Well past 216

[Siraris]

Looks like Health insurance reform will pass today. When are we going to get some health care reform? (http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/1/?)

I'm interested in peoples thoughts on this article, which I'm sure a few of you have seen before.

[Generation ABXY]

Yeah, that's the question I've been asking since the start of this. It'd be nice to think they'd actually start treating the disease (not symptoms), but we'll see...

[Siraris]

I think one of the best points in the article I posted is that health insurance has become a way for us to pay for everything related to our health. It makes us lazy, it puts the responsibility for our well being in another persons hands, and it makes no sense. Do we pay for our oil changes with car insurance? If we buy insurance on our cell phones, do we pay for our monthly bills with it? What makes health care different?

[Hawkzombie]

When it stops being insanely profitable, then you'll start seeing change.

[Kagger]

Looks like Health insurance reform will pass today. When are we going to get some health care reform? (http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/1/?)

I'm interested in peoples thoughts on this article, which I'm sure a few of you have seen before.

Thank you for properly stating what this bill is.

The sucky thing is Pelosi is going to try to take credit, when really she just had to do the Houses will. Plus, the fact that apparently the Republicans are stating the reconciliation bill violates rules and can't pass in the current form.

[Generation ABXY]

I think one of the best points in the article I posted is that health insurance has become a way for us to pay for everything related to our health. It makes us lazy, it puts the responsibility for our well being in another persons hands, and it makes no sense. Do we pay for our oil changes with car insurance? If we buy insurance on our cell phones, do we pay for our monthly bills with it? What makes health care different?

Not to mention, it could help keep costs prohibitively expensive. When going through insurance, a number of people can only pick from approved providers and only ever see a portion of the cost. There's none of the upfront competitiveness and "shopping around" that helps influence the rest of the free market.

When I talk about health care reform (which doesn't happen that much anymore, since things tend to get heated), I usually mention mandating open pricing - that is, making the cost known, not neccessarily setting it. Of course, as a big supporter of MSA, that probably doesn't come as much of a surprise.

[Siraris]

When it stops being insanely profitable, then you'll start seeing change.

That's not true, and it's directly addressed in the article I posted. The government has made numerous changes to reimbursement rates over the years, and when they do, doctors simply order more tests.

[txshurricane]

Many people theorize that private health insurance companies gradually created overpriced healthcare by flooding the market with cash. My wife, who works at two hospitals, would disagree. In her experience, she's seen much more non-payment situations with Medicare and Medicaid - some accounts are over four years old!

I've heard it said that healthcare professionals in the U.S. are not all they're cracked up to be, and as the husband of an award-winning nurse I beg to differ. I'm glad to pay a premium price, and if healthcare reform means going back to the days of *gasp!* paying for what you get, then I'm all for it. But in this case, I think that more government involvement is just going to do the same thing that Medicare and Medicaid did: drive the quality of care down, and pass off the costs to "minor care" patients (like outpatient surgeries, non-life-threatening infections, dental work, etc).

[BigJonno]

Last year, I read a fantastic article by a British music journalist about the medical care that he received in the US, while being treated (unfortunately unsuccessfully) for cancer. Unfortunately, I can't remember the guy's name, otherwise I'd search for and link the piece. I read it around the time that Mrs Jonno was in and out of hospital, and what struck me was that the problems he experienced with quality of care were exactly the same as she was having at the time. They were incredibly simple things, usually caused by lack of communication between medical staff, and issues that were completed unrelated to funding or the lack of it. The only difference between what we were going through here and he went through in the US was the huge bill his wife was left with at the end of it all.

[txshurricane]

Last year, I read a fantastic article by a British music journalist about the medical care that he received in the US, while being treated (unfortunately unsuccessfully) for cancer. Unfortunately, I can't remember the guy's name, otherwise I'd search for and link the piece. I read it around the time that Mrs Jonno was in and out of hospital, and what struck me was that the problems he experienced with quality of care were exactly the same as she was having at the time. They were incredibly simple things, usually caused by lack of communication between medical staff, and issues that were completed unrelated to funding or the lack of it. The only difference between what we were going through here and he went through in the US was the huge bill his wife was left with at the end of it all.
With all respect, I'm quite interested to know why he visited the U.S. for healthcare, instead of being cared for in the U.K. If he was touring, surely the cost to fly home would have been far less significant than the price difference...?

[BigJonno]

With all respect, I'm quite interested to know why he visited the U.S. for healthcare, instead of being cared for in the U.K. If he was touring, surely the cost to fly home would have been far less significant than the price difference...?

He'd been living in the US for years. Apologies, I should have made that clear. I just found it interesting that, for all the cost involved and all this medical insurance business, that the standard of care isn't necessarily better. Previously, I'd had this idea that US healthcare must have been fantastic, because it was all private.

[txshurricane]

He'd been living in the US for years. Apologies, I should have made that clear. I just found it interesting that, for all the cost involved and all this medical insurance business, that the standard of care isn't necessarily better. Previously, I'd had this idea that US healthcare must have been fantastic, because it was all private.
I think it's fair to say that there is a diverse selection of quality in any country. I'd like to think that while our worst care may be below that of another nation, our best care is equal or above.

Of course, I personally see dozens of out-of-state and foreign national patients traveling to Houston for care - particularly to our oncology and cardiac care facilities - and I may be subject to local propaganda and biased opinion because of that. So I'm not arguing or anything, I'm just curious. In my defense, I believe that negative opinion generally comes from the vocal minority.

[Ultima Thulian]

100,000 deaths ain't shit. Sorry.

Dumb complaint.

[Kelegacy]

As a person who deals with health insurance companies and their bullshit every single working day, reform is something I would appreciate. People complain about Medicare and Medicaid frequently and use them as examples against government healthcare, but I'd argue the opposite. Oh, even as a liberal I get pissed off with socialized medicine because I don't think it's fair to people that are just outside that coverage bubble yet we still have to pay for others (Medicaid at least), but my problems would be gone if the tax dollars I paid were going to something I could access as well.

Anyway, my point was, as a health care billing specialist, Medicare and Medicaid are pretty cut in dry as far as billing guidelines go. Or, if you have a problem, it's easy to solve most times. For private insurers...they are slimy. I have to appeal claims everyday because of incorrect denials. They do this on purpose to make us do more work to get something paid. If a claim that gets denied falls through the cracks and we don't appeal it in time, even if it was denied in error, we're fucked.

Meanwhile, if an insurance company pays us and then they realize 3 years later that the patient's coverage expired the month before the visit 3 years prior, they can take that money away from us. In this industry the insurance companies have the overwhelming majority of power, while the people treating the patient have the least. It doesn't make sense.

[Slack3r78]

Vote has started. 202-182 as I type this.

Just a matter of waiting for the rest to roll in. Another 5 minutes or so left in the vote.

[Khrymsyn]

CNN's stating this passed. (http://www.cnn.com/2010/POLITICS/03/21/health.care.latest/index.html) 219-212.


I personally do think there should be a mass coverage (even though I'm generally conservative my financial ideals), but I am concerned that this is not the right time, and once again the middle class is getting screwed...
Why?
Because the middle class is going to continue to have to pay for their medical coverage through work, continue to have to worry about their deductibles, and now to top it all off, have to pay taxes for others to get medical insurance. The upper class can afford it, the middle class cannot.
To make matters worse, that is now LESS available money to go back into our floundering economy in terms of consumer monetary support (from the two classes that have that money), and the last thing we need to do in our economy is to actually lower the amount of funds flowing through the consumer space. That is the money that funds the jobs that allow people to pay their taxes. BTW, what do you think will happen to insurance premiums now that government mandates no more "max" amounts and no one can be turned away because of pre-existing conditions? Either Govt. has to seriously undercut the insurance companies at a massive loss (bolstered by taxes), or the Govt themselves have to increase the price.

IMHO, this does nothing to fix the root of the issue. All it does is add more water to the soil. In the end, the government is once again throwing money at a problem, that is more complicated than "throwing money at a problem", but see, that would take time, and be risky, but hell, can't do that. It'd risk the historic change that was promised.

=(
If the government was really interested in fixing the problem, they'd look at the tax breaks given to businesses for offering medical benefeits, and figure out how to get that medical insurance offered on a more "individual" level increasing compeition, or go completely the other way and fully socialize the system. Instead, they take the current broken system, make a few token "tweaks", and create their own version of it.
*sigh*

Oh well. Here's to hoping this doesn't do what my worst fears think, and that it truly does help out.

[torrefaction]

The thing that annoys me the most is all the pork stuck in this bill. Minority college funding? And in particular? $100 mil to hispanics. $85 mil to blacks.

$5 mil to non-tribe native americans. That's just fucked.

I'm not a fan of the bill, but we got what we deserved. The Republicans have turned to sheer idiocy, and stomped their foot rather than proposing any sort of alternative bill.

[digitalErich]

I'm with you Torr...I'm glad that we passed something just on sheer principle and the fact that something needed to get passed less this issue just dies for another decade or two, but I'm not a fan of the bill itself. Then again, I'm not sure I even believe that current government could pass a bill on any issue w/o all kinds of pork.

[Kagger]

The thing that annoys me the most is all the pork stuck in this bill. Minority college funding? And in particular? $100 mil to hispanics. $85 mil to blacks.

$5 mil to non-tribe native americans. That's just fucked.

I'm not a fan of the bill, but we got what we deserved. The Republicans have turned to sheer idiocy, and stomped their foot rather than proposing any sort of alternative bill.

How is all of the pork Republicans fault? The pork was put in to bye off Democrats. The Republicans did not like what the bill stood for, and voted against it.

I'm still amazed that the House bent over and passed the Senate bill, a bill they are not fans of. They passed it hoping the the reconciliation bill will pass, when apparently their are major issues with the current bill. That's not to say SOME reconciliation bill won't pass, just not the one they voted on.

[digitalErich]

100,000 deaths ain't shit. Sorry.

Dumb complaint.
Dump post.

When the prevention of any number of deaths is as simple as cost-free sanitation procedures (ie wash your goddamn hands), I don't weep for anyone opposing it.

I work with in the healthcare industry and I see this blind stubbornness from providers all the time. The system kills anywhere from 12-15k patients every year due to simple transcription errors, the majority due to handwriting and medication incompatibility. Everyone in the industry knows this. Yet, you go to install an EMR (which effectively eliminates these problems) and there's always a group of docs that complain that they now have to type in their Pxs into a computer. Boo-fucking-hoo you lazy, selfish fuck.

Luckily these technophobe docs tend to be older and are all dying off.

[Siraris]

The Republicans are disgraceful. Yelling "Baby Killer" at Stupak - not only the most pro-life member of the Democratic caucus, but someone who has done more to prevent abortions than anyone in the Republican caucus in recent times - was utterly shameful. To try to use abortion as a last ditch effort to derail health care, after 8 years of doing nothing whatsoever to change abortion laws, speaks for itself.

They're using one issue having to do with life, and supplanting it with another issue having to do with life. Say what you will about the Democratic bill, at least they stand for something.

[Ultima Thulian]

Dump post.

When the prevention of any number of deaths is as simple as cost-free sanitation procedures (ie wash your goddamn hands), I don't weep for anyone opposing it.

I work with in the healthcare industry and I see this blind stubbornness from providers all the time. The system kills anywhere from 12-15k patients every year due to simple transcription errors, the majority due to handwriting and medication incompatibility. Everyone in the industry knows this. Yet, you go to install an EMR (which effectively eliminates these problems) and there's always a group of docs that complain that they now have to type in their Pxs into a computer. Boo-fucking-hoo you lazy, selfish fuck.

Luckily these technophobe docs tend to be older and are all dying off.

I'm not doubting that a lot of the issues are solvable. My point is that hundreds of thousands visit American hospitals every day. Some mistakes and casualities are to be expected. 100,000 deaths in a country of about 350 million people, with most of those visiting a hospital at least once a year. The article overblew a statistic to prove a feeble point.

Also, never underestimate the human ability to fuck up. You get EMRs, and it will solve some problems, and cause new ones. Sucks.

[Ultima Thulian]

The Republicans are disgraceful. Yelling "Baby Killer" at Stupak - not only the most pro-life member of the Democratic caucus, but someone who has done more to prevent abortions than anyone in the Republican caucus in recent times - was utterly shameful. To try to use abortion as a last ditch effort to derail health care, after 8 years of doing nothing whatsoever to change abortion laws, speaks for itself.

They're using one issue having to do with life, and supplanting it with another issue having to do with life. Say what you will about the Democratic bill, at least they stand for something.

No, they don't.

What's wrong with some of the people in this thread? Does anyone honestly believe that most, if any, of these politicians honestly pushed this bill out of some sort of moral imperative? Yea right. It just got turned into a partisan issue, just like abortion, illegal immigration, and pretty much any other major issue.

HOWEVER, this is not my endorsement for bi-partisanship. These white-collar criminals do enough damage on their own. I get worried when both parties agree on anything more complex than the Senate Cafeteria menu (R.I.P. Freedom Fries!).

[digitalErich]

I'm with you in that trotting out numbers does little to convince me and yes, that is a relatively small number, but when any number is associated with a problem that ridiculously easy to solve, I pay attention. It's not like they are asking all hospitals to buy some fancy new equipment or add complicated new dx procedures here.

We have scanners that can produce a 3D image of various systems w/in your body, yet shitty handwriting is still killing people. Those two don't really sit well side by side in my mind.

[Kagger]

The Republicans are disgraceful. Yelling "Baby Killer" at Stupak - not only the most pro-life member of the Democratic caucus, but someone who has done more to prevent abortions than anyone in the Republican caucus in recent times - was utterly shameful. To try to use abortion as a last ditch effort to derail health care, after 8 years of doing nothing whatsoever to change abortion laws, speaks for itself.

They're using one issue having to do with life, and supplanting it with another issue having to do with life. Say what you will about the Democratic bill, at least they stand for something.

Uh....while I don't support the hate for Stupak, you don't have your facts straight, and are quite wrong. (http://en.wikipedia.org/wiki/Partial-Birth_Abortion_Ban_Act)

That was passed under Bush, and the Supreme Court upheld it.

I think Stupak did fold too easily. Executive Orders can be reversed at the stroke of a pen.

[J Arcane]

You know what this bill does for me, an actual poor person with no health insurance?

Fuck goddamn all.

In fact, if it weren't for the student insurance I'll be able to get next year at PSU, I'd be in serious fucking trouble, thanks to the COLOSSALLY fucking stupid law REQUIRING me to pay for health insurance anyway whether I can fucking afford it or not.

This bill is nothing for either side to be proud of. The fact that it's fucking passing is in fact the biggest fucking travesty of all. If they had this ability all along, they should've been using it for a proper fucking public option, not some lame bandage subsidies on a broken system.

But the Dems don't really want that anymore than the Reps do. They both get their bribes from the same crooks, this whole fucking year of bullshit has been nothing but political theater, on both sides, playing at incompetence to avoid a confession of the real corruption that's at the root of the problem.

Fuck this useless fucking country.

[Slack3r78]

In fact, if it weren't for the student insurance I'll be able to get next year at PSU, I'd be in serious fucking trouble, thanks to the COLOSSALLY fucking stupid law REQUIRING me to pay for health insurance anyway whether I can fucking afford it or not.
You'll receive some fairly massive tax subsidies to help offset the cost. Part of my concern about the bill is actually that I'm not totally convinced the kind of subsidy levels it requires are long-term sustainable. Well, that and I generally dislike the idea of blanket government subsidy of private enterprise in the first place.

[J Arcane]

Tax subsidies do little good for someone who doesn't make enough to pay taxes as it is.

[civil]

I'm so disappointed this passed. Whatever we're getting now is a shell of a shadow of a reflection that was promised and hoped for. In the end it seemed that Obama cared more about passing something, anything, than in doing right by the American people. This wasn't compromise, it was desperation.

[Kelegacy]

Yeah, this isn't the bill we all wanted. Hell, we should have just gone back to scratch and did universal care or something similar republicans hate because they aren't voting either way.

I understand wanting to get SOMETHING passed, because there could be a stretch real soon where nothing can get passed (we've been waiting this long since the Clinton years for a chance again), but yeah--it's still a shadow of what could have been.

[Ink Asylum]

Does anyone honestly believe that most, if any, of these politicians honestly pushed this bill out of some sort of moral imperative?

I may be cynical sometimes, but I'm not this cynical. "If any"? Do you honestly believe there might not be a single person in the House who voted for this bill because they really believe it will help people? "Most" might be up for debate, but a significant number of House members are very passionate about their beliefs, and about passing bills that help people.

The bill is far from perfect, but there will be good results from it. One of the blogs I read posted a good summary of some of the positive changes that will happen in the next six months: (http://crooksandliars.com/karoli/what-you-get-when-hcr-passes)


Adult children may remain as dependents on their parents’ policy until their 27th birthday
Children under age 19 may not be excluded for pre-existing conditions
No more lifetime or annual caps on coverage
Free preventative care for all
Adults with pre-existing conditions may buy into a national high-risk pool until the exchanges come online. While these will not be cheap, they’re still better than total exclusion and get some benefit from a wider pool of insureds.
Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50% of what they pay for employees’ health insurance.
The “donut hole” closes for Medicare patients, making prescription medications more affordable for seniors.
Requirement that all insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments.
Authorizes early funding of community health centers in all 50 states (Bernie Sanders’ amendment). Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
AND no more rescissions. Effective immediately, you can't lose your insurance because you get sick.

[Iron Past]

You'll receive some fairly massive tax subsidies to help offset the cost.

Then there's people like my family, where my wife is offered healthcare through work, so we're not eligible for those (or has that changed now? Hard to keep track), so I'll be forced to buy into her plan. Unfortunately, that means going from Primary and Dependent (my wife and son) to Family coverage, which more than doubles our current premium, with higher taxes and nothing to offset the cost. There's some good things in the bill, but so much bs also. It seems like much of the individual monetary benefits are based on conjecture, so I guess we'll see in a few years. I'm also just really confused why we're forced to buy insurance; you know how there's car insurance companies that simply offer the absolute minimum to get by the law? I see that happening with health insurance in the near future.

At any rate, I think this'll get tied up in the courts something awful, so who knows what we'll actually see in 2014.

[National Kato]

In fact, if it weren't for the student insurance I'll be able to get next year at PSU, I'd be in serious fucking trouble, thanks to the COLOSSALLY fucking stupid law REQUIRING me to pay for health insurance anyway whether I can fucking afford it or not.

Except, you know, the mandate to buy doesn't take effect until 2014. So, you know, you wouldn't be fucked for another 4 years. So, you know, calm down? ;)

The list of reforms that take effect in the next six months are substantial and will do a lot of positive things for many Americans. I also would've preferred the public option over a mandate, but you have to get everyone into the pool. Overall, I think Obama should've played hardball with the Republicans and passed a public option. But we have significant reforms with this imperfect bill. Hell, even Bill Frist was lauding it as an important first step towards joining the rest of the civilized world.

[J Arcane]

Except, you know, the mandate to buy doesn't take effect until 2014. So, you know, you wouldn't be fucked for another 4 years. So, you know, calm down? ;)
In this is a counter to how fucking stupid that measure is how?

It never should've fucking passed. The clause was inserted when a public option was still on the bill, and at the time was simply a penalty for those who failed to sign up for said option, to alleviate costs.

Now it amounts to gov't force playing complicit to insurance interests, and nothing more.

[National Kato]

In this is a counter to how fucking stupid that measure is how?

I thought your profanity-laced tirade started with how fucked you'd be next year without your student insurance? When in fact nothing would change for you next year as the mandate doesn't go into effect for four more years?

I hope you have a job by then and can afford a basic plan. Or you could join your parents' plan until age 26.

[J Arcane]

My point was that it's only by luck that I even will have the option of insurance through my school. Had I chosen a different school for my degree, or even chosen a non-degree school (pretty common for film), I wouldn't have that luxury.

I'll be 32 by the time I get my bachelor's, and my mothers SSI/Medicare is not a family plan regardless. There's about a 50/50 shot whether I'll be working for an employer or self-employed once I get out, and just as good a shot that employer will be less than 50 people, which means one way another, whether by union dues or mandated "exchanges", that insurance will be coming out of my pocket whether I like it or not, unless I want to eat a penalty that will go up to $700 OR 2% of income, whichever is greater.

The point in all this being that there's still a lot of barriers to entry in the insurance system, nothing much is actually changing without the addition of a real public health plan. It is an indefensibly stupid fine, that should not be on the bill without one.

[National Kato]

The point in all this being that there's still a lot of barriers to entry in the insurance system, nothing much is actually changing without the addition of a real public health plan. It is an indefensibly stupid fine, that should not be on the bill without one.

