Why the individual mandate philosophically is right/ or wrong

[xBiffx]

Yes, including malpractice insurance. According to the CBO the total, cumulative cost of all malpractice insurance and malpractice judgments totals less than 2% of US medical spending. This cost can be highly unevenly distributed by region and specialty, however. Including the costs of 'defensive medicine' the CBO estimates that capping damages would reduce health care costs by about 0.5% going forward.

That can hardly be counted as the 'biggest issue'. It's a red herring used by the extreme right in order to provide a scapegoat for the failures of private health care insurance.

Those numbers sound correct. However, what can't be scored is the damage this does to the willingness of people to enter the medical field and for those already in it, the willingness to stay in it. When living in IL, frivolous malpractice lawsuits were driving doctors from that state. There have been many initiatives to limit the ability of patients to sue their physicians. Laws were being passed to help assure that only cases with warrant were able to proceed. This, although still a small factor, is still an inconspicuous driver of healthcare costs. But it adds up to more than what the CBO numbers show.

 

[xBiffx]

The whole point of the mandate part of the law is to cut down on the number of uninsured. So you can stop saying the bill does not fix this, it's blatantly false.

It may, MAY cut down on the number of uninsured but it doesn't address the cost issue in the slightest. There will still be uninsured, some will not be able to afford it so everyone still gets to cover that cost, and even still there are some who can't get insurance today because of pre-existing but will be required to be covered. The insurance company will spread that cost around because their healthcare is going to be far greater than their share of the premiums. Plus you will have people exceeding a normal (say $1M) maximum benefit so the insurance company spreads that costs around as well. So all in all, the insured public are covering more than their share of healthcare costs, just as it is today. Obamacare fixes nothing from a cost standpoint, only moves a number from one column (uninsured) to another column (insured) on a table.

 

[Atreus21]

Actually that's what bankruptcy is for.

Well as a last resort, yes. But I doubt an entire hospital will have to declare bankruptcy because of some bad debts.

Hospitals and health care providers already do exactly this. Health care debt is one of the largest segments of the collections industry, including civil lawsuits and court enforced judgments. Hospitals already do try to collect, and in the case of failure write off the debt. I guess my confusion is that our system already works exactly like you want it to work, but there is no way that hospitals would be able to sustain that level of losses.

Then perhaps we need a way to help hospitals with that level of debt.

So again, it comes back to my original point. You need to be able to refuse care, or you need to have a mechanism to support that uncompensated care.

I agree, but to me using this as a justification for UHC is kind of like observing an excess of hats as the disease and prescribing an increase in beheadings as the cure. Well maybe not that extreme, but you get the idea.

 

[fskimospy]

Well as a last resort, yes. But I doubt an entire hospital will have to declare bankruptcy because of some bad debts.



Then perhaps we need a way to help hospitals with that level of debt.



I agree, but to me using this as a justification for UHC is kind of like observing an excess of hats as the disease and prescribing an increase in beheadings as the cure. Well maybe not that extreme, but you get the idea.

I really don't get the analogy. If we can agree that all people must be treated regardless of ability to pay, the only question becomes how to pay for it. I would think that this solution would be a favorable one to conservatives as it requires all Americans to take responsibility for their role in our medical system.

If not this, then what would you propose instead?

 

[dank69]

It may, MAY cut down on the number of uninsured but it doesn't address the cost issue in the slightest. There will still be uninsured, some will not be able to afford it so everyone still gets to cover that cost, and even still there are some who can't get insurance today because of pre-existing but will be required to be covered. The insurance company will spread that cost around because their healthcare is going to be far greater than their share of the premiums. Plus you will have people exceeding a normal (say $1M) maximum benefit so the insurance company spreads that costs around as well. So all in all, the insured public are covering more than their share of healthcare costs, just as it is today. Obamacare fixes nothing from a cost standpoint, only moves a number from one column (uninsured) to another column (insured) on a table.

But once again you ignore the added revenue from additional healthy young adults required to obtain health insurance despite the fact that they don't think they need it. These are extremely low risk people and a not very insignificant portion of Americans.

 

[xBiffx]

But once again you ignore the added revenue from additional healthy young adults required to obtain health insurance despite the fact that they don't think they need it. These are extremely low risk people and a not very insignificant portion of Americans.

