24 replies to this topic

[redlion]

Youtube link

This is Bill Clinton explaining to a 4 year old why we need healthcare change.

I think he sums it up ridiculously succinctly. We're the richest in the world and yet have one of the largest gaps in healthcare coverage? What happened to equality of opportunity?

Discuss healthcare as it occurs in your country, and what you think of as the ideal healthcare system.

[anewvision]

Kinda makes you wonder if those "sexual relations" he didn't have were really that bad...

[Musician]

I like the system in Canada. Sure, the waits can be long, but at least it's not privatized. 

[Dan]

[jinq]

I like public health care in Canada although I feel most tax the middle class rather than the millionaires and billionaires. It would be nice if they didn't cap the health care taxes.

[redlion]

Kinda makes you wonder if those "sexual relations" he didn't have were really that bad...

No it doesn't.

[NapisaurusRex]

To me, the ideal healthcare system is an affordable one where no one is forced to have healthcare and the bills regarding the healthcare aren't interspersed with random laws about gold and guns.

[Boggart]

To me, the ideal healthcare system is an affordable one where no one is forced to have healthcare and the bills regarding the healthcare aren't interspersed with random laws about gold and guns.

I don't really like the American system.

 

As someone trying to go through med school and looking to what country in which to practice, I realize I can probably make about 5 times more money in the States than in Canada, but I Could not in good will say "oh, you don't have insurance or the money to pay for treatment? sorry, cant' help you".

 

I'm going into medicine because I want to help people first. and the money is nice but not that ultimate goal for me to become a doctor. I could never practice in the States and arbitrary health care to me just makes no sense.

[NapisaurusRex]

I don't really like the American system.
 
As someone trying to go through med school and looking to what country in which to practice, I realize I can probably make about 5 times more money in the States than in Canada, but I Could not in good will say "oh, you don't have insurance or the money to pay for treatment? sorry, cant' help you".

Well, we'll apparently all have insurance whether we like it or not eventually, so I wouldn't make that a reason not to practice here. The penalties for not having insurance are supposed to steadily increase, so eventually the people who don't want it will get it to avoid massive fines or be arrested for not paying. And you know what you get in jail, right? FREE HEALTHCARE! It's a win-win, really.

[redlion]

an affordable one where no one is forced to have healthcare

You see that there is the problem in your reasoning.

For people to get a good deal on healthcare, it's necessary to buy in bulk. The government (representing We, the People) needs to buy a certain amount of medical services to get the discounts that make healthcare affordable. This is how every country on earth besides the US does things.

If some people aren't "forced" (we'll come back to the forced bit) to get health insurance, then the prices aren't affected because we're still buying individually, piecemeal.

But back to that forced bit... I have two points concerning the ACA specifically. First, the ACA "forces" you to get health insurance by fining you on your tax returns if you can't provide proof of insurance. HOWEVER: The ACA legislation specifically states that, although this fine is assessed by the IRS, the IRS has absolutely no power of enforcement.

In plain English, that means that they can tell you that you have a fine (perhaps repeatedly), but they cannot then put a lien on your paychecks, refer you to debt collections, or any other mechanism for actually collecting the fine. It's an absolutely toothless penalty, one that doesn't really "force" you to do anything.

So yeah. Let me put an end to the "you'll end up in jail for not having insurance" argument.

[NapisaurusRex]

You see that there is the problem in your reasoning.

For people to get a good deal on healthcare, it's necessary to buy in bulk. The government (representing We, the People) needs to buy a certain amount of medical services to get the discounts that make healthcare affordable. This is how every country on earth besides the US does things.

If some people aren't "forced" (we'll come back to the forced bit) to get health insurance, then the prices aren't affected because we're still buying individually, piecemeal.

But back to that forced bit... I have two points concerning the ACA specifically. First, the ACA "forces" you to get health insurance by fining you on your tax returns if you can't provide proof of insurance. HOWEVER: The ACA legislation specifically states that, although this fine is assessed by the IRS, the IRS has absolutely no power of enforcement.

In plain English, that means that they can tell you that you have a fine (perhaps repeatedly), but they cannot then put a lien on your paychecks, refer you to debt collections, or any other mechanism for actually collecting the fine. It's an absolutely toothless penalty, one that doesn't really "force" you to do anything.

So yeah. Let me put an end to the "you'll end up in jail for not having insurance" argument.

Yes, I understand bulk deals. It's similar to forcing children to eat school lunches instead of bringing their own. You asked what my ideal healthcare was. In happy bubbly Napiville, that's how it would go. ACTUALLY, in Napiville, almost no one would get sick cause everyone would eat a healthy individualized diet to prevent that. 

 

Except that just because the IRS has no power of enforcement doesn't mean that anyone else doesn't...? I also just found an article that states the IRS can deduct that amount from your tax return.

Edited by Napiform, 02 November 2013 - 11:31 AM.

[redlion]

Good job, you googled IRS, ACA and enforcement and posted the first link. I know because I too, can work the googles to my advantage. But that link is to USA Today, which is the Daily Mail of the US, so forgive me if I don't take their word for it. USA Today exists to start fires - it's no good to anyone other than as tinder.

