Political Discussion about Healthcare Reform Law

[iluvolives]

If he rode a horse, a bike, a bus, a street car, a train or used his feet- none of these things would require him to purchase auto insurance. So it's a choice- buy a car and recognize that you will now have a responsibility to purchase auto insurance. If you don't want to purchase auto insurance- you don't have too.

[Shwaz]

In a recent Heritage Foundation paper, Georgetown University law professor Randy Barnett and two co-authors note that the decision upholding wheat quotas does not mean "Congress can require every American to buy boxes of Shredded Wheat cereal on the grounds that, by not buying wheat cereal, non-consumers were adversely affecting the regulated wheat market." Likewise, federal regulation of carmakers does not mean "Congress could constitutionally require every American to buy a new Chevy Impala every year."

Yet this is the logic of the health insurance mandate, an unprecedented attempt to punish people for the offense of living in the United States without buying something the federal government thinks they should have. Don't buy it.

This really isn't that absurd. The fed bail out of the auto industry is very similar to bailing out the uninsured using emergency rooms... I can hear the argument already "You're already paying for those Impalas

[Tripoli1711]

Sadly, no.  It is engaging in a bit of a "slippery slope" trick, but it isn't that absurd.  If the federal government has the authority to pass a bill and force me into a contractual relationship with an insurance company against my will, then where does the line get drawn?

What other private entities/companies will I ultimately be forced to contract with?  Suppliers of toothpaste, because dental health affects health care at large?  The makers of band-aid brand band-aids, so that I do not suffer infection from minor cuts, which taxes the system more....



Stephen-

Why do you continue to ignore the points and questions posed by others and simply regurgitate your prior postings? 

1)  Many did support a different plan.  The only problem with that is that the Republicans never had any hand in this process.  The Democrats never needed a single Republican vote to pass what they passed.  Supporting a different plan made no difference.

2)  One cannot be "created" for Florida if the system has to include all of the things the Fed system contains.  The individual mandate is in the Federal plan, by my understanding, as their hope to keep premiums from skyrocketing (which is a hope they don't really have, but that's a story for another thread).  They claim to hope that by making everyone buy plans, it will spread out the risk and keep premiums low.

My guess is that a plan "acceptable" to the makers of the bill wouldn't be sustainable (just like this bill isn't), and certainly wouldn't be sustainable if you didn't force everyone to buy insurance.

Again, I don't know the rules, so I can't make a plan.  Also, someone has asked where particularly the language is in the signed bill.  Any answers?

[Shwaz]

Meh.  Talk to the Republicans about it.  It was their idea, if you don't like it.

Maybe instead of screaming nonsensically about socialism you should have supported a plan more in tune with your liking.

Luckily its not too late.  You can create one for Florida (which is clearly in the market for one, since our AG is suing)

Lets hear how you would do it?

I writing my bill up now Steve... currently on page 3,257... let you know when it's finished.

[Tripoli1711]

Romney is full of manure in that attempt to explain away a horrible policy.

Everyone consistently messes this up:

Do "we" pay for free-riders at the ER?  Yes.

Why?  Because the hospitals charge paying customers more (and therefore our insurance, which raises our premiums) in order to compensate for those who don't pay their bills.

This, of course, is the same reason why credit card interest rates rise.... but anyway----

YOU GET CHARGED A BILL FOR GOING TO THE ER.  It isn't a "free ride" where you can say "aw screw it, Ill just go the ER and the government pays for it."  You get the bill.  A lot dont pay it.  A lot bankrupt it.  Those people are irresponsible IMO.  You should make good on your debts.  But that's getting a bit tangential.

That's nonsense.  Romney's argument is nonsense and the people who use that argument as a justification for this bill are indulging in the very same nonsense.  

[Tripoli1711]

And Im not trying to antagonize the four of you, just understand your point of view.  Is it based in fact, or is it just more of the same political hysteria.  Right now, it sounds like a bunch of political hysteria since none of you can rationally explain the difference which would explain your support for one kind of mandatory insurance, but not the other.

Anyways, please do explain cogently why you are mad about one but not the other.  Thats all Im curious about.

How could I possibly be more cogent than what I have already posted?  What portion of it was veiled or difficult to understand?  I gave you facts supported by logic as to why they were different and why one bothered me and the other didn't.  Shwaz endorsed it, so it counts for him too.  That's 2 of us.  Where is the confusion?

[JagFan07]

Because none of you have yet explained why you are for mandatory auto insurance in a country where almost everyone drives, but are against mostly mandatory health insurance participation.

I really dont understand it.  Most of you guys were defending these same insurance companies a few months ago, werent you?

And Im not trying to antagonize the four of you, just understand your point of view.  Is it based in fact, or is it just more of the same political hysteria.  Right now, it sounds like a bunch of political hysteria since none of you can rationally explain the difference which would explain your support for one kind of mandatory insurance, but not the other.

As for me, I think its pretty clear where I stand on the matter.  I think that the insurance industry decision makers should all be rounded up and given life imprisonment or executions depending on how many people died as a result of their individual contributions to the policies of the past 40years.

