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I'm having some conflicting views on health care reform...

Mensch

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First off, I acknowledge from the get-go the various reasons WHY our healthcare system has become so expensive. I also support individual-driven solutions to the growing problem (I'm being very vague at the moment on purpose).

However, I've recently been thinking about the individual mandate. I'd hate to be just another "fake libertarian" who claims libertarianism as his philosophy and yet commands a completely different set of ideas. Instead, I'm trying to focus on real solutions that will simultaneously benefit the group, as a whole, as well the individual.

Almost my entire family, from my father to my mother to my three cousins I grew up with, etc, are all nurses. They're feeling the brunt of the problem in their daily lives. For my father, his pay has actually been declining steadily ever since his hospital group began covering the costs of patients who do not pay.

My cousin Melissa and her husband Frank are both nurses in LA. Frank works at the county ER and sees immediately the problem of users and abusers. People abuse the system, in plain English. And this statement comes from a guy who wants some sort of universalized medicine. People receive a service, and they don't pay. Obviously, what happens next is the rest of America with health insurance end up paying higher costs for those who don't have any. This is a problem.

Which brings me to the mandate. We all know that in support of this mandate, advocates have also brought up the individual mandates on car insurance. Those mandates seem reasonable to the vast majority of Americans, and well, even to me. I have always supported a basic, bare-minimum insurance mandate for drivers because before the mandates were in place, lawsuits arising from no-insurance accidents caused a system-wide overload. Endless lawsuits also have a way of financially punishing third party participants. Libertarians, and myself included, strongly believe that laws should protect individual rights but must also consider the well-being of non-participatory third party members. In other words, person A and person B should be free to engage in a transaction of sex and money so long as it does not harm person C (a non-participatory third party).

If one can support the mandate on basic car insurance that would reduce the level of tort that financially injures third parties (in that case, the taxpayer), then it would be a logical extension to support the mandate on individual HDICs that would reduce the level of financial culpability that financially injures third parties (in that case, the middle class American who does carry insurance).

The only other option would seriously be to repeal the Emergency Medical Treatment and Active Labor Act, which requires all (or most) hospitals and ambulances to treat anyone regardless of national origin, race, or ability to pay. The EMTALA is an unfunded mandate that has existed since 1986. The individual insurance mandate being debated today would be the funding for the EMTALA. Otherwise, in order to be successful in our endeavor to reduce costs without denying care outright, this seems to be the only option.

Despite the fact that it encroaches on the individual's personal liberty, it at least ensures that all non-participatory third parties will not be seriously injured because of the careless acts of others. And yes, for the most part, many of these people who go without insurance are careless. But we can debate the merits to that argument some other day.

Any thoughts? [h=1]
[/h]
 
First off, I acknowledge from the get-go the various reasons WHY our healthcare system has become so expensive.

It's important to lay these out, IMHO. A lot of folks can't agree why it has become so expensive.

Aside from the other obvious reasons (aging population, shifting demographics), the main reason it's expensive is because employer-based healthcare insurance is inherently inefficient. It's really an idiotic system, if you think about it. Your employer has no obligation to by your food or groceries, so why are they responsible for your healthcare?

It turns out basically any other system (either a market-based system or single-payer) is more efficient than what we have now. Just throwing that out there.

The "individual mandate" was actually conceived by some conservative Republicans during the 1990s (specifically economist Mark Pauly) healthcare debate, as an alternative to the "employer mandate" that was then being put forth by the Democrats. They figured out that pretty much the only way to have both universal coverage, AND to preserve a role for the markets, was to have an individual mandate that would eliminate free riders.

If one is a "purist" libertarian, IMHO, it's impossible to have a healthcare/health insurance system that has universal coverage, but is also non-coercive in nature. Can't have your cake and eat it too, it's either one or the other.

Just a couple thoughts.
 
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Make medical bills for those without insurance, non bankruptable, just like student loans.
Require those who do receive services to set up a fair and affordable payment plan, that if it is not met the payments will be garnished from their checks.
 
Make medical bills for those without insurance, non bankruptable, just like student loans.
Require those who do receive services to set up a fair and affordable payment plan, that if it is not met the payments will be garnished from their checks.

So then they bankrupt on everything else?
 
It's important to lay these out, IMHO. A lot of folks can't agree why it has become so expensive.

That's the truth.

IMO, the most important reason healthcare is so expensive is low-deductible insurance policies. There's absolutely no consumer-driven accountability for healthcare costs. If the consumer had to pay $150 for a doctor visit, he wouldn't be going to the doctor for hangnails (weird example, but I think ya' get it).Or, even more likely, doctors wouldn't be charging $150. Of course, the consumer doesn't have to pay $150. He's got a $20 co-pay....or maybe even less after he's spent his first $500 for the year. Does anyone "shop" doctors for their "per visit" charge? Honestly? I don't know anyone who does. You?
 
