7 Good Reasons to KILL THE PUNISHING MANDATE TO BUY PRIVATE INSURANCE

7 Good Reasons to KILL THE PUNISHING MANDATE TO BUY PRIVATE INSURANCE, not the rest of the bill, just the mandate.

1) The mandate will not lower insurance prices. Big insurance will simply put their mandated profits into their own pockets. (http://docs.google.com/viewer?a=v&q=cache:k2pZl0sNatwJ:hcfan.3cdn.net/578b1f7456962bfa7a_r6m6bhcjn.pdf+health+insurance+profits+statistics&hl=en&gl=us&pid=bl&srcid=ADGEESh56pwmgB8l5InQ2t3oc7xLJEKE_v3HcGcpjJCFRUUVoHvN6YTCn6HsoZB-XIB7BDtzTUy3op8sk6yRKSvOOFylzqT7CYnyUNhj_f0IcKrGMcOH5CF8C1c4sVZeG1T1b3E4dYGK&sig=AHIEtbSW2Ts_zshh87DW8WRvqIlk4XlaFA)

2) "Covering pre-existing conditions" is now law, as is an "end to rescission". Rest assured, by mandating trillions to big insurance, we will simply be giving them the money they need to crush these elements of reform in the bill, indeed they have already started too. (http://www.google.com/hostednews/ap/article/ALeqM5jYnajhWrPEXihcCrpRNfUKN7rN-AD9EKM4O05)

3) There are no studies or evidence to prove that big insurance will suffer in the least by being forced to cover pre-existing without the mandate, just idle speculation from industry types about "Actuarial Tables", with no real substance.

4) If we are lucky enough that big insurance does indeed go belly-up, we can then institute single-payer and take these crooks out of the mix. Remember, these are the same companies who have allowed children to die rather than pay out rightful calims (http://www.msnbc.msn.com/id/22357873/).

5) The mandate will bring a flood of insurance scams and fly by night insurers that will charge cheap rates to cover nothing. (http://www.usinsuranceonline.com/news/article/new-law-brings-health-insurance-scams-19709083)

6) By killing the mandate, we get the best of both worlds - Insurance reform without punishing average Americans. Independents will return to us in November, the Republicans and tea-partiers will have the wind taken out of their sails since the mandate is the thing they dislike the most about the bill.

7) we will avoid the costly constitutional challenges from states Attorneys Generals, and dismantle their main arguments in their cases. (http://www.huffingtonpost.com/linda-bergthold/repeal-health-care-reform_b_568472.html)

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since the SC made them citizens?

that we are the only civilized nation in the world with out universal health care. While the prices for HC in America are the highest in the world, our care is ranked as one of the worst. The CBO, which was not allowed to present their findings to Congress, has calculated that we would save ungodly amounts of money and vastly improve the lives of Americans, if Universal HC were implemented.
I know we have already said this until we are blue in the face, but it has to be repeated.

We must organize, then we can have the power for real change.

Except most people are far to busy just getting by day to day. Right now I'm a caregiver for an elderly woman and we're basically starving because of no money at all and we're going to organize? Maybe I'll drag my starving corpse to the capital steps right as i take my last gasp of breath and congress can happily ignore it then say, "Well, he could have gotten foodstamps..."
Health care is essentially non-existent..I'm on some county sposored deal, but every appointment to see a doc takes months and in the meantime I get sicker and sicker waiting 4-5 months for the next appointment IF I can even get the damned thing in the first place.. My last appointment took almost 6 months to get for almost 3 months into the future.
Am I supposed to be impressed or supposed to organize with everyone?
The other problem is to many people are to busy playing online poker or whatever to actually do anything.. Good luck though..

I cannot get insurance right now being unemployed and with limited income and having diabetes. The only way I will get insurance barring through another employer is by this mandate. There currently is no system for me to buy into a pool with others, get guaranteed coverage if I get sick ie not get dropped or be denied outright, etc. So unless you have found some magical way of providing single payer or even a public option I suggest you move into reality and stop living in fantasy land since nothing remotely possible will satisfy you.

be able to get coverage!

The danger is that if we do nothing, there is the possibility that the mandate will not pass the Supreme court challenge.

If that happens, then the court may strike the entire law - not just the mandate - including the part that gives you coverage.

If we form a coalition to get rid of the mandate now, it will prevent this from happening.

In addition, it is not the mandate that guarantees you coverage, it is the provision that companies must cover pre-existing conditions, we will keep this provision.

Further, if we give big insurance their mandated trillions, they will simply use they money to challenge the provision that helps you in court, and in congress, eventually eliminating the provision that helps you in it's entirety.

Let's not give them the money to do this.

Can you afford that?

The mandate will easily pass Supreme court challenge.

The provision that companies must cover pre-existing conditions means NOTHING if they have to charge as premiums the full value of covering each and every pre-existing condition. And that is EXACTLY what would happen in your no-mandate fantasy world.

In fact the opposite is true:

"Insurers have continued to reduce their share of
premium dollars spent on actual medical care
while using the money for marketing, under-
writing, overhead, administration and huge CEO
salaries.7 In 1993, the leading insurers used about
95 cents of every premium dollar on medical
benefits ... By
2007 investor-owned health insurers had reduced
spending on actual medical care to less than 83
percent of premiums collected."

