ACA (a.k.a. Obamacare) Upheld

[sportage]

It's true, Romney raised 4mill the day after the decision from his supporters.
Both of them gave 2 mill each.

 

[lopri]

I believe Obama's already been issuing ACA waivers to his donors, I don't see why Romney (or the next Republican President down the line) couldn't issue waivers to other companies or instruct the IRS not to pursue people who aren't paying the ACA tax.

If you are going to lie then at least be a good lier. How large a donation per how big of a penalty are you estimating?

You're wrong. I'm a conservative and I have posted ideas before, rather detailed and with links. I will not go to that length again. Nor would I have responded if you had said "GOP".

My proposal is drawn from the medical profession itself and based, at least partially, upon studies carried out by the New England Journal of Medicine. Briefly, they found that identical patients with identical medical conditions received hugely differing amounts of care - differing by 6 figure $ amounts. There was no explanation other than unnecessary procedures arising from a lack of standards for medical care. Fix this lack of medical care standards and you fix the real problem - the high cost of the medical care itself.

Fern

I admire you and wouldn't mind reading your idea if you provide a link. Said that, don't you think you should persuade your side first before you attempt to persuade the liberals? (I say this as an ex-conservative)

Justice Scalia made his position perfectly clear during oral argument: Let them die.

Yes, that's what he said about those without insurance or those who are unfortunate or perhaps free-riding, and that's what the libertarian scholars essentially advocate, without the courage and honesty of Scalia. (Note: These scholars often sneak in the virtue of organ markets in health care discussions. Also, Scalia is NOT a libertarian but a partisan.) You may have to reason with their incoherency first before talking about any reform with the liberals.

Edit: I am talking about the libertarian scholars who injected this action/inaction theory into the Commerce Clause during the ACA litigation. Not every libertarian has the same ideas.

 

[OneOfTheseDays]

Conservatives on here are too scared to admit that they really don't have an answer for the uninsured. Or rather their answer is to simply let them die. They literally have no answer to the healthcare problems facing this country.

Fuck you, I got mine. This is all you need to know about Republicans and healthcare. Truly sickening individuals that claim to be followers of Christ.

 

[michal1980]

Conservatives on here are too scared to admit that they really don't have an answer for the uninsured. Or rather their answer is to simply let them die. They literally have no answer to the healthcare problems facing this country.

Fuck you, I got mine. This is all you need to know about Republicans and healthcare. Truly sickening individuals that claim to be followers of Christ.

I'd rather have no answer. They wrong answers.

And yes, some will die. Lifes not fair.

 

[nehalem256]

Conservatives on here are too scared to admit that they really don't have an answer for the uninsured. Or rather their answer is to simply let them die. They literally have no answer to the healthcare problems facing this country.

Fuck you, I got mine. This is all you need to know about Republicans and healthcare. Truly sickening individuals that claim to be followers of Christ.

And the Democrat solution is the same one they used for AIG billions in government bail outs.

Neither party want to address the root cause which is the high cost of health care.

 

[Phokus]

I'd rather have no answer. They wrong answers.

And yes, some will die. Lifes not fair.

Is that the compassionate conservativism i've heard so much about?

Edit: Funny how a couple of ATPNers were pissed at me over this comment when it's so accurate:

"Ugh, why can't poor people just die already" - Conservatives

I know what conservativism means more than the self proclaimed conservatives on this board.

 

[Jhhnn]

Yes. Democrats crafted the legislation unilaterally behind closed doors. Obamacare passed along party lines especially in the Senate. The Democrats won this political fight hands down.

I think it's important to recognize that Repub leaders set out to make HCR Obama's Waterloo, even said as much. Within that framework, whatever they suggested as amendments & features of new legislation were intended as poison pills.

I mean, really. they had no intention of allowing Obama any victories at all, even ones where they could claim partial credit. They offered Dems no choice but to craft legislation w/o their input, if there were to be any meaningful legislation at all.

They lost, and from a historical perspective, they lost big. Frum called it at the time, and the SCOTUS decision screws down the lid of the coffin even tighter-

http://www.frumforum.com/waterloo/

 

[Svnla]

Neither party want to address the root cause which is the high cost of health care.

