Healthcare in America

[Gfted1]

Huge step forward...to socialism.

[Humodour]

EDIT: Sorry, I misread. You don't want to do anything for the poor. You're happy for them to wither and die as long as you don't get taxed more. My bad.

 

Its like you and Killian share a brain or something. For the thousanth time, nobody withers and dies due to lack of healthcare. It is illegal to refuse healthcare to anyone who shows up at any public hospital in the country. What people want to avoid is the bill for those services. "Pay for resources I consumed!?!? F-that! Someone else should pay it for me! IM ENTITLED!"

 

Oh, sorry, so if you have MONEY you won't wither and die under your scheme. Sorry, my mistake.

 

Wait, no, that's pretty much what we agreed on earlier, Gfted.

[Enoch]

How is that different from requiring everyone to participate in Social Security? Federalism has been dead since FDR.

I'm not 100% certain about this, but I think that Social Security was effectuated via the taxing power. Legally, it's not a regulation of interstate commerce-- it's an income tax under the 16th Amendment coupled with an expenditure under the General Welfare clause.

[Wrath of Dagon]

So the penalty for not having medical is also an income tax, it's not like they throw you in prison. Really not so different from having to pay a lot more tax if you don't have a mortgage. The Feds can do whatever they want, it's settled law. I think it's unlikely a costitutional challenge will succeed.

[Hurlshort]

I was meeting with a financial planner on Friday, and he said taxes are currently at a 30 year low. I was surprised by this.

 

So taxes go up but we get nearly everyone covered medically, why is that the end of the world?

 

I absolutely love the insurance market reforms, those were a long time coming. The current system is just terrible. This will be a bit different. It addresses a couple of the problems, it will probably create a few more, but at least it is an attempt at changing a crappy status quo.

[HoonDing]

"Billions for defense, but not one penny for healthcare!" will be the new Republican slogan.

[GreasyDogMeat]

http://www.msnbc.msn.com/id/35977921/ns/po...form/?GT1=43001

 

"Republicans hope to force major changes to the reconciliation bill, some that could set up a political nightmare scenario for Democrats. If certain unpopular provisions of the Senate

[Humodour]

The only valid argument to come out of the Republican side during this whole schamoozle. The problem is the Republicans are 50% to blame. WHAT TO DO.

 

Ah, I see, you think Im Republican and therefore object for that reason. Thats not the case, I hate stupid ideas no matter who generates them. And fyi, 100% of the Republicas voted against this bill.

 

100% of the Republicans voted against the bill because a) it was healthcare (not because of spending - they're quite happy to spend BIG, in fact history indicates more so than Democrats), b) it was a Democrat bill.

 

As far as I know that's how the opposition works in every single democratic government: They vote against whatever the government wants, and they vote as a bloc on any issue they deem fundamental.

 

Correction: Every single democratic country with a 2 party government. But let's not get into the problems with America's political system in this thread.

[Amentep]

Its like you and Killian share a brain or something. For the thousanth time, nobody withers and dies due to lack of healthcare. It is illegal to refuse healthcare to anyone who shows up at any public hospital in the country. What people want to avoid is the bill for those services. "Pay for resources I consumed!?!? F-that! Someone else should pay it for me! IM ENTITLED!"

 

I'm pretty sure you end up paying for it anyhow, either through raised insurance premiums or through local taxes to support the hospital. I live in a county that supports a local Level 1 Trauma center and they pull tax money to keep it running from the surrounding counties. Of course there's always problems with that which for years have threatened the place staying open...

 

I'm under the impression that insurance ran hospitals will hike prices to insured customers to cover the fact that they're unlikely to recoup most of the money charged to insurance-less emergency patients and to make the hospital itself profitable.

 

So - and perhaps I'm wrong - the question seems to be "does the money go to and come from the insurance company, the local government or the federal government in terms of subsidizing the health care of the currently uninsured".

[Killian Kalthorne]

So it seems we've finally narrowed this down to the point. People dont want to pay for their own elective medical services and that should somehow become societies burden.

