertarianism.
I agree with this. I am not saying that there should be a revolution, but major revisions to our legal system and the way in which we conduct our affairs. I believe in the idea of a Democratic Republic as the best guardian of a libertarian agenda. I merely seek to undo the endless growth of the power of the State over the individual to make his or her own decisions. Where Obamacare seeks to strike a better balance for individual rights I applaud it. I am not against all forms of collectivism, such as insurance for major catastrophe, but the plan of this administration is unreal in it's application and their talent at governing is telling by their failures here.
The United States would have been better served if the administration had spent less focus trying to disarm and shame lawful gun owners and more time doing everything it could to help better vet the new healthcare system.
Regarding my assertion that old, dead ancestors have no right to tell me how to live strengthens the bill of rights. It is a document that tells government to cram it and leave us alone. I like all laws which restrict government actions against the people, few which restrict the individual.
Look at what happened this week, the NYC government has defamed a judge who legitimately judged stop and frisk to diminish the rights reserved against unreasonable search and seizure - and the government has had her taken off of the case and then frantically stacked the bench with patsies who are beholden to government. We are in hostile territory, we need to tear these laws apart through constant disruption.
We imprison people for long periods of time with dangerous felons for smoking wacky tobacky. Libertarianism is needed desperately in this country. We are focused on the wrong things and doing everything we can to gut equal protection and the rights of citizens.
I don't care about Obamacare. As I have stated in the past - the health system which we are shackled with is an abomination, if Obamacare ruined it it wouldn't be the worst thing. Unfortunately, this admin is inept at fixing a problem. His attempts are worthy of scorn and any plans to make our system worse should be resisted. All I have seen so far is worse.
Democratic Republics (UK, USA, numerous others since)
I disagree with the naming and such here. United States is more of an exception, but leads the Constitution/Democratic Republics whilst various Commonwealth countries and Europe are mostly Social-Democracies. USA in particular has that special very limited government and wants less, in comparison to those with strong welfare states and national health services. Not to say there isn't Social-Democracy interest in the United States, it is very tame compared to elsewhere.
The healthcare market is supposed to make people healthy but the suppliers actually make money and profit with people who are not healthy, if you deregulate the market completely, what will stop companies from trying to introduce medicine that is addictive or makes people healthy slower than it could so they have to take more?What? They're not doing that already?
Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.
Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them. :yes:
Pannonian
11-02-2013, 01:37
I disagree with the naming and such here. United States is more of an exception, but leads the Constitution/Democratic Republics whilst various Commonwealth countries and Europe are mostly Social-Democracies. USA in particular has that special very limited government and wants less, in comparison to those with strong welfare states and national health services. Not to say there isn't Social-Democracy interest in the United States, it is very tame compared to elsewhere.
"Social" in social democracy refers to the political direction, rather than the political structure. Seamus was only describing political structures. A democratic republic can lean in any way it wants depending on the present government, but as long as its structures are in that form, it is still a democratic republic.
Pannonian
11-02-2013, 01:42
What? They're not doing that already?
Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.
Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them. :yes:
It's easier for a customer to push for changes in a food market than for said customer to push for changes in something as large scale as healthcare. See the problems your country is having on the subject. Something on the scale of healthcare requires large scale concerted action, which means driven by the government, or it doesn't happen at all and the status quo more or less persists.
ICantSpellDawg
11-02-2013, 02:58
It's easier for a customer to push for changes in a food market than for said customer to push for changes in something as large scale as healthcare. See the problems your country is having on the subject. Something on the scale of healthcare requires large scale concerted action, which means driven by the government, or it doesn't happen at all and the status quo more or less persists.
The American health care system needed some form of intervention. Market forces were not working because the system wasn't designed with those in mind. I am all for something being done to open it up to greater consumer choices with tax incentives to do so. The tax incentives should be present as a recognition that choices made regarding ones own health can be made under duress and that healthcare is a different ballgame than car and home insurance. I'm not looking for home tax deductions, I believe that those are unethical. I want to see lower taxes across the board and and end to most tax write-offs of everything other than health care.
Writing off your home? deleted. renters shouldn't be punished with higher taxes because you own a home. Writing off your education? deleted. Individuals are held back by the system of higher education grants which encourage irresponsible education over local community, commuter and online education. HSA's for everyone, because the money that we spend on most healthcare should be our own and it shouldn't be handicapped by government. Lower taxes for everyone, but cut the cuts.
