So, to summarize:

I don't care if they force us to get Obamacare, because other countries force thier people to do the same: It's socially and economically responsible, if all your people have health care. It's just something everyone needs and should be required to have, and that's not violating any rights, that's addressing an issue with the only solution there is, and that's that.

What sucks is that Obamacare is only one type of coverage, meant to take business away from the others, and to force people who can't switch over or don't want to, to pay a hefty fine for not having it. It's complicated because over in European countries, there is on kind of health care, it is usually free or affordable, and it is all they have: one plan, multiple options.

In the USA it's: multiple plans, limited options depending on the plan, and now they're forcing it so there's only one plan, or a handful of them, and then penalizing people for not getting with the program.

It's just...stupid way of going about it really. Although, I don't see Republicans offering any alternatives.(why is that?)

At 4/7/14 05:06 PM, WallofYawn wrote: It's complicated because over in European countries, there is on kind of health care, it is usually free or affordable,

Don't fall into this trap. Single payer is NOT free. You just pay differently. Instead of paying a premium, you pay a percentage of you income/property value/purchases/and so on.

At 4/7/14 05:06 PM, WallofYawn wrote: Although, I don't see Republicans offering any alternatives.(why is that?)

Politics.

They really don't want to repeal it, but they want to make a show of it that they do. However their constituents are upset and are aware of the game being played, which in turn gets the law maker a primary challenger. Which is why we get things like the debt ceiling crisis.

At 4/11/14 12:03 AM, MOSFET wrote: Politics.

They really don't want to repeal it, but they want to make a show of it that they do. However their constituents are upset and are aware of the game being played, which in turn gets the law maker a primary challenger. Which is why we get things like the debt ceiling crisis.

The GOP would gladly repeal the ACA and reinstate it unchanged word-for-word. This way they can actually get credit for passing legislation they themselves drafted.

At 4/7/14 05:06 PM, WallofYawn wrote: So, to summarize:

I don't care if they force us to get Obamacare, because other countries force thier people to do the same: It's socially and economically responsible, if all your people have health care. It's just something everyone needs and should be required to have, and that's not violating any rights, that's addressing an issue with the only solution there is, and that's that.

Nope...that is most definitely NOT that.

First of all, not everyone needs healthcare. See what health coverage is is a way of managing risk. This is all ANY insurance is. The risk managed by healthcare is the threat to financial security posed by getting sick. Now I'm pushing 40 so my risk is greater. Someone who is 18 with no family history of serious disease does not have much risk. So why make them buy something that they, reasonably & rationally, do not have a need to own? (Yes some people do get sick when they are young, my daughter being one, but this does not change the statistics.)

Secondly, I don't really care about what is 'socially' acceptable. What is 'socially' acceptable/just/equal/etc quite often makes for bad public policy. Beyond that, it can also lead to the destruction of liberty and individual rights. Just see the erosion of economic liberty caused by the ACA on the Left and anti-gay marriage measures on the Right.

Third, this is not economically responsible. The ACA is wreaking havoc on the health industry. The government has a long and HORRIBLE history of messing with the healthcare industry. Much of the inflation of healthcare prices comes from the federal government's involvement. About 1/3 of the country is insured by Medicare, Medicaid, or Tricare. These programs fix prices at a 1984 level. An example of this is the last billing statement I got for my daughter's treatment (I'm on Tricare). The bill was $1,200. Tricare paid $120. The provider eats the difference, he cannot come after me for the $1,080 that he was NOT paid. Furthermore, these programs require the providers to dedicate an employee to deal with the government contractor to get paid. These expenses are transferred to those with private insurance and those few able to self-insure.

To summarize point 3: government involvement in healthcare is one of the MAIN things causing medical prices to rise!

Fourth, it is an infringement on people's right to the pursuit of happiness. See the source material that Jefferson drew upon for the Declaration of Independence originially was the right to life, liberty, and the pursuit of property. By requiring someone to buy a product/good/service they do not need/want the government is depriving them of their means to acquire wealth and spend the fruit of their labor as they see fit.

Finally, this is NOT the only solution NOR should it be the first one tried.
* Tort-reform to reduce the cost of liability insurance for providers.
* Deregulation: before ACA each state came up with mandated things to be covered in all healthcare plans. The ACA doubled down on this foolishness. Examples of what I'm talking about: men paying for OB/GYN coverage or women paying for prostate cancer coverage. In the information age, there is no reason why people cannot go online and pick what they want coverage for a la carte.
* Increasing competition. In the information age, insurance is now a good that can be traded across state lines. So why should states be regulating it? Allowing consumers in Missouri to buy insurance from providers in South Carolina would reduce A LOT of the bureaucratic cost of insurance.

So no my friend, the debate is NOT over nor should it be.

What sucks is that Obamacare is only one type of coverage, meant to take business away from the others, and to force people who can't switch over or don't want to, to pay a hefty fine for not having it. It's complicated because over in European countries, there is on kind of health care, it is usually free or affordable, and it is all they have: one plan, multiple options.

Who cares about Europe? Part of the reason they can have such programs is after WWII the US took over much of the defense of Europe effectively reducing their needs for large military budgets and ending an epoch of warfare. When the US reduces our military footprint over there, their defense budgets will go up. Their domestic spending will go down.

Furthermore, each European country is pretty homogenous. They also have relatively small populations, you're comparing apples to walnuts.