 

You see, if one gets solid preventative care, regular check ups, and good medical advice and help one can avoid needing expensive emergency care in the first place. Thusly, in the long run, less resources are used and save a lot more money.

 

Of course, you seem to be incapable of thinking in the long term.

Edited March 22, 2010 by Killian Kalthorne

[213374U]

The legal challenges will be interesting. My bet is that the SCOTUS, as currently composed, won't think that the 'individual mandate' provision is within Congress' power. The Commerce Clause has never been used to mandate that individuals purchase a good or service before. Anthony Kennedy is generally the 'swing vote' on the politically sensitive cases. He has a pretty conservative record on Commerce Clause cases, although he also has a history of reading into public opinion and holding back from issuing decisions that would make the Court a bigger political target than it already is.

Can you explain this a bit more in detail? Can this bill really force people to get a private medical insurance? And, not being American myself, I have no idea of the extent to which the Supreme Court allows its rulings to be influenced by (partisan) politics and public opinion. If it's not mostly unaffected by that, what's the point of having such an organ to begin with, and by extension, a Constitution?

 

Imagine if they put forward a bill that forces Americans to own a gun...

 

 

"Billions for defense, but not one penny for healthcare!" will be the new Republican slogan.

Yeah, cool. You do realize that if the US start enacting huge cuts on their defense budget, it's not the US that will no longer benefit from their defense umbrella, right?

 

 

Correction: Every single democratic country with a 2 party government. But let's not get into the problems with America's political system in this thread.

Actually, having each rep be answerable to his electors directly is WAY more "democratic" than having MPs vote en masse one way or the other because they only have to worry about the party's official line.

 

Read the votes as you will.

Edited March 22, 2010 by 213374U

[Killian Kalthorne]

Huge step forward...to socialism.

We already have a lot of socialistic institutions in this country.

 

Public Schools

Police and Crime Prevention

Emergency Services

Social Security

Farm Subsidies

Unemployment

Welfare System

Municipal Utilities

and so forth and so on...

 

One more isn't going to break us. What do you prefer, we ditch all socialistic institutions in this country? Privatize the police force and criminal justice system? Our fire departments? I can just see that now. "Sorry man, you need to pay us $10,762 for us to put out the fire at your house. What? You can't pay? Sucks to be you."

Edited March 22, 2010 by Killian Kalthorne

[Hurlshort]

Its like you and Killian share a brain or something. For the thousanth time, nobody withers and dies due to lack of healthcare. It is illegal to refuse healthcare to anyone who shows up at any public hospital in the country. What people want to avoid is the bill for those services. "Pay for resources I consumed!?!? F-that! Someone else should pay it for me! IM ENTITLED!"

 

I received about $80,000 in bills for services rendered a few months ago when I broke my leg. It was an emergency situation. How, exactly, is someone supposed to realistically pay that bill off? Thankfully I have good health coverage.

 

I have a student who hurt her knee awhile back. Her family did not have good health care coverage. They went to a local 'off the books' doctor from Mexico. Her knee was made worse, and now she needs more serious medical attention. This will hopefully not happen with the health care reforms.

[Killian Kalthorne]

Exactly, Hurlie. Hell, last month near where I live a woman died in her living room because she didn't want her husband to call for an ambulance because they had no way to pay for it. Even if the state would have paid for it, the way things were before this bill gave the appearance that the poor are screwed even in emergencies.

[Gfted1]

One more isn't going to break us.

 

Lol. One more TRILLION dollar program isnt going to break us? Ok, if you say so.

 

Psst, we just spent a TRILLION dollars last year bailing everyone out. Maybe we can cool our jets until we can, you know, afford it?

 

I received about $80,000 in bills for services rendered a few months ago when I broke my leg. It was an emergency situation. How, exactly, is someone supposed to realistically pay that bill off?

 

Um, thats a bummer? How, exactly, should it be my problem to pay off your broke leg?

