ACA Individual Mandate Struck Down! (Page 3)

This goes back to a point that i made on a previous thread.  Where was the outrage from the R's when their party was proposing similar plans, but now is the end of our nation.

Obama could say Republicans are wonderful people that Republicans would start screaming how dare you say that about us, we are evil.

That already exists on a state level with car insurance. 

...

Twenty years from now, I believe that the country will be healthier physically and financially because of the ACA and costs of healthcare will be lower than they would be without ACA.   People will get preventative care and health counseling before they become disabled to the extent that they cannot work and wind up on Social Security.  Mothers will get prenatal care and avoid the costs of birth defects from vitamin deficiencies which could be prevented. Catastrophic illnesses will no longer drive families into bankruptcies.   It is a good thing.  There is a cumulative effect of healthcare provided over time.  It is already working in Massachusetts thanks to Gov. Romney.

I'm saying that complaining about the individual mandate is nonsense. The government has done exactly that in the past, with the exact same issue - i.e. making people buy insurance in order to provide a large enough pool for the risk. You can say it was limited at that time, but now we are just arguing about degree to which it can be mandated, not the mandate itself.

Except that Romney made the best argument for the individual mandate in Romneycare as governor of Massachusetts.  He said that it was a fairer system that everyone should have to contribute to healthcare rather allow uninsured people to get free health care at emergency rooms. 

I expect that this will be a red meat election issue.  Some changes to the law will result, I hope they are improvements.  I see the point of those who dislike being forced into paying for healthcare but it is for a greater good that everyone cannot be denied coverage for pre-existing conditions.

I have great health insurance as a job benefit.  With my company, I am in a pool of healthcare recipients who are well-paid, well-educated, and health conscious. As a result, I am a better healthcare risk for insurance companies. They want me in their pool of insureds and don't want others.  The people who are currently uninsured that will become insured ACA are, on average, less healthy and will cost more to cover than the people who are currently insured. Under the ACA, I will be able to keep my insurance, but I believe that my costs will go up and the benefits will go down as currently uninsureds are added to the insured pool.  The need for the individual mandate is that the costs would go up astronomically if only the uninsured with health care problems joined the insured pool. And they were free to do so under the clause that prevents excluding coverage for pre-existing conditions.

The recognition of the likely cost increases, at least initially, to people who are currently insured (but healthy) is at the root of the opposition to the healthcare mandate rather than those who are uninsured and wish to remain so.  I accept the mandate and the likely increases in premiums as a necessary loss to make healthcare fairer to the country as a whole.  Even though I have personally benefitted by it, I do see this exclusionary practice as inherently unfair to a majority of Americans.  The ACA will end this practice. 

Twenty years from now, I believe that the country will be healthier physically and financially because of the ACA and costs of healthcare will be lower than they would be without ACA.   People will get preventative care and health counseling before they become disabled to the extent that they cannot work and wind up on Social Security.  Mothers will get prenatal care and avoid the costs of birth defects from vitamin deficiencies which could be prevented. Catastrophic illnesses will no longer drive families into bankruptcies.   It is a good thing.  There is a cumulative effect of healthcare provided over time.  It is already working in Massachusetts thanks to Gov. Romney.

I wasn't sure which way you were going with this at first. But I think this paragraph really does highlight something for me which is important. At the time of enactment, many things seemed to be poised to be seen as evidence of the end of the republic and over-reach of the fed. I'm thinking of things like the "right" to own slaves, or social security, or civil rights legislation. Yet no one in their right mind today would suggest we dismantle and abandon these things and go back to the way we did them 100 years ago. I suspect once people have seamlessly integrated healthcare, we will think the whole debate was pretty pointless. In the same way that almost no one blinks an eye at the idea of having women doctors or interracial marriages.

So is Massachusetts much healthier since Romney was in office?

I just don't see this happening.  We're a FAT, LAZY, HAND OUT, WHAT WILL YOU DO FOR ME NATION.  For your predicition to take place this country will have to do a complete 180.  In the past 20 years the obesity rate has gone throught the roof.  What do we do to accompate these fat people, we give them motorized carts to drive around the malls, Disney World and other outdoor venues. 

If you read the bill people who can't afford the new healthcare plan because of their income will still get it, so how will this change from our current model?  We the people, will still be paying for your healthcare.

I'm lucky I have a very healthly fit family.  We chose to live this way.  We don't smoke, we don't eat large quanity of fat meals but yet I have to pay for your poor decisions in life. 

People keep bringing up smoking, well that's a choice, just like eating fast food and being overweight.  We should tax these fat people.  Your tax (penalty) rate should be based off your obesity rate. 

Now that might get some people in gear.   

