VA Senate bans health insurance mandates

[Winehole23]

Tuesday, February 02, 2010

Va. Senate bans health insurance mandate (http://www.stateline.org/live/details/story?contentId=457138)

Stateline.org Staff Reports

http://www.stateline.org/live/stateline/images/icons/comment-icon.gif (http://www.stateline.org/live/details/story?contentId=457138#comments) http://www.stateline.org/live/stateline/images/icons/write-icon.gif http://www.stateline.org/live/stateline/images/icons/print-icon.gif (http://www.stateline.org/live/printable/story?contentId=457138)

The Democratic-led Virginia Senate sent a strong message about health care reform efforts in Washington, D.C., on Monday (Feb. 1), passing a bill that makes it illegal for Virginians to be required to buy health insurance.

With Republicans in control of the state’s House of Delegates and governor’s mansion, the bill could become law, The Washington Post reported (http://www.washingtonpost.com/wp-dyn/content/article/2010/02/01/AR2010020103674.html?hpid=topnews). The effort would throw another wrench into congressional Democrats’ plans to revamp the nation’s health care system in the wake of a special election in Massachusetts that stripped the party of its 60-vote, filibuster-proof majority in the U.S. Senate.

An “individual mandate” that requires Americans to buy health insurance is a centerpiece of federal health care legislation. Virginia’s move could suggest that President Obama — who reiterated his support for reform during his State of the Union address last week — “is failing to reassure members of his own party that current reform efforts remain worthwhile,” The Post said.

A groundswell of opposition to the federal effort is emerging in statehouses around the country, The Associated Press reported today (http://abcnews.go.com/Business/wireStory?id=9715139). Bills similar to the legislation cleared by the Virginia Senate are being considered in 35 states, with some lawmakers seeking constitutional amendments to prohibit mandatory health insurance. An Idaho legislative committee has approved a bill similar to Virginia’s, and in Missouri, an overflow crowd showed up at a hearing room when that state’s constitutional amendment was being debated, the AP reported.

What is notable about Monday’s action in the Virginia Senate, however, is that Democrats joined the effort, which has been led by conservatives in most states. Five Democrats joined all 18 Republicans in opposition to a health care mandate. The votes “suggest that Democrats on the state level fear that supporting health care reform could be politically damaging,” The Post said.

[coyotes_geek]

While I wholeheartedly endorse attempts to kill the craptastic Obamacare venture, how exactly is something like this constitutional? How can a state make it illegal to follow a federal law? Or whatever legal mechanism it is that would give the state the ability to regulate what the federal government can or can't tell it's citizenss to do?

[Winehole23]

Without having the proposed law in front of us, it's pretty hard to say. It's a hard question to start with. If the Civil War didn't settle the issue of nullification by the states, federal purse strings are the effective levers now.

[Winehole23]

I'll see if I can find the law.

Maybe someone else can address the the legal ins and outs of how state/federal conflicts can and are supposed to play out. I'd just be shooting in the dark.

[coyotes_geek]

Seems to me like if the states could get away with something like this that we'd have 50 states with 50 laws making it illegal to require a state's citizens to pay federal income taxes.

[Winehole23]

Opponents also question whether the state has the power to block the federal government's requirement. Even if the bill passes, the issue would have to be decided in the courts, which traditionally have ruled that federal law trumps state law.

Virginia's new Attorney General Kenneth Cuccinelli said he is ready to challenge any mandate in court.


"I most assuredly would, but I would more welcome them not passing a bill that is constitutionally unfirm," Cuccinelli said.
http://www.businessweek.com/ap/financialnews/D9DJJV500.htm

[Winehole23]

http://leg1.state.va.us/cgi-bin/legp504.exe?ses=101&typ=bil&val=sb417

[coyotes_geek]

So at the end of the day, it sure looks like to me that there's no way something like this would stand up in court. That would make this pretty much just a symbolic gesture. That being said, if 30 something states make the same gesture, that would certainly garner a lot of attention from members of congress.

[ElNono]

They're just sending a message... It's all they can really do, so why not? plus Pelosi and Co are so scared shitless of any potential electoral loss that it will probably work.

If Obamacare were to pass, then it would trump this thing... the thing is, they can make all sort of noise while it goes all the way to the Supreme Court, so it's a win-win for them.

[Supergirl]

They're setting themselves up to challenge the soon-to-be federally passed health insurance reform in court. I suspect they'll lose that case in the Supreme Court, but I am no legal expert.

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

[DarkReign]

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

Well thats one silly-ass way of characterizing it.

How bout this?

The Federal government forcing its citizens by law to pay for healthcare out of their own pockets. BTW, it isnt like theyre mandating everyone gets a raise from the employer who provides it now. No, no, no. You still make the same amount of money, but now you have a new car payment every month.

By Federal law.

Its fucking bullshit.

I dont want to assume anything about you, but I pay for my employee's healthcare. Its $1000+ per family and $750+ per single.

I imagine a Federal program would bring about some discount in price. But even being optimistic at say, a 30% reduction in cost, youre looking at a single individual getting a new $525 monthly bill mandated by law (in Michigan, anyway). All this with no raise, 15-20% unemployment, businesses shuttering left and right and people losing their homes.

Oh yeah, I am suuuuuuure this is going to work swimmingly.

Score one for insurance companies, yeah! How unethical, right? So we keep privatized insurance companies, but mandate everyone pay for insurance. This sint like car insurance because owning a car is optional.

This isnt a choice. There is no option. You will be fined or go to jail if you do not have (or provide) health insurance.

What about the millions of people who cant fucking afford it?

Are the rest of us supposed to support them in this shit, too?

Tell me, does the cost decrease per policy get offset by the number of people who cant afford it?

So, the Federal government has basically kept the profit and cost of health insurance private, but socialized the expense on the rest of us?

I hope this administration crashes and fucking burns on this. I hope it is Obama's Epic Fail moment.

Not that I dont want healthcare reform, I just dont want THIS healthcare reform. Because this is a fucking abortion, direct evidence that our government is bought and sold by corporatists who twist the system. The insurance companies are probably jealous of the bankers who have/had private profit and socialized risk. They want in on that deal.

If this shit (yes, horse shit, bull shit, fly shit, your shit, my shit) passes, thats what it is. Another win for big business and another means for big business to get all the more wealthy and create dependance from a populace.

WTF!!!!!! Who cant see this?!!?!

