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Lefty

Utterly Average Citizen Takes a Look at HR 3200

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1. Will the plan ration medical care?

Medical care is always rationed. It could be rationed by accessibility, quality or price. You cannot have all three. Currently it is rationed by price; the real question is whether it is going to be rationed by accessibility or by quality. This wasn't explained.



If by accessibility you're talking about waiting times, then accessibility will most likely be the choke point. Like gas lines. Artificially lower the price, raise demand. That's not exactly a compelling argument in favor of the bill.


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2. Will the plan punish Americans who try to opt out?

Out out of what? Government healthcare or having health insurance? As the one who actually went through the bill, I know that the referenced section is related to the people who can afford to pay for healthcare, but decided not to have any coverage - neither governmental, nor private. They will be punished, and this is a good thing.



Here's a bit more from the bill:

" ‘(A) IN GENERAL- The tax imposed under subsection (a) with respect to any taxpayer for any taxable year shall not exceed the applicable national average premium for such taxable year. "

So it might actually be cheaper to just pay the penalty then pick up the taxpayer-funded plan if something happens.


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3. What constitutes “acceptable” coverage?

His first objection is that "The bill defines acceptable coverage and leaves no room for choice in this regard.". The bill defines _minumal_ acceptable coverage, and looking through the list I can't understand what exactly a sane individual would exclude. Hospitalization? Prescription drugs? Mental health? I do not see it requiring to cover boobjobs, or bullshit like urine drinking and herb sniffing.

Second objection is that "By setting a minimum 70% actuarial value of benefits, the bill makes health plans in which individuals pay for routine services, but carry insurance only for catastrophic events, (such as Health Savings Accounts) illegal". The problem is, what to do with those who elected such plan to save money, but have no money to actually pay for a non-catastrophic events? One of the goals of the bill is to avoid "emergency room with no pay" scenario. It's bad that those of us who maintain their budget and could plan and save for unexpected will suffer - but, at the end, there are only few of us. So this requirement is understandable.



Maternity care? Well baby care? I'm male, unmarried, and childless.

The preventative services section just baffles me. You know checkups are coming, you can plan for them, they're not unexpected. Why would any insurance cover this? Oh yeah, because the government tells them they have to--which this bill makes very clear if people didn't know it already. No wonder the costs are so high nowadays.


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4. Will the plan destroy private health insurance?

The business which provides crappy insurance gets some savings. If it does not pass savings to employees, then the best employees will choose the business with better insurance, putting the former one into disadvantage. If the business passes those savings to employees, then there is no payroll disadvantage. At least in IT large employers usually have lower salary, but better benefits (including health), and it attracts people. They will not reduce themselves to crappy insurance.



What you say is true (go free market!), but you're not addressing Lewis' point. In order to provide insurance to government "standards" through a private plan, an employer must pay more than a competitor who simply goes with the taxpayer-funded plan. Thus, the privately insured employer is at a disadvantage. The rest of Lewis' points naturally follow from this situation.


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5. Does the plan tax successful Americans more than others?

Yes it does. This is where it might get stuck. It gets dangerously close to the point when using tax evasion schemes starts making sense to a lot of people. There is already a lot of good reasons NOT to have an IT company set up in USA (software patents, litigations), and adding more of them will only make things worse.



I suppose Lewis' point goes without saying. As if the politicians were going to spread the costs out to the voting masses...


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6. Does the plan allow the government to set fees for services?

Of course it does. What would a reasonable person expect? To have everything for free, from tatoo removal to boobjobs?



Might get into some issues here with medical services unable to allow their prices to fluctuate with quality and demand. "I don't care how well you transfer hearts. You'll charge the same as Dr. Nick and like it." Goodbye, skilled doctors.


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7. Will the plan increase the power of government officials to scrutinize our private affairs?

It will just transfer power from insurance companies to the government. So it's not like we are losing something. Is it good? No. But we already lost it.



Hardly the same. The government can legally use force against you, the insurance companies cannot. As such, the burden of proof that this plan is beneficial is on the government. They're failing miserably in convincing me.

Anyway, as Lewis points out, item (v) says the government can basically snoop into anything it wants. We all know that the government never exploits vaguely-worded clauses...


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8. Does the plan automatically enroll Americans in the government plan?

This is perfect! Don't want it? Then get your lazy ass up, and do something!



