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Tags Affordable Care Act , AHCA , donald trump , health care issues , health insurance issues , obamacare , Trumpcare

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Old 7th March 2017, 11:51 AM   #681
BobTheCoward
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Originally Posted by Skeptic Ginger View Post
For the record, some tax credits come out of taxes owed. If you are too poor to owe income tax (remember you still pay FICA and other taxes) then the credit does you no good. And I'm sure the Republicans know that full well.
I think this is a refundable tax credit so you get a refund on a negative income tax.
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Old 7th March 2017, 12:30 PM   #682
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Originally Posted by PhantomWolf View Post
John Oliver takes on the Republican Health Care plan.

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.
I AGREE
Good stuff as usual from Oliver.
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Old 7th March 2017, 12:31 PM   #683
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Quote:
Originally Posted by TragicMonkey View Post
I read it allows (compels?) a 30% premium increase if you 'let' coverage lapse. So if you're like most people and get your insurance through your employer does that mean you're more tied to not switching jobs than before? Would suck to get laid off without enough notice to get a new private policy...
Originally Posted by Skeptic Ginger View Post
It's insanity gone wild. You run out of money, or lose your job and can't keep up your insurance premiums and the GOP would have you the priced out of the insurance market for years hence.

The alt-thinking on this boggles the mind. It speaks to their world view that all poor people are shiftless and lazy so let's threaten them for letting their health insurance lapse.

Then there is the alt-reality that these uninsured people will not cost the rest of us money when they seek their health care in the ED and leave the hospitals with bad debt to pass on to the rest of us paying consumers.
I tried to read this portion of the bill to understand it but did not have much luck.
SEC. 133. CONTINUOUS HEALTH INSURANCE COVERAGE IN- 17 CENTIVE.

Is this much different than the penalty currently imposed under ACA when you have no insurance?
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Old 7th March 2017, 12:32 PM   #684
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Originally Posted by eeyore1954 View Post
I tried to read this portion of the bill to understand it but did not have much luck.
SEC. 133. CONTINUOUS HEALTH INSURANCE COVERAGE IN- 17 CENTIVE.

Is this much different than the penalty currently imposed under ACA when you have no insurance?
1) They don't call it a mandate, so that makes it acceptable
2) It is I think less than the current penalty
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Old 7th March 2017, 12:39 PM   #685
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Originally Posted by eeyore1954 View Post
I tried to read this portion of the bill to understand it but did not have much luck.
SEC. 133. CONTINUOUS HEALTH INSURANCE COVERAGE IN- 17 CENTIVE.

Is this much different than the penalty currently imposed under ACA when you have no insurance?
Depends on how it works. If its a permanent 30% higher premium because you changed jobs and you new coverage didn't kick in for three months, and you pay 30% higher as a result then yes, that's a great deal more than a $500 annual fine you'd pay one quarter of.
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Old 7th March 2017, 01:11 PM   #686
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Originally Posted by TragicMonkey View Post
Depends on how it works. If its a permanent 30% higher premium because you changed jobs and you new coverage didn't kick in for three months, and you pay 30% higher as a result then yes, that's a great deal more than a $500 annual fine you'd pay one quarter of.
That what I tried to find out by looking at the bill. I don't think that will be it but I got lost when I tried to read it.
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Old 7th March 2017, 01:17 PM   #687
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Originally Posted by BobTheCoward View Post
Probably would have turned out marginally okay if they could have raised the no insurance tax as needed.
It's not really an enforceable tax though. The IRS can't put a lien on your assets to force you to pay. The only thing the IRS can do is deduct it from your refund, if any.

The only thing of any value in Obamacare was the Cadillac tax, which has already been delayed once, and which now the Republicans will delay again. Oh well ...
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Old 7th March 2017, 01:21 PM   #688
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Originally Posted by sunmaster14 View Post
Apparently it did require secret legislation in the future, because right now Obamacare is a mess.
How is it a mess?
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Old 7th March 2017, 01:23 PM   #689
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Originally Posted by sunmaster14 View Post
It's not really an enforceable tax though. The IRS can't put a lien on your assets to force you to pay. The only thing the IRS can do is deduct it from your refund, if any.

