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This topic is not about the American Invasion of Iraq. Stop. - Page 23 |
On June 30 2012 04:27 farvacola wrote:Show nested quote +On June 30 2012 04:24 Kaitlin wrote:On June 30 2012 04:09 BluePanther wrote:
It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do.
Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states.
Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine).
It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right".
(for clarification, I specialize in government/constitutional law)
Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty).
For example:
It is unconstitutional to say "You must buy 10 pounds of brocolli a year."
It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year."
It's a federal power loophole.
You are incorrect in assuming "no jail time". There are several "tax crimes" that are criminal and upon conviction are punishable by "jail time". Have a look at the 7200 series in Title 26. That is where tax evasion and other tax crimes reside. Since this 'penalty' has been deemed a 'tax' by the SCOTUS, tread carefully in these waters. The act itself explicitly dictates that failing to pay the tax cannot result in criminality.
and under pre-Obamacare law, simple failure to pay did not result in jail. However, taking measures to "evade or defeat any tax" does. Simple failure to pay is always answering every question correctly in the assessment of the correct amount of tax. However,providing false information so that such amount cannot be properly determined is criminal and is the exact type of behavior that makes for a nice stay in the big house.
edit: also, does the law say mere "failing to pay the tax" or does it say "willfully failing to pay" ? Because even willful failure is criminal, of course generally only a misdemeanor (7203). If the law doesn't preclude "willful failure" as not being criminal, then don't be so sure that 7203 doesn't still apply. 7203 is for "willful" failure, not mere failure, which is all this law seems to claim is not criminal, but then it's not criminal anyways.
Having thought about a good deal of this, I'm actually looking forward to this playing out because I think a lot of people who even now support this are going to realize this is not what they thought it was and won't have the "wonderful" effects on everyone that they thought.
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On June 30 2012 04:09 BluePanther wrote:Show nested quote +On June 30 2012 03:58 hzflank wrote:On June 30 2012 03:08 BluePanther wrote:On June 30 2012 02:53 hzflank wrote:On June 30 2012 02:32 BluePanther wrote:On June 30 2012 02:25 hzflank wrote:On June 30 2012 02:09 xDaunt wrote:On June 30 2012 02:03 BuddhaMonk wrote:On June 30 2012 01:59 xDaunt wrote:On June 30 2012 01:56 BuddhaMonk wrote:
[quote]
Do you also think that national security is something that should be funded by voluntary money, or is that something where it's OK to "coerce" people and use the money for a military? There's clearly a difference between 1) the federal government taxing people and using that tax money to fund government programs, and 2) the federal government using the tax power to force people to buy products from private companies. You may want to consider this point before posting further. Are you suggesting that public money for national security never finds its way into the pockets private companies? Or it's OK in your mind so long as the government is an intermediary? The latter. The feds can spend money for public welfare. That's not in dispute. However, forcing private individuals to engage in behavior (ie buy products from private companies) that they otherwise would not engage in by using the tax power is not right. Sorry, but you are not connecting the dots... There is no real difference between forcing a person to buy a product or taxing that person to generate money to buy the same product. ... and that is why he's saying SCOTUS was not right in their decision. Would you spell it out for me? I am under the impression that the federal government is allowed to instruct states on how to tax their citizens. They are allowed to tax, but the way the law is written, it's basically a fine in substance -- a penalty -- which SCOTUS said quite clearly is not allowable. So the court is allowing the government to do exactly the opposite of what it said the government couldn't do --- penalize someone for not following a mandate. It's circular logic imo. It's basically a fine? Did SCOTUS not just declare it a legal tax? And is SCOTUS not the absolute authority on US law? As I see it, it is as much basically a fine as it is a tax break for insured people. As a layperson, I often feel that semantics have too much sway over common sense (in law). I fully agree that common sense tells us that that you are correct, but legally it seems that you are incorrect. It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do. Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states. Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine). It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right". (for clarification, I specialize in government/constitutional law) Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty). For example: It is unconstitutional to say "You must buy 10 pounds of brocolli a year." It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year." It's a federal power loophole.