So the natural order of things is that the government tries to lasso you into something at every turn and it's your responsibility to stop them? Damn...I actually agree with that. Actually having to pay that 2.5% tax for inadequate coverage discussed earlier will be quite a feat considering how the deck is stacked.


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9. Does the plan exempt federal officials from court review?

This, in my opinion, is very clever troll attempt which assumes the people do not know the difference between administrative court review, and challenging the law by the courts. The plan denies the first one - which actually may be good thing, depending on how current reviews are implemented. This, however, is not "Parts of the plan are set above the review of the courts.".



You may be right on this one. The bill itself doesn't really get into details of what they have planned for "review" that I can see.
Provoking a reaction isn't the same thing as saying something meaningful.
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If by accessibility you're talking about waiting times, then accessibility will most likely be the choke point. Like gas lines. Artificially lower the price, raise demand. That's not exactly a compelling argument in favor of the bill.



That's what the bill is about. In short it provides those claimed 40M uninsured Americans with access to the medical system, while the number of specialists in the medical system is not going to increase proportionally. This must lead to accessibility issues. But the point was that you cannot have non-rationed healthcare.

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So it might actually be cheaper to just pay the penalty then pick up the taxpayer-funded plan if something happens.



Note the word "average" there. This means that having no insurance and paying this tax would make no sense, because having minimal insurance would cost you less than average - and you would have some insurance, which is generally beneficial.

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Maternity care? Well baby care? I'm male, unmarried, and childless.



Maternity and well baby care benefit the society in general. Having no kids you do not need public schools as well, but you're still paying for them. Remember that the goal is to avoid "emergency room - no pay" scenario. If it doesn't cover baby care, what should the mother do if she doesn't have cash?

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The preventative services section just baffles me. You know checkups are coming, you can plan for them, they're not unexpected. Why would any insurance cover this?



Early diagnosis makes the treatment cheaper and easier, decreasing the cost of care. From pure cost view, covering preventive care is the best investment return one could get. There is a huge difference in costs treating a previously vaccinated vs not vaccinated person who got diphtheria.

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What you say is true (go free market!), but you're not addressing Lewis' point. In order to provide insurance to government "standards" through a private plan, an employer must pay more than a competitor who simply goes with the taxpayer-funded plan.



I did. I assume you agree that a private plan which provides exactly the same coverage as the government plan but charges larger premium simply makes no sense, as nobody gonna take it. Therefore a private plan which charges more should cover more, and therefore will be better than a government one. So it will be attractive to the employers who would like to spend more money on their employees. It is like car - you could get a car for $9K or for $100K, and both of them are cars which could perform basic car functions, and there is market for both of them.

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I suppose Lewis' point goes without saying. As if the politicians were going to spread the costs out to the voting masses...



His point is quite useless. It is obvious you cannot get the money from the poor to pay for healthcare for the poor (unless you gonna take away their cell phone and cable which would also be a good thing), so the bill is pretty logical here. As I said, I do not like it, but let's admit it, it would be naive to expect anything else here.

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Might get into some issues here with medical services unable to allow their prices to fluctuate with quality and demand. "I don't care how well you transfer hearts. You'll charge the same as Dr. Nick and like it." Goodbye, skilled doctors.



Having a first-hand experience with socialized healthcare, I have to say skilled doctors are still there. Probably less that we would have if there was pure pay-for-service option, but it's not like they all are gone. From other side, the "negotiated" low rates and enormous bureaucracy requirements imposed by private insurance companies, and malpractice threats hanged over the practicing doctors are reality right now. It's not clear to me what is worse.

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Hardly the same. The government can legally use force against you, the insurance companies cannot. As such, the burden of proof that this plan is beneficial is on the government. They're failing miserably in convincing me.



No, the insurance company has a lot of power against you already. And it is using it. Just search the Internet for rejected claims. Once insurance company rejects your claim, you have to appeal, and you're likely to lose. If the insurance company changes the policy terms - again, usually happens pretty often and they could do it as many times as they wish - you have very few options here too.

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Anyway, as Lewis points out, item (v) says the government can basically snoop into anything it wants. We all know that the government never exploits vaguely-worded clauses...



Right now the insurance company can snoop into anything it wants regarding everything the claims were submitted for - check your policy terms. And the government could get the records from the insurance company - again, happened before. But my point is that your records are NOT really private right now, so you're not really losing anything.

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So the natural order of things is that the government tries to lasso you into something at every turn and it's your responsibility to stop them?