In the USA it's: multiple plans, limited options depending on the plan, and now they're forcing it so there' as only one plan, or a handful of them, and then penalizing people for not getting with the program.

It's called competition. As the government increasingly got involved in healthcare this impacted private insurance negatively and is one of the main reasons why healthcare costs skyrocketed.

We are a diverse country with many different environmental factors that vary across geographic region and even county to county. Plans need to be able to be tailored to individual needs. A one-size-fits-all policy would be very ill-fitted to the needs of Americans.

It's just...stupid way of going about it really. Although, I don't see Republicans offering any alternatives.(why is that?)

Why?

Well from 2008-2010 the Republicans held no power in the federal government. They could only talk about the shortcomings of the ACA. So it is very much a Democratic bill. Now with the state of having a divided government, nothing that the Republicans could offer to replace would go anywhere.

Also, not everyone agrees that the ACA needs to be replaced. As I stated previously, I think there are small things that the government can do in terms of regulation to reduce costs...but I don't think exchanges and individual mandates are justified at this point.

At 4/11/14 12:20 AM, Feoric wrote:

At 4/11/14 12:03 AM, MOSFET wrote: Politics.

They really don't want to repeal it, but they want to make a show of it that they do. However their constituents are upset and are aware of the game being played, which in turn gets the law maker a primary challenger. Which is why we get things like the debt ceiling crisis.

The GOP would gladly repeal the ACA and reinstate it unchanged word-for-word. This way they can actually get credit for passing legislation they themselves drafted.

1) I don't think they'd replace it word for word. Their base is slightly too sophisticated to not catch that.

2) Repeal and NOT replace is a much more realistic option. However, this will not happen until 2017 and then only if:
a) they take the Senate this year (about a 60-80% probability)
b) maintain control of Congress through the 2016 election
c) re-take the White House in 2016

3) I see the Republicans offering alternatives like a la carte plans and allowing insurance to be sold across state lines.

4) Furthermore, there are still SCOTUS challenges that could be made now that it is implemented and people can show harm. So we could see the ACA dismantled by the courts.

Selling insurance across state lines is one of the worst ideas to "fix" the health insurance industry. The current system is that you can only buy insurance that's been cleared by the regulators of your current state, in order to ensure that all insurance sold in the state meets state regulatory guidelines. This is explicitly what the proposal is attempting to do away with.

Once you do away with that, you'll have insurance companies operating under the regulations of their home state on a national basis, bypassing the system of state regulation in the home states of their customers, which is exactly the sort of situation that encourages the race to the bottom scenario.

The only good options available is that you maintain the current system, or you do away with the current system, simply let this happen to state-level regulations, and implement federal regulation to replace the lost state regulations. Well, or option #3, which is that you let the insurance companies decimate the state-level regulations without instituting federal regulation, letting the whole insurance industry become essentially self-regulated and begin racing to the bottom. Don't say this can't happen, because it did with the credit card industry:

"Conservatives want the opposite: They want insurers to be able to cluster in one state, follow that state's regulations and sell the product to everyone in the country. In practice, that means we will have a single national insurance standard. But that standard will be decided by South Dakota. Or, if South Dakota doesn't give the insurers the freedom they want, it'll be decided by Wyoming. Or whoever.

This is exactly what happened in the credit card industry, which is regulated in accordance with conservative wishes. In 1980, Bill Janklow, the governor of South Dakota, made a deal with Citibank: If Citibank would move its credit card business to South Dakota, the governor would literally let Citibank write South Dakota's credit card regulations. You can read Janklow's recollections of the pact here.

Citibank wrote an absurdly pro-credit card law, the legislature passed it, and soon all the credit card companies were heading to South Dakota. And that's exactly what would happen with health-care insurance. The industry would put its money into buying the legislature of a small, conservative, economically depressed state. The deal would be simple: Let us write the regulations and we'll bring thousands of jobs and lots of tax dollars to you. Someone will take it. The result will be an uncommonly tiny legislature in an uncommonly small state that answers to an uncommonly conservative electorate that will decide what insurance will look like for the rest of the nation."

At 4/11/14 11:02 AM, TheMason wrote: First of all, not everyone needs healthcare.

Yes, and not everyone who drives a car needs liability insurance, but it is a requirement nonetheless. Why? Because the consequences of needing and not having it represent a far bigger tax on society than the cost of having it and not needing it.

If someone has it and doesn't need it, sure a fe thousand dollars may be out of their pocket over a span of many years. If someone doesn't have it and needs it, they can easily rack up well over 100,000 dollars in a single incident. Option A: have and not need - someone may not be able to buy that TV they want, that new car they want, or those extra few lattes a day they want, society deals. Option B - doesn;t havebut needs - Cannot pay for anything because they do not have the coverage, person become bankruot and requires society safety nets, society not only picks up the unpaid medical bill, but picks up the person's financial needs until they can get back on their feet. It's a basic risk cost benefit calculation. here the bean counters got it right.

Guess which of those two options best benefits society?

Secondly, I don't really care about what is 'socially' acceptable. What is 'socially' acceptable/just/equal/etc quite often makes for bad public policy. Beyond that, it can also lead to the destruction of liberty and individual rights. Just see the erosion of economic liberty caused by the ACA on the Left and anti-gay marriage measures on the Right.

