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Judge Declares Federal Healthcare Plan (Partly) Unconstitutional
healeyb writes "In a surprise move, US District Judge Henry E. Hudson issued a ruling today that the universal healthcare law that was pushed through by the Obama administration is unconstitutional. Specifically, he invalidated the section of the law that requires all citizens to purchase healthcare insurance, arguing that it does not fall under the purview of Commerce Clause of the Constitution, as has been asserted by the government. The ruling represents the first major setback for President Barack Obama on an issue that will likely end up at the Supreme Court. Two other courts have shot down challenges to the law."
The same guy that went after Michael Mann and others after it was thrown out. He's a young Republican with an agenda that he's forcing down everyone's throat since day one. From trying to change the state seal (it has a mammary in it!) to just stating that "Homosexuality is wrong."
I'm not saying he's right or wrong in this matter (the judge seemed to agree with him) but he's one of those guys and he's a state Attorney General for Virginia pushing his conservative agenda to a national level.
My work here is dung.
Too bad "unconstitutional" is only defined by which party has the bench packed at the Supreme Court, currently
Oh really? Anyone who at least didn't question the constitutionality of this really (regardless of where you end up standing) needs to get a clue.
In brief terms how laws in the US pass? I thought it started from the senate, and the president has veto rights.
But now Judges can mess with the laws?
Thanks in advance.
I don't think the story is flamebait. While the presentation may be slanted, this judicial ruling is certainly newsworthy. It will be interesting to see how this plays out in the higher courts.
Rhymes that keep their secrets will unfold behind the clouds.There upon the rainbow is the answer to a neverending story
How can it possibly be constitutional to force someone sitting at home who has no insurance to leave that home, to forcibly purchase anything? It is like forcing a license to live.
While I think it foolish not to purchase said insurance if possible, I cannot see anyway to legally compel this action by force.
"It seems that we are at the age where life stops giving us things, and starts taking them away..." Indiana Jones
Nerds don't get sick; they're too smart.
The odd aspect of the current plan is that you can be compelled by law, just by dint of being a citizen, to purchase a product from a private company.
If it was an across-the-board tax for across-the-board health coverage it'd clearly be constitutional. But for some reason we have to keep cutting in a for-profit industry that adds no real value to the process and pretend that's better than having the government pool the cash and disburse it as necessary to doctors.
They actually found a worse solution than socialism to the problem.
Only in the US is healthcare a privilege instead of a human right. That so many in a 'civilized' country are opposed to universal healthcare should make people wonder if the term 'civilized' is appropriate at all.
"I use a Mac because I'm just better than you are."
...ask yourself who this is actually a victory for. After all, this was only a ruling against a part of the law, not the entire thing. And this was really the part that was the biggest corporate hand-out of the bill - had a real liberal written it we would have seen a single-payer option instead of forcing people to give more money to large corporations.
So in other words, if this part goes, and the rest stays, what are we left with? A bunch of smaller corporate hand-outs that don't fix much of anything in a horrendously broken system. Most people will still have the shitty insurance they already have, and they will see their costs continue to rise the same way that they would have if nothing at all had happened.
So whether it goes away - in part or in entirety - or not, we still have a crappy broken system. Maybe, just maybe - if we are really truly fortunate - this will motive our politicians to actually write a bill that addresses some of the existing problems and then hold an honest discussion on that.
But I suspect at this rate I (and anyone currently reading this) will be dead before that happens in the US.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
his guy is a gw appointee. he owns part of a gop consulting firm. the republican party is paying him money. http://www.judicialwatch.org/judge/hudson-henry-e
I think the only part of the story that is flamebait is the editorial statement "In a surprise move."
This is NOT a surprise move. The individual mandate has been widely debated by academics and lawyers with many dissenting viewpoints. It was pretty much inevitable that at some point a portion of the bill (and most likely the individual mandate) would end up in front of a judge who didn't find it licit, and that it would end up in front of the supreme court.
I would bet anything that President Obama and and most of the people behind the health care bill were certain that it would at some point be reviewed by SCOTUS.
Claiming that the Federal government does not have the ability to tax people for doing something is ridiculous. If the government has the right to tax us for doing something, it has the right to tax us for not doing something.
Their arugment is specious.
excitingthingstodo.blogspot.com
.complaining about activist judges in 3...2... ...no? Really?
Jonathan Shapiro, a Fairfax defense attorney who first met Hudson when the two attended law school at American University, called him "gracious" and "professional," although he said he's always found Hudson to be a conservative thinker who tends to side with the government against criminal defendants.
In a 1983 Washington Post profile of Hudson, Shapiro recalled that he and Hudson were enrolled in a class called "Legal Problems of the Poor."
"I got the impression he thought it was supposed to be 'Giving Legal Problems to the Poor,' " Shapiro said then.
Shapiro remembers the quote now with a laugh. Hudson never seemed to hold the quip against him, he said.
See, he doesn't always rule against the government.
Anyone with a memory better than a gold fish can laugh with me as I recall that insurance mandates were originally the Republican plan. Republicans loved the idea of a mandate, and Democrats hated it.
Now? The Democrats folded like a cheap suit, gave the Republicans what they had been calling for for 15 years, and suddenly the Republicans hate the idea of a mandate.
We passed "meaningful" health care reform? Was there a replacement bill passed recently that was not publicized?
How is it a surprise that one of the two judges in the various challenges to the law that have been widely been reported as conservative judges that opponents of the law have been very careful in forum-shopping to get their cases before because they are likely to be sympathetic on this particular argument -- that the individual mandate exceeds the Congress' authority under the Commerce Clause -- has ruled that (surprise?) the individual mandate exceeds the Congress' authority under the Commerce Clause.
Especially given that the judges leanings on this issue were heavily telegraphed in the hearings and earlier preliminary rulings in the case, calling it a "surprise" defies reason.
Long story short: it starts in the corporate boardroom, and ends in a room full of senators on a pile of hookers and blow.
I'd really like to see that version on Schoolhouse Rock!
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
There is NOTHING in the Constitution of the United States of America that give the federal government the power and authority to FORCE individuals to buy (or pay for, whichever you prefer) . In this case the item we're inserting is Healthcare coverage. We're not talking about a universal, socialist-style system where everyone is taken care of. We're talking about a system which MANDATES that every Citizen of the United States spend their hard earned money on a specific item - there is no choice. What? You say there is a choice? Not really, because if you don't pay for healthcare coverage under the Obama plan you are _penalized_ -- fined to the tune of enough money that you are basically paying for healthcare anyway.
Is that really a choice? Really?
Here is my choice -- the American government has gotten too big and the "nanny state" has gone too far. I say we need less of each. Let's start with not forcing any Citizen of these United States to spend their money on something that is not by choice.
All right ... all right ... but apart from better sanitation and medicine and education and irrigation and public health and roads and a freshwater system and baths and public order ... what have the Romans ever done for us?
Tic-Tac-Toe, Global Thermonuclear War, and relationships all have the same winning move.
Next they probably rule that being poor is unconstitutional because you cannot buy enough stuff and therefore damage the economy which seems to be the only important factor in the U.S.
Meanwhile I realized that the difference between Obama as president and McCain is probably not much more than the color of their skin. They are both spineless idiots that just follow the way that money leads them. I guess the only way to go for you guys is further down the same road that you apparently chose as the only truth: money, money, money. Will be interesting to see where that will lead you to. I presume civil war at some point when the gap between the rich and the poor has reach a level where the masses won't shut up anymore and even tanks and armed forces will be the lesser evil compared to poverty and the lack of a proper future.
The justification in the law is that it is simply a $750 tax on people who don't purchase health insurance. Or if you like, everyone's taxes went up $750 and you get a $750 rebate for purchasing insurance.
The $750 tax is enforced by the IRS. You can't face any criminal charges for not purchasing insurance.
Democracy Now! - your daily, uncensored, corporate-free
They can't force you to have auto insurance. They can't force you to buy a car.
Do you even lift?
These aren't the 'roids you're looking for.
Federal Government doesn't force you to have auto insurance if you have a car. The state governments say if you want to drive your car on the public roads then you have to have insurance. I know lots of people with a) no cars and b) vehicles never taken on public roads (think real rural areas on massive amount of private land) who don't have auto insurance.
This law basically says you have to have health insurance. Period. Big difference.
The courts are ok with: "If you want to drive a car you need car insurance". They still have issues with: "if you want to live you need to buy life insurance".
If he had simply put a tax increase in the bill to pay for it, it would be totally constitutional. That was not possible from a political PoV, so they came up with the individual mandate.
IMHO, the fatal flaw with the bill is that it doesn't (as a first step) try the low-cost solutions to fixing our system:
1. Abolish the anti-trust exemptions for health insurers. Yes. You heard me. I bet you didn't even know that so-called "progressives" are so ready, willing and able to ignore one of the key ideas of the original Progressive Era, circa 1900.
2. Price transparency. In most states you can't even check to see if you're being ripped off because price lists are secret!
3. Eliminate provider networks. All insurers must pay the same rates from all providers, and must accept claims from any licensed practitioner.
4. Uniform, standard billing codes.
2, 3 and 4 would combine to reveal the regime in ways heretofore unseen, a veritable Wikileak of our current healthcare insanity. It would also help to eliminate over-billing of our current government programs.
None of these very low cost alternatives got on the table. Instead, not only were the inneficient inscos not punished, they were actually rewarded with the individual mandate! It's just another example of how powerful interests have bought government.
For all intensive purposes, "whom" is no longer a word. That begs the question, "who cares"?
I don't have auto insurance, and the gov't doesn't fine me for not having it.
I don't recall the *Federal* government mandating auto-insurance, I believe that all of the states do. But, that is the point. The Constitution explicitly dictates the powers that Congress has. All other powers "are reserved to the States respectively, or to the people". Go read the tenth amendment. It is considerably less muddily worded than some of the Bill of Rights.
There's a lot of FUD out there about health insurance. So here's the facts:
Country A: Health insurance is optional. So only the sick get health insurance. Their premiums are high, because they use their health insurance a lot. The young and uninsured meanwhile, a few of them need to go to the hospital too (broken arms, etc.: anyone can have a health emergency, even the very healthy). However, since the young and uninsured are usually poor, they can't afford the bills. They avoid them. Or declare bankruptcy. The hospital passes the unpaid bills onto the state and feds, and your tax dollars pay to keep the hospital from going bankrupt. Since no self-respecting society can turn away the sick, this already is universal healthcare, just paid for in the stupidest most expensive way possible. As well as destroying young people's credit and encouraging them to freeload and act irresponsibly.
Country B: Health insurance is mandatory. So everyone pays premiums. The premiums are low, because only a small percentage of the insured population actually use the insurance. The young need insurance because they can get sick too, and no, it is not wrong to be using some of the money of the young to treat the older and sick. This is called morality in most societies: you care for the elderly and sick in your society. Only in an immoral society are you encouraged to not care for your elders and your weak.
So why is the USA stuck in Country A status? Because insurance companies are making money hand over fist in the broken system, and don't want to lose their profits. They pay for FUD propaganda about government death panels, massive expense increases, etc., the naive and foolish believe the FUD, and the naive and foolish wind up supporting a system that hurts their health.
And then there is the criticism of quality of healthcare between country A and country B. And it is true: crisis care in country A is superior to crisis care in country B. Why? Because crisis care, like heart attacks, is expensive, therefore generating revenues. See, country A is all about making money, not taking care of your health. Meanwhile, country B actually delivers a genuine higher quality healthcare, at a lower cost, because the emphasis is on preventative care: making sure you get screened, diagnosed, and put on a diet/ pills so you don't even get that heart attack in the first place... but that approach doesn't make as much money, see? It has to be about making money, not taking care of you?
Look: car insurance is mandatory in the USA. If you understand the logic behind that, you understand why health insurance should be mandatory, and not some evil socialist plot to destroy America, blah blah blah, FUD and propaganda paid for by health corporations.
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
You're close to flamebait but I'll try to dig you out with a reply.
"Meaningful" means that of all reform passed, there is a subset of that reform which qualifies as health care reform. However, up to now it's been patchwork issues. "Meaningful" reform has been on some five Presidents' agendas and gotten torpedoed by Politics As Usual. The most famous proponent to get crunched was Hillary Clinton. This was just when the Repub's started hitting grand slams with the voters and vowed to crush anything she proposed.
My first Journal Entry ever, in 8 years! http://slashdot.org/journal/365947/aphelion-scifi-fantasy-horror-poetry-webzine
Congress could pass a law forcing insurance companies operating in interstate commerce (which is basically all of them) to offer coverage regardless of preexisting conditions, etc, and that's clearly within the commerce clause power.
Ah ha, but if insurance companies have to insure everybody (which they do, under the new law), but people aren't required to buy insurance, many people will wait until they're sick to buy health insurance, and the system will collapse. This doesn't have anything to do with the constitutionality of the law, but it does affect its practicality.
I don't have auto insurance, and yet I'm not in jail and I haven't paid a fine and they aren't docking me on my taxes.
So your entire premise is false. Before we even notice that "the government" is two completely separate entities you are pretending are the same.
The "individual mandate" is the most controversial part of obamacare, and it's unprecedented. "You breathe therefore you must buy X" has NEVER been tried before. Hillarycare got around this by being all out single payer (ie: government) health insurance.
Should this mandate survive the Supreme Court (where it is clearly headed) beware, the commerce clause would be ruled to be so all powerful that it can MANDATE PARTICIPATION in interstate commerce... ie, lobbyists could grease the right skids and get virtually ANY product to be mandatory to purchase...
Corporatism != Free Market
Everyone who has voted Republican has the blood of sick Americans on their hands. As well as the blood of Iraqi civilians, and the stench of their stolen oil.
I'm feeling a little vampiric today, can I bathe in that blood??
From a Tea Party Republican's perspective, "meaningful" health care reform would entail eliminating Medicare and Medicaid, freeing all employers from having to pay health care benefits, and all insurance companies from having to pay claims.
The "free market" will provide all that is needed.
Any sect, cult, or religion will legislate its creed into law if it acquires the political power to do so.
I was just reading a column this morning: http://planetthrive.com/2010/04/the-sick-care-economy/. The author is a bit off the wall on some topics, but he has a unique take on the health care legislation.
Wh47 d1d j00 541, 31337 15n't t3h r0xor5 ne m0r3???
"Meaningful" means, representing a substantial change for the affected people.
This bill is by that definition, about as far from meaningful as it gets.
If anything we are worse off than before. No more people are covered, some people have less coverage, and for all it is more expensive.
Cool, so make the law if you want to use public roads to go to the hospital you have to have this.
The War on Drugs is a result of Wickard v Fillburn and more recently Gonzales v Raich. Both decisions were horrible. They allow the government to regulate almost any conduct which affects any interstate market -- including conduct that is purely local. But government regulation (setting rules for a market) is not the same as a mandate which forces people to engage in commerce. The health care bill is distinguished because it requires people to buy something.
> When was the last time our government, did something to help people? I can't think of anything, really.
Oblg. http://www.epicure.demon.co.uk/whattheromans.html
All right... all right... but apart from better sanitation and medicine and education and irrigation and public health and roads and a freshwater system and public order... what have the Government done for us?
the government can force me to have auto insurance, but not health insurance?
Driving a car is a privilege, not a right.
Health care is something everybody is going to need from birth to death.
Call me a socialist if you must, but a for profit health care system is flawed. The judge was right to rule that mandatory participation in a for profit enterprise is unconstitutional. My insurer gladly takes the premium out of my pay check, but is forbids me the operation I need. That procedure would cut into their bottom line.
It's unfortunate that many will take this the wrong way and I'm sure mainstream media won't help to clear the air. It's unfortunate this ruling will be seen by the tea party as affirmation that "ObamaCare" is wrong instead of the correct interpretation that "ObamaCare" didn't go far enough (public option).
Before you complain about your taxes being used to pay for someone else's health care, please understand you're paying for it anyway. Emergency rooms will treat those who need urgent care. The uninsured wait until their condition develops into an emergency instead of getting the stitches or meds or whatever two weeks prior as a routine thing for a routine cost.
Don't want to buy auto insurance? Take the bus.
Don't want heath care? Don't be born in the first place.
