Because it's not a fair marketplace. In a free market, prices are determined by what the market will bear. With life and death health decisions, the market will bear whatever the buyer has. To put it more plainly, the price of something like a heart transplant would simply be, "everything you have, plus everything you can borrow," because the there is no upper limit for most people to pay to stay alive.

This is simply an unfair marketplace. One party in the price negotiations has far too much power.

Lies and crooked politics were used to try and stop it before the neocons even knew what the proposed bill would look like because they disliked the very concept of universal healthcare. Lies and crooked politics were used to stop the mid-90's push for universal healthcare. That may not completely excuse its use, but at the end of the day when people are dying because they can't afford proper healthcare, I can't say I'm completely against fighting fire with fire. Sometimes(or probably often) that's what it's going to take to get a good thing done in Washington, which is sad.

I'm betting I already contribute 2-3x more than you Bovine. Why don't YOU contribute more to society or do you already reap the benefits of my hard work and just want more.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Nice try, sir. I'm afraid you're not going to goad people into dick-waving contests that easily.

But all in all you've proven to be pretty predictable here. You've failed to really reply to any of my questions about why any of this ("Socialism" as you deem it.) is so terrible.

You've failed to articulate why increasing accessibility to health care for everyone is such a terrible thing...aside from a sadly self-centered "I won't use it, ergo it's bad." commentary.

You've done a good job recycling the standard propaganda though. You even got the "my hard-earned..." line in there. You even waved your dick around a little, I guess in an attempt to banish anyone below your income bracket into the "greedy little socialist leeches" category?

A pretty standard showing.

Ah the old "I'm better than you IRL" argument. Persuasive, to be sure.

I contribute more by 8:00am than most people do all day!

Lies and crooked politics may work well for staunch Democrats, but "It's our turn to fuck up the country" doesn't sit well with independents.

Is it really dick waving if it is relevant to the discussion? This is not a flat fee spread out to everyone, it is a percentage, so if he has to pay a much higher total than you do I'm not surprised he isn't thrilled to foot the bill.

There are some ideas I don't mind in this bill, but overall I feel it is too far to the socialism side and doesn't strike the right balance I would prefer to see. I would go into this in more detail if I thought there would be any real conversation about it, but that doesn't seem likely right now.

Quite the opposite, if you have some good input, I'd love to hear it. I grow weary of the usual, vague, "omg socialism!" and "omg USA dead, two weeks tops" stuff.

Drajeck.

Please let us know what you personally define as "socialism" -- please be sure to leave out any references to lenin, stalin, communism or Russia.

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World of Warcraft: Kallaystra, Gweila, Steakumn, Tarathia [ Feathermoon/Horde ]

There is no dick waving going on. Just tell me why I, as someone who already pays thousands a year into Medicare should have to foot the bill for you or anyone else too stupid to get a job, make a good living and pay his own way. Give me one good solid reason other than "It will make you all warm and fuzzy inside knowing you helped someone less fortunate" because that dog won't hunt. It may help you sleep good at night but honestly, I sleep fine already.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

I also love the fact that only 7min passed after this was signed that multiple state attorney generals filed lawsuits citing it as unconstitutional.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Ok Bov, I'll bite. Krby posted an interesting article, so I'll comment on a few of those ideas then. I'll do some more later, too many at a time gets them lost in the shuffle.

1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)

This makes sense to me. If you don't have insurance I am paying for you in the long run anyway because when something happens you still go to the emergency room. This goes along the same lines as why it is required to have auto insurance if you want to drive.

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).

Not allowing insurance companies to charge based on health habits is a horrible way to promote such habits. A person who does thier best to reduce the odds of needing medical services should have those efforts reflected in thier premiums. I understand the premise that this will make insurance unaffordable to lower income families with poor health habits, I just don't like this as the solution.

3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).

I don't really know enough about this to comment.

4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).

I agree with this for the same reasoning as in the 1st part. I am going to be paying for everything you don't prevent, so I don't want you to pocket the $$ on skipping that insurance.

5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).

This one stinks. Disincentives to hire full time employees are not what this country needs right now. This will encourage more use of subcontractors, part time help or even shipping more work over seas. Employers should not be responsible for your children once they are adults. The concept is to allow for children to finish higher education degrees, but putting the burden on employers seems unfair.