[coyotes_geek]

From a moral standpoint, the comparison to slavery is quite apt.

Denying someone a government freebie which can only be provided at someone else's expense is NOTHING like the basic denial of liberty that the slaves endured. You are an idiot for thinking that it is.

[doobs]

Federal preemption, boys. This is all nice, but ObamaCare's individual mandate would trump. (If it's found to be constitutional.)

[doobs]

This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.

[ElNono]

What's novel about this is the federal government forcing people to pay non-government entities. What's novel about it, unlike car insurance in some states, is that there doesn't seem to be any action you can take to avoid having to pay for it.

[doobs]

That said, there's nothing to preempt it yet.

[Spursmania]

Denying someone a government freebie which can only be provided at someone else's expense is NOTHING like the basic denial of liberty that the slaves endured. You are an idiot for thinking that it is.

+10000

I almost spit out my drink lmao at her ridiculous comments.:lmao
It's as if bleeding libs lack the intellectual curiosity to actually look things up like the US constitution, and take a few minutes to read what our founding fathers wrote. Trying to understand the difference between rights and privileges is too hard a concept to grasp because their emotions take over and they just speak out of their ass.

[boutons_deux]

"If it's found to be constitutional."

mandate is "promoting the general welfare", so it's Constitutional.

[doobs]

"If it's found to be constitutional."

mandate is "promoting the general welfare", so it's Constitutional.

The individual mandate is probably constitutional, but you're a fucking moron.

[Aggie Hoopsfan]

While I wholeheartedly endorse attempts to kill the craptastic Obamacare venture, how exactly is something like this constitutional? How can a state make it illegal to follow a federal law? Or whatever legal mechanism it is that would give the state the ability to regulate what the federal government can or can't tell it's citizenss to do?

Therein lies part of the problem.

10th Amendment to the Constitution.... States Rights.


...the powers not granted to the national government nor prohibited to the states by the constitution of the United States are reserved to the states or the people.

The sad part in all this is that Virginia is having to author a bill specifically to assert its sovereign rights in light of Obamacare.

You will be seeing more bills like this directed at Obamacare, Crap & Trade, and some of the other craptastic hyper-liberal ideas of Obama and his crew, as long as they are in power.

[Aggie Hoopsfan]

They're setting themselves up to challenge the soon-to-be federally passed health insurance reform in court. I suspect they'll lose that case in the Supreme Court, but I am no legal expert.

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

No citizen is currently denied health care, but you're too busy on here tossing Obama's salad all the time to understand that.

So take your ethical and moral bullshit and shove it.

[Aggie Hoopsfan]

"If it's found to be constitutional."

mandate is "promoting the general welfare", so it's Constitutional.

LOL. So dumb...

[doobs]

Therein lies part of the problem.

10th Amendment to the Constitution.... States Rights.



The sad part in all this is that Virginia is having to author a bill specifically to assert its sovereign rights in light of Obamacare.

You will be seeing more bills like this directed at Obamacare, Crap & Trade, and some of the other craptastic hyper-liberal ideas of Obama and his crew, as long as they are in power.

The problem with citing the 10th Amendment is that it doesn't really mean anything here. It merely guides how we interpret the Constitution. If the Constitution grants the power to the federal government, then the power is not reserved to the states.

If the individual mandate falls within Congress' powers under the Commerce Clause and the Necessary and Proper Clause, then the 10th Amendment cannot be an independent grounds for challenge.

There's a reason the 10th Amendment does not contain the word "expressly."

[Wild Cobra]

Seems to me like if the states could get away with something like this that we'd have 50 states with 50 laws making it illegal to require a state's citizens to pay federal income taxes.
There is the 16th amendment allowing taxation. There is the tenth amendment on the side of the states rights. The way they are written, the federal government can impose taxes, but health care is not in the constitution.

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

[Wild Cobra]

They're setting themselves up to challenge the soon-to-be federally passed health insurance reform in court. I suspect they'll lose that case in the Supreme Court, but I am no legal expert.
I suspect they will win. This is a no brainier, but then democrats seem not to have brains.

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

You are completely spinning that.

It is not against anyone rights. Quite the opposite. When you mandate someone to buy health insurance, that is the violation of rights.

[Wild Cobra]

"If it's found to be constitutional."

mandate is "promoting the general welfare", so it's Constitutional.
Yes BD... Promote.

Promote is not provide. Promote is to dictate. Promote is not force.

You promote by making it more appealing to buy. Not by mandating it.

Ways to promote:

Kill the trial lawyers... (wait... that may be a bit overboard)

Let the free market work by relaxing some regulations.

Stop taxing medical professionals at 35%.

I'll let others add from here.

[Mr. Peabody]

Well thats one silly-ass way of characterizing it.

How bout this?

The Federal government forcing its citizens by law to pay for healthcare out of their own pockets. BTW, it isnt like theyre mandating everyone gets a raise from the employer who provides it now. No, no, no. You still make the same amount of money, but now you have a new car payment every month.

By Federal law.

Its fucking bullshit.

I dont want to assume anything about you, but I pay for my employee's healthcare. Its $1000+ per family and $750+ per single.

I imagine a Federal program would bring about some discount in price. But even being optimistic at say, a 30% reduction in cost, youre looking at a single individual getting a new $525 monthly bill mandated by law (in Michigan, anyway). All this with no raise, 15-20% unemployment, businesses shuttering left and right and people losing their homes.

Oh yeah, I am suuuuuuure this is going to work swimmingly.

Score one for insurance companies, yeah! How unethical, right? So we keep privatized insurance companies, but mandate everyone pay for insurance. This sint like car insurance because owning a car is optional.

This isnt a choice. There is no option. You will be fined or go to jail if you do not have (or provide) health insurance.

What about the millions of people who cant fucking afford it?

Are the rest of us supposed to support them in this shit, too?

Tell me, does the cost decrease per policy get offset by the number of people who cant afford it?

So, the Federal government has basically kept the profit and cost of health insurance private, but socialized the expense on the rest of us?

I hope this administration crashes and fucking burns on this. I hope it is Obama's Epic Fail moment.

Not that I dont want healthcare reform, I just dont want THIS healthcare reform. Because this is a fucking abortion, direct evidence that our government is bought and sold by corporatists who twist the system. The insurance companies are probably jealous of the bankers who have/had private profit and socialized risk. They want in on that deal.

If this shit (yes, horse shit, bull shit, fly shit, your shit, my shit) passes, thats what it is. Another win for big business and another means for big business to get all the more wealthy and create dependance from a populace.