The government cant force you to have auto insurance any more than it can force you to have a car. The only insurance you are required to have on a car is liability insurance in the event that you do decide to buy one. Just like if you decide to open a medical practice you are required to buy liability insurance.
It also helps the clueless to get a clue. It's about whether you're humble enough to admit that you have gaps in your knowledge. You put it as if the offline world wouldn't be full off arrogant know-it-alls.
same here, living in N.H., but states like mine are few and far between. heck, helmets aren't required for motorcyclists! live free AND die!
First: That's a state law. The healthcare bill is a federal law. For auto insurance to fall afoul of the judiciary, it would have to be shown to violate the constitution of the *state* where the law mandates that purchase.
Second: In *some states* you are obligated to by auto insurance as a condition of registering a car and being allowed to operate it. If you don't want to buy auto insurance, there's a very simple way to opt out: move to a city, take public transit everywhere, and don't own a car.
Do you think for a second that auto insurance could be mandatory for everybody to purchase, whether or not they owned a car or were old enough / competent enough to be licensed to operate one?
It is worth noting that while this judge says that the individual mandate is unconstitutional, two other Federal judges (one in Michigan, and one from a different case in Virginia) have said that it is just fine. This will doubtless go all the way up to the Supreme Court.
If intelligent life is too complex to evolve on its own, who designed God?
Not unless you buy a car and choose to drive said vehicle on public roads. Driving is not a right, so there are some conditions put on it.
Stop driving, cancel your insurance, and see if you get a FINE. You are not forced.
"It seems that we are at the age where life stops giving us things, and starts taking them away..." Indiana Jones
That sounds too easy to work, but I like it.
It does not matter who appointed him or who he gets his money from, this particular decision is the right one. The provision is nothing more than a hand out designed to enrich a small group of already large and powerful corporations, and should not have even been on the table.
Palm trees and 8
You know, this wouldn't be a problem if we just exterminated all the liberals. Conservatives don't expect other people to pay for their health care. They pay for their own.
Liberals - good for solving problems that wouldn't be problems if we didn't have liberals.
There is no provision in the Constitution that affords the central government the power to force citizens to purchase anything. They have authority to "Regulate" commerce but NOT FORCE people to participate in that commerce!
The primary principle behind the US is liberty. Liberty to chose to do business with a cutthroat banker, doctor, or lying politician are all rights. The problem with today's generation is that they are willing to give up their liberty for temporary security! The phrase "Give me Liberty or give me Death" is an anathema to most people today. 9/11 proved that the majority of Americans are more willing to die than defend their liberty!
From a Libertarian's perspective, "meaningful" means all of those in addition to axing the health insurance industry. That system is the biggest part of the cancer that is killing us. Once healthcare providers have no choice but to make services affordable or run out of customers, they will find a way. As long as health insurance exists, they will have no need to make services affordable.
I see the glass as full with a FoS of 2.
Quoting Judge Hudson, "At its core, this dispute is not simply about regulating the business of insurance—or crafting a scheme of universal health insurance coverage—it's about an individual's right to choose to participate."
The problem with his perspective, is that the eventual goal of universal healthcare is aimed at prevention. Not matter how incomplete the current health care bill is, the eventual goal is to decrease high cost of health care associated with late complications of TREATABLE diseases.
If you are sick right now in this country and you walk into an emergency room, they are obligated to treat you. You can't not be turned down for care if you can't not pay, so long as the care is necessary. So if you can't pay and you have no insurance, somebody's gotta suck up the cost. Doctors, nurses and pharmacists arn't going to work full time jobs for free. Guess who has to pay? The taxpayers, through government giving hospitals checks so they don't go bankrupt.
Now take Billy Bob, he is a 40 y/o truck driver, smokes 1 pack a day. He has no health insurance, so he doesn't see a doctor. No one tells him to quit smoking. He has hypertension, but he doesn't get treated because he feels fine and doesn't see a doctor. At Age 50 he develops diabetes, he feels crappy from time to time but he doesn't see a doctor(no insurance) At Age 58 he has an heart attack, get sent to the ER. They find he can't be cathed, and has to go through a bypass procedure. Except he is also is in chronic renal failure from chronic diabetes and hypertension. To save his life they do a bypass and his kidney is shot for good. He stays in the ICU for 2 weeks sick as a dog after his surgery, because
he has COPD and his lungs won't work. Then he gets to go home but is living on dialysis. At age 60 he has a big head bleed from all the anticoagulants he takes for his heart. He goes back to the hospital and slow waste away after a Tracheostomy and PEG(Percutaneous endoscopic gastrotomy or feeding tube.) He dies six weeks later in a nursing home from pneumonia.
Was his care good? Absolutely, top notch care, they did everything right. Except for the last 2 years his life sucked, and he died a miserable death. What's his cost of care? It's probably more than Billy Bob ever made in his entire life. And taxpayers are paying for it.
So what's the alternative? Billy Bob has insurance, he sees a doctor. He can't quit smoking but at least he start taking his blood pressure pills and his diabetes pills. His first heart attack comes at age 68 but he is not as sick so his bypass goes much smoother. He get scared and finally quit smoking. Great, that's a lot more years on his life, that he can enjoy. A lot more years where he is contributing to society by driving a truck. And as a Tax payer...I like the fact that ten years of blood pressure pill and insulin still cost a hell of a lot less than Emergency Bypass+ICU+Diaysis+Trach PEG and nursing home. I think if Billy Bob had to pick, he'd pick this route as well.
That is why everyone should have insurance. Now the other alternative is stop paying for Emergency Care. Grandma has an appendicitis? No insurance...let her die. You wife get shot in a drive by? No insurance...bleed to death. Your kid came out with some rare genetic disease that's gonna cost tens of thousands to fix? No insurance...good luck. You can crawl to the doorsteps of the ER, and they'll shut the door on you if you can't pay.
But are we ready for this kind of society? I don't think we are...yet.
So since I am a taxpayer, and I have to pay for people who can't pay...I rather pay less. So what is wrong with universal health care? Every dumb idiot out there who isn't covered and seeing a doctor, is making me pay more out of my pocket. Because when they are sick enough, they all come to the hospital.
I disagree with Judge Hudson, it's not about an individual's right to choose to participate. It's about if I have to pay taxes, I like to pay less.
. . . a comprehensive, all-encompassing attempt was an absolutely terrible idea. It was doomed to fail from the start. The reason that the reform that was passed was 2,000+ pages was because it was so full of corporate handouts and other special interest nastiness which further screws the taxpayer. That was the highest priority, and beyond that, increasing the number of Democrat voters by increasing the size of the insured pool. Real, meaningful healthcare reform would have actually addressed the cost-related issues in small, incremental amounts, with demonstrable benefits, rather than just handing over trillions to corporations at the citizens' expense, while claiming benefit to the unwashed masses -- all so Obama can declare to his supporters that he passed "the most meaningful healthcare reform in the country's history," just in time for the 2012 reelection campaign. Yeah, meaningful alright, as in prohibitively expensive and overreaching to the point of being unconstitutional.
Why was big pharma left out of the dance? How about tort reform? If we're looking to cut costs, the drug makers and fucking lawyers would sure be at the top of my list.
Before anybody else jumps on it--point 3 has an issue. You'd need to allow insurers to disregard a portion of the claim from "premium" practitioners. Doctors with spotless credentials should be able to charge more, but insurers shouldn't necessarily have to pay the full bill for that unless they were the only practioner available.
I'm not in favor of trying to give everybody the same standard of care. As much as that sounds like the moral highground; it turns out to be the moral low ground due to the evils that come about in the attempt to force equality.
Plainly the devil's in the details on point 3; but I don't think it's an insurmountable problem. A simple "exceeds the mean price by 1 or more standard deviations", is a good starting point. We can work from there...
For all intensive purposes, "whom" is no longer a word. That begs the question, "who cares"?
Who, exactly, is supposed to benefit from health care reform? Why punish people who do not want to enrich the very set of corporations that represents one of the most embarrassing problems with our current health care system (which is the fact that it is based on profit, rather than actually helping people)?
Instead of punishing people who do not want to buy their health insurance from a greedy minority of the population that could not care less about whether anyone other than themselves lives or dies, the government should provide health insurance to those people -- health insurance that cannot be denied to anyone. It is really quite simple: if the point of this bill is to benefit Americans by improving our ability to get medical treatment when it is needed, then the most effective measure for doing that (the public option) should be the center piece of the bill.
Palm trees and 8
You are only required to carry auto insurance to pay for damages that you do to OTHER people / property. This is called having just liability. You are not required to carry full coverage, unless the bank owns your car, then it's really not your car, so again, you're paying in case you damage other persons (the banks) property. Having only liability, you're self-insuring your own vehicle of damages and will pay everything out of pocket to fix your vehicle. Think of the law requiring you to provide full coverage on your vehicle. You are also not required by law to purchase a vehicle.
The only thing that will stop blatantly unconstitutional laws from being passed is for the sponsors of the legislation to be held personally liable for the damages caused by laws ruled unconstitutional.
Personal liability (of CEOs/CFOs for example) has improved the corporate accounting system, and reduced corporate financial fraud. No, it's not perfect, but it certainly has improved under SOX.
--Joe
What really needed to be done is:
1. Single payer system for basic healthcare. You can't have surgeons and insurance company execs who drive Ferraris and reduced healthcare cost at the same time. No pain - no gain, something's gotta give. In the system where the normal pricing rules don't work (because prices aren't even advertised, and you won't bargain anyway when it's your health or life that's on the line), someone has to have the authority to fight the more extravagant examples of creative pricing (i.e. pharmaceuticals that cost 1/10th the price once you cross either of the borders)
2. All premium services (i.e. shit you wouldn't die from if denied care) require separate insurance, with stiff premiums.
3. A separate, progressive, mandatory federal income tax for healthcare (and yes, I know it would hit me disproportionally, since I make quite a bit).
4. To reduce the tax burden, reduce Pentagon budget by 4/5ths or more and get out of fucking Afghanistan. Winning there is _not possible_. If we're so into spending money we don't have, let's at least spend it on things that matter.
5. Put the Congress and the Senate on the same insurance plans as what their constituents have. Not gold-plated, diamond encrusted Cadillac plans they pay $0 for right now. Make them feel the pain of the common man.
As a liberal, I find complaints about healthcare hypocritical, without similar complaints about no child left behind and the patriot act
NCLB is particularly odious to any traditionalist, as primary education has long been the purview of the states
Beyond that, there is something narrow minded and picky about the objections; how on earth can you actually run a country if every single thing has to be spelled out ?
You recall that seen in a few good men, wiht tom cruise and j nicholson, where cruise asks about regs and the mess hall ?
George Bush said if your spouse is not a citizen, he could break into yoiur house, steal your kids, send them to a foreign prision to be torturted and you object to.....a health car bill ?
That doesn't mean the bill is good; it just means that picking on obamacare, and not NCLB or Patriot is hypocritical
So then when you hit me, I am totally screwed since you surely do not have the millions to pay for my permanent disability at your hands.
So much for personal responsibility.
But I looked it up on Wikipedia. How dare you say I'm uninformed!
Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master.
Depends on the state, in NY state you may not plate a vehicle without insurance. The fine is very real.
If anything we are worse off than before. No more people are covered, some people have less coverage, and for all it is more expensive.
Which is odd since it was called the Affordable Healthcare Act(according to TFA). My premiums went up big time. My deductible went up big time. My coverage declined moderately. My ability to purchase drugs from a pharmacy was removed(all mail order now). The company sent a letter stating that "due to recent legislation, costs have risen and they're being passed on to you". Definitely the opposite of what the name of the act implies. If this is what reform is I think I'll stick to the Vote No on Everything platform to prevent Congress from doing anymore harm to the US.
Republicans like insurance, yes? And they like things to be as inexpensive as possible, yes?
Then Republicans ought to love nationalized health care, as it reduces costs with the power of economic force. Statistics (you know, what people are, from an insurance company's perspective) become more predictable and thus cheaper as the pool of risk grows. Competition is counter-productive in this sphere, because it carves up the pool of risk, and increases the administrative burden. Insurance is not and cannot be a competitive industry. The market just does not satisfy the competitive market axioms.
Somehow, this is lost on many Americans.
After all, I am strangely colored.
When they quite literally have you by your life, they can charge whatever they want. It's the definition of unbalanced contracts and negotiating from a position of weakness.
The ______ Agenda
We finally pass meaningful health care reform, and there is a Republican Judge, waiting to strike it down, killing thousands in the process.
As opposed to: .etting the constitutional limits on the government be consigned to the dustbin of history, resulting in a runaway government that kills hundreds of millions?
1) letting the "meaningful" health care reform modify the health care availability in the US in a way that will kill millions, many of them deliberately while
2)
No, thanks. I'll stick with keeping the government within its authorized boundaries whenever possible. Yes, even when (like a crime kingpin donating to a charity) it might use some of its ill-gotten money to do some good for a few. And I'll look into non-governmental solutions to help those the government CLAIMS to help.
Fortunately, practicality and principle virtually always agree when dealing with governments. No matter WHAT problem they claim to be solving, their activities to "solve" it have always made it worse, usually while creating additional problems requiring "solution".
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
Well, you asked...
A) Maintain the security of our nation.
B) Deal with Interstate trade and legal matters. Actual existing ones, mind you, not the creation of new ones.
C) Ensure that constitutional rights of citizens are not infringed by the states or other entities.
That's pretty much all they should be doing or should even be allowed to do. The federal government isn't there to help the people. The federal government is there to make sure we're free to succeed or fail and live or die as our ability and luck give us the means.
Violence is like duct tape. If it doesn't solve the problem, you didn't use enough.
From a Liberals perspective, meaningful health care means you provide free health care to all, the resulting quality of which is so poor only the richest people can have decent health care because anyone who really wants good care pays out of pocket.
Instead of a system where even poor people can buy catastrophic plans to have access to really good health care when needed, the middle class have excellent health care through reasonably priced policies, and you have a safety net of basic coverage for people that cannot afford anything.
The last option of course makes the most sense. If you make something totally free to all the quality will suck as people abuse the system. We are not anywhere near the ideal system because of runaway costs in the system, but the real question is the ideal we should strive for, and a system that is free for all and good for none is not my idea of the best end-goal.
Forcing people to buy health care is not a great idea if you take away choice as to what they can buy and make sure that all plans you can purchase are loaded with options many may not want.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Not to mention, that if this law stands, then I will now start to be taxes on my company (working W2 right now) health benefits like they were regular compensations.
Congratulations, we all just got a raise and didn't know about it. All it will mean to you is...you will have a higher tax bill.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
Auto insurance is a state law. Thank you, come again.
Violence is like duct tape. If it doesn't solve the problem, you didn't use enough.
100% agree.
..the problem is that there is no incentive for a person to shop around when they face the same co-pay regardless of how much the service costs.
..so health care providers can charge just about anything...
The problem is not the insurance companies taking a large cut of the pie, for their profit margins are actually quite reasonable..
When insurance companies tried to do something about it (via HMO's, etc..) the legislators had a field day and re-classified HMO's as something other than insurance (HMO's can't get an Insurance License.. instead they have to get a Certificate of Authority)
We must remove the disconnect between those requesting service and those paying for it.
"His name was James Damore."
A Libertarian might forbid people to freely participate in the commercial act of buying health insurance, but I don't think a libertarian would. A libertarian would merely call for the government to stop encouraging people to participate in the current health insurance scheme with tax breaks.
I personally don't believe a better system would automatically arise in its place; that's a libertarian axiom which I don't believe holds. But it's without doubt true that the present system is deeply flawed. The optimal system is an ideological question, which creates the unfortunate paradox of a hybrid compromise solution that is worse than any of the competing ideological solutions.
What's the difference?
From a Libertarian's perspective, "meaningful" means all of those in addition to axing the health insurance industry. That system is the biggest part of the cancer that is killing us. Once healthcare providers have no choice but to make services affordable or run out of customers, they will find a way. As long as health insurance exists, they will have no need to make services affordable.
How is "axing the health insurance industry" Libertarian? Health insurance is the free market alternative to a single payer system.
And I don't exactly see the time before health insurance as a golden age for doctors or patients.