Vanamar:
Socialist tendencies in a bill imply that it swings too far towards wealth redistribution and Capitalist tendencies would imply that it focuses too much on a "you get what you are worth" mentality. Idealy we should have policies redistribute enough wealth that the difference between the lower class and middle class is in disposable income only. That would mean that even the lower class could afford all of life's necessities, but there is a great reward for achieving more because disposable income is enjoyable to spend and improves the percieved quality of life. That definition may not fit exactly with this health care discussion, but ask and you shall recieve.

Because that's what a society is about. Maybe in the age of materialism we've forgotten that fact, but it's responsibility of all of us to make sure that every member of the society has their basic needs provided for, even if circumstances conspire to rob them of said needs.

This attitude of unbridled capitalism seems to have brainwashed us all into thinking we need to trample over the corpses of the less fortunate in order to achieve our own gratification. That offering a hand to help someone up is something out of communist Russia. We live in a nation that is sometimes stunning in its wealth and grandeur but we hem and haw about our "hard earned money" when someone brings up the fact that it's not free.

When we stop defining our society by who is on the cover of People and start defining ourselves by the lowest, most unfortunate members of society, maybe we'll stop weeping at the shrine of the Neocon Capitalist and remember that we live in a society and that we're all interdependent.

Maybe you don't care. Maybe you've got your piece of the pie and now you want to carry it off to your own little independent, seceded nation-state. If that's how you feel, then I can't say or do much.

Yes, because this is the only kind of people who cannot afford healthcare.

Seriously? It is no ones responsibility but my own to get up and go to work every morning and earn a living. If I don't feel like it one day, will you as a member of this great society go to work for me? I don't think so. I work for myself and my family so that they can have a roof/food/education, no other reason. Please show me someone who gets up every morning and goes to work saying "Golly Gee I sure hope today's 21% of my paycheck goes to help someone in need!"

Say you do and I say you are a flat out liar.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Seriously? It is no ones responsibility but my own to get up and go to work every morning and earn a living.

You are able to earn that living because of the socialist policies in place to protect you. You just don't seem to understand that. You get in your car with federally mandated safety standards, drive on publicly funded roads, benefit from millions of other people who work because of a publicly funded education, are not robbed because of publicly funded police, blah blah blah.

Your money is not earned by just you-- we're all interdependant. You could not get that money you claim you earned "all by yourself" without the society built around you with publicly funded dollars.

Your inability to recognize your dependence on society is a little sickening to me, honestly. You are successful in part because of everyone around you. Your "fuck off and die" attitude towards others not as fortunate as you is pathetic.

1 and 4 I won't comment on since I agree with your take on them and they're somewhat related.



This is to be expected, really. We're all under one giant group insurance plan, basically, and that means we're all in it together. I know that some people - the same people who hate the idea of this bill altogether - hate the idea that someone "lesser" than them might be getting a similar piece of the pie but it's really an emotional response more than anything.

I don't smoke, drink, do drugs or...ugh...eat chicken fat off the floor either. I also don't have brain cancer, heart disease, genetic birth defects or any number of other bad things, either. But the system isn't just for me, it's for everyone.

This really goes back to the, "I don't use it, ergo it's bad." sort of thinking.



This sounds a lot like it's in line with 1 and 4...keeping people from staying in the group pool but paying for less coverage because ultimately when something happens, everyone has to pay for it anyway.



This one I don't really get either. Why age 26 for the cutoff? 18 or maybe even 21 I could understand, but 26? What a strange number. I'd like to hear some reasoning behind it. The IRS recognizes child dependents from ages 19-26 too, hm.

Sorry Khan, but Fribur basically summed up what my reply would have been, so I won't try too hard to address your last post.

Whatever happened to a reasonable slice of empathy for the guy who wasn't blessed with the same genetic gifts as you?

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Kuwen Furyblades
Hunter of Memento Reejeryn
Champion of Faydark

Don't over-exaggerate, dude.