Read the opinion more carefully. Roberts explicitly says that taxes have to be reasonable incentives (else they're penalties); a $10000 dollar tax for not eating broccoli is as ridiculous as (if not more ridiculous than) the 10% tax on the profits of companies that employed underaged children ruled unconstitutional in the controlling precedent, Bailey v Drexel Furniture Company. (Though subsequent commerce clause developments allowed the government to just forbid or strongly restrict child labor instead of "taxing" it). Roberts upheld the ACA "tax" as a governmental incentive analogous to sin taxes on cigarettes, which persuade instead of command.
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On June 30 2012 05:11 imareaver3 wrote:Show nested quote +On June 30 2012 04:09 BluePanther wrote:On June 30 2012 03:58 hzflank wrote:On June 30 2012 03:08 BluePanther wrote:On June 30 2012 02:53 hzflank wrote:On June 30 2012 02:32 BluePanther wrote:On June 30 2012 02:25 hzflank wrote:On June 30 2012 02:09 xDaunt wrote:On June 30 2012 02:03 BuddhaMonk wrote:On June 30 2012 01:59 xDaunt wrote:
[quote]
There's clearly a difference between 1) the federal government taxing people and using that tax money to fund government programs, and 2) the federal government using the tax power to force people to buy products from private companies. You may want to consider this point before posting further. Are you suggesting that public money for national security never finds its way into the pockets private companies? Or it's OK in your mind so long as the government is an intermediary? The latter. The feds can spend money for public welfare. That's not in dispute. However, forcing private individuals to engage in behavior (ie buy products from private companies) that they otherwise would not engage in by using the tax power is not right. Sorry, but you are not connecting the dots... There is no real difference between forcing a person to buy a product or taxing that person to generate money to buy the same product. ... and that is why he's saying SCOTUS was not right in their decision. Would you spell it out for me? I am under the impression that the federal government is allowed to instruct states on how to tax their citizens. They are allowed to tax, but the way the law is written, it's basically a fine in substance -- a penalty -- which SCOTUS said quite clearly is not allowable. So the court is allowing the government to do exactly the opposite of what it said the government couldn't do --- penalize someone for not following a mandate. It's circular logic imo. It's basically a fine? Did SCOTUS not just declare it a legal tax? And is SCOTUS not the absolute authority on US law? As I see it, it is as much basically a fine as it is a tax break for insured people. As a layperson, I often feel that semantics have too much sway over common sense (in law). I fully agree that common sense tells us that that you are correct, but legally it seems that you are incorrect. It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do. Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states. Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine). It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right". (for clarification, I specialize in government/constitutional law) Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty). For example: It is unconstitutional to say "You must buy 10 pounds of brocolli a year." It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year." It's a federal power loophole. Read the opinion more carefully. Roberts explicitly says that taxes have to be reasonable incentives (else they're penalties); a $10000 dollar tax for not eating broccoli is as ridiculous as (if not more ridiculous than) the 10% tax on the profits of companies that employed underaged children ruled unconstitutional in the controlling precedent, Bailey v Drexel Furniture Company. (Though subsequent commerce clause developments allowed the government to just forbid or strongly restrict child labor instead of "taxing" it). Roberts upheld the ACA "tax" as a governmental incentive analogous to sin taxes on cigarettes, which persuade instead of command.
This is one of the points that many commentators have been missing.