As many problems as Republicans have had also being addicted to spending, they had an alternative health care plan (read the house summary PDF) that actually tried to address costs within the system instead of forcing you to buy into a broken system. Just the ability to buy insurance across state lines alone would improve things.
So the best case scenario is the bill gets repealed and in three years or so we get a bill written that actually lowers costs across the system.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
It's way less reform that I'd like see, but it is certainly a lot better than the status quo we had before the bill was passed.
The biggest change is eliminating underwriting based on pre-existing conditions (starting 2014). This is a huge deal because right now we have two insurance markets: one for those who are getting insurance through their employer (the "group market") and a kind of ghetto insurance hell that everybody else falls into, where you may or not be able to find coverage and can even be dropped retro-actively, after you get sick. Note that you may not even have a condition that is expensive to treat - a lot of chronic illnesses are manageable with moderate cost. But the insurance company is in the driver's seat (pre-health care reform) and if they don't like your risk profile, you are not insurable, insurable with conditions, or theoretically insurable but you can't afford it.
So rolling back this part of reform would leave a lot of people back where they were as far as getting insurance is concerned - which is to say, out of luck. Think this doesn't apply to you? Your employer can usually decide anytime to change or eliminate your coverage. Or eliminate you from their workforce. Then once your COBRA period runs out you are out on your own.
Fortunately this is only one legal salvo in a long process. But I'm not cheering the prospect of what reform we now have being reversed.
We finally pass meaningful health care reform, and there is a Republican Judge, waiting to strike it down, killing thousands in the process. Not that Republicans ever give a shit about their fellow Americans.
Everyone who has voted Republican has the blood of sick Americans on their hands. As well as the blood of Iraqi civilians, and the stench of their stolen oil.
I guess President Obama, Nancy Pelosi, and Harry Reid - along with every member of Congress who voted for the bill also have blood on their hands since they delayed implementation of the bill until 2015... I guess only people who die AFTER that time matter, or is this just a partisan attack line about blood on hands?
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
That's the states. The states can regulate commerce inside their state.
There is no federal auto insurance mandate. It's just obscenely common.
Dan
When they quite literally have you by your life, they can charge whatever they want.
If all your potential customers die because you charged more than they could afford, how much money have you made?
There goes my plan to end homelessness by forcing people to buy homes.
Just enough to match the people who voted on it, I suppose.
Nice attempt at deflection...
It's not enough to bash in heads, you've got to bash in minds. - Captain Hammer
Meaningful??? Thank you for messing up my health care, raising my premiums, increasing my deductible, and overall severely lowering the value of my health care, also, causing my taxes to go up as I have to claim health insurance as income now, and my taxes to go up even farther to pay for fiascoes like this. I wish I lived in the world that some people do. Evidently money for things like health care grows on trees.
Kosh: "Understanding is a 3 edged sword, your side, their side, the Truth."
From a Libertarian's perspective, "meaningful" means all of those in addition to axing the health insurance industry. That system is the biggest part of the cancer that is killing us. Once healthcare providers have no choice but to make services affordable or run out of customers, they will find a way. As long as health insurance exists, they will have no need to make services affordable.
How does a Libertarian go about preventing companies from selling health insurance?
It's not enough to bash in heads, you've got to bash in minds. - Captain Hammer
You know, this wouldn't be a problem if we just exterminated all the liberals. Conservatives don't expect other people to pay for their health care. They pay for their own.
Liberals - good for solving problems that wouldn't be problems if we didn't have liberals.
Are you proposing that emergency care services be denied for anyone who doesn't have proof of current insurance or cash on hand when they arrive?
It's not enough to bash in heads, you've got to bash in minds. - Captain Hammer
I prefer the Shakespearean method to fixing our health industry: kill all the lawyers.
"In an easily foreseeable move, US District Judge Henry E. Hudson issued a ruling today that the universal healthcare law that was voted for by super majorities in the House and Senate is unconstitutional. Specifically, he invalidated the section of the law that requires all citizens to purchase healthcare insurance, arguing that it does not fall under the purview of Commerce Clause of the Constitution, as has been asserted by the government. The ruling represents the latest setback for Senator McCain (R-AZ), who introduced the mandate, on an issue that will likely end up at the Supreme Court. Two other courts have shot down challenges to the law."
That reads a little more accurately now.
-Rick
"Most people in the U.S. wouldn't know they live in a tyrannical state if it walked up and grabbed their junk." - MyFirs
From a normal person's perspective, health insurance is setting aside a portion of today's current wages to protect greater losses from tomorrow's future wages. I realize I'm feeding the fire here, but the general ignorance of what insurance is and isn't sticks in my craw.
$9/$10 for your entire life is a lot better than $9/$10 for half of it and $0/$10 for the other half.... like say you're diagnosed with cancer at age 50, and can't afford to pay for treatment so your choices are to A) die, or, B) go bankrupt...and then die.
In summary. Insurance does guarantee minimum wealth via hedging current earnings against future returns. Insurance doesn't make you better - that's the job of hospitals for when you get sick, car dealerships for when your vehicle is stolen, and realtors for when your house burns down. Savy?
Sort of like if they stopped making people buy homeowners insurance burning your house down and losing all your possessions would be forced to become affordable?
OK, Lets forgo the snide example and explain where your idea breaks down, and how the free market solves it. That's right, your arguing against the free market and calling it the libertarians perspective. Lets say there's a rare disease or injury you can receive that requires a machine that is very expensive to make. I was about to start listing example numbers but this is so painfully obvious I think you should see where this is going so I'm going to cut it short. Small market, expensive product. You can either make that cure cost ridiculous amounts of money to the end user, or the end user can PERSONALLY DECIDE to offset the risk of them getting that disease by paying an insurance company a lesser amount of money in a gamble to avoid the risk of coming down with said disease and being shit out of luck or having to pay ridiculous sums of money for access to it. In a world where you've disallowed the free market to have insurance companies the machine would almost surely never be made because a simple cost-benefit analysis to the builder would show he'd never recoup his costs let alone make profit because no one who needs it could afford it out of pocket. Getting rid of the option to buy insurance isn't going to make the production, care, maintenance and training for that machine any cheaper. It'll just mean everything that is available is cheap enough for people to afford, and all the expensive rare and technologically advance treatments simply won't be there or will only be used by the super rich.
Meanwhile people die because some bastards have been paid off to stop a health care plan that is far less ambitious than the Republicans were pushing under Nixon. You can bet he's not doing it because he's a "flaming crazy" but the only way to show that is to follow the money.
No more people are covered, some people have less coverage, and for all it is more expensive.
Jesus Christ, some people here are uninformed.
I will state this bluntly: I was not covered before. I have a pre-existing condition and cannot get insurance on the private market. Not 'cannot afford'...cannot get. I've called up the dozen or so insurance companies that operate in my state, explained my medical condition, they inform me I cannot get insurance from them.
When the goddamn deadline rolls around in 2013, health insurance companies will have to sell insurance to me. (And I think there's a 'Pre-Existing Condition Insurance Plan' I can get on starting 2011.)
Assuming I am a 'people', and I was last I checked, at least ONE more person is covered. Period, the end.
Please fucking google 'uninsurable'
If corporations are people, aren't stockholders guilty of slavery?
[correction] ...is a lot better than $10/$10 for half of it and $0/$10 for the other half.
...it's actually all unconstitutional if one part of it is. This law lives and dies as a single beastie, and if any part of it is struck down, all of it is struck down. While technically not deeming other parts of it unconstitutional, they would need to be repackaged as a new bill before becoming law again.
Well, a lot of the problem comes from the bastardization of the concept of INSURANCE when it comes to health care. Insurance should be there ONLY for catastrophic health events(ie heart attack, accident). Routine health expenditures, should be saved and budgeted for like any other necessity of life (food, shelter, beer...).
If this were the case, then insurance wouldn't be so damned expensive. Also, if we went back more the "in my day" days...you'd have the independent Dr. out there again hanging his shingle out, and could charge reasonable rates, often based on what the person could pay. My uncle was an MD, I saw how this worked in practice. Medical costs weren't outrageous like they are now...IMHO, this is largely due to bean counters and other non-health leeches on the system ratcheting things up to the mess we have today.
Why not go to insurance for more emergency usage, and expand the program for HSA's (Health Savings Accounts) for everyone, to save for their own routine medical/drug needs PRE-Tax, and unlike the FSA's, let everyone have a HSA that is not use it or lose it.
Why should routine health care not be a personal responsibility like anything else in life?
This also might break the strange connection between health insurance and work...which often today, ties one to a job for people that are worried about changing jobs and jeopardizing benefits.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
every single fucking dime they had before they died. that's how much.
We are not anywhere near the ideal system because of runaway costs in the system,
And why are those costs running away?
First, because people pay for insurance and they feel that they are entitled to recover what they paid for that insurance. Too many people get unneeded medical examinations that they wouldn't dream of getting if they had to pay a fair price for each one.
Second, too many juries award damages for medical malpractice that are totally out of proportion. In a response to that, doctors started prescribing every possible sort of test to each patient, just to make sure they cannot be sued for negligence.
If you want a reasonable health care system, there must be a way to avoid all those unneeded tests and examinations. There should exist a reasonable limit on what can be claimed as damages for malpractice and hypochondria should be punished as insurance fraud.
Without controlling costs, there's no chance of a reasonable system, either free market or state provided.
...means you might want to stop laughing. With ObamaCare, if any single itty bitty part of it is deemed unconstitutional, the entire thing becomes null and void as a whole.
It's very likely that there are insurance company folks rolling on the floor laughing right now...
You are stupid. I hope you die because no one wants to pay for your health care.
Ruling that a law is unconstitutional is not "activism". It is, in fact, the only tool that the Supreme Court has to check Congress and the Presidency.
The point of taxation is to get money from people in order to finance the operation of the government. That's why we have the income tax amendment. But that amendment does not authorize the government to collect "taxes" that directly benefit some private (insurance) company. If you really want to call it a tax to fund national health care, then the government should be getting the revenue, not the insurance companies.
Your confusion rests on equivocation -- a use of the same word with two different meanings. "The government" that forces you to have auto insurance is your state government, which has what are known as "general police powers", which means every power not specifically denied to it by the federal Constitution.
The government which (this judge has ruled) cannot force you to buy health insurance is the federal government, which has only those powers provided to it by the federal Constitution. Even if the conditions and products were identical, there are things the federal government can't do that States can (and vice versa, as many of the powers denied to the States in the federal Constitution are reserved for the federal government alone.)
>every single fucking dime they and their loved ones had before they died. that's how much
FTFY.
Somebody on Thom Hartmann's show said this was basically a tax increase, was written like the mortgage credit that you would get back if you purchased health insurance, and, as such, would be constitutional. Guess not.
On the other hand, Hartmann did a video for RT saying it's basically Richard Nixon's plan from 40 years ago. And, yes, it sucks...so whatever.
Insurance is not and cannot be a competitive industry.
So Geico, Progressive, and State Farm are wasting their money on cutesy ads to encourage people to shop insurance because their industry "cannot" be competitive.
Pretty sure you lost touch with reality, there. You might also want to read up on the actual mechanisms implemented by the written health care law, rather than relying on nebulous ideas that could work, if only they were implemented properly.
"Somebody has to do something. It's just incredibly pathetic it has to be us."
--- Jerry Garcia
Who gets to decide what constitutes the "general Welfare of the United States"? What if the people authorized to make that decision are wrong?
I write sci-fi for metalheads
Seems like an amendment could address the 'constitutionality' issues. Of course, those are hard to pass. Then again, there's a reason for that.
Either we have a Constitution, and it applies, or it does not.
Why is this insightful? Human language, the U.S. Constitution in particular, is not a finite state machine.
And then you follow with an artful interpretation of the situation. Good work making us all poorer!
http://www.maxineudall.com/2010/02/should-economists-be-sued-for-malpractice.html
The problem is with trying to fit market principles into everything. Not every square fits into a round hole.
In the case of health care, most people are trying to avoid a case where only some people can afford good health care. And that is what would happen if health care was purely left to the market. Maybe they're willing to let some customers die, as long as enough pay to make a profit. There's no incentive in a free market to provide a service to every single person regardless of ability to pay. And yet we as a society have for the most part decided that health care should be a right granted to everyone.
I regularly have people from the US tell me how I am unfortunate because I do not have the 'benefit' of the US constitution. I am still not convinced.
Apparently, universal healthcare is so evil and unconstitutional that your slightly right-of-centre president was only able to offer a feeble, watered down, insurance based version. Even that is unconstitutional?
I'll see your Constitution and raise you a Queen.
It's not often I find myself agreeing with a libertarian WRT to health care, but everything you said there is true.
Now, I think that the government should be covering large medical costs, and you probably don't...
The health care industry is broken in an amazingly obvious way, for an incredibly obvious reason. No other industry on the planet operates mainly by having people give a flat fee to a reseller, who then purchases and gives the customer as little of the product as they decide he needs.
It's mind-boggling how stupid the basic premise is. To paraphrase Douglas Adams: 'The serious flaws of the system is obscured by the trivial flaws of the system'. We have tax incentives to make this happen!
Now, you think health care would be entirely affordable if we didn't do that, and I agree 80%, but think we need some sort of safety net for people, but I'm glad we both see the actual problem here.
And it's totally absurd that the 'solution' was to funnel even more money to them.
If corporations are people, aren't stockholders guilty of slavery?
The libertarian in me takes all three of those, and distills it down to:
A) Preserve individual liberty by protecting property rights.
Note, the government does not always do a very good job of this.
No one is taking your kidney without your permission
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness
Should the right to have Life be dependent on the money that you have? If so perhaps the liberty and happiness is the same (well it seems to be that way)
Liberty is defended by our US military, a voluntary military, this service is provided to all Americans.
The pursuit of happiness is helped by our public school system and other social services, again provided to every American.
The idea that someone will force you into surgery to remove a vital organ is a plain red herring. What you don't want is to have to pay any money. As far as I know it isn't a right for you to make as much money as you do now. Don't confuse the issue, if you feel that someone else should die from a curable illness so you can buy a new TV just say so.
I'm sure they sing a different tune sitting outside the ER if they were ever refused for not having insurance. Funny how one's perspective changes once they're faced with death. Perhaps they realize they're going to see their maker and maybe, just maybe they've not lived accordingly.
Just like if you decide to be a productive member of society you are required to buy health insurance. At some point do decisions about what we can force on others become more about morality than simply natural law? Haven't we evolved past the point where all that is required out of a person is that they not kill? Is that all you require of a fellow citizen?
When companies start enrolling those with guaranteed costs in excess of premiums they can charge, it's no longer insurance. Insurance is, by definition, a gamble. In order for a company to remain in business, income must at least meet expenditures. You, just you, represent a guaranteed loss of thousands, tens of thousands, or hundreds of thousands of dollars for the rest of your life. It is unlikely you will contribute back that much, so the cost must be made up elsewhere for them to remain solvent.
When the deadline rolls around, you will not have insurance then either. What you will have is a company required to pay medical bills you are already guaranteed to have. It's like having a house burn to the ground and calling up Liberty Mutual: "Hey, I have a smoldering ruin. Give me coverage at $100/month so I can get a $150,000 check cut tomorrow to rebuild it." That's not fire insurance, that's a company's other clients paying for a house that was burned to the ground before you paid them a dime for coverage.
I'm not arguing we shouldn't have healthcare coverage at all. That's way beyond the scope of this comment. What I'm arguing is that you, specifically, are not talking about insurance. What you're talking about requires re-working the way healthcare is paid for from the ground up. When everyone has a policy, and the price is mandated by law, and people with pre-existing conditions are covered, you don't have an insurance system any more.
You can't even compare this to auto insurance, because the bad drivers eventually get kicked off the rolls after they become too expensive to insure. They no longer get to drive legally. The reason that happens is, again, because insurance is a gamble. If you make it no longer a gamble, it is no longer insurance, it's an entitlement. There is no way to pay for universal coverage without splitting the cost amongst everyone. You have to subsidize risky health behavior either at equal cost to everyone else (not going to happen) or at great cost to those who make more money (this is how it will happen if it does). The system is not fair now, but there is not a system in existence (or ever proposed) in the world that is fair by all measures. Every system has to screw someone over, because neither wealth, nor health, nor ability are actually equally distributed. If they were, universal healthcare would be unnecessary.
