MANDATORY health insurance, part 2

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Is it weird to think being forced to buy something is unconstitutional?
No, it isn't. The individual mandate was a stupid idea and only one of many things wrong with the legislation.

But to play devil's advocate for just a sec, TPM, is your state mandating that you have car insurance unconstitutional?

Is it unconstitutional that regulation forces you to adhere to building codes?

Is it "wealth distribution" for the government to garnish your paycheque every pay period to redistribute some of your hard-earned income to the elderly?
 
But to play devil's advocate for just a sec, TPM, is your state mandating that you have car insurance unconstitutional?

To play devil's advocate to your devil's advocate, you're only mandated to buy car insurance if you choose to own a car. You only have to adhere to building codes if you choose to construct a building.

And for that last one, keep the government out of my medicare!
 
Slate, Dec. 14
Why Don't More Americans Use Their Free Health Insurance?


...As Benjamin Sommers and Arnold Epstein recently reported in the New England Journal of Medicine, 40% of people who qualify for free coverage through the government's Medicaid program don't sign up. In the worst-performing states, like Oregon, Florida, Georgia, and Texas, more than half the eligible people aren't enrolled. Using adjusted estimates from the US Census Bureau, tens of millions of Americans don't take the freebie, and tens of billions of dollars' worth of coverage are left on the table.

That's a huge problem for the architects of health reform, whose central aim is helping the 50 million Americans now without insurance. Much attention has been paid to the "individual mandate" in the landmark bill passed earlier this year, which has now been ruled unconstitutional by a Virginia federal court. But previous experience suggests that provision's impact on rates would be trivial. The real driver of expanded coverage is a planned extension of free health care to anybody with an income below 133% of the poverty line—or 15 million Americans, according to an estimate from the Congressional Budget Office. This entitlement is the biggest new federal giveaway of health care since the creation of Medicare and Medicaid in 1965.

...So why on earth would people camp out overnight to buy a discounted toy, while they ignore a windfall like free doctor visits for their kids?

Some of them may have their priorities wrong, but many don't. The real problem is that state governments are trying to save money by keeping eligible people off the insurance rolls. In 2007, Health Affairs reported that fully one-third of all eligible but uninsured children had been booted out of Medicaid or SCHIP for no good reason, after being enrolled in the prior year. Some states make people file yearly or twice-yearly applications in order to stay covered, with in-person interviews and demands for a birth certificate. (Imagine being asked to retake your driver's test twice every year.) Make an error on your paperwork or forget an appointment and your kid automatically loses coverage.

Why are some states so miserly? Because they have every incentive to trim the rolls. Insuring someone through Medicaid costs around $7000 per year, and in 2008, the country spent $340 billion on the program. Only about half of that money came from the federal government, with the rest draining from state coffers. (The exact proportion varies from state to state.) Because they're responsible for up to half the costs, states are given wide latitude to make their own Medicaid policies. That means places like Massachusetts and Pennsylvania are very inclusive and manage to sign up about 80 percent of eligible people for free health care, while cash-strapped states like Arizona—where an actual death panel just decided to deny organ transplants to Medicaid patients—have far more restrictive policies and enroll only half of those who are entitled to free health insurance.

It's clear why states might have worked against enrollment in the past, but according to the new law, the federal government will cover almost all the costs of people who are newly eligible for Medicaid. The states won't be on the hook for the millions of names that might soon be entered in the books, yet they're fighting the expansion of Medicaid benefits nevertheless. (Fourteen have sued to stop it.) So why are some state governments hell-bent on denying free care to needy people when it will hardly cost them a thing?

The answer lies in a little discussed provision of the law that aims to simplify enrollment into Medicaid. The law's architects realized that giving away insurance wouldn't be enough; they also wanted to force states to deal with the people who were already eligible for free care but had been squeezed out of the system.
According to the new rules, you may soon be allowed to sign up for Medicaid via the Web, without any of those repeated in-person interviews. (Some states might start enrolling people into Medicaid automatically, just like how Medicare kicks in when people start collecting Social Security checks.) That's a problem for states with low enrollment rates now. The federal government may be ready to pay for all the newly eligible people on Medicaid, but the states must cough up half the costs for all the previously eligible people who are added to the rolls under the simplified system.