So you are okay with stealing money from decent people? You agree that they don't need insurance because they are healthy and therefore will get no value/not as much from the premiums they pay? You agree that they are nothing more than a cash cow for the unhealthy expensive masses? I know this is the way our income tax system works and many agree it is already broken. So lets just break something else while we are at it, amiright? The ends justify the means I guess.

Well I knew this was the level of thinking of a liberal. Refreshing to hear you actually say it though. Guess its not called socialism for nothing. Refer to my signature as to why this is not a good thing.

One big thing with your assumption there. Its not working on a national revenue level so why would it ever work for healthcare? We are in debt because we give away/spend more money on people than we take in from the rich but somehow its gotta work in the case of healthcare, right? FFS

 

[Ausm]

1. It's not true that everyone needs to buy auto insurance. I went many years without buying auto insurance. I rode the subways or buses.

2. Driving is a privilege, not a right.

3. Living is a right, not a privilege. So, there's no valid comparison.

Fern

Everyone who drives in my State car insurance is mandatory and I don't see collective outrage of citizens protesting in the streets over it.

LOL Wut?? I believe that having healthcare for EVERYONE is a fundamental right and not for only the people who are lucky enough to have it through an employer or can possibly afford to pay for it out of pocket.

 

[Atreus21]

I really don't get the analogy.

The analogy is that the cure is worse than the disease.

If we can agree that all people must be treated regardless of ability to pay, the only question becomes how to pay for it.

First and foremost they should be expected to pay for it themselves. Failing that, measures should be taken to protect hospitals from the debt they would thus incur if it becomes too large.

I would think that this solution would be a favorable one to conservatives as it requires all Americans to take responsibility for their role in our medical system.

No, it requires all Americans to pay for products they don't necessarily need. They should be allowed to buy insurance if they wish, not forced to despite their wishes.

If not this, then what would you propose instead?

To find a way to keep hospitals from going broke due to the mountain of debt they must inevitable incur due to patients who can't possibly pay for their emergency care.

I also think hospitals should be allowed to exercise some judgment regarding what constitutes an emergency. A heart attack patient is clearly an emergency. Someone in need of a band-aid should be turned away.

 

[xBiffx]

LOL Wut?? I believe that having healthcare for EVERYONE is a fundamental right and not for only the people who are lucky enough to have it through an employer or can possibly afford to pay for it out of pocket.

I thinks is great that you believe in this. There's no disagreeing with what you believe is a right but please explain where you come up with having your beliefs imposed on others. Some people believe in certain things but they don't get to impose that belief on others. Some believe in God, others don't. So you agree that believers in God should be able to pass a law saying everyone should have God in their lives? I didn't think so.

I don't disagree with you believing in this anymore than someone believing in God, Satan, Santa, or the Easter Bunny but we are nation with guidelines that don't allow for beliefs to be imposed onto others. Believe what you want, but don't try and make others subscribe to those beliefs.

 

[woolfe9999]

Anything the government purchases with your tax money that does not directly benefit you in theory raises an even more serious ethical question. The idea that a mandate for you to directly buy something that directly benefits you poses special ethical problems not present in our system for over 200 years already is false.

 

[nageov3t]

we should solve the problem of homelessness by mandating that everyone buys a house.

 

[fskimospy]

we should solve the problem of homelessness by mandating that everyone buys a house.

Our country in effect already does this, we have shelter support for the homeless that give those without homes a place to stay (in theory at least), and we have laws against vagrancy in quite a lot of areas in the US.

 

[xBiffx]

Our country in effect already does this, we have shelter support for the homeless that give those without homes a place to stay (in theory at least), and we have laws against vagrancy in quite a lot of areas in the US.

!= buying a house.

 

[sactoking]

Yes, including malpractice insurance. According to the CBO the total, cumulative cost of all malpractice insurance and malpractice judgments totals less than 2% of US medical spending. This cost can be highly unevenly distributed by region and specialty, however. Including the costs of 'defensive medicine' the CBO estimates that capping damages would reduce health care costs by about 0.5% going forward.

That can hardly be counted as the 'biggest issue'. It's a red herring used by the extreme right in order to provide a scapegoat for the failures of private health care insurance.

Just a point: The CBO numbers grossly understate the cost of medical malpractice insurance expenditures because they do not account for risk retention groups, captive insurers, protected cells, and other pool arrangements. Most doctors do not purchase medical malpractice insurance through traditional carriers anymore.

