• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

To those against Obamacare -

Would you approve of the individual mandate if it were passed as an amendment?

  • Total voters
    36
gotta link?
 
I've posted this a couple of times over the past 30 months. It has morphed a bit, and other members have assisted with additions, especially LaMidRighter:

Heath care would be broken up into a three-tiered program:

1) Tier 1: Government subsidized health care. Plans paid for and monitored by the government. These plans would be universal and would be paid for via taxes of folks who "opted in" to this plan. It would be "one size fits all" with no variation on the plan itself. Any treatment deemed medically necessary by the treating physician would be covered. No elective, non-necessary or experimental procedures would be, however.

2) Tier 2: Private insurance, Similar to what we have now with some notable exceptions. No utilization review, Insurance companies no longer have the right to deny coverage for any reason, as long as the benefit is available. Only the treating medical professional can decide whether a treatment is appropriate or not. Strict government regulations aimed at streamlining the paperwork aspect, including mandatory centralization both of billing locations and of billing and other forms. Failure to comply with these regulations, suspend the company's ability to do business.

Folks who go this route, automatically "opt out" of the government plan and are not due to pay the taxes that subsidize that plan.

Borrowing from HarryGuerilla, plans are developed on an "ala carte" basis. You want coverage for catastrophic illness only? No problem. How about physicals and x-rays, only? Easy peasy. What about the works, except for obstetrics? Good to go. This kind of choice will allow for folks to get precisely the kind of coverage they want, rather than getting coverage for things they do not.

3) Tier 3: Private Pay. Complete out of pocket, pay for service plan. No insurance whatsoever. "Opt out" of government plan and related government taxes in total effect.

Additional parts to this.

1) Under no circumstances are illegal aliens covered under any health plan, government or private.

2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.

3) Bankruptcies will NOT eliminate medical costs. They must be paid in full, no matter what.

4) TORT reform with reasonable caps on any suing for malpractice.

5) The ability to sue an insurance company for not paying for services that are in a patient's benefit package. Yes, this happens more often than you think, currently.

6) I love the "apprentice" program that has been suggested in this thread, and am incorporating it in my plan. As one who has trained and supervised many professionals, I would like to see this expanded. Getting appropriate experience is one of the major challenges to entering this field.

7) Denial for pre-existing conditions is eliminated in both the government and the private insurance plans.

8) Preventative care is covered fully by both the government and private insurance plans. No co-pays whatsoever. Tax breaks could be given to insurance companies and doctors who encourage preventative care, and to citizens who engage in this.

9) Reduction of the time period that pharmaceutical companies hold patents on medications, preventing generics from being produced. My thought would be no more than 5 years.

One thing of note. #6... the apprentice plan was actually suggested by LaMidRighter... and now again in the Welfare thread by reefedjib. It was a good idea then, and still a good idea, now. As you can also see, my "plans" tend to be tiered, with different levels of control and freedom, attempting to cater to all sides of the political spectrum, socio-economic levels, but with allowing for the least amount of manipulation.
 
I do not believe that it is legitimate for the government to pass laws requiring citizens to purchase any goods or services from a third party.

If you want to make it mandatory? Make it a tax.
 
1) Under no circumstances are illegal aliens covered under any health plan, government or private.

Then the law that says no hospital can turn anyone away has to be repealed....or millions of illegals will still run to the emergency room when they get the sniffles and pour over the border pregnant to give us the privledge of paying for their child birth and making that baby a citizen.
 
lpast said:
1) Under no circumstances are illegal aliens covered under any health plan, government or private.

Then the law that says no hospital can turn anyone away has to be repealed....or millions of illegals will still run to the emergency room when they get the sniffles and pour over the border pregnant to give us the privledge of paying for their child birth and making that baby a citizen.
Click to expand...

Yup. Part of my healthcare plan requires this law to be changed. See point #2.
 
CaptainCourtesy said:
Yup. Part of my healthcare plan requires this law to be changed. See point #2.
Click to expand...


2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.


Ok gotcha I missed that....I like your plan...its the only viable plan ive seen
 
lpast said:
2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.
Click to expand...


Ok gotcha I missed that....I like your plan...its the only viable plan ive seen...we have to do something..it just cant keep going the way it is....
 
CaptainCourtesy said:
I've posted this a couple of times over the past 30 months. It has morphed a bit, and other members have assisted with additions, especially LaMidRighter:

Heath care would be broken up into a three-tiered program:

1) Tier 1: Government subsidized health care. Plans paid for and monitored by the government. These plans would be universal and would be paid for via taxes of folks who "opted in" to this plan. It would be "one size fits all" with no variation on the plan itself. Any treatment deemed medically necessary by the treating physician would be covered. No elective, non-necessary or experimental procedures would be, however.