The only thing of any value in Obamacare was the Cadillac tax, which has already been delayed once, and which now the Republicans will delay again. Oh well ...
Yes all those extra people who were able to get insured count for nothing in your book, thanks for confirming that.
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Old 7th March 2017, 01:31 PM   #690
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Originally Posted by eeyore1954 View Post
I tried to read this portion of the bill to understand it but did not have much luck.
SEC. 133. CONTINUOUS HEALTH INSURANCE COVERAGE IN- 17 CENTIVE.

Is this much different than the penalty currently imposed under ACA when you have no insurance?
It's much much worse.

Instead of encouraging people who do not have insurance to obtain it, it becomes harder for more people who cannot afford coverage to carry insurance.

Preexisting conditions must be covered. Where is the motivation for the healthy uninsured person to carry insurance? Why should they, they need not purchase insurance until they have an expensive medical need.

But for the poor person having trouble keeping insurance, it gets harder and harder.

And that's only a fraction of the problems with this alt-reality these right wingers live in.

Everyone gets a tax break regardless of income? Heaven forbid a poor person get a handout a rich person doesn't also get.

And the amount of the subsidies in no way helps the poorest people get health insurance, and the rates for the elderly are going to skyrocket because the insurers can now charge 5 times more than younger policy holders instead of 3 times as much while the subsidies don't cover a fraction of that increase.

This plan is a joke. **** the poor, we all know they are just lazy moochers.
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Old 7th March 2017, 01:32 PM   #691
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Originally Posted by Spindrift View Post
How is it a mess?
Obamacare is something of a mess;it's badly flawed. But the GOP "replacement" is worse, much worse.
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Old 7th March 2017, 01:33 PM   #692
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Originally Posted by Spindrift View Post
How is it a mess?
The whole point was to create a viable market for individual insurance. It has failed miserably in that respect. All it has managed to do is redistribute money and health care resources from the middle class to the poor, from the young to the old, from the moderately healthy to the sick, and from the responsible to the irresponsible. It has also had the effect of redistributing customers from good doctors to bad doctors (via the incentive of health insurers to narrow networks).

As for this idea that it gave health care to all of these uninsured people who weren't getting it before, I bet that for every one of those people there is at least one formerly insured person who has had to cut back on his health care consumption because of rising premiums, deductibles, and co-pays.

There really is no free lunch unless you move to a more market-based system where people can express their preferences and do their own cost-benefit calculations. Obamacare exacerbated the fundamental problem of overconsumption of medical care in the US. It jumbled the distribution somewhat, but the fundamental problem remains.
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Old 7th March 2017, 01:35 PM   #693
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Originally Posted by pgwenthold View Post
...
2) It is I think less than the current penalty
I believe you'd be wrong. From what I am hearing on the news, the current penalty for not carrying insurance is a mere $600 or so a year.

30% more in rates if your insurance lapses for 2 months and you try to purchase it again can be a couple hundred more a month, times 12 months, $2400 or 4 times the current penalty.
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Old 7th March 2017, 01:35 PM   #694
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Originally Posted by Garrison View Post
Yes all those extra people who were able to get insured count for nothing in your book, thanks for confirming that.
And all of those people who had insurance before and have had to cut back on their health care consumption count for nothing in your book. Literally, because you have no clue. Thanks for confirming that.
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Old 7th March 2017, 01:35 PM   #695
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Old 7th March 2017, 01:35 PM   #696
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Originally Posted by dudalb View Post
Obamacare is something of a mess;it's badly flawed. But the GOP "replacement" is worse, much worse.
Flawed? Possibly, but that's because the Republicans wouldn't allow single payer.

The health insurance industry was a mess long before Obamacare and continues to be so.
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Old 7th March 2017, 01:37 PM   #697
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Rand Paul and his camp are announcing now their completely market based plan (what did we have before the ACA?)

Magic, costs will go down.
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Old 7th March 2017, 01:38 PM   #698
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Originally Posted by sunmaster14 View Post
And all of those people who had insurance before and have had to cut back on their health care consumption count for nothing in your book. Literally, because you have no clue. Thanks for confirming that.
And if you can show those people exist outside of your imagination that would be great but you seem to have about the same relationship with evidence that Trump does.