Imagine what might happen in Florida. Once the welcome mat of new regulations gets rolled out, 2 million previously eligible but uninsured people could sign up for free coverage. (That would bring the state's enrollment rates in line with, say, Pennsylvania.) Because those enrollees would get only a partial federal subsidy, Florida may be forced to chip in billions of dollars for the program. That liability terrifies state legislators already coping with drastic budget shortfalls. (Of course, these changes could have been avoided if they'd taken their obligations to the poor more seriously in the past.)

Without an explicit guarantee that more of these costs will be borne by the federal government, many states will fight tooth-and-nail against Medicaid expansion.
They'll drag their feet on good-faith efforts to increase enrollment. When the dust settles, it's entirely possible that millions of Americans will remain uninsured. And then we'll talk about another round of health care reforms.
 
Michelle Malkin
May 18, 2011 12:00 A.M.

Waive Me

Hear that? It’s the escalating cry of American employers and workers trying to hold on to their health-care benefits in the age of stifling Obama health-insurance mandates: Gangway! Gangway! Save me! Waive me!

Obamacare refugees first began beating down the exit doors in October 2010. As I’ve documented since last fall, waiver-mania started with McDonald’s and Jack in the Box; spread to Dish Networks, hair-salon chain Regis Corp, and resort giant Universal Orlando; took hold among every major Big Labor organization from the AFL-CIO to the CWA to the SEIU; roped in the nationalized health-care promoters at the Robert Wood Johnson Foundation (whose board of trustees includes health-care czar Nancy Ann DeParle); and is now gripping entire states (Maine, New Hampshire, and Nevada all recently got in on the act).

The latest to catch the waive? West Coast liberals.

Yes, smack dab in the middle of House Minority Leader Nancy Pelosi’s congressional district, a cluster of San Francisco small businesses is among the latest recipients of get-out-of-Obamacare passes. As Jamie Dupree of Cox Media Group and Matthew Boyle of The Daily Caller pointed out this week, there are at least two dozen Bay Area companies — including bars, restaurants, hotels, tourist shops, real estate, and auto firms — that have secured temporary, one-year reprieves from the federal law. It’s the San Francisco Treat that voters didn’t foresee until after the bill was rammed down their throats.

Another noteworthy waiver winner: Seattle-based REI. The trendy Pacific Northwest outdoor-equipment retailer’s progressive CEO and Democratic campaign donor, Sally Jewell, appeared with President Obama in 2009 to tout White House health-care-reform initiatives. Two years later, REI snagged a waiver to protect the health benefits of a whopping 1,180 workers from the very tentacles of the big-government bureaucrats Jewell embraced at Obama’s roundtable.

To date, the U.S. Department of Health and Human Services has granted federal-health-care-law exemptions to more than 3 million American workers covered by more than 1,300 unions, companies, and insurers who had voluntarily offered low-cost health plans with annual-benefits limits. Meddling Obamacare architects outlawed those private plans — nicknamed “mini med” plans — in the name of “patients’ rights.” But without special waivers, the escapees would have been forced to hike premiums or drop insurance coverage altogether for mostly low-wage, seasonal, and part-time workers.

Among the most recent union affiliates to secure pardons from the one-size-fits-all health policy that their bosses spent hundreds of millions of dollars of worker dues lobbying for:

– Teamsters Local 485 Health and Welfare Fund in Brooklyn, N.Y.

– Detroit and Vicinity Trowel Trades Health and Welfare Fund

– Communications Workers of America (CWA) Local 1182 Security Benefits Fund

– CWA Local 1183 Health and Welfare Fund

– Bakers Union and Food Employees Labor Relations Association Health and Welfare Fund

– Service Employees International Union Healthcare Illinois Home Care and Child Care Fund

– United Food and Commercial Workers San Diego Employers Health and Welfare Trust

– Welfare Fund of the International Union of Operating Engineers Local 15, 15A, 15C, 15D AFL-CIO

– United Steelworkers Local 1-0318 Health and Welfare Trust Fund

– United Association of Journeymen and Apprentices Local 198 AFL-CIO Health and Welfare Trust

– Teamsters Local 617 Welfare Fund in Ridgefield, N.J.

