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Monday, July 02, 2012

OT-P: July: Obamacare Decision as Baseball: the Runner is Safe, so Now What?

My favorite play in baseball is the second base steal. In the play, the base runner watches the pitch, and at just the right moment, he sprints toward second. The catcher snatches the pitch, springs up and rockets the ball to the second baseman who snags it and tries to tag the runner as he slides into the base. As the dust clears, all eyes are on the second base umpire who, in a split second, calls the runner safe or out. When the play is over, the players dust themselves off, and the game goes on.

Some on the field may disagree with the umpire’s call.  However, the umpire’s decision is final, and arguing can get you ejected. To stay in the game, great teams simply adjust their strategy based on the umpire’s call.

 

Morty Causa Posted: July 02, 2012 at 02:26 PM | 4025 comment(s) Login to Bookmark
  Tags: politics, special topics

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   101. Ray (RDP) Posted: July 02, 2012 at 07:51 PM (#4171710)
You folks (by which I mostly mean, 'Ray') understand that "unaffordable" is a relative term, right? Something can be "unaffordable" for someone and affordable for someone else. It's perfectly legitimate to say that something is unaffordable for lots of people even though others can easily afford it.


Sigh. It's not helpful to define the meaning out of a word. The fact one person can't afford a pair of shoes does not mean that shoes are "unaffordable." This is a completely ridiculous usage of the word, and it's shameful that people here are stooping to this level of debate.

Merriam-Webster:

1. being within the financial means of most people <once those electronic devices became affordable, sales skyrocketed>

2. costing little <they've added some affordable options>


http://www.merriam-webster.com/thesaurus/affordable
   102. Matt Clement of Alexandria Posted: July 02, 2012 at 07:55 PM (#4171713)
Affordable has a general sense, which Ray has correctly pointed out. One can refer to something as generally "affordable" or "unaffordable", which has an implied "for most people".

Affordable also has a relative sense, which Ray is bizarrely keen on denying. A $3000 suit is affordable for a rich person, but unaffordable for a poor person. This is perfectly normal language use.

The "affordable care act" uses affordable in this perfectly normal relative sense. The goal is for health care and health insurance to be affordable for all people, relative to their wealth, income, and budget.
   103. Ray (RDP) Posted: July 02, 2012 at 08:02 PM (#4171716)
Affordable also has a relative sense, which Ray is bizarrely keen on denying. A $3000 suit is affordable for a rich person, but unaffordable for a poor person. This is perfectly normal language use.


But how is this helpful? The issue is whether health insurance is affordable. It is.

If you want to make it affordable for everyone (*), fine. But don't imply (with the usage of "Affordable care" or whatever) that the issue is the cost of health insurance when the issue is not the cost of health insurance, but is simply that some people, for whatever reason, don't have the means to support themselves.

(*) Though I fail to see how allowing people to get health insurance for free is providing "affordable" coverage to them. That isn't "affordable" either -- it's simply free. (Or, more accurately, paid for by others.) Giving something to someone for nothing is not making it "affordable" for them; that word is misplaced in that context.

My overall point - this is not semantics - is that people use language in order to distract from what is actually going on. If one supports doing X, one should be honest about what X is.
   104. Matt Clement of Alexandria Posted: July 02, 2012 at 08:05 PM (#4171719)
My overall point - this is not semantics - is that people use language in order to distract from what is actually going on. If one supports doing X, one should be honest about what X is.
No, the goal really is for health care to be affordable for all people. The fact that it already is affordable for most people is an irrelevancy. Your struggles with language use notwithstanding, the vast majority of people understand this perfectly well.
   105. formerly dp Posted: July 02, 2012 at 08:07 PM (#4171722)
2. costing little <they've added some affordable options>

You do understand the first and second definitions aren't synonymous, right? One designates a group of people that cost is relative to, while the other doesn't. If you make something cost less in absolute terms (the second definition), it becomes affordable to more people.

The issue is whether health insurance is affordable. It is.

Again, is this by your decree, or do you have numbers to back up what counts as "affordable" and what constitutes "most people"? Are these open to review and discussion? Or are we all just an audience for your self-indulgent proclamations?

==
The "affordable care act" uses affordable in this perfectly normal relative sense. The goal is for health care and health insurance to be affordable for all people, relative to their wealth, income, and budget.

And it recognizes that rising insurance premiums and health care costs are making health care increasingly less affordable to more people. Which all serious people having the conversation seem to acknowledge as a problem. Unfortunately, "all serious people" no longer includes Republicans. And Ray.
   106. Zipperholes Posted: July 02, 2012 at 08:08 PM (#4171723)
My overall point - this is not semantics - is that people use language in order to distract from what is actually going on.
Like when people use the term "free rider" to describe anyone who benefits from a public service more than they contribute to it?
   107. Matt Clement of Alexandria Posted: July 02, 2012 at 08:09 PM (#4171724)
EDIT: Too many arguments. I'm going to eat dinner now.
   108. Ray (RDP) Posted: July 02, 2012 at 08:10 PM (#4171727)
No, Matt, your goal (I don't think you'll disagree with this) is to give health care to everyone, by making some people pay for those who can't pay. Please stop describing a situation where some people get health care for nothing as making it "affordable" to them.

If you force Andy to buy me season tickets for a luxury box at Yankee Stadium, the luxury box has not now become "affordable" to me. It has simply been given to me. This really is not a hard concept.
   109. BDC Posted: July 02, 2012 at 08:17 PM (#4171730)
But objecting to "affordable" really is a surface complaint, right? If the act had been called the "A-1 Peachy Care Act," one could argue about that too, in the sense that it wouldn't have been peachy for absolutely everybody. I mean, the Grand Canyon must look tiny to a Martian, so we could object to that moniker as well on some ground. Everything still stays the same in real terms.
   110. Matt Clement of Alexandria Posted: July 02, 2012 at 08:18 PM (#4171731)
Please stop describing a situation where some people get health care for nothing as making it "affordable" to them.
The people who get fully subsidized care get it through Medicaid. This is paid for through taxes.

The other major reforms in the ACA aimed at making health insurance affordable are the regulation of the industry (to benefit those with pre-existing conditions) and the subsidies for people who aren't Medicaid eligible to purchase insurance. For these people, the ACA ensures that their health insurance will be affordable, and it still requires them to pay direct (but lower) costs for health insurance.
   111. formerly dp Posted: July 02, 2012 at 08:23 PM (#4171732)
No, Matt, your goal (I don't think you'll disagree with this) is to give health care to everyone, by making some people pay for those who can't pay. Please stop describing a situation where some people get health care for nothing as making it "affordable" to them.

This has been explained many, many times, in exhausting detail. You're pretending it hasn't been. Part of the goal of increasing the pool is to drive down health insurance premiums in the aggregate, resulting in more

(wait for it)

Affordable

(health)

Care

(as a result of the)

Act

Is there anything else we can help you with? Any more semantics you want to waste bandwidth complaining about?
   112. Ray (RDP) Posted: July 02, 2012 at 08:31 PM (#4171739)
But objecting to "affordable" really is a surface complaint, right?