Yes because a fair and affordable payment plan causes people to go into bankruptcy.......:doh
Depends on what you consider fair. If I owe a few hundred thousand, what's a fair payment plan that won't effect something else?
 
This isnt the only problem but its the one that is the most pathetic.

Take time and do a study on what a CEO, VPs etc (basically the top brass) used to make at health insurance providers say 15 years ago and look now.

Its obnoxious, basically the CEOs that used to make like 1mil a year with basically 100K bonuses are now making 54million a year with 20 million dollar bonuses.

Now of course I made these numbers up but its not far off in some cases.

This is what is happening in MANY corporations in America and then they wonder "WHERE DOES ALL THE MONEY GO"

Did I mention some of these top brass make this much WHILE cutting jobs, raising the customer costs and lowering quality of care/products.

What happen to the days where a CEO made 500K or even a million a year with Presidents and VPs making 250K to 500K a year AND (big gasping breath) that company offering TOP NOTCH (or at least good) services or products????????

Why was that not good enough? God forbid a CEO is a MILLIONAIRE and gives GREAT product/services to the people.

Now a lot (certainly not all but to many IMO) CEOs Presidents and VPs COMPETE with EACHOTHER and not the market.

They have to top each other with their bottom line while customers and workers get screwed.

I just dont get it, where did the decency go?

Now the name of the game for too many companies is how much can the top brass make while giving services/products just good enough to get by while making as much as possible no matter what. Most products are just barely good enough for you to buy or at least FOOL enough people to buy them until you realize its junk and the money is already made.

Who cares about middle management and below and who cares about the customer AFTER they have paid or have been fooled.

Its sad really.

Again not the only problem but its a major factor that gets over looked far too much.
 
What you can afford and still live comfortably.
That's why I said fair and affordable, not "rape their pay checks of every red cent."

Which could mean it never really gets paid for. And thus, doesn't really solve the problem.

Look, I'm not trying to be difficult, but such simple answers have been thought of before. Even tried. At the end of the day, services were given and not paid for, and expense passed on.
 
What you can afford and still live comfortably.
That's why I said fair and affordable, not "rape their pay checks of every red cent."
that minimum wage worker who had a half million dollar heart transplant
what would be a fair and reasonable repayment plan for him
while also retiring the debt
 
that minimum wage worker who had a half million dollar heart transplant
what would be a fair and reasonable repayment plan for him
while also retiring the debt

ahhhemmm the average cost of a heart transplant in 2008 was 747k in the first year.

Then there is a life time of anti-rejection drug therapy that runs 1.5k to 2k per mnth.

This doesn't included other considerations like a lifetime of biopsies, specific diet, etc.....
 
How is any of this better than a universal healthcare system? Look at the countries that have it. Costs go down, and no one is turned away. For all our vaunted "best healthcare in the world", Americans are shorter lived and less healthy than our European neighbors. If we put measures in place to help the poorer half of our population stay healthy (such as giving them better access to professional health care), perhaps we can improve on that statistic.
 
that minimum wage worker who had a half million dollar heart transplant
what would be a fair and reasonable repayment plan for him
while also retiring the debt

Or a young man with a brain injury? Those can cost upwards of 3 million is serious enough. Just fall off the motorcycle and hit your head on the curb, and there you go. Not dead, but being treated fror a long time. Needing real ad long term care.
 
How is any of this better than a universal healthcare system? Look at the countries that have it. Costs go down, and no one is turned away. For all our vaunted "best healthcare in the world", Americans are shorter lived and less healthy than our European neighbors. If we put measures in place to help the poorer half of our population stay healthy (such as giving them better access to professional health care), perhaps we can improve on that statistic.

I think a single payer system is a better system, not perfect but better. In this country, it would have to be two teired though, so those who can afford more can buy more.
 
First off, I acknowledge from the get-go the various reasons WHY our healthcare system has become so expensive. I also support individual-driven solutions to the growing problem (I'm being very vague at the moment on purpose).

However, I've recently been thinking about the individual mandate. I'd hate to be just another "fake libertarian" who claims libertarianism as his philosophy and yet commands a completely different set of ideas. Instead, I'm trying to focus on real solutions that will simultaneously benefit the group, as a whole, as well the individual.

Almost my entire family, from my father to my mother to my three cousins I grew up with, etc, are all nurses. They're feeling the brunt of the problem in their daily lives. For my father, his pay has actually been declining steadily ever since his hospital group began covering the costs of patients who do not pay.