Using the thing you're claiming has taken away liberty to show how government involvement takes away liberty in order to show that the thing you're talking about takes away liberty ain't the best way to prove a point.

Third, this is not economically responsible.

I call total bullshit on that. That's a garbage excuse. Does medicare low ball on some prices? Yes, I won't deny that. Is that why my presecription sugar water costs $1,000 a day? BULLSHIT. Healthcare costs so much because the actual consumers are separated from the actual cost. Rarely does a person know or care how much their bill is going to be because insurance will cover it. Insurance companies don't care too much to lower the cost because they can just pass those costs onto their consumers who are none the wiser.

Fourth, it is an infringement on people's right to the pursuit of happiness.

I always though a key to owning and explotiing property/happiness was being physically well enough to do so...

* Tort-reform to reduce the cost of liability insurance for providers.

Malpractice needs to be redefined. Or rather the process for suing on malpractice needs to be adjusted. Instead of allowing malpractice to go straight to court, it should go through an EEOC style agency first. This agency can trash 90% of the cases which involve greedy fucks or idiots who don't realize that a risky procedure involves risk. This would let those who have legitimate claims retain their power to be remunerated properly. Taditional tort reform sacrifices justice to favor a xeophobic fear of corruption.

* Deregulation: before ACA each state came up with mandated things to be covered in all healthcare plans. The ACA doubled down on this foolishness. Examples of what I'm talking about: men paying for OB/GYN coverage or women paying for prostate cancer coverage. In the information age, there is no reason why people cannot go online and pick what they want coverage for a la carte.

Actually, a national standard is definitely the best. I'll explain later. I do agree that there should be male plans and female plans. A man doesn;t need child birth coverage the same way a woman doesn't need to turn her head and cough.

* Increasing competition.

Your comments here show a huge lack of understanding of the US health insruance industry. The lack of competition has been EXTREMELY lessened with the ACA. Now consumers can join group insurance not through their employer. Prior to the ACA your options were go individual and get screwed on premiums or go to your employer who has the wide array of options from Company A plan 1 to Company A plan 1.01. Employer based group insurance killed nearly all competition. Those who actually used the insurance were not the ones dictating which insurance they got.

As far as interstate nsurance, which I think is a good idea, you need standardized regulations. If CA requires such and such for their insurance and MO does not, MO would have to make a CA insurance plan and then the insurance would no longer be truly interstate.

It's called competition. As the government increasingly got involved in healthcare this impacted private insurance negatively and is one of the main reasons why healthcare costs skyrocketed.

Again, no. Government nvolvement didn;t kill competition. The insurance companies did.

We are a diverse country with many different environmental factors that vary across geographic region and even county to county. Plans need to be able to be tailored to individual needs. A one-size-fits-all policy would be very ill-fitted to the needs of Americans.

This right here argues directly against your interstate insurance want. For things to work interstate they must trend toward one size fits all. Otherwise, it truly isn't interstate. It would become what we have now which is numerous different arms of the same company working to each state's individual needs.

Well from 2008-2010 the Republicans held no power in the federal government. They could only talk about the shortcomings of the ACA. So it is very much a Democratic bill. Now with the state of having a divided government, nothing that the Republicans could offer to replace would go anywhere.

And? So just because they had no chance of actually replacing it means they shouldn;t even try to do the right thing? This is a PR issue. The GOP may have preached to the choir for the past few years about the perils of Obamacare, but they haven't tried to reach out to the rest of the country who realizes that our previous system was broken. It's easy to dislike Obamacare, it's much harder to go back to the clusterfuck we had before. The GOP should have offered an alternative at the beginning for two reasons: basic PR (instead of wanting to revamp the healthcare system, they came off as merely trying to Hulk-Smash it); osmosis (a good idea is a good idea. If you can create some, they may be adopted.)

Also, not everyone agrees that the ACA needs to be replaced. As I stated previously, I think there are small things that the government can do in terms of regulation to reduce costs...but I don't think exchanges and individual mandates are justified at this point.

You talk about competition, but then you turn around and say the exchanges, the FIRST hint of true competition in consumer based health insruance in pretty much forever, are bad. Which is it? Competition or the talking point?

At 4/12/14 09:12 AM, LazyDrunk wrote: If health insurance were akin to automobile liability insurance, we'd all be born with cars attached to our asses.

Using the US healthcare system is entirely voluntary. Any and every capable adult can turn down medical care. So don't give me that crap. It is not different than driving a car.

Also, mandatory organ donation.

What does this have to do with anything?

At 4/11/14 11:32 AM, Feoric wrote: Selling insurance across state lines is one of the worst ideas to "fix" the health insurance industry...

... which is exactly the sort of situation that encourages the race to the bottom scenario.

I should have been just a little more clear here. First of all, it's a good thing that I'm not a conservative and/or liberal and not bound by either dogma. :)

1) Since it would cross state lines...it would be totally acceptable for the federal government to take care of whatever regulations would be necessary and proper.

2) Not every transaction made between humans needs to be subjected to government regulation. If you allow a la carte coverage (ie: you log onto the website and click what things you want covered), there is no need for the government to dictate what basic plans will cover.

Besides, it won't fuck-up healthcare anymore than the ACA. ;)

At 4/12/14 04:35 PM, Camarohusky wrote:

At 4/12/14 09:12 AM, LazyDrunk wrote: If health insurance were akin to automobile liability insurance, we'd all be born with cars attached to our asses.