This article in Bloomberg (http://A lot of folks with employer-sponsored insurance are also going to see their insurance changed, though not quite as quickly. And not “The benefits will get so much more awesome!” but “The Cadillac tax kicked in and we had to drop most of our plans except for the ones with high deductibles.” A friend who sits on the benefits committees of two organizations says that their experts predict that pretty much all plans will end up being of the “consumer-driven” (read: high-deductible) model once the so-called Cadillac tax kicks in.) seems to suggest that High deductible plans are becoming the expected norm. THis would be fine, just as long as we have a way to pay for our co-pays, co-insurance without being taxed and saving our money in an IRA like account. OPEN US THE HSA program to everyone at slightly lower amounts and mandate that employers set them up.
What? They're not doing that already?
Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.
Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them. :yes:
You're assuming that a majority of customers actually have the nerve and strength of will to use supply and demand tactics to bring about change. This is patently false as shown by the gaming market where people say they do not think a game is worth the money the supplier asks but instead of not getting it, they get it illegally instead since they cannot resist the urge to play it anyway. How many people can't keep their fingers off chocolate or meat or whatnot? If everybody were a purely rational homo oeconomicus who knows everything he needs to know about every product and service they consume, then we wouldn't need market regulation. But the world is not a capitalist utopia, there are markets where the forces work really well and there are markets where they don't work very well due to the nature of the product, the consumer or both.
With healthcare and food you also get additional interests such as children who cannot fully decide for themselves what they consume. You may say children of sloppy parents do not deserve to live or to be healthy anyway but apparently society at large disagrees with that notion.
Society also disagrees with having a large percentage of dumb people who cannot contribute so we introduced mandatory education and a public education system. Letting market forces handle such things has detrimental effects on a society because not everyone always makes the optimal choices or has the desirre/time to put in enough effort to make informed decisions about things.
In my opinion letting the government handle these things through regulations is just a form of centralization and specialization where the people at large outsource the decision making regarding some fundamental things to a small group of people who can make a better informed decision than most.
The system doesn't have to be perfect but there is also no pure and perfect free market, consider that companies using very good marketing and market manipulation can get advantages they should not get on a perfect free market. Intel bribed some electronics stores here so they wouldn't sell any systems with AMD CPUs. Now Intel are so far ahead because they made illegal market manipulations that they have a monopole in the upper mid and high end CPU "market". Now regulation does not stop this since it's illegal and happened anyway but the point remains that regulation is usually there to fix flawed markets that simply do not work properly without it because not everything in the world is perfectly aligned to work on a free market.
Pannonian
11-02-2013, 05:46
The American health care system needed some form of intervention. Market forces were not working because the system wasn't designed with those in mind. I am all for something being done to open it up to greater consumer choices with tax incentives to do so. The tax incentives should be present as a recognition that choices made regarding ones own health can be made under duress and that healthcare is a different ballgame than car and home insurance. I'm not looking for home tax deductions, I believe that those are unethical. I want to see lower taxes across the board and and end to most tax write-offs of everything other than health care.
Writing off your home? deleted. renters shouldn't be punished with higher taxes because you own a home. Writing off your education? deleted. Individuals are held back by the system of higher education grants which encourage irresponsible education over local community, commuter and online education. HSA's for everyone, because the money that we spend on most healthcare should be our own and it shouldn't be handicapped by government. Lower taxes for everyone, but cut the cuts.
This article in Bloomberg (http://A lot of folks with employer-sponsored insurance are also going to see their insurance changed, though not quite as quickly. And not “The benefits will get so much more awesome!” but “The Cadillac tax kicked in and we had to drop most of our plans except for the ones with high deductibles.” A friend who sits on the benefits committees of two organizations says that their experts predict that pretty much all plans will end up being of the “consumer-driven” (read: high-deductible) model once the so-called Cadillac tax kicks in.) seems to suggest that High deductible plans are becoming the expected norm. THis would be fine, just as long as we have a way to pay for our co-pays, co-insurance without being taxed and saving our money in an IRA like account. OPEN US THE HSA program to everyone at slightly lower amounts and mandate that employers set them up.