Yes, because apparently the studies show that some people who are eligible to Medicare are too lazy to get their asses up and fill the forms to get it. I believe them because I happen to know a couple of such people myself. How else would you suggest to make sure that we won't end up again in a situation when someone was just too lazy to apply for a government plan (even if it was free for him), and only once he got sick he arrived in ER for treatment being unable to pay for it?

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Damn...I actually agree with that. Actually having to pay that 2.5% tax for inadequate coverage discussed earlier will be quite a feat considering how the deck is stacked.



Just wonder why do you consider the coverage inadequate?

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You may be right on this one. The bill itself doesn't really get into details of what they have planned for "review" that I can see.



Is anyone here familiar with "administrative review", and could explain it in layman terms?
* Don't pray for me if you wanna help - just send me a check. *

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The law has but one tool - words. All laws are words. So long as a person has the ability to read and basic comprehension, a person can comment and interpret the law.



i feel that my reading comprehention is just fine, however i'm pretty sure that my interpretation of hr 3200 page 16 is wrong.

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

the way i interpret it, once this bill goes into effect, insurance companies can no longer accept new customers unless it is a dependant of a current customer. this seems so rediculous that i must be mis-understanding something and i welcome someone to clear this up for me.


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The law has but one tool - words. All laws are words. So long as a person has the ability to read and basic comprehension, a person can comment and interpret the law.



i feel that my reading comprehention is just fine, however i'm pretty sure that my interpretation of hr 3200 page 16 is wrong.

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

the way i interpret it, once this bill goes into effect, insurance companies can no longer accept new customers unless it is a dependant of a current customer. this seems so rediculous that i must be mis-understanding something and i welcome someone to clear this up for me.



It's been explained a number of times peviously. This section applies to GRANDFATHERED policies, not to new ones.
...

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Will the plan punish Americans who try to opt out?



Out out of what? Government healthcare or having health insurance? As the one who actually went through the bill, I know that the referenced section is related to the people who can afford to pay for healthcare, but decided not to have any coverage - neither governmental, nor private. They will be punished, and this is a good thing.
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Why? we live in a free market and should be free to buy not buy whatever we feel like. forcing someone to buy something they don't want to buy isn't right. Dictatorships work that way, not democracy( that little fact doesn't really matter though does it)

light travels faster than sound, that's why some people appear to be bright until you hear them speak

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>Why? we live in a free market and should be free to buy not buy whatever
>we feel like.

Agreed! And with this plan, you can buy whatever you want.

>forcing someone to buy something they don't want to buy isn't right.

You mean like forcing me to pay for a war I don't support, or a cross on a hill that I don't think should be there? That's called "living in a democracy."

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Why? we live in a free market and should be free to buy not buy whatever we feel like. forcing someone to buy something they don't want to buy isn't right.



The problem is that most of those who decided not to have insurance do not have money put aside to cover their treatment either. So when they got sick, what would be a free market way to deal with those individuals?
* Don't pray for me if you wanna help - just send me a check. *

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>>Why? we live in a free market and should be free to buy not buy whatever
>>we feel like.

B:Agreed! And with this plan, you can buy whatever you want.

>according to some interpretations the bill will auto enroll anyone not buying their insurance , and others that say some 17 million will still be uninsured at the end of 10 years

>>forcing someone to buy something they don't want to buy isn't right.

B:You mean like forcing me to pay for a war I don't support, or a cross on a hill that I don't think should be there? That's called "living in a democracy."

>those dollars were taken from you in the form of taxes, unfortunately we cant individually say what we want are money spent on. what this bill is doing is individually going after people, for the sole purpose of taking money away from them that they decided to keep instead of spending it on a specific product. if you want to penalize not being insured harden bankruptcy rules on hospital bill's. That way at least the person berring the burden would have only them self's to blame

light travels faster than sound, that's why some people appear to be bright until you hear them speak

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>>Why? we live in a free market and should be free to buy not buy whatever
>>we feel like.

B:Agreed! And with this plan, you can buy whatever you want.

>according to some interpretations the bill will auto enroll anyone not buying their insurance , and others that say some 17 million will still be uninsured at the end of 10 years

>>forcing someone to buy something they don't want to buy isn't right.

B:You mean like forcing me to pay for a war I don't support, or a cross on a hill that I don't think should be there? That's called "living in a democracy."