Using the US healthcare system is entirely voluntary. Any and every capable adult can turn down medical care. So don't give me that crap. It is not different than driving a car.

So then...

You negate your argument.

After all, if you do not own or operate a car you are not required to purchase liability insurance.

At 4/13/14 08:15 PM, TheMason wrote: So then...

You negate your argument.

After all, if you do not own or operate a car you are not required to purchase liability insurance.

Everyone has a body and gets sick. Not everyone has a car. Everyone requires health care. That's the difference.

At 4/11/14 01:04 PM, Camarohusky wrote: Yes, and not everyone who drives a car needs liability insurance, but it is a requirement nonetheless. Why? Because the consequences of needing and not having it represent a far bigger tax on society than the cost of having it and not needing it.

Umm...depending on the state you live in you CAN buy surety bonds, CDs, and other things instead of insurance.

Using the thing you're claiming has taken away liberty to show how government involvement takes away liberty in order to show that the thing you're talking about takes away liberty ain't the best way to prove a point.

I was actually making a point that BOTH conservatives and liberals want to grow government which in turn erodes liberty.

Third, this is not economically responsible.

I call total bullshit on that. That's a garbage excuse. Does medicare low ball on some prices? Yes, I won't deny that. Is that why my presecription sugar water costs $1,000 a day? BULLSHIT. Healthcare costs so much because the actual consumers are separated from the actual cost. Rarely does a person know or care how much their bill is going to be because insurance will cover it. Insurance companies don't care too much to lower the cost because they can just pass those costs onto their consumers who are none the wiser.

Only a Sith deals in absolutes. :)

I do not think that government is the TOTALITY of rising healthcare costs. I think there are several factors involved in cost increases. And what you bring up is part of that, after all cost share is a way that Walmart has used to reduce health costs.

Fourth, it is an infringement on people's right to the pursuit of happiness.

I always though a key to owning and explotiing property/happiness was being physically well enough to do so...

Appeal to emotion. I'll count that as a de facto concession.

I see the value in owning health insurance and how it fits in when my financial stability. However, I do not want to use government as a club to make others spend their money as I see fit.

* Tort-reform to reduce the cost of liability insurance for providers.

Malpractice needs to be redefined. Or rather the process for suing on malpractice needs to be adjusted. Instead of allowing malpractice to go straight to court, it should go through an EEOC style agency first. This agency can trash 90% of the cases which involve greedy fucks or idiots who don't realize that a risky procedure involves risk. This would let those who have legitimate claims retain their power to be remunerated properly. Taditional tort reform sacrifices justice to favor a xeophobic fear of corruption.

See this is what happens when there's dialogue. I like that idea, and probably wouldn't have thought of it.

* Deregulation: before ACA each state came up with mandated things to be covered in all healthcare plans. The ACA doubled down on this foolishness. Examples of what I'm talking about: men paying for OB/GYN coverage or women paying for prostate cancer coverage. In the information age, there is no reason why people cannot go online and pick what they want coverage for a la carte.

Actually, a national standard is definitely the best. I'll explain later. I do agree that there should be male plans and female plans. A man doesn;t need child birth coverage the same way a woman doesn't need to turn her head and cough.

If we had a la carte and sold insurance across state lines I think two things would happen:
1) The federal government would legitimately be the level of government responsible for insurance regulation. (This would reduce administrative costs.)
2) The amount of regulation required would be greatly reduced.

* Increasing competition.

Your comments here show a huge lack of understanding of the US health insruance industry. The lack of competition has been EXTREMELY lessened with the ACA. Now consumers can join group insurance not through their employer. Prior to the ACA your options were go individual and get screwed on premiums or go to your employer who has the wide array of options from Company A plan 1 to Company A plan 1.01. Employer based group insurance killed nearly all competition. Those who actually used the insurance were not the ones dictating which insurance they got.

What if we allow employers to subsidize benefits on a tax free basis? $X of my salary is dedicated to buying insurance and is tax-free...I can just choose my plan and coverage. My employer pays.

As far as interstate nsurance, which I think is a good idea, you need standardized regulations. If CA requires such and such for their insurance and MO does not, MO would have to make a CA insurance plan and then the insurance would no longer be truly interstate.

Either way, I think we get to a point where there is one standard set of regulations that reduces the administrative overhead that comes with 50+ (do the territories regulate insurance?) different sets of regulations.

It's called competition. As the government increasingly got involved in healthcare this impacted private insurance negatively and is one of the main reasons why healthcare costs skyrocketed.

Again, no. Government nvolvement didn;t kill competition. The insurance companies did.

Again...there is no ONE thing that killed competition. However, I do think that government is just as responsible as insurance companies. You haven't shown where they are significantly more culpable than government.

I just don't trust either one. They're both inmates in the asylum.

This right here argues directly against your interstate insurance want. For things to work interstate they must trend toward one size fits all. Otherwise, it truly isn't interstate. It would become what we have now which is numerous different arms of the same company working to each state's individual needs.

Not necessarily. I didn't make the point clearly.

If you couple buying insurance across state lines with a la carte policies, you allow individuals (perhaps with some input from someone's doctor) they can tailor their own insurance to their own needs based upon their risk factors (ie: medical history and environmental factors).

