The Kaiser Family Foundation’s latest poll (toplines here) finds that two-thirds of Americans oppose the individual mandate and a clear majority — 54 percent — want the Supreme Court to invalidate the provision. Based on the poll of 1,206 adults, only 17 percent of Americans would like to see the individual mandate upheld.
Another interesting finding from the survey is that a majority of Americans also believe that the Supreme Court will strike down the mandate. In other words, according to this poll, a majority of Americans will be surprised and disappointed if the individual mandate is upheld.
(LvWSJ)
Houston Lawyer says:
Suprised, no; Disappointed, yes.
January 27, 2012, 9:48 amloki13 says:
Holy selective quoting, Batman! Or, in other news, people are rationally ignorant and have conflicting views on everything.
Other results-
People overwhelmingly believe the justices will vote their political/ideological preferences (75%).
A majority doesn’t believe that invalidating the law will cause the entire law to go away.
50% of those polled favor keeping the law as is, or expanding it. Only 22% favor repealing it. 18% favor replacing it with a “GOP alternative” (which would mean some sort of approval in the change of the status quo, um, if the GOP gets around to it, so I guess that’s based around the idea that whatever the Democrats do, it has to be bad).
So what does this mean- you didn’t bother contrasting that one result with this-
50% of the American people want the law as is or expanded. 18% want health care changed, but not by Democrats. That’s 68%.
The headline is that with all the publicity, and all the anger, the GOP can only muster 22% in favor of outright repeal. Think about that for a while.
January 27, 2012, 9:55 amAndrew Marketstuter says:
54% in a poll with a 2.82% margin of error does not equal “clear majority.”
January 27, 2012, 9:57 amfalse seriousness says:
This is total spin from Adler, as usual.
What are the polling numbers for letting people die from treatable conditions because they don’t have insurance?
37 million Americans who don’t have healthcare will get healthcare. Is there a magic program out there that doesn’t have costs and benefits, or should we have a real health system that starts making mature choices that acknowledge reality.
Republicans like Adler do believe in socialized medicine, but it has to be stupid and inefficient for them to support it – just go to the emergency room shortly before you die of a treatable chronic condition and get really expensive care. Or maybe he favors just letting people die.
Not sure.
I don’t think that will poll well.
And, of course, Adler doesn’t mention this part of the poll:
50% of people responding favor keeping the law or expanding it. That doesn’t seem to fit Adler’s narrative.
January 27, 2012, 10:03 amIan Scuffling says:
Not sure 1,206 is a solid representation of “Most Americans.” Especially with a disclaimer like “Note that sampling error is only one of many potential sources of error in this or any other public opinion poll.”
January 27, 2012, 10:06 amElliott says:
You are such a hack.
January 27, 2012, 10:13 amDotar Sojat says:
Clearly, these rubes shoud let the elites decide.
January 27, 2012, 10:16 amloki13 says:
Also, I have heard of polls that indicate the majority of Americans favor more government services. These same polls indicate the majority of Americans favor lower taxes on themselves.
Really- a poll that says Americans are in favor of health care coverage, but don’t like having to do anything to get it? That’s, like, the biggest shocker ever. A poll that asks people- “Do you want this health care coverage, an expanded version, or a (non-existent) plan offered by your party” gets vast support, but a poll that asks, “Do you like penalties on your tax returns” doesn’t? Wow.
[I apologize for the sarcasm, but if you want to trumpet this result, you need to at least put it in context.]
January 27, 2012, 10:18 amloki13 says:
Okay, one more. Just because I’m so disappointed by this post.
“In other words, according to this poll, a majority of Americans will be surprised and disappointed if the individual mandate is upheld.”
This statement is as fair as spinning the poll to say,
“In other words, according to this poll, *the vast majority of Americans will be surprised and disappointed* if the health care law isn’t upheld, expanded, or replaced by a credible GOP alternative.”
January 27, 2012, 10:21 amAdam says:
Was there a question that asked “Please describe, in your own words, what the mandate is?” I’d really like to see the answers to that one. I suspect they would illuminate the (lack of) value in this poll.
January 27, 2012, 10:28 amJoe Blow says:
But people also overwhelmingly want to keep insurers from excluding preexisting conditions. I am shocked to learn that Americans want their cake and would like to eat it too.
January 27, 2012, 10:32 amDavid M. Nieporent says:
were too irresponsible to get
, and don’t have any friends or family who like them enough to help them out, but think they’re entitled to have the government force strangers to support them at gunpoint?
You tell me.
January 27, 2012, 10:43 amuh_clem says:
Other than the mandate, most of the ACA’s provisions are quite popular.
People like the benefits, but don’t want to have to pay for it. Shocking, eh?
See http://www.kff.org/kaiserpolls/8259.cfm for details.
January 27, 2012, 10:43 amChris Rhodes says:
My predictions:
1. The individual mandate will be upheld.
2. Healthcare prices will continue to rise until it becomes unaffordable to even more people than it is now, as the corporate interests that drafted the law reap their reward off the backs of the citizens.
3. The poorest among us will still not have health insurance, but they’ll have the pleasure of paying a yearly fine to the IRS to remind them of the fact.
4. Ten years down the road, this entire boondoggle will be decried as a failure of “capitalism”, and health insurance will be removed from the private sector entirely.
5. Government health care will be the most expensive social program in the history of the united states, but since it will be funded through borrowing and inflation, most people won’t notice.
(This, of course, assumes that our society lasts another 10 years. I’m honesty not so sure at this point.)
January 27, 2012, 10:46 amDan Z. says:
100% of Americans want to get more and pay less.
January 27, 2012, 10:47 amrumpelstiltskin says:
Yeah, I’m with loki – I don’t think this article says at all what Adler cites it to support.
Polls on health care stuff like this are notoriously useless. Anywhere from 45% to 75% of Americans supported the “public option” when that was still on the table in the fall of ’09.
And 65% to 80% of Americans support overturning Citizens United. Who cares.
January 27, 2012, 10:47 amloki13 says:
Look, putting aside the sarcasm for a minute, an interesting post could have been written about these results. Unfortunately, the OP isn’t it. Because it’s a horrible example of confirmation bias. The results cited aren’t either interesting or illuminating in isolation, just like the results I cherrypicked aren’t that interesting or illuminating in isolation. All of this is confirmation bias. Just like the saying goes that you can get a ham sandwich to indict anything, you can slice poll numbers on a complicated policy issue to make it say what you want.
The only thing interesting about the OP was what Prof. Adler chose to highlight which, I suppose, says more about the writer than it does about the poll. What would have been illuminating is using this poll to illustrate how the American people, as a whole, often have conflicting and contradictory views about a complicated issue. Even moving away just from the health care as a policy issue, look at the SCOTUS polling.
How do you reconcile these numbers-
75% think that their ideological views influence their decisions.
59% think their ideology will influence their vote on the PPACA.
But only 29% expect it to be found constitutional.
Hmmmm…. does that mean the public mostly thinks SCOTUS is conservative (strike it down)? Or are the two answers independent of each other (there’s also a question asking if they “should” strike it down). Or are people too distracted by dinner and kids to really think this through? Who knows?
January 27, 2012, 10:49 amAlan Polonsky says:
If you look at the poll results, there are eight specific listed reasons given by people who answered the poll as to why they oppose the individual mandate.
One and a half object based on constitutional principles (Half because one says “The Govt shouldn’t tell you what to do. It’s getting like old Russia” but goes on to say “They should not be able to fine you for something you can’t afford to buy in the first place”
Two and a half object because they believe it is wrong to impose a fine for not buying the insurance they can’t afford. (The fact is that the law provides for assistance to buy insurance and the mandate “fine” only applies when people choose not to obtain insurance)
One believes the mandate will “raise the price of everything” (Someone needs to explain that connection)
One questions the enforceability of the mandate. (Possible, but hardly a reason not to have it in principle)
One believes that “Expanding Health care can bring down the quality of the health care service” (Really)
and one repeats the theme that “it is going to cost jobs and employers can’t afford it” which is the Republican argument against the bill in its entirety, but not specifically the mandate which is individual, does not increase cost to business, and, if anything, by requiring full participation, would lower costs to those who pay for insurance.
So much for rational ignorance. I call this almost completely irrational ignorance.
January 27, 2012, 10:51 amsenor says:
People are opposed to the mandate because they know there is no limiting principle. Even with the margin of error, more than 50% oppose it Kaiser has been pro-healthcare bill. If even they are spinning the poll results against it, that should tell you something. Will the Supreme Court strike it down? Probably not. That would take courage and a willingness to admit that the whole string of decisions since Wickard are suspect. In the end, they would rather let Congress chip away at freedoms than admit they were wrong.
January 27, 2012, 10:58 amLaura(southernxyl) says:
False dichotomy.
January 27, 2012, 10:59 amGreg Q says:
Ok, kids, let’s look at the actual numbers, shall we? And let’s note that the Kaiser Family Foundation is pro-ObamaCare:
Opinions on ObamaCare:
Very favorable: 18
Somewhat favorable: 19
Somewhat unfavorable: 14
Very unfavorable: 30
Don’t know: 19
So that’s 44 against (30 strongly so), 33 in favor (19 strongly so), or 4:3 against, 3:2 strongly so.
How do you think the law will affect you?
Better off: 26
Worse off: 33
Unchanged: 35
IOW, the Democrats bet the House, Senate, and Obama’s Presidency on a law that 68% (over 2/3) think will leave themselves worse off, or no better off.
That’s not much of a “reform”.
Is ObamaCare constitutional:
Constitutional 17
Unconstitutional 54
Yes, kiddies, that’s right, by more than 3 : 1, those Americans who have an opinion on the subject think ObamaCare is unconstitutional. Congratulations, you’ve failed.
January 27, 2012, 11:04 amJoeJP says:
the January poll shows that the requirement that everyone obtain health insurance or pay a fine continues to be unpopular
Very informative. So, all the people exempted from the “fine” (which, spoiler alert, is a tax) no longer are?
January 27, 2012, 11:05 amTravis says:
David,
So people who can’t afford private health insurance, or who had pre-existing conditions rendering them literally uninsurable, are “irresponsible” because… what, it’s their fault they’re poor and afflicted with chronic illness?
Compassionate conservatism shows its true colors yet again.
January 27, 2012, 11:05 amGreg Q says:
Some more fun:
In ruling on this case, do you think the Supreme Court Justices will (base their decision on legal analysis without regard to ideology or
politics) or do you think they will (let their own ideological views influence their decision)?
Base decision on legal analysis 28
Let own views influence their decision 59
Well, I expect the 4 left-wing “Justices” to rule based upon their personal beliefs, and totally ignore the Constitution. I expect the 4 conservatives to vote based upon the Constitution. I expect Kennedy to look at the polls and vote “unconstitutional”.
So, where do I fit? Am I part of the 28, or the 59?
Do you expect the Supreme Court to rule that the requirement that all Americans have health insurance is (constitutional) or
(unconstitutional)?
Constitutional 29
Unconstitutional 55
So, by 2:1 the American people who have an opinion think the Supreme Court will do the right thing.
54% think it is unconstitutional, 55% think the Supreme Court will rule that way. 17% think it is constitutional, but an additional 12% don’t trust “Justice” Kennedy to do the right thing.
I would really love to see the cross-tabs on those last three questions. But since the KFF is pro-ObamaCare, and I expect the cross-tabs would show even worse for ObamaCare supporters than the to line numbers, I doubt we’ll get to see them.
January 27, 2012, 11:14 amJoeJP says:
Can we also have, for comparison, poll numbers on the popularity of the Citizens United law?
Let’s see …
“Paying a fine is unfair. People who can’t afford insurance can’t afford the fine” Oh? Perhaps, there should be an exemption for such people and even an alternative, government based, health plan? And, just spit-balling, a privilege of emergency care, even if you can’t afford it. And, wild idea here, a means, if you are totally without means, to erase your bills. Use some legal sounding word. Um like “bankruptcy.”
“Because it’s going to raise the price of everything”
The law really should have means in it to control costs. And, by “everything,” do they mean, e.g., expanding coverage to those under 27, which for them, at least, wouldn’t “raise prices”? “Everyone” seems to have a special meaning, so it’s confusing.
“Expanding health care can bring down the quality of the health care service”
Yes. Not for those who were denied service before, perhaps. But, they don’t count. Maybe.
January 27, 2012, 11:15 amJosh says:
Complete lack of context. Wow.
January 27, 2012, 11:18 amSteve says:
Considering how many people have been tricked into believing that the ACA creates “death panels,” there is not much we can learn from public opinion polls at this juncture. Maybe in an imaginary world where people had an accurate understanding of what the law does and doesn’t do, but this isn’t that world.
January 27, 2012, 11:18 ambyomtov says:
Laura,
False dichotomy.
OK.
What are the polling numbers for telling people that they can’t get affordable insurance after they lose their job, because they had a few health problems while they were working (and insured)?
January 27, 2012, 11:18 amOrenWithAnE says:
Those with pre-existing conditions are not uninsurable. In fact, group insurance must accept them and cover that pre-existing condition.
January 27, 2012, 11:20 amSteve says:
Please, share more of your thoughtful, objective analysis with us all.
January 27, 2012, 11:21 amAJ says:
I doubt that most people are wrestling with the reach of the necessary and proper clause and distinctions between regulatory power and taxing power. This is an exercise in normative thinking: what do I think the law should be (and to some degree, which side seems more animated). Most people would be surprised by Wickard/Raich and would disagree with the outcome of Kelo. The impulse is that a compelled purchase is wrong because it is unprecedented – in 220 years, we simply don’t see Congress asking us to unilaterally do such things. People understand taxes, they understand spending and tax credits, they understand bans, and they understand quid-pro-quo regulation. This seems different and easily feeds the notions of slippery slopes and corner-cutting. I think the Court is still stinging a bit from the reality that Kelo became: a taking where the public purpose did not materialize. They will be sensitive to the commandeering argument and the possibility of extending such purchase-mandate power with little judiciable limit.
January 27, 2012, 11:25 amrob bob says:
Correct me if I’m wrong, but isn’t medical care available to everyone through ER care/medicaid/debt/bankruptcy? By choosing to go without insurance, what you are risking is your assets, not your life. That was my impression. If not, that’s the way it should be.
Regardless, Obamacare is not primarily a bill that saves a few people in a tight spot. Obamacare is a bill that entrenches and magnifies all the status quo problems that made health care too expensive in the first place. The problem of coverage may also need to be addressed, but it is only a symptom of the real problem, which is cost. Obamacare is a huge step in the opposite direction of solving the cost issue.
January 27, 2012, 11:25 amcaptcrisis says:
At least Prof. Adler didn’t turn comments off.
January 27, 2012, 11:26 amrob bob says:
He is probably one of those folks who keeps it simple. If you asked the framers, would they think this law is constitutional? If no, overturn.
January 27, 2012, 11:29 amNeo says:
Surely, these rubes in flyover country miss the idea of what expanding the power of our central government can yield.
January 27, 2012, 11:32 amCongress would be able to forever (at least till the next election) resolve the battle between which is better .. Coke or Pepsi. It will legislate it and you will buy it.
Just like the Indiana Pi Bill of the 1897 (which declared the value of PI as 3.2 when it is closer to 3.1), the Congress will now have the power to think for you and you will obey (or be sent to Gitmo or worse, forever without a trial), like messing with your toilet and light bulbs wasn’t enough.
No more of that pesky federalism to get in the way.
OrenWithAnE says:
Fixed in 1985.
January 27, 2012, 11:33 amloki13 says:
???????? What? Um, you haven’t really shopped for health insurance, have you?
You do realize that:
1. Group plans offered by employers can exclude coverage for pre-existing conditions for a time period right now AND
2. People with certain pre-existing conditions are either unable to get insurance or priced out of insurance if they have to get it on their own?
Unless there’s some meaning to your words that you’re parsing carefully that I’m not getting, I have no idea what you’re talking about.
January 27, 2012, 11:35 amarch1 says:
“In other words, according to this poll, a majority of Americans will be surprised and disappointed if the individual mandate is upheld.”
Jonathan, “majority surprised” AND “majority disappointed” does NOT imply “majority surprised and disappointed.”
