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This topic is not about the American Invasion of Iraq. Stop. - Page 23 |
On July 01 2012 17:58 Dapper_Cad wrote:Show nested quote +On July 01 2012 14:18 Kaitlin wrote:On July 01 2012 05:36 Teradur wrote:
"Here's how I think we should handle the 'smoker' situation. Require a permit to purchase tobacco products. In order to obtain a permit, someone is automatically registered as being no longer covered for cancer-related illnesses at any point in their life. Nobody can claim they didn't know it was harmful. Everybody knows they won't get treatment for cancer. The amount of smokers drops like a rock. Society doesn't have to fund smoker's bad habit. Everybody's happy."
However, "charging higher rates" follows the same idea. Where do you draw the line? Would you charge higher rates to people who are obeased? Do they have to report their weight redularly to their insurance company? Would you charge higher rates to people who don't exercise regularly? Do you charge higher rates to people who get drunk regularly? Do you have to take a daily alcohol-test and send it to your insurance company? Furthermore, similar to drinking, smoking does not equal smoking. Will people who smoke 3 cigarettes a day have to pay less than those who smoke 2 packs a day? What about people who don't inhale?
Sounds totally reasonable and easily administrable.
It doesn't matter how much smokers pay. They should register in order to buy cigarettes, so they are identified as not being covered under the insurance that everybody else pays for. If they want to be covered against cancer, I have no problem with it, but they enter into a risk pool with only smokers. With that setup, nobody will care how many cigarettes they smoke, if the insurance company wants to charge based on how much they smoke, it's up to them. As long as non-smokers aren't bearing the burden. Obesity, other things aren't the same because smoking is the one thing we've known for a long time now that causes cancer. There are plenty of fat old people. People can gain or lose weight throughout their lives. Not to mention, how can you track that ? Not nearly as easily as licensing smokers. And while we're at it, anyone convicted / tested to have certain illicit drugs in their system automatically lose out on health insurance as well. Setup a separate pool for them, if they want to pay more. I don't see why society should foot the bill to keep them alive if they are intentionally taking drugs that hurt them. This may end up with drug users paying lower premiums. See my previous post. How do you think that will play out?
I read your previous post. I don't find it relevant whether smokers actually are less of a strain in the long-term. Doesn't matter. It's not about fairness to "the right to smoke". It's about non-smokers not paying for the medical treatment of smoking related cancer for smokers. If they die sooner, that was their choice, yay for society for saving money, as you argue. The fact remains, the medical costs incurred during their lifetime brought on by their smoking should be covered by smokers and smokers alone.
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On July 02 2012 00:41 xDaunt wrote:
Here is an interesting tidbit -- because Obamacare is now considered tax legislation, its repeal cannot be filibustered. This means that republicans only need 51 votes in the senate to get rid of it through budget reconciliation.
While some members of the GOP are hoping that the recent galvanization brought about by the upholding of Obamacare is a sign of things to come, others are not so sure that the bill can be so easily defeated. Here is an article in which Republican Representative Tom Rooney discusses just how difficult a repeal of Obamacare is going to be.
"Rooney, a constitutional lawyer who's taught at West Point, added that even if Republicans make gains, it would be highly unusual for Congress to reverse a Supreme Court affirmation of major legislation. "For me to comprehend the Supreme Court making a decision and it being overturned by Congress -- that's an extraordinarily high mountain to climb," he said."
http://www.foxnews.com/politics/2012/07/01/gop-rep-rooney-says-health-care-repeal-wont-be-easy
Straight from the mouth of the beast! 
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I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury.
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On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury.
They do make decisions based on the law, in fact thats all they do...
You probably don't even read their opinions and yet you call the system broken, typical of the average voter.
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On July 02 2012 01:32 farvacola wrote:Show nested quote +On July 02 2012 00:41 xDaunt wrote:
Here is an interesting tidbit -- because Obamacare is now considered tax legislation, its repeal cannot be filibustered. This means that republicans only need 51 votes in the senate to get rid of it through budget reconciliation. While some members of the GOP are hoping that the recent galvanization brought about by the upholding of Obamacare is a sign of things to come, others are not so sure that the bill can be so easily defeated. Here is an article in which Republican Representative Tom Rooney discusses just how difficult a repeal of Obamacare is going to be. "Rooney, a constitutional lawyer who's taught at West Point, added that even if Republicans make gains, it would be highly unusual for Congress to reverse a Supreme Court affirmation of major legislation. "For me to comprehend the Supreme Court making a decision and it being overturned by Congress -- that's an extraordinarily high mountain to climb," he said." http://www.foxnews.com/politics/2012/07/01/gop-rep-rooney-says-health-care-repeal-wont-be-easyStraight from the mouth of the beast!
