Landmark Health Insurance Bill Passes House

theodp writes "A hastily-crafted amendment imposing tough new restrictions on abortion coverage in insurance policies helped pave the way for the House to approve the Democrats' bill to overhaul the nation's health insurance system. 'It provides coverage for 96 percent of Americans,' said Rep. John Dingell. Rep. Candice Miller disagreed, calling the legislation 'a jobs-killing, tax-hiking, deficit-exploding' bill. The 1,990-page, $1.2 trillion legislation passed by a vote of 220-215 and moves on for Senate debate, which is expected to begin in several days." Update — 11/08 at 13:45 GMT by SS: Changed vote totals above to reflect the actual bill vote. The 240-194 number was for the abortion restrictions amendment.

Comments

What's in it?

[serps]

Insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history.

I'm not from the US, but isn't that the main bit of you guys' healthcare system that's most in need of fixing?

In my country, pre-existing conditions just mean that you can't claim anything for 12 months after joining. It doesn't affect premiums or anything, and no health insurance provider can reject your application.

So, I guess, welcome to the 20th century!

Re:What's in it?

[Igarden2]

Dude, get a clue !!! The bill has no provision that the recipient of health care be a legal resident. Regardless of protestations to the contrary, unwelcome aliens will take full advantage of the U.S. taxpayers. The bill does nothing to streamline the payment process which now sucks up a huge amount of premiums. The bill does not limit the insurance companies from denying coverage for any damned thing. True, they can't deny selling you a policy, but that policy can have lots of loopholes to deny specific conditions. There is no mention of tort reform. That alone is the main reason that many doctors and hospitals are going out of business in my state. This nightmare does not really improve our health care system. There are so many other provisions that could have been enacted to make the system better. Do you see any limitations on Big Pharma in this bill? Neither do I. I am in favor of an improved health system. This bill is not even close to an improvement.

Re:What's in it?

[Igarden2]

I forgot to mention the ultimate hypocrisy in this bill. Every member of the legislature is exempt from the bill. They have their own luxury system that is fully paid for by the taxpayers for life.

Re:What's in it?

[Trailer Trash]

The issue is that many people won't buy health insurance until they need it. That fundamentally breaks the model because insurance depends on having a pool of healthy people paying but not costing anything. The legislation kind of makes up for that by forcing everybody to buy health insurance (with threats of jail or heavy fines if they don't), but ultimately that will screw poor people who don't have money to buy it.

Re:What's in it?

[pla]

Pre-existing conditions is a wonderful way of saying that none of your previous doctors noticed it so we're not paying either.

Come again?

Preexisting conditions mean exactly the opposite of that - It means you did have the condition diagnosed before getting your current run of uninterrupted insurance coverage. The original idea behind such clauses actually had some merit - You couldn't skip out on having insurance, find out you have cancer, then get insurance solely to pay for your treatment.

Of course, the insurance companies, interested solely in profit rather than patient outcomes (hey, I hate them as much as anyone, but won't fault them (just) for doing exactly what they exist to do - Make money), discovered they could use this not just for acute conditions, but to deny treatment for things like diabetes or the standard cardiac cocktails most older males take, based on nothing more than the fact that you went one day too long without coverage between jobs.

But if no doctor ever diagnosed your condition, consider yourself good to go. Now, we do have some grey area here... If you had an X-Ray for a broken arm ten years ago, and it has a fuzzy patch near your current tumor, well, the insurance companies have whole teams of people looking for just such meaningless data as an excuse to deny benefits.

Re:What's in it?

[MrKaos]

Regardless of protestations to the contrary, unwelcome aliens will take full advantage of the U.S. taxpayers.

Isn't that what U.S citizen do to Canada now? and wasn't America built on immigrant labor?

The bill does not limit the insurance companies from denying coverage for any damned thing.

Seems to me insurance company profits would be better spent on just providing health care.

What happened to the nice America that looked after all her children?

Re:What's in it?

[Martin Blank]

I thought it was interesting that Associated Press published an article recently on the profits of the health insurance industry, something railed against persistently by various politicians. They found that the usual average profit margin for health insurance companies was 6%, and last year it was only 2%. From 2003 to 2008, the growth in their costs exceeded the growth in their profits.

But then, as the article itself notes, no one seems interested in the actual facts of the debate.

Re:What's in it?

[commodore64_love]

Under the old system there were only 8 million citizens (key word) that were not already covered by existing government programs (medicare, schip) or private insurance (typically provided by the employer). The 42 million number that keeps getting cited is pure propaganda, includes ten million illegal non-citizens, was derived from a mail-in postcard, and therefore highly inaccurate. The number was derived non-scientifically, and you can not trust it.

Under the new system, families will be fined ~$2500 for not buying an insurance plan. The last thing a poor person or a laid-off person needs is another major bill. That's completely outrageous. Furthermore it takes away the freedom of choice. And what's next? Will Congress start fining people because they choose not to buy a hybrid car? Once the legal precedent is set, there's no limit to their power to control what we buy or don't buy.

I will not pay. Congress can shove that fine up its marble ass.

Re:What's in it?

[WindBourne]

The interesting thing is that it really will fix nothing. All this did was offer up some competition to Insurance (not necessarily a bad thing), but will fund the indigent, which is mostly Illegal aliens here.

What is really sad is that it had NOTHING TO LOWER COSTS. We are in need of tort reform (how much money is paid out for lawsuits); costs of the docs eduction; costs of the drugs; costs of the hospital; etc.

What is amazing is that the neo-cons passed a monster drug bill to help buy old votes. Part of it required the feds to pay TOP DOLLARS for the drugs. Here is the American gov who passed a bill that would make the US federal gov the single largest buyers of drugs in the world, and the neo-cons forbid negotiations for LOWEST PRICE. This is expected to costs something like 400 BILLION dollars, instead of 50 BILLION over the ten years that it was looked at. This is a nice and easy 350 billion dollars to be save. So, did the dems include that in this bill? Nope. They are leaving us at paying the TOP DOLLARS for this.

I swear, The only thing worse than a GD democrat is an elected republican. The republicans are about pure greed and corrupt. The dems are stupid. America is in serious trouble.

Re:What's in it?

[commodore64_love]

>>>Isn't that what U.S citizen do to Canada now?

Uh... no. Canadian hospitals ask for ID, and if you wave a US license the hospital will refuse to serve you. The only exception is in cases of emergency (like a car accident), in which case the American will be handed a bill.

>>>wasn't America built on immigrant labor?

LEGAL immigrant labor. Illegals that were rejected at Ellis Island were sent back home. We have the right to control who enters our land, just the same as you can stop me from walking into your living room.

Re:What's in it?

[Eskarel]

The problem with that is that in the US system, if you're unemployed, unless you're also independently wealthy, you almost certainly will not be able to afford to maintain your insurance premiums. Self insurance is insanely expensive, most employed people wouldn't be able to cover it.

This means that if John Smith is covered by his parents till hi finishes college, gets a job works hard and pays his premiums for 20 years, and then gets cancer and can't work(and therefor can't continue to make his insurance payments) he's screwed. If he passes that time limit and they're allowed to call it a pre-existing condition no HMO will cover him.