As I said, I object to casting the Act in this way, because I feel that it is an attempt to veil what is really going on.

Had they called the act the Let's Force Some People To Pay For Health Care For Others As A Further Redistribution Of Wealth Act, I wouldn't have complained about the name.
   113. Bitter Mouse Posted: July 02, 2012 at 08:34 PM (#4171740)
Ray,

Did you equally object to the "Clean Skies Act"?
   114. formerly dp Posted: July 02, 2012 at 08:39 PM (#4171743)
As I said, I object to casting the Act in this way, because I feel that it is an attempt to veil what is really going on.

By describing it in precise terms? Do you disagree that one of the plan's main objectives is to lower premiums in the aggregate, making health care cheaper in absolute terms and therefore more affordable? Or is that just socialist propaganda carefully engineered by those thieving leftists? The title of the bill describes its aims pretty well, especially as bill titles go.

Please, for the love of Christ, please stop using BTF as your own personal b!tchfest. This happens in literally every thread you post in.
   115. Ray (RDP) Posted: July 02, 2012 at 08:44 PM (#4171745)
So they just choose the name as objectively as possible, with no branding effort being made? Is that peoples' position?
   116. Johnny Chimpo Posted: July 02, 2012 at 08:50 PM (#4171747)
Some things are necessary to living a full life in this country, others are optional. Necessary items should be affordable to all. Optional items, not so much. Health care is a necessity, and should be easily affordable to all. If that means taking money from those of us more well-off, then so be it. I'll not lose any sleep.
   117. Tripon Posted: July 02, 2012 at 09:05 PM (#4171750)
Okay, here's a question I have for you. Should Insurers or the Government incentive's people with either a momentary payment or some other form of award to become organ donors? Thousand of people die each year waiting on some sort of list, and the care they receive in the meantime is expensive and time consuming. Plus, becoming an organ donor might be a way to provide 'affordable' insurance. Whatever that means.
   118. Forsch 10 From Navarone (Dayn) Posted: July 02, 2012 at 09:18 PM (#4171760)
Is this bill title more to your liking?
   119. formerly dp Posted: July 02, 2012 at 09:20 PM (#4171762)
So they just choose the name as objectively as possible, with no branding effort being made? Is that peoples' position?

Only the strawman you're arguing with. It is my position that the title's a pretty accurate description of the bill's aims, not that it wasn't strategically titled. It can be both at the same time. And aren't you the one always telling us that marketing and advertising has no impact on behavior? (actually, stating it as a foregone conclusion) Have you reversed that position?
   120. zonk Posted: July 02, 2012 at 09:22 PM (#4171765)
I'm starting to get rather surprised by the apparent unpreparedness of McConnell and Boehner (and Romney, but he's got so many problems over ACA this one sort of hides in the background) to have any lucid comments on what they'd offer up as 'replace' option post-repeal. I guess they must have figured that since the media hasn't had the competence to ask that question since the ACA's passage, they were in the clear.

Near as I can tell... McConnell's position is that health insurance isn't a problem and Boehner seems to favor some form of cross-state insurance shopping, but state-level pools for 'pre-existing conditions'. Romney's position is that the July 4th holiday couldn't get here soon enough.
   121. Ray (RDP) Posted: July 02, 2012 at 09:24 PM (#4171766)
And aren't you the one always telling us that marketing and advertising has no impact on behavior?


No.
   122. Ron J Posted: July 02, 2012 at 10:00 PM (#4171777)
You know Ray I've never felt you were trolling before. I think you are now.

Have you ever known true extended financial hardship? I have. I'm frankly unable to participate in this thread any longer. I am that upset.
   123. Bitter Mouse Posted: July 02, 2012 at 10:04 PM (#4171780)
Ray,

Is there any other bill you object to the name of? I mean really you are just reaching because you don't like the outcome. Hurry through the stages of grief man.
   124. Jolly Old St. Nick Still Gags in October Posted: July 02, 2012 at 10:04 PM (#4171781)
I will admit, I actually find the constant questions to Ray about who will pay for this and who will pay for that to be a little weird. Ray thinks whomever is getting something should be the one paying. If you don't volunteer to pay for something you're not getting, you shouldn't be paying.

Except that he's been given countless opportunities to apply this principle to paying for the Iraq war, and his silence on the subject is all the proof one needs of his utter hypocrisy. I may be the only person who will call out this evasiveness for what it is, but then his entire pretense of having some overriding principle behind his Ayn Randish preferences is little more than a sham to begin with.

Just to summarize our portrait of Ray, Man of Steadfast Principles, as he applies his Principle to different situations:

1. Health insurance: Pay for it yourself, and if you can't, then pass the hat among those who feel sorry for you, and leave me alone.

2. Emergency rooms: Ahhhh, just treat em and write it off as welfare.

3. Wars of option: Go away boy, you bother me.

----------------------------------------------------

And aren't you the one always telling us that marketing and advertising has no impact on behavior?


No.

No, that's David, who thinks that demand for anything other than a specific brand is the product of a virgin birth.
   125. Ray (RDP) Posted: July 02, 2012 at 10:09 PM (#4171782)
You know Ray I've never felt you were trolling before. I think you are now.


I am not trolling.

Yes, some people are in true financial hardship, and can't afford health insurance. But, as I've said, the real problem there is not the cost of the health insurance; it's that the people are in true financial hardship. The health insurance is affordable, by definition, because the vast majority of people can afford it. It may be good policy to provide people with coverage, but that doesn't mean that the issue was the cost of the coverage. And providing them with coverage did not make the coverage affordable.

But now I'm just repeating myself.
   126. Spahn Insane Posted: July 02, 2012 at 10:15 PM (#4171784)
Dayn, thank you for reminding us all what a tool Eric Cantor is (in case we needed reminding).

That that joker has a position of influence in one of this country's two major political parties speaks volumes about the intellectual vacuity of that party.
   127. Spahn Insane Posted: July 02, 2012 at 10:17 PM (#4171787)
2. Emergency rooms: Ahhhh, just treat em and write it off as welfare.

It genuinely boggles my mind that conservatives by and large seem to be just fine with that particular state of affairs, but would rather self-immolate than live in a world where the dread ObamaCare is the law of the land.
   128. Morty Causa Posted: July 02, 2012 at 10:20 PM (#4171789)
No, that's David, who thinks that demand for anything other than a specific brand is the product of a virgin birth.


Beautiful. I wish I had said that.
   129. Brian C Posted: July 02, 2012 at 10:22 PM (#4171791)
This is a completely ridiculous usage of the word, and it's shameful that people here are stooping to this level of debate.

But you're the one who's complaining about the name of the bill, so ...??????

The health insurance is affordable, by definition, because the vast majority of people can afford it.

I'm not sure this is really even true - lots and lots of people have health insurance because their employer pays for most or all of it, and those payments are subsidized by the government in the form of tax exemptions. If people all had to pay market rates for their own health insurance, it's not at all clear that it would be "affordable" for vast swathes of the population.