Your “in other words” implication is wrong as a matter of logic, unless the fraction who think the mandate will be struck down is at least 96%, or you’re basing your conclusion on survey details I didn’t take time to review. A Venn diagram might help you see this.
It’s a separate question whether your conclusion is in fact true in this case. Given that only 54% want invalidation, however, it only takes 5% who want, but don’t expect, invalidation to render your conclusion false, as well.
January 27, 2012, 11:36 amyankee says:
Not quite. People with incomes up to 133% of the federal poverty level will be eligible for the newly-expanded Medicare program (unless the Supreme Court strikes that down as “commandeering”). People with incomes up to 4 times the federal poverty level will be eligible for subsidies.
Generally speaking, anyone who cannot find insurance with a premium of 8% of their income (or less) is exempt from the mandate.
January 27, 2012, 11:37 amkarrde says:
How many of the 37 million are in this group, and how many are simply unable to find an employer willing to both hire them and pay employer-supported health insurance?
How many are young and careless?
In slightly-related news, a government program started by PPACA (formerly known as ‘Obamacare’, and should be known as ‘Obama-Pelosi-Reid-Care’) which attempted to find and get coverage for those who were in the limited-by-pre-existing-conditions group, has a hard time finding people willing to join.
At least, that’s the interpretation of a columnist who looked into the program in detail. Several times.
Thus, I think that the numbers don’t support the claim that most of the 37 million uninsured are those who are precluded by pre-existing conditions.
January 27, 2012, 11:37 amSam says:
Ilya’s recent post about the pervasiveness of political ignorance (rational or not) does undercut the implication that these numbers tell us anything about the actual merits of an individual mandate. As others have pointed out, all it shows is the well known fact that people are capable of adopting inherently conflicting positions and how a political question is framed matters.
January 27, 2012, 11:43 amOrenWithAnE says:
Please read the comment to which I was responding. Both (1) and (2) that you cite are true but that still does not imply Travis’ 11:05.
January 27, 2012, 11:47 amOrenWithAnE says:
Please read the comment to which I was responding. Both (1) and (2) that you cite are true but that still does not imply Travis’ 11:05.
[ Possible dupe, sorry. ]
January 27, 2012, 11:47 amyankee says:
Not quite. The ER can treat you for a one-time event such as a heart attack, but it cannot treat anything that requires ongoing treatment. If you get cancer, you cannot get chemotherapy through the ER. If you get an immune disorder such as HIV or Addison’s Disease, you cannot get your twice-a-day prescription by going to the ER.
If you have untreated cancer, HIV, or Addison’s Disease, you will eventually end up in the ER, but by then it is probably too late.
January 27, 2012, 11:51 amLaura(southernxyl) says:
And these are the people whose problem this whole thing is supposed to fix.
There are ways to get health care for people without a universal mandate. Example: Clinics for low-income folks where they pay based on income. These exist now and could be expanded. That’s why I say this is a false dichotomy.
Here’s another possibility, although there’s more government involvement than some would like: For a set period of time, say 6 months, require that insurance companies cover everyone who applies, pre-existing condition or not. Afterwards, require this ONLY for people who can show continuous coverage. This allows people to opt out of insurance if they want to, [foolish though that is,] and buy insurance if they want to and haven’t been able to up till now b/c of pre-existing conditions, and prevents insurance companies from having to take people who didn’t pay premiums when they were healthy and now want insurance when they’re not.
Just a thought.
I don’t understand why mandatory coverage all of a sudden became the one and only solution to the problem. [I think the problem is ill-defined and that in itself is part of the problem. What is "basic" health care? Fix my broken leg? Fix my heart attack? Provide expensive experimental chemo if I get cancer? What's basic?]
January 27, 2012, 11:52 amAndrew J. Lazarus says:
Polls like this are like polls that ask how many calories a big slice of chocolate cake should have. Part of the question is an attempt to repeal the inevitable, and part is merely a measure of responders’ knowledge or lack thereof.
Oren with an E is something of a case in point. He doesn’t seem to have thought through people who lose group insurance (COBRA lasts what, 6 months?) and either (1) don’t find another job with group insurance or (2) are self-employed. Anything approaching universal coverage requires a mandate. Even Republican Mitt Romney figured that out, before he didn’t.
January 27, 2012, 11:57 amBruce Hayden says:
Are you talking about yourself here?
My view is that only Utopians and socialists truly think that the quality of health care for most will increase. Only people who think that governments can do much of anything well. Yes, maybe some more people will have health care, but at the cost of reducing overall quality for the rest of us, due to the inevitable misallocation of resources due to government meddling. We are already seeing that with the birth control mandates coming down from the Secretary. Somehow, my health care is going to be better because I am paying for someone else’s birth control pills, rubbers, etc.
And, the government mandated reallocation of resources will likely raise the cost of most everything. I would suggest that only Utopians and socialists truly believe the opposite. Currently, we are looking at 1.7% GPP growth this last year, with a 45% increase in food stamps since Obama took office, and a national debt rising from some $9 trillion to $16 trillion or so under his watch of just over 3 years. And, you wonder why so many question government mandates, and their effect on the economy? Where is the money going to come from? Some, sure, by transferring resources from those who choose to pay for insurance. But a lot will have to come from businesses that couldn’t. And where is that going to come from? Thin air? Or, increased prices – which, yes, do ripple through the economy? And, yes, that also means loss of jobs, as the cost of hiring lower paid employees increases, without any corresponding increase in their marginal utility or value.
January 27, 2012, 12:01 pmcaptcrisis says:
Bruce Hayden:
Look at the rest of the developed world, which gives better health care, for far less.
January 27, 2012, 12:07 pmTatil says:
Only if they work for a company that offers group insurance. Many companies don’t, many people own their own business (freelancers, restaurant owners etc.) and a good chunk is unemployed. If you fall into one of these categories, you can easily become uninsurable.
In fact, I wager most Americans only have the illusion of “insurance”. Ask yourself whether you can afford to pay for food, rent (mortgage would be too much, so I am not even asking about that), medicines, co-pays, deductibles and insurance premiums if one member of the family becomes too sick to work? If I believe COBRA runs out after some time, so insurance premiums will either jump or no insurance company will offer coverage after that period. Bankruptcy, followed by Medicaid dependent treatment, seems inevitable for most Americans.
January 27, 2012, 12:07 pmloki13 says:
OrenWithAnE,
I read that post and your response. As I wrote, you are finely parsing it to make a distinction that, near as I can tell, exists only in your mind.
Your response appears to be, well, they can get a job (that might have the correct health insurance) which is the nearest that I can understand from your terse reply. This, of course, assumes the following-
1. Their job offers health insurance that doesn’t exclude their pre-existing condition for a length of time that will cause probelms.
2. The health insurance offered by their job (under the old rules) is of a type that will make a difference for their health condition.
And, as I pointed out, the private market doesn’t offer it.
This is the unfortunate thing in this debate- we read so many things about how much our current system clearly rocks, and yet so many people are deeply dissatisfied with our current system of government-subsidized employer-based health care. And brief one liners that don’t illuminate, but obfuscate the issue (yes, COBRA helped, but didn’t *fix* the issue in 1985) only make the debate worse.
January 27, 2012, 12:11 pmAnon says:
As a policy matter I am in favor of single payer catastrophic coverage. But that doesn’t mean we have to pay for everyone’s viagra, chiropractic, electric wheelchairs, psychotherapy, etc. etc. That’s the real straw man set up by Obamacare supporters, that if you don’t want to cover everyone’s comprehensive health costs and whatever mandates your state legislature throws out for the special interests, then you must want people to die in the streets.
January 27, 2012, 12:13 pmTravis says:
Laura,
It’s glaringly obvious that you have never shopped for health insurance outside the employer-paid context. (Spoiler alert: it’s really, really expensive.)
Telling someone they can get covered if they maintain insurance is useless if that person can’t afford to pay for the insurance. Hence, the need for subsidies.
And as for your clinic idea… one, sounds like a giant expansion of the federal bureaucracy and two, what about poor people who need treatment beyond what a “clinic” can provide?
January 27, 2012, 12:13 pmBruce Hayden says:
Yeh, well, that isn’t most of those who aren’t insured, but nice try. Let’s instead look at the 20 something slacker generation who aren’t paying for health care insurance because they would rather play than work, and when they work, they would rather pay for beer than health insurance.
Of course, some of this is overcome by forcing their parents’ insurers to pay for them long after they should be paying for their own insurance. Not that that won’t raise health insurance costs for everyone else, because it will.
Or, how about those who don’t believe in modern medicine? Some entire religions take this view.
When we were all looking at the uninsured, it turned out that a large majority of those involved either were here illegally (and insuring them, at our expense, is a huge moral risk problem in itself), could have paid for their own insurance, if they were willing to work and to divert some of their pay, or were eligible for some government program already. Getting us to concentrate on the few who were sick, uninsurable, and ineligible for some government program was just slight of hand, diverting our attention from the vast majority of those who would be affected here.
January 27, 2012, 12:13 pmTatil says:
I bet it is cheaper to cover birth control than Medicaid paying for the prenatal care and medical needs of the kid after birth, and your property taxes, state and federal grants paying for his K-12 education. :)
January 27, 2012, 12:16 pmloki13 says:
Speaking of sleight of hand-
Illegal immigrants are not eligible for insurance subsidies or Medicaid, and are exempted from the mandate (query what happens if they’re filing a tax return?).
January 27, 2012, 12:24 pmbyomtov says:
OrenWithAnE,
Fixed in 1985.
For some people. For 18 months. As long as your employer doesn’t go out of business, or discontinue the plan, and has at least 20 employees.
So yes. It helps a little. But in an economic downturn companies do go out of business, and sometimes it takes more than eighteen months to find a new job. And sometimes the new employer doesn’t provide coverage.
So no, not fixed. A small patch put on.
January 27, 2012, 12:24 pmTone Down the Rhetoric says:
In 2014, when they add the new Obama Box to my paycheck, we, and I mean those of us who pay our taxes, will be crying at the new tax rate in the “Obama Box.” Now those 20 million or so illegals can go into the hospital and demand their labor epidural as a RIGHT. So I PAY and they can live off the fat of the land…….my labor that is.
That is just one example for what the PACPA will accomplish. So, for example, I need a hip replacement……..I will have to wait, for who knows how long, to have that surgery. Thats whats happening in Canada and we see Canadiens here in the USA for their surgeries because they can’t wait any longer.
I can go on. We have examples from Europe to Canada to inform us of what will happen if the PACPA is not repealed. How about Health Care Reform instead. Preventative Health initiatives.
Ok, you got me……..I hate socialism. Sue me.
January 27, 2012, 12:25 pmTravis says:
“Yeh, well, that isn’t most of those who aren’t insured, but nice try.”
1. Evidence? 2. Assume you’re right – so because some people are slackers, we’re not going to try to help anyone? The people who aren’t, screw them, get a job, amirite?
Since you provided no evidence for your assertion, I’ll provide anecdata. I’m a 20-something with a pre-existing condition that requires monthly blood tests and medication for life. Without health care reform, I’d be literally uninsurable. But I guess that makes me a beer-swilling slacker.
January 27, 2012, 12:26 pmOrenWithAnE says:
NY runs a freelancer group buy. There was an article about it in the times recently …
I have 12 months living expenses (rent, food) socked away in cash or cash equivalents (short term rolling CDs). I’m currently saving more (about 5% of income, on top of the 6% 401k contribution) because I want to be in good shape if I lose my job (and if not, I have a head start on retirement).
Perhaps Americans could learn to ditch their 200-channel cable, smartphone and trade down to a 10 year old Honda Civic until they have built up that rainy day fund. Unemployment and employment are cyclical events and so ought to be very easy to plan for using a very ancient technique.
January 27, 2012, 12:28 pmLaura(southernxyl) says:
It may be glaringly obvious to you, Travis, but it’s one of those things you know that aren’t so.
Twice at least in my work life I have done this. Individual coverage for my healthy family members through BCBS first and then years later by United Healthcare was actually cheaper than what I had to pay at work to get them covered by the group insurance at work.
I think a lot of folks assume stuff without looking into it.
January 27, 2012, 12:34 pmyankee says:
If you’re a 25 year-old with no preexisting conditions and no history of illness, you’re fine. If not, you’re lucky if you can find private insurance at any price.
January 27, 2012, 12:35 pmloki13 says:
Perhaps OrenWithanE could learn about Rawl’s Veil of Ignorance. I am reminded of of a comment thread with one commenter who couldn’t conceive of people that didn’t have driver’s licenses because, after all, you need them if you go to the airport (not true, BTW).
Yes, there are people who do horrible jobs managing money. Not all of them are poor. There are also people who do great jobs, and still can’t make it work. I hope OWAE doesn’t fall into the second category, but I wouldn’t be so cavalier as to suggest that if it did unforseen misfortune did happen to him (his own Black Swan), that he was just living high on the hog.
January 27, 2012, 12:35 pmLaura(southernxyl) says:
Not if you happened to work for one of the many, many companies that have group plans that cover everyone.
I have been pleasantly surprised to find that my preexisting conditions were covered from day 1.
Once again, you can assume the apocalypse if you want to. I’d rather get hard data, myself.
January 27, 2012, 12:36 pmTone Down the Rhetoric says:
And……
I have to pay for the healthcare of:
SMOKERS, The Obese, the Morbidly Obese, Drug addicts and Alchoholics and all the health problems they eventually have. Criminals who were shot and are quads. etc. etc..
I have no problems paying for those with chronic illnesses, ie. diabetics, Sickle Cell, people who develop cancer, etc. etc..
Hell, if we have ObamaCare, I’m going to do to the doctor if I develop even a sniffle.
January 27, 2012, 12:38 pmIspep Teid says:
There’s a majority with room to spare. When does it become “clear” to you?
January 27, 2012, 12:38 pmTone Down the Rhetoric says:
And……
I have to pay for the healthcare of:
SMOKERS, The Obese, the Morbidly Obese, Drug addicts and Alchoholics and all the health problems they eventually have. Criminals who were shot and are quads. etc. etc..
I have no problems paying for those with chronic illnesses, ie. diabetics, Sickle Cell, people who develop cancer, etc. etc..
Hell, if we have ObamaCare, I’m going to go to the doctor if I develop even a sniffle.
This is going to be one hellava disaster economically. We deserve it.
January 27, 2012, 12:39 pmLaura(southernxyl) says:
Also:
Subsidies = mandate in your world?
January 27, 2012, 12:39 pmTatil says:
Hayden, do you have a source for your assertion that “vast majority” of uninsured are composed of 20 somethings spending their money on beer rather than health insurance? Otherwise, I am going to write it off as a psychological defense mechanism to deny yourself the possibility that you are just one bad illness or layoff away from the rolls of the uninsured.
January 27, 2012, 12:43 pmTatil says:
Medicare, prison health care systems etc. already cover them.
January 27, 2012, 12:50 pmIspep Teid says:
You might as well have said “Damn kids! Get off my lawn.” Few things paint you as a crusty old curmudgeon like bitching about young “slackers.”
January 27, 2012, 12:52 pmTravis says:
Pretty big “if” there.
And if you work for a small business that doesn’t offer health insurance to its employees, then you’re just a beer-swilling slacker, amirite?
January 27, 2012, 12:53 pmAnderson says:
Give me a poll, and I’ll ask 800 Americans “do you approve of a law that requires everyone who can afford health insurance to buy it or else pay a penalty?”
Let’s see what % are opposed to that.
January 27, 2012, 12:56 pmIspep Teid says:
That’s one of the major problems with the current health insurance system. It constrains people’s options, channeling them into suboptimal stations in life. Disconnecting insurance from employment (which Obamacare doesn’t do), would give many people the freedom to change employers, start new businesses, and generally allocate their human capital in a more efficient way.
January 27, 2012, 12:57 pmTatil says:
Good for you.
Slight complications for a birth required a two week stay at the hospital for a friend of mine. The bill came out to be $100,000 and that was 10 years ago. A relatively straightforward surgery can easily hit $50,000 nowadays. I bet vast majority of Americans, with or without cable TV, will never have enough money left to pay for any of these after a year of unemployment due to sickness or as soon as COBRA coverage runs out.