Cor, isn't this pretty much what the NHS is (or was, until they introduced small tariffs for working age people). Healthcare that is free at the point of delivery, so payments are made steadily when one is capable of them, and when the need comes, one doesn't have to choose between that and other necessities. Except we call it a tax, something that our tax package pays for, but Americans, allergic to the idea of taxes, call it a savings fund instead. I guess this just shows that government driven action is the only thing that can make something like this work, whatever language it's dressed up in.
Ironside
11-02-2013, 10:18
What? They're not doing that already?
Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.
Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them. :yes:
Is aspartame dangerous or not? No matter your answer, what source did you base this on?
Why are those bananas "organic"? Because they're labeled that way. What does the label stand for? Do you know the exact formulation, or are you information deficient? Are the labeling correct or not? How do you know? And why are you calling it a stupidity? Is it a secret goverment project to sell it? Or is it market manipulation by the companies, earning money on the costumers information deficiency?
Seriously, you call the organic food costumers (aka parts of the electorate) falling for something stupid, while asking in the paragraph above why the electorate can't force the change. The electorate gave you Obama vs Romney. And was almost split in half. Combined might, combined ingenuity (the electorate has the power to pick someone else that what the parties offers) indeed.
Your basic assumption are that the companies aren't players. In fact, they are the strongest players there is. Because they've got financial might and vested interest. Only the combined might of the public may beat them. But none informed the public that they should fund independent research and make sure that it's not influenced by the companies. Has American companies lied about the dangers of their products in the past? Oh yes indeed, many times.
But since you and everyone else is homo omnieconomicus, that won't ever be a problem would it?
Is it a secret goverment project to sell it? Or is it market manipulation by the companies, earning money on the costumers information deficiency? It's businesses giving consumers what they want.
Seriously, you call the organic food costumers (aka parts of the electorate) falling for something stupid, while asking in the paragraph above why the electorate can't force the change.And?
Your basic assumption are that the companies aren't players.What on earth gave you that idea?
But none informed the public that they should fund independent research and make sure that it's not influenced by the companies. Has American companies lied about the dangers of their products in the past? Oh yes indeed, many times. And has the government lied or been wrong about the dangers of products in the past?
The naive paternalistic view of government that you and Husar exhibit is amusing.
The naive paternalistic view of government that you and Husar exhibit is amusing.
While your darwinian model is much less so.
At least you can laugh about my model while in your model more people end up miserable and/or die while you sit there calling them dumb and saying they deserve it for not being expert biologists and expert chemists.
Your model of personal responsibility is something only an intellectual who is divorced from the reality of the working classes can suggest. It's incredibly cold and narcissistic borne out of the belief that nothing could happen to you in such a world since you are apparently well-informed about everything. What would happen to others is apparently none of your concern then.
The problem with that is that a majority of humanity disagrees with it and decided to build society in a different way that we call more humane. Your attempts to change this are quite amusing.
Ironside
11-04-2013, 11:01
It's businesses giving consumers what they want.
Marketing consists of three parts. The first is to show the world that you exist, the second to increase the number of people wanting your product. The third is to make them willing to pay the price you given (in particular about exclusiveness of a product). The second and third is all about manipulation.
And?
If the people behave like that without "teh guverment keeping dah man down", then why do you expect them to behave differently? To paraphrase. "This would work perfectly if people stopped acting like people." I do remember seeing this about another political system.
What on earth gave you that idea?
Your insistance that "what the consumer wants, the market provides", without acknowledging that the consumers are far from a monolithic mass, and under manipulation from the market. You also ignore that the consumers already got the powers of boycott ("but the electorate itself can't force the change?"), probably because it's too weak. And with your "new, improved" system, that's the only power.
And has the government lied or been wrong about the dangers of products in the past?
The naive paternalistic view of government that you and Husar exhibit is amusing.
A goverment doesn't have any economic reasons for lying about it. A corrupt goverment does, putting it in a similar spot as the companies already bribing them. Remove the goverment and your starting place would be the companies. Or in the best case, underfunded independant research.
My point with the aspartame question is the one of a reliable source. You can choose to be ignorant and ignore it, you can choose to do a basic read up on it, or you can dedicate at least months and probably years of studies to get a full understanding of it.