I understand you now, J. I think the sticking point in all this is we need to get everyone on a plan. How do you do this without the public option, which was doomed to kill any reform from the start (even among Democrats who voted for last night's bill) and would add too much to the deficit? How do you force everyone into the pool without a fine? Because you need to get everyone in in order to bring costs down. That's insurance 101.

[J Arcane]

And how are people supposed to afford this plan? I've not seen any numbers yet on how big these proposed subsidies are actually going to be, and it's pretty fuzzy as well about who will actually qualify for them. From what I've been seeing, it's looking to me like a lot of people are going to wind up having to fork over cash unassisted. The fact that it's a tax subsidy and not an actual monetary one doesn't really make it particularly paycheck-to-paycheck friendly either.

And how do they expect to enforce the fine, exactly? There's almost 100 million people in this country that don't have insurance presently, are they going to start trawling through lists of SSNs and matching them to insurance company lists? Some how I doubt that, which means that those who remain uninsured probably won't be hit with the fine until something happens that makes known they aren't insured, like, say having to be rushed to the emergency room with stomach bleeding, to take a personal example.

I'm sure the "kick 'em when their down" factor of levying a massive fine on someone already facing a ludicrously expensive ER bill will really do much to endear that public with the Dems' great triumph.

[National Kato]

I understand your concerns. You still haven't told me how to lower costs (i.e. get everyone covered) without a fine or public option.

The point is that we can gnash teeth and complain about what will happen in 4 years when the mandate takes effect, if it ever does. Until then, millions of Americans will take advantage of the clear, positive reforms in this bill that take effect within six months.

I agree it's not a perfect bill, not by a long shot. I agree that insurance companies will make more profits as more people buy their plans. I also think that it's long overdue that these same companies now have to cover you regardless of ailment, and cannot remove you from a plan once your stomach starts bleeding. I think it's overdue that the 'donut hole' is now closed because my mother can't afford her prescription drugs each month. I think several other things are great about this bill.

It's not all bad, J. And unless you have the answers to how it will shake out in four years or how to do it better and more comprehensively without the public option or a mandate/fine, I still think you should relax. It's not good for your blood pressure...and you only have student insurance. :D

[Siraris]

The is a fluid process, and won't be completed for years. It is an important first step, though, and a huge legislative victory for the Democrats. It is in no way the silver bullet, and there is a tremendous amount that needs to be done to fix the health care aspect of our country. But in the end, it's a step. We could still see a vote on a public option by the end of the year, but people need time to digest what's going on right now. If they included a public option in this bill, the Republicans have a the evidence that they need that this is a "government takeover of health care", and that doesn't sit well with some people.

Ideally, people wouldn't be utterly dependent on health insurance to pay for their health bills. That being said, I'd much rather have a mandate for everyone to have health insurance, than to have considerable numbers of people going to hospitals without insurance to receive their health care treatments. My friend is an emergency room doctor, and he said you wouldn't believe the number of people who come in for treatments that they could easily have received from a GP.

[J Arcane]

Those people going to ERs for general treatment are doing so because no GP would treat them. Forcing them to buy insurance does technically fix that but it does so by placing the blame and the burden squarely on the wrong shoulders.

All this bill really does is subsidize a corrupt industry and provide them with a captive audience.

[National Kato]

All this bill really does is subsidize a corrupt industry and provide them with a captive audience.

No, it does more than that. You know this, but now you're just being willfully difficult. Several people have spelled out the positive provisions in this bill. You don't like it, fine. But generalizing doesn't help the discussion and is one of the reasons so many Americans are ignorant to the details of the bill. It's not all good and it's not all bad.

[J Arcane]

No, it does more than that. You know this, but now you're just being willfully difficult. Several people have spelled out the positive provisions in this bill. You don't like it, fine. But generalizing doesn't help the discussion and is one of the reasons so many Americans are ignorant to the details of the bill. It's not all good and it's not all bad.
The only actually positive provision of this bill is the pre-existing condition clause, a clause that shouldn't even be necessary in the first place because it should've had the public option the actual voting public wanted in the first fucking place.

I've read all the reports about what the bill does and does not do, and what I'm saying is that it's mostly an overblown waste of time, that serves only to force more people into cooperating with a system that is fundamentally broken.

I'm still going to be required by law (http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html/#scenario-8) to shell out almost $6000 a year (http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html/#scenario-5)for health insurance, with the only assistance received a vague, sliding-scale tax subsidy that only kicks in after the fact. Unless of course that amount proves to be more than 8-percent of my income, which means I don't have to buy the plan, but then that would also put me squarely in the category of "people this bill should be helping in the first goddamn place".

[Dukefrukem]

How is all of the pork Republicans fault?



Republicans have been rejected a new reform for the last 50 years without trying to fix the problems. That's why.

[Ink Asylum]

The New York Times post a quick reference chart to see how the bill will affect you personally. (http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html)

[National Kato]

The only actually positive provision of this bill is the pre-existing condition clause, a clause that shouldn't even be necessary in the first place because it should've had the public option the actual voting public wanted in the first fucking place.

I've read all the reports about what the bill does and does not do, and what I'm saying is that it's mostly an overblown waste of time, that serves only to force more people into cooperating with a system that is fundamentally broken.

If you're not being willfully difficult, than you're just being ignorant at this point. The bill does way more good than you keep stating. You can say it 'mostly' does this or 'all it does' is that, but you're wrong. Do you understand? Wrong.

A summary of what and when: (http://www.reuters.com/article/idUSN1914020220100319)


IMMEDIATE BENEFITS:

*Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.

*Insurers will be barred from excluding children for coverage because of pre-existing conditions.

*Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

*A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

*Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

*A tax credit becomes available for some small businesses to help provide coverage for workers.

*A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

WHAT HAPPENS IN 2011

*Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.

*Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

*A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.

*Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.

*Employers are required to disclose the value of health benefits on employees' W-2 tax forms.

*An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.

WHAT HAPPENS IN 2012

*Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.

*An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.

*The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.

WHAT HAPPENS IN 2013

*A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.

*The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.

*The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.

*A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

WHAT HAPPENS IN 2014

*State health insurance exchanges for small businesses and individuals open.

*Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.

*Health plans no longer can exclude people from coverage due to pre-existing conditions.

*Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.

*Health insurance companies begin paying a fee based on their market share.

WHAT HAPPENS IN 2015

*Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.

WHAT HAPPENS IN 2018

*An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions. (Reporting by Donna Smith; Editing by David Alexander and Eric Beech)So you can keep stating that 'all this bill does is subsidize a corrupt industry' or then downplay that exaggerated rhetoric with 'it's mostly an overblown waste of time.' Maybe after reading what's actually in the bill, you'll eventually tone it down to 'there are many positives in the bill, but I'm still not happy with the many negatives. Plus, I want a public option.'

Which would be a more rational and balanced opinion, and one that I wholly agree with.

[Generation ABXY]

It never should've fucking passed. The clause was inserted when a public option was still on the bill, and at the time was simply a penalty for those who failed to sign up for said option, to alleviate costs.

Now it amounts to gov't force playing complicit to insurance interests, and nothing more.

If it's any consolation, I've heard a number of states are challenging the mandate (among other aspects, of course).

[Siraris]

If it's any consolation, I've heard a number of states are challenging the mandate (among other aspects, of course).

A few states have passed laws showing their distaste with this piece of legislation (most if not all have Republican governors) but from what I've read, what they've passed will not trump the federal legislation. It's more of a symbolic message than anything.

[Inspector Fowler]

This is all a lot of confusion for me. To me it seems like all this would be solved a lot more easily if people were allowed to take the money from their employers and spend it however they wanted on any insurance company that would sell to them.

If I could buy any insurance plan I wanted, I don't think insurance companies would act like they do. Right now I have dogshit insurance. But they are the only option if you work for my university and live in my city. If I lived 200 yards south I could pick a competing company that has better coverage and lower rates. If I could pick that company at any time no matter who my employer was and where I lived, I think my current insurance would suddenly start with some incentives to keep me.

I wish it worked more like car insurance. You tell me what you have to offer, and I get to decide for myself who meets my needs. But that's not the direction we were headed before, and even with this "landmark" bill, it's not where we're headed now.

I also better not hear any griping from the Democrats when the Republicans push their "Free Guns and Bibles for Every Schoolchild" bill without full Senate approval in a few years. :p :eek: I kid, I kid. Both parties are worthless. :)

[Ink Asylum]

The LA Times features an easy to follow explanation of how this will affect people. (http://www.latimes.com/features/health/la-na-healthcare-passage22-2010mar22-g,0,7818440.graphic)

J Arcane, referring to that explanation, wouldn't you fall into the group that is eligible for Medicaid? Or, if you make more than $14,400 a year but less than $44,000 you'll be subsidized to buy your own insurance on a sliding scale as your income increases.

[txshurricane]

The problem with being eligible for Medicaid now is that many pharmacies and hospitals are not longer taking new Medicaid patients because of the inability to make timely collections.

[J Arcane]

If you're not being willfully difficult, than you're just being ignorant at this point. The bill does way more good than you keep stating. You can say it 'mostly' does this or 'all it does' is that, but you're wrong. Do you understand? Wrong.

A summary of what and when: (http://www.reuters.com/article/idUSN1914020220100319)

So you can keep stating that 'all this bill does is subsidize a corrupt industry' or then downplay that exaggerated rhetoric with 'it's mostly an overblown waste of time.' Maybe after reading what's actually in the bill, you'll eventually tone it down to 'there are many positives in the bill, but I'm still not happy with the many negatives. Plus, I want a public option.'

Which would be a more rational and balanced opinion, and one that I wholly agree with.

There's nothing in that article I haven't read.

If you're searching for an argument that will make me accept this ridiculous subsidy, you could've at least started with some basic math (http://www.wolframalpha.com/input/?i=8/100%20%3D%206000/x), instead of calling me an idiot.

You seem to assume that my tone of anger and disappointment automatically means I'm ignorant about the situation, and I can assure you that is not the case.

It is perfectly possible to be deeply dissatisfied with your precious fucking bill, and not be an idiot. I know that's a hard concept for liberals to swallow these days, but it does occur in real life.

[Vigil80]

When does this go into effect, exactly? There's one item that would directly benefit me, for the first time ever. Fairly jazzed.

Is... is this what welfare feels like? :D

[National Kato]

If you're searching for an argument that will make me accept this ridiculous subsidy, you could've at least started with some basic math (http://www.wolframalpha.com/input/?i=8/100%20%3D%206000/x), instead of calling me an idiot.

No, I never expected you to accept the bill. I only began by pointing out that your hyperbole was incorrect. No amount of math disproves that there is more to this bill than what you originally put forth, before watering down your statement.

You seem to assume that my tone of anger and disappointment automatically means I'm ignorant about the situation, and I can assure you that is not the case.I know. I didn't call you ignorant until you repeatedly made generalized statements despite several people explaining to you that there's more to this bill than 'the subsidies.'

It is perfectly possible to be deeply dissatisfied with your precious fucking bill, and not be an idiot. I know that's a hard concept for liberals to swallow these days, but it does occur in real life.I'm dissatisfied with it as well, which you could grasp by my own words to that effect. It ain't precious to me, but it's hard for you to see the positives through rage-filled eyes. I understand that limitation.

I'm sorry you so vehemently loathe the reform bill as passed. I can assure you it helps a great many people. And with us both having made our points, I leave you to your anger.

[National Kato]

When does this go into effect, exactly? There's one item that would directly benefit me, for the first time ever. Fairly jazzed.


Vigil, my long post further up the thread breaks it all down by year. That should help with figuring out how it might affect you.

[Slack3r78]

This is all a lot of confusion for me. To me it seems like all this would be solved a lot more easily if people were allowed to take the money from their employers and spend it however they wanted on any insurance company that would sell to them.

If I could buy any insurance plan I wanted, I don't think insurance companies would act like they do. Right now I have dogshit insurance. But they are the only option if you work for my university and live in my city. If I lived 200 yards south I could pick a competing company that has better coverage and lower rates. If I could pick that company at any time no matter who my employer was and where I lived, I think my current insurance would suddenly start with some incentives to keep me.
I agree. One of the things I really wanted was a greater decoupling of health insurance and employer, but it seems that the measures to that end in the bill are quite weak.

I wish it worked more like car insurance. You tell me what you have to offer, and I get to decide for myself who meets my needs. But that's not the direction we were headed before, and even with this "landmark" bill, it's not where we're headed now.

That's actually kind of the idea behind the exchanges. You feed in your info, get a variety of quotes, and can even see ratings of the company by its customers. The problem is that the bill still incentivizes employer-provided care, so people that work for larger institutions like you will probably be excluded from the exchanges. I'm not happy about that end of it.

[Siraris]

I love the Republican talk about repealing the bill. Can you imagine the blowback against the Republicans if they try to repeal a bill that eliminates excluding people for pre-existing conditions? Or repealing fixing the donut hole in medicare?

[National Kato]

I love the Republican talk about repealing the bill. Can you imagine the blowback against the Republicans if they try to repeal a bill that eliminates excluding people for pre-existing conditions? Or repealing fixing the donut hole in medicare?

Even David Frum, former Bush speechwriter, says that will never happen. He's actually saying that the passage of the bill is the Republican's 'Waterloo,' due in part to their embrace and rallying of the radicals in their party.

[Slack3r78]

I love the Republican talk about repealing the bill. Can you imagine the blowback against the Republicans if they try to repeal a bill that eliminates excluding people for pre-existing conditions? Or repealing fixing the donut hole in medicare?
My observation via Facebook is that the people complaining the loudest are people who have no clue what the bill actually does.

My favorite is the guy who has been unemployed the last 15 months and that just started a low-income job today bitching about being forced to pay for other people's healthcare if they're too lazy to get a job. The cognitive dissonance blew me away.

[Vigil80]

Vigil, my long post further up the thread breaks it all down by year. That should help with figuring out how it might affect you.
Yes, I read your post. The part I'm concerned about would fall under "immediate," but that word usually means something different in my language than politispeak.

Guess I'll find out, whether or not I look like an idiot when I give the insurance company a call this week.

[Siraris]

Even David Frum, former Bush speechwriter, says that will never happen. He's actually saying that the passage of the bill is the Republican's 'Waterloo,' due in part to their embrace and rallying of the radicals in their party.

They're going to kick and scream for a while, because their interests are in being re-elected, not about the general well-being of the American people. When you appeal to the lunatic fringe, you have to sell a piece of your soul in the process. If the Democrats play it right, it could truly save them this fall.

My observation via Facebook is that the people complaining the loudest are people who have no clue what the bill actually does.

My favorite is the guy who has been unemployed the last 15 months and that just started a low-income job today bitching about being forced to pay for other people's healthcare if they're too lazy to get a job. The cognitive dissonance blew me away.

The people who are complaining the loudest are those who have no clue (look at The Continentals video) as you said, AND those who are kowtowing to the fringe. Every Democrat would have voted for this bill if they weren't running in tight contests in volatile areas. If this was any other environment, there would be some semblance of support from the Republican side as well. How can the Republicans look at the bill (which includes 200 Republican amendments) and not say "This is a decent piece of legislation; we have disagreements but we can make fixes down the line"? There are people with potentially legitimate claims, including those who wanted a public option, but there's no reason to see such lopsided support other than catering to the tea party loonies. You have to legitimately believe that the citizens of the most powerful and wealthiest country on the planet do not deserve first world health care.

[txshurricane]

My favorite is the guy who has been unemployed the last 15 months and that just started a low-income job today bitching about being forced to pay for other people's healthcare if they're too lazy to get a job. The cognitive dissonance blew me away.
People like that are a product of the system. What I mean by that is our government very likely caused much of the conditions whereby he lost his job, and then gave him the opportunity to sit on his duff collecting an unearned paycheck for 12+ months. Infuriating? Yes. Surprising? Not hardly.

What's most frustrating to me is that illegal aliens will still get free emergency care by law, but will not be forced to have insurance - instead, taxpaying citizens are required to make up the difference. Meanwhile, illegal aliens continue breaking laws without consequence, and when they catch a bullet for it they go to the ER for free and the Border Patrol agent that shot them goes to prison. Grr.

[J Arcane]

You have to legitimately believe that the citizens of the most powerful and wealthiest country on the planet do not deserve first world health care.

This right here is what I have been saying all along, and why this bill disgusts me, because everything about it is built on further investing in a system that is broken and corrupt, when it should've been building a proper public option.

To my mind, this is not the free market solution the Republicans would like, nor is it the universal option a liberal like myself would like. If anything, a public option would be the more democratic one, not just because the public wanted it, but because it's presence would produce competition with private medical, and mean that the stipulations this bill has to force by law, could instead have been rendered obsolete through competition with a public option that would take those stipulations as read.

It's a Missouri Compromise for health care.

[Slack3r78]

People like that are a product of the system. What I mean by that is our government very likely caused much of the conditions whereby he lost his job, and then gave him the opportunity to sit on his duff collecting an unearned paycheck for 12+ months. Infuriating? Yes. Surprising? Not hardly.
It's just the it's bad when it's anybody but me thing that annoys the shit out of me. He's absolutely convinced that he deserved it, but everyone else that has problems affording (X) is just a lazy leach off the system. It's blatantly hypocritical.

What's most frustrating to me is that illegal aliens will still get free emergency care by law, but will not be forced to have insurance - instead, taxpaying citizens are required to make up the difference. Meanwhile, illegal aliens continue breaking laws without consequence, and when they catch a bullet for it they go to the ER for free and the Border Patrol agent that shot them goes to prison. Grr.

I seem to remember the right making a huge stink about there being guarantees that illegals couldn't be covered under the new system. So, this is what happens when you try to pretend a significant portion of the population doesn't exist.

EDIT:

In fact, the infamous Joe Wilson "You lie!" outburst was in response to Obama talking about healthcare and spending on illegals.

[txshurricane]

It's just the it's bad when it's anybody but me thing that annoys the shit out of me. He's absolutely convinced that he deserved it, but everyone else that has problems affording (X) is just a lazy leach off the system. It's blatantly hypocritical.
Oh, it annoys me, too. But his hypocrisy is no worse than 419 Congresspeeps with free premium healthcare and pre-installed retirement telling taxpayers that our private insurance and our retirement savings are not good enough - and that we must instead provide both to the people who haven't the sense to provide it for themselves.

[J Arcane]

Oh, it annoys me, too. But his hypocrisy is no worse than 419 Congresspeeps with free premium healthcare and pre-installed retirement telling taxpayers that our private insurance and our retirement savings are not good enough - and that we must instead provide both to the people who haven't the sense to provide it for themselves.
Yeah, 'cause that's what's kept me from having health insurance all these years. I just don't have any sense. :mad:

[National Kato]

But his hypocrisy is no worse than 419 Congresspeeps with free premium healthcare and pre-installed retirement telling taxpayers that our private insurance and our retirement savings are not good enough - and that we must instead provide both to the people who haven't the sense to provide it for themselves.

In all fairness, it wasn't just the 419 Congresspeeps saying that. It was a large amount of Americans, uninsured and insured, wanting reform and voting to put representatives in place who might enact it. Despite what you might see on CNN/FOX/MSNBC, the reforms such as removing the caps on coverage, removing pre-existing conditions clauses, closing the 'donut hole,' ending recissions, and many more were communicated by the American people to their Congresspeeps and that is why you see it in the bill.

[Siraris]

This right here is what I have been saying all along, and why this bill disgusts me, because everything about it is built on further investing in a system that is broken and corrupt, when it should've been building a proper public option.

To my mind, this is not the free market solution the Republicans would like, nor is it the universal option a liberal like myself would like. If anything, a public option would be the more democratic one, not just because the public wanted it, but because it's presence would produce competition with private medical, and mean that the stipulations this bill has to force by law, could instead have been rendered obsolete through competition with a public option that would take those stipulations as read.

It's a Missouri Compromise for health care.

I agree with you in spirit, but you have to remember, this is the first step in insurance reform. You are asking for incredibly drastic changes from a country that is known for making incremental steps, and there's a strong argument for pursuing this course. There are so many factors that go into something like this, from the electoral consequences, to the ability for the government to handle it.

The important thing to remember is, I think that the President and the Democrats WANT a public option. They have said that it will come up for a vote before the end of the year. If the Democrats can put together a proper campaign to educate the public on the benefits of a public option, then the support could swell to the point of there being a reasonable chance of it passing. That being said, I think there is a legitimate concern that the government running a health care system would result in nothing but problems.

Getting enough votes to pass this current bill was difficult enough, the addition of a public option would have potentially meant there would be NO bill at all, which would have resulted in no reform for years to come. I'd much rather see them pass the bill that they did, and then fix it over time, then pass nothing, and then have nothing to fix. It's selfish for anyone to demand something like a public option, especially with how hard they had to work to pass the bill in the present form.

