We're not sure about that. The court could rule a bunch of ways:
1) Whole thing is legal
2) Mandate is illegal, but everything else is fine
3) Throw the whole thing out
And there are probably some variances there as well. They could just arbitrarily decide Medicaid is unconstitutional too, because they're kind of assholes.
enlightenedbum on
Self-righteousness is incompatible with coalition building.
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Giggles_FunsworthBlight on DiscourseBay Area SprawlRegistered Userregular
If my girlfriend loses healthcare because of this I just don't even. That basically boils down our options to leaving her uninsured or getting a marriage of convenience (if I'm able to find another job) because like hell if I'm letting her remain uninsured.
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Giggles_FunsworthBlight on DiscourseBay Area SprawlRegistered Userregular
Marriage of convenience and moving to the EU maybe (she has French citizenship) fuck this shit.
But see, she's not losing health care access, she's losing health insurance! These things are totally unrelated and thus not at all intertwined or able to be regulated as if they were the same.
SCOTUS lives in a different universe than the rest of us.
Self-righteousness is incompatible with coalition building.
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AtomikaLive fast and get fucked or whateverRegistered Userregular
Right. Just because the law states that you can receive healthcare in an emergency at any time from any place without your foreknowledge of the cost doesn't mean healthcare institutions and insurance agencies don't have the right to bankrupt you and keep you from negotiating the price of care.
Forcing people to buy insurance has not been ruled unconstitutional. If it is, the ruling will spell out what parts of the ACA go down along with it.
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Giggles_FunsworthBlight on DiscourseBay Area SprawlRegistered Userregular
Yeah, the last time I lost health insurance I was in the middle of a two year stretch of unemployment, got horribly ill over the weekend with Mono, had to see a doctor in the ER, ended up with a $1200 bill for a mono test, a strep test, and two 400mg Ibuprofen ($32 (didn't know they cost that much for the hospital fuck them). California Emergency Medicare (or whatever) denied me because I didn't fill out the right form or something, when I told the hospital I was unemployed they told me I could work that shit out with the collectors and now my credit's fucked for the next six-ish years.
The individual mandate was fucking bullshit because the only people it fucked over were the poor, the only people without insurance are those that can't afford it/their employer doesn't provide it but jesus christ if they get rid of everything that's throwing out the baby with the bathwater. Getting a new job, working for a few years, marrying my girlfriend and moving to Europe fuck this place.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
So now that "forcing" people to buy insurance has been ruled unconstitutional does that mean that people between the ages of 18 and 26, who are not students, are no longer going to be able to piggyback off their parent's insurance policies? Because if so my girlfriend is about to get fucked. She took a semester off because I got fired from my job around when she needed to enroll in a CC where we were planning on moving, but we didn't know if I was going to get unemployment and we were going to be able to move. If she goes back to school will she be able to get insurance. Fuck. I think I'm going to go get drunk Jesus.
Um, nothing's been ruled anything. People need to calm. the. fuck. down.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
But see, she's not losing health care access, she's losing health insurance! These things are totally unrelated and thus not at all intertwined or able to be regulated as if they were the same.
SCOTUS lives in a different universe than the rest of us.
Can we wait until the baby is born to throw it out with the bath water?
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Giggles_FunsworthBlight on DiscourseBay Area SprawlRegistered Userregular
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Right. Just because the law states that you can receive healthcare in an emergency at any time from any place without your foreknowledge of the cost doesn't mean healthcare institutions and insurance agencies don't have the right to bankrupt you and keep you from negotiating the price of care.
See! Free Market!
This. Health care wants to remain a private industry in so very many ways, and yet somehow enjoys so many exceptions that would never, ever be even remotely acceptable from any other profit-yielding business.
I watched my girlfriend go from a midnight emergency room visit to a general practitioner to a specialist over the course of a year without ever receiving a meaningful diagnosis or any consistent level of care from this same constellation of doctors within her network. Being forced to pay through the nose for services that amount to no resolution of any kind (the condition turned out to be insanely mundane, by the way) by no means entitles you to complain or petition for a refund.
So now that "forcing" people to buy insurance has been ruled unconstitutional does that mean that people between the ages of 18 and 26, who are not students, are no longer going to be able to piggyback off their parent's insurance policies? Because if so my girlfriend is about to get fucked. She took a semester off because I got fired from my job around when she needed to enroll in a CC where we were planning on moving, but we didn't know if I was going to get unemployment and we were going to be able to move. If she goes back to school will she be able to get insurance. Fuck. I think I'm going to go get drunk Jesus.
Um, nothing's been ruled anything. People need to calm. the. fuck. down.
It seems entirely reasonable to be alarmed that huge segments of the population are advocating, nay, cheering for the proposition that uninsured people should fuck off and die.