So, while I sympathize with you being unable to afford healthcare, I don't agree with the characterization that this debate has a damn thing to do with insurance. It doesn't. You won't get insurance coverage, you'll get a reimbursement entitlement.
And you'd be basically wrong about all of that. The biggest funding hole in health care these days in the U.S. is just that healthy 20 and 30 year olds don't get health insurance, don't visit the doctor unless their tit's falling off, and don't go into a hospital without a gunshot would. In other words, the healthy simply don't spend money on medicine or save for rainy (i.e., sick) days. They wait until something goes wrong and pay through the nose at that point.
That's why the life expectancy of the U.S. is two years lower than the rest of the first world. The expense isn't the problem, it's the fact that people who aren't sick right now think they don't need to spend the money. If you turned health care into a simple commodity you'd find less spending on it, not more.
Anyone who loves or hates any language, platform, or manufacturer, doesn't know what they're talking about.
No? Oh, right. JA is defined as a judge doing what I don't like, i.e. being liberal.
Actually, "judicial activism" refers to a non-elected judge, who is not accountable to the voters and who sometimes has tenures of a lifetime of employement, making rulings to effectively write new law. In previous societies, these "judges" were known as "kings."
6th Street Radio @ddombrowsky
Generally, insurance companies do not and cannot operate across state lines, which is part of the problem. Individual states set mandates and rules, things that must be covered, etc. If you could buy a less expensive plan from out of state (that didn't cover shit like hair removal, accupuncture, hair transplants, etc), it wouldn't be "fair" to everyone else that wanted subsidized anus bleachings.
Do you even lift?
These aren't the 'roids you're looking for.
Government effectively increasing the cost of living by $5,000-$12,000 per year per person by forcing everyone to buy health care whether they want to or not != reform. It = tyranny.
The Christian Right is Neither (Christian nor right). See: Matthew 23, Matthew 25, Ezekiel 16:48-50
Supposedly the requirement for liability insurance for cars is to prevent people from being stuck with huge liabilities due to an accident. If I don't have liability insurance on my car, I could lose a lot of money or someone else might lose a lot of money if I can't pay the money I would be liable for. Health insurance, on the face of it, is like collision insurance which takes care of my car in an accident. The relation to health insurance is not quite the same sort of beast. A person without collision insurance could lose a car, while a person without health insurance is likely to go to the emergency room and run up debts which will never be paid. So, to some degree, a person without health insurance can be a liability to us all.
Ray Seyfarth, ray.seyfarth@gmail.com, http://rayseyfarth.blogspot.com
I realize I'm feeding the fire here, but the general ignorance of what insurance is and isn't sticks in my craw.
It really does feel like screaming into a hurricane, doesn't it?
Ultimately, my problem with the entire argument is that everyone I know who doesn't have health insurance could easily afford it but for an unwillingness to correct blatant prioritization problems. The latest gadget is far more important than saving for future rainy days. Those same people cry and carry on that people who make better decisions come out way ahead of them, and should now pay for for the problems that they themselves created with their poor decisions. Yes, there are people who truly get screwed through no fault of their own, but those represent a tiny minority of cases, at least amongst those I've encountered.
There are two basic ways to look at the origin of government power in any society. The first system is all power and rights originate with the government, which in turn grants rights and power to people. France is explicitly organized this way. The second system is that all power and rights originate with the people, which in turn grant powers to the government. The US is explicitly organized this way.
This leads to two very different ways of defining which right people have. The first must list what people can have (e.g. a right to healthcare). The second leads to what government can do (e.g. the US Constitution).
The US also has what is called a Bill of Rights, which was considered redundant by the writers of the Constitution, but is very explicit in the limitations of government power. Americans tend to think of these when they think of rights. But we also have rights to everything not listed in the Constitution, including healthcare.
Because the first system is a list of what government says people can have, people hold their governments accountable to deliver on the list. Healthcare as a right and delivered by the government seems natural
Because the second system is a list of what government can do, people expect government to limit itself to that list. Granting an new government power over a personal thing like healthcare seems alien to people in this system. The side effect of having 100% right of personal control over healthcare is that it comes with 100% responsibility (such as paying for it).
Summarizing things in the context of your comment: Americans have access to healthcare as a right, because the government has no right to prevent us from getting it. But we cannot force another American to give it to us. Same as a million other activities.
Here's a great way to interpret the US Constitution, rights, and why it takes so long to gets stuff like universal healthcare sorted out: It's a contract between people on how to govern themselves (what rights to give up). If it's not in the contract, it's not in the domain of government. And if you want to change the contract, everybody has to agree. That's going to be a battle.
The world is made by those who show up for the job.
You cannot compare health insurance to auto insurance. Millions live perfectly well without auto insurance because they do not drive. The cost is split amongst drivers, and habitually bad drivers are kicked off the rolls and can no longer drive legally.
Those same parallels do not apply when you replace "drive" with "live." Unless you're a necromancer.
Ultimately, my problem with the entire argument is that everyone I know who doesn't have health insurance could easily afford it but for an unwillingness to correct blatant prioritization problems. The latest gadget is far more important than saving for future rainy days.
You must not know a lot of poor people then.
I actually know a lot of people without insurance who in no way could afford even the most basic catastrophic insurance. They're not blowing their money on the latest gadgets- it goes towards rent, food, and bills. There's none left over for rainy days.
Additionally, a lot of them probably could benefit quite a lot from better healthcare coverage, since they often are dealing with depression, anxiety, etc. which make it difficult to get an education or hold down a decent job that might actually help get them out of poverty.
The libertarian solution to the failures of capitalism is to apply more capitalism til the failures are fixed.
So, do you not work for a company? I've never heard of a company provided health plan reject an employee, even with pre-existing conditions.
If you are self employed...well, I ran into that for awhile too. After my last W2 gig, I let the cobra run out, and found out that it is very difficult to get insurance if you have let insuranse laps. I had high triglycerides which is a huge flag for insurance companies.
I took the route of getting a bit of a fly by night insurance co to take me on..kept that for 6mos, and then was able to get a better company like BC/BS to take me on.
If working independently, do what it takes to get a high deductible insurance policy, you really only need insurance for catastrophic health events. Set up a HSA for your routine stuff, you take this out pre-tax and save a lot of money this way. A HSA is not use it or lose it either.
I found when I did this...I actually went to have some MRI tests done, when they asked for insurance I told them I didn't have any, and they knocked off like nearly 20% right off the top. I used my HSA funds to pay for it.
If you really have trouble getting insurance, look to your state. I almost did it in mine for the un-insurable. Yes, it is a bit pricey, but will cover you till you can get regular insurance providers to take you on.
But really, just get something that you need for catastrophic events, and plan and save for your routine medical needs and drugs.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
There's no incentive in a free market to provide a service to every single person regardless of ability to pay. And yet we as a society have for the most part decided that health care should be a right granted to everyone.
1. You can't grant rights to people, rights are your natural state and outside forces can only prevent you from exercising them, not grant them to you. Modern health care is not a right, it's someone's goods and services. That we feel compassion for sick people doesn't change that. Private corporations won't help people for free, but I'm not sure why you think private individuals won't. It's called charity. If people are so grossly self centered and uncharitable as not help their friends and neighbors when they're sick, what makes you think they all want health care for everyone?
2. No, we as a society clearly haven't decided that, as debate still rages. Most Americans were against this law. A large chunk of Americans are still against this law. Honestly, I'm surprised more people on the left aren't against it. As someone earlier mentioned, we've managed to find a "solution" even worse than socialism. It's a mandate that everyone has to buy the overpriced products of an industry that caused the problem in the first place.
I would propose that the ER have the option of refusing service, yes.
Learn about Photography Basics.
How is it flamebait? People have been saying this portion of the plan was unconstitutional since before congress passed the thing...
Were you there defending your liberty at the airports during thanksgiving?
Right, tax evasion is illegal. Not having health insurance causes your tax bill to go up. And if you pay it you never go before a judge, get a criminal record, etc.
Democracy Now! - your daily, uncensored, corporate-free
From a Tea Party Republican's perspective, "meaningful" health care reform would entail eliminating Medicare and Medicaid, freeing all employers from having to pay health care benefits, and all insurance companies from having to pay claims.
And that would be bad... why?
Reasonable health care need not be expensive; it's a bunch of basic techniques, basic drugs, and basic preventive care that--together with healthy living--will likely let you live to a ripe old age.
What makes health care expensive is that people want an unlimited supply of the latest drugs, surgical techniques, and gadgets, in a futile attempt to delay the inevitable just a tiny bit longer. In addition, they live under the illusion that health care is totally safe.
Sorry, but a heart or liver transplant is not a basic human right, it's a luxury that only the riches people on the planet can afford. And going to the doctor or hospital always entails a significant risk of getting worse. And it doesn't make sense to bankrupt our economy because people are unwilling to accept that.
I'd take that bet.
First, I don't assume anyone involved read/understood the law as it was signed - they expected the details to be ironed-out when the regulations are written...
Second, POTUS considers himself a Constitutional Expert (and if he doesn't, he's surrounded by enough people that claimed he was that it is a reasonable conclusion, IMHO), he brushed off constitutional questions/challenges during the debate last year.
I can't predict the outcome of the challenge, but all eyes are on the 20 state lawsuit now...
Ken
When they quite literally have you by your life,
Only if you're the kind of fool who still thinks that medicine can magically save you from death.
Liability health insurance, in case you go around hitting people?
When they quite literally have you by your life, they can charge whatever they want.
If all your potential customers die because you charged more than they could afford, how much money have you made?
Not everyone's gonna die before reproducing, even with overly expensive health care. That, and you could teach "abstinence only" sex ed to keep the number of births up.
I am not a crackpot.
Actually, the judge only declared the provision of the new law that requires everyone to buy health insurance unconstitutional, not the entire law (link). The provision that prevents an insurance company from canceling your insurance because you got sick is not affected by this, for example.
This is just one round of a fight that will certainly end up being decided by the US Supreme Court. There's no reason to panic or celebrate (depending on your point of view) yet.
"Reasonable health care need not be expensive; it's a bunch of basic techniques, basic drugs, and basic preventive care that--together with healthy living--will likely let you live to a ripe old age."
Apparently you only need a *very* basic understanding of medicine and statistics as well.
You can do everything right and still get cancer. Or some hereditary condition decides to make itself known. Or get hit by blue ice from an airliner.
Which word would that be, and what's the claimed original definition?
As long as health insurance exists, they will have no need to make services affordable.
To get affordable services you need a competitive market. Patents, prescription rights and licensing are the other pillars keeping prices up, capital pools like insurance are merely enabling to a further extent.
Most often it seems you'd be better off with a database and an expert system doing diagnosis, testing and prescribing already. And soon enough you'll be better off with computer controlled surgery.
Once at that point we might start seeing some cost reduction. But that would require overcoming some fairly strong vested interests.
I've actually known a large number of poor people. I include myself, though only as a result of absolute income rather than because I consider myself "poor." That would be ~$800/month, FYI, which I believe falls a tad below the Federal definition of "poverty."
I probably shouldn't have used the term "gadgetry," since, like the way the Constitution is currently interpreted, people take it as an exhaustive list when it was actually just a single example out of many possible options.
So, do you not work for a company? I've never heard of a company provided health plan reject an employee, even with pre-existing conditions.
I work for (and partially own) a company with less than 10 people. At that scale, they actually look at the people before selling the business insurance.
I am, in effect, denying everyone at my company insurance.
If you are self employed...well, I ran into that for awhile too. After my last W2 gig, I let the cobra run out, and found out that it is very difficult to get insurance if you have let insuranse laps. I had high triglycerides which is a huge flag for insurance companies.
While I feel for you, don't confuse your situation with actually being uninsurable. You had warning flags, but managed to get in.
I have had open heart surgery. I have a pacemaker. I am actually, not kidding, uninsurable in the literal meaning of the word, not 'only fly by night' insurable.
If you really have trouble getting insurance, look to your state. I almost did it in mine for the un-insurable. Yes, it is a bit pricey, but will cover you till you can get regular insurance providers to take you on.
My state is conservative, which means we have no such system. But I can do the Federal thing in 2011.
If corporations are people, aren't stockholders guilty of slavery?
In what way is prohibiting voluntary binding contracts between a consenting adult and a private company a libertarian (big or little L) position? That's a Liberal (in the socially intrusive, not liberty-loving sense) idea.
I'm not arguing we shouldn't have healthcare coverage at all. That's way beyond the scope of this comment. What I'm arguing is that you, specifically, are not talking about insurance. What you're talking about requires re-working the way healthcare is paid for from the ground up. When everyone has a policy, and the price is mandated by law, and people with pre-existing conditions are covered, you don't have an insurance system any more.
You seem to be under the impression I want insurance. I know how insurance works, and I know how incredibly stupid a system it is for something that is not optional, like health care. And I know how 'unfair' the law will be for health insurance companies.(1)
I was just taking issue with the statement of 'mark72005' where he said 'No more people are covered'.
I was not covered, I will be covered, I am a person, he is wrong. Q.E.D.
If you want to know my actual stance on the fucking stupid idea of health insurance or the way we've decided to it make even stupider, please find some other posts of mine.
1) Although I suspect I'm going in the other direction than you WRT to 'unfair'...I think it's unfair we haven't disassembled insurance company CEO for medical parts. A business that makes more money the more service they deny. That would just be stupid if it was lightbulbs or car washes..it's fucking obscene for health care.
If corporations are people, aren't stockholders guilty of slavery?
There's no incentive in a free market to provide a service to every single person regardless of ability to pay. And yet we as a society have for the most part decided that health care should be a right granted to everyone.
1. You can't grant rights to people, rights are your natural state and outside forces can only prevent you from exercising them, not grant them to you. Modern health care is not a right, it's someone's goods and services.
Eh, modern health care is a right, at least in my society. I know it's a right, because there are societies where it's not a right. In both societies, health care is someone's goods and services, but further comparison shows a difference: Here I have something more than similar people have in some other places, and the "something" is the "right to health care", as far as I know English language.
If it's not a right here either, then please tell me, what is it here? What's the English word for it?
I'd love to see you bring that idea up at your next local "Tea Party" meeting. Who will then pay for your medical bills when a hundred bitter seniors beat you with their homemade signs for taking away their Medicare?
Xenon, where's my money? -Borno
They gave us William Shatner rapping the life of Julius Caeser.
http://www.youtube.com/watch?v=3yerCiByca4
Once you see it, you can never unsee it. You've been warned.
I would propose that the ER have the option of refusing service, yes.
Fine. Then I would suggest you run for office on that platform and see how many people agree with you.
It's not enough to bash in heads, you've got to bash in minds. - Captain Hammer
I hope the current law is found unconstitutional. Although I don't think it is, and don't think the SC will find that it is, such a ruling would allow us to pass better reform, which would be a single-payer universal socialized medical system supported by heavily progressive taxes.
Anyway I hold to Jefferson and Madison's opinion that the US was meant to have a FEW enumerated powers, while most of the powers remained with the Member States. Just like the modern EU.
dont go there! dont hold the bunch of corrupt head up their asses unrepresentative scumbags (or the supposedly representative, but more accurately porkbarrelquaffing donothing wasters) as a system worth emulating! The EU is a disaster for the majority of the populace of the member states who were hoodwinked into it.
I think its quite useful to have people on slashdot, and in fact people everywhere, to discourse on the law. The law should be plainly and freely understandable to all people. It should not require a separate priesthood to interpret and translate. This is especially true of the most fundamental laws of the United States, those embodied in the Constitution. Since the Constitution can only be modified by significant levels of public approval, I think its quite obvious that the Constitution is mean to be understandable to that same public that would approve amendments to it.
Rights can be granted. Not all rights are inalienable.
The polls differed on how many were for the health care bill or not, and it depended upon how the questions were asked. Probably no one liked it as a whole indivisible unit, but I think the majority of people certainly were in favor of large parts of it. After all for the majority of Americans it will change nothing at all about their current health care or providers.
And yes, many on the left are opposed to it, because it's essentially a resurrected Republican health care bill and they weren't happy about compromising on some issues.