 

Exactly, Hurlie. Hell, last month near where I live a woman died in her living room because she didn't want her husband to call for an ambulance because they had no way to pay for it.

 

Stupid people do stupid things? I once read a story about a guy who liked to live with Grizzly bears. They ate him.

[Aram]

I'm happy that the bill actually passed and America has actually taken its first progressive baby step in something like 40 years in regards to healthcare, but I'm still only further disgusted by the American political system. So, so many concessions were made to Republicans to try to persuade them not to vote it down, and then every single one voted no anyway. Why didn't they just pass a bill that made real progress? Instead of celebrating a big step forward, it's more like celebrating a handicapped person taking their first wonky, bowlegged retard step out of their bed and to their wheelchair.

[Killian Kalthorne]

Gifted1, you are a very uncaring and callous individual. You disappoint me as a human being. I'm done arguing with you.

Edited March 22, 2010 by Killian Kalthorne

[Gfted1]

Gifted1, you are a very uncaring and callous individual. You disappoint me as a human being. I'm done arguing with you.

 

[Aram]

He's hardcore maaaaaaaan.

[Hurlshort]

I received about $80,000 in bills for services rendered a few months ago when I broke my leg. It was an emergency situation. How, exactly, is someone supposed to realistically pay that bill off?

 

Um, thats a bummer? How, exactly, should it be my problem to pay off your broke leg?

 

 

You aren't paying anything for my leg, because this isn't government run health care. I will continue to have health care coverage through my employer. Your taxes will be supporting those who are unable to afford health care.

 

Do you understand what happens when someone without coverage breaks a leg? They get a bill, and they don't pay it. The hospital then raises the fees on everyone else to cover their losses. They pay expensive insurance premiums to cover their losses. That insurance company pursues legal action, which is fruitless because if the broken leg guy can't afford coverage, he probably doesn't have the money lying around.

 

So if everyone has health coverage, the costs of health care will eventually go down. That means your insurance premiums will eventually go down. Heck, I'll be happy if my premiums just stop increasing every year. They've been skyrocketing across the country in the last couple years. So yeah, you will pay more taxes, but you should also pay less in health coverage in the long run. They still need to reform the insurance industry to really make a dent there, but this is a start.

[Killian Kalthorne]

Do not try to explain the long term effects of this passage to him, Hurlie. He seems to be incapable of forethought. He only cares about his own gratification and not about other people.

Edited March 22, 2010 by Killian Kalthorne

[Enoch]

The legal challenges will be interesting. My bet is that the SCOTUS, as currently composed, won't think that the 'individual mandate' provision is within Congress' power. The Commerce Clause has never been used to mandate that individuals purchase a good or service before. Anthony Kennedy is generally the 'swing vote' on the politically sensitive cases. He has a pretty conservative record on Commerce Clause cases, although he also has a history of reading into public opinion and holding back from issuing decisions that would make the Court a bigger political target than it already is.

Can you explain this a bit more in detail? Can this bill really force people to get a private medical insurance? And, not being American myself, I have no idea of the extent to which the Supreme Court allows its rulings to be influenced by (partisan) politics and public opinion. If it's not mostly unaffected by that, what's the point of having such an organ to begin with, and by extension, a Constitution?

The legislation is modeled in part on state-level policies (as in Massachusetts) that mandate health insurance coverage. The idea being that there is a pretty thoroughly documented market failure in health insurance markets: People know better than their insurers whether they are likely to need lots of medical coverage, but they still can't predict their future demand perfectly. Those who expect high medical bills will choose policies with good coverage, while other choose cheaper options. This selection process forces the insurers to raise premiums for this good policies (because it ends up with more costs than expected), which forces more and more less-medically-needy customers into cheap insurance. The cheap insurance policy has little incentive to improve its coverage and quality, will continue to cut coverage because it doesn't want to be undercut as the 'cheap option' by competitors, which would lead to it drawing an increasing share of sick people. The eventual "spreading equilibrium" in an unregulated market has the people expecting to be healthy opting out entirely, and the price of health insurance being prohibitively high, and only purchased by those people who expect to be sick enough to justify the cost. Setting a defined minimum policy and preventing people from opting out makes the equilibrium more stable and makes coverage more affordable for everyone else.