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
So now that "forcing" people to buy insurance has been ruled unconstitutional does that mean that people between the ages of 18 and 26, who are not students, are no longer going to be able to piggyback off their parent's insurance policies? Because if so my girlfriend is about to get fucked. She took a semester off because I got fired from my job around when she needed to enroll in a CC where we were planning on moving, but we didn't know if I was going to get unemployment and we were going to be able to move. If she goes back to school will she be able to get insurance. Fuck. I think I'm going to go get drunk Jesus.
Um, nothing's been ruled anything. People need to calm. the. fuck. down.
It seems entirely reasonable to be alarmed that huge segments of the population are advocating, nay, cheering for the proposition that uninsured people should fuck off and die.
It is reasonable to be alarmed about that, yes, but that also has fuck all to do with SCOTUS at this point. And certainly not three months before we even learn their decision.
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AtomikaLive fast and get fucked or whateverRegistered Userregular
Right. Just because the law states that you can receive healthcare in an emergency at any time from any place without your foreknowledge of the cost doesn't mean healthcare institutions and insurance agencies don't have the right to bankrupt you and keep you from negotiating the price of care.
See! Free Market!
This. Health care wants to remain a private industry in so very many ways, and yet somehow enjoys so many exceptions that would never, ever be even remotely acceptable from any other profit-yielding business.
I watched my girlfriend go from a midnight emergency room visit to a general practitioner to a specialist over the course of a year without ever receiving a meaningful diagnosis or any consistent level of care from this same constellation of doctors within her network. Being forced to pay through the nose for services that amount to no resolution of any kind (the condition turned out to be insanely mundane, by the way) by no means entitles you to complain or petition for a refund.
Unfortunately, medicine isn't a perfect science. The problem with the US system is that it's based on the philosophy of, "Fuck you. Pay me."
There's two ways this can change: altering the costs or mandating efficient care and diagnoses. As for the latter, I don't think it's reasonable to ask the medical community to be all that much more efficient than it already is. As for quality and outcomes, the US is actually pretty fucking great; the problem is cost and restriction to access as a product of those costs.
But as to your bigger point, yes, the current legal protections offered our healthcare system keeps it completely out of the forces of the free market, and even Adam Smith recognized this. Vital public resources were never considered part of the consideration in capitalist free-market theory.
The only economic leverage a person has over the healthcare system as it stands is WHERE the care is received at and IF they decide to comply the prescribed care plan, unless it's an emergency, and then they have no leverage or choice whatsoever. Costs, time, and quality are variables beyond their control.
Just like a market of rational actors for non-vital goods and services! Amirite? Eh? Eh?
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
There are a lot of products that resemble the healthcare one in just those ways. Off the top of my head:
Wine / food.
Online Game Subscription.
Auto Repair.
Plumbing repair.
From experience, you can almost always turn back food in cases of dissatisfaction, and usually its a pretty polite exchange. Wine, perhaps less so. Plumbing repair - complaining, sadly, can get you somewhere if you really need to.
But the point is, what those examples all have in common is that they are all exceedingly unlikely to cripple your life both physically (in the case of poor or inconsistent care, though Ross is right - our outcomes are, on average, good) and financially. The stakes are so uniquely high in our current system that to have so few proper consumer protections is very nearly inhumane.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
You're going to need to explain this one, because I don't see how it applies to any of the industries you listed. I'm not trying to be combative, I'm just trying to understand.
because you have to get them, and if you don't pay for it, it drives up the costs for those who do pay for it, and if you really really need it you can get a crappy version of it and then they drive you into bankruptcy over it (but you don't have to pay!). Also there's two price points, one for people in the system and one for people out of the system, just like... what other markets were we talking about again? WoW subsriptions? Just like health care!
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AtomikaLive fast and get fucked or whateverRegistered Userregular
because you have to get them, and if you don't pay for it, it drives up the costs for those who do pay for it, and if you really really need it you can get a crappy version of it and then they drive you into bankruptcy over it (but you don't have to pay!). Also there's two price points, one for people in the system and one for people out of the system, just like... what other markets were we talking about again? WoW subsriptions? Just like health care!
More people buying online game subscriptions do not decrease the price though. I mean, supply and demand is characteristic of all markets so this argument is going to need a lot of explanation and support.
I love the contrast between the actual question from AMFE, and the giant goose commenting below him. I've literally been back in this thread 10 minutes.
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
You're going to need to explain this one, because I don't see how it applies to any of the industries you listed. I'm not trying to be combative, I'm just trying to understand.
With all the other services I mentioned, you pay for them regardless of the quality of the service, whether the service was acceptable or accomplished the goal / solved the problem you had, and you can't ask for a refund for any of them, or refuse to pay once the service has been performed / product has been consumed/activated.
I'm really just making the observation that in the way Edd mentioned (quoted above), there are other products and services that share the same traits. I'm not suggesting they're identical or that there aren't important differences! It would be silly to say healthcare is just like plumbing but it is the case that in both professions, once the guy has the snake in the hole, you're going to pay regardless of what he finds.