There is a difference between whether a law is good policy and whether it is constitutional. If the public still considers it to be bad policy, it will be easy to repeal if republicans take the presidency and senate this year.
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On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury.
Whether or not Roberts acted on political or judicial inclinations is still up for debate, as it could be argued that a ruling against Obamacare on his part would be a more politically charged move in that he would have then technically failed to exhaust all possibilities of constitutionality via proper judicial review.
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On July 02 2012 01:58 Smat wrote:Show nested quote +On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury. They do make decisions based on the law, in fact thats all they do... You probably don't even read their opinions and yet you call the system broken, typical of the average voter.
Well, he's right; our system is very broken, and American politics is an embarrassment to the concept of a "developed" nation.
That said, he's wrong about SCOTUS; SCOTUS does, in fact, make decisions according to (how each justice interprets) the law/Constitution. Everyone else makes it political.
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On July 02 2012 02:01 xDaunt wrote:Show nested quote +On July 02 2012 01:32 farvacola wrote:On July 02 2012 00:41 xDaunt wrote:
Here is an interesting tidbit -- because Obamacare is now considered tax legislation, its repeal cannot be filibustered. This means that republicans only need 51 votes in the senate to get rid of it through budget reconciliation. While some members of the GOP are hoping that the recent galvanization brought about by the upholding of Obamacare is a sign of things to come, others are not so sure that the bill can be so easily defeated. Here is an article in which Republican Representative Tom Rooney discusses just how difficult a repeal of Obamacare is going to be. "Rooney, a constitutional lawyer who's taught at West Point, added that even if Republicans make gains, it would be highly unusual for Congress to reverse a Supreme Court affirmation of major legislation. "For me to comprehend the Supreme Court making a decision and it being overturned by Congress -- that's an extraordinarily high mountain to climb," he said." http://www.foxnews.com/politics/2012/07/01/gop-rep-rooney-says-health-care-repeal-wont-be-easyStraight from the mouth of the beast! There is a difference between whether a law is good policy and whether it is constitutional. If the public still considers it to be bad policy, it will be easy to repeal if republicans take the presidency and senate this year.
Indeed, my point was that public consensus made clear through the next election cycle is probably "the" most important factor in the future of Obamacare, rather than what sort of filibuster rules apply.
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I think there is a fundamental misunderstanding about how medical care is given in this country. I am a 4th year medical student at an American medical school and it becomes pretty apparent why medicine is so expensive when you interact with the system on a daily basis. I will take one small example so that you can understand why it is so expensive. First I'd like to talk about the subset population that receives the most medical care (the elderly (over 65)). Now the most expensive place to stay in the hospital is the ICU (intensive care). I would say on average more than 50% of ICU patients are elderly suffering from many chronic conditions. Now lets have a concrete example. Say you have a 70 year old female who has a past medical history of Coronary Artery Disease (CAD) from atherosclerosis, Chronic Obstructive Pulmonary Disease (COPD) from years of smoking, and End Stage Renal Failure (ESRF) again from atherosclerosis (now you may think this to be an extreme example but let me tell you most elderly patients that come to the ER have 7-10 chronic medical problems). Now this patient comes to the ER from a nursing home because of high fever, shortness of breath, etc. Now this woman has a pneumonia probably caused by Strep which can be a serious infection in a healthy person but combine that with all of her chronic medical problems and this is very potentially life threatening. Well of course the first thing they are going to do in the ER is stabilize the patient (this includes getting IV fluids, CBC, BMP, C-Xray etc.) all of this before the patient is somewhat stabilized. If the patient becomes worse and has more trouble breathing you will have to Intubate her and then order another C-xray to make sure the tube is in properly. Now this initial stabilization as well as basic tests is probably going to cost around $2,000 (now i don't know exact costs but these are pretty good estimates from talking with physicians) Next after she is stabilized you order a CT ($2000) to rule out any other potential problems that may occur and consult Internal Medicine. internal Medicine team comes and interviews the patient again and admits the patient to the ICU because with her many medical problems basic pneumonia can not be treated on the regular hospital floor. ICU has one nurse per 2 rooms and is a much more constant care facility than most hospital stays which means it costs a lot more money (approx $5,000 per day and that estimate is really on the low side some ICUs charge as much as $10,000 per day). Most pneumonia patients are in the hospital 1 week with the majority of that spent in ICU. Assuming she has no extra procedures done you are looking at ($45,000) for a hospital stay to treat Pneumonia. Couple that with 50 ICU Beds and you can see why the cost of medicine gets out of control pretty quickly.
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Pneumonia is a major cause of death amongst all age groups throughout the world, and accounts for 4 million deaths annually. Now I realize you've described a fair bit of inefficiency within the clinical setting, but I'm not sure trivializing the disease is the way to go. In fact, influenza/pneumonia is the 8th leading cause of death here in the US. That being said, my entire family is in medicine, and that hospital systems need retooling is certainly an accepted fact.