I'm not on his side, but I can appreciate his point. I think it's more along the lines of giving people the fishing poles, tacklebox, bait and a nice pond, but not actually fishing for them. The items you cite - roads, education, etc., etc., - are just enablers. People still need to be exceptional if they want exceptional things. You still need to get behind the wheel and drive your car on those publicly funded roads. The line that health care starts to step across, and any entitlement, is more like driving the car for you.

And though I disagree with him on health care, I do agree that we should be very limited in how much we give to people as a right, for no effort.

And half the problem with this debate is that people like Fribur, who feel so passionately for their parties' policies, will not engage with people like Drajeck, who post very reasonable arguments. Instead, you guys are picking the low-hanging fruit with dickweeds like Khan because it's easy to pigeon hole him into an extreme point of view that you can mock and poke holes at.

It's telling that the first reactions on this thread were gloating that your side got its way. Now that we're into actual policy, notice how little actual posts and facts are there.

Hell, Randy's point was not even based on reality. He seems to think that healthcare is free now. Lol!

I'm trying to talk to Drajeck! Give us some credit, Jox.

Bovinity wrote:


The one giant insurance plan argument makes sense for your 2nd group of examples, brain cancer, heart disease and generic birth defects, because they are conditions. Conditions may arise from controllable actions (such as lung cancer from smoking) but can also stem from things completely outside of a persons control, or even be a mix of both. I don't believe there is a fair way to distribute costs based on conditions due to this.

I do however believe that life habits should affect the cost. These are items within the control of a person and have a direct affect on the percentage chance of needing said health care. Smoking, drug use, high cholesterol diets etc are all things that impact the cost of health care and are usually (some may have issues/addictions and can't help it, but make the laws for the masses and write in exceptions, not the other way around) controllable by individuals. I believe that these items should affect the insurance rates for two reasons. First, because it is the fair thing to do, and second, because of the old addage "that which gets measured gets done". If you make an incentive to live healthier, the percentage of the populace that adopts those programs will increase. This is coming from a guy who loves cheesesteaks and would be condeming himself to some cholesterol surcharges.

the part of Chicken Little will be played by Khan for the performance this evening.

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Well said. I can't disagree with that at all. There needs to be SOME personal accountability in entitlement programs.

i'm going to stop paying my taxes because i don't use over 90% of the roads in texas, and because i don't go to school anymore, and because i don't need the police to keep me safe because i have a gun.

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Currently the age covered is to 23 I believe. The reason it has been extended to 26 is that people graduating from college now are more likely than previous generations to hold 4,5 or 6 jobs in their first few years out (as well as graduating later) which doesn't allow them to make the month minimum to get insurance. The idea is to close gaps in coverage and currently freshly graduated college students represent a rather large gap in coverage.

The sad thing about Rugen's post is how ironic it actually is.

Because our energy infrastructure, roads, post office, NASA, etc., etc., are all crumbling or noncompetitive. Our energy infrastructure is so bad it's a national security threat, and our transportation infrastructure is rotting, and one of the most common justifications for the stimulus.

So yes, government programs have done great things. They've also proven unsustainable very, very often.

Social Security, Welfare, Medicare, etc all have their large share of problems, but I think the question for most Americans is: Is it, in the end, still worth it? I would venture to say yes, especially if you take into account the countless individuals whose lives were saved(financially, at the very least) by those programs. Universal Healthcare will likely be seen as not much different in a few decades - plenty of problems, lots of bureaucracy... but at the end of the day, managed to save many people.

I wish there were some easy way to get around how inefficient government runs things, but I just don't see it. Of all the ways I can think of for government to waste money though, this would have to rank up there pretty high for a "fuck it, let's do it anyway for the sake of people".

Doing it inefficiently is far, far better than not doing it at all. This is what the republicans fail to grasp and have continued to fail to grasp through this entire process. Inefficiency can be fixed. Starting in the face of opposition can be (as we've seen) difficult if not impossible. How long have they been trying to overhaul our health system?

The ball is rolling and going in the right direction despite the republican party's best efforts. That's what matters in the end.

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Medicare fraud in Maryland, by itself, is ~10% of expenditure. It's projected that about 1/3 of every dollar spent is lost to waste, fraud, and abuse. I take it the program has just not had enough time to fix its inefficiency?