ETA: Actually if you are saying now many more people got coverage than previously then that's an admission your previous post was false, unless you're planning to argue more people lost out than gained. I do hope you are because that will be hilarious.
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Old 7th March 2017, 01:52 PM   #699
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All I see is we're going back to the way it was. I hate to break the news to you conservatives, but our health care system was an embarrassment before the ACA. All you've done is go from one embarrassment to another while other wealthy countries actually DO SOMETHING about controlling costs.
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Old 7th March 2017, 01:59 PM   #700
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Originally Posted by twinstead View Post
All I see is we're going back to the way it was. I hate to break the news to you conservatives, but our health care system was an embarrassment before the ACA. All you've done is go from one embarrassment to another while other wealthy countries actually DO SOMETHING about controlling costs.
Whatever do you mean? Both parties are polishing the turds as quickly as they can, with their eyes closed. Surely the result will be well worth the efforts any day now!
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Old 7th March 2017, 02:10 PM   #701
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Originally Posted by twinstead View Post
All I see is we're going back to the way it was. I hate to break the news to you conservatives, but our health care system was an embarrassment before the ACA. All you've done is go from one embarrassment to another while other wealthy countries actually DO SOMETHING about controlling costs.
Healthcare as an industry is simply too big to fail to continue to expand. Cutting costs would cause say tens to hundreds of thousands of paper pushers to lose their jobs. That is far to bitter a pill for saving a mere 3-4% of the GDP.
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Old 7th March 2017, 03:11 PM   #702
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Originally Posted by Skeptic Ginger View Post
Rand Paul and his camp are announcing now their completely market based plan (what did we have before the ACA?)

Magic, costs will go down.
My bold. What we had was far from "completely market based"; rather a mish-mash of employer plans, private plans, Medicare, Medicare supplements, Medicaid, and cost-shifting from those who couldn't or didn't pay but got treatment anyhow to those who could; and from those with insurance (which could negotiate prices) to those without (who couldn't). In other words, a complete, bolloxed mess. Paul's plan would no doubt revert to something like that, only worse.
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Old 7th March 2017, 03:14 PM   #703
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Originally Posted by sunmaster14 View Post
.....
I bet that for every one of those people there is at least one formerly insured person who has had to cut back on his health care consumption because of rising premiums, deductibles, and co-pays.
.....
Prove it. The only way that would be possible would be for someone to file limited claims. But one of the primary complaints about the previous system was the practice of "rescission," where insurers looked for pretexts to cancel policies when someone started to file big bills. And nothing would prevent a company from refusing to renew a policy that started to cost them money. So those people you're talking about -- if you can find any -- might have been getting cheap office visits and flu shots, but if they ever needed lung cancer treatment or a heart transplant or expensive medication for a chronic condition, they'd be out in the cold. Some of them might have discovered that the hard way.

The ACA is certainly not perfect, as Obama himself acknowledged. But it was based on Republican proposals to expand coverage and share costs. Democrats going back to the '70s supported some variation of taxpayer-supported universal care, which still makes the most sense.

Last edited by Bob001; 7th March 2017 at 03:21 PM.
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Old 7th March 2017, 03:19 PM   #704
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Originally Posted by quadraginta View Post
Responding to my own post.
... snip...

I'm not sure I understand how that works.
Ah I see the mistake you are making, which is to assume it is *meant* to work!
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Old 7th March 2017, 03:20 PM   #705
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Originally Posted by Trebuchet View Post
My bold. What we had was far from "completely market based"; rather a mish-mash of employer plans, private plans, Medicare, Medicare supplements, Medicaid, and cost-shifting from those who couldn't or didn't pay but got treatment anyhow to those who could; and from those with insurance (which could negotiate prices) to those without (who couldn't). In other words, a complete, bolloxed mess. Paul's plan would no doubt revert to something like that, only worse.
We still have the mish-mash (and you left out the VA and Tricare for the military and vets). But the ACA was intended to make insurance available to individuals who couldn't get it any other way, and it would have worked a lot better if the Repubs hadn't blocked Medicaid expansion in many states, which has been pretty successful in the states that permitted it.
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Old 7th March 2017, 03:25 PM   #706
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Originally Posted by Trebuchet View Post
... In other words, a complete, bolloxed mess. Paul's plan would no doubt revert to something like that, only worse.
That was my point. What these Libertarians claim is free market based never is.

But beyond that, there are dozens of reasons the free market would not lower health care costs and is flawed when it comes to things people need to survive like utilities and health care.

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Old 7th March 2017, 03:30 PM   #707
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Originally Posted by Skeptic Ginger View Post
That was my point. What these Libertarians claim is free market based never is.