Not that it particularly matters, but I intend to. Now isn't the time for it, though - I'm 26, and have little establishment political background.
In 5 or 10 years, I'll have made the contacts necessary to try - until then, it would be pure folly.
Learn about Photography Basics.
Maybe more troll than flamebait, but either way it's almost guaranteed that the comments will contain more heat than light, and there isn't exactly a nerd angle in the summary to justify selecting the story.
If it's not a right here either, then please tell me, what is it here? What's the English word for it?
Privilege.
A privilege applied universally is still a privilege.
That makes it immoral according to the categorical imperative, which states that you should only act in a way that can be universally applied. If no one were able to reproduce, society would end. I do believe, however, there are other options for reproduction, such as in-vitro fertilization.
Modern health care is not a right, it's someone's goods and services.
Your own government disagreed when it passed the Universal Declaration of Human Rights more than 60 years ago:
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
IHMO, this includes pro-active medicine (check-ups and such) and not only trips to the ER. Not only is it practical because it helps keeping costs down in the long run, but if every person has a right to be healthy then it follows that procedures designed to prevent him or her from becoming sick should be affordable to him.
Free Manning, jail Obama.
"The War on Drugs is a result of Wickard v Fillburn [wikipedia.org] and more recently Gonzales v Raich [wikipedia.org]."
No it isn't. The war on drugs was underway well before those decisions. They certainly helped.
"The health care bill is distinguished because it requires people to buy something."
Sorry, no, thanks for playing. As others have noted, there is car insurance. Or property taxes (of various kinds). There are the FICA taxes if you work. The only possible difference is one of scale. And you don't have to buy anything if you don't want to. The tax will be cheaper. And you could probably make the case that you shouldn't be charged for going to a public hospital ER....(somebody will)
Rights can be granted. Not all rights are inalienable.
I disagree. If it's not inalienable, what makes it a right? If your government has the power to grant and revoke "rights", then you have no rights at all.
I love the idea of a world where everyone has access to great health care. However, I find the idea of a world where our rights are subject to the whims of the establishment to be horrifying, and I think it demeans the whole concept of rights to suggest that privileges are rights merely because we want them applied to everyone.
There are human needs far more important than health care, like food and shelter, that are currently not being universally met despite public and private efforts to provide them. So what does the concept of "rights" even mean in that case when people clearly don't have those things?
As far as I can see, the US government has done a fine job of violating the security of your nation, by interfering in foreign nations and missing off people to the extent they're willing to suicide to hurt you. Oh, and then miring your security apparatus down in such information overload that they couldn't prevent it when they tried.
And for C, they're preventing by the simple expedient of granting themselves a monopoly on it.
I guess they're performing satisfactorily enough on B.
Just because you're paranoid doesn't mean there isn't an invisible demon about to eat your face
All right ... all right ... but apart from better sanitation and medicine and education and irrigation and public health and roads and a freshwater system and baths and public order ... what have the Romans ever done for us?
They gave us Death and Taxes?
Wrong. It IS meaningful, for the health insurance companies. They get to have higher profits, and their executives make more money. In turn, they give nice "campaign contributions" to the Congresspeople who passed this law benefiting them.
What's not meaningful about that? Are you some kind of communist who doesn't care about corporate profits?
So by that analogy, if I get sick because of you I should be able to sue you for MY medical care...
----- Connection reset by beer
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness"
You have some serious cognitive dissonance. How exactly does health care not become a right if people have a right to life? Perhaps you should ponder the concepts behind the quotes. While you are there, please note that the statement explicity holds that women are inferior (minorities implicitly), that it is an assertion, requires the existence of a Creator (no evidence, appeal to authority). In other words, it leaves a lot to be desired.
"If, however, you believe that a RIGHT can be secured by the TAKING from another, then I suggest that you lock your kidneys up, because someone's right to LIFE might require them to TAKE your kidney, regardless of how you feel about it. If you can demand of me to give to another to secure a "right", then society has the same ability to do the same thing to you in ways that is most unpleasant."
Strawman much? Be very careful of any open flames. And you had better be a pacifist. Because if you are not, then you support precisely what you are strawmaning against.
"It cost money to produce, people to work for it, technology and skills to enhance it."
One of the failings of libertarianism is the idea that somehow money is more important that liberty and life.
I'll presume that giving a tax break for investing in an IRA is also unconstitutional.
upon the advice of my lawyer, i have no sig at this time
It's still insurance, but the definition of insurance has changed. In the end, the "insurance" companies will be the real winners here, because they'll be making more and more money, for the service of doing nothing more than just shuffling paper around and collecting money from taxpayers and giving a small part of it to healthcare providers, after taking a giant cut for themselves.
You're absolutely right: this isn't "insurance" in the traditional sense of the word. If we want to provide healthcare to everyone, then we have to institute universal healthcare, which will mean eliminating insurance companies altogether, and just having the government collect taxes and paying healthcare providers directly. Sure, it's socialistic, but so is providing roads and highways. And, there's nothing in the Constitution that forbids it, as long as it's a service that government owns and operates (unlike this corporatist/fascist POS legislation that was passed).
As for the previous poster, remember that he has a "pre-existing condition". That doesn't mean that he's necessarily dying or in constant need of care, it just means he has some condition which means the gamble for the insurance companies is unlikely to pay off for him, so they decline to provide coverage for him. He may or may not represent a loss, depending on how it goes with his condition, but the companies aren't willing to take the gamble. For instance, suppose he's a cancer survivor. That's something health insurance companies generally won't accept. If someone had cancer before to a significant degree, got chemo or whatever, and it went into remission, there's still a good likelihood it'll come back. But there's also a good chance it won't. If it doesn't, they don't represent more of a loss than anyone else. But the ins companies aren't satisfied with a 50/50 bet, they want something that's more of a sure thing.
Ultimately, the USA needs to find a new solution to the problem, which will probably involve universal healthcare and government regulation of healthcare. Right now, the costs are astronomical, and it's caused partly by the providers themselves (usually because of patients who can't pay, causing them to inflate prices for those who can), and partly by the insurance companies who are just expensive middlemen who contribute nothing of value. However, those expensive middlemen pay handsome "campaign contributions", to make sure the politicians represent their interests instead of the voters', so it's unlikely change will come until disaster strikes.
My government does a lot of things that I don't agree with. That concept of rights is dangerously flawed, as I've mentioned elsewhere in this thread.
If social services become human rights when a society is prosperous enough to provide them, do they then cease to be human rights when that society goes into decline?
How do you know the coverage you are offered will be affordable to you? Just because they're required to offer it doesn't mean you'll be able to afford the price.
A business that makes more money the more service they deny. That would just be stupid if it was lightbulbs or car washes..it's fucking obscene for health care.
No, it's perfectly normal for insurance companies. That's what ALL insurance companies are in the business of doing: gambling that their customers will file fewer claims than they bring in in premiums. Insurance is nothing more than legalized gambling, but for many things (like fire, car accidents, etc.), it makes sense to spread the costs of rare catastrophe around.
Your mistake is in thinking insurance companies care about health care. If you think the government should care about health care, then you need to get insurance companies totally out of the equation, as their entire reason for existence opposes providing quality health care.
Not that it particularly matters, but I intend to. Now isn't the time for it, though - I'm 26, and have little establishment political background.
In 5 or 10 years, I'll have made the contacts necessary to try - until then, it would be pure folly.
Doesn't sound like you'd be an establishment candidate anyway. I don't see either party backing you on your health care view anyway. Of course if you are more like Rand Paul and flip flop on your views and/or add giant caveats that you'd previously neglected to mention, then I'm sure they'll have you.
It's not enough to bash in heads, you've got to bash in minds. - Captain Hammer
The fact that it had to be disguised as a "penalty" or "fee" just shows yet again what incredible wimps the Democrats are in standing up to Republican bullying.
As a common law nation, our constitutional law depends both on the constitution itself and the rulings of the Supreme court.
And indeed the role of the Supreme Court as final arbiter of Constitutionality was not expressly in the Constitution itself - but self-interpreted by the Court's observation that, if it so ruled (by procedures at least partly based in common law), the Constitution specifies that there is nobody who can override the ruling.
Nevertheless, where the Constitution and Common Law are in conflict, the Constitution (as an explicit legislation postdating and overriding the common law of the time) wins. This is because the Framers were well versed in the common law, and could be expected to take it into account and explicitly state any way they wanted the laws of the US to diverge from common law.
That also implies that the Constitution froze the Common Law for the US at the point of its ratification. The framers' intent to include any given bit of the Common Law at that point can be inferred from their lack of action to change it. That can NOT be assumed for any changes to Common Law thereafter.
Which is all immaterial...
Centuries of common law have extended the original scope of the document by quite a bit.
No. Centuries of constitutional interpretation by courts have "found" implied civil rights and government powers in the constitution that weren't necessarily obvious in the plain text. Unfortunately, a few of these findings may have been faulty. And some of the arguably faulty findings served as the basic precedents for explosions of fallout.
Two of those were finding essentially blank checks of government power in the "Necessary and Proper" and "Commerce" clauses - allowing Congress to circumvent virtually all the express limits on its power elsewhere in the Constitution.
The "Commerce clause" is the one we're dealing with here. The basic precedent was set when the Federal Government, during the Great Depression, tried to "fix" the market in farm products by imposing bureaucratically determined production limits on farmers - and busted a farmer for growing "excessive" corn to feed to his own pigs. The farmer tried to defend with a claim that feeding his own corn to his own pigs wasn't interstate commerce. But the Court found against him, ruling that, had he not grown the corn he would have had to buy feed (such as corn) for his pigs, which would have affected the price of corn being traded in interstate commerce.
Needless to say such a broad interpretation of what constitutes "interstate commerce" makes it apply to just about anything. And it's been the basis for a massive increase in Federal control - including the Drug War and the federal gun laws.
Which is why any case where a court finds a limit to the powers the Federal Government claims under the Commerce Clause is Big News.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
If it's not a right here either, then please tell me, what is it here? What's the English word for it?
Privilege.
A privilege applied universally is still a privilege.
I'm pretty sure you're using world "privilege" wrong here, I think it's wrong English to say "you have privilege to health care", that sounds just strange.
"The right to health care is a privilege granted only by the most civilized of today's nations." Now that sounds more like valid English to me (wether I agree with the statement itself or not).
You can't re-define common words used by others to fit your ideology. Try adding defining words instead, such as "negative", "positive", "implicit", "granted" etc. rights, if you hope for a meaningful conversation.
Why should routine health care not be a personal responsibility like anything else in life?
This also might break the strange connection between health insurance and work...which often today, ties one to a job for people that are worried about changing jobs and jeopardizing benefits.
Does "routine" include my wife falling and tearing her rotator cuff ? approximately $60,000 later, it is now pretty much fixed. Of course, I had insurance so the 60K that was billed became $8800, but it was made very clear to me when I asked, that without health insurance, the billed amount would be expected. I don't understand how 60 grand becomes less than 9 grand just because I had insurance.
Just the ability to buy insurance across state lines alone would improve things.
That is not entirely accurate.
First, you already can buy insurance across state lines. If a different state approved a plan that you envy, you can buy it. However, you might not be able to make use of it if it is not blessed by your own state.
Second, the application of which plans work where is dictated not by the federal government, but by the states themselves. Do you really want the federal government to strip that right from the states? I thought the republicans wanted to reduce the role of federal government in health care - removing the right of states to approve health insurance plans would do the opposite of that wish.
Third, more plans increases overhead at the level of the practitioner. As it is every health care office already devotes a significant amount of person-time to handling the billing and prerequisites of the health insurance plans they accept. If you force more plans into the system, you will be consuming more time at the doctor's offices as the total number of plans that they have to handle billing for increases.
So in short, the concept of somehow reducing health care costs by "selling across state lines" doesn't hold water. It strips states' rights, increases costs at the office level, and really doesn't get us anywhere that we aren't already.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
I love your idea - we should just follow the previous examples! We already have a nationwide network of hospitals for military - VA! All we have to do is to widen and let any citizen access them. Just like we did with highways and the Internet. A great suggestion!
they can get ALL your money for treating you for severe illnesses. and what are you gonna do? say no and die? really?
give up the anti-government propaganda and smell the coffee.
The debate we're currently having is about the meaning of words "right" and "privilege", not whether people deserve any particular rights or privileges. In that context, constructing a grammatically incorrect use of the words in question does not actually address my point.
However, I will attempt to address the argument I think you're trying to make.
Rights are inherently inalienable. Privileges are subject to the whims of those that grant them.
If rights can be given and taken away, what separates rights from privileges? Practical example: Is it just and proper that a person in the US or Western Europe can criticize his government and a person in China may not?
Oh right, this was reported on the internet, so it is relevant here.
This is about challenging the bigger of the two constitutional-interpretation blank checks that Congress uses to regulate anything they care to regulate. If it sticks it could put a big stick in Congress' spokes and knock down a WHOLE LOT of federal law - including a slew of current laws (and possible future attempts at passing laws) that restrict what nerds can do.
This is a BIG DEAL. For nerds as well as for the rest of the country.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
No...I think that falls pretty much into my scenario of catastrophic medical events of which insurance should be there for...
Err...because your insurance paid a % of the bill, and you owed the $9K balance? Seems pretty straightforward to me if I'm understanding you correctly.
Routine stuff...normal checkups, getting the flu, regular meds one takes...that kind of thing is easily taken care of by planning, and saving in a pre-tax HSA, and paying from that for the routine health needs.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
car insurance is mandatory in the USA. If you understand the logic behind that, you understand why health insurance should be mandatory
Car insurance is mandatory only if you drive a car. You can chose to walk or bike everywhere, or take a cab or public transportation, and you wouldn't need car insurance. Hell, if you are adept at mooching rides off of friends and family, you don't need car insurance because you aren't driving. There are plenty of places and situations in this country where you can live without owning and driving a car.
That said, I have been arguing for single-payer universal health care in this country for decades. It is a fucking crying shame that we don't have it, we don't deserve to call ourselves a civilized (or even first-world) country without it. But really, health insurance doesn't compare much to auto insurance with the exception of both are disgustingly profitable to all the wrong people. I have less respect for insurance companies than I have for used car salesmen.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
In the same way that saying "voting is a right" is advocating slavery for poll workers, or saying "access to counsel in criminal cases is a right" (hello, Amendment VI) is advocating slavery for lawyers.
"Unreasonable" in policy terms? Sure. Requiring a new purchase every year would clearly make little policy sense. Unconstitutional? No. And you don't even need to look to the Commerce Clause on that one, as Congress has a much more specific express authority to use in that case, the Art. I, Sec. 8 power to "To provide for organizing, arming, and disciplining, the militia."
No, its a very different thing. But I'll agree that they are similarly situated with regard to constitutionality.
Insurance should be there ONLY for catastrophic health events(ie heart attack, accident). Routine health expenditures, should be saved and budgeted for like any other necessity of life (food, shelter, beer...).
Sounds good, but that has an interesting side-effect. It doesn't take much in "routine health expenditures" - especially once they've been suitably padded out by a broken healthcare system - before you're better off dead than alive from a microeconomic perspective. Your proposal will effectively enforce this. Once someone's routine healthcare costs plus other costs of living exceed their income (which is probably going to be severely reduced by medical problems), they'll run out of cash for treatment and die.
Of course, the best part is the unpredictability. You can never be sure that the next day, you'll discover you have a health problem that means you're now worthless, or if a family member or a loved one will suffer the same fate.
Remember, the entire point of insurance is that it spreads risk - the cost of any one person becoming seriously ill is spread across the many people. That spreading of risk is just as necessary for long-term conditions.
Because healthcare isnt a "routine expense". A routine expense is something like a phone bill or a power bill, which you generally know beforehand the expected amount and expected date that you need to pay it by. Healthcare is the polar opposite of this. You don't have any idea when you will need medical care. You could be hit by a bus later today and have absolutely no way to plan for that. As I understand the american healthcare system as a non american, you would need to have 200k or so in a "healthcare savings" account, just to cover you if you, as mentioned previously, got hit by a bus and were in traction for months.
To say that people should plan their healthcare problems says to me that either you or a loved one has never had a serious healthcare problem, which means you are either young or lucky. Mark my words though, one day you will have to pay with the american system. That much is guaranteed.