Where I heard this fact. (Skip to minute 7 if you just want the actual citation of law, but the rest is insightful - not even white house correspondents care to know what's really in law.)

Where other people fact check this fact.
In part:

Spoiler

It's through your tax refund.

The IRS will send a notice to taxpayers who are required to pay the penalty but don’t. If the penalty is not paid, the IRS can take it out of a tax refund.

Most people received a tax refund between $2,000 and $3,000 this year because their employer withheld too much from their paychecks, Williams said.

That can only happen if a taxpayer is getting a refund. If they’re not getting a refund, there’s not much the IRS can do to make people pay the penalty beyond sending a letter.

Taxpayers who don’t want to pay the penalty could tinker with the amount withheld from their paychecks so they don’t overpay the IRS, denying the agency the ability to hold back or minimize a refund. But experts said most taxpayers won’t go to the trouble.

"It’s a mandate that operates through inconvenience," said Jordan Barry, a University of San Diego School of Law professor who co-wrote an essay with Camp examining whether the mandate is really mandatory. "It’s basically right that you could avoid this if you wanted to."

And here's the text of the bill, which, on page 131, details the methods by which the IRS can pursue enforcement.

If you're savvy, there's no reason that the individual mandate will ever negatively affect you if you don't want it to.

~~~

All of that was to prove a point: don't fucking listen to the guy on the radio telling you that you'll go to jail for not having insurance. You don't even have to pay a fine. All it takes is to get off the couch, turn off the boob tube, and get involved in the processes of your life.

[NapisaurusRex]

Actually, I did this

Spoiler

Close though.

 

What about the moral obligation to follow the law though? Some people will take that in itself as "being forced to have health insurance".

[redlion]

What about the moral obligation to follow the law though? Some people will take that in itself as "being forced to have health insurance".

I'm not sure there is a moral obligation to follow the law. There's a practical obligation, sure. But are all laws moral?

People everywhere should have healthcare. Whether it's through 1) a traditional HMO, 2) a public option, 3) or a compulsory socialized system like other industrialized nations. The right not to is the right to die. Terry Schiavo's gang-banger-blastin-fools-nigga right to die.

I'm for health care through the second or third options. But at least the first option still covers more people. Honestly the problem with Obamacare isn't that outcome. It's who benefits. The healthcare industry is making millions because they can quote outrageous prices on the exchange. Until there are publicly owned non-profits competing with them, they won't offer anywhere near competitive pricing. That's why they lobbied so hard to nix the second option, i.e. the public option. Because it would, through just and rightful competition, drive down the price of insurance. They lobbied against the capitalist market.

How's that for a fucked up twist.

[NapisaurusRex]

But are all laws moral?

No.

I guess I don't understand why you think everyone should have insurance. Like I don't think I should have insurance, but you think I should. And your belief I should have insurance to make it cheaper for other people you think should have insurance (whether *they* think they should or not) isn't something I agree with.

[redlion]

No.

I guess I don't understand why you think everyone should have insurance. Like I don't think I should have insurance, but you think I should. And your belief I should have insurance to make it cheaper for other people you think should have insurance (whether *they* think they should or not) isn't something I agree with.

No, no, I don't think that you should necessarily have to have health insurance. But I think you should have to have healthcare because I view it as a fundamental right. The difference between the two is that insurance is almost entirely a for-profit venture, whereas healthcare doesn't need to be.

Remember those famous words, life, liberty, and the pursuit of happiness? That first part is the right to live free of squalor, disease and barbarism, to live beyond survival. Your rights and civil liberties are the second part, and the third puts the onus on government to prove that laws are for legitimate interests when they restrict the former two parts. Undue burden, compelling interest, strict scrutiny - the law is full of phrases that essentially boil down to is this unnecessarily restrictive on the individual's non-enumerated rights?

Again, I don't believe that you should have insurance so that others can have cheaper insurance - I think that everyone should have insurance because that's one step closer to us as a nation giving a shit about the cost of health care. HMO systems are more expensive than single payer systems because the markets can't help but to speculate, and consequently they treat care like a luxury good when it should be a basic commodity.

Edit: 11,000 posts! Party time

[NapisaurusRex]

No, no, I don't think that you should necessarily have to have health insurance. But I think you should have to have healthcare because I view it as a fundamental right.

I guess I don't know the difference. Can you explain it to me please?

[redlion]

I guess I don't know the difference. Can you explain it to me please?

Okay, sarcasm aside, have you read anything about the quality of health care in the socialized democracies of western Europe? It's significantly better for significantly more people, even the rich. Because the rich have a choice between state and whoever they want as well. Free or not.

I don't see what's wrong with having a free option based on taxes. We already pay into medicare and medicaid for old people and poor people, and into social security for old poor people. What's wrong with having medical coverage for young people? Is there some age limit to medical problems that people can't justify until later in life? Seems almost discriminatory to me!

I'm not getting why anyone would not want healthcare, but I can totally understand why someone wouldn't want to buy insurance when so many other countries get healthcare without insurance with no money out of pocket.

[Mishelle]