I love the contrast between the actual question from AMFE, and the giant goose commenting below him. I've literally been back in this thread 10 minutes.
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
You're going to need to explain this one, because I don't see how it applies to any of the industries you listed. I'm not trying to be combative, I'm just trying to understand.
With all the other services I mentioned, you pay for them regardless of the quality of the service, whether the service was acceptable or accomplished the goal / solved the problem you had, and you can't ask for a refund for any of them, or refuse to pay once the service has been performed / product has been consumed/activated.
I'm really just making the observation that in the way Edd mentioned (quoted above), there are other products and services that share the same traits. I'm not suggesting they're identical or that there aren't important differences! It would be silly to say healthcare is just like plumbing but it is the case that in both professions, once the guy has the snake in the hole, you're going to pay regardless of what he finds.
I understand your logic, but I think the take-away here is how incredibly inappropriate such a private-commerce mentality is when coupled to the realities of health care.
And again, none of those services have anywhere near the social consequences for their hostility towards consumers.
EDIT: Also, if your plumber fucks you, you change plumbers and hope for the best. When your insurance company fucks you, are you really in a position to say "Well I'll never use that Blue Cross plan again?" Most people sure as hell aren't.
Edd on
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
I love the contrast between the actual question from AMFE, and the giant goose commenting below him. I've literally been back in this thread 10 minutes.
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
You're going to need to explain this one, because I don't see how it applies to any of the industries you listed. I'm not trying to be combative, I'm just trying to understand.
With all the other services I mentioned, you pay for them regardless of the quality of the service, whether the service was acceptable or accomplished the goal / solved the problem you had, and you can't ask for a refund for any of them, or refuse to pay once the service has been performed / product has been consumed/activated.
I'm really just making the observation that in the way Edd mentioned (quoted above), there are other products and services that share the same traits. I'm not suggesting they're identical or that there aren't important differences! It would be silly to say healthcare is just like plumbing but it is the case that in both professions, once the guy has the snake in the hole, you're going to pay regardless of what he finds.
I mean, I can see how they're similar, but I don't see how that's more than a cosmetic similarity.
You can change supermarkets or grow your own food in a backyard garden. You can go to a new mechanic, you can get a new plumber. I also don't see how you're paying for the services of a plumber if you're not using it. You could also go your entire life without needing a plumber, not so with healthcare. Even doctors need doctors.
I'm not even going to pretend that the online gaming one is a good example, though. I don't play WoW, I don't use Steam, my non use of those services has zero effect on those who do. If every American played WoW or downloaded a game off Steam today that wouldn't lower the rates for those services, where as more healthy people on insurance rolls does reduce cost.
Insurance and healthcare are different ducks than any other market because of this, in my opinion.
There are a lot of products that resemble the healthcare one in just those ways. Off the top of my head:
Wine / food.
Online Game Subscription.
Auto Repair.
Plumbing repair.
<in the vein of>
Being forced to pay through the nose for services that amount to no resolution of any kind, by no means entitles you to complain or petition for a refund.
None of these resemble healthcare in any appreciable way.
Wine and online game subscriptions are entirely luxury items, and it's laughable that you even included them. There is no similarity.
Auto repair is a non-luxury for a decent size of the population, but is avoidable for lots of people. It also can be done fairly well on your own, and has certain cost ceilings. (ie the cost of buying a new car), unlike health care (which can have essentially unlimited costs for certain treatments). Plumbing repair is very similar.
Food is the closest, but is still not comparable due to the plethora of choice, and low cost required.
None of these are required in the same way as healthcare. None of these are as expensive as healthcare. None of these have as many possibly unsatisfying conclusions as healthcare, as problems and solutions are almost always more obvious and easy to tell whether they worked or not. This is not even looking at how for things like cars and plumbing, you can choose to pay larger upfront costs to save on repairs later on (ie buying a more reliable brand) which is just not possible in health care (even if we grant people should be exercising and eating greens, there's lots of problems this won't solve).
With all the other services I mentioned, you pay for them regardless of the quality of the service, whether the service was acceptable or accomplished the goal / solved the problem you had, and you can't ask for a refund for any of them, or refuse to pay once the service has been performed / product has been consumed/activated.
This is just completely untrue. While getting a refund might not be worth it economically to you, you can definitely get refunds for non-repairs and such. Healthcare is different in that just by the nature of medicine, you have to accept that some diseases just won't be cured. This doesn't happen for cars or plumbing, it's just frequently cheaper to buy a new car.
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Lord_AsmodeusgoeticSobriquet:Here is your magical cryptic riddle-tumour: I AM A TIME MACHINERegistered Userregular
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
I hardly think the mandate counts as 'erasing parts of the constitution' more like 'a perhaps or perhaps not overbroad interpretation of the governments ability to control the market'
And people keep talking about if/when this gets removed we can 'start working on a better system' like the Democrats weren't trying for a better system the whole time, and had to compromise to get what we got, because if they didn't we wouldn't have gotten anything due to Republican obstructionism.