It's one thing to say you can't get in a car accident and then get insurance to cover it, that's perfectly fair. It's another to say that because you lost your job, or your husband or wife lost their job through no fault of their own that you're not going to be covered even if you paid premiums your whole life.

There are some pretty easy ways to solve patients rorting the system anyway. You can either make coverage mandatory and pay for it with taxes(which is what we do for our public health insurance here in Australia) or you can put a waiting period for hospital cover(which is what we do on our private insurance).

The US pays an absolutely extraordinary amount for health insurance, far more per capita than pretty much any other nation in the world. Which is pretty damned impressive when you consider how many people in the country are uninsured. If you took all that money that everyone is paying, and pumped it into a public system, like the one which pretty much every western nation in the world other than the US has and runs reasonably successfully, you could have a top notch system with great coverage for everyone without anyone paying one dime extra. You could probably distribute the costs better and get some better efficiency and offer a great system and cut the expenditures it costs an awful lot to run an HMO after all, not even counting profits.

That won't happen of course since the US is so desperately afraid of actually letting their government do anything actually productive with their tax dollars like actually offering halfway decent public services and would much rather pay for guns or bailing out wall street millionaires, but at the least this new system might not screw over people who just have bad luck.

Re:What's in it?

[Anpheus]

Actually, the health insurance exchanges are very similar to the federal health plans. All federal employees are given a choice of option and able to pick what benefits they consider most affordable. Everyone in federal government gets these options.

In addition, the government, being so large, has been able to negotiate terms like bans on "pre-existing conditions" out of many of the contracts, for the benefit of all federal employees.

So, basically, this health insurance bill gives we, the people, the same health insurance options they have. That all federal employees have. And it gives us their protections, and potentially a public option in states where the local monopoly or duopoly has control of the market.

How horrible.

Re:What's in it?

[internic]

All this did was offer up some competition to Insurance (not necessarily a bad thing), but will fund the indigent, which is mostly Illegal aliens here.

On what basis are you concluding that? A quick look suggests that a good estimate of the poor (by official poverty line) in the US is 39 million, while the illegal immigrant population may be something around 11 million. That says that at the most about a quarter of the poor are illegal immigrants, and that's assuming that all illegal immigrants are poor (which isn't strictly true, though I don't know how far off it is). In any case, the bill bars illegal immigrants from getting aid in buying health insurance, although it remains to be seen how that would be enforced.

What is really sad is that it had NOTHING TO LOWER COSTS. We are in need of tort reform (how much money is paid out for lawsuits); costs of the docs eduction; costs of the drugs; costs of the hospital; etc.

While the situation with malpractice suits may be unreasonable, it's probably not a major contributor to health care costs. It sounds plausible on the surface that it would be, but apparently the total expenditure on malpractice insurance is less than $7 billion per year, which is totally dwarfed by total healthcare spending (something like $2.5 trillion). The cost of doctors practicing defensive medicine is, of course, harder to pin down, but it sounds like most studies still peg it as small. In any case, the CBO is estimating the savings on healthcare spending from malpractice award caps at 0.5%. I think this gets talked about a lot by politicians because it sounds plausible, there are some legitimate problems with malpractice suits, and, most importantly, people making malpractice claims are a convenient scapegoat since most of us won't ever be one or probably even know one.

In terms of the other costs I agree, though. We pay an absurd amount for drugs and a lot more for medical procedures than most other developed democracies. I'm not certain of all of the reasons for that, but the most likely major reason is that in most of those places the government collectively bargins with providers on behalf of all citizens, setting prices for drugs and medical procedures (even in many countries where insurance is still provided by private companies, like Japan and Germany). You can certainly debate the merits of such a system, but its one indisputable advantage is cheap prices.

...neo-cons forbid negotiations for LOWEST PRICE. This is expected to costs something like 400 BILLION dollars, instead of 50 BILLION over the ten years that it was looked at. This is a nice and easy 350 billion dollars to be save. So, did the dems include that in this bill? Nope. They are leaving us at paying the TOP DOLLARS for this.

I don't know what the will was among the Democrats to change the rules on drug purchasing by the government, but I'm sure that even those who supported it would not have lobbied for inclusion in this bill only because this bill had uncertain prospects in the first place, so adding something else potentially controversial probably would have killed it. It's bad strategy. If they want to make that change, it should come in a different bill.

Re:What's in it?

[RiotingPacifist]

Why are bills so big and all encompassing?

Somebody should demand they be split up and be resubmitted as individual patches!

Re:What's in it?

[Rick17JJ]

My medical insurance has recently gone up to $995 per month, now that I have just recently reached the age of 55. That is almost $12,000 per year that I am paying for medical insurance, just for myself. That is with a $1,250 deductible and no dental coverage.

I once tried to switch to a less expensive plan, but Blue Cross Blue Shield of Arizona would not let me switch. I have never had any significant health problems, other than being somewhat overweight and having very slight high blood pressure. It was only during the last year, that I finally needed to start taking a mild diuretic to lower my slightly high blood pressure. I am a non-smoker in good health who walks 45 minutes per day, wears my seatbelt, and does not eat junk food. Despite that, I need to pay 1/3 of my net take home income (after taxes) on Medical insurance. How much would I have to pay if I had more significant health problems?

I would like to see more willingness for Congress to ignore the lobbyists, and work on the causes of it being so expensive such as tort reform, big pharma, and the insurance industry.

Is this bill going to make my insurance less expensive, or perhaps subsidise my insurance?

Our government is already spending way more than it collects for taxes, so is this something which our country can afford without having to inflate our money supply more or borrow even money from China and elsewhere? I seem to recall Nancy Pelosi claiming that they had found some way to pay for it all. I have not really been following the news closely enough to know about those details.

Re:What's in it?

[Macthorpe]

Since government care is so damn wonderful, why is there a need for private car in the UK?

Nobody is saying that the NHS is perfect, or even wonderful. However, it is a good baseline for people that need it in an emergency or can't afford better. If you want more than that, you have the option to pay someone else to provide it. It's as simple as that.

And second, why did the college girl let herself be denied access to a PAP smear when the UK Health service said no? Why didn't she go get a PAP smear from the private option?

I don't know, I'm not responsible for her decisions and I don't know her personally. Maybe she couldn't pull together the £60 it would cost her to get one, or maybe she was incredibly stupid. So many possibilities.

Overall it sounds like the UK's not the promised paradise either.

That's because you'll infer your preferred conclusion from any data, even if it doesn't make sense. "Didn't think to go to a private hospital? That's the government's fault! I knew it wasn't a perfect system, even though nobody claimed it was!"

I'm pretty much done with arguing with you, because it's patently clear from your last few comments that you have no idea what you're arguing against and you have no willingness to find out. I could speculate as to why you're so invested in the current system, but as the answers range from somewhere between being paid to advocate for the insurance companies right the way down to the possibility that you'd rather other people die than you have to pay for health insurance, I don't really want to know the answer.

Re:What's in it?

[Rakarra]

There are liberals in the party but not nearly as many as conservative media would lead you to believe.

In the United States, "conservative media" would have you believe that anything to the left of far-right extremism is socialism.

I think I can I think I can

[betterunixthanunix]

Maybe the US will finally join the rest of the industrialized world in actually providing medical care to its citizens, instead of taking the, "find your own care" attitude.