For most people, it'll be the basic read up. It's a staggering number of sites claiming that a waste product of aspartame is toxic. Bonus point is even the goverment and the producer agrees with that, but says it's a trace amount of a toxic waste we already get naturally in higher amounts. And thus we come to my point:
To be able to do a basic research, the thing 99,9% of the population shouldn't need to surpass, you'll need to be able to easily recognize the reliable sources. You have 3 basic options, the goverment, independant research and the companies. The problem with independant research is thier source of money. Without a stable, reliable source, large conditioned donations would dominate (and you can see how the mild ones look like already). And creating a stable, reliable source is pretty much taxing things already. Easier to keep it within the goverment and have the watchers monitoring that, than developing new systems that looks exactly alike.
HoreTore
11-04-2013, 20:14
Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.
Ah, the sweet-sweet smell of blue-eyed market optimism.... It's so cute! ~:)
The simple answer to why consumer power doesn't work, is that it simply doesn't work. If you want real change, history has shown that it must be forced from a position of power. And power is what the state has, while the power of the consumer is an over-hyped nothing.
HoreTore
11-04-2013, 20:46
The consumer's relative lack of power in America is only because of years and years of concerted efforts by deregulation lobbies though.
"Consumer power" never existed and never will, since it rests on a deeply flawed premise; an incredibly simplistic model of human behaviour completely detached from actual reality.
The free market is excellent at giving us cheap crap. If we want anything resembling quality products, we need the regulations only state power can enforce.
HoreTore
11-04-2013, 21:02
Right. In America that power shifts back and forth. These days we live in a golden age for big business and consumer abuse.
Could you please be more specific as to when that period where businesses obeyed the wishes of the consumers was?
HoreTore
11-04-2013, 21:21
Well, taxes on the rich and the minimum wage (adjusted for inflation) were both higher in the 50s and early 60s.
Both examples of state power enforcing regulations, so that pretty much confirms my point, doesn't it?
HoreTore
11-04-2013, 21:30
Your over-agressive socialist rhetoric makes it hard to recognize when someone is supporting your point, I guess.
This is why I love you. :sweetheart:
HoreTore
11-04-2013, 21:50
Get a room!
I have a room. What I need is an airplane ticket for GC and a bucket of lube. Wanna chip in?
Since you're German, you're bound to have some extra lube lying around...
I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans (http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare).
The insurance companies argue that it's simply capitalism at work. [...] By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.
TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace's Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren't necessarily able to stop them.
It's not yet clear how widespread this practice became in the months leading up to the marketplace's opening -- or how many Americans will end up paying more than they should be for health coverage. But misleading letters have been sent out in at least four states across the country, and one offending carrier, Humana, is a company with a national reach. [...]
The most troubling part of the Humana case is that the company was pushing customers into a Humana insurance plan that was more expensive than the plan Humana was selling on the Obamacare marketplace, without the financial help available under Obamcare.
a completely inoffensive name
11-05-2013, 00:52
The power of the consumer is to consume heavily.
It's not a power, it's a weakness, an urge in today's society, and it's why companies can do whatever they want unless government says otherwise.
ICantSpellDawg
11-05-2013, 01:00
I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans (http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare).
The insurance companies argue that it's simply capitalism at work. [...] By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.
TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace's Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren't necessarily able to stop them.
It's not yet clear how widespread this practice became in the months leading up to the marketplace's opening -- or how many Americans will end up paying more than they should be for health coverage. But misleading letters have been sent out in at least four states across the country, and one offending carrier, Humana, is a company with a national reach. [...]
The most troubling part of the Humana case is that the company was pushing customers into a Humana insurance plan that was more expensive than the plan Humana was selling on the Obamacare marketplace, without the financial help available under Obamcare.
Traditionally, State Insurance Departments were developed to stop insurance companies from jacking rates without rational cause. Now that insurance policies are commodities that must be purchased by law, they aren't worried about losing business, and the 1000 pages of cost increases has given them Carte Blanche to spike rates without SID oversight. Hey, If the government was handing out money to private business, I'd raise my prices too.
The reality is this: the new requirements will increase claims payouts. Individuals will not sign up until the last possible minute in the event that they are ever able to. Claim costs will increase immediately, premiums will trickle in. Large numbers won't offset the loss ratio for some time. State and Federal insurance commissioners are to give the insurance industry time and leniency to pad their numbers and ensure that they are solvent, hence the large spikes in cost. Costs which will never go down, only slow in growth as people enter the market.
The idea that the bill was called the "affordable health care act" was a sham. It is affordable for no one. Has anyone signed up yet?