WTF!!!!!! Who cant see this?!!?!

Nice post.

The thing that struck me about the requirement of a mandate is that Obama campaigned against a mandate during the primaries, making the argument that the problem with health care is not that people didn't want it, it was just that they couldn't afford it. Therefore, if you bring cost down low enough, a mandate is unnecessary.

The other problem that I have with the mandate is how do we enforce it? Are people paying fines? So, again, we have situation where someone, according to Obama's logic, can't afford insurance and yet, we hit them with a fine. It's ridiculous.

[mogrovejo]

I knew I had read somewhere about the constitutionality of the a federal health insurance mandate. Here it is:

The Individual Mandate: An Unconstitutional Exercise of Congressional Power (http://www.antemedius.com/content/individual-mandate-unconstitutional-exercise-congressional-power)
by Sheldon H. Laskin,
December 21, 2009 - 2:44pm

It is generally agreed, by both proponents and opponents of the Administration’s health reform bill, that the lynchpin of the legislation is the individual mandate requiring uninsured Americans to obtain health insurance, or pay a tax penalty for failing to do so. Without the mandate, even the Administration’s wildly exaggerated cost savings estimates simply cannot work. The whole plan is predicated on enlarging the risk pool by bringing in younger, healthier people who currently lack the means or the incentive – or both – to purchase health insurance.

Given the centrality of the mandate, it is somewhat surprising that little attention has been paid to the critical legal question of whether Congress has the constitutional authority to require Americans to purchase a commodity from a private, for-profit corporation. Other than some limited commentary on the Right -- George Will and Orrin Hatch both had columns on this topic in the Washington Post and the Heritage Foundation recently published a detailed legal analysis of the question – there has been almost no critical discussion of the issue. The silence on this issue is even more amazing in view of the fact that the Congressional Budget Office raised a red flag on the question during the Clinton Administration’s abortive effort at health care reform:

A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.

CONGRESSIONAL BUDGET OFFICE, THE BUDGETARY TREATMENT OF AN INDIVIDUAL MANDATE TO BUY HEALTH INSURANCE, (1994) available at http://www.cbo.gov/ftpdocs/48xx/doc4816/doc38.pdf

Unlike the states, Congress cannot enact any law even if doing so would foster public safety and health. Under our federal system of government, Congress can only enact laws that are of a type authorized by a provision of Article I of the Constitution, which sets forth the powers of Congress. Proponents of the individual mandate typically cite the Commerce Clause of the Constitution as granting Congress the authority to require individual Americans to purchase health insurance.

Article I, Section 8 of the Constitution grants Congress the power “[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes.” Therefore, in order for Congress to have the authority to require Americans to purchase health insurance, the purchase of health insurance must constitute “commerce” within the meaning of the Commerce Clause. It does not.

In 1982, the Supreme Court declared that, in order for a commodity to be considered an article in commerce, it must be capable of being sold. Sporhase v. Nebraska, 458 U.S. 941 at 949 -- 950 (1982). While there is no doubt that the sale of health insurance by an insurer constitutes commerce, it does not follow that the purchase – or more precisely, the failure to purchase – health insurance by a consumer also constitutes commerce. Health insurance, once purchased by a consumer, is not capable of being further sold in commerce because there is no market for it; who would purchase a health insurance policy naming someone else as the insured?

In order to understand the point better, it might be helpful to contrast health insurance with life insurance. Because paid-up life insurance has a cash value, an industry has developed in purchasing life insurance benefits from terminally ill patients. Known as viatical settlement companies, they will pay a percentage of the value of an insurance policy to a terminally ill patient if the corporation is named as the beneficiary of the policy. The patient gets the cash up front, to pay medical bills or to support his family, and the corporation makes a profit on its investment when the insured dies. Because there is a market for life insurance benefits, the purchase of those benefits may be regulated under the Commerce Clause to make sure that the patient is not coerced by the Tony Soprano Benevolent Society to name it as beneficiary.

But there is no market for health insurance benefits once the policy is issued. No one would buy my health insurance, because no one other than I can derive any benefit from it. Since there is no market, health insurance is not an article of commerce once issued. If it is not an article of commerce, Congress lacks authority under the Commerce Clause to require me to purchase it.

There are two Supreme Court cases that proponents of the individual mandate often cite in support of their position that Congress may require individuals to purchase health insurance. The first case involved government regulation of the amount of acreage used by farmers to grow wheat. A farmer who was fined for exceeding his acreage allotment challenged the fine, asserting that since he was using the excess acreage for personal consumption (he used it either to feed his chickens or to make bread for his family), Congress lacked authority under the Commerce Clause to regulate that excess acreage. The Court rejected this argument, pointing out that even wheat grown for personal consumption is marketable and that therefore the farmer’s excess acreage affected the supply and demand for wheat in interstate commerce. Wickard v. Filburn, 317 U.S. 111 at 137 (1942). Using similar reasoning, the Supreme Court recently affirmed congressional authority under the Commerce Clause to regulate the production and use of marijuana as applied to individuals who personally use marijuana for medicinal purposes under state laws that legalize such use. Gonzales v. Raich, 545 U.S. 1 (2005). Again, Congress had commerce clause authority to regulate personal consumption in this context because marijuana for home consumption is “a fungible commodity for which there is an established, albeit illegal, interstate market.” 545 U.S. at 18.

Unlike wheat or marijuana, health insurance is not a fungible commodity and is therefore not marketable. Again, no one would purchase my health insurance – it is personal to me and cannot be sold for any price.

Finally, proponents of the mandate often cite the fact that states require drivers to purchase auto insurance as justifying a federal individual mandate for health insurance. This is a facile comparison that ignores the constitutional differences between federal and state authority to regulate. As noted above, Congress can only legislate when there is a specific provision of Article I of the Constitution that authorizes it to enact that type of law. Conversely, the states have virtually unlimited legislative authority to pass laws that foster the public welfare, health and safety. Driving is a privilege, and the states are free to impose any reasonable condition on the exercise of that privilege that they choose. In any event, the states have limited the auto insurance requirement to the purchase of liability insurance to cover injuries sustained by third parties. No state requires drivers to purchase insurance to cover their own injuries.