[Slack3r78]

But his hypocrisy is no worse than 419 Congresspeeps with free premium healthcare
I thought one of the provisions of the bill was the Congressmen and their staffs would have to purchase insurance on the exchange?

[J Arcane]

I guess I just can't help but look at it the same way I look at things like gay rights. "We have to take it slow" sounds good to a politician's ear, but to people deprived of what they see as a basic right, a basic right plenty of other countries now have and in this case have had for years, that rings a little hollow.

Fortunately, there's lots of film industry jobs in Canada these days I hear, so here's hoping after school I can move to the Hollywood of the Pacific Northwest and become a proud maple syrup eater. ;)

[Siraris]

I heard something interesting today at lunch. I guess this bill was almost exactly the same bill that Richard Nixon was going to try to pass right before Watergate hit. Anyone else hear this?

[txshurricane]

In all fairness, it wasn't just the 419 Congresspeeps saying that. It was a large amount of Americans, uninsured and insured, wanting reform and voting to put representatives in place who might enact it. Despite what you might see on CNN/FOX/MSNBC, the reforms such as removing the caps on coverage, removing pre-existing conditions clauses, closing the 'donut hole,' ending recissions, and many more were communicated by the American people to their Congresspeeps and that is why you see it in the bill.
The bill is not all negative, I understand that. However, the reasons WHY these people are uninsured is what is so unethical about the bill as a whole. Oh, yeah, we have plenty of people with limited access to healthcare...but why?

Here's a few reasons:

They're not citizens. (Just throw a rock in Houston.)
They don't want the insurance. (Such as my parents in law, who pay cash.)
They can't afford it.

Now, tell me: what about this bill is such a Godsend that the people mentioned above couldn't enact upon themselves in the next four years? Show me one person who cannot change their life in four years, and I'll show you someone who lies through their teeth in exchange for pity.

It's funny how we'll sit and watch these movies about "touch the stars" and "you can do whatever you want to if you try", and then our collective bleeding hearts will cut the legs out from under a determined, struggling American by offering them surplus that doesn't exist. It makes liberals sick when conservatives fight these so-called humanitarian efforts, but your standard issue liberal will punch someone in the face to get to the front of the line at Starbucks, and then ignore the hungry war vet sitting outside. When they get home, they'll actively participate in trying to enforce extra taxes on the American public...but God forbid they pay pittance out of their own pocket.

It's like the pussy who picks a fight and yells at his friends: "hold me back!" He never intended to take a swing, he just wanted to feel like it mattered for a second.

I've rambled a little too much for my own good, but one thing sticks in my mind today:
Bureaucracy is no longer for the politicians.

I thought one of the provisions of the bill was the Congressmen and their staffs would have to purchase insurance on the exchange?

If that's true, I didn't know that. Hopefully it is, but in the end we're paying for it anyway. Automatic salary wages in Washington, anyone?

[Slack3r78]

Now, tell me: what about this bill is such a Godsend that the people mentioned above couldn't enact upon themselves in the next four years? Show me one person who cannot change their life in four years, and I'll show you someone who lies through their teeth in exchange for pity.

Cancer survivors. Preexisting condition and in many cases they've also already exceeded the lifetime cap on payouts. Pretty sure that's something folks can't just hit the 'undo' button on themselves.

[txshurricane]

Cancer survivors. Preexisting condition and in many cases they've also already exceeded the lifetime cap on payouts. Pretty sure that's something folks can't just hit the 'undo' button on themselves.
Whatever happened to just paying? I mean, it's not optimal, but then again: neither is dying of cancer. My wife's grandmother is a breast cancer survivor who used a portion of their retirement to pay for her treatments.

At what point in America did it become okay to just sit on your roof after a hurricane and wait for a government helicopter to save your life?

http://1.bp.blogspot.com/_xNv1sSbltqk/Rs9VLu_VShI/AAAAAAAAAb4/wo7T_sWVgAk/s400/katrina+helicopter.jpg

[J Arcane]

Yeah! Those fucking assholes! Getting caught in a storm! They should fucking swim their way out or die, fucking wussy-ass needy fucks.

[Ink Asylum]

Yeah! Those fucking assholes! Getting caught in a storm! They should fucking swim their way out or die, fucking wussy-ass needy fucks.

Especially old people, children, and the sick! Survival of the fittest! When they drown the species gets stronger!

And why do we need fire departments? People should just form bucket brigades down to the nearest river like in the good ol' days! Or they should just pay private firefighters, and if they can't afford it then just let their house burn down and everyone inside along with it!

Don't get me started on the army, either! Who needs it? When we want to fight another country we should just tell all those patriotic Americans to grab their guns, book passage on the nearest airline, and start kicking whatever asses they find at their destination!

[Generation ABXY]

Don't get me started on the army, either! Who needs it?

To be fair, there are some people here who might agree with you there. :D

[txshurricane]

Yeah! Those fucking assholes! Getting caught in a storm! They should fucking swim their way out or die, fucking wussy-ass needy fucks.
You think there were helicopters doing flybys when our parents were caught in storms?

[civil]

Don't get me started on the army, either! Who needs it? When we want to fight another country we should just tell all those patriotic Americans to grab their guns, book passage on the nearest airline, and start kicking whatever asses they find at their destination!
You do realize you're addressing a Texan, don't you? ;)

[Ink Asylum]

As pacificist as some people here are I highly doubt anyone would advocate for completely disbanding the army. Even the most hard-left people here recognize the need to maintain an army for defense.

[txshurricane]

You do realize you're addressing a Texan, don't you? ;)
Yee-haw. :)

[txshurricane]

Especially old people, children, and the sick! Survival of the fittest! When they drown the species gets stronger!

And why do we need fire departments? People should just form bucket brigades down to the nearest river like in the good ol' days! Or they should just pay private firefighters, and if they can't afford it then just let their house burn down and everyone inside along with it!
Getting rescued from a flash flood or fire is one thing. Sitting on your rooftop in direct defiance of an area-wide evacuation order and getting pissed when it takes the National Guard three days to get to you is absurd.

[Slack3r78]

Whatever happened to just paying? I mean, it's not optimal, but then again: neither is dying of cancer. My wife's grandmother is a breast cancer survivor who used a portion of their retirement to pay for her treatments.

My father was essentially bankrupted by paying for my mother's cancer treatments (and she was ostensibly insured). His retirement, savings, etc were completely wiped out.


Then a few years later, he got sick too. Here's a man that has worked hard his entire life, run a successful business for nearly three decades, and has nothing to show for it besides struggling to get by despite doing everything right.

It's not as simple as "just pay for it" under the current system.

[txshurricane]

My father was essentially bankrupted by paying for my mother's cancer treatments (and she was ostensibly insured). His retirement, savings, etc were completely wiped out.


Then a few years later, he got sick too.

It's not as simple as "just pay for it" under the current system.
I can agree with it not being simple. But, look - it's life or death. You get treated, or don't. Having your finances bombed out is a part of survival in that situation. Don't get me wrong - I wouldn't want to be in that situation, and hope to God never to be...but if I were I can't imagine just giving up. Mind you, this is coming from someone who is willing to deploy lethal force as a line of defense, so maybe I'm not finding any middle ground in this issue.

I'm curious, though: what prevented them from being treated in a less expensive country?

[Siraris]

You think there were helicopters doing flybys when our parents were caught in storms?

Are you saying that it's better to not help people, than to help them? That's the way you're coming across, and the way many conservatives come across to me. "Fuck em! Just let em fend for themselves! Master of my domain mother fucker!". If you see a little old lady struggling to get across the street, would you ignore her, rationalizing that she has two legs, she can get herself across the street?

To me, that's a wild west mentality best left for... the wild west. I guess I assumed we've evolved as a species where we help each other in times of need. Some people can't afford to leave their home, as they have nowhere to go, just like some people aren't able to afford to pay hundreds of thousands of dollars for cancer treatments.

I'm curious, though: what prevented them from being treated in a less expensive country?

Wow, did you just ask why his father and mother didn't leave the United States and seek care somewhere else because they couldn't afford it here?

[Generation ABXY]

But, look - it's life or death.

That's more or less how I view it (though I think you're a tad more extreme than I am, in some respects). I mean, if I had a choice between, say, losing my home and getting treated for cancer, I would think it wouldn't be much of a choice at all - I'm certainly not going to get any use out of the home if I'm dead.

[Khrymsyn]

My father was essentially bankrupted by paying for my mother's cancer treatments (and she was ostensibly insured). His retirement, savings, etc were completely wiped out.
Then a few years later, he got sick too. Here's a man that has worked hard his entire life, run a successful business for nearly three decades, and has nothing to show for it besides struggling to get by despite doing everything right.
It's not as simple as "just pay for it" under the current system.


And unfortunately, it's not as simple as "the government is going to pay for it" under the new system either. The new bill DOES have some good pieces to it, but at what cost? Small(ish) companies ($500,000/year) are now forced to offer healthcare, so what do you think they're going to do? It's not as simple as just offering that coverage. People will be forced to get healthcare, under penalty of ??? Now that insurers are required to eliminate pre-existing condition judgements and max $ adjustments, what do you think are going to happen to premiums? What about that cost to employers who are are paying or helping pay for insurance currently? How do you think that will affect employment rates and salaries? And, as I said in my earlier post, this doesn't really eliminate/approach some of the largest problems with our healthcare coverage in this country, such as the fact that there's a lot of "behind the scenes" hidden numbers done by employer to insurer, and not a fair market system in which employees get to choose.

Again, I really do hope this will help, but my fear is that this is going to be putting more weight on the shoulders of a still-shaky economy that can ill-afford it, by a government that's completely and utterly broke already. Can anyone explain how it wouldn't?

[Slack3r78]

I can agree with it not being simple. But, look - it's life or death. You get treated, or don't. Having your finances bombed out is a part of survival in that situation. Don't get me wrong - I wouldn't want to be in that situation, and hope to God never to be...but if I were I can't imagine just giving up.
It's not a matter of giving up. My mother fought and lost. My father fought it and has beat it back to the point that while not cured, is as cured as it's going to get. But it came at the cost of losing everything he'd worked for years to acquire and will be at the cost of him basically being forced to work until the day he physically falls apart through no real fault of his own.

Sure, life isn't fair, but we're the only industrialized nation in the world where shit like this can happen. For a country so focused on being the best in everything, it baffles me that people consider this acceptable since there just plain wasn't any money left.

Mind you, this is coming from someone who is willing to deploy lethal force as a line of defense, so maybe I'm not finding any middle ground in this issue.
You're talking to somebody that has a firearm on their person any time that doing so isn't illegal.

I'm curious, though: what prevented them from being treated in a less expensive country?
In my mother's case? The fact that the best doctor in the nation for her type of cancer was less than an hour away. In my father's case? Because the insurance company refused payment left and right on my mother's treatments, leaving him with little choice but to be treated locally.

[Slack3r78]

And unfortunately, it's not as simple as "the government is going to pay for it" under the new system either. The new bill DOES have some good pieces to it, but at what cost? Small(ish) companies ($500,000/year) are now forced to offer healthcare, so what do you think they're going to do? It's not as simple as just offering that coverage. People will be forced to get healthcare, under penalty of ??? Now that insurers are required to eliminate pre-existing condition judgements and max $ adjustments, what do you think are going to happen to premiums? What about that cost to employers who are are paying or helping pay for insurance currently? How do you think that will affect employment rates and salaries? And, as I said in my earlier post, this doesn't really eliminate/approach some of the largest problems with our healthcare coverage in this country, such as the fact that there's a lot of "behind the scenes" hidden numbers done by employer to insurer, and not a fair market system in which employees get to choose.

Again, I really do hope this will help, but my fear is that this is going to be putting more weight on the shoulders of a still-shaky economy that can ill-afford it, by a government that's completely and utterly broke already. Can anyone explain how it wouldn't?
I've never championed the bill as the best solution. You'll see that earlier in the thread I've said that I feel the bill should have done far more to decouple employment and insurance instead of incentivizing it, and I can find plenty of short comings in it.

The problem is, I've seen first-hand just how incredibly broken the system is now, and even minor fixes like in the bill are going to go a long way.

[Ink Asylum]

I can agree with it not being simple. But, look - it's life or death. You get treated, or don't. Having your finances bombed out is a part of survival in that situation. Don't get me wrong - I wouldn't want to be in that situation, and hope to God never to be...but if I were I can't imagine just giving up. Mind you, this is coming from someone who is willing to deploy lethal force as a line of defense, so maybe I'm not finding any middle ground in this issue.

I'm curious, though: what prevented them from being treated in a less expensive country?

You can't defend against cancer with a gun. I don't see where your willingness to use lethal force factors into a discussion of health care. Are you going to shoot the cancer to death? Are you going to hold a doctor hostage?

As for being treated in a less expensive country, cancer treatment isn't a one time thing. It's often a routine and expensive treatment for the rest of your life. Do you expect his parents to fly to some country that provides cheap health care every week when she needs chemotherapy?

[Slack3r78]

As for being treated in a less expensive country, cancer treatment isn't a one time thing. It's often a routine and expensive treatment for the rest of your life. Do you expect his parents to fly to some country that provides cheap health care every week when she needs chemotherapy?

Yeah, this is part of why the question puzzled me. My mother was seeing her docs a couple of times a week. My dad usually has to see his doctors at least once or twice a month just to make sure things are still under control even though he's already done with the active treatment phase. Just picking up and going somewhere cheaper isn't a particularly viable solution.

Also just strikes me as an odd response to the position that "healthcare in this country is broken."

[Khrymsyn]

The problem is, I've seen first-hand just how incredibly broken the system is now, and even minor fixes like in the bill are going to go a long way.

As I said though, at what cost? What happens to a government when it can no longer afford to exist, with a populace whom cannot afford to pay it? Hw far away are we from that point? I don't know the answers to those questions, but SOME of the answers that pop to mind are not exactly what I'd consider positive.

Something broken does not require just any fix, it requires a well thought out, appropriate, and well timed fix. Something I don't believe this is. Otherwise you'd be trying to replace motor mounts in a car while the engine was still running with garbage bag twisty ties... something that wouldn't end well.

[txshurricane]

Are you saying that it's better to not help people, than to help them? That's the way you're coming across, and the way many conservatives come across to me. "Fuck em! Just let em fend for themselves! Master of my domain mother fucker!". If you see a little old lady struggling to get across the street, would you ignore her, rationalizing that she has two legs, she can get herself across the street?
If I were to help her, I would do it myself instead of pushing a convoluted bill through congress that required YOU to pay for a contractor to do it for me.

Wow, did you just ask why his father and mother didn't leave the United States and seek care somewhere else because they couldn't afford it here?
Yes, I did. I wanted to know the reason. That's what a question is for. I wasn't implying that they should, I was asking why they didn't.

Wow, did you just ask me to confirm what you just read?

In my mother's case? The fact that the best doctor in the nation for her type of cancer was less than an hour away. In my father's case? Because the insurance company refused payment left and right on my mother's treatments, leaving him with little choice but to be treated locally.
Fair enough. How is the new program implemented last night going to rectify those problems in the future?

You can't defend against cancer with a gun. I don't see where your willingness to use lethal force factors into a discussion of health care. Are you going to shoot the cancer to death? Are you going to hold a doctor hostage?
You're getting way ahead of yourself. Read the post again. It was a critical self-evaluation.

As for being treated in a less expensive country, cancer treatment isn't a one time thing. It's often a routine and expensive treatment for the rest of your life. Do you expect his parents to fly to some country that provides cheap health care every week when she needs chemotherapy?
Um, yes. If that's what she decides is best for her. Isn't that what Michael Moore does?

[TrackZero]

You can't defend against cancer with a gun. I don't see where your willingness to use lethal force factors into a discussion of health care. Are you going to shoot the cancer to death? Are you going to hold a doctor hostage?


http://i42.tinypic.com/2092a0p.jpg

[txshurricane]

http://i42.tinypic.com/2092a0p.jpg
Hahahahahaha! :D

[Ink Asylum]

The bill prohibits the practice of rescission, which is when insurance companies try their best to cancel someone's insurance policy or deny them payment for their treatments by finding some minor mistake a customer made on their insurance applications or some other bullshit excuse. I don't know if this specifically would have worked in Slack3r's case, but it's a change that will save a lot of lives and prevent many bankruptcies for people that have faithfully paid their insurance premiums for years and don't deserve to be screwed over when the insurance company doesn't want to hold up their end of the deal.

[Ink Asylum]

Hahahahahaha! :D

Isn't that just where your logic leads, though? Shouldn't someone be willing to use the threat of lethal force to get treatments that will save their life, or the life of a family member, if they can't afford to pay? Wouldn't that be morally superior in your mind to the government taxing some people to pay for the health care of others?

[Slack3r78]

As I said though, at what cost? What happens to a government when it can no longer afford to exist, with a populace whom cannot afford to pay it? Hw far away are we from that point? I don't know the answers to those questions, but SOME of the answers that pop to mind are not exactly what I'd consider positive.
The populace already can't afford to pay, and costs will only continue to rise if left unchecked. At the .gov level alone, the CBO projects $1.2 trillion in savings over the next 10 years.

Fair enough. How is the new program implemented last night going to rectify those problems in the future?

It'll take time to divine exactly what's going to happen. Increased .gov oversight should make it more difficult for insurers to shrug off responsibility for actually paying for treatment. Like I said, the two big things are lifetime caps and preexisting conditions, which have caused massive issues for my father since my mother died (the insurance company dropped his coverage when she died because of the former, getting new coverage was difficult because of the latter and is nearly impossible since his more recent diagnosis).

Like I've said, I don't think this bill goes nearly far enough. But little could be much worse.

[Slack3r78]

The bill prohibits the practice of rescission, which is when insurance companies try their best to cancel someone's insurance policy or deny them payment for their treatments by finding some minor mistake a customer made on their insurance applications or some other bullshit excuse. I don't know if this specifically would have worked in Slack3r's case, but it's a change that will save a lot of lives and prevent many bankruptcies for people that have faithfully paid their insurance premiums for years and don't deserve to be screwed over when the insurance company doesn't want to hold up their end of the deal.
This. The lengths they will go to to deny payment on things that they preapproved is simply stunning.

[Vigil80]

Isn't that just where your logic leads, though? Shouldn't someone be willing to use the threat of lethal force to get treatments that will save their life, or the life of a family member, if they can't afford to pay? Wouldn't that be morally superior in your mind to the government taxing some people to pay for the health care of others?
Come on, cheap shots Ink, and you know it. You can do better.

Tx was making an analogy. :D

[txshurricane]

Isn't that just where your logic leads, though? Shouldn't someone be willing to use the threat of lethal force to get treatments that will save their life, or the life of a family member, if they can't afford to pay? Wouldn't that be morally superior in your mind to the government taxing some people to pay for the health care of others?
Morally superior? No, not in my opinion. Monetarily, no stone should be left unturned.

When I say "extremes", I'm talking about tanking your credit, borrowing money, liquidating...whatever it takes. But the biggest part of taking responsibility for one's self is that they are responsible.

[Jackel]

The big one for me personally is the lifetime caps issue. My wife had cancer when she was 6 and the costs came within inches of going above her lifetime cap under her parents plan.

So right now we pay close to 40% of our income for insurance, because her pre-existing conditions would likely cause her to be denied if we ever changed insurance.

[Vigil80]

I think the bottom line is that health insurance needed some kind of reform. We won't know whether this is it until long after it has succeeded or failed. But it's what we got, so may as well try to work with it.

No legislation is ever exactly what the doctor ordered. But, it does appear that there's some good that could come out of it, regardless of aspects such as politicians' true motivations.

[Ultima Thulian]

I may be cynical sometimes, but I'm not this cynical. "If any"? Do you honestly believe there might not be a single person in the House who voted for this bill because they really believe it will help people? "Most" might be up for debate, but a significant number of House members are very passionate about their beliefs, and about passing bills that help people.

The bill is far from perfect, but there will be good results from it. One of the blogs I read posted a good summary of some of the positive changes that will happen in the next six months: (http://crooksandliars.com/karoli/what-you-get-when-hcr-passes)

I agree there is some good things in the bill. If you want my honest opinion on it, then I'd tell you I was very split and torn between the issue and what was done, but I'd say that I'm more in favor than opposed.

But c'mon. Me the cynic? The real cynics are the people who actually think things are okay or are gonna change. The real cynics are those who think that politicians care about its constituents despite a 95% incumbency rate, constant pay increases and great benefits (not to mention the best healthcare available), all while having to do next to nothing. Best job ever, and our people, our fucking people, with their dumbass backwards ballcaps and t-shirts with skulls on them, continually vote in these assholes and then say, "Nothing changes! Politicians suck omg."