My cousin Melissa and her husband Frank are both nurses in LA. Frank works at the county ER and sees immediately the problem of users and abusers. People abuse the system, in plain English. And this statement comes from a guy who wants some sort of universalized medicine. People receive a service, and they don't pay. Obviously, what happens next is the rest of America with health insurance end up paying higher costs for those who don't have any. This is a problem.

Which brings me to the mandate. We all know that in support of this mandate, advocates have also brought up the individual mandates on car insurance. Those mandates seem reasonable to the vast majority of Americans, and well, even to me. I have always supported a basic, bare-minimum insurance mandate for drivers because before the mandates were in place, lawsuits arising from no-insurance accidents caused a system-wide overload. Endless lawsuits also have a way of financially punishing third party participants. Libertarians, and myself included, strongly believe that laws should protect individual rights but must also consider the well-being of non-participatory third party members. In other words, person A and person B should be free to engage in a transaction of sex and money so long as it does not harm person C (a non-participatory third party).

If one can support the mandate on basic car insurance that would reduce the level of tort that financially injures third parties (in that case, the taxpayer), then it would be a logical extension to support the mandate on individual HDICs that would reduce the level of financial culpability that financially injures third parties (in that case, the middle class American who does carry insurance).

The only other option would seriously be to repeal the Emergency Medical Treatment and Active Labor Act, which requires all (or most) hospitals and ambulances to treat anyone regardless of national origin, race, or ability to pay. The EMTALA is an unfunded mandate that has existed since 1986. The individual insurance mandate being debated today would be the funding for the EMTALA. Otherwise, in order to be successful in our endeavor to reduce costs without denying care outright, this seems to be the only option.

Despite the fact that it encroaches on the individual's personal liberty, it at least ensures that all non-participatory third parties will not be seriously injured because of the careless acts of others. And yes, for the most part, many of these people who go without insurance are careless. But we can debate the merits to that argument some other day.

Any thoughts? [h=1]
[/h]

I like your post. I think you hit on most every relevant point to this discussion but one, which is the Constitution by which we abide. Requiring licensing and insurance for driving, which is not a right guaranteed to people, but a privilege is different from requiring every citizen to be forced to buy health insurance just because they are alive. The Federal Government has no authority upon which to force you to engage in commerce. Period. Full Stop. That's it.

Government must exist within constraints. Too often we want government to "do something" and it matters not whether it is allowed to involve itself in the problem.

The solution that you hint at, the reversal of EMTALA is the way to go. Announce an intention to reverse it, pass the reversal, and enforce the reversal. This eliminates many of the free riders who are abusing the system. The one's who are truly stupid or indigent can be helped by charity on their first encounter with the system and thereafter if they chose to refuse buying some coverage for themselves then their fate is really on them.
 
that minimum wage worker who had a half million dollar heart transplant
what would be a fair and reasonable repayment plan for him
while also retiring the debt

Obvisously such a person should not get a heart transplant, and instead should be selling a kidney to some wealthy person who requires one
 
Obvisously such a person should not get a heart transplant, and instead should be selling a kidney to some wealthy person who requires one

Yes, you clearly show yourself to be a caring person, with other people's money that is.

welfaresk3wx3.jpg
 
Yes, you clearly show yourself to be a caring person, with other people's money that is.

welfaresk3wx3.jpg

And just where in my post did I suggest the government should pay for a poor persons heart transplant?

In fact I stated that the poor person should not get a heart transplant and instead should sell a kidney
 
Looks truthful. Care to explain welfare is not exactly what that picture says it is?
Is rent robbery? I read a criminal once who siad it was. Know, paying taxes and using taxes for the common good is not robbery. It is more than a little hyperbolic to suggest it is. You have representation. You are nto being robbed.
 
Is rent robbery? I read a criminal once who siad it was. Know, paying taxes and using taxes for the common good is not robbery. It is more than a little hyperbolic to suggest it is. You have representation. You are nto being robbed.

Rent is a service for the person paying the rent that they couldn't get otherwise. Making a system that is only really for a few people that everyone is either forced into and/or forced to pay for is not the same as rent.
 
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Rent is a service for the person paying the rent that they couldn't get otherwise. Making a system that is only really for a few people that everyone is either forced into and/or forced to pay for is not the same as rent.

Ya know disability is open to everyone that qualifies.

Would you want to qualify for something like that?
 
Rent is a service for the person paying the rent that they couldn't get otherwise. Making a system that is only really for a few people that everyone is either forced into and/or forced to pay for is not the same as rent.

NO, everyone who has need and quailifies has access to the same help. I'm afraid there really is little difference in the train of throught. And I don't really see those who have lining up to trade places. Do you?
 
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