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On June 30 2012 05:11 imareaver3 wrote:Show nested quote +On June 30 2012 04:09 BluePanther wrote:On June 30 2012 03:58 hzflank wrote:On June 30 2012 03:08 BluePanther wrote:On June 30 2012 02:53 hzflank wrote:On June 30 2012 02:32 BluePanther wrote:On June 30 2012 02:25 hzflank wrote:On June 30 2012 02:09 xDaunt wrote:On June 30 2012 02:03 BuddhaMonk wrote:On June 30 2012 01:59 xDaunt wrote:
[quote]
There's clearly a difference between 1) the federal government taxing people and using that tax money to fund government programs, and 2) the federal government using the tax power to force people to buy products from private companies. You may want to consider this point before posting further. Are you suggesting that public money for national security never finds its way into the pockets private companies? Or it's OK in your mind so long as the government is an intermediary? The latter. The feds can spend money for public welfare. That's not in dispute. However, forcing private individuals to engage in behavior (ie buy products from private companies) that they otherwise would not engage in by using the tax power is not right. Sorry, but you are not connecting the dots... There is no real difference between forcing a person to buy a product or taxing that person to generate money to buy the same product. ... and that is why he's saying SCOTUS was not right in their decision. Would you spell it out for me? I am under the impression that the federal government is allowed to instruct states on how to tax their citizens. They are allowed to tax, but the way the law is written, it's basically a fine in substance -- a penalty -- which SCOTUS said quite clearly is not allowable. So the court is allowing the government to do exactly the opposite of what it said the government couldn't do --- penalize someone for not following a mandate. It's circular logic imo. It's basically a fine? Did SCOTUS not just declare it a legal tax? And is SCOTUS not the absolute authority on US law? As I see it, it is as much basically a fine as it is a tax break for insured people. As a layperson, I often feel that semantics have too much sway over common sense (in law). I fully agree that common sense tells us that that you are correct, but legally it seems that you are incorrect. It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do. Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states. Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine). It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right". (for clarification, I specialize in government/constitutional law) Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty). For example: It is unconstitutional to say "You must buy 10 pounds of brocolli a year." It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year." It's a federal power loophole. Read the opinion more carefully. Roberts explicitly says that taxes have to be reasonable incentives (else they're penalties); a $10000 dollar tax for not eating broccoli is as ridiculous as (if not more ridiculous than) the 10% tax on the profits of companies that employed underaged children ruled unconstitutional in the controlling precedent, Bailey v Drexel Furniture Company. (Though subsequent commerce clause developments allowed the government to just forbid or strongly restrict child labor instead of "taxing" it). Roberts upheld the ACA "tax" as a governmental incentive analogous to sin taxes on cigarettes, which persuade instead of command.
I understand that, and I'm sure he put it in there so this isn't 100% precedent and can be distinguished. Doesn't mean I have to agree with his reasoning. I only have to accept it.
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On June 30 2012 04:48 FabledIntegral wrote:Show nested quote +On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money.
That's true except for the top notch part. Yes, our doctors are some of the best in the world, but the quality of care is considered very poor compared to other countries. It's not just that we pay more than most countries, it's also that we get considerably less.
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On June 30 2012 04:48 FabledIntegral wrote:Show nested quote +On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money.
I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models:
"The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company."
http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.)
Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness.
As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity.
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On June 30 2012 04:59 Kaitlin wrote:Show nested quote +On June 30 2012 04:27 farvacola wrote:On June 30 2012 04:24 Kaitlin wrote:On June 30 2012 04:09 BluePanther wrote:
It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do.
Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states.
Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine).
It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right".
(for clarification, I specialize in government/constitutional law)
Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty).
For example:
It is unconstitutional to say "You must buy 10 pounds of brocolli a year."
It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year."
It's a federal power loophole.
You are incorrect in assuming "no jail time". There are several "tax crimes" that are criminal and upon conviction are punishable by "jail time". Have a look at the 7200 series in Title 26. That is where tax evasion and other tax crimes reside. Since this 'penalty' has been deemed a 'tax' by the SCOTUS, tread carefully in these waters. The act itself explicitly dictates that failing to pay the tax cannot result in criminality. and under pre-Obamacare law, simple failure to pay did not result in jail. However, taking measures to "evade or defeat any tax" does. Simple failure to pay is always answering every question correctly in the assessment of the correct amount of tax. However,providing false information so that such amount cannot be properly determined is criminal and is the exact type of behavior that makes for a nice stay in the big house. edit: also, does the law say mere "failing to pay the tax" or does it say "willfully failing to pay" ? Because even willful failure is criminal, of course generally only a misdemeanor (7203). If the law doesn't preclude "willful failure" as not being criminal, then don't be so sure that 7203 doesn't still apply. 7203 is for "willful" failure, not mere failure, which is all this law seems to claim is not criminal, but then it's not criminal anyways. Having thought about a good deal of this, I'm actually looking forward to this playing out because I think a lot of people who even now support this are going to realize this is not what they thought it was and won't have the "wonderful" effects on everyone that they thought.
