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OT: Politics and other stuff that is sure to piss everyone off

Hokie200proof

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You can say we're already paying for the uninsured, but the uninsured cost the public $43 billion in 2008. (75% of $57 billion) Obamacare is projected to cost $100 billion a year.

I really wanted to gather some information before I responded because I want to make sure I can offer an informative and respective rebuttal. In that effort, I'd ask you to cite sources for your figures above. I'd be interested to know how your source arrived at those numbers.

Also - Calling the Patient Protection and Affordable Care Act "Obamacare" is engaging in a bit of punditry and is also inaccurate. Yes, Obama championed it through Congress, but it is always the House and Senate who pass it, and a joint committee (even split of Dems/GOP) to do the final mark-up (which, incidentally, is usually where the most important and controversial pieces are added). It would be much more accurate (and perhaps even more inflammatory) to call the law Pelosicare or Congresscade. The buzz term "Obamacare" has gained popularity with conservative opinion personalities and GOP members because it can be an effective political tool to elicit an immediate adverse response from the folks who identify themselves as conservative or Republican. The term leads some people to dismiss the law outright without truly investigating what it actually entails or what it might mean for them. You are, of course, free to continue to use the term, but I will not as it's a very clear example of the "politics-as-sports" mentality we have discussed earlier in this thread.

I feel like there's a lot of misinformation being spread about the Patient Protection and Affordable Care Act (I'll call it ACA for simplicity's sake) and I'd like to review what the law actually says, what it will do and when. Perhaps a sad sign of the times, but the most comprehensive and accurate description of the law that I've found, with a clear and concise explanation of its potential implications, was posted on reddit's "Explain it to me like I'm 5" subsection. I've linked it below and I'd like to review it piece by piece to see if we can identify some of the issues you might have with the law.

Here's the full post -
ACA - Explain it to me like I'm 5

I really like this write-up because 1) I'm not a lawyer and 2) it provides citations to the actual law language. For summary's sake, I not citing anything here as I'm cutting and pasting from the link above. You can go to the summary and follow the cited hyperlinks to see the actual law language if you want to dispute or disagree with anything in this interpretation.

The Patient Protection and Affordable Care Act
The major changes that are already in effect:

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

I think the highlighted section is the absolute key to this discussion. As you mentioned -

...
The reason health care costs are going up is because there is nothing in place to check the cost. The entities in health care are all basically monopolies. The system is NOT about price competition. The AMA, the ABA, pharmaceutical companies, hospitals, and insurance companies are all basically monopolies who negotiate prices among themselves. Pharmaceutical companies have been caught colluding on prices.

Here is the check against rapidly inflating healthcare costs. Insurance companies now have a profit cap. I'm sure their lobbyists are hard at work as we speak to have this portion of the bill repealed. It's also one of the biggest reasons why there is so much misinformation about the ACA - Health Insurance Companies stand to lose millions, if not billions. They'll still be profitable, but not nearly as rich as they could have been had the ACA failed.

Moving along...

Going into effect on 1/1/2013

If you make over $200,000 a year, your taxes go up (0.9%). Translates to $1,800. If you get paid every two weeks, that's an extra $69.23 you'll owe Uncle Sam.

Going into effect on 1/1/2014
No more "pre-existing conditions". People will be charged the same regardless of their medical history.
If you can afford insurance, but choose not get it, you will be charged a fee. This is the "mandate". You can opt not to get insurance, but you'll have to pay the fee (now officially a "tax") instead, unless of course you're not buying insurance because you just can't afford it. (Note: Just upheld by the Supreme Court)

ABOUT THE MANDATE - what determines who can afford it?
Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can't afford?

Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you're worried about it. You can see it here.

Additional Items
  • Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance)
  • Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees)
  • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
  • Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need.
  • Limits how high of an annual deductible insurers can charge customers.
  • Cut some Medicare spending
  • Place a $2500 limit on tax-free spending on FSA's (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
  • Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.
  • Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen.
  • A new tax on pharmaceutical companies.
  • A new tax on the purchase of medical devices.
  • A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.
  • The amount you can deduct from your taxes for medical expenses increases.
 