I hear what you're saying, and I think it would be great if things worked that way, but I am not sure that they do. From this perspective I have to think that when you have a manager running this much of a deficit, and who has been ineffective at curtailing losses, the last thing you do is give them more responsibility. I also think it has been lost on Congress that healthcare overhaul is also about fixing what is already broken.

The agency given authority to pursue 'lost' dollars should really direct its primary effort to internal issues. As it stands, they only get $0.66 of every dollar they recoup; without even counting the cost for them to find and secure it.

In which case, I still believe that doing something inefficiently is better than not at all.

If we wait for the "perfect" thing to come along, it never gets done. Period. Which is unacceptable, particularly on this topic.

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Ok, next batch to cover:

6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

I'm ok with this part also. This paragraph exaggerates the effect of getting coverage you can't possibly use (single guy with pediatric etc). That's just how bulk insurance works as a business model.

7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d)(1)(A))

I don't follow what they are saying here, maybe someone more knowledgable can explain it? Are they saying you are paying 100% of your premium but due to your income level you are only eligible to get 60% of what you paid for?

8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).

The idea of deductible limits works for me, otherwise people could set deductibles so high they would essentially not have any coverage, but these targets sound too low. Minor issue, should be adjusted to higher amounts allowed though.

9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).

Like it or not, the whole idea of universal health care is everyone gets it. How could there not be a fine for employers that don't want to participate?

10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).

The idea is people will no longer need to deduct more than $2,500. This change makes sense to me.



Well, this was a boring 5 topics because I there isn't much I don't agree with. I'll try and hit the next 5 soon, there are more conflicts in those I believe.

I really cannot see much in this 'reform' to be pleased about.

~ It's not universal. Stop calling it universal, 95% is 5% short. And that 5% are the most needy among us.
~ It is a huge transfer of wealth from the taxpayers to health insurance & pharmaceutical company stockholders. (why do you think they performed so well yesterday)
~ It really does nothing to control costs, which are the second-most voiced reason for this 'reform' (the first being morality)
~ It is NOT 'paid for'. The gimmicks used to pretend it's paid for are truly disgusting.
~ Listening to some of the talking heads I fear that this is the first step in a series of government requirements of citizens all in the name of prevention of higher healthcare costs. (ie.: line up for colonoscopies when you turn 40 because if not caught early they cost more)
~ It creates a new taxing mechanism. So, not only will the payroll portion of my medicare tax go up but now they are going to take a 'medicare contribution' from my unearned income. For my family that means they are hitting retirement savings. I am more than willing to have my taxes raised but just raise them. Don't rename a tax a contribution and create a new category.
~ They have reinstated the marriage penalty in this new 'contribution'. Why? It makes no sense to me to raise taxes higher on couples than on singles. (and for those of you opposed to estate taxes they are reinstated also)

I am very much in favor of universal single-payor healthcare. But this? no thank you. It doesn't accomplish what needed to be accomplished and it will cost much too much.

On a side note: The issue of "lifestyle habits" being fodder for allowing higher insurance premiums is an incredibly slippery slope. Smokers? sure, why not. Obese? they mostly chose their condition. High blood pressure? might be lifestyle or genetics. Skydivers? Skiiers? Horseback riders? Bungy-jumpers? I could go on because yeah, they ARE lifestyle choices. Where do you draw the line?

Social Security = Gone before I can even get a dime out of the 10's of thousands I have put into it. Glad I could help!

Welfare = Broken so badly that people know all they need to do is have another baby to get a "raise". Glad I could pay for that 4th illegitimate kid!

Medicare/Aid - Broken so badly, crooks set up shop every day to bilk millions from a system with practically zero checks. Glad I could pay for it!

If none of these piss you off then kudos to you, you are able to turn the other cheek.

Oh and Rugen, practically everything your cute little morning story emphasized was a pay as you use scenario. Not a Fuck-you-give-me-your- money tax like this one is.

I have Zero problems paying taxes on things I use.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

If you had no kids, would you take issue with a portion of your taxes going to fund schools?

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Kuwen Furyblades
Hunter of Memento Reejeryn
Champion of Faydark

And more states to follow...