These politicians don't appear from the sky on magical unicorns. They are raised in American towns, taught in American schools, and are voted in by American people. We suck, and this is the best our feeble asses can do.

mcCPlkw6dO0

Cynic my ass.

[Ink Asylum]

But c'mon. Me the cynic? The real cynics are the people who actually think things are okay or are gonna change. The real cynics are those who think that politicians care about its constituents despite a 95% incumbency rate, constant pay increases and great benefits (not to mention the best healthcare available), all while having to do next to nothing. Best job ever, and our people, our fucking people, with their dumbass backwards ballcaps and t-shirts with skulls on them, continually vote in these assholes and then say, "Nothing changes! Politicians suck omg."

Actually, that's the opposite of cynicism. It's optimism. Perhaps foolishly misguided optimism, but optimism nonetheless. If you think things are okay and going to get better and that politicians are all looking out for your best interests then you really can't be accused of cynicism.

[TheFlyingOrc]

Cancer survivors. Preexisting condition and in many cases they've also already exceeded the lifetime cap on payouts. Pretty sure that's something folks can't just hit the 'undo' button on themselves.

Doesn't that mean that, to cover these people, costs on insurance HAVE to go up across the board? Pre-existing conditions make for good sob stories (and people who get DROPPED because of it are ridiculous - that's the bet the insurance company was taking, blast it) - but why would an insurance company pretty much sign up to lose tons of money?

[Kelegacy]

I can agree with it not being simple. But, look - it's life or death. You get treated, or don't. Having your finances bombed out is a part of survival in that situation. Don't get me wrong - I wouldn't want to be in that situation, and hope to God never to be...but if I were I can't imagine just giving up.

I'm curious, though: what prevented them from being treated in a less expensive country?

I hope I never become so callous to my fellow man...and fellow American, to boot.

We live in America. You'd think it would be better than that. 60-something percent of all bankruptcies are a cause of medical bills. You don't see something wrong with that? We're ruined not because we got sick, but because we can't afford to pay for it.

We all know life isn't fair, but it should be a bit better in our industrialized country. This isn't Somalia. "...just don't get sick" will soon become a nice tagline to the American dream at the rate we're going.

And going outside the country to get treated because it may be cheaper speaks volumes about the broken system we currently have.

[Slack3r78]

Doesn't that mean that, to cover these people, costs on insurance HAVE to go up across the board? Pre-existing conditions make for good sob stories (and people who get DROPPED because of it are ridiculous - that's the bet the insurance company was taking, blast it) - but why would an insurance company pretty much sign up to lose tons of money?

You've just hit on why I'm not a fan of of leaving things privatized. I don't particularly agree with forcing private enterprises to take on customers they will lose money on. But given the screaming we've heard about a plan that rotates around private insurance being socialism, a real solution seems untenable at the moment.

That said, the point of the individual mandate is that by getting younger, healthier people that might ordinarily forgo insurance into the system, you're casting the risk pool wider and helping to cover the cost of these higher-risk cases.

Again, I don't think it's ideal, but it's better than nothing at this point.

[TheFlyingOrc]

That said, the point of the individual mandate is that by getting younger, healthier people that might ordinarily forgo insurance into the system, you're casting the risk pool wider and helping to cover the cost of these higher-risk cases.

I get that. That makes sense. My point was that I don't understand not allowing insurance companies to deny based on previous illness AT ALL. I think the practice of dropping people who develop conditions is abhorrent, and we needed to put a stop to it. I just don't see how that part of it can do anything other than make prices go up.

edit: It's not really insurance at this point, it's nationwide health cost normalization.

[Kelegacy]

The fact that huge health industries are publicly traded on Wall Street is a sign, to me, that things are wrong.

I don't think we should profiteer from peoples' sickness. But companies also profiteer from war, so it's not a big shock.

There are shareholders that benefit from companies denying claims for sick people. That makes me ill.

Thus I have no problem paying higher taxes if it means I can access "free" healthcare. I already pay for the poor and elderly to get care (with the hopes that Medicare will be worthwhile when I'm older, too), but I wouldn't mind paying more, or having the government "suck it up", if it meant I could use it too.

The government takes our taxes and gives us services, as any good government should. That's why I don't mind if it costs us money, like I don't mind that the USPS is a money-losing entity. Trying to prevent them from being money pits is one thing, but not wanting to spend a red cent to give us services in return is foolish, I think.

[Slack3r78]

I get that. That makes sense. My point was that I don't understand not allowing insurance companies to deny based on previous illness AT ALL. I think the practice of dropping people who develop conditions is abhorrent, and we needed to put a stop to it. I just don't see how that part of it can do anything other than make prices go up.
I haven't seen the individual breakdown. It's my suspicion that it probably does cause an increase that's offset by savings elsewhere. I'm certainly not a huge defender of the bill beyond the crazier ravings I've seen about it.

[Siraris]

If I were to help her, I would do it myself instead of pushing a convoluted bill through congress that required YOU to pay for a contractor to do it for me.

I don't think you understand how our current health care system works. If you go to the hospital, your health care bill is higher because you are paying for people who don't have health insurance. This is not something that the Democrats did, this is how the system worked, and one of the reasons it was broken. This new plan makes people take responsibility for themselves, and forces them to buy insurance so that the rest of us don't have to foot the bill.


Yes, I did. I wanted to know the reason. That's what a question is for. I wasn't implying that they should, I was asking why they didn't.

Wow, did you just ask me to confirm what you just read?

Could you be much more belligerent? Seriously? You asked the question as to why his parents didn't go to another country, and I'm shocked you'd even ask that in the first place. This implies you believe on some level they should, even if it's a last resort. I don't think I need to explain the absurdity of that thought.


You asked Slacker what this bill did that was such a Godsend, and he answered you, then you responded with asking why people have to wait around for the government to rescue them. If you didn't mean that, if you weren't implying "Perhaps they should have gone to a country where it would be less expensive" then I apologize for trying to call you out on that. Based on your previous statements, though, it seemed you were in fact implying that in a roundabout way. If you didn't, then I'm shocked that you would imply something like that.

Regardless, you come across as extremely unfeeling in your posts. You imply that because your parents weren't rescued from helicopters, we shouldn't rescue people now. Should we stand in the way of progress because they go against your belief in self-sufficiency?

[Scull]

So my son has a life-threatening heart condition, and I was laid off from my job. I couldn't afford health insurance, and couldn't get state aid to cover him. Then I went back to work, at a lower paying job, but it has decent insurance. My son has a pre-exisitng condition. Should my new insurance deny him coverage? If they do, how do I continue to provide him medical care? My new job doesn't afford me the ability to do so, and my insurance won't cover him. Now what?

Let's add some fuel. Shortly after I got my new job, my wife came down with a debilitating illness and is no longer able to work. Fortunately my insurance covers her as it wasn't pre-exisiting, but she is costing them something like $8,000 a month, and we are paying almost $1,000 a month as well until she recovers. Recovery can take YEARS. The insurance company has recently started denying claims, and although I can't be certain, I expect that they will soon try to remove her from my plan. Then what?

I'm almost to the point where I have to declare bankruptcy so I can get some relief from the overwhelming debt of my family medical bills. This health insurance bill will at least keep her on the plan and should start covering my son. It probably won't save my home or credit rating, but at least in the future my costs will come down. But they won't come down enough to make it viable for us to continue to get treatment as frequently as is needed.

None of this is hyperbolic or hypothetical. This is my daily life. This bill will help a bit. Without a doubt were it not for the ability to get coverage for my family we'd be well and truly fucked.

[TheFlyingOrc]

I haven't seen the individual breakdown. It's my suspicion that it probably does cause an increase that's offset by savings elsewhere. I'm certainly not a huge defender of the bill beyond the crazier ravings I've seen about it.

I'm a bit skeptical on the whole of the assertion that the bill will actually save us money in the long run (I find it quite doubtful that the government will regulate things as well as a company trying to make a profit), but I can see how "everybody has health insurance" would save more money.

[Slack3r78]

I'm a bit skeptical on the whole of the assertion that the bill will actually save us money in the long run (I find it quite doubtful that the government will regulate things as well as a company trying to make a profit), but I can see how "everybody has health insurance" would save more money.

One area I suspect it'll help get under control are the new regulations on insurers having open books and oversight of how they're spending money.

From a Bill Moyers interview with a former insurance exec a few months ago:

WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.

http://www.pbs.org/moyers/journal/07102009/transcript2.html

Personally, I think you'd be hard pressed to argue that the increased profitability ratio is the result of increased efficiency over that timeframe.

[Kelegacy]

So my son has a life-threatening heart condition, and I was laid off from my job. I couldn't afford health insurance, and couldn't get state aid to cover him. Then I went back to work, at a lower paying job, but it has decent insurance. My son has a pre-exisitng condition. Should my new insurance deny him coverage? If they do, how do I continue to provide him medical care? My new job doesn't afford me the ability to do so, and my insurance won't cover him. Now what?

Let's add some fuel. Shortly after I got my new job, my wife came down with a debilitating illness and is no longer able to work. Fortunately my insurance covers her as it wasn't pre-exisiting, but she is costing them something like $8,000 a month, and we are paying almost $1,000 a month as well until she recovers. Recovery can take YEARS. The insurance company has recently started denying claims, and although I can't be certain, I expect that they will soon try to remove her from my plan. Then what?

I'm almost to the point where I have to declare bankruptcy so I can get some relief from the overwhelming debt of my family medical bills. This health insurance bill will at least keep her on the plan and should start covering my son. It probably won't save my home or credit rating, but at least in the future my costs will come down. But they won't come down enough to make it viable for us to continue to get treatment as frequently as is needed.

None of this is hyperbolic or hypothetical. This is my daily life. This bill will help a bit. Without a doubt were it not for the ability to get coverage for my family we'd be well and truly fucked.

Some people like to think you're just anecdotal evidence. I don't. I see this crap all the time in my line of work and I feel for you. You have my sympathies.

[TheFlyingOrc]

Personally, I think you'd be hard pressed to argue that the increased profitability ratio is the result of increased efficiency over that timeframe.

Investors demanding increased profitability of Insurance companies is kinda sorta insane. Insurance works for the same reason casinos work - probability. If you know how often things happen, you have a large enough client base, and you know how much people pay vs. their payout, you can pretty much calculate how much money an insurer is going to make to a very high degree of accuracy. At that point, the only thing you can do to change it is shady things.

[Generation ABXY]

My point was that I don't understand not allowing insurance companies to deny based on previous illness AT ALL. I think the practice of dropping people who develop conditions is abhorrent, and we needed to put a stop to it.

Again, essentially my feeling on that portion; it's no longer Russian roulette when the revolver's fully loaded.

[Slack3r78]

Investors demanding increased profitability of Insurance companies is kinda sorta insane. Insurance works for the same reason casinos work - probability. If you know how often things happen, you have a large enough client base, and you know how much people pay vs. their payout, you can pretty much calculate how much money an insurer is going to make to a very high degree of accuracy. At that point, the only thing you can do to change it is shady things.

Well, the problem is that coporations, as legal entities, exist for the sole purpose of maximizing shareholder profit, and board members can find themselves personally liable for failing to do so. It's the reason why I think that it's a poor fit for the insurance industry, despite the fact that it works very well in some other industries.

(Tangentially, NPR ran a pretty interesting report (http://www.npr.org/templates/transcript/transcript.php?storyId=124468487) on a movement to create a new class of legal entity which is for-profit, but isn't solely beholden to profit motive, and can focus on other mission values without putting themselves at risk of shareholder revolt. Interesting idea, anyhow).

[Kagger]

txshurricane, come on Katrina is an entirely different ballpark. We live in Houston now, but mother lost everything to Camille and Betsy. There wasn't anything that said THIS would be the time the Levees broke when they withstood the worst at least twice before. And not everyone could get out, whether financially or because of transportation, like my Uncle. Katrina was a freaking nightmare, do not take it lightly as a talking point.

I'm absolutely pissed they are going to be taxing the hell out of PPO's.

[Ox]

The fact that huge health industries are publicly traded on Wall Street is a sign, to me, that things are wrong.

I don't think we should profiteer from peoples' sickness. But companies also profiteer from war, so it's not a big shock.
Every doctor and nurse earns money for the treatment they provide. They profit from people's sickness, too. Is that wrong?

You've pinpointed exactly why healthcare reform has always struck fear into my heart. Many of its proponents are fundamentally opposed, not to unfairness, but to the profit-making impulse itself. They are opposed to capitalism in all its forms. Healthcare reform is merely one way of expressing their hatred.

(Tangentially, NPR ran a pretty interesting report (http://www.npr.org/templates/transcript/transcript.php?storyId=124468487) on a movement to create a new class of legal entity which is for-profit, but isn't solely beholden to profit motive, and can focus on other mission values without putting themselves at risk of shareholder revolt. Interesting idea, anyhow).
There are a lot of legal entities that are for-profit but aren't solely dedicated to shareholder profit already. The problem is that you are only analyzing the issue from the outside: you consider the conflict between the shareholders and their customers, but you ignore the conflict between particular shareholders. Once you start saying majority shareholders can screw the interests of minority shareholders so they can pursue their own goals, you open the door to Enron-type dealings.

These programs to reduce shareholder-value lawsuits are looking to shift corporate power away from shareholders and to managers. This is wildly popular with a certain crowd when you are talking about managers who want to waste money on progressive causes, and wildly unpopular when you're talking about managers who want to waste money on conservative causes (see, e.g., Citizens United). It's a great test for identifying the legal scholars who are serious thinkers and the ones who are simply partisan hacks.

[BigJonno]

Every doctor and nurse earns money for the treatment they provide. They profit from people's sickness, too. Is that wrong?

C'mon, Ox, I expect better from you. There is a huge difference between someone who is paid to provide medical care and someone who makes more money from providing less medical care.

You've pinpointed exactly why healthcare reform has always struck fear into my heart. Many of its proponents are fundamentally opposed, not to unfairness, but to the profit-making impulse itself. They are opposed to capitalism in all its forms. Healthcare reform is merely one way of expressing their hatred.

Because supporting capitalism is clearly better than saving people's lives, right?

This may sound harsh and I'm sure some people find this overly simplistic, but if you think it's okay for people in an allegedly first-world country to get sick and die because they don't have enough money, or to be living in or close to poverty because they are paying high medical bills, you seriously need to step back and look at your priorities.

I don't care if people think me a bleeding-heart, socialist, liberal commie or something, but American healthcare is fucked up. There is nothing wrong with capitalism, there is nothing wrong with wanting to make money, but some things are more important than the endless drive for profit and this is one of those things.

[Scull]

Some people like to think you're just anecdotal evidence. I don't. I see this crap all the time in my line of work and I feel for you. You have my sympathies.
I appreciate your sympathy.

[Ox]

C'mon, Ox, I expect better from you. There is a huge difference between someone who is paid to provide medical care and someone who makes more money from providing less medical care.
Not according to the principle that Kelegacy was espousing. What the fuck do you expect me to do, say, "Oh, what you just said is silly. Let me make a completely different argument on your behalf that you might or might not agree with, then have an extended debate with myself about which version of myself is right?" Because I've tried that, and people tend to stare at me in the street.

Because supporting capitalism is clearly better than saving people's lives, right?

This may sound harsh and I'm sure some people find this overly simplistic, but if you think it's okay for people in an allegedly first-world country to get sick and die because they don't have enough money, or to be living in or close to poverty because they are paying high medical bills, you seriously need to step back and look at your priorities.
Thank you for very clearly identifying precisely why I left these debates nine months ago.

Anyway, congratulations to the Democrats. Those words are ash in my mouth, but I believe in showing grace in defeat. For what it's worth, I sincerely hope I'm wrong about the consequences of this legislation. Indeed, I hope the Democrats turn out to be right and this legislation saves more lives than it takes.

[Kelegacy]

Every doctor and nurse earns money for the treatment they provide. They profit from people's sickness, too. Is that wrong?

You've pinpointed exactly why healthcare reform has always struck fear into my heart. Many of its proponents are fundamentally opposed, not to unfairness, but to the profit-making impulse itself. They are opposed to capitalism in all its forms. Healthcare reform is merely one way of expressing their hatred.


I'm not anti-capitalism or profit, and I do get your counter point about doctors. I am all right with the people conducting the services being paid for them.

I work for a hospital, and I sit in on meetings where members of administration like our VPs will say something like, "and we're having a positive financial quarter--chemotherapy services are way up the past couple months" in a happy trill. Or I see employee memos from administration that cite we're not doing good financially because we aren't seeing enough patients and too many beds are left empty. Because either people are healthy (which isn't good for our business) or people can't afford to go to the doctor (which isn't good for our business and worse for their own lives).

On one hand, I wouldn't have a job without sick people. On the other, I think I want out of this industry because of that fact. I'm stuck with all this useless knowledge in my head and to restart in a different field would be too much, though it's what I really need to do. Will I? Probably not.

So I put most of my energy into customer service whenever possible. I am cursed with the gift of empathy.

I'm an idealist, but I understand doctors should and need to get paid--and well--for their services. It's an incentive to keep doctors coming into the field. It's the commercial insurance companies that I don't really think need be part of the equation.

[Ink Asylum]

You've pinpointed exactly why healthcare reform has always struck fear into my heart. Many of its proponents are fundamentally opposed, not to unfairness, but to the profit-making impulse itself. They are opposed to capitalism in all its forms. Healthcare reform is merely one way of expressing their hatred.

And perhaps your fears would be justified if those people were anywhere close to a majority of Congress, the Administration, the media, or the American people. They are firmly in the incredibly small minority, however, and will be there for the foreseeable future, unless you take Glenn Beck's conspiracy ravings as prophecy. America is a capitalist country, albeit one that believes in some kind of social safety net, and that isn't going to change anytime soon.

I would be very surprised, Ox, if you honestly believed that anti-Capitalists numbered enough to make any significant headway in America. You could probably count the number of Senators and Representatives who are opposed to "the profit-making impulse itself" or "capitalism in all its forms" on one hand. They affect policy as much as uber-Libertarian Ron Paul, and any fear of their influence on the health care reform debate is incredibly overblown.

[Ox]

I'm not anti-capitalism or profit, and I do get your counter point about doctors. I am all right with the people conducting the services being paid for them.
Okay. But then the question becomes: are doctors and nurses the only ones in the healthcare industry who provide important services? I presume you aren't a caregiver, but presumably you contribute something to the overall success of your hospital. Even the janitors and the HR personnel are important, and the entire operation would grind to a stop without them. You can't just declare that payments should only go to the doctors and nurses, any more than an army can declare it's abolishing its supply clerks and logistics officers because they don't directly engage in combat.

It's the commercial insurance companies that I don't really think need be part of the equation.
This isn't really an argument against for-profit insurance companies. Any insurer, including a single-payer government option a la the NHS, has a certain amount of staff and therefore rakes off a certain amount of healthcare resources. If you can identify a healthcare system that doesn't have some sort of insurer organization, then you can argue they don't contribute anything and shouldn't receive any resources. All the first-world systems I can think of have at least an NHS-style insurer, though, which suggests (although it does not prove) that some sort of insurer is necessary. Just like the doctors and nurses, all those faceless bureaucrats are in it (at least in part) for the Benjamins.

Imagine a world where there was no gatekeeper of any kind between a doctor and the pot of gold used to pay doctors. How would a doctor's fees be set? Would he simply be given a key to the till and told, "Pay yourself what you think is fair. Honor system!"? Who would look out for the doctor who ordered a complete MRI scan at his brother's MRI office for every patient with a hangnail?

[BigJonno]

Not according to the principle that Kelegacy was espousing. What the fuck do you expect me to do, say, "Oh, what you just said is silly. Let me make a completely different argument on your behalf that you might or might not agree with, then have an extended debate with myself about which version of myself is right?" Because I've tried that, and people tend to stare at me in the street.

Firstly, profiteering is not the same as making a profit. Secondly, doctors and nurses do not benefit from not treating sick people, insurance companies do. I don't think that this is a difficult distinction to make.

Thank you for very clearly identifying precisely why I left these debates nine months ago.

If you can make a single argument against free universal healthcare that doesn't boil down to "I don't want to spend my money on preventing people getting sick and dying," then I'd like to hear it.

[Ox]

And perhaps your fears would be justified if those people were anywhere close to a majority of Congress, the Administration, the media, or the American people.
I kind of feel like today is a bad day to be arguing that, merely because a large majority of Americans oppose a particular policy, necessarily means that policy won't become law.

