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Why couldn't we have a health system that is NOT mandated?

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SHRED Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:02 AM
Original message
Why couldn't we have a health system that is NOT mandated?

Why do we need to have a required insurance?

Why couldn't we instead have just added a public option that would be paid for, and subsidized for those unable to pay, by raising taxes on millionaires and increasing Medicare payroll deductions a bit?


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subterranean Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:13 AM
Response to Original message
1. Universal health care won't work if it's not mandated.
Coverage has to be mandatory if you're going to require the public option and private insurance companies to accept all applicants regardless of pre-existing conditions. Otherwise, some people would just not buy insurance until they get seriously ill. By having everyone, including healthy people, in the system, it keeps down the cost for each individual.
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Coyote_Bandit Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:21 AM
Response to Reply #1
3. Even in a mandated program
with financial subsidies there will be folks who will be unable to make the mandated purchase. Folks who are already hungry and food insecure immediatley come to mind. If they cannot feed themselves now then they damn sure are not going to be able to absorb an additional expense to buy health insurance even if it is subsidized. In many ways this program leaves thse folks worse off - still uninsured and facing penalties for noncompliance.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 11:36 AM
Response to Reply #3
11. Young, single, and childless people will be screwed.
24 year olds barely scraping by in crap jobs at Target (and maybe with fat student loans to pay off) will now be stuck with a health insurance bill that they can't pay. "Oh but they'll get subsidies!" Right, because when you don't have an extra dime to your name a 50% subsidy on a $150 a month insurance policy (don't forget the co-pays and deductibles that will have you out of pocket a few grand before the coverage even kicks in) will magically put money in your pocket that you didn't have before.
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county worker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 12:42 PM
Response to Reply #11
13. I'll bet that they have cell phones.
Edited on Thu Jul-16-09 12:43 PM by county worker
And cable or satellite TV and WIFI.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 01:57 PM
Response to Reply #13
14. Okay, so let's take everyone's phones and computers and TVs away from them
Edited on Thu Jul-16-09 02:01 PM by Hello_Kitty
So they can pay for premiums to make health insurance company CEOs into even bigger billionaires than they are now. Great idea. That won't hurt the economy at all. :eyes:

On edit: Yeah, you do strike me as the type of authoritarian tightass who would begrudge poor people any pleasures they might have. Why, how dare they get any enjoyment out of life! They should be spending every waking hour working and improving themselves! Why, I'll bet as we speak there is a worthless poor slacker who is eating the ramen in the cup with the shrimp bits that costs 45 cents when she SHOULD be eating the ramen that comes in the cellophane package that's 15 cents.
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county worker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:26 PM
Response to Reply #14
15. They need to have health care. I'm making a point that if you want something you'll find a way of
Edited on Thu Jul-16-09 02:36 PM by county worker
getting it.

Your the kind of person that will not think rationally. It's better to enjoy life with gadgets than taking care of your health?

I don't want to deny anybody anything. But there is a hierarchy of needs. The first level is food shelter and clothing. Once that is satisfied you move to the next level. Health care is right there with basic necessities yet people will pay $70 a month for cell phones to text their friends and $55 a month for cable TV and say they don't have $125 for health insurance. Priorities are out of whack.


This economy will begin to put us back where we should have been before the spending on credit bubble burst. I think we will begin to look at how our parents made decisions and begin to adopt some of them.

On edit:

You said "spending every waking hour working and improving themselves." I wonder how you think people improve their lot in life?

I was homeless in San Diego for a time. I came back and almost was homeless again. I'm doing better now because I learned that you have to work to improve yourself all the time. There is no guarantee that if you try something it will work but there is a guarantee that if you don't try things won't get better.

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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:44 PM
Response to Reply #15
17. Since when is a phone not a necessity? Ever tried to get a job without one?
Tried to find a pay phone lately? And most young people only have cell phones and no land line. Computers are increasingly becoming a necessity as well, with so much communication being done electronically. BTW, many young working class people DON'T have them, which you would find out by walking into your local library and seeing how many of them are using or waiting to use the computers there. But hey, you keep telling yourself how these "deadbeats" really have tons of disposable cash that they are wantonly withholding from the health insurance system so they can squander it on the latest gadget.