For single-payer advocates, a very powerful argument is that, while the individual mandate to purchase private health insurance is unconstitutional, Congress can lawfully tax to support a government financed health insurance program. Article I empowers Congress to use its taxing powers in support of government programs that foster the public welfare; this is the constitutional authority for Social Security and Medicare. But to extend that authority to requiring Americans to purchase a private commodity raises profound civil liberties issues. If Congress can compel the purchase of insurance from a for profit insurance company, it can compel the purchase of any commodity if there is an arguable public policy to support it. The auto industry is collapsing? Forget Cash for Clunkers, just order Americans to buy cars or tax them if they don't. Obesity crisis? Order Americans to join health clubs, or tax them if they don't. If Congress gets away with this, there is no stopping point and Big Business will have succeeded in making Americans into involuntary consumers whenever it so chooses.

..............................

Sheldon H. Laskin is an attorney who has appeared in the United States Supreme Court. He is an Adjunct Professor in the Graduate Tax Program at the University of Baltimore Law School. Mr. Laskin specializes in state tax cases under the Commerce Clause of the US Constitution.

..............................

[mogrovejo]

Nice post.

The thing that struck me about the requirement of a mandate is that Obama campaigned against a mandate during the primaries, making the argument that the problem with health care is not that people didn't want it, it was just that they couldn't afford it. Therefore, if you bring cost down low enough, a mandate is unnecessary.

The other problem that I have with the mandate is how do we enforce it? Are people paying fines? So, again, we have situation where someone, according to Obama's logic, can't afford insurance and yet, we hit them with a fine. It's ridiculous.

Obama promised everything to everybody during the campaign.

In this case, he promised universal coverage (no pre-existing condition restrictions) + no mandate + budgetary neutrality.

Well, that's just impossible... he could have promised that he'd end with the existence of hurricanes or something.

[Winehole23]

No state requires drivers to purchase insurance to cover their own injuries.If health care reform as currently construed passes, this comes in the door too and along with it, a raft of wanna-be "public welfare" mandates.

A personal insurance mandate enforced with fines for non-compliance is such a shitty idea that it's amazing -- dumbfounding, to me -- that it was ever taken seriously to begin with.

I wonder what accounts for that?

[Wild Cobra]

Well, that's just impossible... he could have promised that he'd end with the existence of hurricanes or something.
Well, at least he knew his flock of libtards weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!

[Crookshanks]

Well, at least he knew his flock of libtards weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!
Supergirl is. I don't think I've read one comment of hers in this forum that has made sense.

[Supergirl]

Do I have to spell everything out for you fucktards who insist on being obtuse? Or maybe you just ARE obtuse, and it's not something you can have control over.

Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage. Not to mention, that fact is bankrupting our country and health care industry because of the reliance on ERs, so it doesn't even make good economic sense.

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

[SouthernFried]

Health care is a fundamental right.

This is why people might not have the highest opinion of you supergirl.

Where in the Constitution does it specifically state that "health care" is a fundamental right?

[Supergirl]

This is why people might not have the highest opinion of you supergirl.

Where in the Constitution does it specifically state that "health care" is a fundamental right?

Well, in the declaration of independence it says life, liberty and the pursuit of happiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

But I never said it was in the Constitution. I even argued earlier that the VA decision was setting themselves up to try and challenge the constitutionality of the ruling, and that I didn't know whether that had a chance in hell of winning.

What I said was, I find this attitude and use of our legal system to be morally repugnant. I said I didn't think it was ethical. That isn't the same thing as not being Constitutional.

However, the whole purpose of government and of laws is to protect people and make their lives a little easier. Otherwise, governments have no reason to exist.

[Winehole23]

They exist for themselves too, Supergirl.

[Winehole23]

Well, at least he knew his flock of libtards weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!Sometimes, you are that stupid.

[Marcus Bryant]

So it's akin to supporting slavery to oppose a law which would force individuals to hand over a significant portion of their income and wealth to large insurers on an annual basis?

Not to mention what such a precedent could mean for politicians to use on the gullible next time. This uplifter desire to micromanage national life is tiresome.

[mogrovejo]

If health care reform as currently construed passes, this comes in the door too and along with it, a raft of wanna-be "public welfare" mandates.

A personal insurance mandate enforced with fines for non-compliance is such a shitty idea that it's amazing -- dumbfounding, to me -- that it was ever taken seriously to begin with.

I wonder what accounts for that?

From the moment you assume you want almost everybody to have health-care coverage, ergo that you want to prohibit or severely limit pre-existing conditions exclusions, then it's extremely difficult to escape mandates.


Supergirl is. I don't think I've read one comment of hers in this forum that has made sense.

I concur.

[Mr. Peabody]

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

The thing about auto and home insurance is that I choose to purchase a car or home and factor those costs into my budget at purchase. Also, as far as I know, my homeowner's insurance is a requirement of my financing company (which makes sense), but I could be wrong.

I don't know that mandating that everyone buys insurance is in every individual's best interest. What if you can't afford it? What if you can, but it's at the expense of a car or paying for daycare for your kids? Medical insurance is not cheap and requiring people to purchase it is a large added expense. Again, I don't think people are failing to buy insurance because they just don't want it. I think in many cases, it's just too expensive.

Until we control costs, essentially all we're doing is forcing people to participate in a system that gets more and more expensive every year.

[Aggie Hoopsfan]

If the individual mandate falls within Congress' powers under the Commerce Clause and the Necessary and Proper Clause, then the 10th Amendment cannot be an independent grounds for challenge.

That's still a huge reach, mandating that you take your money and buy a service. It is different than taxation.

This basically sets it up so if Obama/Pelosi/Reid try to jam through Obamacare, it is destined for a date with the U.S. Supreme Court.

[Aggie Hoopsfan]

Well, in the declaration of independence it says life, liberty and the pursuit of happiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

If I have to pay for your health care, it's infringing on my pursuit of happiness.

Fuck you.


Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage.

Again, no one in this country is denied health care.

And acting like Obamacare will solve the problem of health care costs is comical. You are one stupid bitch.

[Crookshanks]

Health insurance is not like Auto or Homeowners insurance. You are only required to have liability coverage, unless your car is still being financed. Mortgage companies require homeowner's insurance - but you really are only required to cover the cost of the house, not your belongings. And once your house is paid off, you don't have to have it (although it would be pretty stupid not to).

In both cases, insurance is required to cover losses incurred by the loan holders - not the individual. What Obamacare is requiring is far different - and it's wrong to force a person to buy something they don't want or can't afford.

[Winehole23]

Again, no one in this country is denied health care.At the ER, no.