January 27, 2012, 1:01 pmLaura(southernxyl) says:
No, you’re not right. Are you suggesting that that is terminology that I have or would use? Once again, assumptions will bite you in the butt, Travis. I suggest you try to refrain from making them unnecessarily if you can.
You said that you would be uninsurable. That’s simply not true.
January 27, 2012, 1:06 pmLaura(southernxyl) says:
Ispep, I agree that the current system isn’t wonderful. I simply don’t think that we have to pick one fix and say it’s that or nothing.
I’d like other options looked at and I’d like to see various states’ runs at fixing this problem analyzed to see what worked and what didn’t, and what the unexpected negative effects might have been. You could write a book on TennCare, for instance. Let’s not repeat the same mistakes over and over.
And maybe they’ve done this. I haven’t seen the discussion.
January 27, 2012, 1:10 pmTatil says:
By the way, I checked their webpage. They ask about pre-existing conditions. I have never had an employer provided insurance ask about them, so your rates and waiting period are probably gonna depend on your health. That sounds more like a group discount system, rather than something that prevents you from being “uninsurable” if you have some health problems, but still want to start your own business (or if you are unemployed.)
January 27, 2012, 1:14 pmLaura(southernxyl) says:
Well, looky here.
Look at the list of articles.
What’s not to like?
I remember that Memphis’s children’s hospital, Le Bonheur, almost went under due to TennCare but Methodist Hospitals bought it [dang those religionists, amirite?] in the nick of time.
January 27, 2012, 1:19 pmtheobromophile says:
One of the problems with the law is that affordable insurance becomes (functionally) illegal. The government ends up requiring that insurance cover so many things – even doctor’s appointments – that the prices go through the roof, and affordable 80/20 or catastrophic care plans are not permitted. It’s like making it illegal to drive anything less expensive than a Cadillac and telling people that the price of cars will come down. Right.
January 27, 2012, 1:21 pmtheobromophile says:
Novel idea: let’s have a law that you have to be covered if you already have insurance, or if you are under a certain age (e.g. 25), and then develop a good market for temporary insurance for people between jobs. As an example, if you had Blue Cross from the time you turned 25 until you turned 27 and lost your job, you could then sign up with Aetna, who couldn’t turn you down since you had been continuously insured for a certain period of time.
No mandate, but it gives an incentive to people with chronic conditions to keep themselves insured without requiring that everyone buy super-expensive health care plans.
I would say “problem solved,” but the fact that the Left has never seized on that patient-and-company friendly solution indicates to me that the problem really is not people with preexisting conditions; the problem is the existence of health care system that isn’t run by the government.
January 27, 2012, 1:30 pmGreg Q says:
The ACA creates panels that will decide whether or not your problem is worth treating, and whether a given treatment is worth doing. If they decide “no”, you’re SOL.
They haven’t been “tricked” into believe the ACA creates death panels, because that’s exactly what it does.
January 27, 2012, 1:31 pmN.B. says:
One wonders how many would support the death of the mandate if they realized that this made socialized health care the only realistic solution to cost containment.
January 27, 2012, 1:33 pmGreg Q says:
No honest person claims the US Constitution is a “Living Document” (disagree? Great. What’s the practical, functional, difference between claiming “The Constitution is a Living Document”, and claiming “The Constitution means whatever 5 members of the Supreme Court think they can get away with saying that it means”? Until you can come up with a real difference, my point remains). All four of the left-wing members of the Supreme Court act according to that claim.
Either your rulings are bound by the written Constitution, and your “life experiences”, “sense of fair play”, “sense of justice” are all put entirely to the side, or you’re a black robed thug tromping over the rule of law in order to force your personal beliefs on the rest of us. There is no in between.
January 27, 2012, 1:35 pmloki13 says:
That would be great. Seriously. Then again, why don’t you poll on this question-
“Do you think we should get rid of all employment-provided health care plans?”
Huh. You thought the mandate was unpopular? After all, look at people like Laura- she thinks everything is just great! Because if you’ve got it (and it’s a good employer one), it is wonderful.* I mean, it’s not like you think about the massive government subsidy in the form of the tax break, or the distorting effects, or anything.
*I am only being partially sarcastic. Having had a range of employers, I agree- if you have an awesome health care plan through your employer, it is amazing. But this is what also drives the NIMBYism aspect of this debate.
January 27, 2012, 1:41 pmloki13 says:
No honest person claims what you do. Well, perhaps grossly misinformed is more polite. But I guess you’ve been informed before and chosen to ignore it, so I’ll go with my prior assessment.
January 27, 2012, 1:43 pmLaura(southernxyl) says:
Fail.
January 27, 2012, 1:47 pmTatil says:
For a person complaining that ObamaCare will increase prices, do you honestly believe this idea will reduce prices? This may be patent-friendly in your parlance, but I don’t know how you call it company friendly. None of them support such a provision without a mandate. ObamaCare does include this provision and in order to spread the costs over a wider population, it includes the mandate.
As opposed to the “private” death panels, whose members get paid bonuses for finding excuses to refuse treatment?
January 27, 2012, 1:48 pmbyomtov says:
Theo,
And could Aetna charge whatever they wanted?
This is part of the problem. You could argue that it is unfair to make Aetna charge less than an actuarially reasonable premium. But then you face the problem of being insured by BC, developing a health problem, and then having to go to Aetna and pay a lot. In effect, you weren’t insured, even though it looked like you were.
Once you introduce the possibility of having to switch carriers, and of allowing the new carrier to charge a premium that is fair from its point of view, a lot of the benefit of insurance is lost.
Ideally, a health insurance policy ought to include the option to continue coverage, but how do you make that work if you switch companies? What is needed is very long-term coverage – 40 years or so if we assume Medicare stays in place – but getting that from a private company entails huge and likely unsolvable problems. So if we insist on a private solution there has to be government involvement in the market, beyond what you propose.
January 27, 2012, 1:55 pmIke Kelley says:
Is the good Prof suggesting that the SCOTUS reads polls?
If so, then let’s take bets on when Citizens United gets reversed.
January 27, 2012, 2:00 pmRay Jones says:
The H/C industry is complicated . . . and “for profit.”
There was a time, I think, when the industry was “not for profit”.
Would requiring H/C insurers to be not-for-profit entities lower the premium cost for consumers.
January 27, 2012, 2:04 pmFinger on the Pulse: From Our Blogroll and Beyond « The Legal Pulse says:
[...] Not that it should or will matter to the Justices, but a majority of Americans want ObamaCare’s individual mandate found unconstitutional (Volokh Conspiracy) [...]
January 27, 2012, 2:06 pmFinger on the Pulse: From Our Blogroll and Beyond « The Legal Pulse says:
[...] Not that it should or will matter to the Justices, but a majority of Americans want ObamaCare’s individual mandate found unconstitutional (Volokh Conspiracy) [...]
January 27, 2012, 2:06 pmfalse seriousness says:
As Newt would say, fundamentally that’s untrue.
It is painfully clear that most folks posting here have no idea what they are talking about.
January 27, 2012, 2:07 pmClark says:
To paraphrase the illustrious first poster on this characteristically high quality OP:
Disappointed? Yes. Surprised? No.
Does Fox rehabilitate a certain type of academic like it does failed politicians?
January 27, 2012, 2:10 pmTparty says:
If you don’t want to be called out for being ignorant of the facts, as developed in the test case in Massachusetts, I suggest further study.
http://money.cnn.com/2010/06/15/news/economy/massachusetts_healthcare_reform.fortune/index.htm
January 27, 2012, 2:10 pmbpbatista says:
Quick, somebody get this poll to Justice Anthony “Candle In the Wind” Kennedy!
January 27, 2012, 2:20 pmSarcastro says:
My solution is so awesome, if you find flaw, it’s because you’re arguing in bad faith!
January 27, 2012, 2:24 pmscattergood says:
37M people may not have health INSURANCE, but that doesn’t mean they don’t have health CARE. It is nice to conflate the two, but they aren’t the same. The plurality of the unisured are 18-24 who don’t need very much health care on average. But nice try.
January 27, 2012, 2:40 pmTravis says:
If I’ve lost my job, with what magical non-existent money am I supposed to pay Aetna’s unsubsidized, non-group rates to continue my insurance coverage?
January 27, 2012, 2:43 pmloki13 says:
cf.
I was going to respond to this, but it seemed so glaringly self-evident I wasn’t going to bother. Good last line, though.
January 27, 2012, 2:44 pmAnthony says:
It would be nice (though not available as far as I can tell) to cross-index the question of severability with opinions on the law. A very useful question that they did ask was:
Presumably, the other 10% were no answer. In any case, of those who answered, 75% want some sort of health care law, and a majority want a law that’s at least as strong as the current law. I think the theory of “Americans want universal health care, but don’t want to pay for it” is pretty consistent with the results.
January 27, 2012, 2:47 pmTravis says:
Yes, and that’s what I thought until I, a hale and hearty college student, developed a pulmonary embolism, spent three days in the ICU and racked up close to six figures in medical bills. We like to think we’re invincible, until we’re not. Expensive lesson.
If it wasn’t for coverage under a student insurance plan, I would have simply handed the college-town hospital a list of my assets (virtually none) and my extant liabilities (nondischargeable student loans) and wished them good luck collecting a thin dime.
January 27, 2012, 2:53 pmFub says:
Easiest and most fair way to make that happen:
Make it a major felony for any healthcare provider to charge an individual a dime more for the same service or goods than the lowest “negotiated rate” that they charge big insurance companies.
Today if you go to a physician or hospital and pay directly, your bill will be several times what your insuror would be billed if you had been insured.
Just level the playing field by force of law and healthcare costs for uninsured individuals will come down.
January 27, 2012, 2:59 pmolesparkie says:
Clearly, the poll indicates most Americans want Government to run their lives. Isn’t that obvious, silly rabbits?
January 27, 2012, 3:08 pmfalse seriousness says:
This is a very important point, and worthy of quoting. It’s really the paradigm of coverage that isn’t working.
January 27, 2012, 3:13 pmrpt says:
I believe that Romney’s answer to Santorum’s questions re the mandate in last night’s debate are probably the best pro-mandate explanation and advocacy which we will hear through the rest of the campaign. Romney did it and he believes in it, and his observation that the mandate deals with the free rider problem was effective. We’ll see how public opinion is affected by the presence of two mandate supporters on the ballot. If Paul runs as a third party candidate, so much the better.
In addition, the other effective point last night was the complete inability of any of the candidates to provide a response to the questioner (who had passed screening to get in) who asked about unemployment and the lack of health insurance. She was a real person who asked a real question and got nothing but platitudes instead of answers. What GOP voter could believe that any of the candidates have anything to say about health care other than that “Obama” (the disdainful refusal of any of them to use the simple courtesy of his title “Pres” was pretty apparent) is bad, or “Obamacare” is bad. The choice to the electorate is something imperfect or nothing.
January 27, 2012, 3:14 pmcynical cynic says:
Question for ACA supporters:
The Prez said in State of the Union that the reform was done by working with the private market “without a government program.” I understand the point that it’s not all British-style and run directly by government.
But is it fair to say that the system of regulating what insurers must provide, and what we must buy, is not a program? Or, at a minimum, what about the fact that, as some have pointed out above, some of the coverage is provided by dramatically expanding Medicaid?
Medicaid is a “government program,” isn’t it, and it’s a key part of the reform.
So isn’t Obama’s SOTU statement false, or can anyone defend the proposition that there’s no government program involved?
January 27, 2012, 3:27 pmLaura(southernxyl) says:
Loki, are you having problems today?
Travis said I had obviously never tried to get private insurance. Here is EXACTLY what he said:
That is not true. I have not only shopped for it outside the employer-paid context, I have bought it (twice) because it was less expensive. Now if you want to make up something that Travis said that is glaringly obvious and also true, fine. But it won’t be what he said.
You said I think everything is wonderful.
That’s not true either.
So what’s glaringly self-evident?
January 27, 2012, 3:36 pmFloridian says:
I’m almost tempted to believe Adler assumed no one would read the poll . . . I did and connit see that his post accurately reflects the findings. At the very least it is misleading.
January 27, 2012, 3:38 pmLaura(southernxyl) says:
That’s true. You can look at your initial hospital bill, the one that says “don’t pay this yet, we haven’t billed your insurance company,” and your final EOB from the insurance company, and it’s really startling how much of the hospital’s initial bill never gets paid by you or them.
January 27, 2012, 3:43 pmtheobromophile says:
For those who missed the obvious point:
No. The reason for a mandate, kiddos, is that insurance companies can’t take all comers at the same price if people can wait until they get sick to get insured. The usual analogy is waiting until your house is on fire to get homeowner’s insurance. What my plan does is to remove the cherry-picking by the consumer (i.e. refusing to insure oneself until ill) by incentivising consumers to purchase the product before they become ill, and, in exchange, have a guarantee of being able to switch. In short, you remove cherry-picking by consumers and companies – without a mandate. Go figure!
January 27, 2012, 3:50 pmloki13 says:
He made a point, that it was really, really expensive. Which is a true point. Because, as a general rule, employers have some major advantages. Let me give you two big ones-
1. Tax treatment (aka government subsidy).
2. The ability to bargain, and, if they’re large enough, to demand concessions and hire people to deal with it full time.
That’s huge. Really, really huge. But, in your way, you made a point without a difference (as another commenter did). The key, of course, is that you said “healthy individuals.” Maybe (not assuming- wouldn’t want to do that!) they were kids, or young adults. Maybe the plan didn’t have the exact same standards as your employer’s (which is okay- maybe you don’t need those).
But as a general case, it is *nearly* impossible to find equal coverage cheaper, because the employer is paying a (subsidized) large share of it. Absolutely impossible? No. Because there will be rare cases when you can substitute have, say, a 23 yr. old, completely healthy spouse and have them on an individual plan with different limits and it will be cheaper than having them as a dependent on your employer’s group plan.
But as someone who has also shopped for plans for myself and my family in the past, that’s not the typical scenario. And to pass it off as such is sophistry. Because the point is valid- it’s really, really expensive. If someone tells you the “Maybachs are really, really expensive cars” and you reply, “Assume much? My grandpappy bought me one, so it didn’t cost me a thing” it’s not the rule- it’s the exception.
January 27, 2012, 3:52 pmtheobromophile says:
Incidentally, if you are worried about free riders, you could require people to get some very, very basic plan – like an 80/20 plan or a catastrophic care plan – but that is different from the ultimate effects of these big-government mandates being proposed. Here in Massachusetts, in order to have “minimum credible coverage,” your plan has to conform to 43 different requirements, up from the initial 16 at the time Romney signed the bill into law.
The problem with the mandates are that people start screaming, “Oh, I didn’t know that my fifth doctor’s appointment this year wasn’t covered,” or “Oh, it’s so unfair that I have to pay a deductible to go to my primary care physician” (as if the deductible wouldn’t be built into the cost of the policy otherwise [eye roll]), and then it becomes a mandate that you have to buy insurance that covers all of those things, or pay a tax penalty.
January 27, 2012, 3:54 pmAndrew J. Lazarus says:
Amazing how a little HTML markup makes Scattergood self-refuting.
January 27, 2012, 3:54 pmtheobromophile says:
Defending those who are a bit younger than me: in Massachusetts, it can cost over $300 a month to insure a completely healthy 22-year-old. I don’t think that it’s “slacking” to not throw $4k a year away on insurance when you only make $20k or $25k a year. In states in which I have been able to buy plans that are fairly priced for my risk level, a very comprehensive plan for someone in their mid-20s costs about $75/month.
As I keep pointing out to people, ad nauseum, if your house is worth $100k, you wouldn’t pay $75k a year in premiums. If you only make $50k a year, you wouldn’t pay $40k a year to insure you, your house, your car, or what-have-you. If we want kids to insure themselves, we should set them up with low-cost plans that cover cancer, a broken leg, or an appendectomy. Stop making us subsidise middle-aged women’s in vitro treatments and more of us will get health insurance.