   130. RickG Posted: July 02, 2012 at 10:29 PM (#4171796)
I don't often post here anymore, I just lurk. But you folks seem fairly smart. So tell me why I can't/shouldn't do the following:

1) Get licensed as a health insurance provider
2) Offer only one policy: $10/month health insurance, but with a $1,000,000 co-pay

I mean...it feels like I could make millions by saying "Pay the government $600, or pay me $120 and keep your whole refund."

Those so adamantly against the ACA can save themselves $500/year and be covered for the most catastrophic illnesses, all while maintaining their right to pay for every cent of their health care.
   131. bobm Posted: July 02, 2012 at 10:37 PM (#4171802)
[11] This poem is more the way some people discuss larger questions:

The Sloth by Theodore Roethke


I'm partial to My Papa's Waltz

The whiskey on your breath
Could make a small boy dizzy;
But I hung on like death:
Such waltzing was not easy.

We romped until the pans
Slid from the kitchen shelf;
My mother's countenance
Could not unfrown itself.

The hand that held my wrist
Was battered on one knuckle;
At every step you missed
My right ear scraped a buckle.

You beat time on my head
With a palm caked hard by dirt,
Then waltzed me off to bed
Still clinging to your shirt.
   132. Brian C Posted: July 02, 2012 at 10:39 PM (#4171807)
But you folks seem fairly smart. So tell me why I can't/shouldn't do the following

I'm too lazy to do it myself, but my guess is that it would take you only a few minutes of serious Google research to find out that this would be illegal.
   133. Matt Clement of Alexandria Posted: July 02, 2012 at 10:43 PM (#4171812)
I don't think it's illegal under the ACA, but it would not qualify for the exchanges or for the purposes of the mandate.

It might be illegal as a form of fraud, not under the ACA. And if you marketed a non-qualified plan as being qualified, that would be fraudulent.
   134. Brian C Posted: July 02, 2012 at 10:47 PM (#4171815)
I don't think it's illegal under the ACA...

Right, I don't mean to imply that I think it would be illegal under the ACA - I'm guessing that it would be illegal under plain old insurance regulations.
   135. Lassus Posted: July 02, 2012 at 10:50 PM (#4171817)
Is this bill title more to your liking?

Hee. Thank you, Dayn.
   136. Morty Causa Posted: July 02, 2012 at 10:58 PM (#4171822)
I'm not sure this is really even true - lots and lots of people have health insurance because their employer pays for most or all of it, and those payments are subsidized by the government in the form of tax exemptions. If people all had to pay market rates for their own health insurance, it's not at all clear that it would be "affordable" for vast swathes of the population.


Yeah, taking it off the top in a combination of employer/employee/government works. A big problem is for the people who have to get individual policies. No one is helping them out, and there premiums aren't subject to the modulation of group policy. This people give up trying to keep up keeping up when premiums skyrocket as they age.
   137. Morty Causa Posted: July 02, 2012 at 11:00 PM (#4171823)
131:

Yeah, I have read and re-read that poem many times over about fifty years, and it still stabs each time in the heart with icicle. Just a great poem.
   138. tshipman Posted: July 02, 2012 at 11:05 PM (#4171824)
But how is this helpful? The issue is whether health insurance is affordable. It is.


I think this is sort of factually incorrect. The entire decade of the 2000's was stagnant for American wages, but it was actually negative (in real terms) in terms of take-home pay due to the cost of healthcare increasing so rapidly--155% from 1990 to 2008.

Due to health insurance costs, the average worker had less money than they did 10 years ago. That's a really big problem for a developing economy. ACA was an attempt to fix that, in order to improve the overall performance of the economy.*

*Yes, I know. Get back to me in a decade.
   139. David Nieporent (now, with children) Posted: July 02, 2012 at 11:30 PM (#4171834)
Just catching up on a couple of posts from the June thread:

1335:
Option A admits that all readings of constitutionality are textual interpretations. Now, I have no problem with that, nor does, say, Ruth Bader Ginsburg, but David and Ray and the "reality determines itself" brigades (inclusive of the Thomases and Scalias of the court) are violently opposed* to admitting that basic, obvious truth.
No, that's not remotely correct.

1370:
Yes, but the Court is the final arbiter of what is or is not constitutional. Feel free to argue the decision, but for now, the ACA is constitutional.
For now, the courts deem the ACA to be constitutional. When Ginsburg has to retire midway through Gary Johnson's first term as president, and she's replaced by someone who cares about freedom, then the Court will change its collective mind. And since the Constitution won't have changed in that time, one of those two Courts will have been wrong, by definition.


1378:
Nobody's saying that court decisions can't be subjectively "wrong", according to one's various premises.
This is gibberish. What on earth does "subjectively wrong" mean?

1393:
This sounds like the ACA, though. People are given a choice whether to (A) to invest a portion of one's money in a private account or (B) leave their tax dollars with Social Security, but one is not free to not save for retirement. It's not called a mandate, but it acts in exactly that manner, since it requires everyone to become actors in that particular market.
A tax is not a market. One is free to not save for retirement, simply by staying in social security. (Social security is not "saving for retirement"; it's just a tax.) One isn't free not to pay the tax, but then, that's pretty much the nature of taxes -- they're collected (altogether now) at gunpoint.
   140. Ray (RDP) Posted: July 02, 2012 at 11:31 PM (#4171835)
But how is this helpful? The issue is whether health insurance is affordable. It is.

I think this is sort of factually incorrect.


It can't be, if the vast majority of people were affording it.
   141. tshipman Posted: July 02, 2012 at 11:47 PM (#4171842)
It can't be, if the vast majority of people were affording it.


That's a tautology, though. I mean, you wouldn't say that housing in NYC is affordable, would you? And yet more people can afford to live there than any other city in the country.

I think if the cost of a good rises 8.6% per year for 18 years, it has stopped being affordable and starts to need structural changes.

For a point of comparison, the price of gas in 1990 was $2.24 (in 2008 dollars). If gas prices had risen at the same rate as healthcare, gas in 2008 would have cost $5.71 per gallon. Would you call that affordable?
   142. David Nieporent (now, with children) Posted: July 02, 2012 at 11:59 PM (#4171847)
The issue is that the government is well within its power to require people to purchase insurance. The collective maintenance of insurance for certain things (automobile insurance, home insurance) is taken for granted as an obvious and necessary thing.
Huh? First, the government does not require people to purchase homeowners' insurance -- only mortgage lenders do. Second, the government does not require anyone to purchase auto insurance. Only people who want to drive on public roads are required to have auto insurance. Moreover, there is no "the government"; there are different governments. It's the state governments who require auto insurance. Not the federal government. The federal government has different powers than state governments.
   143. David Nieporent (now, with children) Posted: July 03, 2012 at 12:17 AM (#4171857)
The comparison actually would be if you could opt out of say, service by the local fire department and because of whatever reason you refuse to pay the annual, and then your house catches on fire. You're pleading with the fire department, who shows on your doorstep and *they* refuse to do anything to stop the fire, and are only really there because they want to make sure the fire doesn't spread out to other houses who did pay the annual fee. You might think this is ridicoulious and it doesn't happen, but read this story.