[Mr. Peabody]

Again, no one in this country is denied health care.


So, the studies showing that the uninsured are don't have regular doctors, have limited access to prescription medications, are more likely to forgo needed care, receive fewer preventive services, put off immunizations and routine checkups, and obtain inadequate care to manage chronic diseases, are all mistaken?

Then there's this from the New York Times -


Uninsured children who wind up in the hospital are much more likely to die than children covered by either private or government insurance plans, according to one of the first studies to assess the impact of insurance coverage on hospitalized children.

Researchers at Johns Hopkins Children’s Center analyzed data from more than 23 million children’s hospitalizations in 37 states from 1988 to 2005. Compared with insured children, uninsured children faced a 60 percent increased risk of dying, the researchers found.

The authors estimated that at least 1,000 hospitalized children died each year simply because they lacked insurance, accounting for 16,787 of some 38,649 children’s deaths nationwide during the period analyzed.

“If you take two kids from the same demographic background — the same race, same gender, same neighborhood income level and same number of co-morbidities or other illnesses — the kid without insurance is 60 percent more likely to die in the hospital than the kid in the bed right next to him or her who is insured,” said David C. Chang, co-director of the pediatric surgery outcomes group at the children’s center and an author of the study, which appeared today in The Journal of Public Health.

Although the research was not set up to identify why uninsured children were more likely to die, it found that they were more likely to gain access to care through the emergency room, suggesting they might have more advanced disease by the time they were hospitalized.

In addition, uninsured children were in the hospital, on average, for less than a day when they died, compared with a full day for insured children. Children without insurance incurred lower hospital charges — $8,058 on average, compared with $20,951 for insured children.

I don't know that basic emergency care (as you allude to) equates to "health care" as we think of it in this county.

[coyotes_geek]

Well, in the declaration of independence it says life, liberty and the pursuit ofhappiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

Your point is severely flawed. It doesn't matter if healthcare is essential to happiness. Happiness is not a fundamental right. Only the pursuit is.

[coyotes_geek]

Therein lies part of the problem.

10th Amendment to the Constitution.... States Rights.



The sad part in all this is that Virginia is having to author a bill specifically to assert its sovereign rights in light of Obamacare.

You will be seeing more bills like this directed at Obamacare, Crap & Trade, and some of the other craptastic hyper-liberal ideas of Obama and his crew, as long as they are in power.

I'm all for states rights, so if that tact works then I'm all for it. But I still have my doubts that the supreme court would rule that a state law can trump a federal law when the two are in direct conflict with each other.

[EmptyMan]

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

LOLOLOLOL, you fail at step one.

Start over. You will never understand the game if you blindly accept or assume the government's agenda matches your own.

[DarkReign]

Do I have to spell everything out for you fucktards who insist on being obtuse? Or maybe you just ARE obtuse, and it's not something you can have control over.

Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage. Not to mention, that fact is bankrupting our country and health care industry because of the reliance on ERs, so it doesn't even make good economic sense.

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

You literally embody everything that is wrong with the Democratic party.

You demonstrated about every cliche attached to said party in three paragraphs. Bravo, I say.

Elitist? Check
Knows whats best for everyone? Check
Even if they dont like it? Check
Will create law to enforce their views on everyone? Check
Has no fucking clue how to pay for it? Check
..yet still finds a way to pander to big business? Absolutely Check.


Health care is a fundamental right.

:lmao

No, it isnt. If it were, it'd be in the Constitution. It doesnt appear there, so apparently, the forefathers didnt think much about people's right to lifetime healthcare.

But you obviously know better than all of us as evidenced by your "talking down" podium meeting you just had.

Let me set you straight on some shit, right quick...

You dont dick-all about whats best for every, single American. Nor do I. Nor does government. The inalienable rights dictated in the Bill of Rights are about as close to universal truisms the entire world of developed nations can agree on...sort of.

Outside of those obvious rights, everything else is a debate. Debates have two or more sides. Just because you think healthcare is some God given right doesnt make it so. Move to a state that has universal healthcare, is my suggestion.

As for the rest of us, we worry about things like...ooooh, I dont know....how people like fucking you are going to pay for this? Beyond that, I know more than a few people wonder about, sheesh...lemme think....why health insurance providers will be private institutions with socialized risk. That seems a tad unbecoming of a free and open society, methinks?

What do you think?

What the fuck do you think about health insurance companies having an installed, mandated by law customer base of 400 million people? That their inevitable and exhorbitant profits will be divied up amongst themselves and their shareholders, but you (and us), the mandated-by-law consumer will never see a price break?

What the fuck do you think about that? Are the millions of unemployed not enough for you? You want more?!

Are the hundreds of thousands of bankruptcies shy of your overall goal of complete meltdown? What the fucking fuck do you think will happen when every single mom with 3 kids and 18 year old high school grad with no career has a brand new monthly bill for ~$500?!

What do you think will happen?!

Because, to me, where I stand, the people I know, the unemployed, government-reliant people I know, this would crush them into poverty. Poverty by law and corporate profit.

To me, with your stated position and backing of this...craptastic bill, I know one or three things about you.

a) Youre an idiot that never put any real thought into the logistics surrounding an endeavor like universal healthcare.

b) Youre a blind loyalist. True Blue Through and Through, no questions asked, none required, a lemming on the edge of a cliff and brimming with confidence in mein Fuhrer.

c) You are smarter than you let on. You know this will create dependance and depression on a widescale. A government-reliant society is a controllable government society and that is your true aim.

Honestly, Ive wasted too much time on you as it is. Just stop talking. There will never be a rational mind in this country who will agree with your arguments on their own merits. Your husband agrees with you because you sit on something he wants, your children agree with you because youve brainwashed them and your friends might agree with you only because they know youre harmless.

No one else will, only those close to you. Because if/when you get on a podium in front of a diverse group and read the quoted three paragraphs aloud, I doubt you get through the first paragraph before youre drowned out by "boo's" and calls of "elitist". Rightfully so.

Let this post be my first and last rude interaction with you.

You need and require a much broader and more open mind desperately.

[DarkReign]

FWIW, I see a world with universal healthcare of some sort only because the current setup is far too expensive.

Not because its a right, but because the cost to most American families is dire and that medical expenses literally bankrupt people everyday.

Now, one can be crass and say "Those people probably shouldnt have received medical attention, then". With this attitude, I could never agree. Everyone who doesnt suffer from extreme depression, when faced with their own mortality, will opt for the care they require, consequences be damned.