Whereas in a civilized country, medical costs are socialized. This means that everyone pays a little (which they would pay anyways) and everyone also never has to pay a bill for any emergency proceedure. Also, many non emergency procedures are covered as well, such as requiring blood, or getting a tetnus shot. For context, I pay BC MSP (medical services plan) 100$ a month (50 for me and 50 for the wife, kids under 18 are free) and we are covered for pretty much everything that you would consider routine, AND especially anything major. How much would that cost you in the private system? 500$/mo? 1000$/mo?
You just have no idea how much money you are pissing away, how much waste there is in getting for profit corporations to take a cut at every conceivable level. I do still have to pay for more maintenance type things like non emergency dental work, flu vaccines and eye glasses, but no system is perfect. You would probably even like that part, as those things one might consider routine and something that is needed to be saved up for. The main difference, is all the things that it does not cover, are generally under 1000$ proceedures, which should be easily affordable by most. The most expensive thing i have ever had done (and needed medical insurance to pay for) was having four wisdom teeth pulled out which cost about 1400$. Of that, my insurance paid 1200 and i paid the extra 200$. If it was threatening my life however, i could have gone to the hospital and had them removed for free.
As a potential lottery winner, I totally support tax cuts for the wealthy
Judges aren't supposed to rule on their personal opinion of logic and fairness. They are supposed to rule according to the law. We have two laws, the constitution and the healthcare bill, which many intelligent legal experts consider to be in conflict, in which case the constitution overrides. Others disagree, but we won't have a final answer until this goes to the Supreme Court. The faster than happens the better, as it will remove any doubt, and let us either move forward implementing the bill, or craft a new one that is on firm legal foundations.
I'm sure that large multinationals like ADP have the legal resources available to know when they're being fleeced and the economic resources and pull to shop around for the best deal when selecting health care plans to provide to employees.
Well, this is pretty much what I'm advocating.
Insurance for emergencies...it used to be thie way, it was called "major medical" insurance. To be used for catastrophic medical needs.
The rates for this are pretty low. You take what you would pay for this, plus a little more, and put into a Health Savings Account pre-tax...and you use that fund to pay for routine things like annual checkups, when you need a flu shot..preventative health maintenance.
There is no reason you shouldn't plan and save for this just like you do for food, shelter and transportation.
If you took the bean counters and insurance out of every day routine medical stuff, you'd see prices drop. But people should take responsibiltiy for their health needs and budget for it.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
There's no incentive in a free market to provide a service to every single person regardless of ability to pay. And yet we as a society have for the most part decided that health care should be a right granted to everyone.
There's no incentive to grant care to every single person in an unfree market either. There isn't a free money machine that suddenly bestows enough money to cover the care for everyone. Instead what happens is that the government decides who gets care and who doesn't. Taken to the extreme it means the government will decide who lives and who dies.
The incentive in a government-run marketplace is to do whatever will get the politicians the most votes. Those in power and those who form discernible voting blocks will get health care. Those who form discernible voting blocks that vote against big-government politicians will not get health care. And everyone else will kind of fall through the cracks.
Right now the pro-government health-care message is it's going to reduce costs and make sure everyone is covered. Then they'll act surprised that costs have gone up and the only way to fix it will be to get a single-payer system. Then we'll move to single-payer and someone in the government will come out and say that we have to make tough decisions on exactly which treatments to approve because we only have so much money allocated in the budget. They'll say they are allocating the money based on "need" but in reality it will be based on what will get them the best PR and thus the most votes.
In a true free market system the people with the ability and will to pay for more health care will be able to afford it and will get it. The people who are unable or unwilling to afford it would either have to take charity or not get it. What we had before the new federal healthcare plan was not quite free market because we had various rules already that strongly encouraged expensive insurance plans, but it was reasonably close to it. The way to fix it is to go the opposite direction and encourage people to purchase health-care services in an a la carte fashion. This would likely lower costs back to the levels they were when people bought a la carte instead of buying expensive insurance and expecting everything to be paid for.
Apparently you find the idea of people dying because they don't have money to pay for care offensive. You aren't alone. I don't like it either but I am smart enough to know that in lieu of charity the only alternative is to let the government decide how to allocate health care resources. That ultimately means the government decides who lives and who dies. I find that to be more offensive than anything.
Sorry but that's not a Libertarian's perspective, a libertarian believes the government has no business in the health care business. Libertarians believe the current system would be far cheaper if there were less restrictions on what may or may not be covered and where they may or may not cover it and then let them fend for themselves financially. Personally I think the only rules we really need at all are rules that limit put some limit on price differences between different groups of people (location, age, sex, ethnicity etc).
The only federal law i believe should be passed is one that nationalizes the health insurance licenses and regulations, making policies from anywhere in the country available to anyone, anywhere if that company is willing to sell it there.
Decades are important, though. You have lived your whole life under this system. The judiciary is corrupt? Where were the presidents who opposed this? Where was the congress that opposed this? Where were The People who opposed it? The entire society is corrupt. How can you hang all this on a corrupt judiciary, when every single living person in the judiciary inherited it on the day they were born, decades before they got jobs as judges?
What were they supposed to do? On the day they got appointed, should they have said, "Fuck all the precedents, I have this piece of paper here called the constitution, and this is what is says."? Will ANYONE back up someone who does this? The two parties who completely dominate government are completely opposed to this and have the support of 99% of the voters. I don't like the situation but you gotta give anyone dealing with this legacy problem a lot of slack. Calling them corrupt is silly.
IMHO the best thing to do is to pass new amendments, even if they are word-for-word identical to the original constitution (although it would probably be a good idea to reword them). Constitutionally overturn stupid SCOTUS decisions that were passed a century ago, reopening public debate on whether or not limited government is a good idea (make the people who are alive today, REALLY OWN IT rather than be heirs to dogma), and so on. Get the people to say it's a good idea or a bad idea, because right now with the public's support, it's just ink on a page.
As copyright owner of this comment, I authorize everyone to defeat any technological measure which limits access to it.
Turns out that the judge who ruled against the mandate, is also part owner of a consultancy that worked directly for Republican leadership in opposing the whole bill.
Hmmm... nah, it's just a coincidence...
Anyone who loves or hates any language, platform, or manufacturer, doesn't know what they're talking about.
Is there some way we can turn healthcare into a military project so that conservatives will approve of it when it gets expanded to benefit everyone?
My premiums went up big time.
Same here, over 25%. I had maybe $300 in claims in the last year, and it has been that way for at least 10 years. Also, the insurance company paid none of that $300 because it was all lower than the deductible, and I have no co-pay, no co-insurance. I pay everything out of pocket up to $7500. So I paid the insurance companies thousands of dollars, paid the doctors hundreds of dollars, and now they are raising my rates. I am seriously considering canceling my insurance. What the government has done is unconstitutional and illegal. They essentially just forced everyone in the U.S. to pay more money to the wealthy insurance companies. That is not healthcare reform. Insurance has almost nothing to do with healthcare. Anyone who spends hours on the phone as the go between trying to get the insurance company to pay what they promised to pay to the doctors knows this.
If you are not allowed to question your government then the government has answered your question.
I think you missed my point about having insurance, for catastrophic/emergency medical expenditures. A high deductible (maybe like $1200)...gives low rates, and is there for when you get hit by a bus, break a leg, heart attack....something that requires a hospital stay.
Routine is not that...it is annual checkups, regular meds you take that you know about. Having a cold or the flu is something you can save for, etc. YOu can set up a HSA (Health Savings Account) to save for these annually, the money comes out pre-tax, so you actually lower your taxable income. It is NOT use it or lose it, so the account keeps growing over the years. This is especially good to start young while healthy...if you don't use it all, at retirement, it can roll over to retimement dollars. This system IS available now, I did it when working for myself, and I quite enjoyed it. I'm back to W2 for now...and unfortunately, the company doesn't offer a high deductible medical insurance option, which currently is required.
I would advocate expanding the HSA program to make it easier for all people to get into, it is tough to do as a W2 employee, which most people are.
While I did this, I saved for routine health like annual checkups, glasses, contacts, eye exams, medications I take..etc. I put in a bit monthly just like I save for rent and food and retirement.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
Thats when people stop going to that doctor, I would think.
Unless you are willing to drop all manner of financial instruments in general and reduce every eventuality to what people and businesses can afford with cash on-hand -- and, ergo, deny service to those without at that very instant of service -- this dog don't hunt.
That's fine if that was your actual point, and I agree with you by-and-large. I think your point was confused by this statement, which is why I responded:
When the goddamn deadline rolls around in 2013, health insurance companies will have to sell insurance to me.
While the above may be technically correct, it is only correct since the mandate essentially redefines what the term "insurance" means. Yes, more people's healthcare costs are paid for. No, more people are not covered by anything resembling the up-till-now definition of "insurance."
Only if you are the government and can impose an estate tax. The doctor will see no money unless he treats a patient, and everyone knows dead patients are untreatable.
Eh, they'll treat you until you run out of money, and then they'll let you die. If you can't afford the next procedure, they'll just give you a cheaper one that'll just keep you alive for a while longer. End result = they get all your wealth.
Are you adequate?
right, that's just what happens now. People just opt not to get the care they need or aggressively shop providers for urgent, critical treatment. Hoping, of course that the treatment you need is not for a condition that in any way reduces your ability to reason, calculate complex cost-benefit scenarios, evaluate your situation, or in any other way compromises your ability to be the OMNISCIENT FUCKING BEING you'd have to be to navigate the byzantine world of medical care as a lay person.
Maybe you can shop your prescription drugs and your flu shot provider, but for any complex, urgent, or critical care you are likely to have other considerations higher on your mind.
and there is zero chance that there will be significant competition for that care. Certainly there is zero chance that anyone would invest the huge amounts of capital needed just to reduce the profit margins. You charge what the market will bear, and when you're looking at death, that's pretty much everything.
Sort of like if they stopped making people buy homeowners insurance burning your house down and losing all your possessions would be forced to become affordable?
You have just described what insurance is for. A major catastrophe. This is what health insurance should be. Instead, healthcare has become the equivalent to home insurance that covers (at a profit) periodically painting your house,fixing plugged toilets, and other inane things that would be far cheaper without involving the insurance company as a middleman.
If you are not allowed to question your government then the government has answered your question.
There's always somebody trotting out this argument. It's bullshit. Health insurance makes people who need very little healthcare overpay for it so that the ones who need a lot can underpay. That's insurance; it's a risk transfer scheme that the healthy ones pay a lot for because it protects them if they move over to the other group.
If you think that health insurance should work like car insurance, well, you're making a bad analogy between car accidents and help. Car insurance has these properties:
Health is not like that. Health problems are often chronic and require lifetime care. In addition, unlike with driving, where driving more tends to lead to more accidents and more costs, with health, more health care tends to lead to better health and fewer costs. That's why it makes sense for health insurers to pay for routine care (healthier patients = less cost), but not for auto insurers to pay for your gas (more driving = more accidents).
Because HSA plans can't protect you against the risk of a costly chronic condition. No recipe that models health insurance after the model of auto insurance can do it. If you learn at age 27, just when you've gotten your career really going, that you were born with a congenital problem that's going to require costly periodic treatments for the rest of your life, then you'd be fucked. And if, in addition, you're a valuable member of our society, we're all a little bit fucked for it, too, because instead of doing all the work you'd have done to benefit us all, you're not going to be able to afford the treatments that would allow you to be healthy enough to do that work.
Are you adequate?
No no no, you all have it all wrong.
What was passed was certainly meaningful. What should be questioned is the use of the term "reform." That is supposed to have positive connotations.
Your brain is not a computer.
Taking car insurance as an example (who doesn't like a car analogy?), if you don't bother to pay for routine maintenance, when your engine seizes up your insurance does not cover rebuilding it. With health care, if people don't pay for routine maintenance, are you saying that insurance should be there to cover when their heart seizes up?
I would think that the reason you want a health care system to cover routine stuff is that you want to encourage people to get regular check-ups, and fix things when they are many times less expensive to fix, instead of waiting for catastrophic events. The only reason it is a bastardization of the concept of insurance is because the insurance companies have inserted themselves into something they should not be involved in at all. A single payer system would take care of that.
How do you know the coverage you are offered will be affordable to you? Just because they're required to offer it doesn't mean you'll be able to afford the price.
Huh?
Because the government has subsidies if no plans are affordable?
Does no one here actually remember the more-than-a-year of debate?
No, it's perfectly normal for insurance companies. That's what ALL insurance companies are in the business of doing: gambling that their customers will file fewer claims than they bring in in premiums.
No, normally, insurance companies do not provide 'services'.
Normally, insurance companies provide compensation. You are objectively harmed by something covered by the policy, and when you submit a claim, you get made whole.
Health insurance is nothing like that. You do not submit a 'I have a flu' claim and they pay you $150 dollars.
Strangely enough, we do have actually insurance that compensates for injury...workman's comp, life insurance, and disability all do, to some extent, at least for crippling injuries. That is 'health insurance'.
I don't know what the current health insurance industry really would be classified as. Weird useless middlemen. They're like...anti-resellers.
Insurance is nothing more than legalized gambling, but for many things (like fire, car accidents, etc.), it makes sense to spread the costs of rare catastrophe around.
No, it really doesn't.
In a modern society, there should be absolutely no reason for the common person to have insurance, and there's certainly no reason to require them to have it.
Insurance is for stuff like rare paintings, or a bank to have a house that isn't paid for, or whatnot.
If 90% of people do have a particular sort of insurance, society's safety net is fucked up and someone's profiting off it. There really should be no 'general' insurance. If almost all people need it, then we should figure out some sane compensation and pay it out of taxes.
And if all people who have X need it, like car insurance, we should tax the cars for it. Same with homeowner insurance.
The idea that the government shouldn't provide all necessary services, all services that all citizens need, that we should instead have everyone go to corporations, is perhaps the second stupidest idea that the American people have ever internalized.
Your mistake is in thinking insurance companies care about health care.
I'm pretty certain I'm not making that mistake in any way, shape, or form. I assure you, I believe as much the opposite of that as humanly possible. I actually think insurance companies would wander around stabbing people insured by other companies in the face if they thought they could get away with it.
If you think the government should care about health care, then you need to get insurance companies totally out of the equation, as their entire reason for existence opposes providing quality health care.
'I' need to do this? I'm pretty sure I wasn't in charge of the law.
If I was in charge of the law, the government would pay hospitals and doctors to provide everyone with care.
Not even the nonsensical 'single payer' system, which is government health care inexplicably wrapped in the entirely stupid 'insurance' paradigm. We'd just pay for the damn health care of legal residents, full stop. (People here illegally would just get emergency and contagious disease care.)
I swear, 90% of my responses on this article is me explaining that, yes I do know how insurance works, yes I do know why insurance companies deny people claims, and yes I know it's a goddamn stupid fucked up system.
If corporations are people, aren't stockholders guilty of slavery?
Ah, okay.
I think you're the one attempting to redefine insurance. Insurance doesn't mean profitable insurance, and plenty of insurance companies have accidentally sold policies that do not, on average, make them money.
But whatever. I'd actually argue we already didn't have an health 'insurance' system.
Insurance gives you money when certain conditions are met. Health 'insurance' didn't operate anywhere close to that setup in the first place. It paid someone else for services.
Yes, some other insurance, like comprehensive car insurance, sometimes does that, but you usually have the option of just taking the money.
But health insurance has managed to go so far in that direction it's functionally stopped being insurance, and now is some weird-ass middleman to the health care industry.
If corporations are people, aren't stockholders guilty of slavery?
I do not represent the Libertarian party, and like most people with half a brain (sadly rare from a voter), I do not perfectly align to the party.
I do believe that some government involvement is needed to prevent mob rule. The very existence of the current state of health insurance perpetuates a system where people don't care what the cost is, so there is little incentive to get the cost down. Meanwhile, health insurance companies bargain with providers for price deals that you cannot get as an individual. The overall cost of health care is artificially inflated with excessive salaries for specialists and hidden administrative cost for processing the complicated paperwork. Unregulated, health insurance companies would just deny everything they can. Criminal penalties for corporations are a joke, meaning that there would be no effective incentive to prevent them from doing so. Human nature shows me that consumers would not be aware of most of these atrocities nor would they care until it hits home. The best solution I can come up with at this time is to just cut health insurance out of the picture, or at least cut out plans that cover everything (ala collision insurance).