January 27, 2012, 4:01 pmAndrew J. Lazarus says:
Umm, my private insurance company does this already. Indeed, Michael Moore made quite a nice little movie showing private insurance companies refusing to provide care. (If you follow that link, BTW, you’ll find pseudo-libertarian professional liar John Stossel defending an insurance company’s refusal of care.)
Sometimes I think Obamacare opponents know little about the status quo.
The ‘death panels’ canard didn’t even arise from management of care. It came from a deliberate distortion of insurance reimbursement for doctor/patient consultation about end-of-life decisions, which, BTW, you will probably have anyway unless you get hit by a truck.
January 27, 2012, 4:06 pmLaura(southernxyl) says:
Loki, I didn’t say it was typical.
He said I had never done it, and I had.
Both times, I was working for really small companies that could cover their own employees cheaply, but once you started adding family members it got very expensive, fast.
In the cases where I chose to buy private insurance, I would have paid the employer-based plan if that was the only way to insure my family. The first time I did this, it was before a lot of stuff was on the internet. I called BCBS out of the blue and said, “Don’t y’all just insure people?” They sent me some brochures. I was shocked as to how affordable it was. I had no idea, really.
You’re telling me it’s very rare to be able to afford private insurance. I guess it comes down to your definitions of “rare” and “afford”.
January 27, 2012, 4:08 pmricky says:
Insurance is for unknowns. Your condition is known. What you’re basically saying is that you’re a charity case, and you’re mad that private companies aren’t bending over backwards to give you charity, and so you want the government to put a gun to peoples’ heads to force them to give you their money.
Here’s a radical idea: work hard, get a good job, and pay your own damn medical bills. Or just die, please.
January 27, 2012, 4:11 pmyankee says:
I have a very mild preexisting condition. I once had to look for insurance on the private market. No company would insure me at any price. Fortunately I was not uninsured for very long.
January 27, 2012, 4:18 pmfalse seriousness says:
Actually, the conflation is incredibly apt.
I guess you are also a lemon socialist – you favor stupid and inefficient emergency room care as an insurance coverage mechanism. Or maybe you just favor people dying who can’t pay for coverage?
These healthcare debates always smoke out the people who think they are knowledgeable about these issues but actually aren’t. You are clearly one.
I say this because you say,
In fact, it is critical to get healthy people into the paying risk pool, because they are already receiving the benefit of your form of lemon socialized medicine. They will need it later, that’s the deal, and some not so later.
Furthermore, the last relevant study indicated that 46,000 Americans die every year from lack of coverage. Who knows if that number is right, but it’s clearly a lot of people who die.
I knew a guy who was one. He lost his job, lost his coverage, wasn’t feeling well, but didn’t want to rack up debt, so he hung on, waiting to qualify for medicaid, but then he started feeling really bad, and went to hospital, where he died 2 days later of diabetes, which could have been treated earlier. And this is a sadly common scenario.
January 27, 2012, 4:21 pmyankee says:
I hope this is parody.
January 27, 2012, 4:22 pmfalse seriousness says:
Hey Adler, I don’t think Ricky is going to poll well.
January 27, 2012, 4:24 pmTravis says:
Finally, we see the right-wing ethos in all its unconcealed glory. No paper-thin platitudes about death panels or government takeovers or socialism. That’s just phony nonsense designed to distract and obfuscate.
No, the right-wing is about I’ve got mine, so screw you. If you have a problem, it’s your own damn fault. And that goes double if you’re gay.
Points for honesty, ricky. Points for honesty.
January 27, 2012, 4:28 pmLaura(southernxyl) says:
Yankee, that happened to my daughter after she graduated from college. She got a job through a temp agency and I assumed that she wouldn’t get coverage until she was a permanent employee. The first company we tried to get insurance with turned her down b/c she’d had a migraine we had to seek medical attention for and an MRI showed a cerebellar infarct. The neurologist said it was just that migraine and offered to argue with the company (whose letter said they were open to appeal and also offered suggestions for where else she could apply) but in the meantime it turned out that the temp agency did cover her. So we didn’t take it any further.
It’s irritating to think that in taking care of your problem today you are possibly causing problems for yourself in the future. I suggested several comments upthread that a time period be set during which people with preexisting conditions couldn’t be turned down, and after that that they couldn’t be turned down if they’d had continuous coverage.
January 27, 2012, 4:30 pmLaura(southernxyl) says:
Travis, no you don’t. You see Ricky’s ethos in all its unconcealed glory.
January 27, 2012, 4:36 pmStephen Lathrop says:
Did I misunderstand the poll methodology? It seems to say that they called and asked to speak to the youngest adult in the household. No explanation for why that is the right way to do it. Seems to me that would naturally bias the interviews in favor of the people most likely to oppose the mandate. Why not just ask the person speaking if they are adult, and interview anyone who answers yes?
January 27, 2012, 4:41 pmricky says:
If you’re gay than you’re almost certainly engaging in some extremely risky lifestyle decisions and any health problems you contract are definitely your own fault and I do not want to be forced to pay for them.
But no, not every problem is somebody’s “own damn fault.” However, if you’re a charity case you need to show some gratitude rather than acting like we all owe you something. If you’re going to be a burden on society, you have no right to complain.
January 27, 2012, 4:45 pmcaptain_slow says:
Wow. I guess it would be too much to ask for you to get another job?
Or maybe it’s too much to ask to pay for the product you are consuming?
What in the heck has happened to this country? No, there’s no magic thing that makes you get something you are unwilling or unable to pay for. You are living in a fantasy land if you think there is some kind of magic whereby the expensive thing you want, maybe the thing you really NEED to survive, somehow should by rights be given to you for free.
Now just because you have decided that someone else, who you think should be able to afford to provide for themselves AND provide for you as well, doesn’t make it a reasonable thing to do.
If you can be broke and get expensive stuff for free, then why in the heck will anyone work and pay for stuff themselves?
Are we really this dumb?
January 27, 2012, 4:45 pmBob from Ohio says:
Stupid people. Can’t let them have an opinion. What is this country, a democracy.
If they just had Steve’s vast and totally unbiased level of knowledge, then they can have an opinion.
January 27, 2012, 4:50 pmcaptain_slow says:
This is not a valid suggestion at all.
Socialized anything is not a solution to cost containment.
The solution to cost containment, for anyone who has ever considered basic economics, is to reduce demand. You don’t reduce demand by allowing everyone to have something without paying for it. The high price is supposed to moderate demand. But it doesn’t, because the cost is not paid by those who are making the demand choice.
I don’t care if it’s health care or widgets. Once the cost of an item is decoupled from the consumer of that item, then the cost is not entered into the value proposition and there is nothing to moderate demand.
So when you twist your ankle playing basketball, you can do one of two things:
1. walk it off, go home and ice it, see if it starts getting better, and if so, just take it easy and let it heal on its own
2. go to the ER, get an x-ray, it’s inconclusive, follow-up with an orthopedic surgeon, get an MRI, rack up $10K in medical bills, and eventually be told that you have a sprained ankle that does not require surgery, go home and ice it and take it easy, it’ll heal on its own.
Now, if you have to sell your car to pay those $10K in bills for option #2, you might think real hard about whether option #1 is worth trying. If enough people choose option #1, eventually the demand for option #2 goes down to the point that those costs are reduced.
Sure you can come back with your congenital disease or whatever, and of course there are some issues for which the only option is expensive treatment. But the truth is, there is enormous abuse of medical insurance for things that do not require expensive treatment or any treatment at all, because since it only costs you a $10 copay, and the insurance company is the one on the hook for the $2500 MRI, then you figure, what the heck? Why not? And this is what’s driving up the price of health insurance.
The best solution for cost containment and fixing this problem, frankly, is to ban employer-sponsored insurance. But you know what they say about Peter & Paul.
January 27, 2012, 4:55 pmTravis says:
Yes, because in the real world, getting another job is as easy as just having someone tell you “Get a job.” Brilliant stuff.
Oh yeah, because the standard of living for someone on food stamps and Medicaid is exactly like the standard of living for someone making $150,000 per year. Exactly.
Are you really that dumb?
January 27, 2012, 4:56 pmyankee says:
1) By “extremely risky lifestyle decisions” I presume you mean unprotected anal sex. In that case your claim is simply false as applied to gay men and completely absurd as applied to lesbians. Lesbian sex is the safest sex of all.
2) I presume you have never made any risky lifestyle decisions? I remember a saying about taking out the beam in your own eye that might be applicable to this situation.
January 27, 2012, 4:57 pmBob from Ohio says:
You’ve identified why Romney would be a disaster for the GOP.
January 27, 2012, 4:58 pmDilan Esper says:
I love this post because it encapsulates everything that is wrong with libertarian thinking on health care. Note the gross generalizations– anyone who didn’t buy health insurance must have been too irresponsible to get it. That’s the only reason. It couldn’t be that it was too expensive, that they couldn’t afford it, that they had a preexisting condition and were ineligible, or that the only coverage they could get sucked. It has to be irresponsibility.
And further, the unstated premise. The penalty for that alleged “irresponsibility” is death or serious illness (unless they can convince someone to help them despite their supposedly “irresponsible” choice). That’s the only thing that will teach them.
January 27, 2012, 5:01 pmTravis says:
Or, when you think you twist your ankle playing basketball, you can do one of two things:
1. Walk it off, go home and ice it, realize too late that it’s more than a simple sprain and do permanent damage to the ligaments/joint, leaving you unable to work in your previous job of groundskeeper. End up on disability/Medicaid, costing hundreds of thousands of taxpayer dollars, cumulatively.
2. Get it checked out by a professional, find that it needs surgical repair, get the proper care and return to work as a productive, taxpaying citizen.
See, hypotheticals are fun.
January 27, 2012, 5:01 pmDilan Esper says:
This is an intellectually honest concession that I have some respect for, but bear in mind it’s not one that most of the opponents of Obamacare on the right are ever willing to make (because they are contending that the entire concept of mandating the purchase of ANY sort of health insurance, no matter how frugal, is both unconstitutional and inconsistent with liberty).
January 27, 2012, 5:08 pmAndrew J. Lazarus says:
Ricky and capt_slow exemplify what a friend of mine called Banana Peel Libertarianism. Nothing makes their day as much as seeing others suffer and die, concluding (usually through post hoc ergo propter hoc reasoning) that they deserved it and the world is better for it.
January 27, 2012, 5:11 pmTed says:
Correct. It’s about people dying needlessly, and by “needlessly” The Left(tm) means because the dying cannot pay for a standard level of care.
That’s not going to change. The left is as likely to come to terms with people dying of curable illnesses as the right is come to terms with people dying in wombs.
January 27, 2012, 5:11 pmcaptain_slow says:
As long as you pay for it, be my guest.
While you’re asking me to pay for it, I suggest you should have to at least try the cheap way for a couple of days before spending $10K worth of my money to fund your hypochondria.
January 27, 2012, 5:13 pmrpt says:
I agree, but not necessarily worse than Gingrich. Glad to see him reaching for the moon. But for all those who watched, Romney made a compelling case why the mandate is better than the current GOP alternative of doing nothing.
January 27, 2012, 5:17 pmTed says:
This. This the problem that needs a solution. Provide a solution that prevents this, without changing the fact pattern, and I think we’re on to something.
January 27, 2012, 5:18 pmcaptain_slow says:
Oh, I see. You have created a “standard of living” argument, which somehow suspends mathematics and makes your fantasy land come true.
Man, you are so much smarter than the rest of us! Maybe all of us who are so dumb will keep on working and earning so much more than all of you geniuses who are broke and can’t find a job, that way you can continue to confiscate our money to buy your own health insurance and other welfare. If only we could make those idiots, who happen to also be the ones earning most of the money, be so smart as the enlightened poor people.
January 27, 2012, 5:19 pmJarbidge says:
This concept needs to get a lot more attention. Regardless of what other health care reforms we might try, we should try this one first. Having a procedure cost $X if you have BCBS and $2X or $5X if you are paying cash on the barrel head is a custom that seriously distorts the market. Markets aren’t perfect, but charging all comers the same sure wouldn’t make the health care market perform worse, and might make it perform a lot better. A few people with catastrophic only policies and shopping around for the rest or their care would add some currently nonexistent pressure on costs.
January 27, 2012, 5:21 pmJasonRabbit75 says:
To echo rpt above, Romney’s defense of mandates during the debate (and getting applauded for it by the Republican audience):
January 27, 2012, 5:22 pmArgo says:
Travis,
I think what ricky is saying (in a very heartless fashion completely lacking in empathy) is not that your pre-existing condition is your own damn fault, but rather that it is not ricky’s fault.
All that said, the style of ricky’s argument certainly didn’t help his cause.
January 27, 2012, 5:25 pmrpt says:
We know that Gingrich is on Medicare. What care does Paul and Santorum have? Paul has access to the VA and the Congressional plan; RS probably has coverage through one of his lobbyist employers. What does Romney do; what did he do during his wife’s illness? Questions like this (and the audience members last night) might take this discussion out of the ether and into the real world.
January 27, 2012, 5:25 pmTed says:
So, hush up then.
January 27, 2012, 5:26 pmChrisTS says:
Tatil writes:
19 years ago, as a nonsmoking, nondrinking (from 2 months prior to pregnancy)mother to be, I toted up slightly over a quarter of a million in medical bills for a pregnancy that went slightly haywire at 26 weeks and then again at delivery. I have no idea what that would have meant for us absent excellent insurance. Bankruptcy, I suppose. We are big savers, but ¼ million for one year? Nope.
January 27, 2012, 5:33 pmrumpelstiltskin says:
Yes. That’s why we have a third judicial branch that is two steps removed from popular opinion.
January 27, 2012, 5:41 pmSeth Richmond says:
I can accept that 54% of Americans do want the individual mandate struck down. I wouldn’t accuse that of being “spin.”
The fact that a majority of Americans also appear to be confused and would approve of things that are almost exactly like the individual mandate so long as it is given a different name and perhaps introduced by a different party is another issue.
And whether universal healthcare or the individual mandate is constitutional or a good policy idea is still another argument.
It would have been fairer for Prof. Adler to at least note these things, but as long as there are open comments I don’t think it’s that big deal.
I think the fairest description of the general US feeling towards healthcare right now is that they don’t like the individual mandate, but also don’t like the way things are now. They don’t want completely private healthcare nor do they want government healthcare. In short, they dislike a lot of things, but there is no real consensus on exactly what it is they DO want.
January 27, 2012, 5:57 pmfalse seriousness says:
I do not believe this. You are wrong or you are making stuff up.
There is no way an individual policy is less than a group plan, unless you buying a completely shit individual policy that doesn’t actually provide any coverage.
I actually work for an insurance company and there’s no way what you are saying is true or in context.
Tell me what your insurance cost was at work v. what you were quoted for individual coverage, and tell me what the percent of approved claim was covered under this policy.
January 27, 2012, 6:17 pmSGI says:
Black people were not consulted for this survey. They would have voted 100% against overturning an Obama initiative, but unfortunately they’re too dangerous for sane inquisitors to get near.
January 27, 2012, 6:29 pmBuford T. Justice says:
Most people don’t even know that 35 states already have high risk pools that are guaranteed issue (automatic acceptance even if you have a pre-existing condition). Just allow people to shop nationwide for the health care plan of their choice and force all companies to compete and that will address the pre-existing conditions concern. Yes, the premiums are higher than standard insurance, but that’s how it should be for those who will cost more. After a probationary period, the premiums will start to go down to align with others who have been paying into the system all along. Of course nobody should wait until they have a pre-existing condition to enroll for health insurance.
January 27, 2012, 6:32 pmTravis says:
When ricky’s house burns down, it’s not likely his fault or my fault, either. Yet we’ve decided that it is a societal good that the fire department comes and rescues his family and puts that fire out regardless of whose fault something might be, or whether or not that person can pay, on his or her own, the direct and indirect costs of putting out that fire. Those costs are instead paid for by taxation of the population served by a given fire department – which may include thousands or millions of people who had absolutely nothing to do with the fire.
Every other developed Western nation on the planet has come to the conclusion that treating health care in a similar fashion makes sense.
January 27, 2012, 6:36 pmLaura(southernxyl) says:
No.
I don’t still have the paperwork. I can’t give you numbers. But I picked decent plans and they were less expensive than the spouse and dependent coverage through my workplace. You can believe it or not, as you wish.