This interpretation is flawed, the same opinion provided on the anti-injunction act would apply here. It is only a tax in regards to its constitutionality, not in regards to application for other legal statutes, they essentially said congress can use this sort of terminology to subvert the intent of other laws, just not the Constitution.
From SCOTUSBlog paraphrasing the opinion:
" the Constitution imposes limits upon the Congress, and it would undermine those limits if Congress could circumvent them merely by altering the label on a piece of legislation... However, the AIA is Congressional policy, and so the key question in that context is whether Congress intended for that policy to apply in a particular case. If Congress wants the AIA to apply, it knows to use language echoing that statute. Similarly, if Congress does not want the AIA to apply, it will use different language, and courts should respect that judgment."
Since they can circumvent the anti-injunction act in that way it seems clear that the tax penalties would also be circumvented, wouldn't they?
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On June 30 2012 05:35 TheFrankOne wrote:Show nested quote +On June 30 2012 04:59 Kaitlin wrote:On June 30 2012 04:27 farvacola wrote:On June 30 2012 04:24 Kaitlin wrote:On June 30 2012 04:09 BluePanther wrote:
It's a fine, but it's collected as a tax (by the IRS). It's semantics to say it's a tax and not a fine -- either way you're paying the government money because you didn't do what they told you to do.
Nobody questions that the government could tax the people and then provide the healthcare. But this precedent opens up a new method for the federal government to exercise control over individuals that hasn't previously existed in the united states.
Basically, the government can now control anything it wants (financially, not jail time) if it just assesses the penalty/fine for not doing what they want as a "tax" collected by tax collectors instead of being directly paid to the government (like a normal fine).
It's just lawyers being lawyers, and this just creates a loophole and isn't sound judicial or constitutional (limited government) policy. That's why I don't think they were "right".
(for clarification, I specialize in government/constitutional law)
Yes, legally it's correct, but it flies in the face of common sense (that it's a financial penalty).
For example:
It is unconstitutional to say "You must buy 10 pounds of brocolli a year."
It is constitutional to say "You must pay $10,000 in taxes if you do not purchase 10 pounds of brocolli a year."
It's a federal power loophole.
You are incorrect in assuming "no jail time". There are several "tax crimes" that are criminal and upon conviction are punishable by "jail time". Have a look at the 7200 series in Title 26. That is where tax evasion and other tax crimes reside. Since this 'penalty' has been deemed a 'tax' by the SCOTUS, tread carefully in these waters. The act itself explicitly dictates that failing to pay the tax cannot result in criminality. and under pre-Obamacare law, simple failure to pay did not result in jail. However, taking measures to "evade or defeat any tax" does. Simple failure to pay is always answering every question correctly in the assessment of the correct amount of tax. However,providing false information so that such amount cannot be properly determined is criminal and is the exact type of behavior that makes for a nice stay in the big house. edit: also, does the law say mere "failing to pay the tax" or does it say "willfully failing to pay" ? Because even willful failure is criminal, of course generally only a misdemeanor (7203). If the law doesn't preclude "willful failure" as not being criminal, then don't be so sure that 7203 doesn't still apply. 7203 is for "willful" failure, not mere failure, which is all this law seems to claim is not criminal, but then it's not criminal anyways. Having thought about a good deal of this, I'm actually looking forward to this playing out because I think a lot of people who even now support this are going to realize this is not what they thought it was and won't have the "wonderful" effects on everyone that they thought. This interpretation is flawed, the same opinion provided on the anti-injunction act would apply here. It is only a tax in regards to its constitutionality, not in regards to application for other legal statutes, they essentially said congress can use this sort of terminology to subvert the intent of other laws, just not the Constitution. From SCOTUSBlog paraphrasing the opinion: " the Constitution imposes limits upon the Congress, and it would undermine those limits if Congress could circumvent them merely by altering the label on a piece of legislation... However, the AIA is Congressional policy, and so the key question in that context is whether Congress intended for that policy to apply in a particular case. If Congress wants the AIA to apply, it knows to use language echoing that statute. Similarly, if Congress does not want the AIA to apply, it will use different language, and courts should respect that judgment." Since they can circumvent the anti-injunction act in that way it seems clear that the tax penalties would also be circumvented, wouldn't they?