Now, that's evil and cold blooded.
No, it isn't. It's reasonable and just.
   144. David Nieporent (now, with children) Posted: July 03, 2012 at 12:21 AM (#4171858)
Exactly. That's what I've been saying forever. Health outcomes don't function properly on a profit/loss, "free market" mechanism.
Of course they do. They don't function the way you want them to do, which is magical ponies for everyone. (98.7% of the time, when a liberal talks about market failure, what he means is that poor people can't buy something expensive. But that's not a market failure; that's market operation. That is "functioning properly.")
   145. David Nieporent (now, with children) Posted: July 03, 2012 at 12:23 AM (#4171860)
Well since 60% of bankruptcy is caused by medical bills, then yeah it just might here in the real world.
Uh, no.
   146. David Nieporent (now, with children) Posted: July 03, 2012 at 12:30 AM (#4171861)
Is this bill title more to your liking?
Missing the word "evil."
   147. Gonfalon B. Posted: July 03, 2012 at 12:47 AM (#4171871)
A longer version of this has been making the rounds, with wraparound prose and citations to the bill's text:

Already in effect:
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)
It increases the rebates on drugs people get through Medicare (so drugs cost less)
It establishes a non-profit group that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money.
It makes chain restaurants display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy.
It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them.
It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that)
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths.
It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending.
Kids can continue to be covered by their parents' health insurance until they're 26.
No more "pre-existing conditions" for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans.
People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend.
Insurers can't just drop customers once they get sick.
Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific.)
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down.
Anti-fraud funding is increased and new ways to stop fraud are created.
Medicare extends to smaller hospitals.
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly.
A new website is made to give people insurance and health information.
A credit program that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note - this program was temporary. It already ended.)
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers.
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the aspirin you bought for that hangover.
Employers need to list the benefits they provided to employees on their tax forms.
Any new health plans must provide preventive care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.

1/1/2013
If you make over $200,000 a year, your taxes go up 0.9%.

1/1/2014
This is when a lot of the really big changes happen.
No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history.
If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it. (Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can't afford? Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser has a webpage with a pretty good rundown on it, if you're worried about it.)
Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance)
Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees.)
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need.
Limits how high of an annual deductible insurers can charge customers.
Cuts some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen.
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.
The amount you can deduct from your taxes for medical expenses increases.

1/1/2015
Doctors' pay will be determined by the quality of their care, not how many people they treat.

1/1/2017
If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).

2018
All health care plans must now cover preventive care (not just the new ones).
A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).

2020
The elimination of the "Medicare gap"
   148. Ray (RDP) Posted: July 03, 2012 at 12:51 AM (#4171873)
For a point of comparison, the price of gas in 1990 was $2.24 (in 2008 dollars). If gas prices had risen at the same rate as healthcare, gas in 2008 would have cost $5.71 per gallon. Would you call that affordable?


If most people could afford it, then yes.

My point is that you guys are identifying the wrong problem. The problem is not that the cost of health insurance is too high; the problem is that some people can't support themselves. It may be good policy to provide health care for them, but people should stop pretending that the core problem is the cost of the health insurance.
   149. You Know Nothing JT Snow (YR) Posted: July 03, 2012 at 02:58 AM (#4171897)
The problem is not that the cost of health insurance is too high; the problem is that some people can't support themselves. It may be good policy to provide health care for them, but people should stop pretending that the core problem is the cost of the health insurance.


The problem is these freeloaders want fancy medical care but don't have anything to offer in return. Th solution? Organ markets. Show up at the emergency room crying because you cracked your little noggin? Sign away a kidney and everybody wins. Blindsided by a heart attack? Well here's a fine opportunity for your familiar and friends to show how much they appreciate you being alive. A couple of kidneys, a nice chunk of liver, a few square centimeters of skin, there are myriad ways you and yours can contribute.

Being unable to pay your medical bills only means one thing - the free market has determined that you don't generate enough value to be worth keeping alive. Someone else can take your job, lowering unemployment. Your material possessions can be sold on the second-hand market. You're a good husband? Kids love you? Great, quantify that in dollars or GTFO hippie.

I'm sitting here, a fine upstanding small businessman brimming with entrepreneurship whose dream of a service-oriented organ brokerage is being crushed by the oppressive jackboot of Big Government and you want to whine about linguistic semantics like some elitist snob cloistered in their ivory tower. Shame on you. Shame on all of you.
   150. BrianBrianson Posted: July 03, 2012 at 04:43 AM (#4171905)
No, it isn't. It's reasonable and just.


It's incredibly stupid to live in a city and say "Whether my neighbour's house burns down or not is none of my business". Even if you're maximally callous - fires don't work that way. If the fire department just lets houses burn, the city is going to burn down. And since they know the city is going to burn down, insurance companies won't offer you fire insurance.
   151. Joe Bivens, Minor Genius Posted: July 03, 2012 at 06:01 AM (#4171911)
Here are some quotes from Mitt Romney on his almost identical plan for MA:

"No more 'free riding', if you will, where an individual says 'I'm not going to pay, even though I can afford it. I'm not going to get insurance, even though I can afford it'".

"It's the ultimate conservative idea, which is that people have responsibility for their own care, and they don't look to government to take care of them if they can afford to take care of themselves".
   152. Jolly Old St. Nick Still Gags in October Posted: July 03, 2012 at 06:31 AM (#4171913)
1/1/2013
If you make over $200,000 a year, your taxes go up 0.9%
.

1/1/2014
This is when a lot of the really big changes happen....


Fortunately for Ray and David, none of these really big changes will ever kick in, since on 1/1/2013 the world will have come to an end.
   153. Lassus Posted: July 03, 2012 at 07:04 AM (#4171917)
Well since 60% of bankruptcy is caused by medical bills, then yeah it just might here in the real world.

Uh, no.


Here is a Businessweek post about the Harvard study that puts the figure at 62%.

This one has the figure lower, 42%, but far and away the leading cause.

Here's the referenced Warren report, showing a raise from 46.2% in 2001 to 62.2% in 2007.

I assume you have some reason to dismiss either the figures in the Harvard study, or the facts that even at a lower figure it blows non-medical reasons out of the water. I didn't have much of a chance to look for the opposing figures, which I'm sure exist.

   154. Jolly Old St. Nick Still Gags in October Posted: July 03, 2012 at 09:14 AM (#4171947)
Since one of Ray's principles is never opening links (apparently he's too busy to do that), I'll spare him the trouble by pasting the leading paragraphs from the ones that Lassus just provided. Not that any of these studies will affect David's or Ray's entrenched position in the slightest, but it can't hurt to put a few facts out there for the less doctrinaire who may be lurking.

Here is a Businessweek post about the Harvard study that puts the figure at 62%.

Study Links Medical Costs and Personal Bankruptcy

By Catherine Arnst

Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid.