But beyond that, there are dozens of reasons the free market would not lower health care costs and is flawed when it comes to things people need to survive like utilities and health care.
That's the key point. Health care is not an optional consumer good, like a new car or big TV or even a house. People buy it because they need it, and they are not in a position to haggle. And if they don't get it because they can't afford it, they end up worse off and we all ultimately absorb the cost one way or another. A "market" presumes that buyers and sellers compete on an equal footing. That's just not the case for health care.
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Old 7th March 2017, 04:07 PM   #708
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Originally Posted by Bob001 View Post
That's the key point. Health care is not an optional consumer good, like a new car or big TV or even a house. People buy it because they need it, and they are not in a position to haggle. And if they don't get it because they can't afford it, they end up worse off and we all ultimately absorb the cost one way or another. A "market" presumes that buyers and sellers compete on an equal footing. That's just not the case for health care.
Nonsense, the market is the same for everything!

That's why higher education gets cheaper every year.
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Old 7th March 2017, 04:45 PM   #709
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Originally Posted by Bob001 View Post
Prove it. The only way that would be possible would be for someone to file limited claims. But one of the primary complaints about the previous system was the practice of "rescission," where insurers looked for pretexts to cancel policies when someone started to file big bills. And nothing would prevent a company from refusing to renew a policy that started to cost them money. So those people you're talking about -- if you can find any -- might have been getting cheap office visits and flu shots, but if they ever needed lung cancer treatment or a heart transplant or expensive medication for a chronic condition, they'd be out in the cold. Some of them might have discovered that the hard way.
Exactly, yes some people wound up paying more, but that was because their new policies had to be more than marginally useful. And the big question is do those cases remotely balance out the benefits to those able to get insurance that was previously unavailable?
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Old 7th March 2017, 05:23 PM   #710
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Originally Posted by Skeptic Ginger View Post
Rand Paul and his camp are announcing now their completely market based plan (what did we have before the ACA?)

Magic, costs will go down.
The magic of the marketplace will provide health insurance for $75 a month just like the good old days.

The math works out a bit like this. Customer pays $75 a month and doctor visits have a $20 copay. The insurance pays the doctor an additional $100 for each visit. Sounds like a much better deal than Obamacare. The trick is that the insurance doesn't cover more than six visits a year. The insurance company pockets $25 a month even if the customer visits the doctor six times.

Several of the Obamacare horror stories publicized when the program first came out involved people who had this kind of health insurance policy. One that only provided the illusion of coverage.
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Old 7th March 2017, 06:23 PM   #711
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Well, I for one am rather disappointed in this effort. This is only marginally different than ACA and it's certainly not seeming to be much better. The party in power seems to have cobbled together a crap plan quickly rather than taking their time to craft something truly innovative.

IMO they are just paving the way for the eventual single payer or government owned healthcare system.
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Old 7th March 2017, 06:24 PM   #712
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Originally Posted by Skeptic Ginger View Post
That was my point. What these Libertarians claim is free market based never is.

But beyond that, there are dozens of reasons the free market would not lower health care costs and is flawed when it comes to things people need to survive like utilities and health care.
That is an awful lot of assumptions about what society should ensure for the people in it.
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Old 7th March 2017, 06:53 PM   #713
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Originally Posted by NoahFence View Post
Don't you know? Every single thing that has happened in the insurance industry is a direct result of the muslim usurper in office! Insurance companies are totally off the hook, mainly because Obamacare! allowed them to be meanies.

That's the "Now look what you let me do!" variation on the Ollie Excuse™.



In the same vein as "They didn't do anything illegal."
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Old 7th March 2017, 07:19 PM   #714
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Originally Posted by Bob001 View Post
That's the key point. Health care is not an optional consumer good, like a new car or big TV or even a house. People buy it because they need it, and they are not in a position to haggle. And if they don't get it because they can't afford it, they end up worse off and we all ultimately absorb the cost one way or another. A "market" presumes that buyers and sellers compete on an equal footing. That's just not the case for health care.
Yes it is. At least, the vast majority of it is. The fact that occasionally, medical intervention is life-saving is no different than everything else, which under certain circumstances can be life saving. If the only way to escape the murderer is a gun, then healthcare won't help.