January 27, 2012, 6:38 pmGrover Gardner says:
#1 is exactly what I did when I fell on my knee and chipped a bone. Waited a week to see a doctor because I didn’t have insurance. Guess what was the first thing out of the doctor’s mouth?
“If you’d come in right away this would have been easier to deal with.”
In the meantime, Mr. It-Will-Heal-Itself here fell in the shower and almost killed himself because he could barely move his leg.
Do you know how many people don’t seek immediate treatment because they can’t afford it, and how often that just increases the misery and the costs?
Plus, for someone with a more subtle issue like skin cancer, heart disease or diabetes, your advice to “see if it takes care of itself” is about as bad as it gets.
January 27, 2012, 6:39 pmLaura(southernxyl) says:
…And it’s not hard to see how it could be like that, false seriousness. The workplace coverage covers everybody, regardless of their health, so it’s going to be expensive for small companies. Because my husband is healthy, and my daughter, and at the time I covered her like this she was not yet of childbearing age, the insurance companies were able to quote them specifically, rates for healthy people.
Do not conclude from this, as others have, that I am extrapolating to everyone. I am simply pushing back against the idea that no one can afford individual coverage.
January 27, 2012, 6:42 pmrpt says:
Sorry I couldn’t post the link directly, but here is a report of the first Romney pro-mandate campaign ad:
“By Igor Volsky posted from ThinkProgress Health on Jan 27, 2012 at 3:10 pm
At last night’s GOP presidential debate, Rick Santorum challenged Mitt Romney on the similarities between the health care reform he signed into law as governor of Massachusetts and President Obama’s Affordable Care Act. “Your mandate is no different than Barack Obama’s mandate. It is the same mandate,” Santorum charged. “You take over 100 percent, just like he takes over 100 percent, requires the mandate. The same fines that you put in place in Massachusetts are fines that he puts in place in the federal level. Same programs.”
The comparison immediately put Romney on the defense, who claimed, “I didn’t say I’m in favor of top- down government-run health care,” and explained that he expanded access to “private insurance” and allowed people to “choose any plan” within a state-run exchange. “There’s no government plan,” he added. “And if you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care. So we said, no more, no more free riders.”
Romney’s description of his plan sounded so much like Obama’s rational for the federal health care law that ThinkProgress has compiled a video comparing how both politicians describe their reforms.”
January 27, 2012, 6:43 pmleo marvin says:
Ya think? Last year I had an appendectomy. The bill (in round numbers), excluding doctor fees, was $19K for one day in the hospital. My insurance company paid $4K; the other $15K was “negotiated fee reduction.” The doctors did better, receiving a little more than 30 cents on the dollar of their combined $10K fee for services.
In that world, health insurance is more Mafia protection racket than calculated risk spreading. Nobody with modest assets can afford not to have insurance, yet few people with significant pre-existing conditions can buy it. If you’re lucky enough to be covered by an employer plan, you can’t make otherwise rational career choices for fear of going naked. And a final rarely addressed point is that employers know which employees have the conditions that drive up their group premiums. If you think their jobs aren’t more precarious than their healthy co-workers’, you’re kidding yourself.
In short, there are excellent reasons having nothing to do with Karl Marx, or even the understandable impulse to spite people like Ricky, so much of the advanced world sees the wisdom in removing profit motive from the provision of health care.
January 27, 2012, 6:43 pmLaura(southernxyl) says:
Grover, all of this is complicated by the fact that sometimes people with insurance don’t seek care when they should, for a variety of reasons. They don’t trust doctors. They don’t want to take the time to sit half a day in a waiting room. They don’t want to hear bad news, or they expect to be told to lose weight or quit smoking and they don’t want to hear it. Lack of insurance is not the sole barrier to people getting adequate health care. It could be 100% free and still some people would not avail themselves.
January 27, 2012, 6:45 pmJohn says:
Unfortunately, the individual mandate is the only thing that could possibly keep the provisions in the rest of Obamacare afloat, since those at low risk tend to underselect in health insurance risk pools.
So- if congress/senate/president insist on keeping the rest of Obamacare in place, more and more insurance companies will leave the market and create an even more pressing “health care crisis” which will cause a single payer system to need to be put into place.
January 27, 2012, 6:50 pmGrover Gardner says:
I’m sure that’s true, but what does it have to do with people who *would* seek care if they had insurance?
January 27, 2012, 6:53 pmyankee says:
So if you acquired your preexisting condition as a child, or before birth, sucks to be you?
January 27, 2012, 6:57 pmrpt says:
But we are “exceptional”; just not always for the right reasons.
January 27, 2012, 6:59 pmLaura(southernxyl) says:
Grover, my point is that you can’t assume that lack of health care is due to lack of health insurance.
I don’t believe I’ve ever said here that I don’t care if people can’t get insurance. I think I’ve actually said otherwise.
What I do think is that I don’t think the healthcare problem is clearly understood and defined, and I don’t think the choice is between mandating that everyone buy health insurance or doing nothing at all.
If you think that mandating health insurance means that everyone will now go to the doctor when they need to, you really ought to reconsider. Health insurance is not equivalent to health care.
January 27, 2012, 7:00 pmJonny Scrum-half says:
Would the commenters who warn about the inefficincies, unfairness and moral hazard associated with “Obamacare” be more satisfied with a European-style single-payer system? The per-capita cost of health care in such sytems is typically less than half what we spend.
January 27, 2012, 7:01 pmGrover Gardner says:
Who’s asking you to pay for anything? Do you have health insurance now, on your own or through your employer? If so, what’s your beef?
If you don’t have health insurance, I’m probably going to end up paying for YOU. And at this point, that’s not a very attractive proposition. Can we talk?
January 27, 2012, 7:05 pmObamacare Supreme Court case pre-game analysis - Page 2 - CycloneFanatic says:
[...] [...]
January 27, 2012, 9:35 pmFub says:
So, what are the arguments against a statute prohibiting differential pricing depending on who pays?
I know the reality is that insurance companies would spend as much as necessary to defeat such legislation, but that is not the kind of argument I’m asking about.
What are the moral or economic arguments that might be on a hypothetical ballot proposition for such a statute, or that would be legislatively debated?
January 27, 2012, 11:01 pmStephen Lathrop says:
To begin with, insurance companies would lobby that it would require them to raise the rates on their group policies. They would say they can only afford the present rates because group policies escape the adverse selection risk that individual policies incur. Insurance companies don’t like to say it, but the high rates for individuals are designed to keep individuals out of the market altogether, because it is too risky to let someone judge their own health situation and then apply for insurance, or not, depending on their condition. If continuing to avoid that risk requires raising group rates, because of some regulation that ties the two together, then the no-doubt-saddened insurance companies will just have to raise the rates for everyone. Just business.
It’s like the oil business. Any notable change will generate press releases chorusing a plausible-sounding story, followed by a price increase based on market fundamentals. The only thing that can hold prices down is if nothing happens, so naturally, stuff happens all the time.
January 28, 2012, 4:22 pmRicardo says:
Before PPACA, health insurance underwriters and actuaries were perfectly free to price premiums according to a client’s expected medical costs. Sorry, but $300 per month just might the actuarially fair price for a healthy twenty-something. One reason why it might be is adverse selection or imperfect screening mechanisms to identify people with pre-existing conditions.
January 28, 2012, 10:10 pmGreg Q says:
Oh? Sonia Sottomeyer didn’t claim that the “life experience” of a “wise latina” would make her a better SC “Justice” than a white male of similar accomplishment?
No one claims that the Constitution is a Living Document? What planet are you on?
No one who claims that wants to admit that what they really mean is “the Constitution means whatever the “Justices” I like think they can get away with? I’m sure they don’t want to admit that. it doesn’t make it any less true.
January 28, 2012, 10:41 pmGreg Q says:
January 28, 2012, 10:59 pmleo marvin says:
Doesn’t it give you any pause when you think the only people not lying are the ones who share your policy preferences?
January 28, 2012, 11:39 pmRicardo says:
Whoever implied such a thing? There is a very long and active debate over health care policy and I have never heard any informed person say that the choice is between mandating health insurance and the status quo.
Rather, the idea of mandating health insurance is proposed as a solution to the problem of adverse selection in the individual health insurance market. The Netherlands also mandates health insurance but many other countries do not; typically, these countries have a large amount of government intervention somewhere else in the health care market, though.
January 29, 2012, 12:40 amzuch says:
In other news, asked whether Newt Gingrich is a cereal philatelist, 37% of ‘Merkuns said “yes”, and 26% said “Ohmygawd, yes!”….
Cheers,
January 29, 2012, 12:46 amBuford T. Justice says:
Absolutely not. It’s the mother’s responsibility to be insured which covers her newborn. The child should be insured before even being born and that coverage should be maintained by the parents until adulthood when the now grown child will be responsible for himself/herself.
January 29, 2012, 12:54 amRicardo says:
Which is a fine theory except that such insurance does not appear to exist in the United States. Children are covered by family plans until they reach a certain age or graduate from college (PPACA mandates coverage through the 25th birthday). If someone reaches this point and develops a pre-existing condition, one must secure group coverage through an employer or else one’s options for affordable health care are very limited. Most individual plans will not take someone with a pre-existing condition and there is rarely an option to extend coverage on the family plan; you are either looking at buying into a high-risk pool (if your state offers one) or else becoming poor enough to qualify for Medicaid.
January 29, 2012, 1:04 amzuch says:
Oh, so those whose health is “well-behaved” and doesn’t accumulate any more points will finally be able to afford it?!?!? Health insurance is just like car insurance?
What’s going to make this happen?
And what happens to the people whose health just doesn’t co-operate? A bit of “hurry up and die”, eh?
Cheers,
January 29, 2012, 2:00 amricky says:
20% of gays contract HIV by the time they hit 50 years old. If you choose to live a lifestyle with those risks, OKAY FINE I guess, but don’t expect me to pay your medical bills
Lesbian “sex” is a politically correct fantasy, just like gay monogamy. Just like “gay men” are really just hyperactive sex fiends who will screw any hole presented to them, “lesbians” are hypoactive sex rejects who claim a “lesbian” identity as an excuse to avoid having to deal with men sexually. Lesbian “bed death” is a nearly universal phenomenon because none of these women have any meaningful sex drive towards other women.
yankee: I presume you have never made any risky lifestyle decisions? I remember a saying about taking out the beam in your own eye that might be applicable to this situation.
No, I haven’t ever seriously jeopardized my health by engaging in immoral behavior. The fact that you seem to assume that EVERYONE DOES THIS KIND OF THING says more about you than it does about me.
January 29, 2012, 2:09 amzuch says:
How do you go about “develop[ing] a good marker for temporary insurance”? ‘Socialism! Socialism!!!…’
And how are you going to keep rates down?
And didn’t you just suggest that we ban denial based on pre-existing conditions? which is what PPACA does…..
Cheers,
January 29, 2012, 2:11 amzuch says:
A “fantasy”, eh? Why yes, quite the fantasy … for all those guys that go out and watch all the ‘lesbian’ porno films, which are for some curious reason some of the most popular films!….
Everyone knows real lezzies don’t ever have sex.
Cheers,
January 29, 2012, 2:17 amtomemos says:
I don’t understand. You have all this control over private entities—your insurance company, your employer, other customers—such that, in your case at least, there simply is no insurance crisis. (Perhaps all the people who *have* encountered a problem just don’t have your persistence and will.)
But when it comes to the federal government, which is *actually a democracy in which you have a vote,* you’re powerless to effect any change? If you can motivate others to bring Blue Cross to its knees, why can’t you and your like-minded fellows elect a government that will give you the health care system you want?
Plus, are you under the impression that you can’t sue the government? Let me share with you the Good News!
January 29, 2012, 3:49 amLaura(southernxyl) says:
People right here on this thread, Ricardo. Now, I won’t vouch for their being informed.
This in a thread not about a poll concerning insurance reform, or healthcare reform, but the mandate, looks to me like a choice between mandating health insurance and the status quo. I’m not picking on FS because s/he isn’t the only one but it’s the first comment I came across like that.
January 29, 2012, 8:01 amStephen Lathrop says:
And on your premise—that government action is off the table no matter what, and the companies are in the drivers seat—how practical do you expect those sorts of actions to be?
January 29, 2012, 8:48 amRicardo says:
I admit I merely skimmed most of the comments here but I didn’t see anything that could be characterized as arguing the individual mandate is the only option. Rather, the common argument made is that it is the best available option if one does not want more government provision of medical care or of insurance.
January 29, 2012, 9:24 ambyomtov says:
Greg Q.,
Sure you can. Ever sued anyone, much less a big company with an army of lawyers and all the time in the world? And did you do that while you were sick and dealing with unpaid medical bills?
Public stink? How? Write a letter to the editor? Start a web site? What? If all that worked insurance companies would never turn down claims unreasonably. Yet they do.
January 29, 2012, 11:15 amLaura(southernxyl) says:
Ricardo, I read the comments and responded to them. If you don’t read them then you can’t really tell me what nobody is saying.
January 29, 2012, 12:05 pmFub says:
I think you misunderstood my question. I wasn’t addressing differential insurance rates depending on who the insured is.
I’ll rephrase. Presently healthcare providers (physicians, hospitals, clinics, etc.) charge patients who pay out-of-pocket more for the same services and goods than they charge insurance companies. Those are the differential rates I was addressing.
I was not addressing rates charged by insurance companies to insure different individuals.
My question was what moral and economic arguments would likely be raised against a (hypothetical) statute that prohibited healthcare providers (physicians, hospitals, clinics, etc.) from charging lower rates to insurance companies than to individual payers for the same services?
Note that the healthcare providers would have two choices in that case: they could charge insurance companies the same higher rates they presently charge individual payers; or charge individuals the same lower rates they presently charge insurance companies.
January 29, 2012, 12:07 pmStephen Lathrop says:
I understood you the first time, and I think my argument still stands. Rates that healthcare providers charge individuals, including uninsured individuals, have often been negotiated with insurance companies as conditions of the contractual relationship between the healthcare provider and the insurance company (or else both my pharmacist and the Tufts health plan are misinforming me). Apparently, insurance companies feel they have an interest in making lack of insurance as expensive as possible, and they are in a market position to act on that interest.
Of course that sounds like grotesque collusion that ought to be illegal, but you asked about the debate. And there, I think you have neglected a third choice, in addition to the two you mention. Insurers could argue that regulations linking prices for the uninsured to their much-lower negotiated rates for the insured would increase insurance company risk overall—by providing incentive for healthier group plan enrollees to drop out and take advantage of the new lower individual rates. Therefore, that risk must be offset by raising both sets of rates. The rate for the uninsured goes up to somewhat reduce the unwanted incentive, and the rate for the group-insured goes up to offset the increased risk of a sicker pool of insureds. Only doing that to keep the insurance company, ahem, “solvent,” of course.
I don’t think anything you can do will get the insurance companies out of the legislative picture—except beating them once and for all and putting them out of business with single payer.
January 29, 2012, 12:46 pmStephen Lathrop says:
Rereading, I see the way I wrote it in my post above seems too paradoxical to make much sense. To make sense of it the insurance companies would have to argue that the rates for the insured should go up, to accomplish both objectives. Which is what I believe they would do.
January 29, 2012, 1:17 pmCockleCove says:
The smugness of some here, and the insular nature of their lives, is startling.
Here’s a pre-PPACA snapshot. In 2006 (before the economic collapse), more than 75% of New Yorkers without medical coverage were employed or self-employed or a dependent family member of someone in the work force. 74% of the uninsured workers (not self-employed) did not have access to insurance through their employer; roughly half of the working uninsureds made less than $20,000.
FYI for OrenWithAnE re the Freelancers Union, which BTW is not “run” by New York State: I looked into the health insurance plans offered by the Freelancer’s Union a couple of years ago when I was contemplating “hanging out a shingle”.
Generally speaking, the FU plans do not cover treatment for pre-existing conditions –the definition of which is more expansive & less high risk than many realize — during the 1st year in which you participate.