Capital is only the fruit of labor, and could never have existed if Labor had not first existed. Labor is superior to capital, and deserves much the higher consideration. - Lincoln
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
I hardly think the mandate counts as 'erasing parts of the constitution' more like 'a perhaps or perhaps not overbroad interpretation of the governments ability to control the market'
And people keep talking about if/when this gets removed we can 'start working on a better system' like the Democrats weren't trying for a better system the whole time, and had to compromise to get what we got, because if they didn't we wouldn't have gotten anything due to Republican obstructionism.
If ACA gets struck down, it will only be because Republicans refused to do anything else because to make a workable (and I'm not acquiescing that the current law isn't constitutional as I've not seen any convincing evidence so far) would be to give Obama a win and winning elections is more important than governing the goddamn country to these people.
Also, "erasing the constitution" implies a malice that isn't extant. Laws get knocked down by SCOTUS all the time, Congress or a State will try something and it'll get knocked down. This isn't Obama and the Democrats shitting into Thomas Jefferson's skull and then using the bill or rights to wipe there ass, it's Congress testing the limits. A thing that is necessary for government.
I feel that you guys have never had a plumber spend 3 hours trying unsuccessfully to unclog a pipe, then charge you for the three hours! You don't get that money back, and your bathtub still doesn't drain.
But this is mostly a tangent, and only really goes to discussing whether health insurance is a unique market because my decision not to buy it drives up the cost of insurance nationwide. I don't really buy this argument, on two fronts:
One, I don't agree that health insurance is inextricably bound up in healthcare. We could separate the two, if we had the will. What you mean is not that it's impossible, but that it's really hard and possibly you believe it's a political non-starter, but that's completely, totally irrelevant when discussing Constitutionality, and that's what we're doing with this line of reasoning.
Two, I don't believe that everyone will need to consume enough healthcare to make lifetime insurance a good financial choice. It's possible to never see a doctor for 25 years and then be hit by a bus and die instantly. I know you're saying "how fucking likely is that???" but it doesn't matter. Your argument goes "everyone needs healthcare", but that's not necessarily the case... and it's not the same as health insurance anyway. It's also possible to pay cash to see doctors. I've done it for 2 years at a stretch and if you have any skill at negotiation you can get the cost down to a fraction of what they charge insurance companies and pay it out of your pocket.
Insurance is a tool to mitigate risk. You might be of the opinion that everyone should mitigate their risk, but that doesn't give Congress the power to force them to. The argument must center on an inseparable connection between insurance and care if it's going to have a hope of falling under the Commerce clause, and I don't believe it is inseparable at all.
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
I hardly think the mandate counts as 'erasing parts of the constitution' more like 'a perhaps or perhaps not overbroad interpretation of the governments ability to control the market'
And people keep talking about if/when this gets removed we can 'start working on a better system' like the Democrats weren't trying for a better system the whole time, and had to compromise to get what we got, because if they didn't we wouldn't have gotten anything due to Republican obstructionism.
If ACA gets struck down, it will only be because Republicans refused to do anything else because to make a workable (and I'm not acquiescing that the current law isn't constitutional as I've not seen any convincing evidence so far) would be to give Obama a win and winning elections is more important than governing the goddamn country to these people.
Also, "erasing the constitution" implies a malice that isn't extant. Laws get knocked down by SCOTUS all the time, Congress or a State will try something and it'll get knocked down. This isn't Obama and the Democrats shitting into Thomas Jefferson's skull and then using the bill or rights to wipe there ass, it's Congress testing the limits. A thing that is necessary for government.
Both sides need to calm their shit.
OK, fair enough. However, I have that moment where Pelosi is asked about Constitutionality and she laughs and says "Are you serious?" lodged permanently in my brain. Firstly, I'm very unhappy to have a portion of my memory marred by Pelosi's grim visage and secondly, it sure did seem at that moment like the Speaker of the House didn't give a shit about whether what she was trying to pass was Constitutional.
here's a question though: How did you feel about the 9-1-1 and burial hypothetical mentioned on day 2?
I just want to add, in the vein of separating insurance from care, I do the following on a semi-regular basis:
Child gets pinkeye (or some other common, easily identifiable childhood ill) . I don't want to go to the doctor, because I've had kids for 16 years and I fucking know what pinkeye looks like.
I call my doctor, who has known our family for nearly a decade. I say "my kid has pinkeye, can you please call the pharmacy with a prescription?"
His nurse says "sure, no problem".
I go get the prescription. It costs like $4. I don't even bother with my drug benefit because it costs like $4.
Total cost for pinkeye care: $4 plus gas to the drugstore. Total insurance bill: $0.