– Teamsters Local 734 Welfare Fund in Chicago

– Plumbers and Steamfitters Local 60 Health and Welfare Fund

– New York State Nurses Welfare Plan for New York City Employed Registered Professional Nurses


The ultimate goal, it bears repeating, is to force a massive, revolutionary, and irreversible shift from private to public insurance designed by government-knows-best bureaucrats.

Pelosi and the Golden Ticket Administrators in Washington deny preferential treatment for waiver beneficiaries. But the stench of waivers-for-favors won’t be dispelled until and unless the Obama administration releases a full list not only of those who won exemptions, but also of those who applied and were denied.

With San Francisco businesses caught with their hands in the waiver jar, Pelosi’s office could do nothing else but pout: “It is pathetic,” said Pelosi spokesman Drew Hammill, “that there are those who would be cheering for Americans to lose their minimum health coverage or see their premiums increase for political purposes.”

It is far more pathetic to have cheered, as Pelosi did on the one-year anniversary of Obamacare, the law’s onerous benefits limits from which thousands of her own constituents have now been exempted.

Once again, the rest of America wants to know: Dude, where’s my waiver?

Granted, Michelle Malkin is a bit of a bomb throwing pundit but this is a tidy updating of one of the many farces relating to Obamacare the Affordable Health Care for America Act.

Any Obama voters, union members, Nancy Pelosi constituents or Democratic health care reform advocates here in FYM receive their waiver yet?
 
Granted, Michelle Malkin is a bit of a bomb throwing pundit

That's putting it very kindly.

But last time she wrote anything that got picked up by the right wing media it ended up to be completely false. She's not big on fact checking, and neither was any of the RWM that ran with it.

REI notoriously has one of the better healthcare plans in the country for their employees, even part time employees.
 
Some Recent Grads Face Health Care Coverage Gap : NPR

I don't know if it's in the audio of this report (I'm trying to find it), but NPR had a story this morning that 2 in 5 young adults owed some amount of medical bill debt.

So, they are graduating with tuition debt and some now have medical debt as well. This report was pointing out that he new healthcare reform act will help young adults by allowing them to use their parent's health insurance, which is often better than what they can get in college.


At what point is it too expensive to be alive? :angry:
 
From an employee benefits perspective, this thing is a mess. There are still a lot of unknowns, and employers have only slight ideas of what to expect.

It's hard to prepare for long-term change when so many things are still so unclear, and it seems unclear if it will even ever actually come to pass, with so many people making so much noise about it.

From a personal perspective, I have fairly strong feelings about the availability and affordability of health care, but from an employee benefits standpoint, there has to be a better way to go about it.

I work for a company that also offers benefits to part-time employees as well, and it sucks to realize that we very well could be penalized even though we've been "doing the right thing" for years.

Blerg.
 
Some Recent Grads Face Health Care Coverage Gap : NPR

I don't know if it's in the audio of this report (I'm trying to find it), but NPR had a story this morning that 2 in 5 young adults owed some amount of medical bill debt.

So, they are graduating with tuition debt and some now have medical debt as well. This report was pointing out that he new healthcare reform act will help young adults by allowing them to use their parent's health insurance, which is often better than what they can get in college.


At what point is it too expensive to be alive? :angry:
I am 20, so yeah. I'm too expensive to be alive. It's all the Republicans, too. My tuition has skyrocketed in the few months that the GOP has taken over my state. Natural Gas owns PA. Thanks Tom Corbett!
 
I am 20, so yeah. I'm too expensive to be alive. It's all the Republicans, too. My tuition has skyrocketed in the few months that the GOP has taken over my state. Natural Gas owns PA. Thanks Tom Corbett!

Right, we wouldn't want to blame the federal takeover of the student loan program or the federal subsidizes that have helped college tuition keep pace with health care inflation (which is also heavily subsidized by government programs) over the past decade.