 

[nageov3t]

Our country in effect already does this, we have shelter support for the homeless that give those without homes a place to stay (in theory at least), and we have laws against vagrancy in quite a lot of areas in the US.

wouldn't that effectively be the equivilent of the public option?

 

[fskimospy]

wouldn't that effectively be the equivilent of the public option?

No, not really. It's basically offering taxpayer subsidized housing (health insurance) for those too poor to afford their own while assessing penalties (tickets) to those who choose to go without anyway.

 

[nonlnear]

No, not really. It's basically offering taxpayer subsidized housing (health insurance) for those too poor to afford their own while assessing penalties (tickets) to those who choose to go without anyway.

Wait, homeless shelters are doing means testing? Impressive!

 

[fskimospy]

Wait, homeless shelters are doing means testing? Impressive!

No, they aren't doing means testing. Amazingly enough they are not 100% identical, but that's why I used the phrase 'in effect'. That is unless you are aware of significant numbers of people who have the capacity to obtain housing but just surf the shelters for fun?

Jesus, people.

 

[nonlnear]

Yes, you could call them Jesus people. *rimshot*

Seriously though, you are saying that it's not a perfect analogy because homeless shelters are more of a... public option? I mean, I could go stay in one tonight if I felt so inclined.

 

[fskimospy]

Yes, you could call them Jesus people. *rimshot*

Seriously though, you are saying that it's not a perfect analogy because homeless shelters are more of a... public option? I mean, I could go stay in one tonight if I felt so inclined.

Actually you can't call them Jesus people from what I wrote, the comma sort of stops that.

Homeless shelters would be much more analogous to Medicaid. If you wanted to look for an analogy for the public option that would be public/low cost housing.

 

[dank69]

So you are okay with stealing money from decent people? You agree that they don't need insurance because they are healthy and therefore will get no value/not as much from the premiums they pay? You agree that they are nothing more than a cash cow for the unhealthy expensive masses? I know this is the way our income tax system works and many agree it is already broken. So lets just break something else while we are at it, amiright? The ends justify the means I guess.

Well I knew this was the level of thinking of a liberal. Refreshing to hear you actually say it though. Guess its not called socialism for nothing. Refer to my signature as to why this is not a good thing.

Let's start with the bolded above since much of the rest of this bullshit post depends on it. No, I don't agree that they don't need insurance. I said they are low risk. Anyone can get hit by a metaphorical bus at any time. Everyone should have insurance if they are going to receive medical care by default.

One big thing with your assumption there. Its not working on a national revenue level so why would it ever work for healthcare? We are in debt because we give away/spend more money on people than we take in from the rich but somehow its gotta work in the case of healthcare, right? FFS

It was working on a national revenue level until YOUR party started fucking with it in 1980 and then really fucked it all up from 2000-2008.

 

[shadow9d9]

It should be a tax. We pay taxes for military that is given to private companies. This is no different.

 

[shadow9d9]

So you are okay with stealing money from decent people? You agree that they don't need insurance because they are healthy and therefore will get no value/not as much from the premiums they pay? You agree that they are nothing more than a cash cow for the unhealthy expensive masses? I know this is the way our income tax system works and many agree it is already broken. So lets just break something else while we are at it, amiright? The ends justify the means I guess.

Well I knew this was the level of thinking of a liberal. Refreshing to hear you actually say it though. Guess its not called socialism for nothing. Refer to my signature as to why this is not a good thing.

One big thing with your assumption there. Its not working on a national revenue level so why would it ever work for healthcare? We are in debt because we give away/spend more money on people than we take in from the rich but somehow its gotta work in the case of healthcare, right? FFS

We are in debt because we spend 40% of the entire world's military budget while having 4% of the world's population and are surrounded by 2 oceans and 2 peaceful countries.

 

[Fern]

-snip-
And Fern, I'm sorry to hear about your friend, but I have to ask, why didn't he carry disability insurance when he had a good job?

Thanks.

Disability insurance is another area that needs to be cleaned up IMO.

I've seen people get screwed when they claimed it (real low payout etc.)

But the simple answer is that it's quite expensive. For all I know, it may be that he used to have it but in this down economy he had to drop it.

Fern

 

[Fern]

The mandate is correct as long as hospitals are required to treat people without proof of insurance or ability to pay.

Simple answer: Let hospitals purchase insurance that covers them for treating poorer people with no insurance.

Fern