This.

Just like ILLEGAL immigration, both parties yell out slogans and create some feel good legislations/acts but do nothing to stop it.

 

[feralkid]

And the Democrat solution is the same one they used for AIG billions in government bail outs.

Neither party want to address the root cause which is the high cost of health care.

Wrong.

High cost is a symptom of a messed up system.

 

[Svnla]

Not sure if anyone posted this already or not but 80% of healthcare cost is consumed by 20% of population = http://www.politifact.com/oregon/st...0-percent-population-really-use-80-health-ca/

and http://www.huffingtonpost.com/lester-feder/whining-americans-choose_b_113767.html


and 5% use 50% of healthcare resources = http://www.usatoday.com/news/washington/story/2012-01-11/health-care-costs-11/52505562/1

•Sixty percent were women
•Forty percent were 65 or older.
•Only 3% were ages 18 to 29.
•Eighty percent were white.
•Only 2% were Asian.

 

[nehalem256]

Not sure if anyone posted this already or not but 80% of healthcare cost is consumed by 20% of population = http://www.politifact.com/oregon/st...0-percent-population-really-use-80-health-ca/

and http://www.huffingtonpost.com/lester-feder/whining-americans-choose_b_113767.html


and 5% use 50% of healthcare resources = http://www.usatoday.com/news/washington/story/2012-01-11/health-care-costs-11/52505562/1

Sixty percent were women

Funny how liberals do not mention that men only recieve 66 cents in health care spending for every dollar spent on women

And now thanks to Obamacare are required to spend the same amount for insurance.

 

[munkus]

In the private sector, Ponzi schemes are illegal. In the government, they're standard operating procedure.

 

[Incorruptible]

The likelihood of Iran being attacked if Obama gets 4 more years is MUCH lower than if Romney gets elected. Nice partisan hackery.

No it isn't, barack husein obama serves corporate interests and AIPAC, its just the media defend him

 

[fskimospy]

In the private sector, Ponzi schemes are illegal. In the government, they're standard operating procedure.

No they aren't. Anyone who says Social Security or Medicare is a Ponzi scheme is an idiot. Ponzi schemes are a form of fraud that relies upon deception. Social Security and Medicare are entirely upfront with how they operate.

Think for yourselves, people.

 

[Jhhnn]

Not sure if anyone posted this already or not but 80% of healthcare cost is consumed by 20% of population = http://www.politifact.com/oregon/st...0-percent-population-really-use-80-health-ca/

and http://www.huffingtonpost.com/lester-feder/whining-americans-choose_b_113767.html


and 5% use 50% of healthcare resources = http://www.usatoday.com/news/washington/story/2012-01-11/health-care-costs-11/52505562/1

When you just take a snapshot of this particular point in time, that's probably true. It doesn't mean that the same people who are high consumers now have been that way their whole lives, or that they will be for the rest of their lives. Obviously, some people need more services than others if they're to survive, particularly those with birth defects, etc.

As people age, they often need more care, often end up with "pre-existing" conditions, unless they just drop dead out of the blue or are killed in an accident. Even people who've paid into the healthcare system their whole life end up uninsured because of employment churn & the rules allowing insurers to deny coverage for what's already wrong with them. 40 years of paying premiums & copays? Too bad, chumps- your heart condition isn't covered, nor is diabetes, that bad knee, or any other malady you had before you joined his particular plan. Suck it up, bend over & take it like a man.

People who are badly hurt in accidents of any sort are very high consumers of healthcare, too, if only for a relatively short while. That skews such observations, as well.

The one thing that universal care does that private insurance simply doesn't is to view care over the whole lifetimes of the participants. It's not a question of "what have you done for me lately?" at all, which is the basis of private insurance. We get no credit for past or future contributions to the profit margins of private insurers, at all. With universal care, that matters, it's all figured in actuarially.

We're also very much in denial of the fact that everybody dies, and that there are some diagnoses that are basically 100% fatal, regardless of the care provided. If you're uninsured, very little care is given other than palliative. If you have really good insurance, providers will spend a fortune on tests, specialists, treatments, meds & so forth that they know going in have a snowball's chance in hell of extending life to any significant degree. It's quite common for consumption of healthcare services to spike enormously in what really are end of life scenarios... it's a goldmine for providers.