Increase demand through subsidizes without increasing the supply and prices rise. Hopefully they still teach that in Econ 101.
 
we wouldn't want to blame the federal takeover of the student loan program

:rolleyes: Under the old program, the federal government guaranteed to pay the private lender back if the student defaulted. That means the government was already doing virtually all the legwork for banks who wanted into the program, the private lenders had little role except to pocket the interest as pure profit.

Keep gubmint outta my medicare!
 
Medicare: Give Coburn-Lieberman a Chance - The New Republic, June 29 (Jonathan Chait)
Tom Coburn and Joe Lieberman's bipartisan plan to cut Medicare is one of those notions whose every word ("Coburn," "Lieberman," "bipartisan," etc.) seems designed to provoke liberal antagonism. Talking Points Memo calls it "Ryan Plan 2.0." Joan McCarter and Greg Sargent are attacking it as well. I think they're making a mistake.

First, it's just not accurate to conflate this proposal with Ryancare. Paul Ryan's Medicare plan has two huge problems. First, it privatizes Medicare, fragmenting the system into an inefficient private insurance market. Second, it provides grossly and increasingly inadequate subsidies for insurance within that system. Describing that proposal as "ending Medicare" is contestable but fair. Coburn and Lieberman's proposal does neither of these things. It may not be perfect, but it's basically a standard package of trimming Medicare while leaving the basic structure in place. Here's [TIME]'s handy thumbnail description:

* Raise the Medicare eligibility age from 65 to 67, which the senators acknowledge is only feasible because the Affordable Care Act makes it easier for 65 and 66-year-olds to buy private insurance.
* Institute a single Medicare deductible of $550, ask seniors to pay coinsurance for services from 5% to 20%, and set a new annual “out-of-pocket” maximum of $7500, which will protect seniors from medical bankruptcy. (Higher income seniors will face higher “out-of-pocket” maximums, up to $22,500 for individuals earning $160-$213,000 per year.)
* Limit supplemental insurance coverage so that seniors can’t purchase Medigap policies to cover all of their out of pocket expenses. Studies show this change could reduce over-utilization without harming health.
* Stop paying hospitals for debts incurred, but not paid, by Medicare beneficiaries.
* Increase Medicare Part B premiums for all enrollees, but especially high-income earners. Increase Part D premiums for high-income earners.
* Fix the SGR (Sustainable Growth Rate) for three years. This would prevent Congress from having to constantly vote to prevent Medicare reimbursements from falling dramatically.
* Combat Medicaid Medicare fraud.
The irony here is that comparing this to Ryancare plays into Ryan's intellectual sleight of hand. Ryan argues that Medicare as it's currently structured can't continue. The only alternatives are to do nothing and watch it disappear, impose draconian bureaucratic rationing, or try his proposal. The truth is that Medicare is in trouble, and the cost-saving measures in the Affordable Care Act are an important step toward controlling health care cost inflation but probably not enough to solve the problem on their own. Over the very long run we need to build on its cost-control devices. In the medium-run, we probably need to impose some straightforward cost saving. Coburn/Lieberman is a way to do that while preserving the traditional Medicare system. It's proof that Ryan is wrong. Conflating Ryan's radical plan with standard Medicare cuts is essentially to endorse his argument from the other direction. Ryan paints his proposal as merely a way to bring Medicare's financing into line, while the most ardent critics of Coburn/Lieberman paint a plan to bring Medicare's financing into line as Ryancare. It's not only wrong, it concedes Ryan's argument for him.

Now, it's true that a bipartisan deal on Medicare will help Republicans present the Ryan plan as just a conversation starter they don't really want to, you know, happen. But everybody still knows this is what Republicans would like to pass if they actually had the power to do so, and Democrats should be able to make this case to the voters. Meanwhile, the deficit is an actual problem, and Democrats need to find politically feasible ways to help solve it. There are bright lines to draw: slashing the already-lean Medicaid program, starving the long-starved domestic discretionary budget, and failing to require any sacrifice from the affluent. "No cuts to Social Security and Medicare" is the wrong place to draw the line.
 