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On July 02 2012 01:25 Kaitlin wrote:Show nested quote +On July 01 2012 17:58 Dapper_Cad wrote:On July 01 2012 14:18 Kaitlin wrote:On July 01 2012 05:36 Teradur wrote:
"Here's how I think we should handle the 'smoker' situation. Require a permit to purchase tobacco products. In order to obtain a permit, someone is automatically registered as being no longer covered for cancer-related illnesses at any point in their life. Nobody can claim they didn't know it was harmful. Everybody knows they won't get treatment for cancer. The amount of smokers drops like a rock. Society doesn't have to fund smoker's bad habit. Everybody's happy."
However, "charging higher rates" follows the same idea. Where do you draw the line? Would you charge higher rates to people who are obeased? Do they have to report their weight redularly to their insurance company? Would you charge higher rates to people who don't exercise regularly? Do you charge higher rates to people who get drunk regularly? Do you have to take a daily alcohol-test and send it to your insurance company? Furthermore, similar to drinking, smoking does not equal smoking. Will people who smoke 3 cigarettes a day have to pay less than those who smoke 2 packs a day? What about people who don't inhale?
Sounds totally reasonable and easily administrable.
It doesn't matter how much smokers pay. They should register in order to buy cigarettes, so they are identified as not being covered under the insurance that everybody else pays for. If they want to be covered against cancer, I have no problem with it, but they enter into a risk pool with only smokers. With that setup, nobody will care how many cigarettes they smoke, if the insurance company wants to charge based on how much they smoke, it's up to them. As long as non-smokers aren't bearing the burden. Obesity, other things aren't the same because smoking is the one thing we've known for a long time now that causes cancer. There are plenty of fat old people. People can gain or lose weight throughout their lives. Not to mention, how can you track that ? Not nearly as easily as licensing smokers. And while we're at it, anyone convicted / tested to have certain illicit drugs in their system automatically lose out on health insurance as well. Setup a separate pool for them, if they want to pay more. I don't see why society should foot the bill to keep them alive if they are intentionally taking drugs that hurt them. This may end up with drug users paying lower premiums. See my previous post. How do you think that will play out? I read your previous post. I don't find it relevant whether smokers actually are less of a strain in the long-term. Doesn't matter. It's not about fairness to "the right to smoke". It's about non-smokers not paying for the medical treatment of smoking related cancer for smokers. If they die sooner, that was their choice, yay for society for saving money, as you argue. The fact remains, the medical costs incurred during their lifetime brought on by their smoking should be covered by smokers and smokers alone.
Well that's pretty silly. You've taken the parts of a smokers life which might benefit society -smokers dying before they reach infirmity- and labelled it "their choice" and made the leap that somehow that makes it completely ignorable for insurance purposes. I don't think you understand what health insurance, or even just insurance, is.
You're absolutely right, it's not about "the right to smoke", something I don't think I've even implied. Equally it's not about punishing people for behaviours which you deem wrong. It's about how much someone's health care costs are going to be over a life time.
Cool, this actually tallies up with the BBC article on the WHO report:
"This annual cost is still likely to be an underestimate, they say, because it does not include indirect costs, such as lost productivity and informal care, the costs of treating disease caused by passive smoking, or the full range of conditions associated with smoking."
I still think that the cost of non-smokers increased likelihood of reaching infirmity and the associated costs is a piece of the puzzle that's missing from both, but it's nice to see a little bit more of the picture.
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I felt the ruling went as it should. was expected more or less, but the tax/not-a-tax thing gives Republicans a way to attack it still. Personally though, I think they should quit attacking Obamacare, that line is getting pretty old IMO. If anything, it might end up hurting them if they keep pushing the issue.
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On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury.
You know, just because a case is highly political doesn't mean the Supreme Court isn't allowed to make a decision on it, nor does it mean that highly political legislation is not subject to the constitution. The healthcare legislation is either constitutional or not, either side is "highly political" as you say, and the Supreme Court has given their answer based on what the other two branches has given it.
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On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury.
Blame the President's that nominate them. Personally, I'd prefer if they were selected by a panel of other judges, but meh.
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On July 02 2012 03:51 DocTheMedic wrote:Show nested quote +On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury. You know, just because a case is highly political doesn't mean the Supreme Court isn't allowed to make a decision on it, nor does it mean that highly political legislation is not subject to the constitution. The healthcare legislation is either constitutional or not, either side is "highly political" as you say, and the Supreme Court has given their answer based on what the other two branches has given it.
I think you kinda misunderstood my point. I didn't say the Supreme Court shouldn't be allowed to make a decision on it, but I said it's not okay that the judges decide according to their political orientation. The decision has to be made purely objective using the law. It should just be a decision between 5 judges and not a fight between "liberal judges" and "republican judges". That's just bad.