Health care is right there with basic necessities yet people will pay $70 a month for cell phones to text their friends and $55 a month for cable TV and say they don't have $125 for health insurance. Priorities are out of whack.

Um no, the so-called health "care" system in this country is what's out of whack. Have you priced an individual policy lately? You see, that young person with the crappy-no-benefits job who you think is buying too many gadgets faces more than just a $125 monthly premium, with dental and prescription typically costing extra. There are also co-pays of between $20 and $100 depending on the policy and the procedure and deductibles ranging from $1000 to $5000, depending on the coverage. So this person is looking at paying out possibly thousands from his/her own pocket BEFORE the actual insurance kicks in. So tell me, what's irrational about choosing to take your chances and remain uninsured if you are in this position? Seems pretty rational to me.



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county worker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:52 PM
Response to Reply #17
20. I'm expecting that we will get a health care bill where everyone one will have coverage that they
can afford. I read here that the mandate which will force people to purchase health insurance is not right. That is what I am talking about. If the cost of the mandated insurance to someone was $125 a month and the cost of a cell phone and wifi was $125 a month they would complain to all that the mandate is unfair but the cost of a phone and computer is a not.



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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 03:02 PM
Response to Reply #20
22. But no national health plan has been passed at this time, has it?
Yet you felt perfectly comfortable making judgmental statements about currently uninsured people having their "priorities out of whack". And no, I still don't think a mandate for private insurance is right. It's corporate welfare to a rapacious and parasitic industry who will only raise everyone's costs because they will be given a captive market. See: Massachusetts
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:48 PM
Response to Reply #15
19. I find it remarkable when people who claim to have been homeless spout Libertarian bullshit. eom
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county worker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:56 PM
Response to Reply #19
21. Maybe being homeless teaches you somethings you didn't know before!
Giving labels to ideas to discount them is stupid. It isn't libertarian or right wing or liberal. It is plain common sense. You take care of what's important and you work to improve yourself. If that is wrong then I'm on the wrong planet!
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 03:03 PM
Response to Reply #21
23. I think you are definitely on the wrong message board.
Most of us come here to escape the "pull yourself up by your bootstraps" mentality that pervades the rest of the country.
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Skinner ADMIN Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:18 AM
Response to Original message
2. The mandate serves an important purpose.
Without it, many healthy people would not choose to get insurance. If people could simply wait till they get sick and then buy insurance, then many people would do that.

You need healthy people to subsidise the sick people and keep the per-person cost low.
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TellTheTruth82 Donating Member (123 posts) Send PM | Profile | Ignore Thu Jul-16-09 10:29 AM
Response to Reply #2
6. and just what is the purpose
of keeping the per person cost low? We could keep the cost low by saying no health care for anybody, but I don't think that is what you are aiming for. (I guess it depends on what you mean by per person - person who is seeking medical care, everybody, whatever). I believe the goal should be to minimize the overall cost (but not at the cost of quality)
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TellTheTruth82 Donating Member (123 posts) Send PM | Profile | Ignore Thu Jul-16-09 10:36 AM
Response to Reply #2
7. The other issue is
this is a slippery slope. Once we start telling people what products they have to buy, where do we stop? Are we going to be forced to buy electric cars, or compact cars (at 6' 6" that is a safety issue). Are we going to be forced to buy aluminum foil of a certain kind? Are we going to be forced to buy the right to vote? It's interesting that the government is getting into the business of what we have to buy or not buy. This gets to be too complex - and what is going to constitute a sufficient health care policy? A private insurance plan for $1/month that covers the common cold? This gets too hard too fast....not to mention unfair.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 11:23 AM
Response to Reply #2
8. 2/3 of non-elderly adults have private insurance right now
That's over 100 million people in the system already and health care is still ridiculously expensive. Mandate proponents honestly think that adding the 45 million people who are uninsured will magically bring premiums down. It won't. That's not even talking about the fact that a good number of those uninsured people are uninsured due to "preexisting conditions" so adding them to the system might more than offset the cost-savings you get from forcing the healthy people into the system.
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busymom Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 03:36 PM
Response to Reply #2
24. I agree 100%...
If people only sign up when they are sick and in need of services there won't be enough money coming in to actually pay for things.