I'm not sure what's wrong with the idea that the government could socialize burial costs; there's just no reason to because body disposal isn't an expense that's crippling the national economy
it was the smallest on the list but
Pluto was a planet and I'll never forget
I feel that you guys have never had a plumber spend 3 hours trying unsuccessfully to unclog a pipe, then charge you for the three hours! You don't get that money back, and your bathtub still doesn't drain.
But this is mostly a tangent, and only really goes to discussing whether health insurance is a unique market because my decision not to buy it drives up the cost of insurance nationwide. I don't really buy this argument, on two fronts:
One, I don't agree that health insurance is inextricably bound up in healthcare. We could separate the two, if we had the will. What you mean is not that it's impossible, but that it's really hard and possibly you believe it's a political non-starter, but that's completely, totally irrelevant when discussing Constitutionality, and that's what we're doing with this line of reasoning.
Two, I don't believe that everyone will need to consume enough healthcare to make lifetime insurance a good financial choice. It's possible to never see a doctor for 25 years and then be hit by a bus and die instantly. I know you're saying "how fucking likely is that???" but it doesn't matter. Your argument goes "everyone needs healthcare", but that's not necessarily the case... and it's not the same as health insurance anyway. It's also possible to pay cash to see doctors. I've done it for 2 years at a stretch and if you have any skill at negotiation you can get the cost down to a fraction of what they charge insurance companies and pay it out of your pocket.
Insurance is a tool to mitigate risk. You might be of the opinion that everyone should mitigate their risk, but that doesn't give Congress the power to force them to. The argument must center on an inseparable connection between insurance and care if it's going to have a hope of falling under the Commerce clause, and I don't believe it is inseparable at all.
Those who are not insured are mitigating their risk at the cost of others. When one person does not purchase health insurance, the hospitals and doctors don't just manifest money and call it a day, they're mandated to treat that person.
They treat that person at the cost of everyone else in the state. Not for Profit hospitals and universities get epic (hundreds of millions of dollars) from the states they're in to cover costs. So whether you like it or not, you are paying for their healthcare.
So essentially we're all paying too much for healthcare, we just don't get a bill in the mail. States do, and appropriate your tax dollars. I really wish our tax system was direct about what we're paying for, I'd be all over paying a soldier pension and healthcare fund, or hospital access tax. Right now I feel like I'm just throwing my money over a big wall that someone promised me would do stuff that's good, and there's probably just a bunch of rich fucks on the other side with bags pretending skittles are falling on them.
Healthcare is the prime example of business executives and lobbyists for big money firms (mostly pharma) wanting to privatise profit and socialize loss. If you think banking is a mess, wait until healthcare crashes (and it will).
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
Sorry dudes. Was catching up on the news cycle and didn't realize the hyperbole was hyperbole. If America decides America does not want healthcare reform though, I am out.
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
I hardly think the mandate counts as 'erasing parts of the constitution' more like 'a perhaps or perhaps not overbroad interpretation of the governments ability to control the market'
And people keep talking about if/when this gets removed we can 'start working on a better system' like the Democrats weren't trying for a better system the whole time, and had to compromise to get what we got, because if they didn't we wouldn't have gotten anything due to Republican obstructionism.
If ACA gets struck down, it will only be because Republicans refused to do anything else because to make a workable (and I'm not acquiescing that the current law isn't constitutional as I've not seen any convincing evidence so far) would be to give Obama a win and winning elections is more important than governing the goddamn country to these people.
Also, "erasing the constitution" implies a malice that isn't extant. Laws get knocked down by SCOTUS all the time, Congress or a State will try something and it'll get knocked down. This isn't Obama and the Democrats shitting into Thomas Jefferson's skull and then using the bill or rights to wipe there ass, it's Congress testing the limits. A thing that is necessary for government.
Both sides need to calm their shit.
OK, fair enough. However, I have that moment where Pelosi is asked about Constitutionality and she laughs and says "Are you serious?" lodged permanently in my brain. Firstly, I'm very unhappy to have a portion of my memory marred by Pelosi's grim visage and secondly, it sure did seem at that moment like the Speaker of the House didn't give a shit about whether what she was trying to pass was Constitutional.
here's a question though: How did you feel about the 9-1-1 and burial hypothetical mentioned on day 2?
She laughed because she thought it was constitutional. She was laughing at the implication that the SPEAKER OF THE HOUSE wouldn't take the time and care to make sure what she was passing was constitutional. It's the same reason Obama snapped at that dumbass who asked him if he was purposefully raising gas prices.
I'd have to relisten because I don't remember the 911 call, but I think that the burial hypothetical was fairly specious. I don't need a burial at a funeral home, I could just dig a hole and stick my dead family member into it. If I have a massive heart attack or break my leg or get shot, I can't just sit at home and hope for the best.