2) Tier 2: Private insurance, Similar to what we have now with some notable exceptions. No utilization review, Insurance companies no longer have the right to deny coverage for any reason, as long as the benefit is available. Only the treating medical professional can decide whether a treatment is appropriate or not. Strict government regulations aimed at streamlining the paperwork aspect, including mandatory centralization both of billing locations and of billing and other forms. Failure to comply with these regulations, suspend the company's ability to do business.

Folks who go this route, automatically "opt out" of the government plan and are not due to pay the taxes that subsidize that plan.

Borrowing from HarryGuerilla, plans are developed on an "ala carte" basis. You want coverage for catastrophic illness only? No problem. How about physicals and x-rays, only? Easy peasy. What about the works, except for obstetrics? Good to go. This kind of choice will allow for folks to get precisely the kind of coverage they want, rather than getting coverage for things they do not.

3) Tier 3: Private Pay. Complete out of pocket, pay for service plan. No insurance whatsoever. "Opt out" of government plan and related government taxes in total effect.

Additional parts to this.

1) Under no circumstances are illegal aliens covered under any health plan, government or private.

2) If you opt out of the government plan, and you do not have catastrophic coverage under your private plan, under no circumstances will the government subsidize your care. If a doctor chooses to see you, unsure of your ability to pay for the service, even with a catastrophic illness, even if it is a child, it is then on the doctor to collect fees. The government will NOT subsidize in any way, nor is any doctor or hospital required to provide any charity care. You make a choice, you need to live with it.

3) Bankruptcies will NOT eliminate medical costs. They must be paid in full, no matter what.

4) TORT reform with reasonable caps on any suing for malpractice.

5) The ability to sue an insurance company for not paying for services that are in a patient's benefit package. Yes, this happens more often than you think, currently.

6) I love the "apprentice" program that has been suggested in this thread, and am incorporating it in my plan. As one who has trained and supervised many professionals, I would like to see this expanded. Getting appropriate experience is one of the major challenges to entering this field.

7) Denial for pre-existing conditions is eliminated in both the government and the private insurance plans.

8) Preventative care is covered fully by both the government and private insurance plans. No co-pays whatsoever. Tax breaks could be given to insurance companies and doctors who encourage preventative care, and to citizens who engage in this.

9) Reduction of the time period that pharmaceutical companies hold patents on medications, preventing generics from being produced. My thought would be no more than 5 years.

One thing of note. #6... the apprentice plan was actually suggested by LaMidRighter... and now again in the Welfare thread by reefedjib. It was a good idea then, and still a good idea, now. As you can also see, my "plans" tend to be tiered, with different levels of control and freedom, attempting to cater to all sides of the political spectrum, socio-economic levels, but with allowing for the least amount of manipulation.
Click to expand...

main issues that spring to mind:

1. if insurance companies are not allowed to refuse coverage or care, but the consumer is purchasing a'la carte, then are you allowing insurance companies to charge individuals different amounts - similar to how ones' auto insurance goes up if one has multiple speeding tickets - or are you going to force the rest of insurance purchasers to subsidize those who are really only pre-paying for healthcare they are sure to need? It seems some flexibility needs to be given to the company as well as the consumer to come to a true deal, otherwise we aren't allowing insurance to act as insurance, but rather operates on the same economics as the government option. which brings me to point#2:

2. If healthcare for tier one is paid solely out of the taxes of those who are in it, then how do you deal with adverse self-selection? It seems that such a program would immediately collect a large percentage of those with chronic and exceedingly expensive conditions, who by definition are unable to earn enough to pay for their own medical care. This is a program that will either quickly turn to fatal rationing if it is limited to contributions, and will quickly become a maw sucking in the healthcare dollars of the other two tiers otherwise.

3. This wasn't mentioned - but how do you plan to address the current unfair tax treatment of healthcare dollars? under the tiers above, there is currently a strong incentive structure to the tune of the income tax pushing people from Tier 3 to Tier 2 - would you make all healthcare spending tax free? If so, where would we make up the loss of revenue? Would you keep the tax benefits of HSA's?

4. Tort caps: while I'm a large fan of tort reform, caps have always struck me as ungainly. There are events that happen to some that simply damage them over the course of their lifetime more than $500,000, or $1,000,000 worth. It seems that if you are going to cap tort, then the cap should exclude the future cost of the patients' medical care, which would be assumed by the insurance company or the doctor himself. If you aren't willing to do this, then I would strongly suggest you instead look at enacting a method for "loser pays", where a doctor unrightfully sued by money-seekers can recoup at least the cost of the litigation and his time in court rather than in the clinic.

5. You say no care for one who has failed to provide for themselves, including for children. "you have made your decision". but the child has made no decision. as a generally free-market conservative, I'm going to side with Milton Friedman on this one and say that letting losers suffer for their decisions is a poor model to apply to children and the mentally disabled. it seems that some level of care should be afforded for the child, with the parent perhaps either taking on debt or losing parental rights if they have failed to provide for their offspring. we remove children from parents for other forms of neglect.