Re:I think I can I think I can

[ColdWetDog]

Maybe the US will finally join the rest of the industrialized world in actually providing medical care to its citizens, instead of taking the, "find your own care" attitude.

Not bloody likely. At least, not with this bill.

But thank you for the kind thoughts. Check in again a a decade or so, maybe we will have managed to drop to third world status by then and even Congress will realize that something drastic needs to be done.

Re:I think I can I think I can

[nanoakron]

Doesn't sound like they will.

So this new bill leaves 4% uncovered - that's 4% of nearly 300 million people!

Whereas the healthcare systems of all other civilised nations leave no-one uncovered. Not even the tramps in the street.

NB UK NHS user here - Our system has its faults, but at least one of those isn't "Sorry, we can't give you that treatment because you can't afford it...so just hurry up and die."

-Nano.

Re:I think I can I think I can

[JAlexoi]

A) Health care is a right, that is logically derived from the right to live. And the lack of the right to kill yourself.
B) You probably don't understand that a healthy person will contribute more to society than an unhealthy one. In my country, there is some abuse of the medical system, but we are ok to have it. Because we all understand, that that is what it takes to have a population that is not afraid to go to a doctor at an early stage of an illness(to have the illness shortened). Out of that, there are more healthy people that contribute more and longer in form of taxes and other common wealth.

Re:I think I can I think I can

[Raisey-raison]

When I hear comments about how it's not right that the government provides 'free' things I sometimes wonder what people are smoking. Look, health care is a necessity and because we have such an insanely high gini coefficient, without either employer or government help most households could simply not afford it. And yes people do DIE when they lack proper health care, its not just a matter of going to the ER. They will stabilize you but not provide long term treatment. Good luck getting chemotherapy if you don't have insurance.

It's easy to go about limited government if you are in the top 25% in terms of income in the population. But median family income is $50,000. That is not a lot. How is a household in the 35% percentile earning $33,000 supposed to fork out $13,400 a year? And that figure is assuming that they get the same discount that a large business gets which for an individual is not going to happen.

Why don't the limited government crazies say the same thing about medicare? After all why should the government provide free services? The most f**ked up thing about it all is that those without insurance are expected to pay taxes (medicare tax) to provide other people with the very thing they lack.

And for those who love to go on about what the government should or should not do get this: Why do we spend over 4% of our GDP on defense and spend insane sums in Afghanistan and Iraq... ans: supposedly to protect our country. Now what does it mean to 'protect'. It means to prevent death and destruction. Well what is the point of spending $651.2 billion to maybe prevent an attack when way more people are suffering and dieing because of lack of adequate health care?????

The whole issue is insane. The free market simply does not work in health care. And I am some one who is pro free market. But at some point you have wake up and smell the coffee.

Re:I think I can I think I can

[Raisey-raison]

I hear this theory a lot - that despite the fact that no other country in the world has figured out how to use the free market to provide health care for all - somehow we could, if only the government was not in the way. OK well how about this? Let's follow you deregulatory path for 20 years as an experiment and if we have significant numbers of Americans without adequate health care then you admit it was a failure and it's immediately back to some government based system for everyone. How about that?

By the way if you are earning $8 how are you going to afford health care without government help under any system?

Re:I think I can I think I can

[VincentFreeman]

Health care in this country is about the best in the world.

That is a lie.

"The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland."

"Yet another study, cited in a recent report by the Robert Wood Johnson Foundation and the Urban Institute, looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. What Senator Shelby called “the best health care system” ranked in last place."

It's early, I'm lazy, but the facts match up. http://www.nytimes.com/2009/11/05/opinion/05kristof.html?em

Re:I think I can I think I can

[Ma8thew]

That's the cost of society. You get taxed when you are able to contribute to society. But you get all sorts of benefits. Like roads, police and fire services and (in most places) health services. The alternative? Try living in Somalia. I really don't understand the extreme libertarianism you exhibit. The only possibility is that you are astonishingly antisocial and totally unable to see that some people are, through no fault of their own, far less fortunate than you.

Re:I think I can I think I can

[moortak]

We have both the best health care on the planet and awful health care. If you can afford to go to the Cleveland Clinic for heart troubles Johns Hopkins for cancer and so on you will receive unparalleled care. If you have to rely on what you can afford at Metro hospital in Cleveland or Bon Secours in Baltimore then you are out of luck. God forbid you actually live out in a rural area.

Bill Itself: 220-215

[BBCWatcher]

The final vote was a lot closer: 220 to 215. Which seems like a mid-20th century vote total. It really is quite remarkable that, in 2009, in the United States, there's still widespread debate and disagreement over the proposition that health care should not be rationed on the basis of ability to pay.

Re:Bill Itself: 220-215

[SigILL]

Why should anything be rationed on any basis other than your ability to produce enough for society to afford it?

And why should your ability to produce enough for society be measured by how much money you have?

Re:Bill Itself: 220-215

[Exception Duck]

I think the reasoning is that it benefits society as a whole.

Re:Bill Itself: 220-215

[Hognoxious]

Why should anything be rationed on any basis other than your ability to produce enough for society to afford it?

What does Paris Hilton produce? I'm no communist, but the mere fact that she exists makes me think again.

Re:Bill Itself: 220-215

[MartinSchou]

And why should your ability to produce enough for society be measured by how much money you have?

Because that's how society works.

Are you one of the investment bankers who caused stockmarkets to crash, housing costs to soar and then crash and burn leaving people homeless and cause huge ripple effects in the world wide economic markets leading to millions and millions of people losing their jobs, money and homes?

Congratulations, you have had such an impact on society, that you will be rewarded with insane bonuses. You are worth saving.

Re:Bill Itself: 220-215

[beelsebob]

Why should someone who is sick, and hence can't produce anything for society not be allowed to get good quality health care that will lead to them being a productive member of society?

Re:Bill Itself: 220-215

[uglyduckling]

And that is a circular argument. "Why should x be y?" "Because that's how it works."

Re:Bill Itself: 220-215

[Anne Thwacks]

rationed on any basis other than your ability to produce enough for society to afford it

The logic here in the UK is that

a) You might be able to pay for it, but not when you are sick

b) People contribute to society in other ways than materially

c) Desperate people may be driven to commit crimes "I stole it to pay for my sick other/child's operation"

d) The disease might spread to _ME_

Re:Bill Itself: 220-215

[sp3d2orbit]

You are looking at it completely wrong man. Paris Hilton is a perfect example of capitalism working beautifully. Here is why:

1. Paris Hilton is a worthless bitch who inherited all of her wealth from others.
2. Paris Hilton spends untold amounts of money on utterly worthless crap: clothing, parties, drugs, herpes medication.
3. Paris Hilton will never, ever contribute anything of value to this world. Her movie, The Hottie and Nottie made like $5 in the theaters.
4. Eventually Paris Hilton will transfer all of her wealth to others. The system works without government intervention.

I think it is a wonderful system. Easter island was destroyed by rich people consuming all natural resources in a bid to out do their rich neighbors. In the United States that wealth gets harmlessly diverted into things like shoes and handbags that cost 20,000 bucks. Society is preserved.

Fixing all the WRONG problems

[Timex]

Let's see... Buy insurance, or go to jail. It sounds like Massachusetts.