Anyway, America's faith in capitalism is kind of shaky anyway. Only 53% (http://www.rasmussenreports.com/public_content/politics/general_politics/april_2009/just_53_say_capitalism_better_than_socialism) believe it's superior to socialism, and one out of five think socialism is preferable. These numbers become far more frightening for Americans under 30. Both ideologies (http://www.gallup.com/poll/125645/socialism-viewed-positively-americans.aspx) command exactly the same level of support among Democrats, with large minorities opposed to both. One third of Americans expresses a "negative" view of capitalism.

I don't know what your threshold for "incredibly small minority" is, Ink. But when the majority party in this country is evenly divided on whether capitalism is a good thing or a bad thing, I'm inclined to say it's a dangerous minority, regardless of its size.

[Slack3r78]

Every doctor and nurse earns money for the treatment they provide. They profit from people's sickness, too. Is that wrong?

You've pinpointed exactly why healthcare reform has always struck fear into my heart. Many of its proponents are fundamentally opposed, not to unfairness, but to the profit-making impulse itself. They are opposed to capitalism in all its forms. Healthcare reform is merely one way of expressing their hatred.

Personally, I view profit-motive as a tool. It's an incredibly useful, versatile tool, and in many cases, it's the best tool we have available for achieving a given end.

In the case of health insurance, though, I think that the profit motive fails if your desired end is quality healthcare for the greatest number of people because the incentives toward profit are counter the requirements of maximizing care.

I've said I'm not thrilled with the bill, but I really think the scope of it has been drastically overblown by both sides. It's still fundamentally based around for-profit private insurers with heavy incentives toward coverage being provided by your employer. I think the people hailing this bill as panacea are just as wrong as those declaring it a socialist takeover.

There are a lot of legal entities that are for-profit but aren't solely dedicated to shareholder profit already. The problem is that you are only analyzing the issue from the outside: you consider the conflict between the shareholders and their customers, but you ignore the conflict between particular shareholders. Once you start saying majority shareholders can screw the interests of minority shareholders so they can pursue their own goals, you open the door to Enron-type dealings.

I'm admittedly not particularly well-versed on this end of things, but I thought the idea presented in the article was aimed specifically at resolving those kinds of intershareholder conflicts?

[torrefaction]

If you can make a single argument against free universal healthcare that doesn't boil down to "I don't want to spend my money on preventing people getting sick and dying," then I'd like to hear it.

I don't want to waste money and try to spread that money across a vast urban sprawl and huge country. I don't want legislation to decide what is and what isn't covered. I'm very happy with my insurance. I believe the government is inefficient and not good at healthcare in large areas. I believe Serapth has mocked his own healthcare system on numerous occasions. I don't want to wait 4 weeks for a doctor. I want the right amount of money to flow into the system so hospitals can continuously improve. The government is bad at deciding what that right amount of money is. I don't want government healthcare to affect the great care I've always had as part of compensation for working hard to get where I'm at (There...the only selfish argument.)

I can go on and on, and I hate this bill and think bad things can come of it. Like Ox said...Good job, Democrats, and I hope you're right.

[Slack3r78]

I kind of feel like today is a bad day to be arguing that, merely because a large majority of Americans oppose a particular policy, necessarily means that policy won't become law.

Anyway, America's faith in capitalism is kind of shaky anyway. Only 53% (http://www.rasmussenreports.com/public_content/politics/general_politics/april_2009/just_53_say_capitalism_better_than_socialism) believe it's superior to socialism, and one out of five think socialism is preferable. These numbers become far more frightening for Americans under 30. Both ideologies (http://www.gallup.com/poll/125645/socialism-viewed-positively-americans.aspx) command exactly the same level of support among Democrats, with large minorities opposed to both. One third of Americans expresses a "negative" view of capitalism.

I suspect part of that stems from how an individual defines socialism. Most people of my father's generation basically associate it directly with Stalinism, while there's more of a tendency among the younger population to associate it more with Western European socialist democracy.

I've only known a couple of hardcore Marxists in my time; I know a good many people who would describe their political beliefs as at least partially socialist, however.

[Ox]

In the case of health insurance, though, I think that the profit motive fails if your desired end is quality healthcare for the greatest number of people because the incentives toward profit are counter the requirements of maximizing care.
Profit motive inevitably conflicts with the goal of providing the maximum quality service to the maximum number of people, no matter the market. The issue isn't whether the profit motive fails to provide perfection, but whether there is another way of organizing human society that does a better job.

I've said I'm not thrilled with the bill, but I really think the scope of it has been drastically overblown by both sides. It's still fundamentally based around for-profit private insurers with heavy incentives toward coverage being provided by your employer. I think the people hailing this bill as panacea are just as wrong as those declaring it a socialist takeover.
I agree that relatively few people will die as a result of this bill. But many Democrats and pundits have made clear they view this as the first step on a long road (or long march, if you're historically inclined) to the complete nationalization of healthcare. And I do believe they're right that we've started down the slippery slope, and the bill is designed to fail in ways that make further expansions seductively plausible.

Basically, today I feel a little like I was reading news reports about a few people all over the world suddenly disappearing and leaving behind piles of clothes. Nothing too bad is happening yet, but I have a very bad feeling about what's coming next.

I'm admittedly not particularly well-versed on this end of things, but I thought the idea presented in the article was aimed specifically at resolving those kinds of intershareholder conflicts?
Sure, they're resolved... in the same way my slapping the shit out of my wife resolves my domestic conflicts.

EDIT: Just to clarify: I don't think a large number of Americans are hardcore Marxists. But I don't think only hardcore Marxists can fairly be described as "hostile to the profit-making impulse." I think that's a fair description of a lot of Americans, the entire nation of France, etc.

[BigJonno]

I don't want to waste money and try to spread that money across a vast urban sprawl and huge country. I don't want legislation to decide what is and what isn't covered. I'm very happy with my insurance. I believe the government is inefficient and not good at healthcare in large areas. I believe Serapth has mocked his own healthcare system on numerous occasions. I don't want to wait 4 weeks for a doctor. I want the right amount of money to flow into the system so hospitals can continuously improve. The government is bad at deciding what that right amount of money is. I don't want government healthcare to affect the great care I've always had as part of compensation for working hard to get where I'm at (There...the only selfish argument.)

I can go on and on, and I hate this bill and think bad things can come of it. Like Ox said...Good job, Democrats, and I hope you're right.

Those are either arguments against poor quality free universal healthcare or reasons that you're happy with your current private healthcare. I have plenty of criticisms of the NHS, but that doesn't mean I don't believe that it's better than the alternative.

[Slack3r78]

Profit motive inevitably conflicts with the goal of providing the maximum quality service to the maximum number of people, no matter the market. The issue isn't whether the profit motive fails to provide perfection, but whether there is another way of organizing human society that does a better job.

I'm simply saying that I'm of the belief that human society has enough breadth that I don't think any one ideology is going to result in the most optimal outcome possible. I'm okay with socializing medicine because I think it will provide better results (for what I perceive/value to be better, at any rate), but I'd be against socializing widget production in most cases since private enterprise is likely to do a better job there.

I agree that relatively few people will die as a result of this bill. But many Democrats and pundits have made clear they view this as the first step on a long road (or long march, if you're historically inclined) to the complete nationalization of healthcare. And I do believe they're right that we've started down the slippery slope, and the bill is designed to fail in ways that make further expansions seductively plausible.

As somebody who's been arguing for much more extensive reforms, I actually disagree. I think the debate has been drug out so long over such relatively minimal gains that the chances for any future reform beyond tweaks to what we've just done is probably off the table for a long time to come. The major provisions of this bill don't go into effect until 2014, and with the last major provisions (things like the "Cadillac plan" tax) don't go into effect until 2018. So we're looking at at least a decade from now before we really have a strong grasp of what the current reform's accomplished, and I think it's going to be hard to push for further improvements when the "current" ones are still years away.

Sure, they're resolved... in the same way my slapping the shit out of my wife resolves my domestic conflicts.

I don't see what would be so offensive about allowing a for-profit corporation to define a binding mission other than profit as part of its charter. I'd be against existing corporations pulling a bait and switch in this regard, but I don't see what's wrong about it so long as the shareholders know what they're buying into when they get in?

[Ox]

Can I just take a moment to remind people of something that was posted on the first page of this thread? It struck me when I first read it, but I had forgotten by the time I got to the end of the thread and was ready to post something.

Ready? This was posted (http://www.colonyofgamers.com/cogforums/showpost.php?p=518242&postcount=46) by National Kato as coming from a Reuters summary of the bill:
IMMEDIATE BENEFITS:
[...]
*A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.
According to Reuters, new taxes are benefits now! Oh gosh, I simply cannot wait to see how many more benefits the Democrats will dream up next!

[ShivaX]

I suspect part of that stems from how an individual defines socialism. Most people of my father's generation basically associate it directly with Stalinism, while there's more of a tendency among the younger population to associate it more with Western European socialist democracy.

I've only known a couple of hardcore Marxists in my time; I know a good many people who would describe their political beliefs as at least partially socialist, however.

I think part of it is also that the Right threw the word around so much that people thought, "Well shit, socialism sounds pretty good."

The downside of overusing something is that it loses its impact. People liked what Obama was saying when he was running. The GOP and the Right decried him a socialist. They effectively gave socialism a huge PR boost and made people rethink how they felt about it.

Now socialism is seen as the UK, Canada and France, not the USSR and China. And people like the look of a lot of what the UK, Canada and France have to offer.

[Slack3r78]

Can I just take a moment to remind people of something that was posted on the first page of this thread? It struck me when I first read it, but I had forgotten by the time I got to the end of the thread and was ready to post something.

Ready? This was posted (http://www.colonyofgamers.com/cogforums/showpost.php?p=518242&postcount=46) by National Kato as coming from a Reuters summary of the bill:

According to Reuters, new taxes are benefits now! Oh gosh, I simply cannot wait to see how many more benefits the Democrats will dream up next!

I'd agree that describing it as a benefit is a little dubious. But I mean... it's a pretty reasonable measure in the scheme of things. Not really any worse than last year's tobacco tax hike.

Though I am still highly annoyed that it banned clove cigarettes while still allowing legal menthols. How am I supposed to impress the hipster chicks now?

EDIT:

It = the tobacco bill last year. Fucking English and ambiguous pronouns.

[Ox]

I'm simply saying that I'm of the belief that human society has enough breadth that I don't think any one ideology is going to result in the most optimal outcome possible. I'm okay with socializing medicine because I think it will provide better results (for what I perceive/value to be better, at any rate), but I'd be against socializing widget production in most cases since private enterprise is likely to do a better job there.
Okay, but you have to come up with some fundamental structural reason why you think different structures are more appropriate in those situations. I'm not saying you can't come up with such a reason; but all too often, the argument becomes, "healthcare is different because it's really really important!" This is the sort of argument that people make after receiving severe head trauma.

I don't see what would be so offensive about allowing a for-profit corporation to define a binding mission other than profit as part of its charter. I'd be against existing corporations pulling a bait and switch in this regard, but I don't see what's wrong about it so long as the shareholders know what they're buying into when they get in?
There are a lot of for-profit legal entities that don't necessarily have "profit" and their sole organizing principle. Some of them are known as "partnerships." And it's a huge problem in partnership law that one partner will decide to sacrifice the partnership's financial interest for some other goal, then the disadvantaged partner cries foul.

You say "shareholders [should] know what they're buying into," but that's not really a workable standard. Let's say Ben & Jerry's had declared when they went public that they were dedicated to "social justice and, if there's any money left over, shareholder value." That's a really amorphous standard: what the hell is "social justice"? How is it different from the managers treating the firm like personal piggy banks?

Eventually the minority shareholders will object that there's too much or not enough or the wrong kind of "social justice" being done. Then courts have a decision to make. They can choose to try to enforce the declaration, which will require a legal definition of "social justice" and will basically be a great big clusterfuck that makes us all look stupid.

Or they can ignore it and say, "Sorry, minority shareholders. Guess you get to suck goat balls." The "suck goat balls" doctrine, while simple and cheap in terms of litigation costs, means there's no check on the managers or majority shareholders... which is Enron.

The shareholder value rule doesn't exist because the system is wildly biased in favor of capitalism. It exists because it's the only remotely fair and measurable rule that courts have found.

[Ox]

Though I am still highly annoyed that it banned clove cigarettes while still allowing legal menthols. How am I supposed to impress the hipster chicks now?
Dude, I've already made like 25 posts on this issue. Let's keep it in the proper thread, though (http://www.colonyofgamers.com/cogforums/showthread.php?t=15640).

[Slack3r78]

Okay, but you have to come up with some fundamental structural reason why you think different structures are more appropriate in those situations. I'm not saying you can't come up with such a reason; but all too often, the argument becomes, "healthcare is different because it's really really important!" This is the sort of argument that people make after receiving severe head trauma.

Well, "It's important" is a motivator, but certainly not my entire reasoning. The problem, as I see it, is that because we aren't callous enough as a society, the profit motive falls apart as a means of driving efficient healthcare. Unless our society is willing to, say, allow people to bleed out after an automobile accident, we're inherently introducing inefficiency back into the system. Same thing with patients with catastrophic diseases who rack up unpayable bills.

And since we have people receiving care without paying, the providers inflate charges, and because insurance knows the charges are inflated, they fight actually paying anything. Then it basically becomes a feedback loop where it all keeps getting worse.

I'm more inclined to say as a society "Society, since we're not quite big enough assholes to passively let this guy die because his Mastercard is maxed out, how about we just cut out the middle man and accept that we're already creating a huge combined risk pool, just in a really roundabout manner?"

The shareholder value rule doesn't exist because the system is wildly biased in favor of capitalism. It exists because it's the only remotely fair and measurable rule that courts have found.

Fair enough. I had started to say that it'd probably require triggers that would allow shareholders to tell the managers "fuck off", but as you say, the difficulty is in defining those rules in a clear manner.

[Ink Asylum]

I kind of feel like today is a bad day to be arguing that, merely because a large majority of Americans oppose a particular policy, necessarily means that policy won't become law.

A large majority of Americans don't oppose the HCR bill, especially when it's broken down and explained to them. And if they do, then the Democrats are headed for a monumental upset in November and either next year or once a Republican President gets into the White House if it's that unpopular it'll be repealed.

Anyway, America's faith in capitalism is kind of shaky anyway. Only 53% (http://www.rasmussenreports.com/public_content/politics/general_politics/april_2009/just_53_say_capitalism_better_than_socialism) believe it's superior to socialism, and one out of five think socialism is preferable. These numbers become far more frightening for Americans under 30. Both ideologies (http://www.gallup.com/poll/125645/socialism-viewed-positively-americans.aspx) command exactly the same level of support among Democrats, with large minorities opposed to both. One third of Americans expresses a "negative" view of capitalism.

That first poll was taken in April 2009, less than six months after rampant capitalism screwed the pooch and nearly wrecked the world economy. I'm certain that if you took the same poll now the numbers will have dropped back down a bit. The second poll doesn't ask which people would rather have in our country, and capitalism is still leading socialism by a large margin.

People in America tend to like things in the middle of the road. As I said, we largely like Capitalism but we also like a social safety net of some sort, which falls under Socialism. I am not convinced that what you fear, people who are opposed to "capitalism in all its forms," number anywhere higher than 5-10% in America, and even that's probably being too generous. People in America just largely don't like abandoning the poor, sick, and weak, but that doesn't come anywhere close to wanting to throw away Capitalism completely in favor of pure Socialism. Feel free to prove me wrong, though.

[J Arcane]

Because supporting capitalism is clearly better than saving people's lives, right?

This may sound harsh and I'm sure some people find this overly simplistic, but if you think it's okay for people in an allegedly first-world country to get sick and die because they don't have enough money, or to be living in or close to poverty because they are paying high medical bills, you seriously need to step back and look at your priorities.

I don't care if people think me a bleeding-heart, socialist, liberal commie or something, but American healthcare is fucked up. There is nothing wrong with capitalism, there is nothing wrong with wanting to make money, but some things are more important than the endless drive for profit and this is one of those things.

I am an American, and I endorse this message.

I suspect part of that stems from how an individual defines socialism. Most people of my father's generation basically associate it directly with Stalinism, while there's more of a tendency among the younger population to associate it more with Western European socialist democracy.

I've only known a couple of hardcore Marxists in my time; I know a good many people who would describe their political beliefs as at least partially socialist, however.


Now socialism is seen as the UK, Canada and France, not the USSR and China. And people like the look of a lot of what the UK, Canada and France have to offer.

I would say these describe me very well. I have a great admiration for the Scandinavian system in particular, my people came from there after all, and I think they have the right idea in thinking that a government's job should be taking care of it's people, and using it's wealth to eliminate misery.

I have nothing against free enterprise, anymore than Sweden or Denmark do, but I *do* expect a higher standard of ethics from them than we see in this country, and feel their mandate runs out when they begin to behave in fashions that are hostile and exploitative to society and consumers. People seem to forget that, even in this country, a corporation is a charter granted by the government, their status is a privilege, not a right.

EDIT: Also, I'd like to point out that "corporation" is not synonymous with "capitalism".

[Ink Asylum]

I think part of it is also that the Right threw the word around so much that people thought, "Well shit, socialism sounds pretty good."

The downside of overusing something is that it loses its impact. People liked what Obama was saying when he was running. The GOP and the Right decried him a socialist. They effectively gave socialism a huge PR boost and made people rethink how they felt about it.

Now socialism is seen as the UK, Canada and France, not the USSR and China. And people like the look of a lot of what the UK, Canada and France have to offer.

Hah. This is exactly right. You can blame the unhinged right like Beck and Limbaugh for making Socialism sound appealing to increasing numbers.

You can also blame Free-Market Capitalism's biggest cheerleaders and CEOs. Their endless search for bigger and bigger short term profits at the expense of long term stability and the well-being of the middle class has a tendency to turn people off to Capitalism as some flawless doctrine. If Socialism is ascendant it's because Capitalism fucked up royally. We won't completely get rid of Capitalism, or even pare it back all that much, but it definitely needs to be tempered with some Socialism in the next decade or so.

Okay, but you have to come up with some fundamental structural reason why you think different structures are more appropriate in those situations. I'm not saying you can't come up with such a reason; but all too often, the argument becomes, "healthcare is different because it's really really important!" This is the sort of argument that people make after receiving severe head trauma.

We supported, and continue to support, socialism for the elderly (Social Security and Medicare) because we, as a country, don't like the idea of the elderly suffering in poverty and pain, and there's simply not enough profit to be made off of them for private industry to take care of them.

America is warming up to socialized medicine, at least for the poor and incredibly sick, because we don't like the idea of people dying or going bankrupt because they get sick and there's not enough profit to be made off of them for private industry to care.

[Ox]

A large majority of Americans don't oppose the HCR bill
Now we're just bickering over whether 59%-39% (http://blog.heritage.org/2010/03/22/new-cnn-poll-59-oppose-obamacare/) qualifies as "large." If this is your objection, fine, but let's at least agree our disagreement is purely a matter of spin.
especially when it's broken down and explained to them.
Oh, okay. So in order to protect free enterprise, all I need to do is find someone more eloquent than Barack Obama to state the case for it to the American people. In that case, I'll sleep easy.

And if they do, then the Democrats are headed for a monumental upset in November and either next year or once a Republican President gets into the White House if it's that unpopular it'll be repealed.
Again, I think today is a bad day for arguing that policy is an accurate mirror of the people's preferences.

That first poll was taken in April 2009, less than six months after rampant capitalism screwed the pooch and nearly wrecked the world economy. I'm certain that if you took the same poll now the numbers will have dropped back down a bit.
Maybe you don't understand my point. My fear is that there is a danger that our economic system will be wrecked by an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged. In that case, it's not much of a relief for you to point out that the political balance swings like a pendulum, because it's a lot easier for the socialists to destroy the economy than it is for the capitalists to repair it. The socialists only need to win big once or twice; the forces of truth and justice need to win every time.

I would say these describe me very well. I have a great admiration for the Scandinavian system in particular, my people came from there after all, and I think they have the right idea in thinking that a government's job should be taking care of it's people, and using it's wealth to eliminate misery.
See, Ink? The government's wealth. The Scandinavian system. Wanton misuse of apostrophes. This is the future. And it's frightening.

People seem to forget that, even in this country, a corporation is a charter granted by the government, their status is a privilege, not a right.
No, it's not. Corporations used to need a permission in the form of a charter to form, just like a church used to need a license to hold services. But modern corporations do not receive a charter as a gift from a government, any more than you need a permission to start a church. Both organizations are required to file notifying paperwork with their local government organizations, but their formation is of right, not of privilege. You might try updating your corporate law knowledge up to, say, the century in which you were born.