Medically related bankruptcies have been rising steadily for decades. In 1981, only 8% of families filing for bankruptcy cited a serious medical problem as the reason, while a 2001 study of bankruptcies in five states by the same researchers found that illness or medical bills contributed to 50% of all filings.


This one has the figure lower, 42%, but far and away the leading cause.



10 Leading Causes of Bankruptcy

Percentages represent reasons an individual files bankruptcy. Sources were combined to average top reasons Americans filed.

Medical Expenses (42%)
Recent studies have shown that 42% of all personal bankruptcies are a result of medical expenses. The study also reveals that 78% of those who filed had insurance.

Job Loss (22%)
Millions of Americans are unemployed, which makes them much more likely to file for bankruptcy. Unemployed individuals often pay for insurance out-of-pocket.

Uncontrolled Spending (15%)
Credit card bills, large mortgages, and expensive car payments contribute to bankruptcy. Uncontrolled spending habits can put Americans on a path to filing.

Divorce (8%)
Legal fees, child support, alimony and the burden of providing for a household on one income can result in ample financial stress. Divorce rates are nearly 50% in America.

Unexpected Disaster (7%)
Unexpected disasters such as earthquakes, floods, or hurricanes can be nearly impossible to prepare for. If a homeowner is without insurance, this can possibly lead to bankruptcy.

Avoiding Foreclosure (1.5%)
An individual can spend a life time preparing to purchase a home. Just to avoid foreclosure, some Americans will file for bankruptcy to re-organize debt.

Poor Financial Planning (1.5%)
Not having a sound financial plan can lead to bankruptcy. Financial experts recommend establishing savings for expenses that could lead to debt.

Preventing Loss of Utilities (1%)
Along with home foreclosure is the risk of losing utilities. Keeping lights on and a house warm can be a factor for someone to file.

Student Loans (1%)
Student loans won't be eliminated like other unsecured debt, but it may be possible to consolidate student loans with a bankruptcy.

Preventing Repossession (1%)
If a creditor repossessed your vehicle, filing bankruptcy may force them to return the car, and any other personal property that may have been repossessed.


Here's the referenced Warren report, showing a raise from 46.2% in 2001 to 62.2% in 2007.

BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.

METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.

RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors,
the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.

CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies.

   155. BDC Posted: July 03, 2012 at 09:17 AM (#4171949)
What's funny/sad about the Redneck's riff in #149 is that it's pretty much what Enron decided to do to the energy industry. There are enormous fortunes to be made by tearing up the infrastructure and letting swashbucklers fight over a newly opened market in its services. Much of this comes down to how much infrastructure one thinks we should have. Free public libraries, but no free public operas? Regulated basic electrical power, but no Chevy Volts for all? Boundless free emergency-room care, but no free facelifts? There's always a compromise somewhere in between.

   156. David Nieporent (now, with children) Posted: July 03, 2012 at 09:24 AM (#4171954)
It's incredibly stupid to live in a city and say "Whether my neighbour's house burns down or not is none of my business". Even if you're maximally callous - fires don't work that way. If the fire department just lets houses burn, the city is going to burn down. And since they know the city is going to burn down, insurance companies won't offer you fire insurance.
I agree, but this wasn't in a city. In a place with detached homes, the considerations are quite different.
   157. Ray (RDP) Posted: July 03, 2012 at 09:27 AM (#4171955)
.
   158. Lassus Posted: July 03, 2012 at 09:32 AM (#4171957)
I agree, but this wasn't in a city. In a place with detached homes, the considerations are quite different.

Have you never actually seen a fire? Good lord.

Anyhow, Colorado and much of the Pacific Southwest disagrees.
   159. BrianBrianson Posted: July 03, 2012 at 09:40 AM (#4171959)
I agree, but this wasn't in a city. In a place with detached homes, the considerations are quite different.


The limits are easier to understand than the greyer areas. Detached homes or not, I also don't want to live in a place where people walk around with whooping cough because they can't afford vaccines (or figure it's smart to gamble they won't contract it, because it's affordable but expensive.) One could generate quite a long list.
   160. Morty Causa Posted: July 03, 2012 at 09:42 AM (#4171960)
The fire station on the edge of town won't serve the immediately surrounding unincorporated outlying areas although, visually, you can't see much difference between the two. Moreover, even though it may not take the fire trucks any longer to get to your home in the suburb outside the city limits than it does to get to any place inside the city limit, rest assured that the rural homeowner's premium will have a hefty surcharge.
   161. David Nieporent (now, with children) Posted: July 03, 2012 at 09:52 AM (#4171969)
I assume you have some reason to dismiss either the figures in the Harvard study, or the facts that even at a lower figure it blows non-medical reasons out of the water. I didn't have much of a chance to look for the opposing figures, which I'm sure exist.
I absolutely have a reason to dismiss the figures in the Harvard study: I've read the actual study. First, it defined "medical" to include things that weren't medical, like gambling debt or the adoption of a child. (Seriously!) (It also included lost income due to illness, which - though related to health - doesn't make any analytic sense.) Second, it did not remotely show that those bankruptcies were caused by medical debt. What it actually found was that in 62% of cases where people filed for bankruptcy, they had some small amount of medical debt. Warren's agenda-driven study counted it as a medical bankruptcy if you had $2,000 of medical bills and the rest of your $50,000 in life's savings invested with Lenny Dykstra.

(A good rule of thumb is that when an activist claims a much bigger problem than the supposed victims of that problem to, you can ignore the activist's claims. Bankruptcy filers themselves in Warren's research only claimed that medical bills were a significant cause of their bankruptcy about 30% of the time, even though they have an inventive to excuse their bankruptcies as not their fault by citing medical bills, rather than admitting they spent all their money on designer shoes.)
   162. Rickey! In a van on 95 south... Posted: July 03, 2012 at 09:58 AM (#4171971)
No, it isn't. It's reasonable and just.


And that, my dear ones, is why those of us in the know just sort of throw rocks at David. He has no idea what reasonable or just means.
   163. Rickey! In a van on 95 south... Posted: July 03, 2012 at 10:01 AM (#4171974)
Have you never actually seen a fire? Good lord.


This made me laugh.
   164. Dan The Mediocre Posted: July 03, 2012 at 10:01 AM (#4171975)
First, it defined "medical" to include things that weren't medical, like gambling debt


Someone who feels so compelled to gamble that they completely destroy their finances obviously suffers from a bit of mental illness. That would be a medical issue.

(It also included lost income due to illness, which - though related to health - doesn't make any analytic sense.


It makes perfect sense. They can't work because they are sick? Why, I do believe that is a medical issue! And, more than likely, they couldn't afford treatment to get better.
   165. Spahn Insane Posted: July 03, 2012 at 10:08 AM (#4171980)
Have you never actually seen a fire? Good lord.

Anyhow, Colorado and much of the Pacific Southwest disagrees.