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AManFromEarthLet's get to twerk!The King in the SwampRegistered Userregular
I just want to add, in the vein of separating insurance from care, I do the following on a semi-regular basis:
Child gets pinkeye (or some other common, easily identifiable childhood ill) . I don't want to go to the doctor, because I've had kids for 16 years and I fucking know what pinkeye looks like.
I call my doctor, who has known our family for nearly a decade. I say "my kid has pinkeye, can you please call the pharmacy with a prescription?"
His nurse says "sure, no problem".
I go get the prescription. It costs like $4. I don't even bother with my drug benefit because it costs like $4.
Total cost for pinkeye care: $4 plus gas to the drugstore. Total insurance bill: $0.
You can separate care from insurance.
Cool story bro, but your kids pink eye is an affordable cost. My mother's lack of a thyroid, my girlfriend's asthma, and my grandmother's Alzheimer's isn't. So no, you can't separate care from insurance.
I just want to add, in the vein of separating insurance from care, I do the following on a semi-regular basis:
Child gets pinkeye (or some other common, easily identifiable childhood ill) . I don't want to go to the doctor, because I've had kids for 16 years and I fucking know what pinkeye looks like.
I call my doctor, who has known our family for nearly a decade. I say "my kid has pinkeye, can you please call the pharmacy with a prescription?"
His nurse says "sure, no problem".
I go get the prescription. It costs like $4. I don't even bother with my drug benefit because it costs like $4.
Total cost for pinkeye care: $4 plus gas to the drugstore. Total insurance bill: $0.
You can separate care from insurance.
Now do that with something more serious. Shockingly, you can't, unless you are willing to pay $Texas. Thus the need for insurance, so as to spread the risk (and thus: the cost) around.
And the reason your comparisons are asinine is that you can shop for those things. You can check the price for various plumbers/mechanics (or do it yourself if you have some talent in those areas), you can weigh the value of Whole Foods vs. Kroger vs. eating out, you can not drink alcohol, you can not play WoW (or you can play something free to play instead), but if your arm is broke you go to the damn ER and the price is figured out later.
Self-righteousness is incompatible with coalition building.
Posts
1) Whole thing is legal
2) Mandate is illegal, but everything else is fine
3) Throw the whole thing out
And there are probably some variances there as well. They could just arbitrarily decide Medicaid is unconstitutional too, because they're kind of assholes.
SCOTUS lives in a different universe than the rest of us.
See! Free Market!
The individual mandate was fucking bullshit because the only people it fucked over were the poor, the only people without insurance are those that can't afford it/their employer doesn't provide it but jesus christ if they get rid of everything that's throwing out the baby with the bathwater. Getting a new job, working for a few years, marrying my girlfriend and moving to Europe fuck this place.
Um, nothing's been ruled anything. People need to calm. the. fuck. down.
Can we wait until the baby is born to throw it out with the bath water?
S'cool, it's an important and emotional issue. I would say though that one SCOTUS decision doesn't mean America doesn't want healthcare reform.
This. Health care wants to remain a private industry in so very many ways, and yet somehow enjoys so many exceptions that would never, ever be even remotely acceptable from any other profit-yielding business.
I watched my girlfriend go from a midnight emergency room visit to a general practitioner to a specialist over the course of a year without ever receiving a meaningful diagnosis or any consistent level of care from this same constellation of doctors within her network. Being forced to pay through the nose for services that amount to no resolution of any kind (the condition turned out to be insanely mundane, by the way) by no means entitles you to complain or petition for a refund.
It seems entirely reasonable to be alarmed that huge segments of the population are advocating, nay, cheering for the proposition that uninsured people should fuck off and die.
Correct, it doesn't mean that at all. It just means we can't do it like Obama tried. Once we're done trying to erase parts of Constitution, we can get about creating a system that follows it.
It is reasonable to be alarmed about that, yes, but that also has fuck all to do with SCOTUS at this point. And certainly not three months before we even learn their decision.
Unfortunately, medicine isn't a perfect science. The problem with the US system is that it's based on the philosophy of, "Fuck you. Pay me."
There's two ways this can change: altering the costs or mandating efficient care and diagnoses. As for the latter, I don't think it's reasonable to ask the medical community to be all that much more efficient than it already is. As for quality and outcomes, the US is actually pretty fucking great; the problem is cost and restriction to access as a product of those costs.
But as to your bigger point, yes, the current legal protections offered our healthcare system keeps it completely out of the forces of the free market, and even Adam Smith recognized this. Vital public resources were never considered part of the consideration in capitalist free-market theory.
The only economic leverage a person has over the healthcare system as it stands is WHERE the care is received at and IF they decide to comply the prescribed care plan, unless it's an emergency, and then they have no leverage or choice whatsoever. Costs, time, and quality are variables beyond their control.
Just like a market of rational actors for non-vital goods and services! Amirite? Eh? Eh?
Wine / food.