ICantSpellDawg
11-05-2013, 01:08
What a joke. 1000 pages of law creating an environment for massive companies to exploit will create a backlash? This is what regulation is! This is the outcome of attempting to stack the deck - the deck gets stacked! What are you going to do? not buy the product??!!! What a laugh.
What do you think regulation is? Magical salve for problems? if the new Health care law isnt regulation, I wonder what is, 2000 pages?!!!! unbelievable that you can suggest that de-regulation is responsible for this.
ICantSpellDawg
11-05-2013, 01:23
My healthcare proposals benefit the working members of society. Working members of society will like them more and more. The elderly and those who don't work will like the idea of the pay based on ability, use based on need. If fully socialized medicine comes to be it will be a coup for the elderly and entrenched interests.
I really don't care personally, 12 years ago I was told that I would likely die or get a liver transplant in 10 years time, so I'm on borrowed time. By the time universal health coverage comes around, if I still am, I'll just sit back playing Battlefield 8 or Rome IV total war, living off my welfare that you guys worked so hard to provide me.
Could you please be more specific as to when that period where businesses obeyed the wishes of the consumers was?
Gee, I can't think of anything.....
11197
I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans (http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare).Wait til Donna finds out she can't keep her doctor (http://thelead.blogs.cnn.com/2013/11/04/obamacare-war-room-docs-fewer-options-higher-prices/) either.
Seamus Fermanagh
11-05-2013, 06:57
So far, the only thing that is a known in the whole issue is that the website access to sign up is malfed.
Are some peoples' prices going to go up -- yes. Is it because they are going to have to acquire truly comprehensive coverage that conforms to ACA standards (hence the difference) or because the whole plan is going to be far more expensive than originally forecast so as to offset the cost of subsidies for coverage? Are the number of people facing increases significant? So far, we have a lot of anecdotal data but no hard numbers.
Same numbers question with the "gonna lose your doctor" bit. Well reported anecdotal evidence or statistically significant problem? Plus, how do you keep your doctor if the doctor retires? It is not as though changing your doctor is a guaranteed horror story. The anecdotes of people losing their doctor make Obama look bad because he made a sweeping statement, but so what?
The WaPo Fact Checker weighs in (http://www.washingtonpost.com/blogs/fact-checker/wp/2013/11/07/the-white-house-effort-to-blame-insurance-companies-for-lost-plans/) on Democrat efforts to blame the insurance companies for plan cancellations. Their assessment? 3 Pinocchios.
Blaming the insurance companies can only go so far. First of all, the administration wrote the rules that set the conditions under which plans lose their grandfathered status. But more important, the law has an effective date so far in the past that it virtually guaranteed that the vast majority of people currently in the individual market would end up with a notice saying they needed to buy insurance on the Obamacare exchanges.
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Are some peoples' prices going to go up -- yes. Is it because they are going to have to acquire truly comprehensive coverage that conforms to ACA standards (hence the difference) or because the whole plan is going to be far more expensive than originally forecast so as to offset the cost of subsidies for coverage? Are the number of people facing increases significant? So far, we have a lot of anecdotal data but no hard numbers.
From Forbes (http://www.forbes.com/sites/theapothecary/2013/11/04/49-state-analysis-obamacare-to-increase-individual-market-premiums-by-avg-of-41-subsidies-flow-to-elderly/):
11215
So the ACA allows insurance companies to continue screwing people, as opposed to insurance companies contradicting the law.If by "screwing people", you main raise rates to stay in business, then I completely agree.
The ACA creates incentives for the most sickly, and therefore costly to sign up. It also severly limits what the insurance companies' can charge these people. Necessarily, the premiums for everyone else must go up to cover the increased costs that they're taking on. Frankly, with the way the rollout has gone thus far, many insurers are probably underestimating their costs. If things continue, I expect a new round of sticker shock for exchange users next year as rates continue to jump.
Seamus Fermanagh
11-07-2013, 23:31
From Forbes (http://www.forbes.com/sites/theapothecary/2013/11/04/49-state-analysis-obamacare-to-increase-individual-market-premiums-by-avg-of-41-subsidies-flow-to-elderly/):
11215
Thanks, Xman. First thing resembling collated data I have seen on this. Ohio and Colorado both seem to be "winners" here. I wonder if that will have electoral implications.