>those dollars were taken from you in the form of taxes, unfortunately we cant individually say what we want are money spent on. what this bill is doing is individually going after people, for the sole purpose of taking money away from them that they decided to keep instead of spending it on a specific product. if you want to penalize not being insured harden bankruptcy rules on hospital bill's. That way at least the person berring the burden would have only them self's to blame



Maybe they should tax everyone, and give an compensating credit to those who opt in. That way you will be happy and the effect will be the same except for a lot more bureaucracy.
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>>Why? we live in a free market and should be free to buy not buy whatever
>>we feel like.

B:Agreed! And with this plan, you can buy whatever you want.

>according to some interpretations the bill will auto enroll anyone not buying their insurance , and others that say some 17 million will still be uninsured at the end of 10 years

>>forcing someone to buy something they don't want to buy isn't right.

B:You mean like forcing me to pay for a war I don't support, or a cross on a hill that I don't think should be there? That's called "living in a democracy."

>those dollars were taken from you in the form of taxes, unfortunately we cant individually say what we want are money spent on. what this bill is doing is individually going after people, for the sole purpose of taking money away from them that they decided to keep instead of spending it on a specific product. if you want to penalize not being insured harden bankruptcy rules on hospital bill's. That way at least the person berring the burden would have only them self's to blame



Maybe they should tax everyone, and give an compensating credit to those who opt in. That way you will be happy and the effect will be the same except for a lot more bureaucracy.

then your getting into tax hikes and I am again on the other side of the aisle from you on that issue.
light travels faster than sound, that's why some people appear to be bright until you hear them speak

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So the natural order of things is that the government tries to lasso you into something at every turn and it's your responsibility to stop them?



Yes, because apparently the studies show that some people who are eligible to Medicare are too lazy to get their asses up and fill the forms to get it. I believe them because I happen to know a couple of such people myself. How else would you suggest to make sure that we won't end up again in a situation when someone was just too lazy to apply for a government plan (even if it was free for him), and only once he got sick he arrived in ER for treatment being unable to pay for it?

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Damn...I actually agree with that. Actually having to pay that 2.5% tax for inadequate coverage discussed earlier will be quite a feat considering how the deck is stacked.



Just wonder why do you consider the coverage inadequate?



All good points in your last post. Not much I can respond to without referring to what I already said.

If only the safety net didn't double as a hammock. I'd love to see the people too lazy to even sign up for handouts hung out to dry. Alas...

I don't consider the coverage inadequate. I just have no use for maternity and kid insurance (or mental health insurance, really...is libertarianism a pre-existing condition?). That's why I don't like getting lumped in with everyone else. I'm an individual with individual needs.

By the "2.5% tax" comment I facetiously meant you can't go to the grocery store without getting enrolled in the program five times on your way, or so it sounds. Somehow avoiding enrollment would be like the last bit of Indiana Jones and the Last Crusade.
Provoking a reaction isn't the same thing as saying something meaningful.
-Calvin

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Damn...I actually agree with that. Actually having to pay that 2.5% tax for inadequate coverage discussed earlier will be quite a feat considering how the deck is stacked.



But the ultimate goal of HR3200 is not to collect extra 2.5%. It is to make sure everyone is covered, and the emergency rooms are paid for the service performed. This way auto-enrollment has a lot of sense.

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I don't consider the coverage inadequate. I just have no use for maternity and kid insurance (or mental health insurance, really...is libertarianism a pre-existing condition?). That's why I don't like getting lumped in with everyone else. I'm an individual with individual needs.



You could go even further - it's likely that you do not need hospitalization right now, so why would you pay for that? And the reason is that even if you do not need it right now, you still might need it in several years (even maternity, unless you only have sex with men or not at all).

And try to look on it in a different way. You are already paying for it - when someone with a delivery or a sick baby stops by emergency room, they will be treated, and this treatment will be covered by you through premium raise. And there is little you can do, unless you claim that babies should suffer because their mother was a careless bitch and did not get health insurance (either private or state-provided) to cover the kids. So it's not like you gonna pay more than you're paying already.

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By the "2.5% tax" comment I facetiously meant you can't go to the grocery store without getting enrolled in the program five times on your way, or so it sounds. Somehow avoiding enrollment would be like the last bit of Indiana Jones and the Last Crusade.



I don't really understand how it's related to the topic discussed. Could you please explain?
* Don't pray for me if you wanna help - just send me a check. *

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