Online Game Subscription.
Auto Repair.
Plumbing repair.
From the above:
From experience, you can almost always turn back food in cases of dissatisfaction, and usually its a pretty polite exchange. Wine, perhaps less so. Plumbing repair - complaining, sadly, can get you somewhere if you really need to.
But the point is, what those examples all have in common is that they are all exceedingly unlikely to cripple your life both physically (in the case of poor or inconsistent care, though Ross is right - our outcomes are, on average, good) and financially. The stakes are so uniquely high in our current system that to have so few proper consumer protections is very nearly inhumane.
You're going to need to explain this one, because I don't see how it applies to any of the industries you listed. I'm not trying to be combative, I'm just trying to understand.
because you have to get them, and if you don't pay for it, it drives up the costs for those who do pay for it, and if you really really need it you can get a crappy version of it and then they drive you into bankruptcy over it (but you don't have to pay!). Also there's two price points, one for people in the system and one for people out of the system, just like... what other markets were we talking about again? WoW subsriptions? Just like health care!
I'm not trying to be confrontational or inflammatory, but are you fucking kidding me here?
More people buying online game subscriptions do not decrease the price though. I mean, supply and demand is characteristic of all markets so this argument is going to need a lot of explanation and support.
It only took 10 minutes!
Anyhow.
With all the other services I mentioned, you pay for them regardless of the quality of the service, whether the service was acceptable or accomplished the goal / solved the problem you had, and you can't ask for a refund for any of them, or refuse to pay once the service has been performed / product has been consumed/activated.
I'm really just making the observation that in the way Edd mentioned (quoted above), there are other products and services that share the same traits. I'm not suggesting they're identical or that there aren't important differences! It would be silly to say healthcare is just like plumbing but it is the case that in both professions, once the guy has the snake in the hole, you're going to pay regardless of what he finds.
I understand your logic, but I think the take-away here is how incredibly inappropriate such a private-commerce mentality is when coupled to the realities of health care.
And again, none of those services have anywhere near the social consequences for their hostility towards consumers.
EDIT: Also, if your plumber fucks you, you change plumbers and hope for the best. When your insurance company fucks you, are you really in a position to say "Well I'll never use that Blue Cross plan again?" Most people sure as hell aren't.
I mean, I can see how they're similar, but I don't see how that's more than a cosmetic similarity.
You can change supermarkets or grow your own food in a backyard garden. You can go to a new mechanic, you can get a new plumber. I also don't see how you're paying for the services of a plumber if you're not using it. You could also go your entire life without needing a plumber, not so with healthcare. Even doctors need doctors.
I'm not even going to pretend that the online gaming one is a good example, though. I don't play WoW, I don't use Steam, my non use of those services has zero effect on those who do. If every American played WoW or downloaded a game off Steam today that wouldn't lower the rates for those services, where as more healthy people on insurance rolls does reduce cost.
Insurance and healthcare are different ducks than any other market because of this, in my opinion.
None of these resemble healthcare in any appreciable way.
Wine and online game subscriptions are entirely luxury items, and it's laughable that you even included them. There is no similarity.
Auto repair is a non-luxury for a decent size of the population, but is avoidable for lots of people. It also can be done fairly well on your own, and has certain cost ceilings. (ie the cost of buying a new car), unlike health care (which can have essentially unlimited costs for certain treatments). Plumbing repair is very similar.
Food is the closest, but is still not comparable due to the plethora of choice, and low cost required.
None of these are required in the same way as healthcare. None of these are as expensive as healthcare. None of these have as many possibly unsatisfying conclusions as healthcare, as problems and solutions are almost always more obvious and easy to tell whether they worked or not. This is not even looking at how for things like cars and plumbing, you can choose to pay larger upfront costs to save on repairs later on (ie buying a more reliable brand) which is just not possible in health care (even if we grant people should be exercising and eating greens, there's lots of problems this won't solve).
This is just completely untrue. While getting a refund might not be worth it economically to you, you can definitely get refunds for non-repairs and such. Healthcare is different in that just by the nature of medicine, you have to accept that some diseases just won't be cured. This doesn't happen for cars or plumbing, it's just frequently cheaper to buy a new car.
I hardly think the mandate counts as 'erasing parts of the constitution' more like 'a perhaps or perhaps not overbroad interpretation of the governments ability to control the market'
And people keep talking about if/when this gets removed we can 'start working on a better system' like the Democrats weren't trying for a better system the whole time, and had to compromise to get what we got, because if they didn't we wouldn't have gotten anything due to Republican obstructionism.
If ACA gets struck down, it will only be because Republicans refused to do anything else because to make a workable (and I'm not acquiescing that the current law isn't constitutional as I've not seen any convincing evidence so far) would be to give Obama a win and winning elections is more important than governing the goddamn country to these people.