Hokie200proof

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I'll stop there as (I hit the 100,000 character limit and) this takes us through 2014 and the first year of 1) a reelected or 2) new president and several things can change, be rewritten, repealed, etc by that time. We can delve deeper into the provisions past 2014, but I'd like to address what's above first.

The only new tax for the average American (and under 200K per household income actually includes many million upper-middle class Americans) is one that we, who can afford it, should already be paying - the price of health insurance. If you can afford health insurance, there's no excuse not to have it. If you go without, you put yourself in danger, both physically and financially. People go bankrupt all the time from medical expenses. And now that there is a provision to help ensure that we are not overpaying for it, there's really no incentive not to have it. But, for whatever reason, you can choose not to get it and pay the "tax".

If you add all of that together you get -
1) millions of new health insurance customers
2) income collected by the gov from the can-afford-it-but-for-some-reason-chose-not-to-get-it folks
3) a cap on insurance provider profits

All of which SHOULD have a stabling effect on the completely unchecked (as you yourself claimed, VTscores, and I would whole-heartedly agree) costs of healthcare.

If you've got sources you can cite that make a different claim, I would like to see them and discuss them.
 

Hokie200proof

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I'll hit this too, but then I have to go back to work -

1) Written by one of the most prominent (and perhaps extreme) libertarians of the modern era (who coined the phrase anarchist economist - believed in an almost wildly free economic system).
2) Published in 1994
3) Not entirely relate-able to what we're discussing here, namely the Patient Protection and Affordable Care Act - how can anyone hope to debate this if the position put forward is "and there shouldn't be insurance at all". It's just not practical. But, I'll say a few words about the philosophical elements at work in this opinion:

Rothbard would argue against ALL government programs, so of course he's going to argue against anything that mandates behavior within a free market system. I would happily and fervently disagree with him. I would even concede that he might be right - Health insurance, mandates and government intervention, more often than not, make zero economic sense and can prove to be detrimental to economic growth and prosperity. But that's fine, especially when we're talking about things like healthcare, public services (like water, sewer systems, trash removal) environmental issues, etc, etc that effect all of us. These issues are important to our survival and they become a moral issue and their economic implications become secondary. If we're going to live together in a town, city, state, country, there are going to be costs that we'll all have to shoulder. Some aren't even costs measured in money - jury duty, community service, neighborhood watch, town meetings, governance at all levels.

All of this relates back to why human civilization evolved into what it is today, growing from tribes, to city states, to empires, to countries. There are enormous benefits (to wealth, power, security, discovery, etc, etc,) when we all live/work together in close proximity. These are compounded when we do so with common goals and values. We are part of this country for a greater good. It might seem like a strange question, but what is the purpose of the U.S.? Is it to make the most wealth possible? Is it eventual world domination? Is it scientific discovery? Is it the promotion or protection of certain values/morals? There's no comprehensive answer to this question.

The idea presented in the linked opinion piece suggest that Rothband is only concerned with the answer "America exists to gain the most wealth possible." I would argue that you can never reduce society, governance and human affairs down to its economic cost/gain benefit. If you do, you get terrible, perhaps inhuman results. From a purely economic standpoint, there's no argument against slavery. In fact, there are compelling arguments for it. Slave labor would be a boon to any economy. It would make great economic sense for the U.S. to conquer and enslave Mexico (although some might say we already have through our clandestine support of the drug cartels and our willingness to let most of Mexico work in the US for wages that most Americans wouldn't be able to tolerate). But we're not going to do that because it's morally abhorrent. It's a denial of basic human rights.