Nancy Pelosi is out with the predictable boilerplate liberal rejection of any proposal to rein in out-of-control entitlement spending..

"It is unfair to ask seniors to get less in benefits and wait longer to get onto Medicare – all while Republicans back tax breaks for Big Oil and corporations that ship American jobs overseas. Just like the Republican plan to end Medicare, this proposal is unacceptable, especially for struggling middle-class Americans."
 
xf9Ry.jpg



Both parties are just using the debt ceiling as a political chess piece. No one really seems to give a damn on either side in Congress. Republicans are trying to use the debt as an excuse to cut small potatoes shit to make sure the black folks stay in the inner city/tick off liberals, and Democrats are useless as always and have no plan.

Good times yall.
 
Nancy Pelosi is out with the predictable boilerplate liberal rejection of any proposal to rein in out-of-control entitlement spending..

Republicans successfully campaigned in 2010 against the $500 billion in Medicare cuts and Independent Payment Advisory Board that is specifically tasked with reducing the cost growth rate in Medicare death panels contained in the Affordable Care Act.

Which passed. A Democratic Congress and President signed it.
 
Republicans successfully campaigned in 2010 against the $500 billion in Medicare cuts and Independent Payment Advisory Board that is specifically tasked with reducing the cost growth rate in Medicare death panels contained in the Affordable Care Act.

Which passed. A Democratic Congress and President signed it.

The unconstitutional IPAB is actually scarier than any death panel.
 
Nancy Pelosi is out with the predictable boilerplate liberal rejection of any proposal to rein in out-of-control entitlement spending..

From another thread:-

INDY500 said:
So you feel a person with no insurance has a right to walk into a hospital; get lab work, physician care, medications and possibly a room and meals--for free?

Sure. Why not?

You realise the system you described is in place in many countries around the world, some poorer than the US, and ALL of which, every single one, spend less than the US on health care costs as a % of GDP.

You realise that most of these countries have higher life expectancy than the US, in spite of being, in many cases, no wealthier, and in some, significantly less so?

Have you ever considered the possibility that the reason US healthcare is dramatically more expensive than elsewhere precisely because of the ideologically based and non-rational bias against 'socialised' medical care that right wing politicians shill for and people like you vote for?
 
I have friends overseas and in canada that say they love united health care. I also have a friend here in the states that has medicare and she says that if united health care gets passed here, she's screwed. I guess whatever happens happens, Rome wasn't built in a day.
 
My son was severely sick as an infant. So sick, they couldn't treat him in the town where I live. So a private plane (air ambulance) flies my husband, my baby and I to Toronto for what I can only describe as a miracle. One of the best hospitals in the world at my fingertips. I didn't pay a penny. I love Canada's healthcare system. It isn't perfect, but I never, ever take it for granted.
 
You realise the system you described is in place in many countries around the world, some poorer than the US, and ALL of which, every single one, spend less than the US on health care costs as a % of GDP.

How viable are these systems without the direct and indirect subsidies provided by the American people? Could you spend the % of GDP you now spend on health care if not for the U.S. military providing the bulk of the defense for NATO countries?

Would you enjoy the quality of health care you now enjoy if not for the innovations and new drugs developed in the "for profit" American health care system?

American conservatives worry about the failure of American leadership in foreign policy and the looming Obamacare bill. So should you imo.
You realise that most of these countries have higher life expectancy than the US, in spite of being, in many cases, no wealthier, and in some, significantly less so?

Have you ever considered the possibility that the reason US healthcare is dramatically more expensive than elsewhere precisely because of the ideologically based and non-rational bias against 'socialised' medical care that right wing politicians shill for and people like you vote for?

Life expectancy numbers are quite misleading as an indicator of health care quality. If reflects poorly on many things when a 19 year old gang member is shot dead in the street during a drive-by shooting--- but the healthcare system isn't one of them.
 
PhilsFan said:
If the United States doesn't lead the league in foreign policy, you will all die.

And if they do only the poor will die(according to indy's thinking). Think about that as you chug your beer for July 4th, isn't that worth it?
 
since that line of Dalai Lama action figures didn't work out

gijmedic.jpg
 
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