Oh, Lassus--stop being disingenuous. You know full well David only meant neglecting a house fire is "reasonable and just" where (1) the owner hasn't paid his public works "use fee" or whatever; (2) it's a detached home, and (3) the precise environmental conditions at that precise moment (dryness of terrain, wind currents, current and forecasted heat and cloud cover levels, etc., etc.), and whether they're conducive to safely letting the conflagration die out on its own in a blaze of libertarian glory without inconveniencing one's neighbors (I'd say the "public good," but there of course is no such thing) can be precisely determined. Duh.

EDIT: Oh, and where, of course, as a corollary to (3), we can with total assuredness calculate that the blaze won't cross from one municipality into another. Jeez, you liberals...
   166. tshipman Posted: July 03, 2012 at 10:09 AM (#4171982)
My point is that you guys are identifying the wrong problem. The problem is not that the cost of health insurance is too high; the problem is that some people can't support themselves. It may be good policy to provide health care for them, but people should stop pretending that the core problem is the cost of the health insurance.


20+ years ago, the cost of health insurance wasn't as big of a problem as it is today. Today, the rising price of health insurance has eaten up all the gains in salary from increased productivity and then some.

I'd also like to know how you think you can lift the American worker into a place where they're making as much money (after paying for healthcare and housing) as they were 20 years ago. You hate wealth re-distribution. What policies that are not re-distributive address the problem?
   167. Jolly Old St. Nick Still Gags in October Posted: July 03, 2012 at 10:09 AM (#4171983)
(A good rule of thumb is that when an activist claims a much bigger problem than the supposed victims of that problem to, you can ignore the activist's claims. Bankruptcy filers themselves in Warren's research only claimed that medical bills were a significant cause of their bankruptcy about 30% of the time, even though they have an inventive to excuse their bankruptcies as not their fault by citing medical bills, rather than admitting they spent all their money on designer shoes.)

Those cited in the Warren study as having had medical bankruptcies had an average net worth of -$44,622. Their out-of-pocket medical expenses had been an average of $17,943, but for uninsured filers it had been $26,971, which of course doesn't include those still-unpaid bills. Somehow I don't think that the issue here was expenditures on designer shoes.
   168. Dan The Mediocre Posted: July 03, 2012 at 10:16 AM (#4171993)
I'd also like to know how you think you can lift the American worker into a place where they're making as much money (after paying for healthcare and housing) as they were 20 years ago. You hate wealth re-distribution. What policies that are not re-distributive address the problem?


You miss his point. He doesn't think it's a problem. That's just how the market has worked.
   169. Spahn Insane Posted: July 03, 2012 at 10:17 AM (#4171996)
As a follow to #165, and to depart from snark for just a moment:

David, as a matter of "reasonableness and justness," is the fire department's non-response equally "reasonable and just" in your hypo if the home in question is renter-occupied, and not owner-occupied, or doesn't that matter? (And do other considerations [i.e., has the owner disclosed his obligation to pay the public works "use fee," and whether he's paid it or not, to the renter] come into play? )

EDIT: Also, does it matter whether said renters are home or not at the time of the fire?
   170. The Good Face Posted: July 03, 2012 at 10:17 AM (#4171997)
Being unable to pay your medical bills only means one thing - the free market has determined that you don't generate enough value to be worth keeping alive.


Finally somebody in this thread is talking some sense, even if wasn't intentional.
   171. Johnny Sycophant-Laden Fora Posted: July 03, 2012 at 10:20 AM (#4172002)
No, it isn't. It's reasonable and just.

And that, my dear ones, is why those of us in the know just sort of throw rocks at David. He has no idea what reasonable or just means.


You don't need to create a strawman when Dave is around, eventually he'll make those arguments/statements for you.

and if he doesn't GF will (see 170 above)
   172. Spahn Insane Posted: July 03, 2012 at 10:26 AM (#4172007)
You don't need to create a strawman when Dave is around, eventually he'll make those arguments/statements for you.

The key is to be patient enough to let him actually make them, lest he otherwise accuse you of attacking a strawman.
   173. formerly dp Posted: July 03, 2012 at 10:29 AM (#4172013)
For now, the courts deem the ACA to be constitutional. When Ginsburg has to retire midway through Gary Johnson's first term as president, and she's replaced by someone who cares about freedom, then the Court will change its collective mind. And since the Constitution won't have changed in that time, one of those two Courts will have been wrong, by definition.

If you insist on your ideologically-loaded interpretation as The One Truth. All texts require human interpreters. Your definition of "freedom" is highly subjective and ideological. Your understanding of the Constitution is similarly charged. Pretending otherwise, and then expecting others to play along with the charade, is a rhetorical strategy masking itself as an argument.

Nobody's saying that court decisions can't be subjectively "wrong", according to one's various premises.


This is gibberish. What on earth does "subjectively wrong" mean?

This is the part where you recognize that others have different opinions, David, and you have to coexist with them. This is something everyone but Libertarians learned when they were growing up.

"Wrong according to your interpretation of the text and the values you're bringing to bear on it" = "subjectively wrong"

That you want there to be an objective truth beyond your interpretation doesn't make it so, no matter how many times you repeat it.

==
If most people could afford it, then yes.

You keep saying most. What's the threshold for "most"?

My point is that you guys are identifying the wrong problem.

That became your point as of 4 minutes ago.

people should stop pretending that the core problem is the cost of the health insurance.

Stop. This has been explained to you. You have your ears stuffed with wax. The cost of insurance, and the cost of health care, is rising, and it's going to keep rising, and without taking steps to address that, it will become inaccessible to greater swaths of the population-- so what every your threshold for "most" is, the percentage of people who can *afford* insurance is shrinking. Only a Libertarian ideologue looks at this situation says, "eh, #### 'em." The rest of us have moved out of the 19th century.

Putting your "all government regulations are slavery" nonsense, in the list Gonfalon posted in #147, which regulations do you find unbearable?


   174. Benji Gil Gamesh Rises Posted: July 03, 2012 at 10:35 AM (#4172020)
I'd also like to know how you think you can lift the American worker into a place where they're making as much money (after paying for healthcare and housing) as they were 20 years ago. You hate wealth re-distribution. What policies that are not re-distributive address the problem?
I suspect the obvious answer to this is that he doesn't agree with the premise that anything needs to be done to address it, and that any government-driven attempt to do so would likely be 1) an unjustified imposition and 2) not efficient or effective. (Really the clue is in the word "lifting" -- I think once you talk about lifting people up, you're already (in most cases) past what he and others with similar views would consider to be the proper function of government. People should only ever be lifting themselves up, or being lifted by those who have specifically and voluntarily agreed to do so, in this worldview.)

I don't agree with this personally, but I think this part of that philosophy is pretty clear.

Edit: or what 168 said.
   175. Rickey! In a van on 95 south... Posted: July 03, 2012 at 10:44 AM (#4172030)
The key is to be patient enough to let him actually make them, lest he otherwise accuse you of attacking a strawman.