Which brings us to the key element of this and where Murray Rothbard's arguments, in my mind, fall down. You can't put a value on health. Economics shouldn't even enter the picture. You might be able to find the fair/market value of healthcare or certain procedures, but those will always be inflated as these are vital for survival. What would you pay to save the life of someone you loved? Anything? I know I would. I think we all would. Even if it meant a great reduction in the quality/comfort of our own life, we would pay whatever the cost. It's almost unthinkable that money is even involved in medical care. But it is how it has all evolved and now we can't figure a way out of it. Nearly all of issues involved in the healthcare debate are about money when they should be able patient health, patient care and the continued evolution of human existence.

Money has been the cause of all the issues to begin with -
1) We shouldn't be incentivising expensive procedures if they don't benefit patients.
2) The current rules of drug patents and the costs of drug research incentivise pharmaceutical companies to rush results (or worse, skew or fabricate results) to ensure that research investments are always positive. Then new drugs are obscenely expensive so the developer can recoup their research costs and make a large profit before their patent expires.
3) Prior to ACA, there were no caps on profits made by insurance providers, so we paid (and have been paying) practically any cost put in front of us for our health care, even when it included a surcharge for the care of uninsured or otherwise indigent patients
4) We shouldn't allow patients to sue doctors for breaking their ribs in the process of saving their lives.
5) We shouldn't be throwing away the entire medical aid support system because there have been instances of fraud.

Final point. I would agree with Rothband about one thing. Insurance should not exist. It certainly shouldn't be a money-making industry. It should be something that a group pays collectively to offset the rare, unforeseen and unfortunate expenses of those who are beset with misfortune. It should be a zero-profit trust. Whatever remains in excess, given a particularly lucky year, should be returned to all of the participants. Insurance companies, no matter what insurance they provide, make their money on fear. The fear of getting sick, the fear of a car accident, the fear of a flood/fire/earthquake that could destroy your home, etc, etc. These are rare but very real occurrences. If you don't have a safety net, you could lose everything or even your life. We should all pay a fee to help those who fall victim to these tragedies, but the free-market of "how much do you fear this happening to you" shouldn't set what we pay. The actual costs of these events should set those fees, the rest shouldn't be taken as profit.

Unfortunately, as it was removed from the final bill, the "public option" (which was only an "option", not a mandated government-run health insurance that everyone had to have - a common bit of misinformation I've heard from countless political loud-talkers) was the first step to zero-profit insurance. It would have given the for-profit insurance companies a zero-profit competitor... something the healthcare lobby was successful in getting removed. Shocker.
 

hokiegrad

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There is absolutely NO chance of this bill having a stabilizing effect on healthcare costs. If anything it will have the opposite effect. You talk about insurance provider profit caps, but that is only one of many factors involved in healthcare costs, many of which aren't addressed by this bill and some of which are exacerbated by it.
 

Hokie200proof

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There is absolutely NO chance of this bill having a stabilizing effect on healthcare costs. If anything it will have the opposite effect. You talk about insurance provider profit caps, but that is only one of many factors involved in healthcare costs, many of which aren't addressed by this bill and some of which are exacerbated by it.

Please feel free to list example or cite studies that backup your claim.

As to my point, from the same post I pulled from...

"The PPACA will cost a lot of money... at first. $1.7 Trillion. Yikes, right? But that's just to get the ball rolling. You see, amongst the things built into the bill are new taxes - on insurers, pharmaceutical companies, tanning salons, and a slight increase in taxes on people who make over $200K (an increase of less than 1%). Additionally, the bill cuts some stuff from Medicare that's not really working, and generally tries to make everything work more efficiently. Also, the increased focus on preventative care (making sure people don't get sick in the first place), should help to save money the government already spends on emergency care for these same people. Basically, by catching illnesses early, we're not spending as much on emergency room visits. According to the Congressional Budget Office, who studies these things, the ultimate result is that this bill will reduce the yearly deficit by $210 billion. By the year 2021, the bill will actually have paid itself and started bringing in more money than it cost."