 

[Zebo]

Terrible decision that will break us once and for all. Would have much preferred a modeling after countries like S Korea or Taiwan single payer system and this could have a serious deleterious effect to ever achieving true non job attached UHC in long run. Once states and Fed go broke, the right will say "see we tried insuring everyone and look at bankruptcy it caused"

 

[Zebo]

And the Democrat solution is the same one they used for AIG billions in government bail outs.

Neither party want to address the root cause which is the high cost of health care.

This. And it's about to get a lot worse (supply and demand). If I'm a orthopedic surgeon and 50 ppl now want surgery where as before only 25 wanted it I'm jacking my prices. It's only like first rule of business that when you have more business than you can handle, raise prices until you are satisfied with lvl of work flow. This supply and demand curve is also why controlling costs on necessary items like medical care is done in every country that has UHC.

But our congress is bought and paid for by HC lobby and insurance (among others) so no sane good for nation proposal will ever be done.

 

[lopri]

Terrible decision that will break us once and for all. Would have much preferred a modeling after countries like S Korea or Taiwan single payer system and this could have a serious deleterious effect to ever achieving true non job attached UHC in long run. Once states and Fed go broke, the right will say "see we tried insuring everyone and look at bankruptcy it caused"

What makes you say that? I am curious because I grew up in South Korea. Their system has its own virtue/vice but I highly doubt it will work in the U.S., and I don't believe it is desirable, either.

 

[Fern]

But the penalty isn't incurred until after the regular tax is paid.
-snip-
The penalty for defying the mandate will not be calculated and applied until the annual return is filed.

It seems to me the (regular) tax and penalty will be calculated and assessed simultaneously.

It is only upon receipt of the tax return that the IRS can calculate and assess taxes, regular or penalty. (In the absence of filing they can calculate and assess, but that is not relevant here.)

I have not read the ACA, but my reading of Robert's opinion suggests the penalty will calculated on the 1040, just as regular tax is. Is this not the case?

It seems to me our difference is that I am seeing the penalty as a tax, as SCOTUS has ruled, and you are seeing it as a penalty. Normal income tax penalties are based upon assessed tax (less payments) and therefore cannot be calculated and assessed simultaneously with the (income) tax. The one must follow the other.

I am anticipating that this ACA penalty will be calculated like any other element in arriving at "total tax" since it is not based in your tax amount. Please see a 2011 form 1040, page 2, line 61.

If the IRS instead creates a new line below line 61, such as adding a line 78 (below estimated tax penalty) than I can see it being assessed separately and agree with your understanding. However, doing so will essentially condemn Robert's decision that this is a tax. It will be clearly reflected as something other than a tax. It will be no more a tax than the Presidential Election Campaign voluntary contribution one can make with the tax return.

Also if the IRS puts it anywhere above line 76 ("Amount You Owe") in the absence of further rules the underpayment cannot be attributed directly to the lack of payment for the ACA penalty. When you are found to owe money on line 76 the IRS does not chose to point to some line item above that and say on their notice that "this is what your deficiency is attributable to".

I am not saying you are incorrect, I'm saying we need some more rules to clarify this.

Fern

 

[CaptainGoodnight]

I was speaking about financial problem of Medicare, not the effectiness/efficiency. More Problems (cost wise) Than Solutions in Medicare Report (from Washington Post) = http://www.washingtonpost.com/wp-dyn/content/article/2009/06/15/AR2009061501545.html

and LATimes = http://articles.latimes.com/2011/may/14/opinion/la-ed-socialsecurity-20110514

Preventive measures are good, no doubt. But how preventive measures will help with increasing cost to care for ten of millions of overweight/obese new enrollees with many pre-existing dieases (and I am pretty sure those folks are not well to do, therefore, would not be able contribute much financially to the system)?

What I am trying to say is I am still not clear of how the cost would go down (compare to now) if you add ten of millions of the poor (they would not be able to contribute much financially by themselves) that are in bad shape already to the system and by having preventive measures.