Why on earth are we choosing to pay for our medical needs based on the risk factor that we might get sick anyways?  Its a stupid model.  Why not pay for building construction based on the risk factor that the business might be eventually bought out by another entity?

Anyways, please do explain cogently why you are mad about one but not the other.  Thats all Im curious about.

Stephen,

I think I have been very clear, you just choose not to listen, or better yet give any credence to any idea outside of your beliefs.

1) The Federal Government is restricted by the Constitution from requiring citizens to purchase a product. It is a gross use of the Commerce Clause.
2) Reform is needed in the Health care industry and Insurance Industry.
3) This Bill is not about health reform, this is an attempt to seize control.
4) The Public Option will not increase competition, rather it will destroy competition as it will be allowed to run at a deficit as most Government programs do.

My code is done compiling, so I need to test. Will check back later.

[Shwaz]

Stephen if I gave you the flu... would my insurance be charged for your antibiotics? Would health officers go out on location and draw up directions I coughed or sneezed? Maybe put caution tape & flares up around a door handle I touched?

[JagFan07]

It's called the "Empowering States to be Innovative" amendment. And it would, quite literally, give states the right to set up their own health care system -- with or without an individual mandate or, for that matter, with or without a public option -- provided that, as Wyden puts it, "they can meet the coverage requirements of the bill."

Stephen,

I have had some time to peruse the Bill and can't seem to find this language in it. At least not in the actual bill that was passed. Now maybe I am missing something, but if you could show me where this phrase is worded in the bill I would like to read it.

To help you http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.+4872:

http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111aVBTRI:e1429841:

How to Get a State Single Payer Opt-Out as Part of Reconciliation
By: Jon Walker Monday March 8, 2010 6:06 pm    
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The current Senate health care bill has a provision (Section 1332. Waiver for State Innovation (PDF)) that will allow states to opt out of the current reform structure if they can provide the same level of care for the same amount or cheaper with a different plan. Given how poorly designed the Senate bill is, that shouldn’t be hard on a policy level. In theory, this could allow for state-based single payer plans, and reconciliation could deal with two major problems with the provision.

Delayed Until 2017

The first problem is the date of implementation. States can’t apply for the waiver until 2017, which is completely ridiculous. There is no reason for the delay, and it would make state innovation very difficult to implement. It would first require states to go through all the work of setting up the new system of exchanges for 2014, only to turn around and try to replace it with another new system three years later.

The other big problem with the date is that 2017 would be right after Obama left office (assuming that he served two terms). Since it is very rare for one party to hold the presidency for three straight terms, it will likely be a Republican in the White House in 2017. Assume their HHS secretary would not be open to granting the waiver for a state-based single payer system, it would likely not be until 2020 or 2024 that this provision could be used for creating state single payer, and that assumes a supportive Democratic president is elected. This is completely unacceptable.

Getting Around ERISA

The other major impediment is the scope of the waiver, which I interpret to mean it can’t be used for a waiver of ERISA. From the Senate bill (with Secretary defined as Secretary of HHS and Treasury):

    (c) Scope of Waiver-

    (1)IN GENERAL- The Secretary shall determine the scope of a waiver of a requirement described in subsection (a)(2) granted to a State under subsection (a)(1).

    (2)LIMITATION- The Secretary may not waive under this section any Federal law or requirement that is not within the authority of the Secretary.

ERISA falls under the jurisdiction of the Departments of Labor and Treasury. I don’t think this provision could be used waive ERISA without further action by Congress, at least I think it would become a potential legal mess if that were tried.

ERISA prevents states from telling employers or labor unions what kind of insurance they must offer. Not having an ERISA waiver would make adopting a true state-based single payer system incredibly difficult, if not impossible, and make implementing a very cost effective, Hawaii-style, strict employer mandate system impossible in other states.

Dealing with the Problem Through Reconciliation

To solve the problem, the start date would need to be moved up to as early as possible, and the Secretary of Labor would need to be added to the waiver. To make the changes possibly qualify under the Byrd rule would require a slight redesign for how the federal money is passed through if a state gets a waiver. Instead of providing the state with 100 cents on the dollar, the state would be required to prove its new plan would be at least 5% more cost effective for the federal government, with federal government able to keep that 5% of cost savings. This would make the provision deficit reduction (actual numbers could be changed as needed to qualify). Ideally, the waiver and the way the money is spent by the federal government could be changed so that it is calculated over a five- or ten-year window, potentially giving the most cost effective state single payer plans the ability to start in 2012 or 2013, with the first year of cost paid for with long-term savings.

Conclusion

The Senate bill spends a large amount of money on a very inefficient way of expanding coverage. With modest modifications, the state waiver provision could allow individual states to use that money to pursue single payer systems, a move that would potentially save the states and the federal government a large amount of money. Despite what Obama is telling Dennis Kucinich (D-OH), the current state waiver provision can’t do that.

