Affordable Health Care Law under review by SCOTUS

[GwynnInTheHall]

no he wasnt. Forgoing a new iphone is just part of saving for health insurance.

OK IF that's what he meant (to which I disagree) THAT'S what he should have said--something to the effect of--streamline your life and if you can do that we'll provide insurance that you can afford.

It's not unreasonable to ask everyone to do their part, it's douchey to imply people can't afford something because they life outside their means. The FACT is, they couldn't afford it if the had NO phone. And that's the real issue here.

[GwynnInTheHall]

Pretty soon - cellphones will be a "right"

Now you're just being a D Bag (see what I did there?)

[Sour Masher]

Something that many seem to be missing about Republicans shifting focus toward "choice" and tax credits and free markets is the grouping together of high risk/high costs patients into pools. This process will do two things:

1. It will likely reduce costs of insurance for the majority of relatively healthy, relatively young, relatively low risk patients.

2. It will greatly increase costs of insurance for those who need it most, namely those with chronic, expensive conditions. These costs increases would be so dramatic that many people with expensive health care needs would not be able to afford coverage, no matter how many cellphones they give up--the costs would simply be impossible to cover even if their entire paychecks went to them.

I think in debating this, we need to be clear about both points, and honest about what we think is right regarding them. The two sides to this debate are

1. Do we want a system that forces society as a whole to to share the costs of health insurance somewhat evenly, even if that means many healthy people who don't use their insurance much or at all will pay a good chunk of money for it. Doing that will also mean that all people will have the opportunity to get the medical care they need to live and to minimize suffering.

2. Do we want a system where free markets will bring health care costs down for the majority of Americans, but which will leave many Americans uninsured or with limited insurance and unable to have access to necessary medical treatments, which essentially condemns them to suffering or early death, and/or their families to financial ruin trying to stave of that suffering and early death.

It comes down to where we want to save the majority money, or we want to ensure that the minority get what some might consider a basic human right, and part of the social contract we all agree to within a society--medical treatment.

[Pogues]

Okay, so long as we are not talking about chickens and house calls.

I believe you said doctors should not be required to treat people they don't want to treat, or to treat people who cannot pay. It is not an unusual concept. Lawyers have to do it all the time. Lawyers get appointed to handle cases pro bono in both criminal court and in civil court. Sometimes there a nominal fees, sometimes not. The rational is that by becoming part of the profession you owe back to duty to serve. Sometimes that means representing those who cannot afford representation. Bear in mind, now, that we're talking about scummy lawyers here, not saintly doctors. It seems they would be happy to minister to the needy.

Besides, I don't think anyone said anything about doctors working for free. The ACA never required them to work for free. Insurance companies ask doctors to cut their bills all the time. I had a procedure recently that cost around $1200. It was insured. My part was around a hundred dollars. The insurance company paid around $250. That was all. That was the deal they had with the doctor. If you went in without insurance, you would have to pay the whole $1200. And yes, if you had a health care savings account instead of health insurance, you would have paid the whole $1200.

I don't believe that is true at all. Doctors charge less when a patient does not have insurance. A visit to the primary doctor with insurance, priced at $125 when you have insurance which might get chopped down with some agreement. But on an EOB it's $125. Go without insurance? Get charged $60.

It's so prevalent that there are people who go without insurance, or just with catastrophic insurance, and shop around for the best prices. With the continued rising costs in health insurance, many others will start moving in that same direction. Health insurance has made us lazy, and we are being taken advantage of because of this. We'll shop around for the best price for a TV, but we will happily pay our $25 co-pay no matter if they are the best deal in town or not.

[cardboardbox]

OK IF that's what he meant (to which I disagree) THAT'S what he should have said--something to the effect of--streamline your life and if you can do that we'll provide insurance that you can afford.

It's not unreasonable to ask everyone to do their part,

stop here and we can agree.

it's douchey to imply people can't afford something because they life outside their means. The FACT is, they couldn't afford it if the had NO phone. And that's the real issue here.

if this is the case they probably qualify for medicaid?

[baldgriff]

I think healthcare is a right and I think we live in a society, which means--we share responsibility for maintaining it.

I don’t think that any service the government has to force someone else to provide me – is necessarily a right. The Declaration of Independence that our Creator endows us unalienable rights among them being Life Liberty and the Pursuit of Happiness. To secure these rights – Governments are instituted among Men, deriving their just powers from the consent of the governed.
Nowhere does it say that Life, Liberty or the Pursuit of Happiness will be done in health or without pain or that everyone will start at the same place or should end up at the same place.

Your taxes pay for things you don't care about as do mine.
I pay my taxes – and believe that the government wastefully spends my money on many programs. I do care, but I am not willing to go to jail for not paying my taxes.

Becoming a doctor is about caring for your fellow man, healthwise NOT about making money that's why they have to take an oath to DO NO HARM.

Not true – in the generation that I grew up in Many kids wanted to be doctors because they could be rich and they wouldn’t have to struggle to get by like their parents did.

Withholding healthcare if you're a doctor is doing harm--Period. The founding fathers thought that LIFE was/is a right. To that extent our government and those who are citizens must find a way to make sure people get the care they need to live that life.

Nowhere does it say that Life, Liberty or the Pursuit of Happiness will be done in health or without pain or that everyone will start at the same place or should end up at the same place. Life is not easy and it is not fair, governments should not be trying to make it that way.

