@NetRunner, you contradicted yourself. You said this claim was utterly and completely false: "It's been proven that government intervention in the medical industry has driven the cost of medical care up." Yet, you immediately agreed that "forcing hospitals to treat every person that comes into the hospital" increases costs.

>> ^blankfist:

I know we're all largely atheists on here, but the predominant number of hospitals tend to be created by churches. Why? Because as much as we may despise dogma, these followers do sometimes hold the belief of taking care of their fellowman. This includes people with life-threatening illnesses.

Churches can do good works. I love the things they usually have to say about social justice, even if I have a fairly skeptical view of the type of reasoning they use to conclude there's a moral obligation for it.

That's why I want the nation I live in to set up a system that formalizes that universal moral obligation to provide care for those who need it.

It's why I'm happy the nation I live in has gotten 90% of the way there.

>> ^blankfist:

It's been proven that government intervention in the medical industry has driven the cost of medical care up.

Utterly and completely false. Virtually every country everywhere has a much higher degree of government intervention into the health care market, and literally every single country in the world's health care costs are less than ours per capita.

The kind of intervention matters a lot.

>> ^blankfist:
By forcing hospitals to treat every person that comes into the hospital, people tend to use it as a welfare clinic and come in with hangnails and common colds. They can then refuse to pay for the service which drives the costs up. That's fact.

Increases costs...but also increases the number of people alive at the end of the day, no?

Let's look at this situation another way, and see if you don't understand it better. Should paying patients have a right to choose between paying full price, and getting a discount on their treatment, so long as they give the doctor permission to let a poor person die?

Of course, the smart thing to do here would be for everyone to have insurance, and feel free to see doctors for a small co-pay when they first get sick and get a simple, cheap treatment rather than wait (because they can't afford an appointment with the doctor) until they're at death's door and need radical and costly treatment to save their life.

>> ^blankfist:
If you ordered food at a restaurant, then refused to pay, would it be fair for the government to stop that restaurant from refusing service to you?


If food cost thousands of dollars, and could only be prepared by a small number of highly-educated people, and someone came into a restaurant already unconscious and minutes away from death...yeah, I think it'd be fair to say that restaurateurs have a legal responsibility to save a life first, and haggle over payment later.

>> ^NetRunner:

But here's the thing, unless you're prepared to tell doctors not to treat people with life-threatening illnesses if they can't immediately pay for their own care, you're going to wind up having your tax dollars going to cover the care of people who can't pay their medical bills when they have heart attacks or diabetic shocks (or end-stage lung cancer). Alternatively you're just going to make all healthcare more expensive so providers can cover losses.


Speculation and leading arguments. I'm not prepared to tell doctors anything, and neither should any one of us. I know we're all largely atheists on here, but the predominant number of hospitals tend to be created by churches. Why? Because as much as we may despise dogma, these followers do sometimes hold the belief of taking care of their fellowman. This includes people with life-threatening illnesses.

In fact, currently, hospices are free. When my grandmother passed away recently they didn't charge her a penny for their amazing services. They exist on charitable donations as far as I know.

It's been proven that government intervention in the medical industry has driven the cost of medical care up. By forcing hospitals to treat every person that comes into the hospital, people tend to use it as a welfare clinic and come in with hangnails and common colds. They can then refuse to pay for the service which drives the costs up. That's fact.

If you ordered food at a restaurant, then refused to pay, would it be fair for the government to stop that restaurant from refusing service to you?

hmm.

On one hand, I find the production quality of these bids for our sympathies distasteful and disingenuous in light of the true Human Suffering Event they represent; both with the utter commonness of such stories one encounters in hospital [and this is rather run-of-the-mill, imho] and the fact that most every person could claim an 'equal' Human Suffering Event or two in their life, I ask cynically "what makes you think your suffering is so special" and immediately suspect this is just a ploy to 'get rich' from donations [sure, the tragedy may be real, but do they REALLY need my paypal dollar more than the Sudanese, or me for that matter].

On the other hand, I got to get myself a production and marketing team...

<edit>
I guess what bugs me about this is the generic portrayal of this story. This could be ANY family with a young child in need of a transplant [or serious medical care, for that matter], and everyone could just as easily be actors. What makes this a story about Penny, specifically, or the life-changing effects of such a transplant on the Gormans? It comes off feeling like a PSA.