As you point out, the problem is that its a business. It can't be a business if we are to have healthcare as a Right! Now if our options are back to the bad old days or onward to socialized medicine, its onward no contest.
I'll never understand how you can think a service is a right. For a service to be provided, people have to provide it. What happens to your right if not enough people are willing to provide? Do we force them to provide your rights? It smacks of Orwellian-ism.
I'll never understand how you can think a service is a right.
Meh, casting healthcare as a "right" is a distraction.
Markets are great, but they aren't great at everything. I see absolutely no real-world evidence that healthcare can function well as a market-driven enterprise. No other industrialized nation is trying to control/enact it as such, and there might be a reason. Most other nations also frown on privatized military, privatized police, privatized roads, etc.
The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland (http://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/).
ICantSpellDawg
11-08-2013, 02:18
Meh, casting healthcare as a "right" is a distraction.
Markets are great, but they aren't great at everything. I see absolutely no real-world evidence that healthcare can function well as a market-driven enterprise. No other industrialized nation is trying to control/enact it as such, and there might be a reason. Most other nations also frown on privatized military, privatized police, privatized roads, etc.
The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland (http://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/).
I am effectively convinced of your argument at this point, with caveats:
Most things fail to function well as government driven enterprises. It is a peculiar situation, where many things work well in a market-driven setting, but health care has flopped.
Personally, I believe that duress-based services do not follow market forces and should be treated differently. We should aim to harness the benefits of market forces with the security of government intervention ONLY for health care. The ACA can be adjusted to help do this. It is going to be difficult and it won't be done if we act purely as impediments to it, or if we eliminate even the harshest critics.
Our system was broken before the President touched it. It is now shattered - BUT, like the London Fire of 1666, maybe it is just what we needed to start fixing it and building something world leading again.
The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland (http://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/).
Swiss citizens buy insurance for themselves; there are no employer-sponsored or government-run insurance programs. Hence, insurance prices are transparent to the beneficiary.Boom. Right there is the answer. Ever since FDR-era wage controls (that forced employers to add insurance coverage to their compensation packages since they couldn't raise wages), our insurance system has been spiraling out of control. Any serious healthcare reform has to break the attachment of work and insurance.
The best insurance I ever had was when I was out of work and forced to get private insurance. I asked if I could keep it when I got my next job- but they were legally unable to offer it to someone who had insurance offered to them at work. That's moronic.
As I read it, the Swiss system is basically Obamacare, had it been written by people who were reasonably intelligent... instead of by Democrats.
As I read it, the Swiss system is basically Obamacare, had it been written by people who were reasonably intelligent... instead of by Democrats.
You might want to read up a little more on Swisscare (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland) ... which begat HeritageCare (http://www.forbes.com/sites/theapothecary/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/) ... which begat RomneyCare (http://en.wikipedia.org/wiki/Massachusetts_health_care_reform) ... which begat ... eh, you know where this leads.
The most productive thing for Republicans, going forward, would be to look at the obvious problems in Obamacare, and reach back to the solutions (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland#Private_coverage) already tested and applied in SwissCare (and already obstructed by Republicans in congress), declare that they are geniuses and have a fix, and move forward.
Hell, if it salves their egos, they can even tell everyone that this is what they meant by "repeal and replace." Whatever. Go nuts. But maybe, you know, work together to make something better. All of that touchy-feely let's-actually-try-to-govern stuff.
Seamus Fermanagh
11-08-2013, 04:18
You might want to read up a little more on Swisscare (http://en.wikipedia.org/wiki/Healthcare_in_Switzerland) ... which begat HeritageCare (http://www.forbes.com/sites/theapothecary/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/) ... which begat RomneyCare (http://en.wikipedia.org/wiki/Massachusetts_health_care_reform) ... which begat ... eh, you know where this leads..
So, it is akin to labeling the latest scandal "urinatinginthewindgate" or whatever "gate" is being lobbed about. Gads but our public lexicon is thin.
HopAlongBunny
11-08-2013, 12:57
I am curious.
In Canada, under "socialized" medicine I just got discharged from the hospital.
I ended up going to emergency from a clinic I stopped in at due to nausea and a continued lack of appetite.
The doctor called me in to discuss test results=>I walked in the door and was handed a letter=>you are a sick man, get to emergency.
Turns out, my kidneys shut down at some point,...I had no idea.