How would this get paid for, I wonder? It's written by the same people that brought you "Cash for Clunkers" and the "Stimulus Package", and we know what came of THEM.

The Senate isn't expecting to make a vote on their version until next year. Hopefully it will die a horrible death. This bill has no business at ALL being the Law of the Land.

Re:Fixing all the WRONG problems

[Lakitu]

I read the link to the Ways and Means Committee where this idea that you will "buy or go to jail" has come from, which cites IRS tax codes for the reasoning you might go to jail.

The Republicans on the Ways and Means Committee, and various media outlets, like the Drudge report, have spread this idea that you will go to jail if you do not want this health bill passed. It's not true. You will face civil and/or criminal penalties for failing to pay taxes. That should be obvious.

Re:Fixing all the WRONG problems

[Teckla]

How would this get paid for, I wonder? It's written by the same people that brought you "Cash for Clunkers" and the "Stimulus Package", and we know what came of THEM.

When it comes to this recession, the first stimulus package happened on George W. Bush's watch.

Also, Ronald Reagan passed a massive stimulus package as well. When inflation is factored in, it was larger than Obama's stimulus.

Even factoring in the Obama stimulus package, the vast majority of U.S. debt was accrued under the watch of Republican presidents.

Let's try to stay grounded in reality and realize that both dominant political parties in the U.S. spend too much. There is plenty of blame to go around. Partisan bickering is blinding Americans to the fact that the real problem is that the government is even allowed to spend money it doesn't have.

Re:Fixing all the WRONG problems

[ScentCone]

It's like when the government promises to create 2 million jobs in 3 years, and then those jobs are CREATED IN TWO MONTHS!!

Which, as you surely know, is complete fiction.

The cash for clunkers program gave certain people a discount off of a new car (most of which were made by foreign companies, as it turns out), and cost the future taxpayers (who will have to pay for it, with interest to the Chinese) roughly $20,000 per car to administer. All of that (including the junking of thousands of useful vehicles that could have gone to people who cannot afford to buy brand new car, even with a discount, and for a very spikey, extremely temporary boost in sales that was more than made up for weeks later by the complete collapse of the same. It was an expensive, wasteful, absurd stunt that achieved nothing except to force a bunch of lower-middle-class tax payers who can't afford to buy new cars hand some fresh debt to their children so that other people could get a fake discount on a nice new vehicle.

Jobs were not saved or created. Money was not saved. The environment wasn't impacted in any meaningful way. All we have is the normalization of more government involvement in dealings between people who make something, and the people who buy it. All at the expense of everyone's grandchildren. No, they can't get anything right. And you know it.

Re:Fixing all the WRONG problems

[Eightbitgnosis]

We destroyed perfectly working cars and then gave out freshly printed money to replace them. This is fiscally sound?

Re:Fixing all the WRONG problems

[sycodon]

"under the watch of Republican presidents"

Repeat after me: "Congress is the only government branch that can raise money and spend it."

Re:Fixing all the WRONG problems

[blueg3]

The only branch that can pass laws, too. So how does Obama always get mentioned with health care and economic stimulus?

Re:Fixing all the WRONG problems

[NeutronCowboy]

Then why is this called "Obamacare" by the Republicans and Conservatives?

Re:Fixing all the WRONG problems

[Artifakt]

And it's not like Bush had a Republican congress for most of both terms, right? And he didn't make that speech where he told congress immediate action was vitally necessary in under seven days or the whole economy was threatened with total collapse, did he? So let's, by all means, rewrite history to make it all the Democrat's fault.

Oh sweet

[JimboFBX]

So surely this bill, which makes it illegal to charge more for being a woman, also makes it illegal to charge more for being a man with car insurance and life insurance. Right? I mean, god forbid the democrats come up with a good idea and poorly execute it or create unfair exceptions that favor special interest groups that voted them in like they always do. So who read more than 100 of the 1,990 pages of this thing before voting? How do you even summarize something so simply in a matter of a few paragraphs, then someone manage to bloat that to 1,990 pages? Obviously there is a LOT more to this bill than what has hit the press releases.

Well, countdown until this article gets over a 1,000 comments and only the top few become the ones actually read...

Don't forget ... privacy destroying

[Jah-Wren Ryel]

I'm of the opinion that even the current system of private coverage is fundamentally a violation of doctor-patient confidentiality. You've got these insurance companies just itching to monetize any piece of data they can get from their paying customers, such that the half-assed nature of HIPAA really provides no assurance that your medical information won't be used in one way or another that is ultimately against your well-being.

The only way to be sure your information (any info, not just medical records) won't be systematically abused is to make sure it isn't entered into a file or a database in the first place. Unfortunately, there seems to be a real focus on doing just the opposite with these healthcare changes - some sort of magical computer worshipping cargo cult thing where too many people think that if they can just get all our personal info into a database it will be the best thing since sliced bread. I'm tired of sacrificing privacy for the promise of increased efficiency and convenience and I am doubly tired of those promises failing to pan out in the long run. But that's exactly what I expect is going to happen here too.

Re:Don't forget ... privacy destroying

[TheGavster]

Fuck privacy between you and your health insurer. You have no expectation that your history of leaving open flames unattended be kept from your home insurer, or that your history of reckless driving be kept from your car insurer. If you have an expectation to bill $10K/month in healthcare expenses, I as a fellow premium-payer would expect you to kick a bit more in the pot than I do, since you are certain to pull more out.

Re:12 million people excluded?

[mustafap]

>What's with the remaining 4%? How come not everyone will be covered?

That 4% will be lawyers.

Re:On behalf of rest of the civilized world

[Starlon]

For as long as I've read /. there has been news about health, whether that be some health related tech, a new life saving procedure, or some new finding in biology.

Slashdot is not just a news site. That's its primary motivation. Its secondary existence is the discussion, and for some that's their primary reason for returning to /.. There's a sense of quality to the discussion on this forum thanks to the system in place.

1.2T = 120B per year

[volt4ire]

Let's be clear: 1.2 Billion is the cost for 10 years, not 1 single upfront cost (like bailouts or emergency war funding supplementals)

A Step Into the Dark Ages

[TheMonkeyhouse]

so health care reform bill has passed it first step - actually a move forward even if you dont like the bill, everyone (except the fat insurance companies) admitted that things had to change, and so this is a start. however, the amendment restricting abortion coverage is HUGE step backwards and another reminder just how much the lunatic Religious Right has taken hold in the US. Hopefully this does not force people into coat hangers and whiskey again. so close, but yet so far still to come.

Re:Those aren't the same

[SigILL]

Your wage does not correlate with how necessary you are to our society.

Spot on! Consider garbage collectors; no other profession has had a larger impact on the health of society as a whole. Without them rampant cholera would actually be the least of our troubles.

Re:Strikers Vow

[Anonymous Coward]

Seems the adults also know that you cannot rely on the private sector to provide for people. Capitalism isn't about compassion.

Banning illegal aliens is shortsighted

[gordonb]

You will pay for the health care of illegal aliens - period.

Let me repeat that. Whether they come to the ER without coverage or are enrolled in a government subsidized insurance program, you will pay. At least, in the latter case, they will contribute something and, perhaps, get some earlier care that will avoid expensive hospitalizations.

