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Thread: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386, 590]

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Kandahar View Post
    Except you'll change your tune if you get hit by a bus and don't have health insurance. THEN you'll suddenly decide that you want someone else to pay for your health care after all. And that's exactly the free-rider problem. One of the original plaintiffs on the ACA case was an outspoken activist who didn't want to have health insurance. When she got sick and stuck the public with the bill, her name was dropped from the lawsuit.
    Just because you would behave that way doesnt mean I would.

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by Kandahar View Post
    Right. So in other words, the Supreme Court ruled that it's covered under Congress' power to levy a tax.


    So did Obama lie, make a false statement or a mis-statement?
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by Kandahar View Post
    No, they are functionally identical. If you reward someone who does something via the tax code, then you ARE penalizing those that do not. The foregone tax revenue that the government loses by having a tax credit could have been spent on public services, to pay down the debt, or used as an offset to cut taxes in general. Therefore all tax credits are penalizing those who do not receive them.

    And do you mean to tell me that you wouldn't be having a tantrum about the individual mandate if it was written as a tax credit for those who DO have insurance (and this was paid for by a general tax increase)? Somehow I doubt it.



    Except it's not. At all. The functional result is exactly the same either way...the taxpayers, the government, the participants, and the non-participants all end with exactly the same amount of money in either scenario.



    The Supreme Court disagrees with you.
    That "same either way" NONSENSE assumes EQUALITY in the penalty and benefit, which is NOT true under PPACA. The "tax reward" for an employer spending $4K on medical care insurance (per employee) is the lack of taxation on that $4, say $1K (at a 25% tax rate), but the fine for NOT doing so is up to $2K. The same is true for an individual taxpayer, if they now get employer provided medical care it costs them ZERO in tax penalty (or any personal after tax costs), yet one working for a an employer that does not provide that benefit is is now given a choice of paying a fine (new tax) or spending much MORE of their after tax money on insurance and STILL paying for much (if not all) of their own medical care. Having insurance saves me NOTHING, since I now pay CASH for my medical care and spend less than $2K annually at that. If I get sick or injured, beyond what I can pay for, then I will likely die; for that "privilege" I am now to be taxed?
    Last edited by ttwtt78640; 07-01-12 at 01:43 PM.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by clownboy View Post
    No, a better place to start is how the WHO determines health care quality. If you really want a clearer picture, contrast us with a nation that is as large or larger than us.
    That's quite the standard considering there are only two of them, and both are developing nations.

    It's relatively easy to maintain quality among a small group in a highly subsidized environment.
    What exactly are the scalability problems that you envision with health care?

    And if the care is better in Colombia, why are my American friends in Doctors Without Borders always doing missions down there?
    Probably because parts of the country were a war zone until recently.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by clownboy View Post
    Yes, as the Obama admin argued it was before the court. Thank you for acknowledging the facts. That clearly makes the president a liar, he's still telling people it's not a tax.
    I already told you I'm not going to play semantic games. I really don't care if you want to call it a tax, a penalty, a giraffe, or anything else you like. I'm interested in POLICY.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Fletch View Post
    Just because you would behave that way doesnt mean I would.
    I really don't care what you think you would do. Most people would suddenly decide that it is the public's responsibility to care for them after all, and the overall numbers are what our health care system needs to be concerned with. Not what you think you would personally do.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Kandahar View Post
    Except you'll change your tune if you get hit by a bus and don't have health insurance. THEN you'll suddenly decide that you want someone else to pay for your health care after all. And that's exactly the free-rider problem. One of the original plaintiffs on the ACA case was an outspoken activist who didn't want to have health insurance. When she got sick and stuck the public with the bill, her name was dropped from the lawsuit.
    You left out ONE important option, which is to sue the bus company, exactly what your medical insurance provider would do.
    “The reasonable man adapts himself to the world: the unreasonable one persists to adapt the world to himself.
    Therefore all progress depends on the unreasonable man.” ― George Bernard Shaw, Man and Superman

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Fletch View Post
    Explain to me how those three countries offer better care than the US.
    Lots of ways. First, and most importantly, they have kept costs reasonable. So, they are able to ensure that everybody has access, and they don't need all these mechanisms to try to discourage people from seeking medical care like we do with the deductibles and whatnot. They usually have shorter wait times.