And? So just because they had no chance of actually replacing it means they shouldn;t even try to do the right thing? ... The GOP should have offered an alternative at the beginning ...

Again...it's only the right thing to a portion of the population. Not everyone agrees that this was 'the right thing to do'.

I think we need a reset, I think the 'clusterfuck' we had before is preferable to the monstrosity that is the ACA.

The Republicans were in no position to offer alternatives either emotionally or practically. They had suffered a total defeat politically and had absolutely NO power. The Democrats were drunk on a victory that was going to last a generation (James Carvill)...and not interested in Republican alternatives. In fact some of the alternatives I've talked about have been discussed by Republicans but got shouted down by Dems.

You talk about competition, but then you turn around and say the exchanges, the FIRST hint of true competition in consumer based health insruance in pretty much forever, are bad. Which is it? Competition or the talking point?

Yeah...talking points.

Once you look at how the law works (and not just the Democratic talking point that exchanges are 'competition') you see that the exchanges do NOT provide competition. In many places there is only one insurer. Secondly, doctors and hospitals do not have to accept these plans. SO consumers MAY be paying lower premiums...but they are seeing their options for providers decreased (where competition REALLY matters).

At 4/13/14 08:10 PM, TheMason wrote: 1) Since it would cross state lines...it would be totally acceptable for the federal government to take care of whatever regulations would be necessary and proper.

Well, no, that defeats the whole point of deregulating the health insurance industry to allow it to sell across state lines.

2) Not every transaction made between humans needs to be subjected to government regulation. If you allow a la carte coverage (ie: you log onto the website and click what things you want covered), there is no need for the government to dictate what basic plans will cover.

What mechanism is put into place that would even inevitably result in a la carte markets? What incentive is provided?

At 4/13/14 08:42 PM, Feoric wrote:

At 4/13/14 08:15 PM, TheMason wrote: So then...

You negate your argument.

After all, if you do not own or operate a car you are not required to purchase liability insurance.

Everyone has a body and gets sick. Not everyone has a car. Everyone requires health care. That's the difference.

Yes, that is a difference.

Another difference is what we're talking about is how people pay for health care.

And yet another difference is that a person has a right to the product of their labor and (in a free society) to their property. A person's body is a requirement of their existence, a car is personal property that an individual voluntarily partakes in.

At 4/13/14 09:02 PM, Feoric wrote:

At 4/13/14 08:10 PM, TheMason wrote: 1) Since it would cross state lines...it would be totally acceptable for the federal government to take care of whatever regulations would be necessary and proper.

Well, no, that defeats the whole point of deregulating the health insurance industry to allow it to sell across state lines.

Not.
At.
All.

If you have a la carte plans much of the need for regulation (on the state or federal level) disappears. What regulatory needs that are left can be handled by the federal government. This in turn provides ONE standard that insurers have to meet.

* This reduces the number of forms that insurers need to maintain (since forms, be they paper or e-based, are dictated by the states).
* It reduces the personnel required to ensure regulatory compliance.

What mechanism is put into place that would even inevitably result in a la carte markets? What incentive is provided?

The barriers are removed. I believe this is something that many consumers would want.

This may rock your world: but no artificial mechanism is required since the incentive would be customer demand.

Perhaps the closest thing would be employers saying they will pay $X/mth for health insurance and this is tax free income (perhaps companies receive tax breaks for this benefit). The employees are free to log onto the internets (a series of tubes that bring information into home and/or work), shop for insurance and click on what things they want covered.

All without interference by Uncle Sam or their state legislatures.

Hell, perhaps we take employers out of it completely. We allow individuals to deduct (even if they do not itemize) the cost of insurance (up to a certain amount). Yes this is an idea of the ACA...BUT the ACA only covers policies bought over the exchanges.

At 4/13/14 09:28 PM, TheMason wrote: Not.
At.
All.

If you have a la carte plans much of the need for regulation (on the state or federal level) disappears. What regulatory needs that are left can be handled by the federal government. This in turn provides ONE standard that insurers have to meet.

* This reduces the number of forms that insurers need to maintain (since forms, be they paper or e-based, are dictated by the states).
* It reduces the personnel required to ensure regulatory compliance.

You're not actually answering my question, nor are you addressing the meat of my original post. I'm not talking about the pros and cons of a la carte plans. I'm asking how allowing insurance to sell across state lines invariably results in a la carte plans being available in the first place, in spite of the massive pitfalls I've addressed in my earlier post. I'm not even saying I'm for or against a la carte -- in fact I'm all for it. Purchasing health insurance is a lot like getting a cable subscription -- you have to get a plan that comes with 100 other channels you don't give a shit about despite you only being interested in 3 or 4.

What mechanism is put into place that would even inevitably result in a la carte markets? What incentive is provided?

The barriers are removed. I believe this is something that many consumers would want.

This may rock your world: but no artificial mechanism is required since the incentive would be customer demand.

Perhaps the closest thing would be employers saying they will pay $X/mth for health insurance and this is tax free income (perhaps companies receive tax breaks for this benefit). The employees are free to log onto the internets (a series of tubes that bring information into home and/or work), shop for insurance and click on what things they want covered.

All without interference by Uncle Sam or their state legislatures.

Hell, perhaps we take employers out of it completely. We allow individuals to deduct (even if they do not itemize) the cost of insurance (up to a certain amount). Yes this is an idea of the ACA...BUT the ACA only covers policies bought over the exchanges.