The bone-headed reflexive anti-immigrant nonsense that passes for debate in the US just saddens me. We really need to upgrade our educational system.

Re:Banning illegal aliens is shortsighted

[TarPitt]

How will illegal non-citizens support the government program when they are (1) not paying income or social security/medicare taxes

WRONG!!

Very few illegal immigrants are paid cash under the table. Most are paid in the same fashion as legal employees, and have taxes and social security withheld.

In fact, illegal immigrants are a net contributor to the social security fund, as many use fake social security numbers for which they will never be able to collect benefits:

http://www.azcentral.com/business/articl
Illegal immigrants pay taxes, too

He calculates that illegal immigrants contributed $428 billion dollars to the nation's $13.6 trillion gross domestic product in 2006. That number assumes illegal immigrants are 30 percent less productive than other workers.

The Social Security Administration estimates that about three-quarters of illegal workers pay taxes that contribute to the overall solvency of Social Security and Medicare.

"Overall, any type of immigration is a net positive to Social Security. The more people working and paying into the system, the better," Hinkle said. "It does help the system remain solvent."

My Issue Is...

[forbin_meet_hal]

...when did "health insurance" become conflated with "health care"? You buy insurance to ensure that you can get past some kind of catastrophic event, say, if you total your car. I don't expect AllState to pay for my gas, tune-ups, etc. It's about spreading risk, rather than a mechanism to take money from one guy and give to another to that you can buy what you want. HSAs for routine procedures is the way to go. Keep the insurance markets competitive and targeted towards what "insurance" actually means IN EVERY OTHER INSTANCE WHERE IT IS APPLIED!

Unconstitutional

[Coolhand2120]

Can anyone show me where in the U.S. Constitution it says the government can force you to buy health insurance? On this basis alone this bill should never have come to fruition. We have this thing call enumerated powers in our Constitution and nowhere does it say the government can compel anyone to buy health insurance just because they are alive.

Re:Unconstitutional

[forkazoo]

Can anyone show me where in the U.S. Constitution it says the government can force you to buy health insurance? On this basis alone this bill should never have come to fruition. We have this thing call enumerated powers in our Constitution and nowhere does it say the government can compel anyone to buy health insurance just because they are alive.

Huzzah! If the government taxes me and provides a service, I'm okay with that. (Single Payer.)

If the government says I must buy some service from a private company, then I am living in Gilliam's Brazil, and people should be shot.

The insurance companies have no right to exist, and no right to my money. People say that increasing pool size will bring down costs, but the insurance companies will just pocket the savings. There is no reason to believe that they would reduce cost to consumers because you remove the key defining force of the market. Business must entice buyers to the market with valuable goods and services. Once you make purchasing mandatory, businesses no longer have to compete with the competetive market force of 'Fuck You.'

Re:Unconstitutional

[quacking duck]

Huzzah! If the government taxes me and provides a service, I'm okay with that. (Single Payer.)

If the government says I must buy some service from a private company, then I am living in Gilliam's Brazil, and people should be shot.

The insurance companies have no right to exist, and no right to my money. People say that increasing pool size will bring down costs, but the insurance companies will just pocket the savings. There is no reason to believe that they would reduce cost to consumers because you remove the key defining force of the market. Business must entice buyers to the market with valuable goods and services. Once you make purchasing mandatory, businesses no longer have to compete with the competetive market force of 'Fuck You.'

I agree with the sentiment, but I'm pretty sure you're already forced to buy a service from a private company.

Own a car? The liability part of car insurance required by law. And though some Canadian provinces manage auto insurance, I doubt your state does, forcing you to use a private company.

Re:Unconstitutional

[twostix]

I have five nice mod points I'd just love to use right now, but you will I've just got to reply to this...

The Federal Government exists only because it has the powers given to it by the legal contract between the states and itself. Without the constitution all those people sitting in Washington DC are just yet another toothless political activist organistion passing non-binding resolutions.

It's highly extraordinary and rather worrying that you regard demanding the US Federal Government limit itself to the legal powers that it was given and ALSO the restrictions that were placed upon it as nonsense just because historically it has ignored them (or more likely because you happen to like the current party in power - I wonder if you sang the same tune 5 years ago).

Your Federal Government also "gives you" extraordinary rendition, torture, military bases in every country in the world, the highest percentage of people in prison in the western world, undeclared wars, a rogue CIA, warrant-less wiretaps etc, etc, etc.

Perhaps if your Federal Government was forced to stay within the bounds of the very legal document that gives it ANY authority to exist at all your country and the rest of the world would be a hell of a lot better off.

Oh, but college kids get cheap loans via the Department Of Education so that makes it ok! The same entity that forced No Child Left Behind on every school in the country...

And if the Federal Government isn't bound by the law that creates it and gives it power over the people why should people be bound by it? Surely if it gets to choose, so does the individual.

Because it has all the guns, tanks and army you say? Then what's the difference between it and every other despotic regime that's held power over the people through the barrel of a gun rather than the rule of law?

Re:Strikers Vow

[millennial]

Also, if you honestly find that your concern for corporate incomes trumps your compassion for your fellow human beings, I pity you . Health care is a right. If you think that people who provide for things that are rights are somehow enslaved by the fact that they're rights, you're out of your mind. People always choose what they do.

Pushed just far enough

[AlpineR]

The close vote is intentional. The leaders realize that this is a once in a generation opportunity to reform healthcare, so they're going to push that reform as far as they can. They could propose some really minor changes that everybody agrees with. They could propose some really radical changes that almost nobody agrees with. Or they could push the biggest change they could get without failing.

As for the party split, the Constitution does not entitle all political parties to equal happiness. In a time when reality has a liberal bias, the wishes of the electorate are reflected in the composition of the legislative bodies. Aside from their role in achieving a majority of votes in Congress, the Republicans are no more entitled to appeasement than are the Greens, Libertarians, or Communists.

Re:Strikers Vow

[amiga3D]

I rely on me to provide for me. Government isn't about compassion either. It's about control. We've pretty much abandoned the intent of the constitution. The federals were never supposed to have this much power. I think it's time for the States to step up and take some of this power away from them.

Re:Strikers Vow

[sycodon]

Capitalism is the worst...except for everything else.

Re:Strikers Vow

[Laukei]

The 1950s called, they want their red scare back.

Seriously though, you need to get a grip. People who are ill are by definition less able than those around them. Why should it fall to them to help themselves? Do you actually just strive for the destruction of society? If so, there's a group of people in the Middle East who'd love to hear from you.

We have national healthcare in the UK, and, having had both parents working within it for 25 years apiece, it's not slavery. Are the police slaves? The fire department? Your logic is flawed.

Laukei

Re:Strikers Vow

[Rising Ape]

Presumably, in the same way that any other tax evasion will. Does the police force, military, court system, fire brigade etc. enslave people?

Re:Strikers Vow

[value_added]

You can start by explaining how a multi-trillion dollar government program is going to make things better. Perhaps, you can cite the dozens or perhaps hundreds of other programs the government has run that efficiently made things better?

Sigh.

Has it occcurred to you that the argument implicit in your questions, the One Argument To Rule Them All (or, to use Ronald Reagan's words, "Government is the problem"), is not an argument at all? It's an idealogy. And one that's been gradually discredited since the 1980s, and especially so of late.