Also, "erasing the constitution" implies a malice that isn't extant. Laws get knocked down by SCOTUS all the time, Congress or a State will try something and it'll get knocked down. This isn't Obama and the Democrats shitting into Thomas Jefferson's skull and then using the bill or rights to wipe there ass, it's Congress testing the limits. A thing that is necessary for government.
Both sides need to calm their shit.
But this is mostly a tangent, and only really goes to discussing whether health insurance is a unique market because my decision not to buy it drives up the cost of insurance nationwide. I don't really buy this argument, on two fronts:
One, I don't agree that health insurance is inextricably bound up in healthcare. We could separate the two, if we had the will. What you mean is not that it's impossible, but that it's really hard and possibly you believe it's a political non-starter, but that's completely, totally irrelevant when discussing Constitutionality, and that's what we're doing with this line of reasoning.
Two, I don't believe that everyone will need to consume enough healthcare to make lifetime insurance a good financial choice. It's possible to never see a doctor for 25 years and then be hit by a bus and die instantly. I know you're saying "how fucking likely is that???" but it doesn't matter. Your argument goes "everyone needs healthcare", but that's not necessarily the case... and it's not the same as health insurance anyway. It's also possible to pay cash to see doctors. I've done it for 2 years at a stretch and if you have any skill at negotiation you can get the cost down to a fraction of what they charge insurance companies and pay it out of your pocket.
Insurance is a tool to mitigate risk. You might be of the opinion that everyone should mitigate their risk, but that doesn't give Congress the power to force them to. The argument must center on an inseparable connection between insurance and care if it's going to have a hope of falling under the Commerce clause, and I don't believe it is inseparable at all.
OK, fair enough. However, I have that moment where Pelosi is asked about Constitutionality and she laughs and says "Are you serious?" lodged permanently in my brain. Firstly, I'm very unhappy to have a portion of my memory marred by Pelosi's grim visage and secondly, it sure did seem at that moment like the Speaker of the House didn't give a shit about whether what she was trying to pass was Constitutional.
here's a question though: How did you feel about the 9-1-1 and burial hypothetical mentioned on day 2?
Child gets pinkeye (or some other common, easily identifiable childhood ill) . I don't want to go to the doctor, because I've had kids for 16 years and I fucking know what pinkeye looks like.
I call my doctor, who has known our family for nearly a decade. I say "my kid has pinkeye, can you please call the pharmacy with a prescription?"
His nurse says "sure, no problem".
I go get the prescription. It costs like $4. I don't even bother with my drug benefit because it costs like $4.
Total cost for pinkeye care: $4 plus gas to the drugstore. Total insurance bill: $0.
You can separate care from insurance.
Pluto was a planet and I'll never forget
Those who are not insured are mitigating their risk at the cost of others. When one person does not purchase health insurance, the hospitals and doctors don't just manifest money and call it a day, they're mandated to treat that person.
They treat that person at the cost of everyone else in the state. Not for Profit hospitals and universities get epic (hundreds of millions of dollars) from the states they're in to cover costs. So whether you like it or not, you are paying for their healthcare.
So essentially we're all paying too much for healthcare, we just don't get a bill in the mail. States do, and appropriate your tax dollars. I really wish our tax system was direct about what we're paying for, I'd be all over paying a soldier pension and healthcare fund, or hospital access tax. Right now I feel like I'm just throwing my money over a big wall that someone promised me would do stuff that's good, and there's probably just a bunch of rich fucks on the other side with bags pretending skittles are falling on them.
Healthcare is the prime example of business executives and lobbyists for big money firms (mostly pharma) wanting to privatise profit and socialize loss. If you think banking is a mess, wait until healthcare crashes (and it will).
She laughed because she thought it was constitutional. She was laughing at the implication that the SPEAKER OF THE HOUSE wouldn't take the time and care to make sure what she was passing was constitutional. It's the same reason Obama snapped at that dumbass who asked him if he was purposefully raising gas prices.
I'd have to relisten because I don't remember the 911 call, but I think that the burial hypothetical was fairly specious. I don't need a burial at a funeral home, I could just dig a hole and stick my dead family member into it. If I have a massive heart attack or break my leg or get shot, I can't just sit at home and hope for the best.
Cool story bro, but your kids pink eye is an affordable cost. My mother's lack of a thyroid, my girlfriend's asthma, and my grandmother's Alzheimer's isn't. So no, you can't separate care from insurance.
Now do that with something more serious. Shockingly, you can't, unless you are willing to pay $Texas. Thus the need for insurance, so as to spread the risk (and thus: the cost) around.
And the reason your comparisons are asinine is that you can shop for those things. You can check the price for various plumbers/mechanics (or do it yourself if you have some talent in those areas), you can weigh the value of Whole Foods vs. Kroger vs. eating out, you can not drink alcohol, you can not play WoW (or you can play something free to play instead), but if your arm is broke you go to the damn ER and the price is figured out later.