Now you might completely disagree with many or all of what I've said--and that's ok, but I'll leave you with this. If you continually deprive people of basic necessities , they will find a way to get them--Survival instinct outstrips lawfulness.

Then in your world, food and water should also be free as it is the most basic of necessities. Yet we require people to purchase their breakfast, lunch and dinner along with the drinks that accompany those meals. We also generally allow restaurants determine who they will or will not serve.

[Sour Masher]

if this is the case they probably qualify for medicaid?

Please see my post just above. There would be many middle class people with expensive medical issues who would not qualify for Medicaid who would also not be able to afford necessary medical treatments. There has to be a trade off. We can't both save most people money without sacrificing some people with expensive treatment needs. That is the choice people are making in advocating for universal coverage vs choice/affordability. Being more affordable for many necessitates coverage being much more expensive for some.

[senorsheep]

How do you know the street person is in that position through no fault of their own?

So if the person is sick through no fault of their own, well you might step up - but if they are some guy sleeping on the street with a mental illness - screw him??? Why does the doctor have more responsibility to make the same decision you do?

Oh, the irony.... how many of those street people would be off the streets if they were treated for their mental illness and addiction problems? There are centuries of lessons about the wisdom of prevention.

Hey, I'm the Grinch-y libertarian guy on the board, remember? But healthcare is an arena where I'm willing to shift out of the capitalist/ individualist/ free market paradigm a bit. For me, the bottom line is: I'm not going to adhere to a philosophical stand if it results in people being ill and not getting the help they need. I understand fully that the collectivist approach invites all the usual problems, but I'm willing to try to make it work in the case of healthcare, because I think it would likely solve a host of other more important societal problems. The main reason I identify as libertarian-ish is because I believe we have on obligation to encourage the fulfillment of human potential, and sick people cannot do that.

I don't think the doctor should bear the responsibility to cover non-payors. Society should bear that responsibility. I would like the doctors to focus on healing, and for society to focus on how to cover the shortfalls in a way that is effective and fair to all stakeholders.

[baldgriff]

I don't think the doctor should bear the responsibility to cover non-payors. Society should bear that responsibility. I would like the doctors to focus on healing, and for society to focus on how to cover the shortfalls in a way that is effective and fair to all stakeholders.

Your thought that society should take care of the poor is somewhat based on Judeo-Christian teachings that we should care for the poor and elderly. It was not the responsibility of the government to do so - it was the Church that was to take these people in. You cant turn the Government into the Church, just as you cant turn the Church into the Government.

[TranaGreg]

Your thought that society should take care of the poor is somewhat based on Judeo-Christian teachings that we should care for the poor and elderly. It was not the responsibility of the government to do so - it was the Church that was to take these people in. You cant turn the Government into the Church, just as you cant turn the Church into the Government.

societies were taking care of their poor & elderly long before Jesus appeared. It's human nature.

[baldgriff]

societies were taking care of their poor & elderly long before Jesus appeared. It's human nature.

Societies were taking care of their poor - agreed. It was not a responsibility of the government - it was a responsibility of the children.

http://www.aplaceformom.com/blog/history-caring-for-elders-08-06-2013/

History of Elder Care

Humans are inherently caring. Recently, archaeologists unearthed bones of an early human who lived approximately 500,000 years ago. Analysis showed the bones belonged to an aged and disabled man who would have had trouble walking or carrying the slightest load. To live as long as he did despite his disability, he must have had support from others in his group, which suggests that that senior care is at least half a million years old and that caring and empathy are core human traits.

In Ancient Greece and Rome, elderly people who required care had to rely on their children or extended family. In Ancient Greece, Athenian law required that children care for their aging parents, and the punishment was loss of citizenship (the second most severe punishment for Athenians, besides execution).

Senior care was ultimately the responsibility of the elder’s family, and the arrangement did not change much for 2,000 years.

[senorsheep]

Your thought that society should take care of the poor is somewhat based on Judeo-Christian teachings that we should care for the poor and elderly. It was not the responsibility of the government to do so - it was the Church that was to take these people in. You cant turn the Government into the Church, just as you cant turn the Church into the Government.

None of my thoughts are based on religion, I assure you.

In general, I agree that the more we can lean on localized, private, free market solutions, the better. Those solutions might cover all the gaps in a purely libertarian society, but we are not, never have been, and never will be one. In our society, purely libertarian healthcare solutions will leave too many gaps, more than most of us are comfortable with, I think.

Since you brought up the Church, wouldn't it be great if all the money and effort poured into fighting gay marriage could be channeled into covering healthcare shortfalls instead?

[baldgriff]

None of my thoughts are based on religion, I assure you.

In general, I agree that the more we can lean on localized, private, free market solutions, the better. Those solutions might cover all the gaps in a purely libertarian society, but we are not, never have been, and never will be one. In our society, purely libertarian healthcare solutions will leave too many gaps, more than most of us are comfortable with, I think.

Since you brought up the Church, wouldn't it be great if all the money and effort poured into fighting gay marriage could be channeled into covering healthcare shortfalls instead?

I dont believe governments should be in the marriage business - very libertarian of me dont you think.

[Moonlight J]

The uninsured will get coverage again in the ER's and the hospitals will write it off as indigent care while including the offsetting costs into paying customer's bills and will then inflate the rates of those paying for insurance. Someone will pay the costs and it won't be the insurers or the hospitals.

[DMT]

BG going back even further now to make his arguments. We're supposed to evolve dude, not pretend we're still in agrarian times. Amazing that I have to explicitly state this.