I see the glass as full with a FoS of 2.
No, they pretty much only have only done worth a damn at A. That they've more or less done pretty well at given that we've yet to be successfully invaded by any credible threat. Yes, we've been hit a time or two but we've never even gotten close to losing a home game.
That they do all three better than most other governments is some solace but I'd still prefer they de-head their collective asses and do better.
Violence is like duct tape. If it doesn't solve the problem, you didn't use enough.
I actually have an anecdotal aside to your point on prescription drugs here. Aside from rare instances, many many generic patent expired drugs exist to treat the same thing that many doctors prescribe new patented brand name drugs for. I'm no expert at all on this and maybe I'm completely wrong, but chemotherapy (an example I choose for the fact that it is often cited as a massive health expense) has been around for quite a while now. I find it hard to believe that most chemotherapy options are not in generics at this point, which should be dirt cheap.
I see the glass as full with a FoS of 2.
I don't think people really understand the cost consequences of health insurance as it exists now. For one, you have patients who do not think to shop around for maximum value and doctors who do not compete because they all get paid mostly the same anyways. Then there is the negotiated payments from insurance companies which encourage the industry to artificially inflate prices (for those without insurance) to get what they believe is a fair compensation (less than list price). Then there is the administrative cost for doctors to process the paperwork. The system results in costs where people cannot afford to even protest against it.
Consider this. For health insurance companies to turn their fat profits, we need to spend a LOT more on our insurance premiums than the entire country is spending on health care. This is madness even in a pure free market.
I see the glass as full with a FoS of 2.
You are absolutely right and that is the only reasonable solution in this diverse society. Maybe when we are obviously and completely bankrupt, such solutions will be seriously considered.
Why should routine health care not be a personal responsibility like anything else in life?
Too expensive... even for healthy people. Then the damn doctor is prescribing all sorts of unnecessary procedures and drugs. (you have high blood pressure, you're overweight) Get a second opinion? (okay, you're ugly, too) Oh yeah, let's double the cost
For justice, we must go to Don Corleone
It hasn't failed in any of those places, or any other. It has succeeded in every place it has been tried. American doesn't like to follow a lead, even when it's a good lead. We like to do things our own way, even when our own way is dumb. Eh, at least we sit on top of the world. It's still pretty sweet to be an American, and I have just fine health insurance anyway. I just wish taxes were raised on people like me, to transfer some of my wealth to poor people, in order to support socialized social services for those people. No private effort has ever or could ever exist on a scale sufficient to solve the problem, so only a governmental solution will suffice.
You have some atheists protesting whenever a mayor admits he believes in God, puritans who protest whenever a nipple slips, and environmentalists who protest whenever somebody looks at a whale crosseyed.
All together they make sure everything is challenged. I'd say on the balance it's a good thing, and it provides for some measure of entertainment.
The only question here is whether it is constitutional. In my opinion, absolutely not. Not even fracking close.
But the Constitution has a built-in mechanism to correct its deficiencies.
It's not called activist judges making shit up. It's called amendments.
If they do an amendment allowing this, then by definition there can be no question it is constitutional.
Do you NOT understand what insurance is? Insurance is: hey, let's all put our money together, so that when X happens to one of us, we can pay the costs. So I guess you are against insurance, because insurance is inherently not paying for your own costs
And now, on to disagreeing with you! ;)
I will address the points you bought up, and how to cut costs, with a hypothetical government-paid healthcare system, when the government reimburses doctors for providing medical care.
For one, you have patients who do not think to shop around for maximum value
See, that's just a little silly. Patients are not competent just how much health care they need, nor are they involved enough in the process to actually cut costs.
We do need to cut costs, but it should be because the providers have an incentive to do it cheaper, not because patients figure that one place is 5% cheaper. What should happen is that place makes 6% profit and the other place make 1% profit...and then we racket it down where they make 4% and -1%. (Which would result in people having to pay things out of pocket, and presumably they would go elsewhere when they learned of this.)
and doctors who do not compete because they all get paid mostly the same anyways.
Getting paid mostly the same is an excellent reason to cut costs. I think you're looking at the problem backwards.
What we should have is set payments for stuff, and doctors get paid that much. If they can do it cheaper, hey, look, they just made money. Once everyone starts doing it cheaper, we lower payments a bit.
What we absolutely need to stop doing is having medical facilities set their own prices, and have the government, or insurance companies, or even random people who really can't comparison shop, pay whatever they are. That way lies madness. (In fact, we've already gone that way, and gone insane.)
Then there is the negotiated payments from insurance companies which encourage the industry to artificially inflate prices (for those without insurance) to get what they believe is a fair compensation (less than list price).
As an uninsurable person who actually pays their bills (Yes, we exist.), negotiated prices piss me the fuck off, especially when insured people assume I'm the one freeloading. They're freeloading off me. My last hospital visit I paid about $17,000 for something that should have cost $6000.
Then there is the administrative cost for doctors to process the paperwork.
Right, which is why I think 'insurance', even single payer, is the wrong model.
A doctor turns in evidence they did a certain procedure. They get paid a fixed rate for that. That's it, the end. No administrative overhead. (At least not for payment, obviously doctors have a lot of other paperwork.)
Yes, we have to worry about fraud...but we always have to worry about that. And we don't have to worry about some of the fraud, either...we don't worry about is doctor lying how much they charged (A common medicare scam) because they don't paid based on that. All we have to worry about is doctors making up stuff.
And we don't have to worry if they're 'covered' or what their 'deductible' is.
For health insurance companies to turn their fat profits, we need to spend a LOT more on our insurance premiums than the entire country is spending on health care.
They make about 5% profit, and about 20% overhead, so by definition, we are paying 25% more than if we just threw all our money in a big swimming pool and grabbed some when we went to the doctor. (And that's not counting the administration on the doctor's end.) It's insane.
This is madness even in a pure free market.
Having a middleman who makes more money the less he resells is...well, we're past 'melted clock faces' territory and into complete dadaism. And that's absurd enough, without having what they fail to provide result in the sickness and death of people...well...
From the outside, the health insurance industry looks essentially like a satirical deconstruction of the free market by communists.
Look at us, comrade, mocking the free market, as it cannot provide basic services because of the bourgeoisie sucking all the money out. The lack of health care is a metaphor for the living death the proletariat is forced to toil in...wait, what? It's not a metaphor? People are actually dying?
If corporations are people, aren't stockholders guilty of slavery?
Ultimately, my problem with the entire argument is that everyone I know who doesn't have health insurance could easily afford it but for an unwillingness to correct blatant prioritization problems.
Hello, I would like you to meet me. I am David. I do not have health insurance. I do not have it not because 'I cannot afford it'. I actually can afford it.(1)
I do not have health insurance because I had heart surgery as a child, and have a pacemaker, and hence insurance companies will not sell insurance to me.
1) Well, whether or not I can 'afford' something that does not exist is something of a metaphysical question. I could afford what other people seem to pay for their insurance.
If corporations are people, aren't stockholders guilty of slavery?
I don't know what the current health insurance industry really would be classified as. Weird useless middlemen. They're like...anti-resellers.
Exactly.
Insurance is nothing more than legalized gambling, but for many things (like fire, car accidents, etc.), it makes sense to spread the costs of rare catastrophe around.
No, it really doesn't.
Yes it does, and you actually agree with me, you only disagree about who should provide the insurance service (or rather, compensation when something catastrophic happens).
With private insurance companies, investors pay money to start a company that takes money from customers, gambling that the customers won't need any compensation for catastrophes. It is gambling, but it makes sense in a way, because most people couldn't afford it if something catastrophic happened, and it would economically devastate them, so they pay a monthly fee, gambling that if something does happen, they'll get a big check compensating them for the loss, rather than go bankrupt or wipe out their life's savings. So, in the end, a big group of people pay into a pool, people with catastrophes get paid out of that pool, and the remainder is spread amongst the investors as profit.
If 90% of people do have a particular sort of insurance, society's safety net is fucked up and someone's profiting off it. There really should be no 'general' insurance. If almost all people need it, then we should figure out some sane compensation and pay it out of taxes.
And if all people who have X need it, like car insurance, we should tax the cars for it. Same with homeowner insurance.
The idea that the government shouldn't provide all necessary services, all services that all citizens need, that we should instead have everyone go to corporations, is perhaps the second stupidest idea that the American people have ever internalized.
I hate to break it to you, but this isn't an exclusively American idea, it's shared by basically all developed countries, including the "socialist" western European countries.
However, you do have an intriguing proposition, that most insurance companies should be eliminated and those services provided by the government instead. There is some merit to the idea: most citizens do need insurance of some kind (renter's, auto, homeowner, AD&D (not the game!), etc.), and instead of having it provided by for-profit companies, the government should just do it directly, eliminating the profit overhead.
However, historical record for governments that are too large and provide too many services isn't so great. Look at what happened to the Soviet countries, after all.
Also, having multiple companies providing the same services provides competition, so that (as long as government regulation keeps the competition fair) prices are held low. Many government services have suffered from cost overruns and general inefficiency.
Then again, the USPS seems to work pretty well these days, and can ship a small parcel for me much cheaper than UPS or Fedex, and even better, they can do it with far less damage, according to a recent Popular Mechanics experiment.
There's other services that just about everyone needs in today's society, which aren't provided by the government: electricity, communications, and water and sewer in some places. Not many people complain about power rates in the USA, but power is only provided by private corporations. However, those companies are strictly regulated, since they are utility monopolies. On the other hand, we have a bunch of competing wireless communication companies, and our rates and service totally suck compared to the rest of the developed world. Regardless, I don't see anyone saying we should nationalize electricity and cellphone service, even though those are used by probably 99% of the population, while there's actually a pretty sizeable part of our population which has no insurance of any kind (i.e., the poor--they don't bother with auto in
What's dangerous is trying to put a price to everything and then failing to act because some activities may be unprofitable. People like to blame the "free market", but it's insufficient political will that is the problem.
If social services become human rights when a society is prosperous enough to provide them, do they then cease to be human rights when that society goes into decline?
Didn't you argue above that rights are the natural state and one can only be prevented from excercising them? How does your scenario not apply to the right to life and/or the pursuit of happiness? I would imagine that these rights are similarly constricted in a poor society, are they not?
Free Manning, jail Obama.
We do need to cut costs, but it should be because the providers have an incentive to do it cheaper, not because patients figure that one place is 5% cheaper
Completely agree here. But keep in mind that "value" does not always mean cheaper. If a doctor costs you twice as much but fixes the problem in 1/4 the time and more reliably, generally it's worth the upfront cost. Patients need to educate themselves. With information flowing so freely, there's no reason to rely entirely on what your doctor says. For anyone with a moderate education, those days should be over.
Getting paid mostly the same is an excellent reason to cut costs. I think you're looking at the problem backwards. What we should have is set payments for stuff, and doctors get paid that much. If they can do it cheaper, hey, look, they just made money. Once everyone starts doing it cheaper, we lower payments a bit.
Ha, good point. But remember, value does not always mean cheaper. There is a lot of expense that the family practitioner does not make nor invest money on (such as diagnostic testing, imaging, prescriptions, etc).
They make about 5% profit, and about 20% overhead
Plus all of the consequential cost increases due to the existence of the system.
Now this is the kind of civil, sane, and healthy debate I wish the rest of the country could have on this topic.
I see the glass as full with a FoS of 2.
I'm not sure about his for instance, but I can tell you about my for instance.
I had a hospital stay that was billed to me as $108,000. I looked at that bill and freaked. I thought, where am I going to come up with 15,000 for my part. After it went to insurance and came to me, I owed a little over $2000. So after the negotiated rates were applied to my insurance, that is all I owed. I actually called them to make sure this was correct and covered my whole 10+ day stay,
If I had been uninsured my bill would have been $108,000.
Another case
I had a blood test which was being taken monthly for over a 2 years. The charge to me was $30 after insurance. I had a friend who worked with the health insurance company and said that's not right.
She went and found the code they should be entering for that blood test and the charge to me went to $5 dollars per test.
The way it was explained to me was that there was a negotiated rate for the blood test and that I needed the lab to use the correct code to get the negotiated rate.
So I can believe that $60,000 billed all of a sudden became $8,800.
No, I'm saying being constitutional or not is completely irrelevant as to why it is being opposed. It is just an angle that is being tried to stop it while the real reason is purely financial.
Insurance gives someone money when certain circumstances are met, though that is very frequently not the named insured. Most types of insurance policies have been used in large minority or even predominantly as risk-reduction by interested third parties where large sums of money are concerned, typically lenders who hold a significant financial stake in the item or person insured. Most health insurance plans use direct-to-provider payment because people are unable to afford to make the upfront payment on their own to be reimbursed, and medical care usually can't wait for the claim process to complete in the same way every other type of insurance can.
I would agree that we didn't really have health insurance, since the monolithic process that the industry has become means that they control the construction of loopholes you can drive a bus through in order to avoid paying when they are contractually obligated to.
I don't see how my view of insurance is a re-definition, but I suppose we can just simply disagree on that point.
Why should routine health care not be a personal responsibility like anything else in life?
Probably because some sort of public-coordinated health care system would be more effective and cost efficient. Public systems can track things like medical history, vaccines, mediations, allergies, etc. more reliably. Not to say there aren't implementations of this that have their own issues, but if handled properly a taxpayer-funded, single payer system is optimal. Similar reason why we don't think policing or fire-fighting should be 'personal responsibilities'...
Nice to meet you. That really sucks. You now fall into this category:
Yes, there are people who truly get screwed through no fault of their own, but those represent a tiny minority of cases, at least amongst those I've encountered.
By the way, my name is Trevor. I have cancer. Should I survive to see remission, I will probably be in exactly the same boat you are.
Being on the short end of the stick myself, I am sympathetic to crappy personal situations. That sympathy doesn't cause me to support solutions that are short-term political hack jobs created because nobody has enough balls to actually tackle the root problems though. The system was screwed up before, and this course is going to screw it up even more. Either the Supreme Court finds it unenforceable by invalidating the individual mandate, or they indiscriminately expand the power of the Commerce Clause to allow Congress to compel individuals to buy any product deemed necessary to promote "the general welfare." Neither of those outcomes produce any meaningful, beneficial change.
In my part of the world, everyone spending a % of income on a universal healthcare system is part of the sanitation system. Under your system my neighbours down the hill have to put up with a stream of my excrement flowing past them. We can't all live on top of the hill.
There, fixed that for you.
In Soviet Russia, our new overlords are belong to all your base.
Consider that costs for the MD and for the administration are roughly proportional -- and regard this chart with due alarm:
http://www.capecare.info/img/pnhp_growthphysadmin.png
THAT is where the inflation in healthcare costs comes from.
And yes, I too remember when anyone with 10 or 20 bucks could afford to see the doctor.
~REZ~ #43301. Who'd fake being me anyway?
Wow. Common sense at last. It felt good reading this comment.
In Soviet Russia, our new overlords are belong to all your base.
There's an interesting pay-as-you-go billing chart on the wall at the Los Angeles County Health Clinic. Most procedures are $80 and any surgery is $400. This is their actual cost, without any billing or admin fees or insurance. (I asked.)
Also, there have been some studies of hospital bills which found they are typically padded by up to 80%, therefore you should always verify EVERY item on the bill, as you'll find many you never received, but are simply part of the default billing.
~REZ~ #43301. Who'd fake being me anyway?
Great post, I have a 2 observations however.
Firstly the reason that your fictional Billy Bob's hypothetical 2 years after no insurance is so high is because medical care in the us price gouges ridiculously in order to game the rest of the system into getting an actual reasonable care cost. The insurance companies clearly go along with this, and it seems to me that they do so that they have these big scary numbers to quote whenever the cost of premiums gets questioned. The fact that they get insane discounts just proves that they're complicit in the gouging.
The secong observation is that a universal healthcare system that universally pours money into the pockets of third parties that in no way actually contribute to improving the standard of care, or outcomes, is just looney tunes!