Well, I know little about the AIA. What I do know is that there is a difference between "failure to pay" which is not a crime, even before Obamacare, and "willful failure to pay" which is a crime (7203). I also know that "willful attempt to evade or defeat any tax" is a crime, in fact a felony (7201). I also know that the Supreme Court has ruled that this is a tax. I also know that the IRS has been given additional access to information which it didn't legally have automatic access to before, without a subpoena. Any "willful" actions by anyone, such as filling out paperwork dishonestly impedes the IRS' determination of imposition of this tax and is a crime. The "willful" nature of such actions is what crosses the threshold of illegality, and nothing I've seen in the Obamacare legislation says anything about "willful failure to pay" not being a crime as it has always been. Only that non-willful "failure to pay" wasn't a crime under Obamacare, but then it wasn't a crime without willfulness in the first place.
edit:
Also, since it's reported and collect on your personal income tax return, nothing is stopping the IRS from allocating the first dollars of taxes paid to this healthcare tax, and if there is a shortfall, it's not the healthcare portion, but the "other' tax portion. Something in the law to prevent this ? Of course not.
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http://bit.ly/NZHQsU
"But prior to the government’s entrance into the medical field, health care was regarded as a product to be traded voluntarily on a free market—no different from food, clothing, or any other important good or service. Medical providers competed to provide the best quality services at the lowest possible prices. Virtually all Americans could afford basic health care, while those few who could not were able to rely on abundant private charity."
"You are free to see a doctor and pay him for his services—no one may forcibly prevent you from doing so. But you do not have a “right” to force the doctor to treat you without charge or to force others to pay for your treatment. The rights of some cannot require the coercion and sacrifice of others."
------------
Evidence that bureaucracies don't work.
http://bit.ly/LKxeQ0
There's a good graph in there. I'm sure the same could be shown for "the war on drugs".
When did adding a bunch of people to regulate a field ever make it cheaper? And when has it brought quality standards up? Must acknowledge that America has not had private medicine for some times. There were countless regulations that made it more expensive then it had to be even before this ObamaCare act. This last ruling is just another nail in the coffin.
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A rally in Colorado against the ruling by the average Coloradan.
http://bit.ly/Mek51b
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On June 30 2012 04:48 FabledIntegral wrote:Show nested quote +On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money.
Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare.
EDIT: Also if copays are necessary is debatable.
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On June 30 2012 09:54 Epocalypse wrote:http://bit.ly/NZHQsU"But prior to the government’s entrance into the medical field, health care was regarded as a product to be traded voluntarily on a free market—no different from food, clothing, or any other important good or service. Medical providers competed to provide the best quality services at the lowest possible prices. Virtually all Americans could afford basic health care, while those few who could not were able to rely on abundant private charity." "You are free to see a doctor and pay him for his services—no one may forcibly prevent you from doing so. But you do not have a “right” to force the doctor to treat you without charge or to force others to pay for your treatment. The rights of some cannot require the coercion and sacrifice of others." ------------ Evidence that bureaucracies don't work. http://bit.ly/LKxeQ0There's a good graph in there. I'm sure the same could be shown for "the war on drugs". When did adding a bunch of people to regulate a field ever make it cheaper? And when has it brought quality standards up? Must acknowledge that America has not had private medicine for some times. There were countless regulations that made it more expensive then it had to be even before this ObamaCare act. This last ruling is just another nail in the coffin. ----------- A rally in Colorado against the ruling by the average Coloradan. http://bit.ly/Mek51b
Ari Armstrong, an average Coloradan? An incredibly deceiving and intellectually dishonest graph from the Cato institute? And of course, aynrand.org. This guy ought to be forced to say something original for once, I rather enjoy seeing the logic of "the cult of the individual" on display.
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On June 30 2012 05:26 TheFrankOne wrote:Show nested quote +On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity.
Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated.
When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up.
I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself.
Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma.
On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view.