I dont think we as Americans should condone a system like this by way of inaction.

But IF we are going to do it, then do it fucking right. This ObamaCare bullshit is the exact wrong way to do this. This will kill us as a country (or at least until the day we erase it from the books). Not every American can pay their own insurance on their net income. So any law that says "You will be mandated to pay from your own pocket" is asinine.

How to enforce that? what about the millions who cant afford it? Is their drain on society just going to be subsidized by the rest of us? How will that affect costs to those of us who pay? What about the lowering of cost per premium? What about older people on fixed incomes and the highest medical bills on average?

No.

What Obama and Congress propose is an abortion. You either do it right the first time (which requires fucking over a lot of billion-dollar businesses) or you dont do it at all. It would seem the spineless wonders on Capitol Hill have found their nice, sleezy middle ground that accomplishes nothing but appeasing the poor, the rich and the clueless.

Once again, government dances to the lowest common denominator.

[Winehole23]

http://www.tune-in-tokyo.com/wp-content/uploads/gotch_suplex.jpg

[Winehole23]

http://www.zerooneusa.com/images/2007/2007-8-2-25.jpg

[Marcus Bryant]

You literally embody everything that is wrong with the Democratic party.

You demonstrated about every cliche attached to said party in three paragraphs. Bravo, I say.

Elitist? Check
Knows whats best for everyone? Check


Indeed. It reminds one of those who feel propelled to spread the good news of salvation and then are aghast when someone doesn't want what they have to offer. The shock often turns to disdain and exclusionary thoughts, as well as thinly veiled anger. How could they not want this? Don't they know what we're doing for them? Political salvation is at hand!

[Marcus Bryant]

The non-believer is the unclean, the immoral, the evil. The skeptic or the agnostic also falls in the line of fire.

[Aggie Hoopsfan]

FWIW, I see a world with universal healthcare of some sort only because the current setup is far too expensive.

Not because its a right, but because the cost to most American families is dire and that medical expenses literally bankrupt people everyday.

Now, one can be crass and say "Those people probably shouldnt have received medical attention, then". With this attitude, I could never agree. Everyone who doesnt suffer from extreme depression, when faced with their own mortality, will opt for the care they require, consequences be damned.

I dont think we as Americans should condone a system like this by way of inaction.

But IF we are going to do it, then do it fucking right. This ObamaCare bullshit is the exact wrong way to do this. This will kill us as a country (or at least until the day we erase it from the books). Not every American can pay their own insurance on their net income. So any law that says "You will be mandated to pay from your own pocket" is asinine.

How to enforce that? what about the millions who cant afford it? Is their drain on society just going to be subsidized by the rest of us? How will that affect costs to those of us who pay? What about the lowering of cost per premium? What about older people on fixed incomes and the highest medical bills on average?

No.

What Obama and Congress propose is an abortion. You either do it right the first time (which requires fucking over a lot of billion-dollar businesses) or you dont do it at all. It would seem the spineless wonders on Capitol Hill have found their nice, sleezy middle ground that accomplishes nothing but appeasing the poor, the rich and the clueless.

Once again, government dances to the lowest common denominator.


Costs are out of control because catastrophic event insurance, as well as end of life procedures, coupled with every candy ass going to the doc every time they get a splinter, cost a lot.

The 'evil' insurance companies make less than 5% net profit on their services. Damn them!

Cutting out waste and fraud, opening up insurance purchases over state lines, and raising the deductible amount would do more to control costs than the 2000 pages of bullshit the Dems and their medical/pharmaceutical special interests put together.

[ChumpDumper]

How much would the selling of insurance over state lines lower premiums?

[TeyshaBlue]

The 'evil' insurance companies make less than 5% net profit on their services. Damn them!


I agree with some of what you say, but when you look at their ROE figures, that 5% is a bit misleading.

[ElNono]

I agree with some of what you say, but when you look at their ROE figures, that 5% is a bit misleading.

Not to mention what they spend in overhead to make it a for-profit venture.

[mogrovejo]

FWIW, I see a world with universal healthcare of some sort only because the current setup is far too expensive.

Why do you think universal healthcare coverage will make it less expensive?



But IF we are going to do it, then do it fucking right. This ObamaCare bullshit is the exact wrong way to do this. This will kill us as a country (or at least until the day we erase it from the books). Not every American can pay their own insurance on their net income. So any law that says "You will be mandated to pay from your own pocket" is asinine.

How to enforce that? what about the millions who cant afford it? Is their drain on society just going to be subsidized by the rest of us? How will that affect costs to those of us who pay? What about the lowering of cost per premium? What about older people on fixed incomes and the highest medical bills on average?

What's exactly the solution you propose?

[DarkReign]

Why do you think universal healthcare coverage will make it less expensive?

Thats a good question, one I do not have an answer to.

Let me put this straight.

I have two opinions, the realistic, non-scorched-Earth perspective.

...and then the "fuck those who cant take care of themselves" attitude.

Healthcare?

Realistically, the country needs to reform it in some meaningful way. What way is that...I have no idea. My second perspective dictates that I dont have a supreme interest one way or the other.

Because really, I dont give a fuck about people. Starving, broke, homeless, no healthcare, no education, I dont give a shit.

Yeah, it bums me out and makes me want to see some of those unfortunates succeed, but its the cold, hard truth that the dead-weight in this country is expanding. Any assitance program, HealthCare overhaul or other domestic, social change is going to be absolutely abused by a very loud minority.



What's exactly the solution you propose?

Take the warning labels off of everything and let nature take its course, but thats me.

If you mean healthcare, there is no solution. There just plain isnt one. Any plan to give 400 million people health coverage comes with an insurmountable price-tag that has to be paid by someone. Those "someone's" are me and you...and I am not particularly charitable, especially by way of government mandate and law.

Reality Sucks: There is no way to pay for Universal Healthcare without further taxing the successful to prop up the unsuccessful.

But I see healthcare reform as an inevitablity, nonetheless. At some point, something is going to be passed on this topic. Unfortunately, I have nothing to suggest as a better way. Again, my sympathy for other humans is all but nonexistent.

But I look at ObamaCare, the setup, the socialized risk, the private profit, law enforcement having to fine/ticket/arrest citizens because they didnt pay their insurance bills, the bureaucracy, the shady dealings that even lead to this and I can say with a certain amount of conviction that this is not the best way.