I really think that if people are going to be selfish enough to not sign up and pay in from the beginning and are willing to take the risk that they should not be able to opt in when they are sick. That sounds harsh, but people have to have some personal responsibility.

None of us ever thinks that we are going to fall ill when we are young. I never bought life insurance for myself because we couldn't seem to make it a financial priority. Imagine my surprise at getting diagnosed with cancer at age 35. Now I would have a beast of a time getting any life insuranceand I totally understand why. If something happens to me, my husband won't have additional financial help to pay for adequate childcare. I sure wish we had found a way to cut out the Cappuccinos and pay for my life insurance back then.

We mandate that everyone has car insurance in case they have an accident that damages our bodies or property! We need to mandate catrophic healthcare cover at a minimum.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 04:23 PM
Response to Reply #24
25. 'Selfish'
The uninsured truly are the new Welfare Queens. The latest scapegoat to cast blame on and demonize. Sigh.

We need to mandate catrophic healthcare cover at a minimum.

Catastrophic coverage kicks in AFTER you pay thousands out of pocket. And you still have to pay an expensive premium every month. It is less-than-useless to people who are struggling to pay their bills as it is.

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busymom Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 04:50 PM
Response to Reply #25
26. hmmm
Edited on Thu Jul-16-09 04:51 PM by busymom
Poor wording on my part. Sorry.

I absolutely do NOT think of the uninsured as welfare queens...not even close. What I find sad is that people who are the poorest can get medicaid or state health insurance in my state. It is the hard working middle class that is forgotten and neglected.

I guess what I meant is that catastrophic coverage should be an absolute minimum for people. No one should be bankrupted by cancer, an accident, etc and too many people live with exactly that fear hanging over their heads.

The thing is...I do have insurance and I considered myself blessed in that regard. It is not free though, by any stretch (and I don't expect it to be) and we have huge out-of-pocket deductibles before the insurance kicks in....$3000/person/year with a family maximum of $6000. Ouch. This means that I have to pay for my CT scan and oncology visits each year for my follow-ups and other necessary doctor visits at the beginning of each year. At least I know though that if I had a recurrence that my treatment would be paid for and I won't be bankrupted.

I guess that's what I meant.

But...not signing up and paying into a system and then demanding it if you are sick...is selfish and is unfair to the others who pay in.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 05:00 PM
Response to Reply #26
27. You had me up until this:
But...not signing up and paying into a system and then demanding it if you are sick...is selfish and is unfair to the others who pay in.

What should they do instead? Die?
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busymom Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 05:06 PM
Response to Reply #27
28. No. It's why I think it should be mandatory from the get-go
I don't ever think someone should die because of lack of access to healthcare!!!

But think about it...you don't pay in a penny to the system for years because you take the chance that you won't get sick. Other healthy people pay into the system. Their premiums help support others who are currently sick and are getting care. Then, when if/when they get sick, the premiums that others are paying help to pay for their care...and so it goes.

If people don't pay into the system except when they want something from it, it collapses because there is no money there to pay for it.

It IS selfish for people to expect to get something without having to contribute until they bring in more expenses than can cover the cost of their care!

Can you imagine waiting to buy life insurance until you have a terminal illness? That can't happen.

I fully support the public option, but in my eyes it has to be mandatory...if it is a situation where people can opt out, then...opt out has to be opt out...not opt out until I need it.

Of course I don't want people to die...
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 05:40 PM
Response to Reply #28
29. Well, you could address the homelessness problem by making it mandatory to have a home.
But that won't put money into homeless peoples' pockets to be able to afford shelter. And no, giving them a subsidy doesn't cut it either. If you don't have the money to begin with giving you a 50% discount doesn't do anything for you.
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busymom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jul-17-09 11:25 AM
Response to Reply #29
32. No, but if we could assume that at some point, everyone will become homeless...
and ... if those who have been paying their mortgages/rent payments for years have to foot the bill for the people when they become homeless, then we could say that everyone (since everyone will likely become homeless at some point if we are to create a proper analogy)should have to pay into a *homeless prevention* fund to make sure that they are covered when their time comes.