The individual plan with the least expensive monthly premium was ~$300/month. That plan’s co-insurance rate was 70%-30%; the annual deductible was $3500; and you didn’t reach the cap on annual out-of-pocket expenses until you had paid $30,000 of your own money.
Unless one is blissfully ignorant of hospitalization-related charges, it’s not hard to conceive of a non-catastrophic medical event whereby you’d be expected to come up with 37G+: ~$300 premium x 12 months + $3500 deductible + $30,000 out-of-pocket expenses. And of course, the annual deductible and $30,000 out-of-pocket requirement begins running anew as soon as the policy year ends.
Further FYI, the Freelancers Union’s group plans are not available to everyone who is self-employed. You have to be a NY resident & working in one of their “eligible industries” (e.g., arts, entertainment, technology, financial services), and so many NY entrepreneurs, including lawyers and a sizeable majority of small business owners, do not qualify.
January 29, 2012, 2:56 pmLaura(southernxyl) says:
Cocklecove, I don’t mean to be smug or insular, but a lot of things cost money like that. How many people are upside-down in their mortgages and can’t sell their houses to lower their note. Or have reasonable mortgages but lose their jobs and can’t keep their homes. How many people have ridiculous amounts of student loans and can’t get a job. What you are describing is kind of the human condition. Yes, if we can make it easier for people we should. But a lot of times people get the care and are then in debt after the fact. That’s not very nice but it’s not like not getting the care.
January 29, 2012, 5:45 pmCockleCove says:
I have never thought of you as smug, Laura, or cavalier or blithely uninformed. My first sentence above was prompted by the declamations of, e.g., ricky, capt_slow & (surprising to me) David M. Nierporent’s jeer up-thread; the “talking through one’s hat” pontifications; etc.
That said, PPACA takes a different approach than I would have drafted. I would much prefer to sever the link between employers and insurance.
January 29, 2012, 8:12 pmRicardo says:
Laura, frankly, I have better things to do with my time. Since you have not provided a quote or citation to the exact comment you have in mind, I don’t really know whether you are reading that comment in a charitable manner or not. In any case, though, the views you attribute to supporters of the mandate are a strawman as far as informed commentators are concerned.
January 29, 2012, 9:26 pmLaura(southernxyl) says:
Ah. Well, I have come to expect certain things from certain people.
I’d like to see a problem defined and agreed upon, myself.
Is it:
(A) People can’t get insurance.
(B) People can get insurance, but it’s too expensive and they can’t afford it.
(C) People can get insurance, but it’s very expensive and they can have high out-of-pocket expenses anyway.
(D) People aren’t getting health care.
(E) People aren’t getting health care because they have no insurance.
(F) People without insurance are getting health care, but it’s spotty and there’s not much there for chronic problems.
(G) People without insurance are getting health care but they run up life-crushing debt.
(H) People without insurance are getting health care but the rest of us are having to bear the cost.
(I) People without insurance are getting health care but it’s more expensive than it would be if they’d not put off going to the doctor.
Because I’ve seen most or all of these put forth as the problem, but some of them contradict each other and one solution won’t necessarily fix them all.
January 29, 2012, 9:32 pmLaura(southernxyl) says:
Ricardo, fine, don’t read the comments. But then don’t tell me no one is saying it’s mandate or nothing. I read them all once, which you did not bother to do, and I don’t feel like going back through them to reconstruct the conversation for you.
January 29, 2012, 9:35 pmBuford T. Justice says:
You’ve misunderstood. Yes, in some policies it is like car insurance if there is less utilization. Those who join a high risk pool will pay higher premiums for a probationary period. After that period, they will be rated more along the rest who have been paying into the system all along. The premiums may depend on the specific plan and amount of utilization during the probationary period. If there’s more utilization (due to the pre-existing condition), they will likely pay a higher rate than the others for a longer period of time. Others will pay less. Those are the actuarial risks and costs of customers and they will still keep their coverage.
January 30, 2012, 12:39 amBuford T. Justice says:
My last post might already be up, but the website wasn’t responding, so disregard if this post is redundant.
You said it yourself with the high risk pools. Allowing insurance to be purchased across state lines will extend this opportunity to all.
Another way is to have overlap with the expiring policy and a new one that has a probationary period that will not pay for the pre-existing condition. Yes, it’s two policies at once for a period which would likely be more expensive than waiting until the first policy stops and joining a high risk pool.
January 30, 2012, 1:13 amjmaie says:
When ricky’s house burns down, it’s not likely his fault or my fault, either. Yet we’ve decided that it is a societal good that the fire department comes and rescues his family and puts that fire out regardless of whose fault something might be, or whether or not that person can pay, on his or her own, the direct and indirect costs of putting out that fire.
Inapt analogy, we put out fires to keep them from spreading.
January 30, 2012, 2:56 amfalse seriousness says:
Laura, it’s pretty clear you are, once again, reading what you want to read and making up whatever points you want to make up.
I’m not sure what audience you think will be impressed by that, but I’m not.
January 30, 2012, 9:09 amloki13 says:
This may come as a shock to you, but some “issues” aren’t resolvable to one clear, simple, easy to resolve “problem.” FWIW, you haven’t even listed all the problems.
Moreover, the PPACA isn’t one solution. One of the criticisms is that it’s too complex. So I guess you could say that it seems contradictory that opponents would both claim that it is too complex and trying to do to much, and yet it doesn’t address “one problem.”
Right back at ya. ;)
January 30, 2012, 9:48 amLaura(southernxyl) says:
Well, here we have a major understanding breakdown.
I’m not trying to impress an audience. If you are, that explains why we are talking past each other.
January 30, 2012, 11:18 amLaura(southernxyl) says:
Loki, I suspect that it will come as a bigger shock to you that you are making my point for me.
It would be real damn cool if people would look at what I am saying instead of making up in their head what I ought to be saying, based on the political pigeonhole they have shoved me into, and respond to that.
January 30, 2012, 11:25 amloki13 says:
It would be real damn cool if you would acknowledge that people did actually respond to the exact thing you just wrote, and then, maybe, clarify what you meant if it wasn’t what you wrote, instead of always pulling the same routine.
I mean, do you want a detailed analysis of your prior post- here goes. First, you list a bunch of things. You then erect a strawman by saying that “people” identify the things you listed as “the” (you used bold) problem. This is incorrect, as there are a bunch of different problems. Then you write that “one solution won’t necessarily fix them all.” Which is rather self-evident; the question that should be asked is-
Is this “one solutuion” (no, it clearly isn’t- it’s a whole bunch of proposals we call Health Care Reform or the PPACA or ObamaCare).
Is any one saying that it will “fix them all”? Well, it will make some problems better (allegedly- that’s what the debate is about). In the real world, nothing “fixes everything”- if it did, it would get 100% support.
But I was able to point this out in a much shorter post. Better? :)
January 30, 2012, 11:54 amloki13 says:
For example, if you wanted to really contribute to the debate, you might note that most people that have really studied the problem on the left and the right agree on one thing- the main “problem” is employer-based health care.* Now, there’s a big divide between the two camps as to what to do once we get rid of that (as you can imagine), but there’s a good overlap of agreement on that idea.
So why doesn’t that happen? Because of path dependency (that’s what we have) and politics. There’s no way it could happen currently. It would be political death (people, like you for example, are happy with their current employer-based health care, and politicians don’t want to touch that). In addition, there’s political money (insurance companies do contribute to campaigns).
*I’m speaking loosely here. In terms of the evolution of our insurance industry and coverage, this has been the problem. Overall, rising costs of health, loosely defined, is our biggest problem.
January 30, 2012, 12:01 pmDotar Sojat says:
Well, loki, I’m happy with my employer sponsored family health care plan. I’s competively priced, offers a variety of levels of coverage and a large list of every specialty one could want. My family has never been denied any coverage or procedure. How ’bout the government leaving it the frack alone? Or is that too Goram hard?
January 30, 2012, 12:12 pmloki13 says:
cf.
Wow. It only took one post. As I was saying…
January 30, 2012, 12:14 pmLaura(southernxyl) says:
Loki, is the OP about polls concerning the PPACA or about the mandate?
Maybe that’s what the problem is. I read “mandate” and understand “mandate” where I should understand “PPACA”.
Also, if you would actually go back and look at the comment where I listed problems, you will not see where I said that they were an all-inclusive list.
You say that it’s incorrect that I am saying that the list are things that people are saying are “the” problem because there are a bunch of different problems. Can you spot the logic fail here? I don’t want to talk down to you, Loki, but if I have to spell it out: My point is that people are putting forth any one of these things as the problem we have to fix. If I am incorrect, it’s not because of the fact that there are a bunch of different problems – which I have said myself – but because no one is saying “the problem is …” and then one of the things on the list.
You have False Seriousness saying the problem is that people will die from treatable conditions due to not having insurance.
You have Grover Gardner saying he did get treatment but his situation was worsened by the fact that he didn’t go to the doctor right away b/c he didn’t have insurance. So his problem was not having his treatable condition not treated, his problem was that he put off going to the doctor b/c he didn’t want to spend the money that he ended up spending anyway.
What I think I said was that I would like, if we’re talking about the mandate, to talk about the mandate and not the whole multi-page act, and then to identify the specific problem(s) we expect the mandate to fix rather than throw out every problem the current healthcare system has. Because that ends up with the polarizing “you just don’t want to take responsibility for yourself” and “you just want people to die” crap that doesn’t advance the conversation.
January 30, 2012, 12:25 pmJoe says:
jmaie says:
When ricky’s house burns down, it’s not likely his fault or my fault, either. Yet we’ve decided that it is a societal good that the fire department comes and rescues his family and puts that fire out regardless of whose fault something might be, or whether or not that person can pay, on his or her own, the direct and indirect costs of putting out that fire.
Inapt analogy, we put out fires to keep them from spreading.
We provide medical coverage to various people to prevent negative resulting spreading. For instance, people can have communicable diseases. People might not get care until its more costly or will result in unpaid bills, the costs spread to others.
And, a fire in an isolated area that will just burn out or will be limited to merely the property in question is put out as well.
Dotar: “How ’bout the government leaving it the frack alone? Or is that too Goram hard?”
I have mine & if the needs of others will in some way affect me, well, heck with them. Yes, it is hard. Big problems are hard to address and any resolution will usually not only affect the specific people trying to be helped.
And, when the problem is dealt with by imperfect institutions, not in utopia, the result also will be imperfect. Princess Bride: “We are men of action, lies do not become us.”
January 30, 2012, 12:34 pmloki13 says:
The “mandate” (aka a tax penalty for people that don’t get coverage and that can afford coverage that is somewhat enforced by the IRS) is a part of the PPACA which doesn’t address any of the problems you’ve identified. It’s part of the larger regulatory scheme of the PPACA to incentivize people to acquire coverage. So if that was your point, it makes even less sense.
January 30, 2012, 12:34 pmLaura(southernxyl) says:
Okay, so rising costs of health and employer-based insurance are items J and K on my list.
I am glad that you have consensus among yourself, Loki, as to what the problem is, but I don’t think there’s consensus in the group.
January 30, 2012, 12:36 pmLaura(southernxyl) says:
Loki, if the mandate doesn’t address any of the problems I listed, then how come any of them were brought up in a thread about a poll concerning the mandate?
Once again – you are making my point.
January 30, 2012, 12:38 pmloki13 says:
Let’s see- first, claim that everyone is just missing your brilliance and not understanding you. Then declare victory. Of course, everyone else is to blame.
FYI, why don’t you take a dose of your own prescription and try to understand why these point were made in a response to a poll about the mandate.* For a helpful hint, you could refer to my first criticisms of the post.
*You would note that people have pointed out repeatedly that the poll wasn’t just about the mandate, although that’s the only thing the OP points out.
January 30, 2012, 1:01 pmBuford T. Justice says:
Obamacare does not contain a “tax” penalty. A command to obtain a product (buy health insurance) that produces no government revenue and does not fund a specific area of the government is not a tax. A monetary exaction due to breaking the law (a command to enter and remain in a marketplace) by virtue of NOT buying or obtaining a product (health insurance) is also not a tax. Out of 19 judges who have ruled on this, only 3 have called it a tax. It is not realistic to expect at least 5 judges on the Supreme Court calling the mandate or fine a tax.
What “incentive” is there to buy insurance? Not only will the fine (not a tax) be less than the cost of the premium, but why even pay the fine if there is no arrest, lien, audit or garnishment? All they can do is withhold a tax refund. 47% of the country doesn’t even pay federal income tax in the first place. Out of the 53% who do, how many are owed a refund? Out of those, how much are they owed (i.e. even less than the amount of the fine)? Even if they pay the fine, they are still not in the insurance pool to spread the cost around which totally defeats the purpose of Obamacare. It’s not is if the government is going to hand over the money collected from the fines and give it to the insurance companies to simulate participation of individuals. Even if they did, it still wouldn’t make a dent in keeping premiums down for those who do buy insurance. The mandate is a joke and nothing more a charade since it’s so easy to game the system. The Democrats knew that (those few that actually bothered to read the bill at all) but also knew this window dressing would be enough to fool an ignorant and gullible public into believing it had any teeth to it.
January 30, 2012, 1:24 pmloki13 says:
So, to sum up-
1. It’s a command.
2. It’s not a tax.
3. It’s really just a joke, because it’s just some thing that’s not really enforced, and it’s administered through a rebated on your tax return, and, oh, it’s not as costly as just getting insurance.
It’s just so bad, it’s really hard to keep track and reconcile all the horrible things about it.
January 30, 2012, 1:39 pmloki13 says:
And while this was a snarky comment, I thought it was worth highlighting. There’s the old bit about sausages and laws. If I, or the Heritage Foundation, or someone else, could design the system from scratch, the system would be different. Not even necessarily better (designed systems have that… disadvantage… in the real world) but different. But that’s not the way it works.
Moreover, Congress (as a group) is constrained by political realities. Some things that might be good solutions can’t pass either for popular vote reasons or for special interest reasons. Changes tend to be gradual (which again, is usually a feature).
I think the PPACA is sub-optimal in several aspects. OTOH, I think it is better than the status quo. I wish many things had gone differently (my primary wish is that the GOP had been more constructive and instead of just opposing it, had worked with the Democrats to get more cost-containment into it and either bought into the mandate as a free-market solution or chosen a different one), but them’s the breaks.
January 30, 2012, 2:01 pmBuford T. Justice says:
Good summary until the last sentence. It is horrible because it’s unconstitutional. The government has no authority to tell people to enter a market due to existing (and remain there) at government whim, and to pay a fine for not doing so. This kind of government power is why the colonists fled England and wrote a Constitution forbidding it. The ease of avoidance regarding the mandate and possibility of avoiding a fine does not justify this abhorrent legislation.
January 30, 2012, 3:00 pmLaura(southernxyl) says:
1 – The opening poll was about responses to questions having to do with the mandate. I don’t mean to be snarky but if you want a different discussion to be had about the poll then you need to write a different OP and put it on a blog you have access to. KA is talking about the mandate questions.
2 – The fourth comment down addressed “letting people die from treatable conditions because they don’t have insurance”.
Was this relevant to the questions about the mandate and the assertion that most of the people polled don’t want it? Or was it just a big ol’ non-sequitur?
3 – There sure as hell better be consensus in Congress as to what problems the PPACA as a whole is aimed at and is expected to solve. At some point the sausage metaphor ceases to be funny.
January 30, 2012, 3:11 pmAJ says:
The mandate is required so (1) people cannot postpone getting health insurance until they have a substantial need (game the system) and (2) insurance companies get sufficient customers to offset the costs of insuring those with pre-existing conditions (to cap the required growth in everyone’s premiums). But these are based on a couple of axioms: those with pre-existing conditions ought not come into the market with any penalty and no government tax money should be used to induce “those suitably off” into the insurance pool. Few disagree that those with pre-existing conditions should have practical access to the insurance market and that private health insurance should not disappear. The political reality is that during slow economic times with high deficits it is hard to deliver new entitlement programs….period. Hence we get the mandate which avoids taxes and massive subsidy spending to get the desired outcome. A better solution would have been an intermediate scheme that would have guaranteed health insurance access using reasonable rate caps and every imaginable pooling scheme that is possible, including greater ability to go across state lines.