Thats all I got.

[DarkReign]

Costs are out of control because catastrophic event insurance, as well as end of life procedures, coupled with every candy ass going to the doc every time they get a splinter, cost a lot.

The 'evil' insurance companies make less than 5% net profit on their services. Damn them!

Cutting out waste and fraud, opening up insurance purchases over state lines, and raising the deductible amount would do more to control costs than the 2000 pages of bullshit the Dems and their medical/pharmaceutical special interests put together.

I am more than willing to bet that insurance companies will have windfall profits the moment their target market went from 80 million-ish to 200 million (dont know why I kept saying 400 million) bound-by-law customers.

Expenses go up, sure. But revenue goes through the roof as well. And lets be reeeeeal honest here...

These insurance companies, under Obamacare, dont have any risk of failure. Your company would have to be so incredibly derelict and incompetent in that environment that your failure was a razor-thin margin anyway.

You have law enforcement mandating people pay their bills to you, a non-government agency. Youre a private company, with private profit with 200 million adults/families who are now bound by law to pay for your service (obviously spread over X number of providers, big and small).

Government will be heavily involved with their business practices. If the government is now reponsible in enforcing that their revenue stream stays solvent, I am sure they will have interest in their premium costs, entry conditions, etc.

But it would seem to me a bloated and cumbersome method of execution.

[TeyshaBlue]

I am more than willing to bet that insurance companies will have windfall profits the moment their target market went from 80 million-ish to 200 million (dont know why I kept saying 400 million) bound-by-law customers.

Expenses go up, sure. But revenue goes through the roof as well. And lets be reeeeeal honest here...

These insurance companies, under Obamacare, dont have any risk of failure. Your company would have to be so incredibly derelict and incompetent in that environment that your failure was a razor-thin margin anyway.

You have law enforcement mandating people pay their bills to you, a non-government agency. Youre a private company, with private profit with 200 million adults/families who are now bound by law to pay for your service (obviously spread over X number of providers, big and small).

Government will be heavily involved with their business practices. If the government is now reponsible in enforcing that their revenue stream stays solvent, I am sure they will have interest in their premium costs, entry conditions, etc.

But it would seem to me a bloated and cumbersome method of execution.

With their current ROE, expenses are hardly a concern to the contemporary insurance company. Were it a concern, insurance companies would already be working together for a common documentation standard at the very least. But no, each company maintains it's own, uniquely retarded, byzantine, counter-intuitive administrative methodology.

[boutons_deux]

"universal healthcare coverage will make it less expensive"

I heard an SA doctor on the radio, working in public health care say for every $1 spent on his service treating poor people now, $20 were saved later when they would be much sicker, and more expensive to treat (eg, undetected/untreated diabetes allowed to progress to where it caused kidney failure, peripheral neuropathy, cardiovascular disease)

[TeyshaBlue]

"universal healthcare coverage will make it less expensive"

I heard an SA doctor on the radio, working in public health care say for every $1 spent on his service treating poor people now, $20 were saved later when they would be much sicker, and more expensive to treat (eg, undetected/untreated diabetes allowed to progress to where it caused kidney failure, peripheral neuropathy, cardiovascular disease)

I've heard that too, and on the surface it makes sense. However, when applied across a population, it actually doesn't save much if any money. It does, however, result in a healthier population. Advocates of universal healthcare, and I am one, need to understand that cost reduction is not the droid we're looking for.

[boutons_deux]

"force individuals to hand over a significant portion of their income and wealth to large insurers on an annual basis"

employees in group plans already do that. what the fuck is your problem?

[TeyshaBlue]

"force individuals to hand over a significant portion of their income and wealth to large insurers on an annual basis"

employees in group plans already do that. what the fuck is your problem?

The participants in group plans are not compelled to do so by federal law. That's one major difference.

[mogrovejo]

These insurance companies, under Obamacare, dont have any risk of failure. Your company would have to be so incredibly derelict and incompetent in that environment that your failure was a razor-thin margin anyway.

Do they have now? There's no serious competition. How many health insurance companies have failed in the last decade?




If you mean healthcare, there is no solution. There just plain isnt one.

I fully agree. I think there are ways of making some marginal, small improvements, but the grand, definitive, absolute, solution many dream about is a dream.

Then, it's about time. A few centuries ago, large scale famine was still a frequent occurrence in the Western World. Today is unthinkable. The access, relative affordability and quality of the health-care people have today, even the poorest of the poor, is way superior to what it was 100 years ago.


Reality Sucks

Yeps, often that's the case.

[TeyshaBlue]

I fully agree. I think there are ways of making some marginal, small improvements, but the grand, definitive, absolute, solution many dream about is a dream.

Solutions often start just like that.

[boutons_deux]

wrongies want to be "free" to choose to be sodomized like this:

"customers incensed over premium increases of 30% to 39%"

http://www.latimes.com/business/la-fi-insure-anthem5-2010feb05,0,3002094.story

year after year after year.

[mogrovejo]

Solutions often start just like that.

As dreams? Maybe.

Obviously there's the inevitable downside: at some point you have to wake up. Some European countries are dealing with it right now.

[TeyshaBlue]

wrongies want to be "free" to choose to be sodomized like this:

"customers incensed over premium increases of 30% to 39%"

http://www.latimes.com/business/la-fi-insure-anthem5-2010feb05,0,3002094.story

year after year after year.

If you'd drop your myopic, partisan hackery, you and I could actually agree on a few things. However, for every cogent post you generate, you post 100 asinine talking points like that.:rolleyes

[TeyshaBlue]

As dreams? Maybe.

Obviously there's the inevitable downside: at some point you have to wake up. Some European countries are dealing with it right now.

We're not in Europe.
Obviously? Inevitable? Please.

[Winehole23]

The sly use of question begging (obviously and inevitable) marks out all potential critics as unreasonable or ignorant. I do find it odd how often mogrovejo resorts to this trope.

[TeyshaBlue]

agenda teflon

[Winehole23]

It looks like another rhetorial crutch.

[mogrovejo]

We're not in Europe.

I doubt the geographic location matters. I think the rule that one can't keep overspending forever is applicable regardless of the latitude.

[Winehole23]

Should mogrovejo acquire any more, it raises the question just how many lame legs his arguments are dragging along.

[TeyshaBlue]

I doubt the geographic location matters. I think the rule that one can't keep overspending forever is applicable regardless of the latitude.