That said, the following quotation should address your questions about governemnts programs that run efficiently or make things better:

This morning I was awoken by my alarm clock powered by electricity
generated by the public power monopoly regulated by the U.S. Department of
Energy. I then took a shower in the clean water provided by a municipal
water utility. After that, I turned on the TV to one of the FCC-regulated
channels to see what the National Weather Service of the National
Oceanographic and Atmospheric Administration determined the weather was
going to be like, using satellites designed, built, and launched by the
National Aeronautics and Space Administration.

I watched this while eating my breakfast of U.S. Department of
Agriculture-inspected food and taking the drugs which have been determined
as safe by the U.S. Food and Drug Administration.

At the appropriate time, as regulated by the U.S. Congress and kept
accurate by the National Institute of Standards and Technology and the
U.S. Naval Observatory, I get into my National Highway Traffic Safety
Administration-approved automobile and set out to work on the roads build
by the local, state, and federal Departments of Transportation, possibly
stopping to purchase additional fuel of a quality level determined by the
Environmental Protection Agency, using legal tender issued by the Federal
Reserve Bank. On the way out the door I deposit any mail I have to be
sent out via the U.S. Postal Service and drop the kids off at the public
school.

After spending another day not being maimed or killed at work thanks to
the workplace regulations imposed by the Department of Labor and the
Occupational Safety and Health administration, enjoying another two meals
which again do not kill me because of the USDA, I drive my NHTSA car back
home on the DOT roads, to my house which has not burned down in my absence
because of the state and local building codes and Fire Marshal's
inspection, and which has not been plundered of all its valuables thanks
to the local police department. And then I log on to the internet --
which was developed by the Defense Advanced Research Projects
Administration and post on Freerepublic.com and Fox News forums about how
SOCIALISM in medicine is BAD because the government can't do anything
right.

Credits to the orginal poster or writer.

Re:Strikers Vow

[PrescriptionWarning]

The "federals" also allowed slavery when the constitution was written. The point of it is that it can be changed through amendments as changing times require changing purpose. Wrongs that couldn't originally be righted can through time be resolved.

Re:Strikers Vow

[TubeSteak]

The adults know that you can't fix the problems of a mostly government-controlled mess by making it fully government-controlled. Keynesians are infantile morons.

1. America has a "free" market for health insurance/care
2. America pays more than most Western countries for health insurance/care
3. America gets worse results than most Western countries
4. Most States have one insurer that has >40% of the insurance market

I'd like to hear your theory on how the current free market de facto monopolies are "a mostly government-controlled mess".
And how those facts, taken together, do not suggest a failure of the current "free" and "competitive" market.
But if you're not actually going to explain your position, don't bother responding.

Re:Strikers Vow

[Cyberax]

"Except for every time Keynesian remedies have been tried, you mean?"

WTF?

"The first great depression, the Japanese lost decade, the second great depression that we're heading into right now..."

WTF cubed?

These are examples where Keynsian remedies WERE NOT tried (at first). During the first great depression Keynes has not even formulated keynsianism.

During the 'lost decade' Japan tried the 'fiscal conservatism' policy, by raising the interest rates and stopping the flow of money. So economy ground to a complete halt. Only after many years of low interest rates and various stimulus packages the Japanese economy started to grow again.

You simply don't understand economics.

Wanna to take bet that there will be the second great depression? Say, if in 2 years DOW falls below 7000 for period of more than 1 month then I'll give you 10 grams of gold (or its equivalent in the currency of your choice).

Re:Strikers Vow

[jcr]

The "federals" also allowed slavery when the constitution was written.

They also offered to let the south keep slavery in perpetuity, if they'd rejoin the union and pay the tariffs. This offer was made several times during the war. The northern claim to moral ascendancy on the slavery issue is a load of crap.

-jcr

Re:Strikers Vow

[zippthorne]

Tried that a century and a half ago. Unfortunately we coupled "state sovereignty" with "states' rights to allow slavery." So we lost that one. We all lost. Even the freed slaves lost.

Re:Strikers Vow

[jcr]

These are examples where Keynsian remedies WERE NOT tried (at first).

What's your next guess?

Most of the "new deal" was continuation of Hoover's interference in the economy. Hoover was the secretary of the treasury in 1920, and he was incensed that he wasn't allowed to interfere in the depression of 1920 (which was over in about a year and a half). When the crash of 1929 came on, he got to try out all of his clever "progressive" ideas and turn the crash into an unmitigated disaster. Roosevelt then dragged it out for the rest of his life.

We didn't get out of the first great depression until 1946, when a million men were released from military service, the federal budget was cut by 2/3, and most of Hoover and Roosevelt's insane economic policies were lifted.

During the 'lost decade' Japan tried the 'fiscal conservatism' policy, by raising the interest rates and stopping the flow of money.

No, the Japanese government refused to let failed banks go out of business. They poured money into them, just as the congress did in the TARP program.

You simply don't understand economics.

Project much?

Keynes didn't understand economics, either. He understood how to curry favor with politicians by lending an air of "scientific" justification to their power-grabbing. He was the Lysenko of economics.

-jcr

How healthcare should be fixed

[jonwil]

This is how I would fix the problems:
1.Eliminate company health plans (the providers of these plans have little to no incentive to offer any actual benefits to the employees as the companies cant change to someone better due to lock-in contracts and the huge costs of changing, nor can the employees generally switch without paying a lot more)

2.Give every citizen a certain amount of tax-free money they can use to buy health insurance. i.e. the first $x of their health insurance costs are tax free. This makes up for the loss of company health plans (which are generally tax free)

3.Make it super-easy for people to switch to another health provider anytime they choose without penalty (i.e. if they switch to a similar plan from a different provider, the new provider cant suddenly deny coverage for all your pre-existing conditions just because you switched providers)

4.All health care providers must charge the same amount for the same treatment no matter who is paying. If a hospital charges $2000 for a procedure to one person, they must charge the same $2000 to everyone who gets the procedure (no matter if its the government via medicare, a large health plan, a small insurance company, an individual paying out of pocket or whatever else). Obviously they can increase the price anytime they want but again they need to charge the same new price to everyone

5.Take away all incentives for doctors and hospitals and others to order "unnecessary" tests (including a reform of medical malpractice law so that lawyers cant argue "I sue the hospital for $$$$$ for failing to carry out when carrying out would have saved my clients life/heart/kidney/good looks/whatever")

6.Remove any laws and red tape that make it harder to start up a health fund. Making it easier to run one (and reducing the administrative costs) may encourage new players into the market who offer better value much the same as what companies like Jet Blue did for air travel)

7.Remove any rules/laws/etc that in any way restrict what health insurance companies are allowed to offer coverage for. If an insurance company wants to offer coverage for prescription glasses (for example), they should be allowed to do so.