My real life scenario does not coincide with your hypothetical scenario. In the real world the state with the worst regulation environment becomes the standard for all. This is not a free market.

At 4/13/14 08:15 PM, TheMason wrote: After all, if you do not own or operate a car you are not required to purchase liability insurance.

Not really. I take it the opposite direction, in that one who does not have health insurance has no right to use the healthcare system. As that is atrocious and draconian, and forcing health insurance upon everyone is a SUPER INCREDIBLY MINOR INCONVENIENCE, all should have heath insurance becuase all are using (at some point in their lives) the US health system.

At 4/13/14 09:02 PM, TheMason wrote: Umm...depending on the state you live in you CAN buy surety bonds, CDs, and other things instead of insurance.

Walks like a Duck, talks like a Duck. You can buy an HSA account instead of full on health insurance. It still performs the same need.

I was actually making a point that BOTH conservatives and liberals want to grow government which in turn erodes liberty.

Wasn't saying you were wrong, was just saying your reasoning was circular to the point of being meaningless.

Only a Sith deals in absolutes. :)
I do not think that government is the TOTALITY of rising healthcare costs. I think there are several factors involved in cost increases. And what you bring up is part of that, after all cost share is a way that Walmart has used to reduce health costs.

Yeah, true, but this is healthcare, not sins in the Bible. Differing levels of harm pose differing problems. The government involvement problem is quite minor. The detatchment of actual customers from insurance as well as our WalMart syndrome, as I call it, are bigger problems. WalMart syndrome is the idea that one can afford something beyond their means.

I see the value in owning health insurance and how it fits in when my financial stability. However, I do not want to use government as a club to make others spend their money as I see fit.

Well, if you choose not have health insruance and then not have it when you need it, or purchase it late you are doing precisely that: telling others how to spend their money. So the money issue will happen either way. We cannot use that as a reason to fault this. It's a wash, and may in fact be better with the forced insurance.

See this is what happens when there's dialogue. I like that idea, and probably wouldn't have thought of it.

It is somewhat expensive, for the goverment at least. It would be an entirely new agency that would need a good amount of funding. However, it should reduce the overall costs and strains of the lawsuits on the system.

I do agree that we need more dialogue. However, as I pointed out in another topic the who and th how of the dialogue are huge. When most people on the right mention things like "tort reform" it is done in a tone that suggest they merely want to save the big guys' a buck at the expense of the little guy. It is also often discussed in the form of welfare queens, where a very useful and very productive system should be completely and utterly gutted just to stop a very small minority from misusing it, completely disregarding how the honest users would be affected.

If we had a la carte and sold insurance across state lines I think two things would happen:
1) The federal government would legitimately be the level of government responsible for insurance regulation. (This would reduce administrative costs.)
2) The amount of regulation required would be greatly reduced.

This is largely why I am more in favor of Federal power than state power. While I do understand states have needs and wnats that are often very nuanced and unique, the application of such, especially in our ever more connected world, creates needless redundancies and significant amounts of waste.

What if we allow employers to subsidize benefits on a tax free basis? $X of my salary is dedicated to buying insurance and is tax-free...I can just choose my plan and coverage. My employer pays.

A voucher system is how many employers have responded to the exchange system. Yet, without the exchange system it is damn near impossible for an individual to join a group policy. As far as the ACA goes, I fail to see why anybody dislikes th exchange system other than to use it as ammo against the ACA as a whole and Obama as a president.

Again...there is no ONE thing that killed competition. However, I do think that government is just as responsible as insurance companies. You haven't shown where they are significantly more culpable than government.

I have pointed out why there is no real competition. The customers who use the insurance are rarely the ones who pick the insurance. Usually the employer picks the company and style of plan and the employer gets an either-or choice from it. In short, most competition is intra-company (hell even intra-plan) and maybe gives the consumer a realistic shot at 0.1-0.5% of the possible plans available. The insurance companies structured it like this to hedge their bets. The government may have encouraged employers to participate, but the insurance companies were the ones who decided this was pretty much the only way to join a group plan.

With the exchanges the government has now found a way to get group plans out there in the open for individuals to shop around for. No longer is it a choice between just "employer's choice 1", "employer's choice 2", and individual rate insurance. We finally have the opportunity for something resembling competition in this formerly highly closed off market.

I just don't trust either one. They're both inmates in the asylum.

Yeah, but you're trying to claim the suicidally depressed patient is just as crazy as the bi-polar homicidal schizophrenic.

If you couple buying insurance across state lines with a la carte policies, you allow individuals (perhaps with some input from someone's doctor) they can tailor their own insurance to their own needs based upon their risk factors (ie: medical history and environmental factors).

I don't trust full on a la carte plans to solve any of the current problem. Furthermore, what it does is open a back door for pre-existing conditions and individual backgrounds to play a significant part in rate tables. There needs to be a base level of coverage that ALL people get. This would include routine doctor visits, catastrophic healthcare, and a few other basics (of which my inexperience leads me to not know or forget.) I do not like the idea of changing how much people pay based on any demographic except for age. It allows far too much discretion on the part of for profit entities in an issue that for conscionability reasons should NOT be for profit.

Again...it's only the right thing to a portion of the population. Not everyone agrees that this was 'the right thing to do'.
I think we need a reset, I think the 'clusterfuck' we had before is preferable to the monstrosity that is the ACA.