 

As to whether Congress can permissibly do this, it remains to be seen. The bill recites that it does this under Congress' power to "regulate interstate commerce," but it is doing so in a way that is somewhat unprecedented, and over the last 25 years the Court has upheld a few challenges to statutes on the grounds that they were beyond the scope of the commece power.

 

Officially, there is no feedback from public opinion to the Court, except that the Justices are originally appointed and confirmed (for life terms) by the political branches of government. But the Court can be subject to other political influence (its budget, its composition, and many aspects of its jurisdiction are set by statute rather than in the Constitution), and, most importantly, it doesn't actually have the authority to enforce its decisions itself. So all of the Justices are at least a little bit aware of the Court's institutional legitimacy. And that legitimacy comes largely from the perception that it is fair and not overtly political. This does influence outcomes. For example, starting with Brown v. Bd. of Education, the Court's internal leadership insisted that all desegregation decisions would be unanimous, because any dissention among the Justices could be read as an excuse for unwilling states to disregard the opinion. This tradition held throughout the civil rights cases the Court heard in the 50s and 60s. As a counter example, the Court outlawed prayer in public schools back in 1963. This was widely ignored for a long time (an informal poll of my Con Law classmates in 2003 revealed that a substantial majority of the students who had attended public school had seen some official school prayer). It reached the legally correct decision, but it didn't actually change much and it made a huge swath of the American public very angry at the Court. Some Justices try to avoid that kind of result.

 

 

Aside: Some of the anger among the President's political opponents went a little too far. I want to , but there's nothing funny about what's going to happen to that guy.

[Gfted1]

He's hardcore maaaaaaaan.

 

 

Heh, I am. I expect people to live within their means and not become a burden to me due to them being lazy/getting a bum hand in life/being stupid. Lifes a b1tch, deal with it and stop coming to me with your hand out.

 

The only glimmer of hope I see is reigning in runaway medical costs. Of course, my government will screw the pooch on this and the entire thing will blow up in our faces and cost us 2x/3x/4x the projected cost while at the same time driving our world leading medical research out of the country. IMO, we need to be ready for a significant drop in our standards of medical care now that we will have to cater to the lowest common denominator, namely whoever is offering the cheapest deal to the government.

[Enoch]

You aren't paying anything for my leg, because this isn't government run health care. I will continue to have health care coverage through my employer. Your taxes will be supporting those who are unable to afford health care.

 

Do you understand what happens when someone without coverage breaks a leg? They get a bill, and they don't pay it. The hospital then raises the fees on everyone else to cover their losses. They pay expensive insurance premiums to cover their losses. That insurance company pursues legal action, which is fruitless because if the broken leg guy can't afford coverage, he probably doesn't have the money lying around.

 

So if everyone has health coverage, the costs of health care will eventually go down. That means your insurance premiums will eventually go down. Heck, I'll be happy if my premiums just stop increasing every year. They've been skyrocketing across the country in the last couple years. So yeah, you will pay more taxes, but you should also pay less in health coverage in the long run. They still need to reform the insurance industry to really make a dent there, but this is a start.

Actually, a lot of people who are unable to afford healthcare have been getting taxpayer-supported insurance for a long time. It's called Medicaid. (Also SCHIP, although that's only for children.)

 

 

I'd argue that the healthcare providers are where reforms are needed to keep costs low, moreso than insurers. The real problem is that they can get away with charging $80,000 to fix a broken leg. It's a politically unappealing option, because everybody hates insurance companies, but they tend to like their own doctors, etc. IMO, you'll know that costs are being properly addressed when the AMA, Hospitals, device manufacturers, drugs manufacturers, heathcare-based litigators, and the like start screaming boody murder.

[Aram]

If you don't like it you can go to Canada--oh, wait!