Everyone will need healthcare coverage at some point...and most people well before the age of 65. Most people don't plan for this either! Who thinks that when they are young and seemingly healthy that they will be diagnosed with cancer, schizophrenia, or have a terrible accident requiring expensive medical care? Most people assume that they will stay healthy. If you only start to put money in the pot when you are sick and require care then there won't be money to pay for the treatments.

I think people should be allowed to opt out. Then though, I think they shouldn't be able to opt in. If they are willing to take that risk and also risk having to sell their house to pay for their care, then that is their choice.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jul-17-09 11:48 AM
Response to Reply #32
33. Funny how a large percentage of bankruptcies are due to health expenses
And most of those people HAD insurance.
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busymom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jul-17-09 01:10 PM
Response to Reply #33
34. Well, I'm all for healthcare reform...and I still think
it needs to be mandatory.

My chemo buddy lost his health insurance while he was in the MIDDLE of a bone marrow transplant for "missing too many days work". That's just messed up in the worst way.

I sure as hell hope that whatever is coming down the pipe will be better than the crap we already have.
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YewNork Donating Member (449 posts) Send PM | Profile | Ignore Thu Jul-16-09 08:54 PM
Response to Reply #28
31. Allowing people to not buy health insurance until they get sick would be like
allowing them not to buy car insurance until they have an accident.

Everyone has the potential to need health services, and they should have to buy insurance or show that they have enough cash to cover potential health expenses.
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Lasher Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:26 AM
Response to Original message
4. Because it's the only way except single payer to get everybody enrolled.
Edited on Thu Jul-16-09 08:27 AM by Lasher
With single payer the government provides health care for everybody. With individual mandate the government makes everybody buy insurance.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 11:26 AM
Response to Reply #4
9. MA has 'mandatory' health insurance and yet everyone is not covered
There are people who are choosing to pay the fine rather than buy the insurance because the fine is cheaper. Recently, the state had to exempt thousands of adults from the mandate because the premiums, co-pays, and deductibles they were expected to pay added up to too high a percentage of their income.
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Lasher Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 12:15 PM
Response to Reply #9
12. Programs like MA's certainly have their flaws.
The mandate is one of the potential disadvantages of this legislation. Another one is moving funds from existing single-payer Medicare to support this initiative. That is a move in the wrong direction and an incredibly bad idea.

I wonder if this cure is going to end up being worse than the disease.
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rurallib Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 08:59 AM
Response to Original message
5. All in or it falls apart
see Massachusetts.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 11:28 AM
Response to Reply #5
10. Huh? Massachusetts HAS a mandate.
And yet everyone isn't covered and health insurance costs haven't gone down.
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rurallib Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:38 PM
Response to Reply #10
16. Mass also has an opt out provision that has let
a great many out.
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Hello_Kitty Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-16-09 02:46 PM
Response to Reply #16
18. Yep. Doesn't sound too universal to me.
Also, it hasn't brought the costs of insurance in MA down.
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matteo1234 Donating Member (1 posts) Send PM | Profile | Ignore Thu Jul-16-09 07:58 PM
Response to Original message
30. There shouldn't even be a plan....look at the numbers....
Here is a link to the 2007 Census Bureau report on
"Income, Poverty, and Health Insurance Coverage in the
United States: 2007"