If this video is to garner charities, then one would like to get some sort of hook into the lives of the receiving family. This is gereric suffering, by what we see here, and nothing about Penny other than she is adorable...but so's my kid.

@chilaxe to point #1, I would agree, I would like a society where rationalists would have a larger influence on society, but I'm not sold on the idea that we have an effective way to discern the rational, moral and wise from everyone else. Even if we did, I'm not comfortable with the idea of giving such hypothetical supermen some sort of inviolable authority over mere mortals like myself -- the kind of power that would flow from a strict libertarian view of property rights and contract enforcement.

To point #2, I agree that humans should not only merely have "at least some responsibility for their actions," but a tremendous amount of responsibility for their actions. I think the point Rawls is making is that whether you become rich or poor depends on so many arbitrary factors that you can't really make a claim that you morally deserve your precise economic status, because very little about how much you make for a living has to do with choices you actually make yourself.

I'd also add that it's not like failure in a market economy is some sort of moral failing that justifies the punishment of poverty. Yes, it's important to have feedback in the system for failure, but I think once you start stripping away basic necessities like food, shelter, clothing, medical care -- things it would be considered unconscionable to deprive prisoners of -- you're crossing into a territory where you've lost sight of people's fundamental human rights.

If brown folks bother you, just say it.

The position is one of law enforcement. The only relevant factor is 'legal' or 'illegal'. It is pretty weak when the only argument is to toss the race card and ignore the germaine issue of law enforcement.

...tyrannical overreach of government, but now assert ... this Arizona law that empowers the police to shake down anyone for documentation on mere suspicion, and arrest people who can't prove their citizenship on the spot.

The opposition to health care has always been discussed as the tyrannical overreach of the FEDERAL government. I've always stated that the state, county, and municipal level is where government should primarily be vested with Federal authority being limited to oversight & regulation. I know the left generally distrusts an approach that isn't centrally planned though. Let a STATE decide what is best for itself? The horror!

That's the hardest thing about this bill is that it seems to be doing some good, when in reality it is not

I tend to agree, but for different reasons. I can only shake my head at the left's attempt to paint this as a race issue. That seems like unfounded race baiting based only on presumption. But on the other hand, Arizona's law is a bandaid on a sword stroke. There are a lot of illegals of all shapes & sizes and they exist all over the country. Even if Arizona manages to clamp down, the illegals will just go somewhere else. The US has an OK - if cumbersome - student, temp worker, and immigration program. What we don't have is an effective system to deport illegals when they are identified.

The first step is to cut off the influx. Build the border wall. Walls work. Walls are effective. Ask the Huns, East Germans, and Palestinians. The US built the Panama Canal. Building an effective border wall is child's play by comparison.

Next, we have to require citizenship ID in order to obtain essential services. Renting or owning property, utilities, phones, education, bank accounts, cash by wire, employment, credit cards, driver permits, insurance, medical care and other key functions should all require ID. If you cannot supply the ID, then you get flagged for review and if you are an illegal you get deported. And yes, any time a cop pulls you over or picks you up - no matter who you are - you should be identified. If the police find they have an illegal, then the illegal gets remanded and deported.

I see no racism or malice in the sensible enforcement of immigration policy. Illegals are - by definition - illegal. I don't get why there are people who think that enforcing the law is racist. The accusation of racism seems to be a politically motivated red herring to me.

The kids survived even though the military tried to delay their medical care and send them to ghetto hospitals.

http://www.youtube.com/watch?v=BflAj2txMVQ


Also, 39 minutes of raw video including the Hellfire missile attacks.

http://www.youtube.com/watch?v=is9sxRfU-ik

Last month, my dog woke up abruptly, and confused my lower lip for a chew toy. I needed 12 stitches.

The ER doctors asked if I had any allergies, then Rx'd me an antibiotic I was allergic to. Thankfully, I asked my pharmacist some questions that might have saved my life. The dose they gave me at the ER caused me to itch violently (especially around my lymph nodes).

And I get to pay over a grand for the so-called "best medical care in the world." What a fucking joke.

This doctor is an asshole. Isn't this what the Republicans were threatening would happen? Except they thought that Obama supporters would be withholding care from registered Republicans...

Fucking stupid. You'd have to be to vote Republican or believe the lies that Fox spews.