Such is the fate of he who replaces justice and humanity with economic materialism reduced to nothingness by dint of "principles."
   176. BrianBrianson Posted: July 03, 2012 at 10:57 AM (#4172047)
Putting your "all government regulations are slavery" nonsense, in the list Gonfalon posted in #147, which regulations do you find unbearable?


This question answers itself. All of them.
   177. Jolly Old St. Nick Still Gags in October Posted: July 03, 2012 at 11:05 AM (#4172057)
This is the part where you recognize that others have different opinions, David, and you have to coexist with them. This is something everyone but Libertarians learned when they were growing up.

Actually Libertarians share that self-referential conceit with Leninists. They don't agree on economics or much of anything else, but when it comes to rhetorical tactics and an obsessive striving towards a rigid "correctness", those groups are like two peas in a pod. It's always ideology first, and every other consideration little more than an afterthought.
   178. zonk Posted: July 03, 2012 at 11:06 AM (#4172059)
I think I'm just going to stock up on popcorn now to beat the rush for the coming day when the Black Bloc anarchists on the left and the glibertarian "TAXES ARE SLAVERY!!!" set on the right finally realize that they want close enough to the same thing that they decide to march on DC together and let the chips fall where they may afterwards.

It was a nice society we had for a while -- who knew that Al Gore's secret wish to reduce us to hunter-gatherers living in caves would come about in this fashion?
   179. tshipman Posted: July 03, 2012 at 11:07 AM (#4172060)
You miss his point. He doesn't think it's a problem. That's just how the market has worked.


I suspect the obvious answer to this is that he doesn't agree with the premise that anything needs to be done to address it, and that any government-driven attempt to do so would likely be 1) an unjustified imposition and 2) not efficient or effective. (Really the clue is in the word "lifting" -- I think once you talk about lifting people up, you're already (in most cases) past what he and others with similar views would consider to be the proper function of government. People should only ever be lifting themselves up, or being lifted by those who have specifically and voluntarily agreed to do so, in this worldview.)


Isn't it a bit disingenuous for him to be saying that healthcare isn't the problem when he doesn't think that there is, in fact, a problem?

Edit: I mean, I'm not an idiot, so obviously the above occurred to me as well. My point is simply that his phrasing indicated that he thought that there was a problem, so I was asking the question sincerely.
   180. CrosbyBird Posted: July 03, 2012 at 11:15 AM (#4172068)
It's incredibly stupid to live in a city and say "Whether my neighbour's house burns down or not is none of my business". Even if you're maximally callous - fires don't work that way. If the fire department just lets houses burn, the city is going to burn down. And since they know the city is going to burn down, insurance companies won't offer you fire insurance.

Not that I'm defending the policy, but the fire department showed up and watched this guy's house burn (to make sure the fire didn't spread to other, participating homes). IIRC, the homeowner offered to pay on the spot, and the fire department refused. (That I have a problem with. Just charge the guy cost and a penalty if you're committed to the program.)
   181. formerly dp Posted: July 03, 2012 at 11:22 AM (#4172076)
This question answers itself. All of them.

Some regulations on that list are about disclosure; I thought maybe a few of these would be acceptable. I'd like to see a poll on a right-winger site where people rank-ordered those on a scale of "slits freedom's throat" to "slits freedom's throat, ##### the bleeding wound, douses freedom in gasoline, lights freedom on fire, then throws freedom's burning body into a wood-chipper".

Obviously the tax increase would be the worst transgression.
   182. BrianBrianson Posted: July 03, 2012 at 11:26 AM (#4172083)
But the point is as long as my neighbours' houses are on fire, the fire department's ability to save mine is not very secure. Them standing around waiting for my house to catch fire so they can put it out is better than nothing, but I'm much better off if it never catches in the first place.

They guy did offer to pay the $75 annual fee on the spot, which the fire department refused. I don't think you can reasonably have much of a problem with that. If they put out all fires, nobody would pay (or very few people, anyhow), and they'd soon be bankrupt. Only by forcing everyone to pay can you avoid all your houses burning down. (Or the Crassus method, of course. But a Fire Department that only got paid when they actually put out a fire would more or less have to go the Crassus method.)
   183. tshipman Posted: July 03, 2012 at 11:31 AM (#4172092)
They guy did offer to pay the $75 annual fee on the spot, which the fire department refused. I don't think you can reasonably have much of a problem with that. If they put out all fires, nobody would pay (or very few people, anyhow), and they'd soon be bankrupt. Only by forcing everyone to pay can you avoid all your houses burning down. (Or the Crassus method, of course. But a Fire Department that only got paid when they actually put out a fire would more or less have to go the Crassus method.)


Yeah, I agree with this. It really points to the problem of non-collective action for collective goods like fire control. By allowing people to opt out--even though the fire co-pay is very affordable, just $6.25 per month!!!--there are too many people who do so.

This gets back to why it's necessary to pay for collective goods collectively.
   184. Benji Gil Gamesh Rises Posted: July 03, 2012 at 11:33 AM (#4172094)
Isn't it a bit disingenuous for him to be saying that healthcare isn't the problem when he doesn't think that there is, in fact, a problem?
Well, I think he acknowledges the truth of what many other people think is a problem -- that not everyone can afford health insurance -- but he himself either doesn't consider it a problem, or agrees that it is a problem but strenuously disagrees that it's a problem that government should be trying to solve. I mean he did say this:

But don't imply [...] that the issue is the cost of health insurance when the issue is not the cost of health insurance, but is simply that some people, for whatever reason, don't have the means to support themselves.
   185. CrosbyBird Posted: July 03, 2012 at 11:40 AM (#4172103)
Here are some quotes from Mitt Romney on his almost identical plan for MA

There are some minor differences. I think that's the approach that Romney will take in the debates: a "one-size-fits-all" federal program isn't the same as a state-specific program, and the plan had a much higher approval rating (positive) in Massachusetts than Obamacare does nationally (negative).

"Romneycare is the solution that the Massachusetts voters wanted, and within the scope of the powers granted by the Constitution to the states. Obamacare is an attempt to force something on the American people that they don't want, and four justices agreed that it is an abuse of federal power."
   186. Ray (RDP) Posted: July 03, 2012 at 11:42 AM (#4172106)
Isn't it a bit disingenuous for him to be saying that healthcare isn't the problem when he doesn't think that there is, in fact, a problem?

Edit: I mean, I'm not an idiot, so obviously the above occurred to me as well. My point is simply that his phrasing indicated that he thought that there was a problem, so I was asking the question sincerely.


This is a fun game you guys are playing, where you ask me questions and then answer them for me while forming a circle with each other and taking your high fives.

I agree that it is a problem that some people can't afford health insurance. (I'm glad we got that out of the way. Who's trolling now?) But I don't agree that the only way to attempt to solve this problem is by forcing everyone to pay through government.

   187. Ray (RDP) Posted: July 03, 2012 at 11:50 AM (#4172112)
And as I've said I don't think the problem is the cost of health insurance per se. Yes, the cost of health insurance can serve to be reduced, obviously, because there is a lot of "waste, fraud, and abuse" in the system. But there were other ways to overhaul the system that would have been better.