I don't necessarily mean to be snide, but I always find it odd when people insist that something is the law when it not only is not the law, not only has it not been the law the entire time they were alive, but it has not been the law since their great-great-grandparents walked the Earth. Yet another failing of our public schools.

[BigJonno]

The socialists only need to win big once or twice; the forces of truth and justice need to win every time.

And some people accuse you of bias. ;)

[J Arcane]

And some people accuse you of bias. ;)
It was only a matter of time before he made it abundantly clear that he was Glenn Beck with a law degree.

[Ink Asylum]

Maybe you don't understand my point. My fear is that there is a danger that our economic system will be wrecked by an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged. In that case, it's not much of a relief for you to point out that the political balance swings like a pendulum, because it's a lot easier for the socialists to destroy the economy than it is for the capitalists to repair it. The socialists only need to win big once or twice; the forces of truth and justice need to win every time.

Because clearly the economic collapse of 2008 was all thanks to socialism? The capitalist forces of truth and justice just couldn't hold back all those socialist banks that leveraged the hell out of toxic assets.

You're really falling into Glenn Beck territory with your black and white, capitalism vs socialism rhetoric. Americans like socialism for some things and capitalism for other. They can exist in the same country, and they do in America. Tell people that we're going to socialize health care for the elderly and they fucking love it! Tell them we're going to socialize Apple and the government will be making the next generation iPhone and you'll see a different reaction.

[J Arcane]

Interesting you should mention that, really. With the exception of broad access communications (phone, broadband, etc.), corporate capitalism has been generally damn good at the field of consumer technology.

Nationalized tech business seems to lead to things like Soviet Russia still making new vacuum tube computers well into the 80s.

On the flipside though, academic research is subsidized heavily by the government, and as many of the major advancements that corporate capitalism has gone on to exploit and improve started in academia as not.

As in all things, nothing is black and white.

[Vigil80]

Side note, Beck is just a tv personality playing a role. Another year or two, he'll be churned under and someone else will take his place, like most tv personalities. Except Jay Leno, he just won't die, apparently.

Anyways, his boogieman status is getting rather, well, boring.

[J Arcane]

Side note, Beck is just a tv personality playing a role. Another year or two, he'll be churned under and someone else will take his place, like most tv personalities. Except Jay Leno, he just won't die, apparently.

Anyways, his boogieman status is getting rather, well, boring.
Well, what the fuck else can I compare that ridiculous display of fear-mongering bullshit to? Rush Limbaugh's been passe for years, and I gotta say, the delivery was pretty much straight out of Beck's playbook. That lunatic rant about commas and word choice only needed a nice big fucking chalkboard to seal the deal.

[Ox]

Because clearly the economic collapse of 2008 was all thanks to socialism?
I didn't say it was. Are you claiming that only capitalists are capable of destroying the economy?

You're really falling into Glenn Beck territory with your black and white, capitalism vs socialism rhetoric.
Hold on a fucking second here. I expect J Arcane to resort to name-calling at the drop of a hat, it's his wheelhouse. But you're capable of better than that. Let's go back over the course of this conversation.

I started off by saying I thought this healthcare bill was the beginning of a much longer trend toward a much more socialistic economy, because there are some people who are fundamentally opposed to the profit-making impulse. Not necessarily all the fruits of capitalism, but the emotion that drives capitalism: greed. Some people are inherently suspicious of this emotion.

You retorted that only an "incredibly small minority" could be described as "anti-capitalist" and claimed this was a "capitalist country." So I cited some polling to demonstrate that "capitalism" commands far less than universal respect, and indeed about half of all Democrats say they prefer socialism.

You say, effectively, they didn't really mean that, they just meant they want to shift the balance a little. Okay, I hope you're right. But I'm going on what they actually said -- that they have a "negative view" of "capitalism" and that they think "socialism" is "better" than "capitalism." Not "a little more socialism," but "socialism." Again, I hope you're right and Democrats are just really inarticulate. But I don't think you want to say that Glenn Beck's sin is to take people at their word.

Tell people that we're going to socialize health care for the elderly and they fucking love it! Tell them we're going to socialize Apple and the government will be making the next generation iPhone and you'll see a different reaction.
Sure, because people are enthusiastic about the iPhone. People don't usually clamor for changes in a system they think is working great.

But there are a lot of sectors of the economy that people don't think are working quite as well as the iPhone, right? Don't you think you're skewing the deck here just a little? And do you see me suggesting that we're going to wind up with a purely communist system at any time?

[Ink Asylum]

I didn't say it was. Are you claiming that only capitalists are capable of destroying the economy?

Nope, but you seem to believe that socialists are solely out to destroy the economy and that capitalists are the only ones who can save it. Your recent posts have been far more extreme in rhetoric than mine.

Hold on a fucking second here. I expect J Arcane to resort to name-calling at the drop of a hat, it's his wheelhouse. But you're capable of better than that. Let's go back over the course of this conversation.

You're also capable of better than this: "My fear is that there is a danger that our economic system will be wrecked by an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged." Or this: "The socialists only need to win big once or twice; the forces of truth and justice need to win every time." That's Glenn Beck rhetoric.

You say, effectively, they didn't really mean that, they just meant they want to shift the balance a little. Okay, I hope you're right. But I'm going on what they actually said -- that they have a "negative view" of "capitalism" and that they think "socialism" is "better" than "capitalism." Not "a little more socialism," but "socialism." Again, I hope you're right and Democrats are just really inarticulate. But I don't think you want to say that Glenn Beck's sin is to take people at their word.

What they "actually said" is simple one word answers to a poll that can be interpreted and spun in a number of directions. You're spinning it way more than I am if you beleive that half of Democrats want to replace modern Capitalism with hard-Left Socialism. I know a lot of Democrats and participate in discussions on blogs and forums where there are a whole lot more, and they don't want that. Not half of them, not a third of them, not a tenth of them. They just want to temper what they see as Capitalism-run-amuck in the past generation with some Socialism to help people who are losing their jobs, homes, 401ks, etc.

Sure, because people are enthusiastic about the iPhone. People don't usually clamor for changes in a system they think is working great.

Barack Obama and the Democratic majority won the largest victory they've had in decades and they did it while running on a platform of which health care reform was a major plank. People have been clamoring for changes in the current system.

[J Arcane]

Barack Obama and the Democratic majority won the largest victory they've had in decades and they did it while running on a platform of which health care reform was a major plank. People have been clamoring for changes in the current system.

Remember the lessons of the last 65+ years of American foreign policy: Democracy only matters if it agrees with whatever makes us the most profit.

Who cares who the people voted for, clearly the Republicans know what's best for us, and have no ulterior motives at all.

[Ox]

Nope, but you seem to believe that socialists are solely out to destroy the economy and that capitalists are the only ones who can save it.
Of course I don't believe socialists are out to destroy the economy. How often do I claim my political opponents are malicious toward other human beings? At most, socialists hate capitalists, but they don't want to make the great mass of Americans poorer. That's just going to be the unhappy effect.

And, uh, yeah. I think capitalism is, with very rare exception, a much more economically successful system than socialism. If that's enough to make me into Glenn Beck in your eyes, I'm guilty as charged.

You're also capable of better than this: "My fear is that there is a danger that our economic system will be wrecked by an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged." Or this: "The socialists only need to win big once or twice; the forces of truth and justice need to win every time." That's Glenn Beck rhetoric.
The "forces of truth and justice" was an attempt to inject a little bit of levity in an otherwise increasingly heavy conversation, but obviously it fell flat. Sorry. Although it seems you'd agree that a wave of socialism would only be propelled by "an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged." Weren't you saying a minute ago that the people opposed to capitalism were an incredibly tiny minority that have no power? What exactly are you objecting to, the notion that this "incredibly tiny minority" are "zealots" or that they're "unhinged"?

What they "actually said" is simple one word answers to a poll that can be interpreted and spun in a number of directions. You're spinning it way more than I am if you beleive that half of Democrats want to replace modern Capitalism with hard-Left Socialism.
You seem to feel like I'm ignoring all my psychic intuition that Democrats don't really believe this stuff. I really don't have psychic powers. I'm willing to concede I might be wrong, but I would like you to recognize the limited dataset I'm going off of. I only know what people say, not what they really believe in their hearts of hearts.

I know a lot of Democrats and participate in discussions on blogs and forums where there are a whole lot more, and they don't want that. Not half of them, not a third of them, not a tenth of them. They just want to temper what they see as Capitalism-run-amuck in the past generation with some Socialism to help people who are losing their jobs, homes, 401ks, etc.
First, without meaning any insult, I have incomplete confidence in your anecdotal impressions. Second, again without meaning any insult, I'm not sure where "some Socialism" ends. "A little more Socialism" repeated a whole bunch of times really adds up after a while. Part of the problem here is the fundamental emotional appeal of a little more socialism: capitalism is founded on greed, which is icky. Socialism is founded on hugs and unicorn farts, which is pretty and nice and you'd have to be a terrible person (as I've been told an uncounted number of times) to oppose. It's possible to fight against this effect a little bit by screaming "COMMUNISM!", but (a) it's distasteful, (b) it's not really true until the very end, (c) it's subject to diminishing effects, and (d) did I mention it's distasteful?

A good example of this, and third, is how "a little socialism" has changed over time. Social Security was controversial when it was introduced; it's not now. All the stuff you're suggesting would have been seen as borderline Communist 60 years ago. It's not borderline Communism, but it was controversial even among Democrats back then. 60 years from now, where will the line for "just a little more socialism" be?

Barack Obama and the Democratic majority won the largest victory they've had in decades and they did it while running on a platform of which health care reform was a major plank. People have been clamoring for changes in the current system.
Yes, of course. People also want changes in university tuition, used car salesmen, supermarkets, fast food, air travel, home equity lending, and a whole bunch of other industries. I'm hardly surprised that healthcare was an industry that Democrats targeted for "improvement." I just don't expect them to stop there.

[Ink Asylum]

And, uh, yeah. I think capitalism is, with very rare exception, a much more economically successful system than socialism. If that's enough to make me into Glenn Beck in your eyes, I'm guilty as charged.

Economically successful more often, perhaps, but a system which ran on 100% Capitalism unbridled by regulation or socialist programs would greatly centralize wealth in hands of the few and everyone else would be much worse off. What I, other Democrats, and other forum posters have been arguing isn't that we need all Socialism, or even more Socialism than Capitalism, but a mix of the two. You and I differ a bit one what the exact percentage of that mix is, but I think neither of us wants an absolute system in either direction.

The "forces of truth and justice" was an attempt to inject a little bit of levity in an otherwise increasingly heavy conversation, but obviously it fell flat. Sorry. Although it seems you'd agree that a wave of socialism would only be propelled by "an unholy alliance of unhinged zealots and a populace that temporarily forgets that the unhinged zealots are unhinged." Weren't you saying a minute ago that the people opposed to capitalism were an incredibly tiny minority that have no power? What exactly are you objecting to, the notion that this "incredibly tiny minority" are "zealots" or that they're "unhinged"?

I object to the notion that, even with a temporarily panicked population turned off of Capitalism, that the zealots will have any real influence over policy. If it didn't happen in 2009, when the panic over the 2008 crash was at its highest and the Democrats were at the height of their political power it's not going to happen anytime soon.

First, without meaning any insult, I have incomplete confidence in your anecdotal impressions. Second, again without meaning any insult, I'm not sure where "some Socialism" ends. "A little more Socialism" repeated a whole bunch of times really adds up after a while. Part of the problem here is the fundamental emotional appeal of a little more socialism: capitalism is founded on greed, which is icky. Socialism is founded on hugs and unicorn farts, which is pretty and nice and you'd have to be a terrible person (as I've been told an uncounted number of times) to oppose. It's possible to fight against this effect a little bit by screaming "COMMUNISM!", but (a) it's distasteful, (b) it's not really true until the very end, (c) it's subject to diminishing effects, and (d) did I mention it's distasteful?

A good example of this, and third, is how "a little socialism" has changed over time. Social Security was controversial when it was introduced; it's not now. All the stuff you're suggesting would have been seen as borderline Communist 60 years ago. It's not borderline Communism, but it was controversial even among Democrats back then. 60 years from now, where will the line for "just a little more socialism" be?

I know when I drink coffee that I want a little sugar, so I add a little sugar. Maybe I still need a little more, so I add a little more. At some point, though, I stop adding sugar because the coffee tastes right. The guy to my right adds a bit less sugar than me before stopping, and the guy to his right even less. The guy to my left adds more, and so on.

Now if the counter has a hundred people at it maybe there's some crazy guy at the far left that's eating sugar out of the bowl with a spoon, and maybe there's some crazy guy on the right doing the same with raw coffee grounds, but the other ninety eight of us aren't going to end up doing either because we know about when to stop.

I guess I have enough faith in the American people that I think, while we might swing a bit too far in one direction or the other at times, that we're self-correcting and the risk that we're going to end up eating either a bowl of sugar or a bowl of coffee grounds is small. It's not nonexistent, but we can stay alert without going off the rails fearing the slippery slope.

Fearing a Health Care bill which relies so heavily on the private insurance industry because it's also a bit socialist and that might, emphasis on the might, lead to some uncertain socialist future in sixty to a hundred years is simply paranoid.

[Siraris]

I thought this would have happened sooner (http://abcnews.go.com/Blotter/health-care-bill-spurs-assassination-calls-twitter/story?id=10170233)

[Generation ABXY]

Wow, Twitter's a source of news now... this debate has reached its high point.

[Ox]

I guess I have enough faith in the American people that I think, while we might swing a bit too far in one direction or the other at times, that we're self-correcting and the risk that we're going to end up eating either a bowl of sugar or a bowl of coffee grounds is small. It's not nonexistent, but we can stay alert without going off the rails fearing the slippery slope.

Fearing a Health Care bill which relies so heavily on the private insurance industry because it's also a bit socialist and that might, emphasis on the might, lead to some uncertain socialist future in sixty to a hundred years is simply paranoid.
Yours is a good example, and in general your point is very well taken. I've often argued against slippery slope arguments myself.

However, it's worth pointing out that we're already the guy eating raw coffee grounds: America is vastly more capitalistic, and vastly less socialistic, than most of our perceived peer countries. There's already a powerful force pushing us toward relatively extreme socialism: the fact that Americans are constantly hectored by sneering socialists with sophisticated cigarettes* and sexy accents.

Now, I agree that even this, standing alone, wouldn't really be enough to warrant significant concern about the bill. But let's consider a couple of points.

1. This bill will not actually fix American healthcare. This is just about the only point on which everyone on all sides can agree. No matter whether your criticism comes from the right or the left, everyone -- with the possible exception of the President -- agrees that medical costs will continue to rise unsustainably (if possibly slightly slower than before), many Americans will still tragically go without adequate healthcare, and the government will have to spend an awful lot of money.

2. Naturally from the above point, there will very soon be debates over how to reform American healthcare again. A search for "only the beginning healthcare march 22 2010" turns up over three million hits, which is pretty good for a single day.

3. The current bill will be the uber-capitalist status quo, and the debate will focus upon whether to add more socialism to it. Opinions on the chance of repeal tend to range from "maybe in a perfect world, but not this one" to "pull the other one."

In light of this, I'm nervous -- nervous, mind you, not stockpiling weapons, but nervous -- about a slippery slope.

* I was told recently that Gauloises had been discontinued, an announcement that prompted me to shriek that the French had finally gone too far. A quick google suggests my source was mistaken, however.

[Ink Asylum]

However, it's worth pointing out that we're already the guy eating raw coffee grounds: America is vastly more capitalistic, and vastly less socialistic, than most of our perceived peer countries. There's already a powerful force pushing us toward relatively extreme socialism: the fact that Americans are constantly hectored by sneering socialists with sophisticated cigarettes* and sexy accents.

Absolutely not. The coffee grounds are pure capitalism providing all needs and no functional government, just as the bowl of sugar is pure socialist government control over the economy and methods of production. We may drink our coffee black with one sugar while the French have a cafe mocha frappucino and the British drink flavored tea, but when we spend hundreds of billions of dollars on Social Security and Medicare, have lots of regulations over corporations, provide socialized roads, police, fire department, education, food stamps, unemployment insurance, Medicaid, disaster response, etc, we're plenty socialist already.

Just because, compared to other rich industrialized first world nations we're one of the most capitalist doesn't mean we're nearly as capitalist as we could be. America 1900 was way more capitalist than we are today, and even then we weren't as capitalist as we could've been.

3. The current bill will be the uber-capitalist status quo, and the debate will focus upon whether to add more socialism to it. Opinions on the chance of repeal tend to range from "maybe in a perfect world, but not this one" to "pull the other one."

If you're googling, why don't you google "repeal the bill"? That's what the Republicans will be running on in 2010 and, if they make some gains this year, in 2012 and beyond. The bill that just passed is not going to be one side of the debate with more socialism on the other. It'll be repeal the bill vs expand on it.

[J Arcane]

America 1900 was way more capitalist than we are today, and even then we weren't as capitalist as we could've been.

Indeed. The US has tried pure capitalism many times, on both large and small scales. They haven't been particularly successful with it.

Those who forget history are doomed to repeat it, and we keep forgetting it over and over again.

[Ox]

Just because, compared to other rich industrialized first world nations we're one of the most capitalist doesn't mean we're nearly as capitalist as we could be. America 1900 was way more capitalist than we are today, and even then we weren't as capitalist as we could've been.
Agreed. I should have said we were the most extreme currently extant capitalist country, not the most extremely capitalist country that ever existed or that could be imagined.

If you're googling, why don't you google "repeal the bill"?
How successful do you think that slogan will be? Not in terms of getting Republicans elected, I mean how likely do you think it is that the major provisions of this bill will actually be repealed? I'm having trouble thinking of a middle-class entitlement that has been repealed in modern history.

Indeed. The US has tried pure capitalism many times, on both large and small scales.
Didn't you just quote Ink saying that the US could've been more capitalist than it was? Doesn't that suggest we weren't, in fact, "pure capitalism"? Or would that be some sort of extra-virgin cold-press capitalism?

[Ink Asylum]

Agreed. I should have said we were the most extreme currently extant capitalist country, not the most extremely capitalist country that ever existed or that could be imagined.

Also limiting the field of contenders to first world nations. There are more capitalist countries out there, but they tend to be places most of us wouldn't want to live.

I'm not saying that if we become slightly more capitalist that we'll inevitably slide down into too much capitalism and lose our first world nation status, just that there are countries that exist right now which are more capitalist and have less socialist policies and programs than we do. Just as there are existing countries that are more socialist than the most socialist first world nations.

As always, the best balance is somewhere in the middle. We're probably right of middle at the moment, other countries are left of middle. I believe that we can shift a little closer to the middle of the capitalist/socialist balance without having to fear that we'll shoot through the middle and into collapse on the far, far opposite end of the spectrum.

How successful do you think that slogan will be? Not in terms of getting Republicans elected, I mean how likely do you think it is that the major provisions of this bill will actually be repealed? I'm having trouble thinking of a middle-class entitlement that has been repealed in modern history.

If it doesn't work as advertised I definitely could see some parts of it being repealed. The individual mandate for starters, and a lot of heavy cutbacks could happen to the subsidies and the taxes that help pay for them. Especially if the economy doesn't recover soon and Republicans can sweep back into power by saying that the Democrat solutions failed.

It probably won't be repealed completely, but the bill in its current state definitely won't be the absolute wall on one side of the debate that you say it will be.

[txshurricane]

We live in America. You'd think it would be better than that. 60-something percent of all bankruptcies are a cause of medical bills. You don't see something wrong with that? We're ruined not because we got sick, but because we can't afford to pay for it.

And going outside the country to get treated because it may be cheaper speaks volumes about the broken system we currently have.
I don't think you understand how our current health care system works. If you go to the hospital, your health care bill is higher because you are paying for people who don't have health insurance. This is not something that the Democrats did, this is how the system worked, and one of the reasons it was broken. This new plan makes people take responsibility for themselves, and forces them to buy insurance so that the rest of us don't have to foot the bill.
You guys make all good points, but why is everyone ignoring that fact that our so-called broken system is perfectly fine for the illegal aliens that flood it daily? Forcing someone by law to purchase insurance - and skirting the immigration issues that are deeply inherent to the system now - is just adding more injustice on top of what was already there.

None of this is hyperbolic or hypothetical. This is my daily life. This bill will help a bit. Without a doubt were it not for the ability to get coverage for my family we'd be well and truly fucked.
I believe you are an exception, and one that we should all pay close attention to. But while I'm glad this bill will help your family, were I you I would not want to carry the burden of taxpayer dollars. I'm sorry - I'd rather beg, borrow, or go bankrupt.