6. is the "apprentice" program a way around the current guild stranglehold on the supply of doctors?
 
Last edited:
Since we're making alternative suggestions here, let's try this:

(1) Medicare/Medicaid are completely done away with (including their portion of the payroll tax). Instead the Department of Health and Human Services implement a far less costly bloc grant for the states to implement requiring a voucher program to assist means-tested individuals on a temporary basis in the purchase of health insurance to be applied towards a Medical or Health Savings Account. States would be barred from providing assistance to non-citizens. There would also be stipulations for work and/or school requirements, prohibition against non-essential services and mandatory drug-testing as a qualification for receipt of assistance.

(2) EMTALA amended to exclude illegal immigrants from service and to strengthen ability of hospitals and health care providers to seek financial restitution from free riders where reasonable to eliminate abuse of the system.

(3) National health care portability legislation enacted to my insurance available on a national market.

(4) FDA streamline drug-approval process. Importation of foreign drugs no longer prohibited, helping lower pharmaceutical costs for consumers.

(5) National tort reform enacted to limit to damages to reasonable amounts and enact "loser pays" guidelines for frivolous suits.

(6) Tax reform to make health care expenses 100% deductible. Eliminate capital gains taxes for hospitals and health care facilities. Cut corporate tax to 10 percent for pharmaceutical and health care technology manufacturers.

Using these principles government's intervention in the marketplace would be substantially reduced, allowing for the market to work more freely. Low-income families would still receive a modest form of government assistance, though delivered at the local level, requiring personal responsibility and maximizing consumer choice. Costs would be substantially reduced both for health care providers and consumers, accessibility would be increased, and waste and fraud would be substantially reduced.
 
fredmertz said:
Assuming you are against the 'individual mandate' clause, would you support it if it were instead passed as an Amendment to the constitution?

My issue with most liberal-based legislation is that it continues to change the interpretation of the words in the constitution to allow for such legislation. The more we change the meaning of clauses, the less important those clauses become (and eventually, anything can be done under the clauses which render them useless). We once thought it necessary to amend the constitution to abolish alcohol. Now look what we get away with!

I'm a constitutionalist. Which does not imply that I don't want to amend it or even that I don't want a bigger government necessarily. But if you don't have 2/3's approval in Congress and 75% of the states ratifying an increase of powers, than such an increase is not appropriate.

I'm personally on the fence about an individual mandate clause, depending on what it says exactly. But I'm absolutely against such a law without a constitutional amendment.
Click to expand...
The Libertarians and many conservatives love the Constitution so much...which in some ways is good.
But this document was written and designed hundreds of years ago.
Then, health care as we know it today did not even exist....on this basis, I cannot understand how the constitution is even involved.
But, this is obvious, there is much more...we do not want a government becoming "too big for its britches", do we ???
We, in this case, is NOT the Liberals
 
cpwill said:
so, no having the average citizen be deadbeat, like the government.

I'm down. A mandate that doesn't really mandate isn't a mandate in the first place. Allow anyone who wishes to opt out of Obamacare.
Click to expand...

Yes, everyone's a deadbeat. I remember back before the law and a young girl died in Georgia. Damn Deadbeat.

Anyway, that is what will have to happen. We will have to say we won't care for those who can't pay. Absent that, you will have to plan for those who can't in one form or another.
 
fredmertz said:
Assuming you are against the 'individual mandate' clause, would you support it if it were instead passed as an Amendment to the constitution?

My issue with most liberal-based legislation is that it continues to change the interpretation of the words in the constitution to allow for such legislation. The more we change the meaning of clauses, the less important those clauses become (and eventually, anything can be done under the clauses which render them useless). We once thought it necessary to amend the constitution to abolish alcohol. Now look what we get away with!

I'm a constitutionalist. Which does not imply that I don't want to amend it or even that I don't want a bigger government necessarily. But if you don't have 2/3's approval in Congress and 75% of the states ratifying an increase of powers, than such an increase is not appropriate.

I'm personally on the fence about an individual mandate clause, depending on what it says exactly. But I'm absolutely against such a law without a constitutional amendment.
Click to expand...

Pretty much the entire body of federal law "changes the interpretation of the words" of the U.S. Constitution, because the domestic and international challenges of the last 100 years have required it at a higher degree than ideological scruples and rivalries have been able to accommodate.
 
Last edited:
Blackstone said:
A cursory glance at public education can answer this question for you. One-size-fits-all government solutions decrease quality and increase costs. That's just the way intervention in the marketplace works whether we're talking about health care, education or what-have-you.
Click to expand...


well gosh. gee wiz you mean in the two sectors of the economy where we see massive government intervention and subsidy (healthcare and education), we also see skyrocketing costs?


what a surprise.
 
cpwill said:
well gosh. gee wiz you mean in the two sectors of the economy where we see massive government intervention and subsidy (healthcare and education), we also see skyrocketing costs?


what a surprise.
Click to expand...