A better state waiver redesign would not just allow for state-based single payer, but other systems like a German-style all-payer system, a Hawaii-style strict employer mandate system, a Singapore-style system of HSAs combined with catastrophic insurance, etc. The current Senate bill is unpopular with a broad spectrum of people, and a true waiver for states to try something better should appeal to people across ideological boundaries. Even if the changes can’t be crafted to steer clear of the Byrd rule, it might still be possible to get 60 votes in the Senate for a waiver of the Byrd rule, or even convince Joe Biden to play hardball with reconciliation.

These slight modifications that could potentially be part of the reconciliation sidecar should be a rather small request. A small group of House Democrats/Progressives could easily demand the changes in exchange for their voteâ€"if they don’t follow Lynn Woolsey’s example of throwing away all negotiating leverage in return for nothing. Personally, I consider the inability of the single payer movement to actively force members of Congress into including a properly designed state waiver provision one of the most serious failings of the health care fight.

http://fdlaction.firedoglake.com/2010/03/08/how-to-get-a-state-single-payer-opt-out-as-part-of-reconciliation/

I saw this, however it currently is only a stub (as much of this bill we are arguing about is, BTW how do you pass a bill that isn't finished being written?) with many issues as this article points out.

[Ron Mexico]

Blah blah blah...

Next time you see some fat piece of shit coming out of a 7-11 with her arms full of Donuts, Mountain Dew...her Cheeto-stained paws filled with lotto tickets and a carton of Kools under her arm, hold you head up high and be proud that you are an American.  And be proud that we have a compassionate, benevolent Government who will confiscate your hard earned money to help her live in the style to which she is accustomed...and give her free Type II Diabetes medication.

Now, her problems are our problems. We are all in this together America - I feel righteous now that I can directly fund her poor choices.  We are all in this together America.  I am going to volunteer to pay more taxes next year...my cup filleth over with compassion for the bottom 10% of humanity.

[JagFan07]

So.  Schwaz is concerned about paying for my antibiotics if he gives me the flu,
Jag Fan has some kind of rusty argument about the commerce provision as well as suspicions of a government takeover (despite simultaneously believing that the anti tax corporations will be the main benefactors)
and Im still waiting on Trips explanation of the cognitive dissonance.

I guess this  administration  and the last have considered the Constitution to be "rusty". Looks like they just wish to throw out the old, and make up a nice shiny new one. Oh why bother just ignore the old man and do as you please. Maybe I missed it but where did I say Anti-tax corporations would be the benefactors? Its another argument but there is no such thing as taxing businesses, as all taxes are passed to the people either directly or embedded in the price of goods.

[finehoe]

Now, her problems are our problems. We are all in this together America - I feel righteous now that I can directly fund her poor choices.  We are all in this together America.  I am going to volunteer to pay more taxes next year...my cup filleth over with compassion for the bottom 10% of humanity.

Better her than a fat piece of shit banker coming out of the Palm confiscating our hard earned money to help keep him living in the style he's accustomed to.

My cup runneth over with compassion for the top 5% of the country that already owns 90% of the wealth, and still wants more.

[Tripoli1711]

One more time:

They are different, as I have illustrated.

I have no problem with being required to hold insurance should I choose to drive an automobile.  I recognize that driving is an inherently dangerous endeavor and that if something goes wrong, I might injure someone.  If I were poor and did not have insurance, I couldn't compensate the person I injured.  Thus, I have no problem with being made to carry insurance.  It is even more so in the reverse.  If some idiot causes me to be injured in a car accident, I want them to have insurance.  I have no problem with that being a two way street.


I do have a problem with the government telling me I have to buy insurance for myself and myself alone.  My failure to have insurance doesn't have the potential to directly impact the rights and property of others.

[Tripoli1711]

Now, her problems are our problems. We are all in this together America - I feel righteous now that I can directly fund her poor choices.  We are all in this together America.  I am going to volunteer to pay more taxes next year...my cup filleth over with compassion for the bottom 10% of humanity.

Better her than a fat piece of shit banker coming out of the Palm confiscating our hard earned money to help keep him living in the style he's accustomed to.

My cup runneth over with compassion for the top 5% of the country that already owns 90% of the wealth, and still wants more.

What nonsense.  Bankers do not confiscate your wealth at the point of a gun.  Only government does this.  I don't understand when the rights of "predatory wealthy" have been defended.  Sadly I am rather certain that the two of you both feel anyone who is wealthy is "predatory wealthy".  That sort of attitude cannot be reasoned with.

[JagFan07]

Jagfan.

Please don't mistake your understanding of the Commerce clause as being synonymous with "The Constitution".

Well if we are going to ignore one part, why not ignore the whole thing.

Any ideas on the auto insurance v health insurance question?

Will you show me the Federal Law that mandates Auto Insurance? Would love to see it.

Or why we are funding our heath payments with a risk based pyramid scheme?

I never said the Health industry and insurance industry did not need reform. So how would you run a for profit Health Insurance company? If risk control isn't the model what works?