On June 30 2012 09:59 mcc wrote:Show nested quote +On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable.
Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost...
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On June 30 2012 05:20 DoubleReed wrote:Show nested quote +On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. That's true except for the top notch part. Yes, our doctors are some of the best in the world, but the quality of care is considered very poor compared to other countries. It's not just that we pay more than most countries, it's also that we get considerably less. + Show Spoiler +
Actually care is top notch, just the overall results are not so great because of high cost of that care which prices out certain segments of population and makes preventive care less efficient as people think twice before going to a doctor.
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On June 29 2012 12:57 rogzardo wrote:Show nested quote +On June 29 2012 12:48 STYDawn wrote:On June 29 2012 12:37 rogzardo wrote:On June 29 2012 12:32 JonnyBNoHo wrote:On June 29 2012 12:17 rogzardo wrote:On June 29 2012 12:12 JonnyBNoHo wrote:On June 29 2012 12:05 rogzardo wrote:On June 29 2012 12:03 JonnyBNoHo wrote:On June 29 2012 11:55 ackbar wrote:On June 29 2012 11:49 STYDawn wrote:
[quote]
Obamacare would be a good competitor to healthcare companies.
But the problem is the mandate, which forces you to pay no matter what. So you're paying for a service that you don't want.
No, its making you pay for a service that you need and will inevitably use instead of making others pay for it - or allowing you to die i the streets because you don't have it. How will someone 'inevitably' need health insurance? Because, someday, you will inevitably get sick. If you're 20 its hard to contemplate. When you're 60, and almost certainly long before then, you will need to spend lots of money on a doctor to maintain a reasonable standard of living. If you can't afford it, you're just fucked. That's not correct. Insurance only works if some need it and others don't. Otherwise it is financing and not insurance. What is not correct? The only 2 points I brought are: You will need medical attention someday, and that some people can't afford the care they need. I don't think either of those can be disputed. Yes you will need medical attention someday. But it may turn out that you can afford it without insurance or it may turn out that you cannot afford it without insurance. So some will benefit from having insurance and others will pay more into it than they ever receive back in benefits. In other words some win and some lose. So no, everyone will not need health insurance. This does not mean that mandatory health insurance is a bad idea - just that the need argument doesn't hold water. You need healthcare not health insurance. You could have a single payer system that does not involve insurance, correct? Not everyone's cost/benefit ratio will be the same. I accept the slight tax increase for the richest people in the country in order to provide health care for the poor. I don't understand how you went from your 1st paragraph to 'So no, everyone will not need health insurance'. If you have a super awesome idea to provide health care to those who cannot afford it, without health insurance, I'm all ears. You accept a slight tax increase for the richest people in the country... You know wut? I think you're viewpoint may be coming from a biased background, as you think that everyone who doesn't want to pay for healthcare is rich, which implies you are just a jealous bastard who just feels frustrated about your current financial situation and just think you are entitled to healthcare that the so-called "rich" have to pay for. Look, lets say your 35 years old and you have a friend who is a doctor and will treat for free because you helped him a lot sometime in your life. Why will you pay for something you don't need? Lets say you are 23 years old, strong and delivers pizza while going to college. Why pay money for something you have a very little chance of needing atm when you could be saving that money to pay off your crushing student loans? Risk vs reward man, people aren't as stupid as you think. The plan specifically raises taxes on insurance companies and pharmaceutical companies, i.e. 'the rich'. Large corporations with very high profit margins will pay small amounts. One example are medical device companies, whose sales will now be taxed 2.3%. In exchange for this, millions of Americans will receive health care who weren't previously. I'm not going to argue with you why a 23 year old would need health insurance. Take my word for it that illness and injury kills people of all ages, and it is not expected. Also, these people would not be paying any significant portion of the plan. As I said, it will primarily be paid for by insurance companies, pharmacetical companies, etc.
1. Im not arguing with you about taxes and shit. Im arguing with you about the individual mandate, though I don't believe money should be taken from people who make life-saving devices to the unemployed as that is communism.
2. Thats their decision if they want healthcare or not. If they think they don't, let them take the risk.
"Also these people would not be paying any significant portion" uh huh, only around the money they usually pay for healthcare.