Here's the CBO report -
http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/107xx/doc10731/reid_letter_11_18_09.pdf

The executive summary says -
CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting the Patient Protection and Affordable Care Act would yield a net reduction in federal deficits of $130 billion over the 2010-2019 period (see Table 1).

Table 1 is on page 3 of the linked document.
 
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hokiegrad

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Who cares what else Rothbard wrote... a lot of THAT article was very good. And THAT article didn't say, nor would I agree, that there shouldn't be insurance at all. I have no idea where you're coming from there... Did Rothbard say that elsewhere? Why exactly are you bringing it up?

You say that that article suggests that Rothband is only concerned with the answer "America exists to gain the most wealth possible." Um... no, absolutely not. Again, I can't even imagine how you could get that...

No comprehensive answer to the purpose of government? We're really going off topic to get to that question, but ok... this one's pretty simple. To protect the people it governs. Or as Thomas Jefferson said, "The purpose of government is to enable the people of a nation to live in safety and happiness. Government exists for the interests of the governed, not for the governors."

You said "You can't put a value on health. Economics shouldn't even enter the picture." Seriously? Denying that economics should be in the picture is akin to denying that gravity should enter the picture in engineering. You can't just ignore one of the key actors on the system... I'm sure we'd all love to be able to ignore the economic factors here, but we can't. They are factors. What happens when you ignore a factor in your design? Bad, bad things...
 

hokiegrad

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This is pointless. You are already drinking the cool aid... You don't want to talk about how to make things better, you just want to live in the dream world where the ACA has fixed everything.
 

VTscores

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I really wanted to gather some information before I responded because I want to make sure I can offer an informative and respective rebuttal. In that effort, I'd ask you to cite sources for your figures above. I'd be interested to know how your source arrived at those numbers.

Also - Calling the Patient Protection and Affordable Care Act "Obamacare" is engaging in a bit of punditry and is also inaccurate.

Calling the ACA "affordable" is EVEN LESS ACCURATE than calling it Obamacare. Call it ACA or Obamacare -- we all know what law we're talking about.

My source is a report put out by the Kaiser Commission called "The Uninsured: a Primer," and is the least partisan of any source I've found today. I'm actually pretty open minded about it, but that doesn't mean I'm willing to not use my mind at all.

The SUPER HUGE MISTAKE that many pundits make who are in favor of this legislation is in the assumption that the only people making excessive profits on health care are insurance companies. This is absolutely not the case. While the ACA did put limits on insurance company profits, it fell very short of analyzing the obscene profits in the rest of the industry.

We're not paying double the amount for care than other developed countries just because of insurance companies. The problem that we have is that an interconnected set of monopolies: Doctors , Pharmaceutical companies, insurance companies, hospitals, and medical equipment suppliers who negotiate rates among themselves.

For me, to reform health care you have to go after the costs. Why are Americans spending double what other developed countries pay? Cut the costs, and you'll better be able to make it more affordable. My sense is that the two parties are bought and paid for by the industry, so the profits are going unscathed. Instead of cutting costs, the ACA leaves those alone and creates a mandate under which new subscribers are enrolled who will be subsidizing the new enrollees who can't afford care.

The assumption is that in the long term, costs will come down by themselves. Why would they? They're not currently driven by any market forces whatsoever.

The fact is that Obama was interested in universal, not in making health care more affordable to the middle class. The 85% of Americans who actually have insurance are getting thrown under the bus to pick up those 15% who aren't insured, and I object to that.
 

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And now that there is a provision to help ensure that we are not overpaying for it, there's really no incentive not to have it. But, for whatever reason, you can choose not to get it and pay the "tax".

If you add all of that together you get -
1) millions of new health insurance customers
2) income collected by the gov from the can-afford-it-but-for-some-reason-chose-not-to-get-it folks
3) a cap on insurance provider profits

All of which SHOULD have a stabling effect on the completely unchecked (as you yourself claimed, VTscores, and I would whole-heartedly agree) costs of healthcare.