Texas, Florida, South Carolina, Nebraska, Pennsylvania, Louisiana, Washington, Colorado, Michigan, Utah, Alabama, South Dakota, and Idaho, filed its legal challenge in the Federal District Court in the Northern District of Florida. It was filed shortly after President Barack Obama signed the bill into law. The legal action specifically challenges the Patient Protection and Affordable Care Act and names the U.S. Departments of Health and Human Services, Treasury and Labor as defendants because those federal agencies are charged with implementing the Act's constitutionally impermissible provisions.

I would say there is a problem when 4 of the top 8 most populated states in the US filed a lawsuit 7 min after this shit was signed. But maybe you board warriors know better then them.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Glad you asked! Nope, not at all. In fact, I wind up paying 2x since I have one child in public and one in private schools and don't get a credit on tuition for the one that is in private.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Tax had nothing to do with what you said (and I responded to).



was the quote.

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I don't agree. FSA's are for inevitable and unforeseen expenses. Vision, dental prescriptions, re-reimbursement of deductibles paid. An employee should be able to apply as much to an FSA as they want or anticipate needing for the following year.

Example: The dentist tells you that someone in your family needs braces and it will be $3k up front then payments over the next 30 months. You set up an FSA for 3k and put the initial 3K down payment on your credit card. You then turn in your receipt to your FSA and you get your 3K back and pay your CC bill.

Why shouldn't you be able to do something like this?

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

This made me think, does this bill cover Dental? If it does and since braces are generally not covered by Insurance, will they be considered a "Cosmetic" procedure and be subject to the added 5% tax? What about crowns vs extractions? Cheaper to get one pulled than to get a root canal and crown by about 70%.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Challenging things they don't like as "unconstitutional" is nothing new. It happens more commonly than you might think, actually. And it doesn't automatically mean they know something special or have a leg to stand on.

Serious question...if they want to set aside more money than the alloted $2500 for something like that, can't they just put it in a savings account or something?

HSA's are pre-tax.

Just putting it in savings removes the pre-tax nature, and exposes you to more tax liability via interest.

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World of Warcraft: Kallaystra, Gweila, Steakumn, Tarathia [ Feathermoon/Horde ]

It's tax free in a FSA, similar to 401k or IRA contributions, that's why it's superior to a savings account. They are inherently flawed though because there is a time duration on the account. If you contribute money and don't spend it, you lose the money. This is ridiculous and the main reason more Americans have never used them. The entire FSA program is poorly designed and ends up screwing a lot of the people it is supposed to help. In Khan's example the more practical solution would be to make required dental work an allowable tax deduction, completely removing the need for a FSA in the first place, and with no danger of forcing people to lose contributed funds.

We have been using an FSA account for years and have never lost a dime. In fact, we have usually exhausted it by early September.

What some people fail to realize is that if you get a 3k bill on January 2nd and your FSA acct for that year is 3K, you can immediately be reimbursed the full 3k, you don't have to wait until it is fully funded to get your money back.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

Conveniently taking a single line from a paragraph out of context and posting your lame bed time story is weak Rugen, even for you.

Practically every agency you listed doesn't do a damn thing except enforce regulations. None of them provide a service to the public other than State/local level infrastructure of which none of what I listed is.

Weak.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

There was nothing out of context about your statement that I quoted. You claimed anything run by the government is a failure. I called it out as the over-reactionary lie you and I both know it was (and is favored by a certain slant of political follower these days). But keep right on justifying. It's fun to watch.

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We have a government program, inefficiently, now. With a full 30% of wiggle room to improve and provide care to those that need it; albeit in one state but I can't imagine it's much better in the others.

Granted the intent is to phase out the other programs, but I'm not going to drink the kool-aid and presume that will cure the gross mismanagement. The margin on the health insurance industry is ~2-3%. A great many hospitals and general practitioners are in the red, partly due to the government programs that exist. As a whole the industry pretty lean. That's not where the problem is. The problem is in pharma and specialists/specialty care.

If reform doesn't address cost, the money has to come from somewhere. I'd honestly be surprised if the savings tabulated even cover or address the added waste of the bureaucracy.

His quote isn't nearly as untrue as you want it to be. Nearly everything you cited is in a sad, sad state of disrepair. My favorite was the post office, though. heh

A better line would be "Has society not learned that anything coined and run by the government is doomed to inefficiency, waste and fraud."