January 30, 2012, 3:53 pmloki13 says:
I don’t mean to be snarky, but I can’t imagine a single post, ever, on this website that has managed to escape the constraints of what the OP has narrowly talked about. Ever. Moreoever, I cannot possibly imagine the commenters here noting that the poll asked a bunch of other questions, and commenting about those, instead of just the two ones the OP highlighted. Horrors! Finally, I can’t imagine a thread dealing with the health care mandate part of the law dealing with the overall law, or about the mandate in general.
But perhaps you should follow your own advice, and instead of bringing up irrelevant issues such as whether health care is good or bad in this country, concentrate on the methodology of the two questions asked. And please save the personal anecdotes for a blog you have access to. Kay!
January 30, 2012, 3:58 pmLaura(southernxyl) says:
Thank you for a complete, coherent, on-topic comment.
And I agree that that would be a better solution.
January 30, 2012, 4:00 pmLaura(southernxyl) says:
My comment was aimed at AJ.
Loki, Travis told me I had clearly never shopped for private insurance. I don’t know how I was to refute that without a personal anecdote. If you want me to take people’s inaccurate attacks and not respond, you are in for disappointment. I suggest that you scroll over my comments from now on.
January 30, 2012, 4:02 pmBuford T. Justice says:
Better than the status quo? No way. Obamacare adds about 25 million freeloaders to the system via Medicaid expansion and tax credits/subsidies who will pay nothing or almost nothing for their premiums. It’s hypocrisy at it’s best. Those on Medicaid now already have a hard enough time finding a doctor, and those who do find one will have an even longer wait time. Flooding the system with 32 million more people (16 million on Medicaid) will increase waitlists and rationing. This will increase emergency room visits, not decrease them as we’ve seen in Massachusetts where ER visits have gone up by almost 10% since Romneycare passed.
I’m glad you spoke of cost, since Obamacare does the exact opposite of what the Left claims. The taxes on medical devices, pharmaceuticals, hospitals and doctors who make over $200k increases the costs of health care and health insurance.
Romneycare was supposed to cost $352 million the first four years. Actual cost? $4 billion, a good portion of which was supplied by the federal government to cover only 4% of the MA population. As of 2012, it’s several billion more. Who will the federal government get to cover the massive cost overruns? China? Millionaires, billionaires, Wall Street “fat cats” and corporate jet owners who will already be assessed a new surtax?
As for the so-called “popular” provisions? New taxes on the insurance companies, guaranteed issue, community rating, medical loss ratio, no lifetime caps, “children” up to 26 on their parent’s insurance until 26 and “essential” benefit coverage cause insurance premiums to skyrocket, making it more unaffordable than ever. These popular provisions will be nullified and overtaken by the destructive side effects they create.
Obamacare is the most unaffordable, unsustainable, unrealistic, unwieldy, corrupt, destructive and convoluted regulatory mess ever created.
January 30, 2012, 4:24 pmloki13 says:
I have no problems with personal anecdotes- I use them from time to time (although I note that they are anecdotes, not data). THe only issue I have is the following-
1. Make a point.
2. When questioned, say that “oh, how dare people misunderstand my point!”
3. Try to re-characterize everything. As in- how dare other people go off-topic… clearly, my list of A-whatever was clearly responsive the OP, and all about the poll.
It gets a little tiring sometimes. To the extent that I don’t like arguing about arguing, I will stop. But if I had a nickel for every time you’ve posted some variation of “It would be real damn cool if people would look at what I am saying instead of making up in their head what I ought to be saying” then I could pay every one’s health care, and we wouldn’t have this debate. In the alternative, maybe you could explain your points more clearly instead of assuming everyone is either a doofus who can’t understand you or is arguing in bad faith.
January 30, 2012, 4:29 pmLaura(southernxyl) says:
How about you explain to me how to post comments on VC.
January 30, 2012, 4:49 pmLaura(southernxyl) says:
January 30, 2012, 5:02 pmStephen Lathrop says:
loki13, you are sounding a bit cranky. Laura and I disagree quite a bit, but that doesn’t stop me from admiring here consistent clarity, and the high standard she sets for good faith.
January 30, 2012, 7:51 pmzuch says:
What didn’t I understand? What did you understand of what I said?
If someone has an accident, the car insurance people raise the rates. If someone has a heart attack? Needs a pacemaker? What then? How does one go about recovering from that actuarial “anomaly”? How about if one is diagnosed with MS? Or is found to have BRCA1 phenotype? Tough t*tties to them, eh? Just suck it up and go broke [and then go on Medicaid if they’re not accommodating enough to just die right away)?
Cheers,
January 30, 2012, 8:42 pmBuford T. Justice says:
What didn’t I understand?What did you understand of what I said?
If someone has an accident, the car insurance people raise the rates.If someone has a heart attack?Needs a pacemaker?What then?How does one go about recovering from that actuarial “anomaly”?How about if one is diagnosed with MS?Or is found to have BRCA1 phenotype?Tough t*tties to them, eh?Just suck it up and go broke [and then go on Medicaid if they’re not accommodating enough to just die right away)?
Cheers,
Your sarcastic tone aside, I already answered this in my previous posts. Yes, rates will rise the more utilization and the older they get. That’s the case for everyone. If you’re hoping for some kind of rate increase forgiveness scenario, you’re in for a big letdown. Money drives our world whether we like it or not. Goods and services cost money, especially health care which is and always will be extremely costly. No amount of government intervention will change that. The more government intervenes, the more things cost. Interstate competition of insurance companies with a variety of plans is an excellent way to help keep premiums in check.
Nobody is wishing death on those with multiple, expensive conditions. What percentage of the population have a multitude of new illnesses piling up their whole life? Yes, some will be charged premiums that become too high for their income and will have to go on Medicaid. Either way, they will have insurance.
January 31, 2012, 12:15 amloki13 says:
Yeah, I was a bit cranky (work-related). While I think I did have a somewhat valid point in there, that didn’t excuse the way in which I expressed it; moreover, I normally don’t express my pet peeves, and I should not have in this case.
So, I give an unreserved apology to Laura, who, as you point out, comments in good-faith even when I disagree.
January 31, 2012, 7:33 amzuch says:
“Just one word, Ben. Are you listening? ‘Medicare’…”
Cheers,
January 31, 2012, 11:17 amzuch says:
“The poor will always be with us. F*ckem.” That’s what I thought you were saying.
You know, of course, that you can’t have Medicaid when you have a job, and you can’t have a job when you have Medicaid…. So who pays for Medicaid, now that you’ve forced people to be destitute and unemployed?
Cheers,
January 31, 2012, 11:21 amfalse seriousness says:
That’s exactly what the ACA does; you will be left alone. People really ought to understand what it does and how things work before they start expressing really strong, but ignorant opinions.
Which brings me to Laura. Are you seriously disputing that people die because they do not have insurance coverage? It’s a simple fact that people die because of lack of insurance coverage.
And suggesting that my counter was a “false dichotomy” is absolute foolishness. It’s an exact corollary, and debunks the post’s thesis immediately. Reality checks are always relevant and effective, and I provided one.
Racing to the ER in critical condition is not medical coverage, and people die of preventable conditions because that DOES NOT WORK AND IS VERY EXPENSIVE. Outside the morality of letting people die, it’s inefficient and expensive.
For me, the morality of it matters a lot; obviously for “libertarians” (which I bracket, because I think there’s little intellectual consistency here), morality means nothing, whether it’s children or just some poor bastard who lost his job. It’s one reason why they disgust me.
The ACA, and it’s component mandate is *an* option, but it was never the only option. Personally, I favor just letting everyone buy into Medicare if they want to. If people like you want to pay private insurers and believe that the private carriers are more efficient and will be cheaper and provide better customer service, go for it. You can deal with Aetna, or BC/BS or whoever’s “death panels” all you want.
Moreover, as Ispep stated above, I’d sever the link between employment status and health insurance because it’s not working very well.
January 31, 2012, 12:03 pmMH says:
If the individual mandate is upheld, at least there will be a ready solution for poor Chevy Volt sales.
January 31, 2012, 12:23 pmAJ says:
If you mean to provide those who are otherwise uninsurable some insurance option (that is subsidized by the general tax fund), this is at least consistent with the idea that it is all of society’s responsibility to make this available and not just the duty of the young and healthy to pay into the market (through compelled insurance). I would also think that the buy-in cost would need to be higher than the cost to buy private insurance by someone of the same demographic group without the pre-existing condition or else you just move the adverse selection problem around. Most everyone agrees that developing a serious medical condition while uninsured should neither be a death sentence nor an inevitable bankruptcy situation. Portability (detaching insurance from employment) is also a concept that most agree upon. I accept Loki’s point that this is a difficult one to surmount, but that’s why we need a few more grownups in Congress. We are now entrenched in a process that values ideological regidity at all costs. Sensible starting points to budget reforms like Simpson/Bowles languish on the sidelines as each side pushes ideology.Enuff.
You may want to check the minimum income requirements for Medicaid. The answer is not zero as you imply.
January 31, 2012, 1:42 pmBuford T. Justice says:
Good point. If Congress can mandate we enter a market to begin with and stay there, there’s no limiting principle to stop them from requiring we buy anything else.
January 31, 2012, 2:22 pmBuford T. Justice says:
I don’t know who Ben is, but Medicare is currently costing over $550 billion for one year. It will double to over $1 trillion in only 10 years. It has $37 trillion of unfunded liabilities. Medicare and Medicaid combined are the biggest causes of our debt. It’s a bubble created by Congress that will burst sooner than later.
January 31, 2012, 2:48 pmBuford T. Justice says:
Medicaid eligibility does not require unemployment. For the percentage of the population that is so disabled they cannot work enough to make an income that allows them to afford standard insurance, Medicaid will always be available to them. It’s not an ideal source of insurance but it’s better than none at all. Nobody is “forcing” them to be destitute and unemployed.
January 31, 2012, 2:58 pmAJ says:
Some would argue that SDP kicks in to distinguish a health insurance purchase from the purchase of say an aircraft carrier. What I am unclear about though is the difference between one hundred $3k mandates and one $300k mandate with regards to SDP — when does the aggregate mandate or penalty demand offend liberty sensibilities?
January 31, 2012, 3:43 pmfalse seriousness says:
I agree with pretty much everything you said (including in your earlier post) except this part. I watched the republican debates (most of them), and I think you are wrong if you think that’s what they think. The libertarian Ron Paul acknowledged it outright; the others are merely less honest about it.
Heck, look at the posters here.
Look at it this way, how does getting critically ill while uninsured NOT result in death or bankruptcy? Because of safety nets some people want to eliminate? Other countries have figured this out, and the ACA is a good start to us figuring it out.
January 31, 2012, 4:16 pmBuford T. Justice says:
There is not one Republican who wants to eliminate safety nets like Medicaid. Just the opposite; they want to strengthen them so they don’t implode into insolvency. Both sides of the aisle support Medicaid for the genuinely disabled who cannot “fend for themselves” as Obama would say. The able bodied can be eligible for assistance, but more of a temporary or limited basis (i.e. not for life without limits, expiration dates, caps or payments). SS and Medicare would change so those of higher income will pay more and the eligibility ages will be slightly raised. The GOP does not wish hardship on anyone.
January 31, 2012, 4:58 pmAJ says:
The obvious route is that you run out of money and go onto Medicaid and become a charity case, and society picks up some part of cost while life becomes doubly hard for those who are sick and their family. I disagree that Republicans do not want to address this (Paul is an exception – he may in fact be closer to buy it or die, but libertarians in general would also move quicker to making insurance portable rather than hooked to a job). I would acknowledge that Republicans will be far more incremental, probably less generous with lifetime caps, and rely more on insurance pooling to also compete with a Medicare buy-in, but that merely distinguishes the two parties philosophically.
Certainly Repubs have foot-dragged for the last 20 years on this issue, coming up with alternatives when pressed but not leading when they have the opportunity. Their base fears creating another actuarial time-bomb like Medicare and to a lesser extent social security. Both sides have valid ideas but too little has been done on the cost side. How about stimulating the number of doctors while looking at ways to reign in preventative medicine? Both ideologies get something. The problem is that our political system is no longer able to accommodate a horsetrade, in part because every maneuver is broadcast 24/7 to the base via FOX/MSNBC. I am not opportunistic that this can be changed unless something goes really, really wrong and we hit a crisis.
January 31, 2012, 5:12 pmfalse seriousness says:
By definition, being eligible for medicaid MEANS bankruptcy, except for people that poor bankruptcy isn’t even really worth it. Aren’t you admitting your error by relying on the “charity case” scenario? Plus, you pretend that the eligibility is smooth, and that everything is magically covered. Do you know what the waiting period is?
Buford, your point is nonsense, although I appreciate you are parroting the standard republican talking point. Republicans absolutely want to destroy those safety nets and convert them into something that is not a safety net.
AJ, this shallow “pox on both your houses” stuff is great except when it’s wrong. Sometimes one side is wrong.
January 31, 2012, 6:20 pmfalse seriousness says:
Buford, I’ll supplement as to why your point is nonsense. It is because a voucher is not the same as a guaranteed benefit. Under your Ryan plan, very soon the people who need the help will not afford it because the costs have been shifted back individually. All they will have is a voucher for an increasingly smaller portion of costs. That’s the whole Ayn Rand bullshit that republicans have bought into. And they cause all this harm while STILL being fiscally irresponsible and blowing up the budget. That’s quite a trifecta Buford – heartless, stupid and fiscally irresponsible.
Either
(1) you support highly expensive, grossly ineffective lemon socialized medicine through ER care only (but still demagogue against “socialists”, i.e. the traditional republican/Buford approach); or
(2) you let people die (the libertarian/Ricky approach); or
(3) you implement a coverage system that actually covers everyone with a cost and cost containment scheme (the Obama/false seriousness approach). The details of (3) can certainly vary for it to work for me, so long as the poor, the sick, the old and children are covered and not denied medical care.
I like my approach better.
And why hasn’t Adler acknowledged the portion of the poll he was hiding because it didn’t fit his narrative? The part where 50% of respondents want the ACA left alone or expanded? That’s pretty poor.
January 31, 2012, 7:06 pmBuford T. Justice says:
Hi AJ,
I’ve just posted a reply to this line of thought on the “Three types of limits of Congress” page regarding three points you raised.
The question isn’t whether it’s $3 or $3 million, but whether Congress can require you to spend any amount of money on a designated product in the first instance. The answer is no, as there is no such constitutional power over simply being alive to require market entry to begin with and to remain there for life or relinquish money to the government for not doing so.
January 31, 2012, 7:45 pmAJ says:
Thanks but clearly your moral conviction on the matter taints your view. How could any restraint be justified if you are correct? Republicans fear that PPACA will overspend and not deliver on cost containment. This is neither reactionary nor hyperbolic. You’re just arguing that the moral gravity justifies a bad bill because it starts to address the moral hazard. Dems needed broad consensus; they chose another path. Here comes the blowback.
January 31, 2012, 11:00 pmfalse seriousness says:
This is completely ahistorical when one recognizes (1) Obamacare is basically a republican plan (it is the republican counter to Clinton); and (2) all through 2008 Obama made it painfully clear he would accept any possible compromise, but the republican senate took the approach that any agreement, even on positions they once advocated, was bad politics for them. Heck, republicans who voted for the bill IN COMMITTEE still ended up filibustering because that was McConnell’s grand strategy. There never was a chance at any broad consensus because the republican announced plan was that there would not be agreement on anything, period.
Your inability to thread through compromise and a moral position is odd. Does that mean you don’t believe in morals, or that you don’t have any morals? There’s nothing admirable about being a robot, that’s as much an ideological position as anything else.
February 1, 2012, 9:29 amAJ says:
You might want to review what was in the Heritage plan (see below) and contrast it with what is in PPACA. The individual mandate is about the only item that they truly share – so it’s disingenuous to say that they are basically the same plan. There are simply not very many attractive market incentives in PPACA. Further, the concept of the individual mandate was not seriously scrutinized in the early 1990s. It was not in legislation that passed a house of Congress and no briefs were forwarded to argue its Constitutionality.
http://healthcarereform.procon.org/sourcefiles/1989_assuring_affordable_health_care_for_all_americans.pdf
You are creating a false choice between a moral imperative and no morals. We may simply value liberty and view the nature of government compulsion a bit differently. Government should err on the side of using incentives and disincentives rather than proscriptive mandates. I think the mandate goes where the feds ought not go.