Putting limits on insurance company profits falls far short of stabilizing or controlling health care costs. You still have an unaccountable industry, only now it's mandatory that everyone fund it. There is no cost transparency anywhere. In fact the latest craze in the industry is to hire professional coders who can maximize profits. It's all how you game the system.

You couldn't shop for health care by price today if you wanted to, because all the prices are essentially "made up" for maximum benefit to the health care entities.

Its all "let's make a deal".
 

Hokie200proof

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Who cares what else Rothbard wrote... a lot of THAT article was very good. And THAT article didn't say, nor would I agree, that there shouldn't be insurance at all. I have no idea where you're coming from there... Did Rothbard say that elsewhere? Why exactly are you bringing it up?

From your linked article, Rothbard writes -
"But why are rates high and increasing rapidly? The answer is the very existence of healthcare insurance, which was established or subsidized or promoted by the government to help ease the previous burden of medical care. Medicare, Blue Cross, etc., are also very peculiar forms of "insurance."

He very clearly blames health insurance, along with subsidized medicine (for those who are unable to pay for it), as the major reason for why healthcare costs are increasing.

You said "You can't put a value on health. Economics shouldn't even enter the picture." Seriously? Denying that economics should be in the picture is akin to denying that gravity should enter the picture in engineering. You can't just ignore one of the key actors on the system... I'm sure we'd all love to be able to ignore the economic factors here, but we can't. They are factors. What happens when you ignore a factor in your design? Bad, bad things...

Rothbard's article -
"If your house burns down and you have fire insurance, you receive (if you can pry the money loose from your friendly insurance company) a compensating fixed money benefit. For this privilege, you pay in advance a fixed annual premium. Only in our system of medical insurance does the government or Blue Cross pay, not a fixed sum, but whatever the doctor or hospital chooses to charge."

You're forgetting that you, if you're a government, can change the whole system. Just because things have worked a certain way in the past, doesn't mean that that's the right way of doing things. You and Rothbard are trying to simplify an issue that is far more complex than you are admitting. Rothbard's fire insurance analogy above would be great if a house acted in the same way as a person, or if property and human life could be valued by dollars. What's the cost of a house that burned down? Easy to assess in insurance terms - the cost of the building materials, the belongings inside, the cost of labor to build a new one perhaps? What's the cost of lost life? Or lost quality of life? Or a lost limb? Or the loss of the use of your legs? Health insurance is completely different from other forms of insurance as it has no start and end point. It's also a much more active as a person will always need additional care. You get sick, you get treated, you get hurt, you get treated, you get a rare disease, you get treated... over and over again until you die.

In the house/fire insurance analogy, you could pay for fire insurance for 100 years with no fires. Or, your house burns down and you get paid for what you lost. You total up what's been lost, you get money. That's property. It's a fixed cost.

Health is maintained, not lost and then recouped monetarily. It's a series of preventative or invasive procedures so you DON'T lose things - like your life (from some rare disease, or diabetes, or heart disease) or a body part (from some terrible cut/laceration or an infection) or your ability to do certain things (from back issues, joint pain or paralysis from a serious injury). What would you pay for these things in a market economy? Is there an amount you WOULDN'T pay to stay healthy? In a completely free-market healthcare system, the market demand would dictate what these procedures would cost. Why do you presume that they would cost less? Do think the supply of health would somehow start to outnumber the demand?

If your house keeps burning down, your insurance company will drop you. If they don't drop you, they're raise your premiums. Should the same practice be allowed for health insurance? If you get sick, get a disease, get hurt "too often", should health insurance be able to drop you? If they're in it for making a profit (which has been the case since it began) the answer is a loud and resounding yes.

If your house/fire insurance drops you, you can choose to rebuild at the peril of losing all of the money it costs to build a new house. If your health insurance drops you, what can you do? Hope you don't get sick? What if you are dropped (even for non-medical reasons, like you lost your job) and you get cancer? What happens then? You have two choices really. You go bankrupt trying to get care, or you bankrupt all of your friends and family as you borrow money for care. Or you chose to die.