Twenty years from now, I believe that the country will be healthier physically and financially because of the ACA and costs of healthcare will be lower than they would be without ACA.   People will get preventative care and health counseling before they become disabled to the extent that they cannot work and wind up on Social Security.  Mothers will get prenatal care and avoid the costs of birth defects from vitamin deficiencies which could be prevented. Catastrophic illnesses will no longer drive families into bankruptcies.   It is a good thing.  There is a cumulative effect of healthcare provided over time.  It is already working in Massachusetts thanks to Gov. Romney.

Yeah cause that is working out so well for Social Security and Medicare which are running of a rail.

Maybe a tax for NOT doing basic preventative medicine would be more in line with making a healthier nation... 

I think, in theory, this is the goal of the act.  The problem is that people that don't get preventative health care.  My mother-in-law has great insurance and is 56 years old...hasn't had a mammogram in over 5 years, despite endless hounding by her daughter who does research on breast cancer patients.  I know plenty of people that just don't go to regular dental cleanings (even on my crappy insurance, those are free) or women that won't go for an annual gyno exam.

The ACA does nothing to change our behavior.  Preventative care only works if you get off your butt and check in with the doc even when nothing is wrong.  And giving insurance to people that don't have it...doesn't fix that.  Maybe a tax for NOT doing basic preventative medicine would be more in line with making a healthier nation... 

^^X2

This bill does nothing to change behavior.  I would suggest that there are a large number of people who use emergency rooms as their PCP because of convenience.  It is much easier to take your son or daughter to the ER and be seen in a few hours than it is to schedule something with your Doc that may or may not get you in this week.

I don't see this as making us healthier at all.  That won't happen until you change behavior. Availability doesn't mean use.

Hear, hear.

Think about this a second.  Social Security and Medicare are government funded programs.  The Congress legislates the benefits and then separately legislates the taxes to pay for them.  They find the benefits easier to pass than the taxes.  The ACA is different.  It is just a law regulating the private insurance companies.  The law just limits some of the unfair practices that insurance companies have been free to use in the past. 

The good part is that it is not a government run program.  The private insurance companies have to make a profit.  So premiums have to match benefits and expenses with a little left over for the shareholders.  No deficit spending for them.  The really clever thing is that the private insurance business is not a monopoly like the government-run Socical Security and Medicare.  The company that does the balancing best gets all the business and wins. It's capitalism, kids.  It is great stuff.  It is just that now under ACA the industry operates under the minimum laws to be fair to all citizens.

I say genius and I say thanks to the many, many Republican thinkers who came up with the idea and advocated it for so many years.  And, I say thanks to a Democratic Congress and President for getting it passed.  And thanks to a Republican Chief Justice of the Supreme court for not legislating from the bench.  Despite the number of Republicans who have advocated for this sort of insurance reform, the Republicans could never have done this by themselves.  Now that it is in place and has passed all three branches of government, it actually has a great chance to be something that fixes the system.

And how, exactly, would that work? 

You really think that there is a large number of people that decide to go the ER for PCP for convenience?  Have you been in an ER recently? (Hopefully not)

I wasn't sure which way you were going with this at first. But I think this paragraph really does highlight something for me which is important. At the time of enactment, many things seemed to be poised to be seen as evidence of the end of the republic and over-reach of the fed. I'm thinking of things like the "right" to own slaves, or social security, or civil rights legislation. Yet no one in their right mind today would suggest we dismantle and abandon these things and go back to the way we did them 100 years ago. I suspect once people have seamlessly integrated healthcare, we will think the whole debate was pretty pointless. In the same way that almost no one blinks an eye at the idea of having women doctors or interracial marriages.

I think comparing it to slavery and civil rights is a bit of a stretch.  Healthcare is a service that is paid for.  Slaves didn't have access to freedom because they couldn't afford it.  Same thing for civil rights.

This discussion is about making healthcare more affordable and available to everyone and more importantly, who is going to pay for said healthcare coverage.

As for people looking back with "seamlessly integrated healthcare," (not sure what that is anyway) I'm not so sure.  Reason being is I don't think any of us really know what this thing is going to look like when it gets fully implemented.  It's most certainly not a top to bottom healthcare plan, its more like a mandated health insurance offered by the government that will pay private doctors and hospitals for your care.  That could be good, or it could be bad.  Personally, I think the payments will be so low to the clinics that care will ultimately go down, or clinics will refuse (not sure if they can) to service people on Obamacare.

i was mostly being facetious.  i like pieces of ACA (mainly that people with pre-existing conditions must be covered), and i've read your arguments about the staffing to process all the insurances, but really i'm not convinced that this will make people live healthier lives, if that is even the goal.

er... what you're describing is a single payer gov't run healthcare system.  That's not what Romneycare... ooops, Obamacare is.  What you're describing is Medicade.