8.Low income earners and the poor (who cant afford health insurance) would get subsidized cover. Not government run cover but money from the government paid to the individual to cover part or all of their health insurance costs

9.Health insurance companies would be banned from doing deals with specific hospitals or doctors (i.e. "you will only get coverage if you go to OUR hospital"). Further to this, companies that own health insurers would be prohibited from owning any operation involved in the provision of health care (e.g. hospitals, drug companies, medical equipment makers etc). Also, Health insurance companies would be banned from dictating treatment terms to doctors (i.e. if you want us to give coverage for this heart operation, you will do it the way we specify)

and 10.Health insurance companies would be required to disclose upfront how much they will pay on a given treatment before the treatment is carried out and they must pay up. No more cases of saying one thing before you go into hospital and then changing their mind and denying payment AFTER the patient has racked up the big medical bills.

Re:Strikers Vow

[Anonymous Coward]

I'm not going to do a bulleted rebuttal of the programs, but I will say that for any inefficiencies or problems, I cannot imagine life if they were controlled by private interests, which is what we are talking about; if healthcare is on the level of roads, schools, and mail, and should be at least available to anyone who needs it.

"Just off the top of my head. I don't know why many people so love the idea of being under the finger of faceless bureaucrats and Congresscritters"

Because it is at least marginally better than being under unelected CEOs and millions of nameless managers and directors, whose only goal in life is to suck more money out of the economy for their own gain.

"even pretend to let you have a say in what they do (see people like Rep Eric Massa (D-NY) who said he will vote for the health care bill even if his constituents don't support it)"

They elected a democrat, fully aware of what that would probably mean. Cry me a river.

"over having an elected business (you vote with your dollars)"

Yeah, I'll vote with my dollars when I have none, penniless because my job went over to China. I'll vote with my dollar when every choice in town is a member of the same cartel, just like ISPs, phone companies. I'll vote with my dollars when no one wants it, because of a condition that makes me "not worth" selling to. I'll vote with my dollars when my coverage is dropped because I wasn't quite as profitable as the guy next door, and profits had to be raised this quarter.

Yeah, my dollars may be powerful, but how about my voice instead? How about the other things the founders of the country gave me?

"with at least some ovresight (government, you, interest groups, etc)"

That is really the issue here, isn't it? The government putting in some oversight, and the fat cats not liking it one bit. So your argument is at best paradoxical; at worst, hypocritical.

"so you're giving me a free house, a $50-100k salary, a vehicle, etc too right?"

Ever hear of unemployment, social security? Probably; those are evil socialist systems designed to rob you of your hard earned money, too..

"where France has people rioting because they can't get jobs"

Right on topic.

"sick to get needed health services"

You mean like the vast majority of those with "pre-existing conditions" in the US? I'd say they are probably still better off than us!

"Didn't we fight a war to separate ourselves from Europe so that they couldn't dictate our way of life to us?"

There is the spirit! The not-made-here, blindly nationalistic spirit that permeates US politics. Because at one time we had a war with them, no matter what they do, we are superior and should do things even when they are proven to be wrong just to avoid being like them.

Is it any wonder why we are quickly headed towards third world status?

Comment removed

[account_deleted]

Comment removed based on user account deletion

Re:This is how freedom dies

[jareth-0205]

Yup, everyone likes the freedom to get sick and die at the whim of big business that desperately wants to find any way not to cover you when you need it.

The poor, of course, also don't deserve to live. They're free.

Re:Strikers Vow

[Anonymous Coward]

This morning I was awoken by my alarm clock powered by electricity
generated by the public power monopoly regulated by the U.S. Department of
Energy.
[Electricity was generated before there was a public monopoly. Most electric power is still generated by private companies. I own stock in many utility companies. You don't think government involvement degrades the efficient generation and delivery of power?]

I then took a shower in the clean water provided by a municipal
water utility.
[Local government is greatly preferred over federal government. Water was clean before government got involved.]

After that, I turned on the TV to one of the FCC-regulated
channels
[What exactly has the FCC done for you?]

to see what the National Weather Service of the National
Oceanographic and Atmospheric Administration determined the weather was
going to be like,
[These are very small government organizations linked to one of the legitimate functions of government - provide for the common defense]

using satellites designed, built, and launched by the
National Aeronautics and Space Administration.
[There are more private satellites than public. NASA doesn't design anything. Northrop Grumman, and Lockheed, and Boeing, and raytheon design and build satellites to meet Nasa specifications.]

I watched this while eating my breakfast of U.S. Department of
Agriculture-inspected food and taking the drugs which have been determined
as safe by the U.S. Food and Drug Administration.
[USDA is one of the most dysfunctional government agencies. It does not inspect a statistically significant amount of food, and it is horribly inefficient at regulating drugs.]

At the appropriate time, as regulated by the U.S. Congress and kept
accurate by the National Institute of Standards and Technology and the
U.S. Naval Observatory, [provide for the common defense]
I get into my National Highway Traffic Safety
Administration-approved automobile [what is better because it is "approved"?]

and set out to work on the roads build
by the local, state, and federal Departments of Transportation,
[Local and state are one thing. The federal highway system has been a mixed blessing]
possibly
stopping to purchase additional fuel of a quality level determined by the
Environmental Protection Agency, [Think about that one for a moment]
using legal tender issued by the Federal
Reserve Bank. [for which a constitutional amendment was required and which was complicit in every financial scandal since inception.] On the way out the door I deposit any mail I have to be
sent out via the U.S. Postal Service [Shining example right there] and drop the kids off at the public
school. [Another shining example] ...

Not soclialist -- if anything this bill is fascist

[pkbarbiedoll]

Few people will actually be covered under the reduced "public option". This bill was another payout to corporate America, on the taxpayers' dime.

Re:Strikers Vow

[drsquare]

You can also elaborate on exactly how trying to make health care/insurance a government mandated "right" doesn't effectively enslave those who provide such services?

Clown comments like that are why libertarianism will always be a joke philosophy, confined entirely to Internet conspiracy theorists and anti-social hillbillies.

Remember all that Ron Paul crap that infested the Internet all the way up to the last election? You'd have thought the absolute trashing of their candidate would have silenced the Randroids, but they're back like a really stubborn weed.

In short, if all you've got are insults, you need to take your socialist government loving self somewhere else. Real adults take care of themselves and don't look to the government for handouts.

Real adults realise the benefit of society and the welfare state over 'fuck you got mine' anarchy. Libertarians want to turn the US into Brazil, or Victorian England. Maybe they should re-open the workhouses, or is that too much government interference?

Re:Strikers Vow

[jcr]

The point of it is that it can be changed through amendments as changing times require changing purpose.

Yes, if the government cared at all about the rule of law, they'd be trying to amend the constitution to permit this kind of blatant power-grab. The problem is that the people let FDR get away with all kinds of things that should have gotten him hanged, and now the power-grabbers see no need to even consider the constitutionality of anything they want to do.

When someone asked Pelosi where in the constitution the authority for this monstrosity could be found, she asked "are you serious?", and then fobbed the question off with the old commerce clause excuse. The commerce clause exists to prevent the states from erecting trade barriers against each other, not to give the federal government authority over anything and everything that is bought or sold. If the commerce clause gave that kind of power, then the rest of the constitution would be moot.

-jcr

We rank 37th in infant mortality (Correction...)

[tomhath]

We rank 37th in infant mortality

The US ranks 37th in *reported* infant mortality. The main difference is what is considered a live birth vs. still birth. Most countries don't count it as an infant death if the baby dies within 24 hours of birth, and in countries with less capable neonatal intensive care that happens a lot. Premies simply die and don't get counted, except in the US.

