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

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

No need to convince you. But hey, let's see those studies you claim that show that "Greece, Morocco, and Columbia have better doctors, better hospitals, better equipment, better results than the US" (what Fletch posted).

I made no such claim, but since you asked, I found that information for you anyway. Here are the rankings for health care quality for the four nations in question, as determined by the World Health Organization:

#14 Greece
#22 Colombia
#29 Morocco
#37 United States

And in terms of COST, the United States is #1, Greece is #30, Colombia is #49, and Morocco is #99.

http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

OK then, tell me where a better array of doctors, hospitals, equipment and results can be found than in the US.

The 36 nations that rank higher in health care quality than the United States would probably be a good place to start.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The Supreme Court disagrees with you. :2wave:

Except it doesn't, and if you had read the decisions/dissents you'd know that. Some of the justices clearly say this is a punitive tax on inaction, the others say it's just a tax, and one says it should have been allowed under the Commerce Clause, but she'll go along with the tax thing anyway.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

There is no problem with care in the US. The problem is cost and, thus, coverage.

Well, coverage is a big variable in the quality equation. If you have one person with awesome care and the other with terrible care, your average quality of care is mediocre.

But, on top of that, like I said, even for the wealthy, there are serious quality problems in the US. Long waits, little preventative care, no home visits, etc.

By the same "logic", if a country has 2 doctors for every 1,000,000 people, yet all may queue up to see their doctor for free, then they have "superior" equality and "access" to that medical care. ;-)

Er, no... That would be terrible quality of care. Extremely poor access. Not sure what you're thinking of there.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

I made no such claim, but since you asked, I found that information for you anyway. Here are the rankings for health care quality for the four nations in question, as determined by the World Health Organization:

#14 Greece
#22 Colombia
#29 Morocco
#37 United States

And in terms of COST, the United States is #1, Greece is #30, Colombia is #49, and Morocco is #99.

World Health Organization ranking of health systems - Wikipedia, the free encyclopedia
Explain to me how those three countries offer better care than the US.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

Mtt Romney accepts the basic premises of the left, I am not denying that.

Not just Romney. Gingrich too:

"We also believe strongly that personal responsibility is vital to creating a 21st Century Intelligent Health System," Gingrich wrote in the memo which was found on an old Gingrich website by BuzzFeed's Andrew Kaczynski. "Individuals who can afford to purchase health insurance and simply choose not to place an unnecessary burden on a system that is on the verge of collapse; these free-riders undermine the entire health system by placing the onus of responsibility on taxpayers."

And of course the conservative Heritage Foundation which came up with the idea of the mandate to begin with.

See, when conservatives push the idea it's about personal responsibility. When Obama adopts their idea it's a government takeover of health care. :roll:
 
Re: Health care mandate is tax, will negatively affect middle, lower class, some say

My how the tune has changed. Anyone remember what proponents on this mandate argued before this ruling? Before SCOTUS upheld the mandate so many proponents on this board were using the arguement that it was a tax to those that were against the mandate and therefore was constitutional. Now that SCOTUS has affirmed that it IS a tax and this particular side of the arguement has come up it is magically "not a tax".

But regardless of what proponents are saying in this thread now, facts are facts. And the fact is that SCOTUS has upheld the mandate AS A TAX!. Not a penalty. You can continue to argue that it is not a tax all that you want but SCOTUS showed otherwise. If you continue to deny this fact then only one of three conditions arise.

1: You're stupid.
2: You're a liar.
3: You're both.

Or you can accept the facts and admit that it is a tax which will show everyone that...

1: You're not stupid.
2: You're honest.
3: You're both.

Obama and Co. has already shown which ones they are. Will you continue to follow him on this issue or think independently? Something which many of you claim to value and claim that those on the opposite aisle do not do.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

By the same "logic", if a country has 2 doctors for every 1,000,000 people, yet all may queue up to see their doctor for free, then they have "superior" equality and "access" to that medical care. ;-)

Nope. The WHO's methodology takes into account responsiveness (speed of service, protection of privacy, and quality of amenities). What else you got?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Except it doesn't, and if you had read the decisions/dissents you'd know that. Some of the justices clearly say this is a punitive tax on inaction, the others say it's just a tax, and one says it should have been allowed under the Commerce Clause, but she'll go along with the tax thing anyway.

Right. So in other words, the Supreme Court ruled that it's covered under Congress' power to levy a tax.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

Explain to me how those three countries offer better care than the US.

The rankings are based on an index of five factors:[1]
Health (50%) : disability-adjusted life expectancy
* Overall or average : 25%
* Distribution or equality : 25%
Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
* Overall or average : 12.5%
* Distribution or equality : 12.5%
Fair financial contribution : 25%
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

Not just Romney. Gingrich too:



And of course the conservative Heritage Foundation which came up with the idea of the mandate to begin with.

See, when conservatives push the idea it's about personal responsibility. When Obama adopts their idea it's a government takeover of health care. :roll:
For the record, I disagree with all of them. Personal responsibility to me is taking personal responsibility not foisting it upon others. I have no more right to health care I cannot afford than I do to a car or a pair of shoes or a loaf of bread that I cannot afford. Neither you, my neighbor, the public, the collective or the state is responsible for my health care. I am. That is what personal responsibility means.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

The 36 nations that rank higher in health care quality than the United States would probably be a good place to start.

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. It's relatively easy to maintain quality among a small group in a highly subsidized environment.

And if the care is better in Colombia, why are my American friends in Doctors Without Borders always doing missions down there?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

The rankings are based on an index of five factors:[1]
Health (50%) : disability-adjusted life expectancy
* Overall or average : 25%
* Distribution or equality : 25%
Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
* Overall or average : 12.5%
* Distribution or equality : 12.5%
Fair financial contribution : 25%
50% is based upon life expectancy which has little or nothing to do with standard of care. And 25% has to do with "fair financial contribution" which is subjective and has nothing to do with actual care. So at least 75% has little or nothing to do with actual care.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Right. So in other words, the Supreme Court ruled that it's covered under Congress' power to levy a tax.

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

For the record, I disagree with all of them. Personal responsibility to me is taking personal responsibility not foisting it upon others. I have no more right to health care I cannot afford than I do to a car or a pair of shoes or a loaf of bread that I cannot afford. Neither you, my neighbor, the public, the collective or the state is responsible for my health care. I am. That is what personal responsibility means.

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

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.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

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?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

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. :2wave:

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

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. :roll:

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.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

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

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

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

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

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

That's quite the standard considering there are only two of them, and both are developing nations. :roll:

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.

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.

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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