So 6 days in the hospital; much blood, electrolytes, heart medicine, oxygen, food, bed rest and a raft of specialists.
Out of pocket costs so far = $0.00; that will change when I fill my prescriptions => what would be my experience in the USA?
I am also slated to be fitted with a fistula and will be undergoing a regime of home dialysis; machine and materials provided by the state.
I guess in the American system it would be something like 2000$ for the letter the doctor handed you, 100$ for the hour he spent examining and talking to you, 3000$ for sending stuff to the lab, 50000$ for six days in the hospital and you can buy the dialysis machine yourself for 10000$ if you want to live a little longer.
In an ideal system however, the free market would decide whether you get a kidney failure or a heart disease in the first place.
Greyblades
11-08-2013, 15:09
Yikes! what happened to make your kiney shut down?
Out of pocket costs so far = $0.00; that will change when I fill my prescriptions => what would be my experience in the USA?
Two thoughts:
The USA system is a lot more complicated than you make it out to be (who exactly gets stuck with the inflated bills is a hotly contested issue every single time), but you've got the general outline correct.
Your out-of-pocket may be $0, but you are still paying. (Ain't no such thing as a free lunch.) But you are paying in a much more rational manner than we do south of the border.
HopAlongBunny
11-08-2013, 18:19
Yikes! what happened to make your kiney shut down?
As I understand it I suffer from a condition that causes the kidney to eat itself. Had I caught it sooner, it is treatable with steroids; by the time it was discovered I had only 3-5% of my kidney remaining.
Vote +1 for regular check-ups :p
Crazed Rabbit
11-08-2013, 19:02
I guess in the American system it would be something like 2000$ for the letter the doctor handed you, 100$ for the hour he spent examining and talking to you, 3000$ for sending stuff to the lab, 50000$ for six days in the hospital and you can buy the dialysis machine yourself for 10000$ if you want to live a little longer.
In an ideal system however, the free market would decide whether you get a kidney failure or a heart disease in the first place.
This is ridiculous. No way the dialysis machine would be that cheap to buy. That's probably the cost just to have it used on you for that week. Also, the cost is way to low for the doctor examination (I've gotten $175 bill, pre-insurance, for 15 minutes).
I'm not really joking.
However, you should read the article "Bitter Pill" by Steven Brill (http://livingwithmcl.com/BitterPill.pdf)(PDF alert!). It discusses, in great depth, the astronomical cost of care in the USA and looks at reasons why (like hospitals charging 100x the cost for over the counter medicine).
As I understand it I suffer from a condition that causes the kidney to eat itself.
Wow, that's unnerving. Best of luck with your treatment.
CR
Also, the cost is way to low for the doctor examination (I've gotten $175 bill, pre-insurance, for 15 minutes)
It is $32 for that from our private sector, 'free' if you visit the local GP you are registered to.
*Free at the point of access.
This is ridiculous. No way the dialysis machine would be that cheap to buy. That's probably the cost just to have it used on you for that week. Also, the cost is way to low for the doctor examination (I've gotten $175 bill, pre-insurance, for 15 minutes).
I'm not really joking.
I know, and I'm sorry.
I was trying not to look anti-american by using numbers that are too high. :sweatdrop:
The numbers were loosely based (from cheese-like memory) on some I saw in another forum recently.
Also wish you all the best HopAlongBunny!
Seamus Fermanagh
11-08-2013, 23:01
Condolences, Bunny. That ____ing sucks. Healthy enough for transplant in near future? Or is there some hope of returning to useful function percentage?
HopAlongBunny
11-09-2013, 02:06
Thank you for the good wishes!:yes:
The good news is that I am a good candidate for transplant (young and healthy); that was a shocking description made by one doctor.
I repeat though: get regular check-ups! Had I followed the initial signs over the last decade or so, I would be free and clear today.
~:grouphug:
The Chicago Tribune's editorial board slams Obamacare. This was something of a surprise seeing as how it's his hometown paper. As always, read the whole article, but here's the last line money-shot....
Truth, consequences and Obamacare (http://www.chicagotribune.com/news/opinion/editorials/obamacare-ct-edit-1111-20131111,0,459810.story)
It was a mistake to attempt such a massive government intrusion on a marketplace and a mistake to do so without anything close to a public consensus.I couldn't say it much better. :yes:
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