How? A few people paid less, but got a shit ton less, and tons of people were denied for bullshit reasons? Sound slike a better situation than the ACA.

The Republicans were in no position to offer alternatives either emotionally or practically. They had suffered a total defeat politically and had absolutely NO power. The Democrats were drunk on a victory that was going to last a generation (James Carvill)...and not interested in Republican alternatives. In fact some of the alternatives I've talked about have been discussed by Republicans but got shouted down by Dems.

So what if the Dems had power? The Republicans still had far more than enough power to parde their alternative to their group and the independents. The problem now is that the Republicans have fought so damn hard to repeal it, and have looked like cowns in the process whose sole goal is to trash whatever Obama does. Had they had a legit (I'm not even talking about reasonable, just something that wasn't a for show piece of garbage replacement) they would have about 10 times the credibility than they do now. They had their chance to play the long run. They chose not to and it has come back to really hurt them. People may not like Obamacare, but they recognize as an attempt to fix a blatant problem. The GOP seems like it would rather return everyone to a clearly broken system than make the simplest of efforts to fix it. They essentially bronzed their scorched earth policy with this move.

but they are seeing their options for providers decreased (where competition REALLY matters).

So they should go back to no options? This isn't golf where less is more. It's an attempt, and that is 1,000 times more than the GOP has even made the effort to look like they're doing.

@ Camaro

A few things:
* There was nothing circular about my reasoning, I was show casing a false dichotomy. Using a previous example is key to writing on-topic and with purpose. It is only circular if A causes B and B causes A. Since I was not making the claim that Left & Right anti-freedom policies cause each other...there is nothing circular about what I wrote. :)

* The overarching point I was trying to make was: the debate is NOT over, and the principles put forth in the ACA are NOT the ONLY options.

* I understand about how pools work. But is government really the first option we should go to? Why not let the free market try to work? Perhaps insurance companies can figure out ways of pooling potential clients akin to the exchanges...minus Obama's web-design savvy.

* We disagree on who is the depressive suicidal patient and who is the sociopathic homicidal psychopath. I trust the person who covets money over the person who covets power. The corporations cannot force me to deal with them. However, those holding government power have the ability to force me to do their will.

* "...looked like cowns in the process whose sole goal is to trash whatever Obama does." This is complete and utter BULLSHIT. This is a cliché. This narrative that there is something special about 'this president' and Republican opposition to him is Left hysteronics and designed only to manipulate the emotions of the Democratic base. Am I going to deny that there are some people who don't think a black man should be president? That would be stupid. I've known a few people who think that way. But guess what? Not all of them are conservative Republicans! One guy I knew was a FDR Dem from WWII!

I came of age during the Clinton presidency.
* Republicans fought Clinton on healthcare.
* Republicans fought Clinton on gun control.
* Republicans shut down government in response to Clinton's agenda (and BOTH Clinton and Congressional Republicans got covered in shit).
* Republicans fucking impeached Clinton.

What's the difference?
* Obama comes from serving in the Illinois Senate which had one party rule. The only coalitions he learned to build there was between blue and lighter blue. Then he did a stint in the Senate where the Dems had pretty strong control. The man does not know how to reach across the aisle.
* Obama got handed a Washington staff of top Democrat aides...he did not have to learn how the institutions work.
* Obama's top executive experience coming into the White House: Editor of the Yale (or was it Harvard) Law Review.
* Following losses in Congress in 1994...Clinton triangulated his agenda.
* Following poll number losses after the shutdowns...Clinton re-accessed his relationship with Newt Gingrich and the two actually was able to get things done.

Perhaps the narrative that Republicans are 'racist' and oppose Obama (in any way different from Clinton or Carter)...is just a cover for Dems picking a crappy candidate for president in 2008.

At 4/18/14 06:31 PM, TheMason wrote: What's the difference?
* Obama comes from serving in the Illinois Senate which had one party rule. The only coalitions he learned to build there was between blue and lighter blue. Then he did a stint in the Senate where the Dems had pretty strong control. The man does not know how to reach across the aisle.

Jesus Christ this is not 2008 it's fucking 2014. We have many examples of attempted bipartisanship and it's the same answer THE REPUBLICANS ARE FULL OF SHIT.... and they know it too. Obama presents his idea for healthcare, GOP and some Dems object, Obama says ok and hosts a conference to gather ideas and comes away with the present Obamacare which the GOP still didn't vote for despite it being an idea that they support and one which they passed at the state level. Recently Obama attempts immigration reform, GOP says they won't negotiate because they don't trust the President to enforce the law, Democrats say ok and begin working on a bill that will take effect after Obama has left the presidency, the GOP says no because they don't trust Obama to enforce the law......

Obama knows how to, it's just the Republicans think that any bipartisanship will be detrimental to them, the GOP learned this under Clinton. There they caved into demands and in turn handed Clinton a 2nd term. This time they caved in at the last moment to merely delay the situation further. And you know they're probably right.

* Following losses in Congress in 1994...Clinton triangulated his agenda.

Well Obama got what he wanted for the most part, all he had to do was hold off the GOP's futile attempts to repeal it.

* Following poll number losses after the shutdowns...Clinton re-accessed his relationship with Newt Gingrich and the two actually was able to get things done.