Regardless, reducing the cost of health insurance by a little is only going to help around the margins. The real problem (one of them, anyway) is that there are some people who can't support themselves any way you slice it. They can't afford health insurance - or rent, or a car payment, or food - not because these things cost too much or are "unaffordable," but because the people ended up in a place - for whatever reason - where they cannot financially provide for themselves and their families. In that case health insurance is just one of a number of things they can't pay for. And so the problem is not the cost of health insurance per se. Now, the ACA forces everyone to pay for them. Fine. But I reject out of hand the notion that the core problem was the cost of something that the vast majority of people were affording.
   188. CrosbyBird Posted: July 03, 2012 at 11:54 AM (#4172120)
I agree that it is a problem that some people can't afford health insurance.

I don't think it's a problem that some people can't afford health insurance. I think it's a problem that some people cannot afford health care.

It's like George Carlin used to say: the problem isn't that people are homeless, but that they don't have houses. The more abstractions we create from the real problem, the less likely we are to address it properly.
   189. Lassus Posted: July 03, 2012 at 11:55 AM (#4172122)
...and taking your high fives.

I simply cannot believe you are returning to this goofy petulance.
   190. Yeaarrgghhhh Posted: July 03, 2012 at 11:59 AM (#4172127)
The fact that some people can't afford health care is more than just a moral problem (although that's very important). Having a bunch of untreated, chronically ill people has got to be a drag on our economy. And our current system probably stifles entrepreneurs by tying our health care so closely to our employers. Leaving your job at a big company to start your own shop is always going to be a risky venture, but the cost of health insurance makes it far more difficult.
   191. Benji Gil Gamesh Rises Posted: July 03, 2012 at 12:07 PM (#4172134)
This is a fun game you guys are playing, where you ask me questions and then answer them for me while forming a circle with each other and taking your high fives.
I don't know if I am being included in that swipe, but I was actually trying to accurately paraphrase you and indicate that while I don't have the same fundamental beliefs, I do (I think) understand your position on this issue.
   192. Dan Szymborski Posted: July 03, 2012 at 12:14 PM (#4172141)
Providing health care to people may or may not be desirable, but it's not really an issue comparable to a free rider problem unless we're only requiring health insurance to cover health issues that are easily communicable to an unwilling third party. In this case, the free rider problem is the artificial result of creation of legislation to make a free rider problem - if we pass laws stating that every time someone wants a pie, they can go to a government bakery and get a free pie, the free rider issue comes from the law mandating this, not something inherent in pie consumption that creates a free rider.

As such, it's not comparable to the fire insurance or car insurance or military comparisons unless we're talking about, say, influenza or chickenpox treatment. Bill's house fire can spread to Rick's house, Bill's car can crash into Rick's car, and the army's actions necessary to protect Bill's house also protects Rick's house, but Bill's broken leg, cancer, or irritable bowel syndrome aren't doing anything to Rick - the free rider problem is one artificially created by the law mandating coverage. Now, that's not to say a universal health care system can't be a positive idea for other reasons (I'm not going into that one), but it's not because of free riders.
   193. Rickey! In a van on 95 south... Posted: July 03, 2012 at 12:16 PM (#4172145)
I think I'm just going to stock up on popcorn now to beat the rush for the coming day when the Black Bloc anarchists on the left and the glibertarian "TAXES ARE SLAVERY!!!" set on the right finally realize that they want close enough to the same thing that they decide to march on DC together and let the chips fall where they may afterwards.


Okay. Let me just say this once. The Bloc wants nothing to do with those guys. The Bloc knows the value of a man on a barricade, and a man who relies on the power of the police state to prop up his Law Uber Alles is not a friend of the Bloc. Should the Bloc lose itself in this manner, the Bloc will have to reassert itself against the Bloc.
   194. Ray (RDP) Posted: July 03, 2012 at 12:17 PM (#4172146)
First, it defined "medical" to include things that weren't medical, like gambling debt

Someone who feels so compelled to gamble that they completely destroy their finances obviously suffers from a bit of mental illness. That would be a medical issue.


Once you start whining that crap like this isn't covered, you lose people.

(It also included lost income due to illness, which - though related to health - doesn't make any analytic sense.

It makes perfect sense. They can't work because they are sick? Why, I do believe that is a medical issue! And, more than likely, they couldn't afford treatment to get better.


It is not an issue of insurance. It's an issue of not being able to earn the same income that the person did before.
   195. Randy Jones Posted: July 03, 2012 at 12:19 PM (#4172151)
the army's actions necessary to protect Bill's house also protects Rick's house


Don't see how this argument applies to the Iraq War...
   196. Dan The Mediocre Posted: July 03, 2012 at 12:19 PM (#4172152)


Once you start whining that crap like this isn't covered, you lose people.


Are you conceding that it is a medical issue?

It is not an issue of insurance. It's an issue of not being able to earn the same income that the person did before.


So a debt caused by a reduction in income stemming from medical issues isn't a debt caused by medical issues?
   197. David Nieporent (now, with children) Posted: July 03, 2012 at 12:20 PM (#4172153)
Have you never actually seen a fire? Good lord.
Indeed I have. Have you actually seen a suburb?
Anyhow, Colorado and much of the Pacific Southwest disagrees.
I was going to write something about that, but I figured it was so obviously irrelevant that nobody would need it pointed out. Yes, wildfires present an entirely different scenario than house fires. When there are wildfires, the people trying to stop them aren't trying to put out individual homes at all; they're trying to stop the spread of the fire.
   198. Johnny Sycophant-Laden Fora Posted: July 03, 2012 at 12:23 PM (#4172158)
Someone who feels so compelled to gamble that they completely destroy their finances obviously suffers from a bit of mental illness. That would be a medical issue.


IMHO if someone feels so compelled to gamble that they completely destroy their finances, that person should be sterilized and prevented from passing on their genes...

In no fecking way should such people be enabled in their destructive behavior by being told, "there there it is not your fault, you're sick you can't help it."

   199. Johnny Sycophant-Laden Fora Posted: July 03, 2012 at 12:24 PM (#4172160)
I was going to write something about that, but I figured it was so obviously irrelevant that nobody would need it pointed out. Yes, wildfires present an entirely different scenario than house fires. When there are wildfires, the people trying to stop them aren't trying to put out individual homes at all; they're trying to stop the spread of the fire.


The fun part is that he honestly has no idea how bad an argument this is.
   200. Rickey! In a van on 95 south... Posted: July 03, 2012 at 12:25 PM (#4172161)
Now, that's not to say a universal health care system can't be a positive idea for other reasons (I'm not going into that one), but it's not because of free riders


In this vein, supporters of the universal healthcare or the ACA never argue to the 'it eliminates free riders' point as an end-point. The mandate was included because without universal coverage, by attempting to split the middle and go with a "free market solution" you have to address the free rider problem that comes from not turning insurance into a public utility.

No one that I know suggests that we should have universal healthcare because else we'd have free riders. People argue for universal healthcare for those "other reasons" you're not going into."
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