All the more reason to look with skepticism and suspicion any time the government wants to take over an entire sector. Sometimes you make exceptions, and we should for health care. But it's a legitimate concern.

Khan.... I agree with your stance in general on social programs. However, your arguments are based on the sensationalized exceptions not the rule. Generally speaking, these programs help millions. In any program of this size there are abusers and I would agree that it gets worse when run by the federal government.

Big picture though, your arguments to focus less on the exceptions and more on the rule. This program gets things started. Now it needs to be fixed.

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That right there is one thing that I don't think a lot of people understand. Hospitals every year treat people who can't pay. Where do you think the money to cover those treatments comes from? It is passed on to you and I in the form of higher health care costs.

In theory, more individuals having insurance will reduce the amount of unfunded care hospitals shell out each year and therefore reduce the amount of excess costs that need to be handed down to other individuals in the form of higher health care costs. Will it be successful? Probably not as long as hospitals are allowed to be for profit. The additional money that comes in will just be allotted as profit.

Vanamar - Not for Profit does not mean we pay our doctors and nurses shit wages. It simply means that the costs charged for procedures not exceed the actual cost associated. There are plenty of excellent doctors working at not for profit hospitals that make very good money.

Rofl. What??

Well thank God all the kickbacks and bribes made it into the bill.

Just one of what I am sure will be a hundred items we thought were being taken care of which are not.

If nothing else, reduce patent laws on pharmaceuticals to 2-3 yrs instead of 15 so that generics are available faster. Think of the money this would save the average person. Oh yeah, I forgot, this bill does nothing but ass-fuck the general person, not help them.

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"Every normal man must be tempted at times to spit upon his hands, hoist the black flag, and begin slitting throats." -Henry Louis Mencken
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VEGETARIAN -Noun (vej-i-tair-ee-uhn): Ancient tribal slang for the village idiot who can't hunt, fish or ride.

I'd go with five years on pharmaceuticals -- that way we can at least get the companies who spent millions/billions in the black on the product, then we can allow generics (and drug importation would be nice too)

Also tort reform to protect doctors from frivolous malpractice suits.

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World of Warcraft: Kallaystra, Gweila, Steakumn, Tarathia [ Feathermoon/Horde ]

There's more disagreement in this batch...

11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))

I'm torn on this one. I respect a business' right to privacy, but there is certainly value in free information. I'll have to give this one more thought.

12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A)).

Hospitals need to accept medicare. No surprise there.

13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).

These limitations are put in place to prevent over development of profitable areas and are intended to force growth into under serviced areas. This is unfair to any business, even hospitals. If you want hospitals to move to areas they normally wouldn't want to be, you need to provide incentives for them to do so, not make it so that is the only place they are allowed to expand. It's an unfair bully tactic.

14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)

Health care insurers are publicly held companies and are expected by thier stock holders to charge more than thier operating expenses cost each year. That is why it is a business and not a hobby. Healthcare is a touchy subject with this as others have pointed out in this thread though, as negotiating a new heart could easily go for the price of everything you own + everything you can borrow. This needs to be carefully monitored, and I suspect insurance companies are going to end up with the short end of the stick until they figure out the right people to bribe, and then we'll have the stick passed to us.

15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).

I disagree with new taxes isolating a specific business segment. Do auto makers have to pay a special tax to fund road research, or are food companies expected to pay special taxes for obesety issues? The concept is unfair and the extra cost will be passed directly back to the consumers of the specialized research services anyway. This magnifies the bad policy by making already expensive procedures even more cost prohibative since the passed on tax cost associated with them will be passed to only a few instead of to the masses. This is counter intuitive for medical progress and only in place to make it look like we are not paying for as much of the new policy as we actually are.

Regarding the argument about punishing smokers, drinkers, the obese, bad diets, etc. I can't see this being a good thing. What I could possibly see working is incentivizing good health. Credits for wellness updates, gym memberships, etc., that reward people for doing the right thing.

Only difference is in the wording, same net effect. I agree that it would be better recieved to have rates set higher and then have healthy lifestyle choices reduce them instead of base rate lower with unhealthy raising.