Lest this sound like argument for argument's sake, I'd like to point out that underlying the issue, in a major way, is how much healthcare is the "right" amount and what are we willing (as a society) to pay for. We must not lose track of the choice element in play.
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Old 7th March 2017, 07:32 PM   #715
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Originally Posted by Kestrel View Post
The magic of the marketplace will provide health insurance for $75 a month just like the good old days.

The math works out a bit like this. Customer pays $75 a month and doctor visits have a $20 copay. The insurance pays the doctor an additional $100 for each visit. Sounds like a much better deal than Obamacare. The trick is that the insurance doesn't cover more than six visits a year. The insurance company pockets $25 a month even if the customer visits the doctor six times.

Several of the Obamacare horror stories publicized when the program first came out involved people who had this kind of health insurance policy. One that only provided the illusion of coverage.
If you think a doctor's visit costs $120, you haven't seen a billin statement lately. Try more like $300 for the GP visit and $600 for the specialist, not counting procedures, labs and drugs.

My dental insurance OTOH, they insist the dentist charge less to an insured person. I pay $50/mo and the coverage they provide amounts to the discount they insist the dentist give. I'm trying to talk my dentist into collecting my monthly payment and just charging me less.
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Old 7th March 2017, 07:39 PM   #716
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Originally Posted by BobTheCoward View Post
That is an awful lot of assumptions about what society should ensure for the people in it.
No it isn't. And I've pointed out the flaws in Libertarian thinking re heath care many times.

The uninsured get emergency care and leave the hospital with bad debt that paying consumers end up paying.

The market encourages copycat drugs to take a share of the known market usually by marketing and almost never by being better drugs.

The market is not conducive to investing R&D in new antibiotics until deaths from drug resistant infections are rampant.

The list goes on. The market does not solve all ills and it's not just about the right to healthcare.

And why the hell shouldn't people have the right to life? That doesn't mean taxpayers need fund everything from food to flu shots, but the society as a whole benefits when they are at least part of the process.
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Old 7th March 2017, 07:43 PM   #717
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Originally Posted by marplots View Post
Yes it is. At least, the vast majority of it is. The fact that occasionally, medical intervention is life-saving is no different than everything else, which under certain circumstances can be life saving. If the only way to escape the murderer is a gun, then healthcare won't help.

Lest this sound like argument for argument's sake, I'd like to point out that underlying the issue, in a major way, is how much healthcare is the "right" amount and what are we willing (as a society) to pay for. We must not lose track of the choice element in play.
This is naive. Other countries have national health insurance and everyone pays less.

You right wingers need to open your eyes. Some things are better covered by the community than the individual just as much as some things are better covered by the individual.
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Old 7th March 2017, 07:54 PM   #718
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For some reason, they want to push this through before the CBO can crunch the numbers and give us estimates on how much it will cost and how many more (or less) people will be covered.

Heck, they haven't even given their own estimates have they?
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Old 7th March 2017, 07:57 PM   #719
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Originally Posted by thaiboxerken View Post
For some reason, they want to push this through before the CBO can crunch the numbers and give us estimates on how much it will cost and how many more (or less) people will be covered.

Heck, they haven't even given their own estimates have they?
That's what I've heard. If that is true, how can anyone support it? I'd like to hear from right-wingers how it would be acceptable to rush a bill through without a projection of costs?

Then again, rumors from the last GOP meeting is that they are going to need D support to get it to pass, because they don't have enough GOP votes.
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Old 7th March 2017, 08:03 PM   #720
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Originally Posted by Skeptic Ginger View Post
This is naive. Other countries have national health insurance and everyone pays less.
While it is not true that "everyone pays less" it is true that healthcare can be delivered differently.

Quote:
You right wingers need to open your eyes. Some things are better covered by the community than the individual just as much as some things are better covered by the individual.
This too is a matter of choice. We could, for example, decide that gasoline was better treated as a utility, supplemented for the poor, and so on. It is not true that "healthcare" is some kind of natural right, nor that it has been for most of our country's history. Historically, you got the amount of healthcare you could afford and no more - just as you can get as much electricity or gasoline now.

I understand the idea that medical care is a commodity is met with moral outrage, but let's leave that card for the WWJD crowd to play. The truth is the life-saving bit is far outweighed by consumers desiring treatments not directly linked to mortality or even quality of life issues. In a commodity environment there is one tried and true path to cost reduction - buy less.
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