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On June 30 2012 10:02 FabledIntegral wrote:Show nested quote +On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view.
Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok.
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On June 30 2012 10:02 FabledIntegral wrote:Show nested quote +On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Show nested quote +On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost...
Great post right there.
Everything in essence society does should have a good probability on benifiting it.
Helping a poor street performer/musician: if he/she is good then you donate.
If not then you don't.
Sponsoring a poor kid go to college: If he is promising, yes
If you remember him as the kid who graffitied your window, no
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On June 30 2012 10:21 STYDawn wrote:Show nested quote +On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Great post right there. Everything in essence society does should have a good probability on benifiting it. Helping a poor street performer/musician: if he/she is good then you donate. If not then you don't. Sponsoring a poor kid go to college: If he is promising, yes If you remember him as the kid who graffitied your window, no
But what if you forget what he looked like, and all you can remember is that he was black. Yeah....great.
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On June 30 2012 10:02 FabledIntegral wrote:Show nested quote +On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost...
Not US government as a whole, just the healthcare programs run by it. As for what I mean, administrative overhead is bigger.
I might be missing something but how are copays in any way necessary for what you say. If periodical payments (is the word for them premiums ?) are high enough how are copays necessary. The only reason for copays I can see is to discourage overuse of care. But in healthcare the overuse part is debatable as using healthcare services when not necessary is not something most people do too much (getting operation when unnecessary seems strange  ).
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On June 30 2012 10:13 mcc wrote:Show nested quote +On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok.
measuring people's value: you take into account all knowledge you have about that person and you make a decision.
Letting people die: You try not to let them die, but if you don't have money to give away then you don't
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On June 30 2012 10:13 mcc wrote:Show nested quote +On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok.
Yeah, I've heard that about smokers. But what I'm saying is that I don't think they deserve to be able to be insured. They shouldn't be 65, realize "oh fuck I need health insurance" and then be allowed to get it. In the current state, insurance companies can deny coverage, hence the "it's not a right" argument.
Concerning the tax on tobacco, I definitely think that would be the most ideal. I think the sympathy is simply lacking from my part in many cases, but I meant to clarify that it doesn't have to revolve around death. The lack of sympathy is more so towards the person who isn't covered when they break their leg. They should just have to bear the costs of that type of thing.
Addressing the dying issue in particular, I think possibly things classified as "life threatening" could be covered; my biggest issue are things that aren't life threatening, just costly. I think the best scenario, from my perspective, would be to tax everyone an equal percentage tax (rich still pay more since they make more) on their income, OR fund it through a federal sales tax.
With my mentality, I would be completely fine with a person who wasn't covered who still received healthcare due to a lifethreatening cause to have the option of something like post treatment having their wages garnished by 10% for the next ten years, assuming they are above the poverty line. Probably won't pay it off, but I think the person receiving the treatment should have to bear a large portion of the cost.
On June 30 2012 10:25 mcc wrote:Show nested quote +On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Not US government as a whole, just the healthcare programs run by it. As for what I mean, administrative overhead is bigger. I might be missing something but how are copays in any way necessary for what you say. If periodical payments (is the word for them premiums ?) are high enough how are copays necessary. The only reason for copays I can see is to discourage overuse of care. But in healthcare the overuse part is debatable as using healthcare services when not necessary is not something most people do too much (getting operation when unnecessary seems strange ).
There has to always be some sort of deterrence from making a claim (or in this case, using any part of it). Part of the principle of insurance itself is that the insured has to be financially worse off, there should never be any incentive to actually use it. It's to protect against uncertainty, not to benefit from regular use. Overall, the insured is supposed to be indemnified, but indemnification, despite its definition, is actually supposed to be *just less* than the previous financial situation, otherwise everything falls apart due to moral hazard.
If you take an insurance course, it's one of the first things you'll learn in "in order for something to be considered insurance, these particular principles MUST occur." Without it, I don't believe it's actually considered insurance, although that might be semantics.
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EPT![[image loading]](http://thesocietypages.org/graphicsociology/files/2011/04/cost_of_health_care_Nat_geo.png)