Preventive care does not reduce overall medical costs. To the individual yes, but to the system no. I'm not saying not to do preventive care, but to bill it as a cost saving measure is clearly false.

 

[Fenixgoon]

No they aren't. Anyone who says Social Security or Medicare is a Ponzi scheme is an idiot. Ponzi schemes are a form of fraud that relies upon deception. Social Security and Medicare are entirely upfront with how they operate.

Think for yourselves, people.

it's not whether it's deceiving or not. it's the fact that a dwindling tax base is being asked to support an increasingly larger pool of funding, and eventually that system will not be able to pay out its full returns, i.e. the system goes "bankrupt" (yes i know not truly bankrupt, but try telling any lender that you can only pay them 80% of your payment this month and see what happens...)

 

[Incorruptible]

No they aren't. Anyone who says Social Security or Medicare is a Ponzi scheme is an idiot. Ponzi schemes are a form of fraud that relies upon deception. Social Security and Medicare are entirely upfront with how they operate.

Think for yourselves, people.

Social security will collapse which is a good thing, too many people are stealing taxes from the rich. SS is a ponzi scheme or whatever you want to call it, it will collapse

 

[fskimospy]

it's not whether it's deceiving or not. it's the fact that a dwindling tax base is being asked to support an increasingly larger pool of funding, and eventually that system will not be able to pay out its full returns, i.e. the system goes "bankrupt" (yes i know not truly bankrupt, but try telling any lender that you can only pay them 80% of your payment this month and see what happens...)

It really is whether or not it's deceiving. A Ponzi scheme is fraud, Social Security is not. Ponzi schemes are inherently self destructing while Social Security is simply an issue of demographics. If the ratio of the elderly to the taxpaying were to change (with another baby boom or whatever), then things would in fact go the opposite direction in terms of solvency.

As for its future, Social Security will be fine. There need to be adjustments made for life expectancy and other things, but it's hardly an insurmountable problem for such a valuable program.

 

[lopri]

Just for fun, I dug up what Scalia had to say about action/inaction circa 1990:

The second asserted distinction -- suggested by the recent cases canvassed by the Court concerning the right to refuse treatment, relies on the dichotomy between action and inaction. Suicide, it is said, consists of an affirmative act to end one's life; refusing treatment is not an affirmative act "causing" death, but merely a passive acceptance of the natural process of dying. I readily acknowledge that the distinction between action and inaction has some bearing upon the legislative judgment of what ought to be prevented as suicide -- though even there it would seem to me unreasonable to draw the line precisely between action and inaction, rather than between various forms of inaction. It would not make much sense to say that one may not kill oneself by walking into the sea, but may sit on the beach until submerged by the incoming tide; or that one may not intentionally lock oneself into a cold storage locker, but may refrain from coming indoors when the temperature drops below freezing. Even as a legislative matter, in other words, the intelligent line does not fall between action and inaction, but between those forms of inaction that consist of abstaining from "ordinary" care and those that consist of abstaining from "excessive" or "heroic" measures. Unlike action vs. inaction, that is not a line to be discerned by logic or legal analysis, and we should not pretend that it is.

But to return to the principal point for present purposes: the irrelevance of the action-inaction distinction. Starving oneself to death is no different from putting a gun to one's temple as far as the common law definition of suicide is concerned; the cause of death in both cases is the suicide's conscious decision to put an end to his own existence. Of course, the common law rejected the action-inaction distinction in other contexts involving the taking of human life as well. In the prosecution of a parent for the starvation death of her infant, it was no defense that the infant's death was "caused" by no action of the parent, but by the natural process of starvation, or by the infant's natural inability to provide for itself.. A physician, moreover, could be criminally liable for failure to provide care that could have extended the patient's life, even if death was immediately caused by the underlying disease that the physician failed to treat. (Emphasis added, internal quotations omitted)

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0497_0261_ZC1.html

Oh how the times have changed.

P.S. On a second reading, the joint dissent (by Scalia, Kennedy, Thomas, and Alito) is absolutely crazy.

 

[lopri]

For the record, I don't believe the times have changed for Scalia. He will go right back to whichever rationale that satisfies his desired (i.e. partisan) results.