How can you put a price on living or living healthy? How is it just to say to someone you need X amount of money to be able to live? How can you justify that morally? If you can't answer that, and you want to follow the system that Rothbard is recommending, you've got a problem... because that's exactly what a purely libertarian healthcare economy would force us to do - set the market price for life. And you think that will be cheaper than what we have now?

No comprehensive answer to the purpose of government? We're really going off topic to get to that question, but ok... this one's pretty simple. To protect the people it governs. Or as Thomas Jefferson said, "The purpose of government is to enable the people of a nation to live in safety and happiness. Government exists for the interests of the governed, not for the governors."

It's a great quote by Jefferson, but it's impossible to say exactly what that all entails. But, let's relate this quote to what we're talking about here:
Would the government be improving the lives of its citizens by providing affordable healthcare? I would presume you'd argue no, or, at the very least, you would respond only after knowing the potential cost? Otherwise, how could the answer be no?

I, not surprisingly, would say yes. How can society function without proper healthcare? If it's not the obligation of the government to ensure the health and well-being of its populace (some might even argue this would even fall under your goal "To protect the people it governs"), where does this obligation lie? In private companies? What if the healthcare they are selling is too costly for certain segments of the populace? Do we just let these people die? Do we deny treatment?
 

VTscores

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Nothing about the ACA makes health care any more affordable for anyone other than half of the 15% of the uninsured who will get subsidized care, at the expense of the other half, who will be subsidizing that care.

Stop with the "affordable" propaganda, because it just ain't so.
 

Hokie200proof

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Putting limits on insurance company profits falls far short of stabilizing or controlling health care costs. You still have an unaccountable industry, only now it's mandatory that everyone fund it. There is no cost transparency anywhere. In fact the latest craze in the industry is to hire professional coders who can maximize profits. It's all how you game the system.

You couldn't shop for health care by price today if you wanted to, because all the prices are essentially "made up" for maximum benefit to the health care entities.

Its all "let's make a deal".

I would agree with you. It certainly doesn't solve all of the problems of the rising costs of medical expenses. But neither would the status quo.

Would you have supported the "public option"? It would have been the only zero-profit healthcare provider with, theoretically, a very large subscriber base that would be able to better negotiate the costs of different procedures, supplies and meds.
 

Hokie200proof

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Nothing about the ACA makes health care any more affordable for anyone other than half of the 15% of the uninsured who will get subsidized care, at the expense of the other half, who will be subsidizing that care.

Stop with the "affordable" propaganda, because it just ain't so.

It's the name of the law. I'm not promoting anything. Besides, it's passed and it's been upheld by the Supreme Court. I'm just trying to understand why there are so many people who think it will a disaster. I never said, nor would I ever argue, that it's a cure all, but I do believe it's better than doing nothing at all.

Besides, what additional obligation will you have from the implementation of this law? Do you make more then $200K annually? Do you run a tanning salon? Can you afford health insurance, but you choose not to have it? If the answer is no, it won't cost you anything more than what you're already paying in taxes.
 

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It's the name of the law. I'm not promoting anything. Besides, it's passed and it's been upheld by the Supreme Court. I'm just trying to understand why there are so many people who think it will a disaster. I never said, nor would I ever argue, that it's a cure all, but I do believe it's better than doing nothing at all.

Besides, what additional obligation will you have from the implementation of this law? Do you make more then $200K annually? Do you run a tanning salon? Can you afford health insurance, but you choose not to have it? If the answer is no, it won't cost you anything more than what you're already paying in taxes.

I'm not at all convinced it was "better than doing nothing at all". An opportunity to actually reform the system was wasted. Certainly, 30 million more people will now have health insurance. Some of which will be subsidized, and some of whom will be subsidizing care for someone else.

The additional obligations will be:

1) to the taxpayer who is essentially guaranteeing this bill. In spite of what the CBO is currently saying, this bill WILL cost money to the taxpayer. The only thing the CBO does is check bills based on the assumptions provided. Faulty assumptions = faulty conclusions.