Re:Strikers Vow

[rhakka]

that's great, until you can't, or otherwise fail to. Then what?

Then we all have to deal with you, one way or another. Most of us have decided we're not ok with letting people die on the streets, or more accurately we have to deal with people who are faced with either dying on the streets OR doing other stuff that is unpleasant to others to avoid dying in the streets. Such as fraud, theft, murder, etc.

it would be great if, having failed to provide for yourself and all of your needs (including health care no one can afford), you just would decently wander off and shoot yourself in the head so as not to cause any more problems for anyone. Oddly though, that's not what people DO when they are faced with either bad luck or the results of their own bad decisions. No, they typically try to survive by any means necessary.

and if they fail, I am STILL not ok with watching them die in the streets. I guess I'm just one of those frail, lily-livered human beings, who thinks maybe the world is improved by reducing desperation as much as possible. There are downsides to that as well, but none as bad as the alternative.

Re:Strikers Vow

[MightyMartian]

And that's the rub, isn't it. Even the UK, with its hybrid system, shows far better universal results than the US. The US is pretty much a half a century behind the rest of the industrialized world, and yet what's the arguments I'm seeing here against it? Ayn Rand? Keynes was a moron? The Constitution is shredded? The rest of the First World is watching the US with their jaws on the ground.

Re:Is mandated health care constitutional?

[Lakitu]

Section 8: The Congress shall have power To lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defence and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States;

You hide that "general welfare" part behind the Interstate Commerce clause in your sentence so well! It almost makes it seem like it has nothing to do with establishing laws that affect the general welfare of the people. I bet a lot of people who read it actually stop and have a wtf? moment, which makes them miss out on those two little important words!

You are trying to make it seem as if Congress has no power to do anything other than that which is explicitly granted in the Constitution, which is comically untrue. It makes me wonder why we don't just fill all 535 seats of Congress with printed copies of the Constitution.

The answer to your question, then, is "never", at least for a legitimate challenge. It may be "challenged" in court, wherein someone will ask that very same question ("where does the Constitution authorize Congress ..."), which is when the judge will probably have the very same response as Mrs. Pelosi.

Re:We rank 37th in infant mortality (Correction...

[level_headed_midwest]

The infant mortality statistic has a lot of things that affect it and make it appear much worse in the U.S. than it really is, if you actually read the scientific literature on the topic, such as the CDC's infant mortality data rather than just regurgitating propaganda. First, not all industrialized countries even calculate infant mortality the same way. Secondly, American doctors are much more likely to deliver the infant in a pre-term threatened pregnancy, while in Europe they are more likely to not intervene and the fetus is miscarried. A delivered infant that dies counts in the stats, while a miscarriage generally does not. The U.S. has the some of the lowest pre-term infant mortality rates in the world according to the literature, but that fact is certainly NOT being publicized. Yes, term infant mortality rate could use a little work here, but some of the biggest risk factors for that one are solved culturally (i.e. reducing the number of teen pregnancies, which are correlated with higher infant mortality rates) rather than medically.

Re:It's Not About Health, It's About Control

[MightyMartian]

I'm Canadian, and while a lot of health care delivery is Provincially delivered, it's not that different up here. While we don't yet have a "fat" tax, per se, we do have high taxes on cigarettes. I'm in British Columbia, and drugs are covered to some percentage for seniors or those of low income. However there is a cap so that if I, for instance, were to get cancer or HIV, once my med costs hit a ceiling (I think for me it's something like $2000 or $3000 a year), the government would begin subsidizing me (there is also a provision for applying for disaster coverage if you have to take very expensive drugs for life-threatening conditions).

I'll say this about our system. It isn't perfect. There tend to be a lot more backlogs, particularly for the less medically-necessary procedures (ie. orthopedic surgeries). There is provisioning based on need. But when my wife got thyroid cancer in 2006 around the same time I lost my job, I didn't lose the house we had just bought. She was diagnosed in April of that year and had a thyroidectomy in June. She is alive and well three years later.

The system works, not always as well as I'd like, but I absolutely shiver at the thought of being in the US during that period.

Re:It's Not About Health, It's About Control

[RealGrouchy]

Once the government is paying for your health care, they can pretty much mandate what you eat, what you smoke, what you drink, how long you live, etc. Hey, the repercussions of "bad" behavior are on their nickel, right?

Funny you mention that. We have universal health care up here in Canada, and last time I checked, we can still buy cigarettes and unhealthy food, we can buy alcohol at a younger age than you can, and anything that is controlled as illegal (e.g. marijuana) is only illegal because of pressure the freedom-loving Americans.

- RG>

Re:Strikers Vow

[Curunir_wolf]

I rely on me to provide for me. Government isn't about compassion either. It's about control. We've pretty much abandoned the intent of the constitution. The federals were never supposed to have this much power. I think it's time for the States to step up and take some of this power away from them.

That effort has already begun.

Re:Is mandated health care constitutional?

[Shawn is an Asshole]

You are trying to make it seem as if Congress has no power to do anything other than that which is explicitly granted in the Constitution, which is comically untrue.

So what the hell does the 10th Amendment mean, then?:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

The Virginia Resultion of 1798, written by James Madison (the main author of the Constitution and the author of the Bill of Rights, including the 10th amendment) says:

That this Assembly doth explicitly and peremptorily declare, that it views the powers of the federal government, as resulting from the compact, to which the states are parties; as limited by the plain sense and intention of the instrument constituting the compact; as no further valid that they are authorized by the grants enumerated in that compact; and that in case of a deliberate, palpable, and dangerous exercise of other powers, not granted by the said compact, the states who are parties thereto, have the right, and are in duty bound, to interpose for arresting the progress of the evil, and for maintaining within their respective limits, the authorities, rights and liberties appertaining to them.

Plus, the Kentucky Resolution of 1798 written by Thomas Jefferson says this:

"Resolved, That the several States composing, the United States of America, are not united on the principle of unlimited submission to their general government; but that, by a compact under the style and title of a Constitution for the United States, and of amendments thereto, they constituted a general government for special purposes -- delegated to that government certain definite powers, reserving, each State to itself, the residuary mass of right to their own self-government; and that whensoever the general government assumes undelegated powers, its acts are unauthoritative, void, and of no force: that to this compact each State acceded as a State, and is an integral part, its co-States forming, as to itself, the other party: that the government created by this compact was not made the exclusive or final judge of the extent of the powers delegated to itself; since that would have made its discretion, and not the Constitution, the measure of its powers; but that, as in all other cases of compact among powers having no common judge, each party has an equal right to judge for itself, as well of infractions as of the mode and measure of redress."

Re:37th because...

[amRadioHed]

Is that why American women are 11 times more likely to die in childbirth than a woman in Ireland? Too much giving birth while driving?

Re:Strikers Vow

[DMiax]

We didn't get out of the first great depression until 1946, when a million men were released from military service, the federal budget was cut by 2/3, and most of Hoover and Roosevelt's insane economic policies were lifted.

Redefining history much? For everyone else the recession ended in 1933. It does not matter when the wealth levels came back to normal, it matters when they started to increase. The fact that the economy was back in shape at the end of the war means that it cannot be an effect of the end of the war.