I'm not saying you should feel the same way (obviously, you don't). My scruples would get the best of me.txshurricane, come on Katrina is an entirely different ballpark. We live in Houston now, but mother lost everything to Camille and Betsy. There wasn't anything that said THIS would be the time the Levees broke when they withstood the worst at least twice before. And not everyone could get out, whether financially or because of transportation, like my Uncle. Katrina was a freaking nightmare, do not take it lightly as a talking point.
I was displaced by Rita and nearly lost my home in Ike. I did contract work for FEMA helping Katrina victims try to rebuild their lives. I don't take it lightly. But it was the lamp in a dark room - it uncovered government contract corruption, FEMA ineffectiveness, and a LOT of human laziness. I remember reading the stories and watching the interviews of people who lived in government housing projects with no jobs, and they were scolding the president for not getting them their relief ATM cards fast enough. Ugh.

[Ink Asylum]

Nate Silver weighs in on the issue of the HCR bill passing despite recent polls showing it's unpopular. (http://www.fivethirtyeight.com/2010/03/fourth-branch.html) He makes fourteen points. Here are a few:

3. That polls show the overall concepts of reforming the healthcare system and providing for universal coverage were popular at the start of the process and remain reasonably popular now.

4. That polls show that the specific details of the Democratic plan are (mostly) popular, and that when a neutral and accurate description of the contents of the bills are read to the respondent, support usually increases to plurality or majority levels.

5. That substantial elements of the public lack basic knowledge about verifiable facts of the bill, sometimes because of deliberate misrepresentations on the part of the bill's opponents.

7. That a tangible percentage of those who register as opposed to the bill oppose it from the left -- probably enough to form a majority with those who support it -- and may nevertheless prefer it to the status quo (the more explicitly a poll compares the current proposals with the status quo -- see Question 25 here -- the more favorable the results tend to be).

14. That were the Congress closer to a direct democracy -- such as by having proportional representation of Senators, non-gerrymandered congressional districts, and a norm for majority-rules procedures in the Senate -- health care reform would have been signed into law months ago and would likely be substantially more liberal and sweeping than the reforms that have in fact been enacted.

[Siraris]

You guys make all good points, but why is everyone ignoring that fact that our so-called broken system is perfectly fine for the illegal aliens that flood it daily? Forcing someone by law to purchase insurance - and skirting the immigration issues that are deeply inherent to the system now - is just adding more injustice on top of what was already there.


I am a supporter of the President, and liberal in certain views, but I can not accept, or condone (and i have stronger words that I will not use here) illegal immigrants, and if the President allows these people to stay in the country legally, I will be VERY disappointed.

I don't want to go as far as to say we should turn away an illegal immigrant from being treated for a serious injury, but to be honest, I would say that unless they have been shot or stabbed, they should be turned away and deported back to their own country. And even if they have received a severe injury, they should be treated, and then deported. I'm sorry if this seems heartless, or crass, or even offensive, but no one should be rewarded for breaking the law. No one.

[National Kato]

You guys make all good points, but why is everyone ignoring that fact that our so-called broken system is perfectly fine for the illegal aliens that flood it daily? Forcing someone by law to purchase insurance - and skirting the immigration issues that are deeply inherent to the system now - is just adding more injustice on top of what was already there.

I agree. I think it's something Obama should begin to address once this major piece of legislation has passed into law. We are a country of immigrants...but the legal process is one that is important.

During Sunday's rally, Obama addressed the crowd via a taped message reaffirming his commitment to reform, but he didn't set a specific schedule.

[Shrinn]

Apparently, the bill is unconstitutional and 13 Attorney Generals are suing over it. (http://seattletimes.nwsource.com/html/nationworld/2011417340_apushealthoverhaullawsuit.html)

Any guesses as to the nature of their argument?

[Kelegacy]

Apparently, the bill is unconstitutional and 13 Attorney Generals are suing over it. (http://seattletimes.nwsource.com/html/nationworld/2011417340_apushealthoverhaullawsuit.html)

Any guesses as to the nature of their argument?

Hmm, interesting.

[National Kato]

Any guesses as to the nature of their argument?

It comes down to the mandate portion of the bill. It's going to be a dispute over the Tenth Amendment of the U.S. Constitution (http://en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_States_Constitution) (1) vs. the Supremacy Clause (http://en.wikipedia.org/wiki/Supremacy_Clause) (Article VI, clause 2) (2).

(1) providing that powers not granted to the national government nor prohibited to the states by the constitution of the United States are reserved to the states or the people

(2) The clause establishes the Constitution, Federal Statutes, and U.S. treaties as "the supreme law of the land."

[Kelegacy]

You mean the mandate about getting healthcare or pay a penalty?

[Siraris]

I'm curious how many states sued over the car insurance mandate?

[National Kato]

You mean the mandate about getting healthcare or pay a penalty?

Yes, that's the gist of it. I believe four state legislatures have already passed laws blocking the bill.

[LordDon]

I'm curious how many states sued over the car insurance mandate?

This... (10char)

[Generation ABXY]

I'm curious how many states sued over the car insurance mandate?

I would say the key difference is, driving is a privelege.

I also think they should take out the mandate, just as I did when the public option was on the table; if people want to cut out a third party - whether it's an insurance company or the government - and pay their doctor directly, I think they should be allowed (of course, they also assume certain risks by doing so).

[txshurricane]

I'm curious how many states sued over the car insurance mandate?
Only the ones where citizens need a car to stay alive. :)

[Shrinn]

I think the problem is that they assumed that people will forgo the insurance plan and survive on emergency care as opposed to paying their doctor cash directly if there wasn't a mandate.

[Kelegacy]

I'm curious how many states sued over the car insurance mandate?

That's what I was getting at. And look at Massachusetts. They have a health insurance mandate already in place. I believe it was a republican governor that helped institute it, or the very least was in office.

[Ink Asylum]

I also think they should take out the mandate, just as I did when the public option was on the table; if people want to cut out a third party - whether it's an insurance company or the government - and pay their doctor directly, I think they should be allowed (of course, they also assume certain risks by doing so).

Those risks include the chance that an uninsured person is going to need emergency medical care or some other service that they won't be able to afford, which means that the health care system has to absorb the cost, which ends up getting passed on to people who are paying for insurance. The "Free Rider" problem.

I don't necessarily agree that the problem is sufficient enough to justify the individual mandate as it is, the numbers are too complex for me to either completely believe or disbelieve either side, but I understand the argument behind it, even if the math is debateable.

[Siraris]

I think the problem is that they assumed that people will forgo the insurance plan and survive on emergency care as opposed to paying their doctor cash directly if there wasn't a mandate.

Absolutely. You can totally continue to abuse the system by just continuing to go to the emergency room without insurance.

[txshurricane]

Absolutely. You can totally continue to abuse the system by just continuing to go to the emergency room without insurance.
Which is why I mentioned illegal immigrants. This bill does nothing about the VAST majority of emergency room abusers. And the relatively small number of citizen abusers that will now have mandatory insurance will be insured by the worst-paying entity in healthcare history: the U.S. government.

Speaking of which, many hospitals and pharmacies are rejecting all new Medicaid and Medicare patients because of non-payment. Hmm...guess that still doesn't solve the ER abuse problem...

[Slack3r78]

Which is why I mentioned illegal immigrants. This bill does nothing about the VAST majority of emergency room abusers. And the relatively small number of citizen abusers that will now have mandatory insurance will be insured by the worst-paying entity in healthcare history: the U.S. government.
So what's your solution? Allow illegals to bleed out in the emergency room waiting room? Because I have a hard time pin pointing anything else that would prevent this.

Because, again, there was a huge stink made by the GOP about making sure that illegals wouldn't be covered under any new plan, and the direct, end result of that is that they continue to freeload off emergency services.

[J Arcane]

The solution to illegal immigrant is not to treat them like criminals and escaped slaves, it's to not make them illegal in the first fucking place.

This country was founded on immigration, but the way we have treated immigrants in the last couple of decades, and the road blocks we have introduced into the immigration policies, are ridiculous.

The immigration bill was one of the only things I agreed with Dubya on. The amnesty thing was a good idea. Lets get these people into the system, and then they'll get the rights they deserve, and we avoid problems like this that arise from their non-person status.

[txshurricane]

So what's your solution? Allow illegals to bleed out in the emergency room waiting room? Because I have a hard time pin pointing anything else that would prevent this.

Because, again, there was a huge stink made by the GOP about making sure that illegals wouldn't be covered under any new plan, and the direct, end result of that is that they continue to freeload off emergency services.
I don't have a legislative solution, but from the viewpoint of someone who works with border agents on a weekly basis I'd have to apply Ted Nugent's one-liner when asked the same question: "Let 'em do their jobs!"

I'm all for any human being getting emergency care if needed. I'm completely against letting them leave the hospital without getting arrested and deported. And if they were in the hospital to being with, they should have had to evade the strongest nation's strongest border guards to do so.

The solution to illegal immigrant is not to treat them like criminals and escaped slaves, it's to not make them illegal in the first fucking place.

This country was founded on immigration, but the way we have treated immigrants in the last couple of decades, and the road blocks we have introduced into the immigration policies, are ridiculous.

The immigration bill was one of the only things I agreed with Dubya on. The amnesty thing was a good idea. Lets get these people into the system, and then they'll get the rights they deserve, and we avoid problems like this that arise from their non-person status.
Apparently you've not been properly introduced to a latino ghetto. Those sweet-mannered little downtrodden immigrants more often than not live like animals. They increase crime, they deface property, they break the law every day that they are here without proper documentation.

It's funny how you rarely see Burmese and Libyan ship's crewmen hopping the dock to live in the States. It's the lazy bastards who don't have the constitution to migrate legally, and care nothing about the children they endanger when they cross the border.

[Kelegacy]

I have trouble believing the vast majority of insurance-less people that go to the emergency room are illegal immigrants. Maybe in some areas, but the majority of the country? Maybe I'm just naive, living here in Maine where the only border jumpers would be Canadians, and they've already got better healthcare than we.

[Ink Asylum]

And the relatively small number of citizen abusers that will now have mandatory insurance will be insured by the worst-paying entity in healthcare history: the U.S. government.

No, the people who will be required to buy mandatory insurance will be insured by private insurers.

[Siraris]

Which is why I mentioned illegal immigrants. This bill does nothing about the VAST majority of emergency room abusers. And the relatively small number of citizen abusers that will now have mandatory insurance will be insured by the worst-paying entity in healthcare history: the U.S. government.

Speaking of which, many hospitals and pharmacies are rejecting all new Medicaid and Medicare patients because of non-payment. Hmm...guess that still doesn't solve the ER abuse problem...

This is factually untrue, there is no public option in the bill, so no, the federal government will not insure anyone with this bill.

[txshurricane]

I have trouble believing the vast majority of insurance-less people that go to the emergency room are illegal immigrants. Maybe in some areas, but the majority of the country? Maybe I'm just naive, living here in Maine where the only border jumpers would be Canadians, and they've already got better healthcare than we.
I don't have a source for that sentiment, just personal experience.

[TheFlyingOrc]

I have trouble believing the vast majority of insurance-less people that go to the emergency room are illegal immigrants. Maybe in some areas, but the majority of the country? Maybe I'm just naive, living here in Maine where the only border jumpers would be Canadians, and they've already got better healthcare than we.

I don't know if it's a majority or a "vast majority". Every one I've ever been to had a significantly higher hispanic population than anything else, and, while there are many hispanics in the US, the only reason so many would be in the emergency room would be illegality.

[J Arcane]

I don't know if it's a majority or a "vast majority". Every one I've ever been to had a significantly higher hispanic population than anything else, and, while there are many hispanics in the US, the only reason so many would be in the emergency room would be illegality.

Please tell me that was sarcasm.

[Vigil80]

I have trouble believing the vast majority of insurance-less people that go to the emergency room are illegal immigrants. Maybe in some areas, but the majority of the country? Maybe I'm just naive, living here in Maine where the only border jumpers would be Canadians, and they've already got better healthcare than we.
That's just a case of the ol' greener grass syndrome. You might be surprised at the number of Canadians, Europeans, and so on who believe there's better health care to be found in the US.

Really it's just a matter of making accurate complaints, tearing down the right institutions. The fact is that there is no better health care than can be found in the US. The rub is the amount of money it takes to get access to the best of it.

[Ink Asylum]

I don't know if it's a majority or a "vast majority". Every one I've ever been to had a significantly higher hispanic population than anything else, and, while there are many hispanics in the US, the only reason so many would be in the emergency room would be illegality.

Because only illegals can't afford insurance? That's really your belief, Orc?

[txshurricane]

Because only illegals can't afford insurance? That's really your belief, Orc?
Is that what you got out of it? I read that as most illegal aliens that he's witnessed in the ER can't afford health insurance, not the only people who can't afford insurance are illegal aliens.

[Vigil80]

Shouldn't that be "no illegal aliens can get health insurance?" I haven't bought much insurance myself, but doesn't purchase require various forms of ID?

[Siraris]

That's just a case of the ol' greener grass syndrome. You might be surprised at the number of Canadians, Europeans, and so on who believe there's better health care to be found in the US.

Really it's just a matter of making accurate complaints, tearing down the right institutions. The fact is that there is no better health care than can be found in the US. The rub is the amount of money it takes to get access to the best of it.

This is an utterly unfounded perception, and factually untrue if you examine the numbers. The US does not have the best health care in the world, not even close. We rank high in certain areas, such as cancer treatment, but fall short in many many other areas. The technological advancements we have made have not translated to better results. France has the best health care system in the world, by the numbers, and in many ways, so does Singapore.

You can check out this article (http://www.satvathealthcare.com/uploads/2/6/3/3/2633830/rodwin2003amjourpubhealth.pdf) if you're interested in reading a bit.

[txshurricane]

Shouldn't that be "no illegal aliens can get health insurance?" I haven't bought much insurance myself, but doesn't purchase require various forms of ID?
Two words: anchor babies.

[TheFlyingOrc]

Because only illegals can't afford insurance? That's really your belief, Orc?

No, but if it were only based around poverty you would expect to see similar numbers of Hispanics and African Americans in the emergency room. I'm not saying that illegality is the only reason that anyone is there, but that it probably accounts for a large amount of the disparity.

[Scull]

I believe you are an exception, and one that we should all pay close attention to. But while I'm glad this bill will help your family, were I you I would not want to carry the burden of taxpayer dollars. I'm sorry - I'd rather beg, borrow, or go bankrupt.

You missed it. I have begged, I have borrowed, and I'm about to go bankrupt. And I'm nowhere near the end of this. What are the next steps to take? After I lose my house and move my family in with my parents, then what? Only because I have health insurance have I struggled to this point. This bill will allow me to cover my son again, which will be a great relief, but still, I doubt that I will be able to cover all the non-covered expenses. It's simply the way of things.

[Slack3r78]

You missed it. I have begged, I have borrowed, and I'm about to go bankrupt. And I'm nowhere near the end of this. What are the next steps to take? After I lose my house and move my family in with my parents, then what? Only because I have health insurance have I struggled to this point. This bill will allow me to cover my son again, which will be a great relief, but still, I doubt that I will be able to cover all the non-covered expenses. It's simply the way of things.

It's really unfortunate that people tend not to realize how common situations like yours are until they end up in them themselves.

[Ink Asylum]

No, but if it were only based around poverty you would expect to see similar numbers of Hispanics and African Americans in the emergency room. I'm not saying that illegality is the only reason that anyone is there, but that it probably accounts for a large amount of the disparity.

Demographics would be another factor. Different parts of the country have much higher percentages of hispanics then they do blacks.

Cultural differences as well. Hispanics tend to have larger families, making health insurance more expensive.

Different budget priorities. Hispanics, many of which are legal immigrants yet still have families in their home countries, may value sending money they earn to them instead of buying their own insurance, similar to how younger people have different budget priorities and often rank health insurance pretty low.

While I don't doubt that illegal aliens use emergency rooms it's a huge leap of logic to take your anecdotal emergency room experience and believe that the "only reason" you see more Hispanics is illegality. If you have stats, feel free to post them, though.

[txshurricane]

You missed it. I have begged, I have borrowed, and I'm about to go bankrupt. And I'm nowhere near the end of this. What are the next steps to take? After I lose my house and move my family in with my parents, then what? Only because I have health insurance have I struggled to this point. This bill will allow me to cover my son again, which will be a great relief, but still, I doubt that I will be able to cover all the non-covered expenses. It's simply the way of things.
I am glad for you that this bill improves your situation. I believe what you're saying, which is why I called you an exception. Because I think that you're case is very, very limited and there should be a better recourse than to depend on the government to squeeze the money that you need out of taxpayers.

Face it: the government did nothing this weekend to make healthcare more accessible - they made insurance more accessible. If anyone thinks that medical facilities charge too much now, wait until mandatory insurance goes into effect. And if you're required by law to have insurance, what's to make the insurance costs competitive? Just look at auto insurance and home insurance - neither are a legal requirement, but in both cases many people are cornered into needing them, and as a result the customer gets reamed.

So, yes, it will be considerably easier to get a policy for your family. But after treatment, you will be required to keep some kind of policy, no matter the cost. It may well be just a matter of going bankrupt during the treatments, or after.

[Vigil80]

This is an utterly unfounded perception, and factually untrue if you examine the numbers. The US does not have the best health care in the world, not even close.
Well, I examined the numbers you provided, and found little to nothing that refutes my statement. As a matter of fact, I saw that of the numbers that were even available in the report for the US - a few of the most important figures, in my opinion, were N/A - some of them seemed rather favorable, such as the US having vastly more specialist and non-physician personnel.

Based on the study - which is approaching a decade old, by the way - the systems seem comparable.
Despite the achievement of universal coverage under NHI, there are still striking disparities in the geographic distribution of health resources and inequalities of health outcomes by social class.

There is one problem that I've been concerned would arise from US reform, and France would appear to be an example. Disgruntled docs. Don't know about you, but the idea of my physician going on strike makes me a bit itchy.
Although the level of health services use is high in France, prices per service unit are exceedingly low by US standards, and this has led to increasing tensions (physicians’ strikes and demonstrations) between physician associations and their negotiating partners—the NHI funds and the state.

Are you sure you linked me to the right report? Nevermind one other clear advantage of US care over France: not having to deal with smelly Frenchmen. But thanks, you turned my "unfounded" perception into a founded one.

Don't feel badly, I'm yanking your chain a bit. I would have rejected most of the report anyway, as most pure numbers reports fall terribly short, especially when comparing the vastly different populations of two countries. An accurate study really needs a control group, of which there can be none in such a report. Apples and oranges, almost. Something which even this report author realized, I believe.
Perceptions of health systems abroad can become caricatures of what we wish to promote or avoid at home. It is thus a risky venture to derive lessons from the French experience for health care reform in the United States.

[J Arcane]

In my area, I pretty much see nothing but white people in my emergency rooms.

Does that mean anything?

Not a bloody thing at all.

[Ink Asylum]

Clearly all those white people are illegal immigrants. There's no other explanation. I bet they don't even speak American, but some weird dialect with too many U's and their E's and R's reversed.

[Slack3r78]

I don't have a legislative solution, but from the viewpoint of someone who works with border agents on a weekly basis I'd have to apply Ted Nugent's one-liner when asked the same question: "Let 'em do their jobs!"

I'm all for any human being getting emergency care if needed. I'm completely against letting them leave the hospital without getting arrested and deported. And if they were in the hospital to being with, they should have had to evade the strongest nation's strongest border guards to do so.

What's your proposed mechanism for proving citizenship during hospital stay, housing and detaining those who are deemed to be there illegally, and then transferring them from the hospital to federal custody without further adding to the chaos of the ER? How do you prevent the use of fake IDs and stolen social security numbers from bypassing the whole thing? This is how many illegals manage to get hired in the US, after all.

It's real easy to say "somebody ought to do something" without stopping to think through real solutions.

[Vigil80]

In my area, I pretty much see nothing but white people in my emergency rooms.

Does that mean anything?

Not a bloody thing at all.
Could mean a lot, actually. Might depend on your area. And how much time do you spend in ERs?

Oh sorry, am I zing-blocking? Pardon me.

[TheFlyingOrc]

It's really unfortunate that people tend not to realize how common situations like yours are until they end up in them themselves.

Well, as always, government is a balancing act between stopping bad things from happening to people and making sure that stopping those bad things doesn't blow up something else important - obviously, if we cover these people, but the whole medical industry eventually collapsed because of it (not saying it will! This is an extreme example purely to illustrate my point!), obviously we shouldn't do it, no matter how terrible some people's situations are.