2) to anyone paying an insurance premium. Premiums will continue to rise, and part of this will be due to Obama's changes to the system. We will be paying for contraception for Georgetown law students who weren't covered before. Joe Blue Collar worker will now be subsidizing Suzy law student.

But the biggest issue is that this is an opportunity wasted to get to the bottom of the cost structure. The health industry managed to dodge that bullet. I see two ways to bring the costs down 1) make the costs transparent and introduce consumer choice, or 2) create a single payer system, where the government controls the costs.

The health industry isn't too upset now, because they can just lobby for whatever they want. No consumer choice is involved, and Congress has no backbone.

The cost of health care has increased from 7.2% of GDP in 1970, to 16.2% of GDP in 2007. Health care costs have exceeded economic growth in every recent decade.

If you don't somehow control the costs, this is a futile game. Sorry, but someone is going to have to pull the plug on excessive health care profits, and I'm NOT just talking about insurance company profits.
 

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My opinion is that something should have been done for the 85% of Americans who are overpaying for health care. It's not as sexy as making history with universal coverage, but it would have been more beneficial in the long term, and made covering those other 15% so much easier.
 

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RABBLE RABBLE RABBLE RABBLE!
 

Hokie200proof

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I'm not at all convinced it was "better than doing nothing at all". An opportunity to actually reform the system was wasted. Certainly, 30 million more people will now have health insurance. Some of which will be subsidized, and some of whom will be subsidizing care for someone else.

The additional obligations will be:

1) to the taxpayer who is essentially guaranteeing this bill. In spite of what the CBO is currently saying, this bill WILL cost money to the taxpayer. The only thing the CBO does is check bills based on the assumptions provided. Faulty assumptions = faulty conclusions.

2) to anyone paying an insurance premium. Premiums will continue to rise, and part of this will be due to Obama's changes to the system. We will be paying for contraception for Georgetown law students who weren't covered before. Joe Blue Collar worker will now be subsidizing Suzy law student. E

But the biggest issue is that this is an opportunity wasted to get to the bottom of the cost structure. The health industry managed to dodge that bullet. I see two ways to bring the costs down 1) make the costs transparent and introduce consumer choice, or 2) create a single payer system, where the government controls the costs.

The health industry isn't too upset now, because they can just lobby for whatever they want. No consumer choice is involved, and Congress has no backbone.

The cost of health care has increased from 7.2% of GDP in 1970, to 16.2% of GDP in 2007. Health care costs have exceeded economic growth in every recent decade.

If you don't somehow control the costs, this is a futile game. Sorry, but someone is going to have to pull the plug on excessive health care profits, and I'm NOT just talking about insurance company profits.

How would you propose we lower costs?

We are now in something of an awkward spot where I think you agree more with me and less with hokiegrad. You are asking for more reform, which would mean more government intervention in the form of added controls on the costs.

Murray Rothbrand would argue strongly against that and I would assume so would hokiegrad.

And I seriously doubt the cost of suzy law students birth control pills is anything more than fractions of fractions of a penny... When compared with the fiscal and societal cost of an unwanted kid, it's an even better deal. Especially if suzy law student is actually suzy welfare mom who has six kids already. I'm sure Joe Blue Collar is costing us all way more with his type2 diabetes and heart disease. He might even be at home collecting workmans comp while we pay for his treatment. Or claiming disability as obesity is a medical condition in our country. Just mentioning that as you don't need to be in the ghetto using food stamps to be part of the welfare system.
 

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What's the faulty assumption here? We're already paying for the uninsured everytime they go into the ER. It's not like these uninsured people haven't been receiving medical attention.

As far as the paying for the Georgetown law student's birth control, that will not cost the taxpayer anything. The issue there was that religious institutions should not deny contraceptives. They are private institutions, so the burden of the cost will be with the institution.
 
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