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So as im understanding it not having healthcare has become a sintax. It's in the same realm as smoking and drinking now.
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On July 02 2012 04:15 StoRm_res wrote:Show nested quote +On July 02 2012 03:51 DocTheMedic wrote:On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury. You know, just because a case is highly political doesn't mean the Supreme Court isn't allowed to make a decision on it, nor does it mean that highly political legislation is not subject to the constitution. The healthcare legislation is either constitutional or not, either side is "highly political" as you say, and the Supreme Court has given their answer based on what the other two branches has given it. I think you kinda misunderstood my point. I didn't say the Supreme Court shouldn't be allowed to make a decision on it, but I said it's not okay that the judges decide according to their political orientation. The decision has to be made purely objective using the law. It should just be a decision between 5 judges and not a fight between "liberal judges" and "republican judges". That's just bad.
it's reaaally reaeeeeeeaallly rare for someone to be in the middle. like no matter how hard you try your political conscience will often the deciding factor. the judges don't say "well i'm a conservative so i'm gonna say no", the conservative judge's process of thought is conservative in nature and that is why they decide whatever they decide. these are smart people and they do try and make it as non-political as possible.
this is actually a bad case to pull out that argument seeing as how roberts is a conservative and he was the deciding vote
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On July 02 2012 03:38 Dapper_Cad wrote:
Well that's pretty silly. You've taken the parts of a smokers life which might benefit society -smokers dying before they reach infirmity- and labelled it "their choice" and made the leap that somehow that makes it completely ignorable for insurance purposes. I don't think you understand what health insurance, or even just insurance, is.
You're absolutely right, it's not about "the right to smoke", something I don't think I've even implied. Equally it's not about punishing people for behaviours which you deem wrong. It's about how much someone's health care costs are going to be over a life time.
But that's exactly what "excise taxes" are. Punishing behavior, through taxes, that the government considers bad. Why you find it necessary to calculate the "benefit" of smokers dying early is beyond me. You seem to think the world is fair and perfect. In reality, it's not about "how much someone's health care costs over a life time", it's "smoking causes cancer" so non-smokers shouldn't have to pay for costs associated with cancer treatment for smokers.
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On July 02 2012 04:18 Jisall wrote:
So as im understanding it not having healthcare has become a sintax. It's in the same realm as smoking and drinking now.
Roberts draws an analogy to sin taxes. More correctly, not having health care is something the government is allowed to influence through tax incentives. Drinking and smoking fall into this category, but so do having kids, giving to charity, etc. (Yes, those are tax deductions as opposed to additional taxes, but...) Tax incentives are a longstanding and unchallenged power of the government; this decision simply reaffirms that power.
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On July 02 2012 04:15 StoRm_res wrote:Show nested quote +On July 02 2012 03:51 DocTheMedic wrote:On July 02 2012 01:52 StoRm_res wrote:
I'm just surprised every time how political the decisions of the supreme court are. I mean a court should make objective decisions based on the law and not decisions according to their political orientation.
The whole system just seems very broken, the separation of powers does not work at all. As for obamacare, I'm swiss, not american, but the "Broccoli" debate seems just ridiculous. And there are enough examples of working modern states with healthcare similar to obamacare, which work out just fine. Healthcare just can not be a luxury. You know, just because a case is highly political doesn't mean the Supreme Court isn't allowed to make a decision on it, nor does it mean that highly political legislation is not subject to the constitution. The healthcare legislation is either constitutional or not, either side is "highly political" as you say, and the Supreme Court has given their answer based on what the other two branches has given it. I think you kinda misunderstood my point. I didn't say the Supreme Court shouldn't be allowed to make a decision on it, but I said it's not okay that the judges decide according to their political orientation. The decision has to be made purely objective using the law. It should just be a decision between 5 judges and not a fight between "liberal judges" and "republican judges". That's just bad.
As others have said, political orientation affects how judges interpret the constitution, whether strictly or loosely (blame that on the constitution for being purposefully vague). Yet they still base their decisions on the law; that's what they publish along with the dissenting opinion. That's like saying a jury can't come to a law grounded conclusion on a trial about rape because they recognize rape as a serious crime; they can still reach a legal conclusion. Also, there are 9 judges, not 5. Usually the decisions are unanimous, but you will have ambiguous laws, for which it comes down to majority rule. Luckily they don't filibuster all day waiting for a unanimous agreement. In fact, you can think of it as the decision of the 9 judges, and take the dissenting opinion just exactly as what it's called: a secondary opinion. Plus, judges are only labeled as "liberal" or "conservative" based on the media so that the court seems exciting and is accessible to the public. In the case of ACA, some justices have defied media expectations and cross the ideological line generally associated to them. It's definitely not clear cut politicized and broken as you mentioned earlier.
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EPT