Here's something Lee Atwater, the architect of the Ronald Reagan and George H.W. Bush campaigns and mentor to Karl Rove, said in 1981:

You start out in 1954 by saying, “Nigger, nigger, nigger.” By 1968 you can't say “nigger” — that hurts you. Backfires. So you say stuff like forced busing, states' rights and all that stuff. You're getting so abstract now [that] you're talking about cutting taxes, and all these things you're talking about are totally economic things and a byproduct of them is [that] blacks get hurt worse than whites. And subconsciously maybe that is part of it. I'm not saying that. But I'm saying that if it is getting that abstract, and that coded, that we are doing away with the racial problem one way or the other. You follow me — because obviously sitting around saying, “We want to cut this,” is much more abstract than even the busing thing, and a hell of a lot more abstract than “Nigger, nigger.”

The idea is to package conservative ideas in such a way to attract racists, and provide them with a cover story so they have plausible deniability. In other words, so people like Southern Avenger here can claim "all they're doing is taking a principled stand based on their well-reasoned philosophy", even if they seem to be tolerating outrageously racist commentary and signage within their midst, and espousing a policy set that is generally condoned by racists due to its negative impact on non-whites.

These days it's less about racism per se, and more of a generalized form of xenophobia. It's the fear of people you don't know, don't understand, and who you don't want to have to care about or feel responsible for. It's why attempts to formally establish a legal responsibility to others (strangers!) are seen as intolerably intrusive.

Personally I think a lot of the rhetoric today is about dehumanizing the poor. It's often an expression of the belief that people who're poor have individually made some sort of choice that directly warrants things like losing their house, not having money for food, being unable to pay for medical care, etc. People who want on the government dime are all lazy leeches who're dragging all of society down, and if we give them help, they'll just stop trying to be productive, and try to leech more.

That started with racism, but I think just like the rhetoric, the emotional core got a lot more abstract -- it's not about demonizing black and brown people anymore, it's more about demonizing anyone who's different, so that the idea of having to take responsibility for them seems tyrannical.

I know that there's a huge percentage of moderately conservative people who don't buy into that emotional core, and want conservative-ish things done for pragmatic reasons. There's also a group of people who are True Believers, and think that the conservative ideology is morally superior to the alternatives, or that a libertarian policy set would benefit everyone greatly, even (especially?) the poor.

Those guys I like, and truly hope they find a way to purge the racists from their political organizations (i.e. the Tea Parties and the Republican party). That is, assuming they cool off on the calls for political violence (but that's a whole other conversation).

Building on what dft said, charges of racism wouldn't really stick if you guys stopped responded to it by saying "we condemn what you're talking about, and we'll take steps to ensure it doesn't happen again because racism won't be tolerated in our movement", instead of always saying "there's no racism here, and you're a racist for calling me a racist, racist!"

>> ^NetRunner:

There are also caps on how much of your income the insurer is allowed to ask you to put up in terms of deductibles and copays, and the insurers are required to spend 80-85% of every dollar they collect in premiums on medical care for their customers.


I'm still concerned about the flimsiness of the medical loss ratio. Unless the bill clearly defines what constitutes medical care, it's not very meaningful. As an extreme example, public service announcements could be claimed as part of medical care, as a form of education...while in actuality being more of a commercial. Don't laugh, I've seen at least one class-action lawsuit get settled such that SW Bell was allowed to "refund" the victims by offering them free services (like call-waiting and forwarding) for 2 months, which exactly duplicated what they did several times previously as an ad campaign.

Unless there are very strict watchdogs, the insurance companies are going to run wild with this. And even with watchdogs, it really doesn't do anything to slow down prices. If anything, it gives them incentive to raise rates and pay providers more, just to increase the actual value of their 20%.

@rougy, I'm generally going by this for detail on the bill. That's the original Senate bill, the reconciliation fix will alter specific percentages, dollar amounts, and some of the fine details, but for the most part that's the bill.

There are two main subsidies for people under 400% of FPL. One subsidy is for premiums, and is set up as a maximum percentage of your income you will have to pay for insurance premiums. The final bill has a scale that goes from 2% at or below 133% of FPL, to 9.5% at 400% of FPL. Insurance still sets its own prices for insurance plans, which may cost more than that "cap" -- if it does, the subsidy covers the cost of your premium above that cap.

The other one is a little more complex, meant to offset out of pocket costs. It's probably best explained by example.