Okay, sarcasm aside, have you read anything about the quality of health care in the socialized democracies of western Europe? It's significantly better for significantly more people, even the rich. Because the rich have a choice between state and whoever they want as well. Free or not.

I don't see what's wrong with having a free option based on taxes. We already pay into medicare and medicaid for old people and poor people, and into social security for old poor people. What's wrong with having medical coverage for young people? Is there some age limit to medical problems that people can't justify until later in life? Seems almost discriminatory to me!

I'm not getting why anyone would not want healthcare, but I can totally understand why someone wouldn't want to buy insurance when so many other countries get healthcare without insurance with no money out of pocket.

 

Politicians have done a really good job at getting a lot of dumb people to believe that all Socialism is bad and that Socialism and Communism are the same thing. I would prefer a single payer system over obamacare because as far as obamacare goes it only seems to be doing well in states that want it. The states that didn't accept the medicaid expansion and don't want obamacare are full of people struggling to get healthcare.

[NapisaurusRex]

Okay, sarcasm aside, have you read anything about the quality of health care in the socialized democracies of western Europe? It's significantly better for significantly more people, even the rich. Because the rich have a choice between state and whoever they want as well. Free or not.

I don't see what's wrong with having a free option based on taxes. We already pay into medicare and medicaid for old people and poor people, and into social security for old poor people. What's wrong with having medical coverage for young people? Is there some age limit to medical problems that people can't justify until later in life? Seems almost discriminatory to me!

I'm not getting why anyone would not want healthcare, but I can totally understand why someone wouldn't want to buy insurance when so many other countries get healthcare without insurance with no money out of pocket.

Yes, I have. As you pointed out earlier, I pretty much google what I want to get the answers I want though. ;p

 

For the middle paragraph, the issue is that we can't afford it. We can barely afford medicaid and we can't afford medicare and social security for old people... there simply weren't enough kids being born and there continues to be fewer born, in addition to the economy. 

[Waser Lave]

For the middle paragraph, the issue is that we can't afford it. We can barely afford medicaid and we can't afford medicare and social security for old people... there simply weren't enough kids being born and there continues to be fewer born, in addition to the economy.

America can't really afford to continue with the status quo either though. They already spend much more than any other country on healthcare (per capita) and even when you only take into account public expenditure (despite private expenditure accounting for more than half of total expenditure) it's still more than a lot of countries with nationalised healthcare systems. The key question is where does that money go and why are Americans getting such poor value for money given that average life expectancy is one of the lowest amongst developed nations?

[Mishelle]

America can't really afford to continue with the status quo either though. They already spend much more than any other country on healthcare (per capita) and even when you only take into account public expenditure (despite private expenditure accounting for more than half of total expenditure) it's still more than a lot of countries with nationalised healthcare systems. The key question is where does that money go and why are Americans getting such poor value for money given that average life expectancy is one of the lowest amongst developed nations?

 

Because these companies know that healthcare is inelastic so they continue to raise prices because people are going to pay it regardless. I went to the emergency room for a blood test and a couple tests and without insurance it would've easily ran me hundreds of dollars. It doesn't make any damn sense, I didn't see a single doctor. Everything was done by nurses and technicians.

[redlion]

For the middle paragraph, the issue is that we can't afford it. We can barely afford medicaid and we can't afford medicare and social security for old people... there simply weren't enough kids being born and there continues to be fewer born, in addition to the economy.

You're not hearing me, and your reasoning isn't sound.

Part of the reason we can't afford it, as you say, is because of the demographic issues you raise. That has to do with the nature of the programs: only covering the old makes the programs effectively into ponzi schemes. Waser very nicely raises the more salient second reason - we can't afford it because we insist on buying Rolexes when Timex will tell you the time for a fraction of the cost. We insist that we have the best system in the world, but outcomes, cost, and coverage disagree.

We can afford it, we already pay more than anyone else. We just have to insist on a system that works instead of a merely adequate system for the rich and no system at all for the poor and middle classes.

[NapisaurusRex]

You're not hearing me, and your reasoning isn't sound.

I'm *trying* to understand, I'm just failing.

Waser did help a lot though. Thanks!

I'm not getting why anyone would not want healthcare, but I can totally understand why someone wouldn't want to buy insurance when so many other countries get healthcare without insurance with no money out of pocket.

(read back through in an attempt to understand)

I still wouldn't want healthcare depending on what I would have to do to get it. I refuse to go through unnecessary procedures to get things done. I don't think it matters whether there is a gun in the house or not when we take a kid in with an ear infection. It is one of my primary reasons for avoiding insurance also... There is absolutely no reason to have my weight checked when I go into the doctor to have a sore throat looked at, so I refuse. Depending on the type of insurance I had, that would be unacceptable and the doctor wouldn't be able to see me. Since I pay out of pocket, it's *usually* ok. (There has been an instance where a doctor told me they could only do x if y and I told them no and they said it was an office policy and we stared at each other for a bit and then I left.)

Edited by Napiform, 03 November 2013 - 06:16 PM.