    Remember the idea of a "check up"? It used to be that everybody usually went to the doctor about once a year here just to see if everything was in tip top shape. These days women still do that, but guys generally don't at least until they hit 40. Or, remember "house calls"? It used to be that if you were sick, the doctor would come to you if it would be uncomfortable for you to travel. Not anymore. Today you have people taking the bus and sitting around in a waiting room to see a doctor when they are just barely able to keep it together. I remember it used to be that you hardly had to wait to see the doctor and when you got in, he could take however much time you needed for the appointment. If you came in because of a fever, he'd also make sure to run through a bunch of simple tests of your reflexes, maybe your blood, he'd talk to you about your diet and exercise, listen to your heart and lungs, look in your throat and ears, etc. Today you show up and they're 45 minutes behind schedule. If you are there because of a fever they'll give you a kind of exasperated "why are you wasting my time with this" look, tell you to drink plenty of fluids, and shoe you out of their office within 2 minutes. People here used to have a life long relationship with their doctor. Their doctor would know a bit about them, know what health issues they were struggling with, etc. People used to talk about "trusting" their doctor. Now it's just a commodity. As often as not, health care plans now just slot you with whatever doctor happens to be free. Many people don't even have a specific doctor they go to anymore.

    That decline didn't happen in other countries. They still have check ups and house calls and relationships with their doctors and appointments that are as long as they need to be.

    The quality here has been getting worse and worse for decades. And it is happening slowly enough that we aren't freaking out about it. Like the frog in the slowly warming water. That is bizarre. It isn't that it is super odd that the quality kept improving in other countries. Most industries, a steady improvement is expected. We're the oddity- a country where despite charging radically more every decade than the last, the health care industry continually gives us worse care.

    Not that the quality here is terrible. We're still 37th out of 196. And some of those other countries that score above us aren't really representative of the typical country in their economic bracket. Columbia and Morocco, for example, have exceptionally good health care systems for third world countries. They put a good chunk of resources in and have had particularly good luck making it all work together. They're role models for other third world countries in terms of making the most out of what they have. But, yeah, after say 25 years of slipping here for quality, we have gotten to the point where the poorest first world countries, like Greece, are almost all ahead of us, and some third world countries with exceptionally strong systems are now ahead of us.

    But, for what we pay, it is terrible. We pay twice as much per person as the other first world countries. Every single person in the country should have world class health care far better than what we had 25 years ago. We are paying roughly three times as much as we did 25 years ago adjusted for inflation. The quality should be absolutely, unequivocally, head and shoulders above the quality elsewhere. But it isn't. We're getting ripped off.
    Last edited by teamosil; 07-01-12 at 01:55 PM.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by ttwtt78640 View Post
    You left out ONE important option, which is to sue the bus company, exactly what your medical insurance provider would do.
    Yeah, and what happens then? You don't have enough assets to pay your bills. You can't work.
    "The necessaries of life occasion the great expense of the poor. They find it difficult to get food, and the greater part of their little revenue is spent in getting it. The luxuries and vanities of life occasion the principal expense of the rich, and a magnificent house embellishes and sets off to the best advantage all the other luxuries and vanities which they possess. ... It is not very unreasonable that the rich should contribute to the public expense, not only in proportion to their revenue, but something more than in that proportion."

    -- Adam Smith

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Kandahar View Post
    That's quite the standard considering there are only two of them, and both are developing nations.
    That's right. My point is the WHO are comparing apples and oranges. Subsidized systems and systems that have contribution to health services from outside with those without that.

    Quote Originally Posted by Kandahar View Post
    What exactly are the scalability problems that you envision with health care?
    Equipment, geographic range of services, bureaucracy and administration of services, cost of services.

    Quote Originally Posted by Kandahar View Post
    Probably because parts of the country were a war zone until recently.
    Doesn't explain why, if their native quality of care is "better" according to the WHO, why do they require outside help to provide basic medical services?

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