The only way for this system to work is for there to be one payer. I am a brit and I thank god for the farsighted people who set up a healthcare that is truly free at the point of use, and a sensible way of having people pay for it!
Easy...LOSE WEIGHT.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
I don't necessarily disagree with what you're saying, I'm just confused as to why you're classifying it as libertarian, big 'L' or small 'l'. What you're talking about is a fair market rather than a laissez faire market which is what libertarian generally means.
Since when were semi-automatic firearms the ultimate tactical weapon of the evil-doing belligerent revolutionist masses? Do people even know what semi-automatic means or has the media completely succeeded in demonizing them beyond rational logic?
1) Since Bill Clinton, Chuck Schumer, and Diane Feinstein rolled out poor old Brady and forced thru the ill-fated assault weapon ban (now sunsetted).
2) They've succeeded. Between the media and entertainment businesses, 'everyone' knows that M16's are evil, and that pistols are meant to be fired with the grip held horizontally.
The ban was laughable - it depended on how evil the gun looked, not on its mechanisms. (aftermarket stock = evil, standard wood stock ok).
Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
Oh, don't make the mistake of thinking I like the bill, or even that I think it's constitutional.
I'm just glad that insurance companies can no longer go to my hospital, drive rates lower for themselves and higher for everyone else, and then I, who cannot get insurance from them, have to go pay the higher rates.
It is blatant violation of anti-trust laws, it really should already be illegal, and the entire system is so stupid to start with it's incomprehensible. (But you just read my other post about how insurance seems to have become an anti-reseller of health care. Which is, um, utterly insane as a premise.)
There's plenty of good in the bill, though. Even if the mandate is struck down, and it takes away the 'no previous conditions' rule...well, there are still the stop-gag 'Pre Existing Condition Insurance Plans' which were supposed to last until then.
And, of course, it's already in effect for children. Taking that away is going to piss people off.
I think giving people a taste of a (slightly) saner system and then snatching it away has to be better than doing nothing, politically.
If corporations are people, aren't stockholders guilty of slavery?
I hate to break it to you, but this isn't an exclusively American idea, it's shared by basically all developed countries, including the "socialist" western European countries.
Yeah, but they have much tighter regulations, and often require those corporations to be non-profits. They almost always regulate every aspect of the payout, so the only difference is that they compete on overhead.
There's other services that just about everyone needs in today's society, which aren't provided by the government: electricity, communications, and water and sewer in some places.
This works saner if you divide it into two things: The service of moving electricity into your house, which is a service and, as everyone needs it (and it requires a monopoly), the government should probably do it. And the actual production of electricity, which is a 'good' (although perhaps only metaphorically) that people use in different amount, just like food, and private companies should produce it. Where and how private companies get paid is up for debate...perhaps the government should bid, and charge people, perhaps private citizens should choose 'which company' they are using.
Strangely, while I'd always thought we should do utilities that way, I hadn't actually phrased it that way until just now.
For instance, with auto insurance, you can get a liability-only policy to save money, or you can get comprehensive and collision coverage for more money.
Everyone doesn't need collision, so people who wanted that would go out and buy that from third parties.
In fact, the government insurance should probably just provide for the other person, period. (This would work a lot saner if the government was covering medical expenses anyway.)
Interesting trick: Instead of trying to tax people different for how bad a driver they are, or tax everyone the same, we can just increase fines for accidents and tickets. You don't get a rate increase for an accident, but you get hit with a $1000 fine.
Our society needs to sit down and decide if we want one of two situations: A) everyone has a minimum level of health care that they don't need to pay for, or B) health care is completely private, and not a right at all, but a luxury.
But deciding things as a nation would require politicians to actually attempt to lead us, instead of just emotionally manipulate us.
If corporations are people, aren't stockholders guilty of slavery?
Completely agree here. But keep in mind that "value" does not always mean cheaper. If a doctor costs you twice as much but fixes the problem in 1/4 the time and more reliably, generally it's worth the upfront cost. Patients need to educate themselves. With information flowing so freely, there's no reason to rely entirely on what your doctor says. For anyone with a moderate education, those days should be over.
Ah, you have greater faith in humanity than I do.
You certainly could have some sort of system where people ended up paying more for medical inefficiencies, and yet everyone got care. Like people pay 5% of their medical care up to $100 every month or something, which is low enough that everyone should be able to get care (Or have a charity pick up the tab.), but enough that they'd pick the $500 MRI instead of the $1500 MRI, because it costs them $10 instead of $30.
I'm just not sure there would be a net benefit.
Sure, 20% of patients, if incentivized right, might pick a better value...but then another 20% might be swayed by some TV ad, and another 20% will attempt to save money by not getting that prescription for anti-biotics so they develop full pneumonia, or not get that MRI the doctor said they needed because their cancer might be back, utterly and totally undoing all our gains.
I know that there's a longing that people would make better medical decisions, but I don't think there's any evidence that more decision making==more affordable care in general.
Plus, now you've added a level of bookkeeping. The entire point of what I suggested is that there is literally no reason to keep 'per-patient' financial bookkeeping. Doctor's payments are entirely per-procedure. Did a procedure, get paid X for it, that's it. No checking anything, no figuring anything.(1) You don't even need a billing system.
If you just get some sort of appointed medical board to set prices for medical procedures, and say 'This procedure pays with $150 + location cost of living adjustment', then doctors automatically have incentives to do it cheaper.
1) Strictly speaking, some areas would get checked. Doctors would probably need permission before plastic surgery that they intend to bill the government for, for example. Presumably, some sort of local board could be set up. But 95% of the doctors wouldn't have to deal with any permissions, and of the 5% doctors left, 90% of their procedures wouldn't involve the government at all. It's only the rare medically needed breast implant or plastic surgery that would get filtered past a board.
There is a lot of expense that the family practitioner does not make nor invest money on (such as diagnostic testing, imaging, prescriptions, etc).
Someone is going to have to explain to me, someday, how MRIs are anywhere near as expensive as they are. Them, and labs, are a huge example of absurd amount of wasted money in the system. And it's because patients don't really understand what's going on.
But, strangely, they're the easiest to fix under my system, because they are the most objective. It's possible for a doctor to argue that he should get paid more than another doctor, because he does a better job, and a flat fee totally removes incentive for him to do a better job.
While I don't really agree with that, because which doctors people go to is random and if they've choosing a more expensive one it's probably because of his bedside manner rather than any 'medical' ability...
The fact some of them cost five times as much as others demonstrates there's something seriously wrong with the system.
Plus all of the consequential cost increases due to the existence of the system.
Like deliberate lying on the part of patients who do have pre-exist
If corporations are people, aren't stockholders guilty of slavery?
Yeah, but they have much tighter regulations, and often require those corporations to be non-profits. They almost always regulate every aspect of the payout, so the only difference is that they compete on overhead.
Yes, of course, but it's not like American insurance companies are unregulated. They're regulated by the States they operate in. Of course, these days it seems like it's not very good regulation, but still, it's there.
This works saner if you divide it into two things: The service of moving electricity into your house, which is a service and, as everyone needs it (and it requires a monopoly), the government should probably do it. And the actual production of electricity, which is a 'good' (although perhaps only metaphorically) that people use in different amount, just like food, and private companies should produce it. Where and how private companies get paid is up for debate...perhaps the government should bid, and charge people, perhaps private citizens should choose 'which company' they are using.
Won't work. You can't divide electric power that way, so that customers can choose which generator their power comes from. The whole system is a grid, and has to be managed as a system, including the generating plants. You can't have one entity managing the grid, and other people managing the generators, and occasionally fighting over things, because the whole system will fall apart.
Sure, having the "pipes" managed separately from the providers works great with the Internet (e.g., ISPs are separate from Google, NYTimes, NetFlix, etc.) , but not with other services. That's why it has to be run as a highly regulated monopoly.
Interesting trick: Instead of trying to tax people different for how bad a driver they are, or tax everyone the same, we can just increase fines for accidents and tickets. You don't get a rate increase for an accident, but you get hit with a $1000 fine.
Won't work. First, if you fine people $1000 for being involved in an accident that wasn't their fault, there'll be an uproar. Second, if there's only one insurance company (the govt), and you try to fine people for bad driving, there'll be all kinds of lawsuits from people who don't think it's fair, think the accident report was wrong, etc. etc., and the burden to the legal system will be too great. There won't be any alternative, because there's no competition, so people will see the legal system as the only way to get any justice. With competing insurance companies, if one company charges you bad rates, you have the option of simply going to the competition, which is cheaper and easier than filing a lawsuit, so lawsuits are only used as a last resort. With a monopoly provider, lawsuits are the ONLY resort.
But deciding things as a nation would require politicians to actually attempt to lead us, instead of just emotionally manipulate us.
Where are you going to find politicians who are also good leaders? People who are good leaders go into other fields, namely business, where they don't have to put up with all the BS that politicians do, plus they get paid more, and don't have to worry about the media following their every move, and their families too. Additionally, with voting available to everyone, the general population is too stupid to pick good leaders, and would rather pick people like Sarah Palin, despite the fact that she quit her job halfway through to work on a book deal, and thinks that Africa is a single country.
Someone is going to have to explain to me, someday, how MRIs are anywhere near as expensive as they are. Them, and labs, are a huge example of absurd amount of wasted money in the system. And it's because patients don't really understand what's going on.
Radiology is a cash cow of hospitals everywhere. Essentially, it's the health care system pushing for the latest and greatest technology, which is extremely expensive. Since you and I are in no position to say we're happy with the resolution that we have, we just get to bit the bullet and pay for it. Making diagnoses based on medical imaging is a special skill to be sure, but believe me the salaries paid to radiologists is jaw dropping.
I see the glass as full with a FoS of 2.
The existing medical regulation is a huge part of why medical care is a byzantine process... including special tax breaks, HIPAA, licensing, medical schools... the AMA worked to reduce the supply of doctors because they thought there was going to be a surplus, which of course would mean lower pay for their members. If there was no one standing between customers and doctors, the whole damn system would be a hell of a lot simpler.
If I didn't have to see a doctor to get a prescription for just about every drug I might find beneficial, doctors visits would be a hell of a lot cheaper. Every single regulation that reduces the supply or increases the demand, even if it's justifiable for some reason, ALSO acts to raise prices.
"Pulling together is the aim of despotism and tyranny! Free men pull in all sorts of directions" -- Havelock Vetinari
Rights can't be granted. Entitlements and privileges can be, but only at the expense of someone else's rights. The only reason to claim otherwise is so people can feel good about using force to institute their preferred distribution. I may tolerate some amount of redistribution (i don't really care about medicare for instance), but no one has a right to force other people to help them.
This is an argument about definitions. The redistributors successfully got their redefinition of rights accepted a long time ago, but much like defining racism in terms of the group in power instead of making judgements based on race, it's inherently dishonest. Definitions matter.
"Pulling together is the aim of despotism and tyranny! Free men pull in all sorts of directions" -- Havelock Vetinari
Remember, you can't just do one thing. If the pseudo insurance wasn't there, those amounts would NOT be what was charged. The existence of health maintenance in the insurance industry ratchest prices higher than they would otherwise be. Just like government guaranteed loans increase the demand for college degrees and raise tuition. Without the guarantee, no bank would be providing loans for a degree in 17th century french history...
"Pulling together is the aim of despotism and tyranny! Free men pull in all sorts of directions" -- Havelock Vetinari
Sure. However medical care MUST be heavily regulated, since it is so incredibly lopsided between provider and consumer. there is no possible way to negotiate from equal footing when to one person it's life and death and to another it's a paycheck. And that's about administrators of hospitals, not doctors. the doctors still have to follow hospital policy.
Other than that though I agree with you and I myself do not believe a person's right to self-medicate should be infringed. FDA approved should be a selling point and prescription only should be a recommendation, not hard and fast requirements.
also though, medical care will ALWAYS be byzantine to a lay person. Just like any specialized profession it's just way too complicated to fully educate every consumer about every decision that must be made.
and there is little benefit to doing so for the providers of such care as well.
Won't work. You can't divide electric power that way, so that customers can choose which generator their power comes from. The whole system is a grid, and has to be managed as a system, including the generating plants. You can't have one entity managing the grid, and other people managing the generators, and occasionally fighting over things, because the whole system will fall apart.
Uh, lots of things already work that way. Natural gas does in most place. Electricity does in many places.
The problem is mainly that generators cost a lot of money to build, and have to operate all the way, so the market is a bit weird. Usually the government ends up contracting to buy a set amount of power from specific places, and just resells that.
Won't work. First, if you fine people $1000 for being involved in an accident that wasn't their fault, there'll be an uproar.
Second, if there's only one insurance company (the govt), and you try to fine people for bad driving, there'll be all kinds of lawsuits from people who don't think it's fair, think the accident report was wrong, etc. etc., and the burden to the legal system will be too great.
People are already fined for bad driving. You drive badly, you get given a ticket. I am confused by your premise.
People might be more likely to fight a ticket in court if it was $1000 vs. $100, but whatever. I don't think the solution is extra-judicial punishment from private companies. The solution is to operate more courts. (Which we badly need anyway.)
There won't be any alternative, because there's no competition, so people will see the legal system as the only way to get any justice. With competing insurance companies, if one company charges you bad rates, you have the option of simply going to the competition, which is cheaper and easier than filing a lawsuit, so lawsuits are only used as a last resort. With a monopoly provider, lawsuits are the ONLY resort.
I don't know why you think this would be sold as 'purchase monopoly insurance'. This is a car tax.
I don't see people suing because they think they should be able to pay their car tag with some other company!
If corporations are people, aren't stockholders guilty of slavery?
You can do everything right and still get cancer.
You can do everything right and you *will* get cancer, provided something else doesn't kill you first. It's inevitable, and the same with heart disease, infections, and dementia.
And those cancers generally (with a few exceptions) fall into two categories: those that are fairly inexpensive to treat, and those that will consume enormous resources and then still kill you quickly after a lot of suffering. It's the same with the other big killers.
Hence: reasonable health care need not be expensive.
Radiology is a cash cow of hospitals everywhere. Essentially, it's the health care system pushing for the latest and greatest technology, which is extremely expensive.
Yup.
Since you and I are in no position to say we're happy with the resolution that we have, we just get to bit the bullet and pay for it.
Well, 'I' am not in that position, as I have a pacemaker and hence cannot get a MRI. ;)
But, yes, almost all the 'advances' in the technology have been quite pointless. Sure, maybe one time out of a thousand the super duper fine-grain scanner is needed, so, sure, build one in each major city so we can scan for that hidden brain clot or whatever.
But 999 out of 1000, the cheap one is fine, and hasn't needed upgraded since it was installed in 1983. (Hardware, that is. Software is another story.)
If corporations are people, aren't stockholders guilty of slavery?
The point of government isn't to "help people", it's to protect your fundamental rights, such as ownership of private property.
I think giving people a taste of a (slightly) saner system and then snatching it away has to be better than doing nothing, politically.
Well, there is always the hope that something that can pass as a silver lining exists in the mess. Unfortunately, the more years go by the more faith I lose in people in general to act out of any emotion other than fear. I suppose that's in large part because the fearful/angry are the loudest and most insistent, but dealing with that portion of humanity is like holding a belt sander to your soul.
And this one clearly isn't. I wouldn't really mind a hybrid system here, since I lived under the rather effective German one. But it needs to be done constitutionally, which means either getting every single state on board voluntarily, or passing a constitutional amendment.
But yes there are a huge number of people who go by agenda. Look at Obama's ridiculous suit against Arizona's immigration law, or the Thomas More Law Center suing to stop state benefits for same-sex couples. They don't really care whether the action is legal or constitutional or not, it just went against their agenda so they want it stopped.
And it's still a good thing that they challenge unconstitutional laws regardless of motivation.
That's when you start paying ambulances to default bringing emergency patients to your hospital. You have patients sign essentially gag orders before beginning treatments. And you rename / rebrand yourself every few years.
Heck, how many hospitals do you know of in 100 miles? If you heard that your wife or husband was just hit by a car and brought to a hospital, would you immediately google that hospital and search for its reputation? If it was a bad hospital, would you take him or her, still strapped to the firemen's board, into the back of your car and drive them somewhere else?
The ______ Agenda