You have it the other way around. When the government shut down both times the GOP was blamed, and so they were pushed to pass a deal. The GOP under Gingrich got something out of it removing some welfare programs and the like whereas the current GOP got nothing. Both Obama and Clinton enjoyed more approval and sympathy.

Perhaps the narrative that Republicans are 'racist' and oppose Obama (in any way different from Clinton or Carter)...is just a cover for Dems picking a crappy candidate for president in 2008.

Again with the whole "race card" myth. Korriken keeps bringing it up but doesn't back it up with good evidence showing Democrats accusing the GOP of being racist. It's just a lie repeated over and over.

At 4/18/14 06:31 PM, TheMason wrote: Why not let the free market try to work?

There cannot possibly be a free market solution to healthcare. The American health care market is subject to an extremely high degree of regulation. All of those regulations impose costs. Hence, it is valid to say "the American health care market is not free," even in the absence of explicit price controls, because the vast array of health care regulations operate to alter and affect costs and pricing. Even if all of those regulations are completely justified, it would still be error to call a market "free" that was so heavily regulated, unless you want a completely deregulated health insurance market, which is frankly insane. In the end, though, a private, for-profit insurance company has no duty or obligation (or incentive, really) to either keep healthcare affordable or to provide services to its customers. Its duty is to provide dividends and financial returns to its stockholders--a duty the industry has managed to keep by increasing costs to consumers over the years.

Or, if you're erroneously using the term "free market" to mean "less regulated than what it currently is now but still maintain a base level of regulation" the let me ask you this: healthcare insurance has increased astronomically since Bush took office. Which specific governmental regulatory factors explain or correlate with those increases?

so its either we have no healthcare or you have to pay for it by defacto force.

Supposedly theres a bunch of hardship exemptions and whatnots for regular people

http://blog.heritage.org/2014/03/13/delaying-obamacares-individual-mandate-due-hardship/

Who knows how this will work out. I'm guessing it will be some new thing to add into the tax form hence why they need all these IRS agents. Then they'll have to go over your 1040 with a fine tooth comb to make sure you qualify.

Realistically theres already tons of people that don't file income tax. Since most of the reporting is self induced anyways its going to hit the average hardworking joe the most. Some bum that doesnt work or is on the dole will qualify for an exemption since he doesn't have enough whereas Joe working man is going to be paying out his arse.

Then again the law originally was so convoluted and with all of these delays and exemptions and executive orders and postponements being put into place, I doubt theres a single person in this country that understands how and what will be happening.

http://www.huffingtonpost.com/2014/03/25/obamacare-individual-mandate_n_5007960.html

The main reason they're postponing this crap is so they have a fighting chance for the elections. Not the current brand of repubs is really much better at this point.

At 4/22/14 12:19 AM, Kel-chan wrote: Realistically theres already tons of people that don't file income tax. Since most of the reporting is self induced anyways its going to hit the average hardworking joe the most. Some bum that doesnt work or is on the dole will qualify for an exemption since he doesn't have enough whereas Joe working man is going to be paying out his arse.

Your biased link doesn't even say that. Here's what it says

"Most recently, the administration extended the “hardship exemption” from the individual mandate for those who had their previous policies canceled because of Obamacare until October 2016."

The exemption is for those who had their healthcare plans cancelled since they did not meet the standards of Obamacare.

At 4/22/14 01:24 AM, Warforger wrote:
Your biased link doesn't even say that. Here's what it says

"Most recently, the administration extended the “hardship exemption” from the individual mandate for those who had their previous policies canceled because of Obamacare until October 2016."

The exemption is for those who had their healthcare plans cancelled since they did not meet the standards of Obamacare.

yeah thats what i said...

Healthcare is not free. For everyone that gets an exemption or reduced price - somebody else has to pay for that. Or we al end up paying for it through direct monetary inflation.

You either take money from some people to pay for other people or you print that money out of thin air depreciating the value of everyone's money. At the end of the day it still has to be paid for because nothing is free.

At 4/22/14 02:36 AM, Kel-chan wrote: At the end of the day it still has to be paid for because nothing is free.

The point of healthcare reform is not to make it free. It's to do two things: to increase access and to reduce cost. The former has a tendency to aid the latter.

By spreading out the cost, those who have little resources can get proper and timely healthcare. The benefits of wider access to healthcare are very good. You have less loss of productivity due to illness, and healthier and more active citizenry.

The increased access also lowers costs. When one does not have covered healthcare, they tend to put things off. This can have a simple cheap stomach problem lead into a very expensive ulcer. A cheap toothache into an absess. Fairly cheap diabetes into full of astronomically expensive kidney dialysis. The examples go on and on.

Also, when it comes to these minor things, proper health coverage leads to cheaper method of dealing with it. People with proper health coverage are more likely to get a primary. A primary doctor visit is cheaper than an urgent care or an emergency room visit (and with the latter, the primary doctor visit doesn't use of resources that could be spent dealing with actual emergencies.)

There are very few, if any, downsides to wider access to health coverage.

At 4/22/14 10:48 AM, Camarohusky wrote: There are very few, if any, downsides to wider access to health coverage.

Except nobody is arguing against 'wider access to health coverage' per se. The concerns are with how it is achieved.

At 1/4/15 12:47 AM, rajNG wrote: Unless you broke as FUCK,...then,...No.

Fuck ObamaCare.

You tell 'em, Raj!