February 1, 2012, 10:11 amfalse seriousness says:
You have to acknowledge that it’s the mandate that is driving these hysterical denunciations of “TYRANNY!”, and that was the core aspect of the typical republican plan from 1989 all the way through to 2007. It was comical when the Heritage Foundation started killing their links and purging their site. I am sufficiently cynical to acknowledge that if it wasn’t this, their own concept, that republicans would demagogue and demonize, it would be something else.
So if states start enacting the mandate individually, all of a sudden your concerns about LIBERTY fade and it’s all good?
What if government just taxes us more and provides universal coverage? You are all good with that? Or is that tyranny as well?
February 1, 2012, 11:20 amAJ says:
It’s less offensive. Romneycare was popular and was passed by a substantial margin. People in Massachusetts are free to do as they please, however it appears that one thing to learn from their experiment was that the penalty was too low and the promised benefits too high. They will be sinking in red ink. Is that a great forewarning for what Obamacare will bring? I just don’t believe that the federal government has a power to unconditionally mandate economic actions. There needs to be something that the individual does that voluntarily draws himself into the path of regulation. Holding onto one’s money, aka “self insuring”, just doesn’t cut it. “Essential to a comprehensive regulatory scheme” requires an interstate policing issue, not just any matter and not just any means.
It’s at least Constitutional, we can agree on that. The country desperately needs tax and entitlement reform. We need to get started on improving access to health insurance and reducing cost. I don’t think either requires single payer, a public option, or an individual mandate. A public option or expanded Medicare might make sense at some point. As I said before, incremental is best. You are willing to bet the farm – I’m not. You might think spending other people’s money gives you the moral high ground – I’m not so sure.
February 1, 2012, 10:40 pmfalse seriousness says:
Well, you are obviously wrong about the economics of the ACA and healthcare generally. How obvious does it have to be that our system is both absurdly inefficient and absurdly expensive?
Medicare/Medicaid are far more successful at bending the cost curve of health care coverage than private carriers, and early standards from the ACA are proving surprisingly successful in reducing the cost curve more.
So much for your theories, and supposed concerns about red ink. Poof. The only way they are not cheaper is if you simply don’t treat people.
In the end, either you treat people, or you don’t treat people.
If you don’t treat people, then admit you are prepared to have people die for lack of treatment.
If you are going to treat people, then do it smart and effectively and in a way that carries the least burden and causes the least amount of pain (financially and in human toll).
I don’t think that’s an unreasonable moral standard. The ACA is as incremental as possible. It’s 2012. Our health care system is clearly crumbling and is certainly inhumane, and it is actually a burden on American competitiveness.
I’m confidant that ultimately, perhaps years from now, we will have an universal health care system, because it is simply necessary. I only regret that people will unnecessarily suffer in the meantime because of other people throwing obstacles out. Kill the mandate, and you make medicare for all the next battle, with a much greater likelihood of success.
February 1, 2012, 11:29 pmBuford T. Justice says:
My comments are my own. I “parrot” no one. Your false accusation that Republicans “want to destroy” safety nets is pure nonsense.
There is not one Republican who wants to eliminate these safety nets, but strengthen them so they don’t implode into insolvency. Both sides of the aisle support Medicaid and Medicare for the elderly and genuinely disabled who cannot “fend for themselves” as Obama would say. The able bodied can be eligible for assistance, but more of a temporary or limited basis (i.e. not for life without limits, expiration dates, caps or payments). Social Security and Medicare would change so those of higher income will pay more and the eligibility ages will be slightly raised. The GOP does not wish hardship on anyone.
There is no such thing as a voucher in the Ryan plan or the Ryan-Wyden plan; the government will send payments to the insurance company of their choice for the plan of their choice, depending on their income. The latter actually continues Medicare for those who prefer it over the premium support option. The former still preserves current Medicare for 55 and over. Your comments are hypocritical because you insist on continuing a program that cannot continue no matter how much taxes are raised. It is heartless, stupid and fiscally irresponsible if you want to see Medicare collapse in bankruptcy as it is projected to occur in only 12 years. Pursuing entitlement reform that is grounded in economic reality is being responsible and smart. If you want to govern solely by your heart, you advocate bankruptcy from unaffordable, unsustainable programs.
Yes, beneficiaries will have to pay more and collect later. That’s economic responsibility and reality, so call it whatever you like. Those under 55 will have to be more responsible with their pursuits, lifestyle choices and finances, not wait for the government to take care of them from cradle to grave or bail them out at every turn. If you want such open ended entitlements with no regard to economic and resource realities “so long as the poor, the sick, the old and children are covered and not denied medical care” than Europe is a better place for you. We’re seeing how that’s working out in places like Greece, Spain, Portugal and Italy. The able bodied poor and temporarily sick do not need the government to take care of them. Children have parents who are responsible for their health care. They will all be denied care if the wait list is too long and there aren’t enough doctors, facilities and resources to provide it.
If we narrow entitlements to those who are so disabled they can’t do anything for themselves, there will be more money to care for them, since those capable will support themselves, contribute to society (working and paying taxes) and enjoy the pride that comes with self-reliance and accomplishment. Your support for Obamacare and leaving Medicare forever unchanged is badly misguided. Barney Frank joined the effort to repeal the Independent Payment Advisory Board, a key portion of the law that would “recommend levels at which Medicare recipients, including seniors, can be reimbursed for health care expenses.”
Congress has a long history of dramatically underestimating Medicare costs. In 1966, Medicare cost $3 billion and was projected to cost $12 billion in 1990. The true cost in 1990: $107 billion. In 2003 it was $244 billion. Medicare currently costs over $550 billion for one year. In only 10 years it will cost over $1 trillion per year. It has $37 trillion of unfunded liabilities. Medicare and Medicaid combined are the biggest causes and continued drivers of our debt. It’s a bubble created by Congress that will burst sooner than later. Waiting until later would require much deeper changes that can be avoided now with gradual reform.
As to your supplementary comments:
Obamacare adds about 25 million freeloaders to the system via Medicaid expansion and tax credits/subsidies who will pay nothing or almost nothing for their premiums. It’s hypocrisy at it’s best with trying to reduce freeloaders. Those on Medicaid now already have a hard enough time finding a doctor, and those who do find one will have an even longer wait time. Flooding the system with 32 million more people (16 million on Medicaid) will increase wait lists and rationing. This will increase emergency room visits, not decrease them as we’ve seen in Massachusetts where ER visits have gone up by almost 10% since Romneycare passed. You haven’t made the distinction of health insurance versus health care and you’re obsessively fixated on “getting people covered”. Just because someone has an insurance card does not mean they will get timely care, quality care, if they get care at all and wind up going to the ER instead.
Speaking of Romneycare, it was supposed to cost $352 million the first four years. Actual cost? $4 billion, a good portion of which was supplied by the federal government to cover only 4% of the MA population. As of 2012, it’s several billion more. Who will the federal government get to cover the massive cost overruns? China? Millionaires, billionaires, Wall Street “fat cats” and corporate jet owners who will already be assessed a new surtax? As a quick aside, Romney (a Republican and the front runner likely to get the nomination) deserves all the criticism he gets.
Your blind desire for an indefinite “safety net” is narrow minded, naive and ignorant. It is not the government’s responsibility to get everyone covered. It is up to able bodied individuals to cover themselves. We cannot afford open ended entitlements just because we like them and want to keep them. Safety nets are not a right and we should not count on government to bail us out when we suffer economic hardship or provide for us throughout our lives including retirement. None of these programs are on a sustainable path, but are headed straight for insolvency. There are not enough millionaires, billionaires and corporate jet owners to tax that will preserve these programs in their current form. Your wishing them to stay as they are accomplish nothing, as you insist on denying the fiscal reality of not only welfare programs, but our entire economic situation nationwide.
In terms of cost, Obamacare does the exact opposite of what it claims. The taxes on medical devices, pharmaceuticals, hospitals, doctors (who make over $200k) increases the costs of health care and health insurance. The Medicare actuary, Richard Foster, has said growth in the net cost of health insurance will increase by nearly 14 percent, compared to 3.5% if Obamacare never passed. The growth rate of private insurance costs will rise to 9.4 percent, from 5.0 percent under prior law: an 88% increase.
Since passage, we’ve seen:
The 1099 provision repealed
Insurance companies dropping kids only policies so they don’t have to cover pre-existing conditions in children
The Class Act die before it even started with Kathy Sebelius saying the program is “totally unsustainable” along with a report showing Democrat supporters of the health care law of recklessly promoting the CLASS Act despite knowing that the program would eventually blow up the budget. Barney Frank joined the effort to repeal the IPAB/Death Panel 1, a key portion of the law that would “recommend levels at which Medicare recipients, including seniors, can be reimbursed for health care expenses.”
The price of health insurance provided by employers for families jumped 9% in 2011 from 2010 as rising health care expenses contributed to the largest premium increases in six years. At least 2% was is directly attributable to Obamacare. So much for Obama’s promise of “bending the cost curve downward”
People canceling their policies that have gotten too expensive with the new requirements
Only a tiny fraction sign up for the new high risk pools (a redundancy of 35 states that already have them)
Discovering that nobody will be eligible for tax credits and subsidies in states that don’t run exchanges and Washington does it for them instead. This will lead to the elimination of the employer mandate. Companies will sue over the $2000 per employee fine which should not apply if the employees are not even eligible for federal aid after joining an exchange. Health care experts doubt that the federal insurance exchange program will be fully operational by the Jan. 1, 2014 deadline, since many states have refused to implement the state exchange program.
Illinois-based pharmaceutical company Abbott Labs cuts 1,900 jobs “in response to changes in the health-care industry, including U.S. health-care reform and the challenging regulatory environment.” The National Federation of Independent Business releases a report saying that in 2012 the law’s new health insurance tax will reduce private sector jobs by between 125,000 and 249,000
The Early Retirement Reinsurance Program will spend its allotted $5 billion far earlier than its Jan. 1, 2014 expiration date
Over 1300 waivers for those who cannot comply with the mandates, including 20 percent of new waivers from the law that have gone to gourmet restaurants, nightclubs and fancy hotels in Nancy Pelosi’s district
A McKinsey & Company survey of over 1,300 private sector employers found that 30 percent of employers would definitely or probably stop offering insurance to their employees after the law is implemented in 2014
A glitch in the law, discovered after Obama signed it, would allow middle-class Americans to get subsidized health care intended for poor people. Medicare’s chief actuary says the policy “doesn’t make sense”
An Employment Policies Institute report finds that the Affordable Care Act would incentivize employees to switch to a government-subsidized insurance exchange even if employers were to continue their health care coverage, costing taxpayers “significantly.”
HHS issues a regulation requiring all group health insurance plans to cover FDA-approved “contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” which will increase premiums for everyone
“Essential benefits” are required which must include pre-natal/post-natal/maternity, pediatrics, drug addiction, psychiatry, contraception, chiropractors. Men and women beyond their child bearing years and those without minor children will still be required to have the above coverage. More can be added by HHS at any time.
A federal inspector general finds that the IRS is having trouble collecting the 10-percent federal tanning tax established by the law.
The Accountable Care Organizations: all pilot participants say they have “serious reservations” about the new rule and that without major revisions “we will be unable to participate.”
It is revealed that the Department of HHS has the power to request and receive your medical records without your knowledge or consent
And how about Obama’s other promises: “If you like your insurance you can keep your insurance” and “If you like your doctor, you can keep your doctor”. Both have been proven false. Early on, Principal Financial withdrew from the health insurance market, dropping everyone who had a policy which was about 1 million people. They lost their insurance regardless of whether they liked it and wanted to keep it. If their doctor does not accept their new policy, they will not keep their doctor. No such protection exists in Obamacare, so look for more companies to dump their employees health insurance even if they like it and want to keep it.
Regarding polling, the latest Rasmussen poll shows 52% want repeal, 41% oppose repeal.
As for the so-called “popular” provisions? New taxes on the insurance companies, guaranteed issue, community rating, medical loss ratio, no lifetime caps, “children” up to 26 on their parent’s insurance and “essential” benefit coverage will cause insurance premiums to skyrocket, making it more unaffordable than ever. These popular provisions will be nullified and overtaken by the destructive side effects they create.
Obamacare is the most unaffordable, unsustainable, unrealistic, unwieldy, insidious, corrupt, destructive and convoluted regulatory mess ever created.
February 2, 2012, 6:59 pmBuford T. Justice says:
Obamacare is not a Republican plan. The Republican plan has been available for viewing since July 30, 2009 and can be viewed at:
http://rsc.jordan.house.gov/UploadedFiles/HR_3400_EPFA.pdf
If you’re referring to the mandate proposed by the Heritage Foundation, that proceeded no further than an idea for the purposes of discussion. At no time was there Republican consensus, a bill written, a bill introduced, a bill approved by committee or voted into law. How many Republicans currently serving in Congress supported the mandate who now oppose it? The Heritage Foundation is not a lawmaking body. Olympia Snowe was the only one to vote for Obamacare in committee once she knew it was not the swing vote. She voted against it in the full Senate vote on Christmas Eve. None of these flimsy complaints about the Heritage Foundation justifies passage of Obamacare. The individual mandate is unconstitutional regardless of which party passes it into law.
What compromise by Obama are you referring to? Republicans said over and over again they supported portability, tax breaks for individuals and tort reform. All were rejected by Obama and the Democrats. The GOP never said they would not agree to “anything, period.” The filibuster is not an excuse to force it through with Budget Reconciliation. It should never have been passed at all for the reasons I’ve stated previously. This isn’t about morals, it’s about common sense on what is a workable, affordable, viable, realistic plan for health care reform. Obamacare is none of those things.
Other than the RINO Romney, not a single Republican advocates states imposing such a mandate. There would not be a court challenge since states have plenary policy power, but the outrage across the states would be the same. We already have evidence from Virginia, Missouri, Oklahoma, Arizona, Colorado where the voters overwhelmingly rejected a health insurance mandate. The 28 states suing the feds also shows they are not supportive of a mandate.
A payroll tax resulting in single payer has more constitutional footing, but the Democrats know Americans do not want such a system, hence Obamacare. Excessive government power (especially unconstitutional legislation) is always tyrannical, whether its health insurance related or not.
February 2, 2012, 7:44 pmBuford T. Justice says:
You deem single payer to be necessary. With the crappy health care systems of other nations, feel free to go there for your health care. Private market competition nationwide with tort reform and tax breaks for individuals instead of corporations, we’ll continue to have the best health care system in the world.
The mandate is meaningless in terms of its enforcement power. You’re also assuming the SCOTUS will only remove the mandate and leave the rest intact. Not so. Even the government has conceded that guaranteed issue and community rating will have to go down as well. If the court takes into account the failed structure of the exchanges-employer mandate (discussed above) along with medical loss ratio, the entire law will be scrapped. Losing the mandate will do nothing to increase support for single payer.
February 2, 2012, 7:57 pmfalse seriousness says:
When you end a wall of cheap rhetoric, cliche and factual error with a clearly wrong analysis, you aren’t left with much Buford.
The backlash the S.Ct. will generate with another highly partisan decision will be enormous.
I was combing through your responses looking for actual substance, but it’s just a stew of republican ahistorical gibberish and hysteria.
February 6, 2012, 10:25 amfalse seriousness says:
There’s a lot of propaganda here, but the basic point is the Ryan plan’s method of “cost-conrol” is simply to offload costs to people who need the services and have no actual ability to pay those costs. That’s eliminating the safety net and it’s why I’m right and you are wrong.
I assume you voted for Bush and supported the Bush cuts. They blew up the budget to a tune of 2 trillion dollars. So it’s obvious that your objections aren’t actually about fiscal responsibility. That’s a total red herring. Then there are the costs of the Iraq war, which I assume you also supported.
It’s not about budgets for republicans; that lie has been exposed.
February 6, 2012, 11:24 am