That's one of the areas I get most frustrated talking with people of leftist sensibilities: the fact that bad things happen to people is not enough of a reason to do something without a thorough assessment of its effects. Many may feel that this was done for the bill - I'm not convinced. At the very least, this bill was more about partisan politics than reform. The republicans smelled blood in the water, and the democrats, I feel, primarily passed the bill to seem stronger in November (Obama needed to succeed at something). They also opened a giant can of worms with this reconciliation stuff, and it's going to come back to bite them if the GOP ever controls congress again.

[txshurricane]

In my area, I pretty much see nothing but white people in my emergency rooms.

Does that mean anything?

Not a bloody thing at all.
It could mean several things. It could mean that the hospital you visit turns away patients that don't pay. It could mean that you don't have an infestation of illegal aliens in your area. It could mean that you visited the hospital on Cinco de Mayo (my wife will attest that the number of latinos in the hospital mysteriously diminishes when there's something more interesting to do).

What's your proposed mechanism for proving citizenship during hospital stay, housing and detaining those who are deemed to be there illegally, and then transferring them from the hospital to federal custody without further adding to the chaos of the ER? How do you prevent the use of fake IDs and stolen social security numbers from bypassing the whole thing? This is how many illegals manage to get hired in the US, after all.
Actually, many illegals manage to get hired because business owners break the law to do so...not to mention that there is a HUGE overlook among federal agents and police forces, thanks to that horse crap known as political correctness.

My method? Do the same thing that the Shell refinery does: pay a subscription service to have an ID reader on the spot. Easy, fast, legal.

It's real easy to say "somebody ought to do something" without stopping to think through real solutions.
Funny, that's exactly what I think about the healthcare bill!

[Slack3r78]

Face it: the government did nothing this weekend to make healthcare more accessible - they made insurance more accessible. If anyone thinks that medical facilities charge too much now, wait until mandatory insurance goes into effect. And if you're required by law to have insurance, what's to make the insurance costs competitive?
If the mandate were the only thing in the bill, you'd be correct.

It's not, however.

[Slack3r78]

It could mean that the hospital you visit turns away patients that don't pay.
That one's outright illegal so you can cross it off the list.

[Vigil80]

That one's outright illegal so you can cross it off the list.
Hospitals are required to stabilize patients, but that's about it as far as I know. Don't know how closely some hospitals walk that line.

[TheFlyingOrc]

Demographics would be another factor. Different parts of the country have much higher percentages of hispanics then they do blacks.


Believe it or not, I've seen it in North Carolina AND NYC. (my brother got sick on a trip) ;)

edit: And NC has 4 times as many African Americans as Hispanics (well, in 2005). Guess again.



Cultural differences as well. Hispanics tend to have larger families, making health insurance more expensive.

Different budget priorities. Hispanics, many of which are legal immigrants yet still have families in their home countries, may value sending money they earn to them instead of buying their own insurance, similar to how younger people have different budget priorities and often rank health insurance pretty low.

While I don't doubt that illegal aliens use emergency rooms it's a huge leap of logic to take your anecdotal emergency room experience and believe that the "only reason" you see more Hispanics is illegality. If you have stats, feel free to post them, though.

Dude, I get it. If I suspect illegal immigrants might cause any effect on anything, I'm a racist. I forgot to take the fact that I'm a racist into account, and I'll try to make sure to remember that I'm a racist in the future, who is racist.

Seriously, man, you can disagree, but it's not like I put a lot of careful thought into my original speculation, and this dogpiling you're giving me isn't appreciated. I don't hate illegals, I pretty much don't care about them, and the level of vitriol I feel like you're assigning to me is just uncalled for.

[TheFlyingOrc]

It could mean that you don't have an infestation of illegal aliens in your area.


Infestation? That's completely hateful and uncalled for. You're one more of these from my ignore list. (and there's nobody on my ignore list)

[Vigil80]

Infestation? That's completely hateful and uncalled for. You're one more of these from my ignore list. (and there's nobody on my ignore list)
It's just a word, albeit not a PC one. Relax. No reason to start doing the very thing you were just complaining about.

[txshurricane]

That one's outright illegal so you can cross it off the list.
Nope. Where I live, if the federal government does not supply a certain amount of funding directly to a privately owned facility, that facility can turn away patients. Among the staff it's known as a "drive by", and my wife sees it a lot. That's why when illegal aliens get into a traffic wreck on north 59, they have to take a 30-minute ride to Ben Taub hospital in the southeast area...despite having two top-notch private emergency rooms on 59 north.

Infestation? That's completely hateful and uncalled for. You're one more of these from my ignore list. (and there's nobody on my ignore list)
How is that hateful? I think it applies:
in·fest (n-fst)
tr.v. in·fest·ed, in·fest·ing, in·fests
1. To inhabit or overrun in numbers or quantities large enough to be harmful, threatening, or obnoxious

[J Arcane]

It could mean several things. It could mean that the hospital you visit turns away patients that don't pay.

Nope. I didn't have insurance or any money either.

It could mean that you don't have an infestation of illegal aliens in your area.

Nope. Madras, one of the 4 key cities in this area, is almost entirely dominated by Hispanics, many of them illegal, and the rest of the area has quite a generous percentage as well. Indeed, my neighborhood where I live now is majority Hispanic.

It could mean that you visited the hospital on Cinco de Mayo (my wife will attest that the number of latinos in the hospital mysteriously diminishes when there's something more interesting to do).

It was in the middle of summer.

Anecdotal evidence isn't, and neither is conjecture.

[Slack3r78]

Actually, many illegals manage to get hired because business owners break the law to do so...not to mention that there is a HUGE overlook among federal agents and police forces, thanks to that horse crap known as political correctness.

So the $9 Billion+ per year the federal government receives in social security revenue from illegals isn't real?

http://www.usatoday.com/money/perfi/taxes/2008-04-10-immigrantstaxes_N.htm

[QUOTE=txshurricane;519774]My method? Do the same thing that the Shell refinery does: pay a subscription service to have an ID reader on the spot. Easy, fast, legal.

Who pays for it? I'm seeing you propose all sorts of hugely expensive enforcement mechanisms, but where's your cost-benefit of the whole thing?


Funny, that's exactly what I think about the healthcare bill!

Except the healthcare bill actually puts a real, tangible plan in place. That's more than I can say about your repeated complaining about this bill and illegals.

[Ink Asylum]

Perhaps you shouldn't use extremely anecdotal and limited experience to make sweeping generalizations about an entire race of people if you don't want to be dogpiled for it, then.

[Vigil80]

Anecdotal evidence isn't, and neither is conjecture.
Perhaps you would care to examine your own statement with that scope?

Perhaps you shouldn't use extremely anecdotal and limited experience to make sweeping generalizations about an entire race of people if you don't want to be dogpiled for it, then.
Unless we're calling "illegal immigrants" a race, I think you're being overly sensitive.

[txshurricane]

So the $9 Billion+ per year the federal government receives in social security revenue from illegals isn't real?

http://www.usatoday.com/money/perfi/taxes/2008-04-10-immigrantstaxes_N.htm
The source for that article is a third-party unnamed "expert". It also states that the actual number is not tallied by the government.

I'm sorry, but when the IRS sends three agents to track down 20 cents in unpaid taxes (http://www.sacbee.com/2010/03/13/2604902/irs-agents-storm-sacramento-car.html), I have my doubts that it collects revenue from illegal aliens and does not account for it in public record.

Perhaps you shouldn't use extremely anecdotal and limited experience to make sweeping generalizations about an entire race of people if you don't want to be dogpiled for it, then.
I'm not being racist. I visited Mexico and loved it. The people are wonderful.
I'm talking about the law-breakers who de-civilize many aspects of the culture we've spent many years building.

Edit: responded to a comment not made to me, I think. Nonetheless.

[Ink Asylum]

Unless we're calling "illegal immigrants" a race, I think you're being overly sensitive.

No, he said that he saw a lot of "hispanics" in emergency rooms and therefore determined that the only reason they'd be there is because they're illegal, without any evidence.

[J Arcane]

Perhaps you would care to examine your own statement with that scope?

It was the whole bloody point of my statement. As I said: "My emergency rooms are full of white people. Does that mean anything? Not a bloody thing."

Such a statement is indeed, no more useful than the Orc's generalization. The difference is I stated as such.

[txshurricane]

No, he said that he saw a lot of "hispanics" in emergency rooms and therefore determined that the only reason they'd be there is because they're illegal, without any evidence.
Oh, crap. I think Vigil and I assumed you were addressing me.

[TheFlyingOrc]

Perhaps you shouldn't use extremely anecdotal and limited experience to make sweeping generalizations about an entire race of people if you don't want to be dogpiled for it, then.

Listen, this is getting ridiculous. I should have worded the phrase "the only reason that comes to mind" instead of "the only reason". Argue in good faith, not as Ink Asylum, finder of racists. I think you made several good points that I'm considering and probably accepting, but your plum post was insulting, inappropriate, and, good sir, please kindly shut up.

edit: Seriously I'm not even concerned about illegal immigration I don't care what the government does about it, even going with that I'm making a sweeping generalization tell me what exactly about doing so is morally repugnant to you. At worst I'm simply jumping to conclusions too fast.

[Ink Asylum]

Listen, this is getting ridiculous. I should have worded the phrase "the only reason that comes to mind" instead of "the only reason". Argue in good faith, not as Ink Asylum, finder of racists. I think you made several good points that I'm considering and probably accepting, but your plum post was insulting, inappropriate, and, good sir, please kindly shut up.

Fair enough, I retract the post you quoted and apologize if I went too far. I just believe people should be much more careful with using anecdotal evidence to imply conclusions about much larger groups of people. It rarely helps the debate and often harms it, as it devolves into one side defending the group while unable to disprove that you saw what you saw. Passions are bound to flare up.

[Vigil80]

Whew, glad that's over.

I see what you were saying, Ink. I think we can just call it a case of sub-prime word choice.

I see the point you were trying to make too, J. I would still have question, but the thoughts are complete by now.

[National Kato]

They also opened a giant can of worms with this reconciliation stuff, and it's going to come back to bite them if the GOP ever controls congress again.

I'm pretty sure most Democrats are well aware of the majority of times reconciliation has been used in the past for major legislation (http://voices.washingtonpost.com/ezra-klein/2010/02/the_recent_history_of_reconcil.html) (COBRA, Medicaid, CHIP, EMTALA, etc). They also likely know that Republicans have used it more than Democrats (http://www.themonkeycage.org/2010/02/which_party_uses_reconciliatio.html) between FY1981-FY2005.

It's not like the Dems have all of a sudden crossed some crazy line from which there is no return. You're just hearing the GOP threaten and complain because someone decided to play by their rules, which Republicans hate.

[TheFlyingOrc]

Fair enough, I retract the post you quoted and apologize if I went too far. I just believe people should be much more careful with using anecdotal evidence to imply conclusions about much larger groups of people. It rarely helps the debate and often harms it, as it devolves into one side defending the group while unable to disprove that you saw what you saw. Passions are bound to flare up.

That's cool. Correct me if I'm just completely off base - I encourage it, actually.

Oh, and for the record, my best friend is Cuban, so it is LITERALLY IMPOSSIBLE for me to be racist against him or other Mexicans like him.

[Draconis]

Whether or not this turns to ash in certain peoples mouths, this was needed and LONG overdue.

Its not everything we wanted, but at least its a good foot forward in the right direction. Thank God its passed. No more rescission, no more BS where the insurance company can basically pull the trigger on your life because they want to kill the care YOU paid for as an individual.

All I have to say is this, Thank God my mother is a vet when she went through her Breast Cancer ordeal. If she were not, she'd likely be broke and dead right now.


My own recent medical ordeals, at the age of 32, have brought to light with me how frigging broken our system is. I HAVE medical insurance, HAVE IT....and I'm STILL paying through the damned nose on medical bills, well over 5,000 dollars thus far, and that's WITH my insurance deducting the costs. That amount accrued is only 2 months of care. Thats it, in two months I've had to pay that much money even though I have health insurance.



Anyone who sits there and doesn't support the welfare of their fellow man and beholdens themselves to the almighty dollar just sickens me to my stomach. Everyone has a right to live. EVERYONE.

No person should be sentenced to death because they cannot afford care or because some schmuck in a suit who wants to buy another yacht decides to kill their insurance policy because it doesn't help the corporate bottom line.



Its not everything we wanted, but Thank God some of the important parts are in there.

[Khrymsyn]

Oh, and for the record, my best friend is Cuban, so it is LITERALLY IMPOSSIBLE for me to be racist against him or other Mexicans like him.

Holy shit... Mexico annexed Cuba? When the hell did this happen!?!?

[Vigil80]

Holy shit... Mexico annexed Cuba? When the hell did this happen!?!?
Pretty sure it was meant as a joke. Or we're reading it wrong.

(Giving you an easy out here, TFO. ;) )

[Scull]

Holy shit... Mexico annexed Cuba? When the hell did this happen!?!?
1994. They call it Floaty Mexico. Damn schools not teaching our kids anything!

[Ox]

It comes down to the mandate portion of the bill. It's going to be a dispute over the Tenth Amendment of the U.S. Constitution (http://en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_States_Constitution) (1) vs. the Supremacy Clause (http://en.wikipedia.org/wiki/Supremacy_Clause) (Article VI, clause 2) (2).

(1) providing that powers not granted to the national government nor prohibited to the states by the constitution of the United States are reserved to the states or the people

(2) The clause establishes the Constitution, Federal Statutes, and U.S. treaties as "the supreme law of the land."
Actually, it's probably going to be the Ninth and Tenth Amendments versus the Interstate Commerce Clause and the Taxation Clause. The plaintiff states will be hoping for a United States v. Lopez situation. Rehnquist's dead, though, so I'm skeptical.

I'm curious how many states sued over the car insurance mandate?
The car insurance mandate is a state-imposed mandate, not a federal mandate. It would be extremely strange for a state to sue the federal government because the state decided to impose a requirement on its citizens. Some questions that would arise in such a suit would be:

1. Why is the state suing? If it doesn't like the car insurance mandate, nobody's stopping it from abolishing it.

2. What the fuck does the federal government have to do with it? If the state has developed schizophrenic personality disorder, that's not obviously a federal concern.

[Ultima Thulian]

I never thought I'd see something intelligent on 4chan...but...

http://i.imgur.com/590Ev.png

I gotta admit. It's a good point.

[Vigil80]

The flaw in his fun speech is that most of the things he listed aren't provided by the government, merely inspected. There are already federal quality standards in effect for healthcare, so the situation he's actually pushing (but doesn't know it because he's a /b/tard) is already in place.

[J Arcane]

I never thought I'd see something intelligent on 4chan...but...

http://i.imgur.com/590Ev.png

I gotta admit. It's a good point.
Here's another of my favorite 4chan copypasta, in much the same vein: http://jarcane.tumblr.com/post/437081927/the-self-made-man

[Ultima Thulian]

The flaw in his fun speech is that most of the things he listed aren't provided by the government, merely inspected. There are already federal quality standards in effect for healthcare, so the situation he's actually pushing (but doesn't know it because he's a /b/tard) is already in place.

Give the man some credit. His point was the notion that the government can't do anything right and that any government involvement somehow equals socialism is overblown.

Besides...as you said...this is a /b/tard. Lower your expectations. :p

[Ox]

Give the man some credit. His point was the notion that the government can't do anything right and that any government involvement somehow equals socialism is overblown.
So his point was that arguing against strawmen is fun? I can get behind that.

[Siraris]

Ox - Lawrence O'Donnell said tonight that there's no legal prescedent for this kind of action, there is nothing to buttress the case, and thus, these attorney generals have nothing to stand on. Would you agree with this? Is this entirely for show?

He also said that this would be a tax issue, and that makes sense to me.

[Ox]

Ox - Lawrence O'Donnell said tonight that there's no legal prescedent for this kind of action, there is nothing to buttress the case, and thus, these attorney generals have nothing to stand on. Would you agree with this? Is this entirely for show?

He also said that this would be a tax issue, and that makes sense to me.
Lawrence O'Donnell is simply wrong to say there's no precedent. United States v. Lopez and United States v. Morrison are two obvious recent precedents for the proposition that the Commerce Clause is limited. Also, it's "attorneys general."

I'm not sure what he meant by "a tax issue." If he's saying that the case will turn on whether the "fine" is considered a "tax" under the Taxation Clause, he's right that that's a potential argument the United States will likely make. I'm not convinced that will be the deciding argument, and I definitely don't think that's what you are saying makes sense.

Ultimately, I don't think the state suit will be successful. But I don't really feel the need to lie to make that argument. This is just one of the many differences between me and O'Donnell.

EDIT: All the above analysis, including the word "lie," assumes that I'm understanding O'Donnell's argument. Obviously, it's not inconceivable something is getting lost in the translation here.

[National Kato]

The Democratic Policy Committee's health care bill website (http://dpc.senate.gov/dpcdoc-sen_health_care_bill.cfm) has been updated to include an Implementation Timeline (http://dpc.senate.gov/healthreformbill/healthbill65.pdf) [PDF] that has more specific rollout dates on the provisions.

The website also has bill summaries and a section-by-section analysis of the bill.

[Siraris]

This is really interesting. I guess Senator Wyden of Oregon put in a provision that allows states to opt out, and create their own health plan (http://www.huffingtonpost.com/2010/03/24/wyden-health-care-lawsuit_n_511748.html) as long as it achieves the required coverage.

This is pretty compelling if you ask me. I'd like to see a state with Republican leadership who disagree with the current plan, setup their own plan, and see how it fares.

[J Arcane]

Oregon, it should be noted, has been trying desperately to keep afloat it's own public health care plan, OHP, for some years now. It's currently on wait list to even apply, as they had to cut back significantly in recent years.

Apparently, one of the bonuses of this bill is that we in Oregon will get $5 billion to be put towards helping OHP do it's thing.

[National Kato]

Siraris, that looks similar to the article I read on CNN.com from Timothy Stoltzfus Jost, professor of law at Washington & Lee University (http://www.cnn.com/2010/OPINION/03/24/jost.health.bill.challenges/index.html?hpt=T2):

The lawsuit claims that it compels the states to enforce the federal law or to operate exchanges that would make health insurance available to consumers. Section 1321 gives states the choice of doing so or not, and if states elect not to do so, the federal government will enforce the law and operate the exchange in the state.

No state has to do anything, except make its choice known to the federal government. Moreover, section 1333 of the act allows states to apply for a waiver to take a completely different approach to covering their residents if they have a better idea.

[Voodoo]

By the way, the final vote was 220 (Aye) vs 215 (Nay). Of the 220, 219 were Democrats and 1 was a Republican. Of the 215, 39 were Democrats and 176 were Republicans. So what was up with those 39?

EDIT: My bad, that was the November results. In this recent vote, 34 Democrats voted no.

[Siraris]

Voodoo - They were from conservative districts where voting for health care would have proven a liability to their campaign. That was one of the hardest parts of the vote - who could and couldn't vote yes.

I strongly believe that all 258 Democrats wanted to vote yes.

[Voodoo]

Voodoo - They were from conservative districts where voting for health care would have proven a liability to their campaign. That was one of the hardest parts of the vote - who could and couldn't vote yes.

I strongly believe that all 258 Democrats wanted to vote yes.
Ahh! Well then I suppose that makes sense. I do believe, though, based on where they came from they may loose their seats anyways. In my opinion they should have voted yes, damned be the seats. :)

I have been checking through the lists of major initiatives of this bill but can't seem to find if we can purchase out of state medical insurance. Was that included or are we still restricted to only buy within our own states? I thought it was going to be opened up nation wide with restrictions based on a minimum coverage or something along those lines.

[Hemalin]

I have been checking through the lists of major initiatives of this bill but can't seem to find if we can purchase out of state medical insurance. Was that included or are we still restricted to only buy within our own states? I thought it was going to be opened up nation wide with restrictions based on a minimum coverage or something along those lines.
States have the option to join together and offer plans to each other. It's not exactly what some people wanted but it's some compromise.

Ahh! Well then I suppose that makes sense. I do believe, though, based on where they came from they may loose their seats anyways. In my opinion they should have voted yes, damned be the seats. :)
I'm very curious to see how the November elections turn out. I'm wondering if voting no now has any effect or if they might as well have voted with the rest of the Dems since they'll get lumped in with them when election time comes around anyway.

[DoctorFinger]

I'm posting this in both of the HCR threads. If the trolling, insults and other crap doesn't stop, I'm closing the threads and any other HCR threads which pop up. This is the first, last and only warning.

[LordDon]

Did you even read the thread Doc? It was self-moderating already.