If you're an individual making $14,500, and you bought a plan that expects you to pay 30% of medical costs out of pocket. According to the subsidy, you should only have to pay 10%. This subsidy pays for the difference between what the insurance company expects you to pay out of pocket, and what the subsidy says you should pay out of pocket.

In both cases, the insurance company collects the amount of money they expected to get from it. The government is making up the difference between these "caps" and what the insurance company charges.

There's a lot of stuff aimed at getting insurance companies to bring down prices, but because everyone's afraid of teh socialisms, there are no prices directly set by the government, nor are there prices negotiated by government on the behalf of the people.

The closest we come to that is the requirement that insurance companies spend at least 80% of the money they collect from premiums on medical care (i.e. a minimum "medical loss" ratio).

Mostly the cost-cutters are about changing incentive structures, and encouraging competition via the exchanges.

I'd be happier with a public option and/or a Medicare buy-in to let us at least put these market-loving reforms against some good old fashioned European socialism and see which one really is more popular, but for now this is a huge step in the right direction.

>> ^NetRunner:

>> ^swedishfriend:
How are insurers going to survive with premiums capped at 1/10th or 1/20th of what they charge now? Does anyone here know if there will be regulations as to what the insurers have to cover and how high their deductibles can be?

Insurers aren't eating the cost, that "cap" is actually how they're defining the government subsidy. In other words, insurers charge rate X, people receiving the subsidy pay as much of the premium as possible, up to the "cap", and the government picks up the rest of the tab, so that the insurer gets the full X.
There are also caps on how much of your income the insurer is allowed to ask you to put up in terms of deductibles and copays, and the insurers are required to spend 80-85% of every dollar they collect in premiums on medical care for their customers.


Got a source on that?

Doesn't the cap on how much of our income the insurer is allowed to ask for have something to do with a national average?

>> ^swedishfriend:
How are insurers going to survive with premiums capped at 1/10th or 1/20th of what they charge now? Does anyone here know if there will be regulations as to what the insurers have to cover and how high their deductibles can be?


Insurers aren't eating the cost, that "cap" is actually how they're defining the government subsidy. In other words, insurers charge rate X, people receiving the subsidy pay as much of the premium as possible, up to the "cap", and the government picks up the rest of the tab, so that the insurer gets the full X.

There are also caps on how much of your income the insurer is allowed to ask you to put up in terms of deductibles and copays, and the insurers are required to spend 80-85% of every dollar they collect in premiums on medical care for their customers.

Most importantly, I wasn't suggesting that the current setup is in any way acceptable, only that what @ghark alluded to wasn't accurate.

Exactly what sort of life-saving surgery can be done at the GP's office? Or were you just trying to change the topic? Argumentum ad misericordiam.

>> ^Stormsinger:
Sure, they'll give you the surgery, if you survive the delays in getting around to it. And you're responsible for a bill that you have absolutely no way to pay. Then guess what, you get to declare bankruptcy.
And that's not even beginning to ask -why- we want the hospital to be supplying medical care that -could- have been handled for a tenth the cost by a GP at his office. But the GP won't see anyone who doesn't have either insurance or cash...and if he does, the pharmacy sure as hell isn't going to give you your meds unless you can pay.
So we get tens of thousands of people dying each year because they don't have insurance and can't afford care. But that's okay, because hospitals are required to treat them.
Every other industrialized country in the world can do it...but the richest one is too stupid or too incompetent to provide even minimal health care to all its citizens. It blows my mind that people can be so pessimistic about our country.

>> ^xxovercastxx:
That's not actually legal in the US. If you need treatment, a procedure, surgery or whatever, then the hospital cannot turn you away whether you can pay or not. Don't believe everything you hear on CSPAN.


Sure, they'll give you the surgery, if you survive the delays in getting around to it. And you're responsible for a bill that you have absolutely no way to pay. Then guess what, you get to declare bankruptcy.

And that's not even beginning to ask -why- we want the hospital to be supplying medical care that -could- have been handled for a tenth the cost by a GP at his office. But the GP won't see anyone who doesn't have either insurance or cash...and if he does, the pharmacy sure as hell isn't going to give you your meds unless you can pay.

So we get tens of thousands of people dying each year because they don't have insurance and can't afford care. But that's okay, because hospitals are required to treat them.

Every other industrialized country in the world can do it...but the richest one is too stupid or too incompetent to provide even minimal health care to all its citizens. It blows my mind that people can be so pessimistic about our country.