http://www.census.gov/prod/2008pubs/p60-235.pdf
 


Here are the facts I got out of the sections dealing with
"Health Insurance Coverage":
1) 253.4 million "people" are covered and 45.7
million "people" do not have health coverage of any
kind. You are considered to have had coverage whether you had
insurance for the entire year, or for part of the year.
(although it also states research shows health insurance is
underreported because people will make the mistake of
indicating thier current situation at the time of the
questioning rather than indicating if they insurance at any
time during the year.). If I was running the survey and
somebody answered that they did not have coverage for the
entire year, I would want to know,"Well, for what period
of that year do you think you or your household had
coverage?" My best guess that this isn't asked because
there are huge funding streams for programs based on this and
if they performed it truly like they should there would be a
lot of funding that would go away, and there is a lot of
political pressure to keep these numbers "grey" so
that this funding can continue.....really sad and embarassing
in my opinion. When you look at the numbers you have to take
them with a grain of salt because they didn't take this
questioning out to the next level down this means the numbers
reported are misleading in that it states 45.7 million
"people" don't have insurance, when the number is
actually higher than stated because I wouldn't consider
someone who had coverage for 2 months out of the year really
insured, etc...
2) Uninsured people has increased to 45.7 million, but the
uninsured rate of the US has been constanty hovering around
15% since 1992. This tells me we don't have an issue with
access to healthcare, we have an issue with healthcare costs.
We have to fix costs, and this plan to try and cover everybody
doesn't even address the real issue so it will fail, and fail
miserably.
3) Here is a set of interesting numbers: 35.92 million
"Americans/Naturalized Citizens" are uninsured,
9.737 million "Not a Citizen" are uninsured. This
comes to 35.92 million "Americans" uninsured. We
certainly shouldn't be basing budgets on poeple who don't
belong here...people say they are here and we depend on these
people to do so many jobs....so what...I have a lot of things
in my apartment that weren't made in the US but I bought at a
store meaning "it was important that somebody somewhere
else made the thing", but we don't feel compelled to go
pay for their healthcare costs overseas because they sell us
goods...just because they are "here" doesn't really
change that argument. You are either a US citizen, you are
here in some legal way, shape or form, or you are here
illegally.
4) Oh let's dig deeper into this so we can pull back the onion
of deceipt. Forget the politics of these numbers above and
let's just look at this from an income standpoint, which makes
this look more like "business" decisions rather than
politics. These are the numbers that really made my eyes pop
and should make everybody else's:
Uninsured "people" and average Household income:
<25K/year - 13.539 million
25-49K/year - 14.5 million
50-75K/year - 8.488 million
>75K/year - 9.115 million
This report states the average household income in the US was
50.233K for 2007 (for the lower 48 states). The 2007 Health
and Human Resources Poverty line for a family of four in 2007
was 20.65K/year. Any houshold earning above 50K/year certainly
is either making the choice to not have coverage or are
illegals making a good living and don't want to get health
insurance because it would put them into a system and
increases their exposure to being found out and deported. In
any case, that is 17.603 million people who don't need any
kind of assistance and there should be no provisions made for
them. For the 25-49K group I would say the majority of these
people choose to not have heathcare either. They are either
young, out of school and choose to rather have the money to
spend, are young and just want to have more money int thier
pocket or have made some bad fiscal choices and in order to
try and have more income have taken the risk of not having
health insurance. I'm sure anybody can go out and find cases
to show how someone needs help here or there, but I would say
the 2-sigma band for this bell-curve would easily show
probably 90% of these people made their choice to not have
healthcare. Let's not forget that all people who dont have
healthcare don't always go to the emergency room. My brother
and his family have been on and off healthcare from
time-to-time, and they have chosen to take the risk of having
more money in their pocket and they pay for any doctor/dental
visits out-of-pocket (probably because the costs are in fact
high...which goes back to my sentences earlier). If there is a
real problem and they do have to go to the Emergency Room,
yeah they are going to be in trouble but that is the risk and
choice people make. I'll be generous and say 75% are making
the choice. Since 20K is the poverty line for a family of 4,
I'll take that whole bottom bracket and 25% of the 25-49K
bracket which comes to a total of 17.164 million
"people" without health insurance or at risk. For
the sake of arguing, since there are 9.737 million "Not a
citizen" people without health insurance, I'll go ahead
and proportionatly distribute that number for the four income
brackets stated with a 40, 30 , 20, 10 distribution. This
means there are 3.989 million "Not a Citizen" people
who are included in the <25K bracket, and .73 million
"Not a citizen" people in the 25-49K bracket. THIS
MEANS THE SUM TOTAL OF "AMERICANS" WITHOUT HEALTH
INSURANCE IS SOMEWHERE AROUND 12.445 MILLION POEPLE.  SO FROM
NOW ON ANYTIME YOU HEAR A POLITICIAN SAY THERE ARE 45 MILLION
PEOPLE UNINSURED THAT IS A LIE.

For a trillion dollars (to start) that comes to around
80,353.56 cents per person. My healthcare costs (for me and my
employer) per year for my "household" run about 11K
(medical, dental and eyecare). So when Washington says they
are going to tax exorbently expensive healthcare plans are
they going to be taxing their own plan???? who is out-of-whack
here??????
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