As I recall, you want government in education. Vouchers and having government pay for private school largely involves government more heavily in education. As one of my forgien students said when we watched the Stossel film, "dosn't he (Stosseel) know that is socialized education?" She explained that the examples he was using came from countries that socialed education. I laughed.

But, for here, do you really believe that govenment won't involve itself in education it pays for?
 
Tigger said:
If it were passed as an amendment to the US Constitution I would accept its legitimacy. I would also leave the United States permanently and rescind my US Citizenship if that were to happen.
Click to expand...

Oh, man, what a temptation.
 
CaptainCourtesy said:
1) Tier 1: Government subsidized health care. Plans paid for and monitored by the government. These plans would be universal and would be paid for via taxes of folks who "opted in" to this plan. It would be "one size fits all" with no variation on the plan itself. Any treatment deemed medically necessary by the treating physician would be covered. No elective, non-necessary or experimental procedures would be, however.
Click to expand...

Do you believe the first tier would have enough people opting in? What are the incentives to opt into government insurance vs private?
 
fredmertz said:
Assuming you are against the 'individual mandate' clause, would you support it if it were instead passed as an Amendment to the constitution?

My issue with most liberal-based legislation is that it continues to change the interpretation of the words in the constitution to allow for such legislation. The more we change the meaning of clauses, the less important those clauses become (and eventually, anything can be done under the clauses which render them useless). We once thought it necessary to amend the constitution to abolish alcohol. Now look what we get away with!

I'm a constitutionalist. Which does not imply that I don't want to amend it or even that I don't want a bigger government necessarily. But if you don't have 2/3's approval in Congress and 75% of the states ratifying an increase of powers, than such an increase is not appropriate.

I'm personally on the fence about an individual mandate clause, depending on what it says exactly. But I'm absolutely against such a law without a constitutional amendment.
Click to expand...
I thought that you would have posted on my poll: What should we do with emergency medical care, EMTALA? Your Amendment to the constitution question comes up here also. So what is your position with EMTALA?
 
CC, your plan would do nothing more than turn the government into a private insurance company. The public program you outline would only be paid for by those who cannot afford anything in the first place. It wouldn't drive costs down, just create a useless program that is too underfunded to accomplish anything. The point of a UHC system is to ensure good care for everyone, by having everyone pay for it collectively. And you take the middlemen out of the equation, and costs drop, allowing everyone to receive care, and make that care more efficient. Like the current reform, your plan complicates things too much to achieve this.
 
Boo Radley said:
Yes, everyone's a deadbeat. I remember back before the law and a young girl died in Georgia. Damn Deadbeat.
Click to expand...

i'm not sure what you are talking about here, since you had argued that people shouldn't be allowed to underpay, and I had merely responded by pointing out that that is what the government does.
 
whysoserious said:
Do you believe the first tier would have enough people opting in? What are the incentives to opt into government insurance vs private?
Click to expand...
We had a long discussion on C.C.'s plan about two(?) years ago and one thing that stood out was that the government tier would have to work by the same rules as private insurers but would not be allowed PECs(this was before the last health bill got passed), so I think the fact that so many people do not like the private high risk options if that tier would provide a reasonable alternative to people with private problems it would be more than competitive from an enrollment standpoint.
 
cpwill said:
i'm not sure what you are talking about here, since you had argued that people shouldn't be allowed to underpay, and I had merely responded by pointing out that that is what the government does.
Click to expand...

I'm not sure what you're talking about. I suspect you may have taken lines out of overall meaning to convince yourself of something not said.

You may want to back up and say soemthing I can follow. I don't think I ever used the word underpay. But, explain where you got that from.
 
Boo said:
And no having the providers passing on the costs.

cpwill said:
so, no having the average citizen be deadbeat, like the government.
Click to expand...
Click to expand...

that would be it. government underpays, and providers pass on the costs to the rest of us. you were arguing that individual citizens should not be allowed to do the same.
 
cpwill said:
that would be it. government underpays, and providers pass on the costs to the rest of us. you were arguing that individual citizens should not be allowed to do the same.
Click to expand...

That has nothing to do with what I said. No one paying passes on the cost. The patient doesn't pay, as he likely really can't. And the government doesn't pay. So, that leaves passing it on.

Now, I know someowhere in your logic, if a bill is 100,000 and the government pays 75,000, that is worse than the entire 100,000 not being paid. I question your math skills on that. But that too isn't much different than your insurance.
 
deadbeatism is deadbeatism and underpayment is underpayment. you are the one setting up some kind of free rider strawman, as though that is what we were arguing.
 
You must log in or register to reply here.
Back
Top Bottom