There is the whole cultural thing in Europe...you know...they're kinda not like us in some ways.:lmao


OMFG.

[TeyshaBlue]

Should mogrovejo acquire any more, it raises the question just how many lame legs his arguments are dragging along.

morgrovejo, the argumentative, octoplegic spider.

[ChumpDumper]

Why do you think universal healthcare coverage will make it less expensive? Mandates seem to have lowered costs in Hawaii, and also gave insurers the leeway to try new methods and programs of coverage.

[Winehole23]

bork! bork! bork!ZOKUdMr95Ig

[TeyshaBlue]

I think we have to be careful in how we measure costs in these arguements.

Costs to whom, for instance? Are the cost savings realized or are they simply shifted expenditures?
I say this because I recently read a study (and I'm searching like hell to find it) that projected the conglomerate costs, that is all costs together, to be slightly higher under a classic, universal plan. The reason behind this...for example........you're now undertaking millions of mammograms more than before. Yes, you will most likely catch more breast cancer cases earlier...bystepping costly chemo and surgical costs. But those savings would not offset the additional costs of the mammograms.

The benefit is in health and access. If we can do it and almost break even, that would be awesome. If we could do it with a net cost approaching what we spend now, then I think it would be a slam dunk. I don't think we could ever do it and actually realize savings, and I don't think that should be the focus.

[DarkReign]

The benefit is in health and access. If we can do it and almost break even, that would be awesome. If we could do it with a net cost approaching what we spend now, then I think it would be a slam dunk. I don't think we could ever do it and actually realize savings, and I don't think that should be the focus.

I like your good, better, average projections.

Tell me, whats the worst that could happen?

My money is on healthcare breaking the country financially. Rather quickly, too. Say...less than 15 years?

Unless of course we stop waging foreign wars and spending a zillion times more on our military than every other country combined, healthcare, IMO, is the end game of the US's financial viability.

[TeyshaBlue]

I like your good, better, average projections.

Tell me, whats the worst that could happen?

My money is on healthcare breaking the country financially. Rather quickly, too. Say...less than 15 years?

Unless of course we stop waging foreign wars and spending a zillion times more on our military than every other country combined, healthcare, IMO, is the end game of the US's financial viability.

Personally, I think we hit critical mass < 10 years.

[boutons_deux]

"If we could do it with a net cost approaching what we spend now"

Will NEVER happen, because that would mean delivering more total care to millions more people for the same cost.

What also will never happen is Americans of all social levels taking care of themselves. 100s of $Bs every year are "wasted" on treating people with self-inflicted life-style diseases.

$200B year = cost of obesity and obesity-worsened co-morbities.

400K smoking/lung cancer deaths/year at probably well over $100K cost each for end-of-life care.

[TeyshaBlue]

"If we could do it with a net cost approaching what we spend now"

Will NEVER happen, because that would mean delivering more total care to millions more people for the same cost.

What also will never happen is Americans of all social levels taking care of themselves. 100s of $Bs every year are "wasted" on treating people with self-inflicted life-style diseases.

$200B year = cost of obesity and obesity-worsened co-morbities.

400K smoking/lung cancer deaths/year at probably well over $100K cost each for end-of-life care.

Point noted. One of the tenants of universal care would be examining the cost of treatment. Lots of oxen to be gored in that fight. I don't have any real expertise in the treatment arena, that is, the methodology of doctors and hospital as they determine treatment scenarios. I know there are some damning indicators that beg examination for cost efficiency. The utter opacity of treatment costs for example. Market forces, which can actually do some good, could help drive treatment cost reductions if we actually knew how much that fucking tonsilectomy was going to cost before we went to the hospital A. Hospital B might be a couple of grand cheaper. But today, we have no clue.
I do have some expertise in pharmaceutical pricing and contracts. I can tell you right now, with a high degree of certainty, that a universal cost structure could save billions. There is no compelling reason why Hospital A has to pay $5 for a bottle of Tylenol, when Hospital B, using a different GPO pays $3.75. That pricing differential is what drives pharmaceutical profits in a big way...that and the collusion between pharma and GPOs. I think it is indeed possible to approach today's costs in a universal plan. Hell, boutons, we're already covering some of those costs today as uninsured hit the ER's with their ailments.

[boutons_deux]

"the cost of treatment"

AMA and docs are already fighting ANY reduction in medicare/medicaid fees, and many docs already won't accept any medicare/medicaid patients.

Other docs won't deal with any insurance and demand cash upon delivery, and YOU fight with the govt or private insurer for reimbursements.

The health care providers and insurers have simply priced themselves out of reach millions of citizens. The ONLY way this will be resolved is through forceful govt intervention.

iow, to repeat ad nauseam, the health care system is broken, and it AIN'T the govt's fault.

Even shielding all providers from malpractice and allowing interstate insurance sales won't fix the system.

I read an article about last year where some group like the American College of Surgeons polled their members and 50% said they wouldn't choose medicine again.

BROKEN BROKEN BROKEN

The US is really fucked up in this and other very serious ways.

[mogrovejo]

There is the whole cultural thing in Europe...you know...they're kinda not like us in some ways.:lmao


OMFG.

Obviously. And I believe that's a very relevant factor, often overlooked, to explain the difference on health-care costs. Culturally dictated consumer preferences are extremely difficult to measure but they exist. For example, different tastes are an explaining factor on why Americans work more than Europeans - Americans tend to prefer consumption to leisure relatively to Europeans, so Europeans tend to use productivity raise to increase leisure rather than income, while the U.S. has done the opposite.

And there are factors with mixed causes - the difference on medical personnel salaries is partially explained by the predominance of subsidized college education in Europe plus a much less litigation oriented society. Something that should give pause to those who believe that controlling this kind of costs is something short of an extremely complicated and utopian adventure.

Olivier Blanchard, the French economist from MIT who's now the chief economist at the IMF, has published loads of work on the issue of how cultural preferences affect economic choices in Europe vs. America.

However, there's one thing that, as I've been saying, that works the same way in Europe, America, Africa or Asia: you can't keep on spending wealth you don't create forever.

[mogrovejo]

In France, physicians are leaving the French public health-care system like there's no tomorrow and joining the private sector. Universal health care means some different form of rationing - decided by politicians.

[ChumpDumper]

In France, physicians are leaving the French public health-care system like there's no tomorrow. Universal health care means some different form of rationing - decided by politicians.Numbers, please.

Where are they all going?