So, the more money they make, the less they spend on care!


http://docs.google.com/viewer?a=v&q=cache:k2pZl0sNatwJ:hcfan.3cdn.net/578b1f7456962bfa7a_r6m6bhcjn.pdf+health+insurance+profits+statistics&hl=en&gl=us&pid=bl&srcid=ADGEESh56pwmgB8l5InQ2t3oc7xLJEKE_v3HcGcpjJCFRUUVoHvN6YTCn6HsoZB-XIB7BDtzTUy3op8sk6yRKSvOOFylzqT7CYnyUNhj_f0IcKrGMcOH5CF8C1c4sVZeG1T1b3E4dYGK&sig=AHIEtbSW2Ts_zshh87DW8WRvqIlk4XlaFA

Medicaid.

All the mandate does is to funnel Medicaid funds through the Private Insurance Industry. The majority of people who have to be mandated to pay, are those who, like you, cannot afford to buy their own insurance. They will be supplemented by Public Funds, but those funds, instead of going directly to those in need, will now go first to the Private Insurance Industry where an approx. 20% will be taken off the top for profits. Private Ins. is providing no service that is not already being handled, at much less cost by the government.

This bill is just another transfer of Public Funds into private hands. If the mandate goes, with the expansion of Medicaid, it would save tax-payers that 20%.

Every public fund has been targeted for private business, including Education funds. Now they have the Healthcare Funds.

Next will be Social Security, a huge fund they have tried to privatize for decades. Fortunately Bush wasn't able to get the job done, or much of it would be funneled to Wall St. and lost in the economic meltdown.

No true reform until we pass a public option or MC for all. No reform until we control cost. No reform until we cap prescription drug pricing.

........will only get worse as it SLOWLY kicks in. I truly believe that the majority of folks would be better off with nothing rather than this "abortion".

pulling pieces of dog poo around trying to "fix" it.

I am getting premium increases on both medical and dental policies. Tests that my doctor ordered are not be approved by the IPA. This is exactly what I thought would happen. Copays are getting to the point, you may as well pay cash and see a good doctor. The option of travel to other states for medical care is looking more viable. The health insurance companies are in open revolt, thinking the Democrats and then Obama will not be reelected, and the changes will be reversed. Why did we let this happen? We had the mandate. We had the people. We let the Republicans dictate our direction.

hell was Obama? Sucking the corporate appendage and lining things up for "after". At 17 months in office he is in line for the second worst (so called) democrat President, right behind Billy Boy Clinton.

buy a product they can't afford. Despite the subsidies, there will be people left out in the cold. At this point I'm grateful that by the time this kicks in, I'll be a month away from Medicare. Assuming I survive another 4 years without medical care. Single payer paid for by taxation makes so much sense, but when did common sense have anything to do with our bought and paid for government?

There is no place for profit as a priority in the practice of medicine. I say if we're liberators, the first thing we should liberate is the doctors from the health insurance industry, I know a great many of them want just that.

Where's the CBO score for HR676? I thought one was to be had. Given the fictitious state of our nation's financial folly, I'm not sure what the point would be. The whole picture just bites!

I first heard the idea proposed to make people buy our rightwing, for-profit, unregulated mafiosi health insurance by Newt Gingrich; why the fuck is the "democratic" party now advancing Gingrich's ideas?

Every day, 273 people die due to lack of health care in the U.S.

We need single-payer health care NOW.

is you have the government pay everything for everyone no matter what the cost because politicians feel it's in their political best interest, and we eventually become Greece. It mirrors the path we've been on with other entitlement programs, Democrats expand them and add burdens to business to create hidden taxes while Republicans pass them and don't pay for them adding burdens to deficits.

If it were 60 years ago and healthcare was largely pain management and telling patients, "I'm sorry, there's nothing we can do for you", then single payer would be a viable option. It isn't in 2010, and as we continue medical innovation and cost, the only way healthcare is sustainable is to have tiers of service based on ability to pay.

It only makes the crap we've been handed look more stupid.

I think almost everything in the OP is bunk. But your argument is no better, and basically every part of every sentence in your post is wrong.


"the alternative to insurance co's is you have the government pay for everything for everyone no matter what the cost because politicians feel it's in their political best interest"

There are many alternatives, but that is decidedly not one of them. Most single payer countries do not pay for everything for everyone no matter what the cost. And there are plenty of non-single-payer countries where government doesn't even have a public insurance option, and all insurance is private (yet everyone has access through subsidies).

"and we eventually become Greece"

Right now, most countries that provide healthcare for all (single payer and non-single payer) are not on any path remotely approximating Greece's path.


"as we continue medical innovation and cost, the only way healthcare is sustainable is to have tiers of service based on ability to pay."

As mentioned above, healthcare is sustainable in most other countries, where ability to pay is either not a significant factor or not a factor at all. So your argument would only be true if no other country has medical innovation. And that is baloney. Plenty of medical innovation comes from other countries. Much of perscription drug "innovation" in this country is new drugs that provide minimal benefit over the previous best drug, with high side affects and/or high cost. While there are certainly many life-saving breakthroughs, there are also plenty of such breakthroughs in other countries. While the degree of medical innovation might vary, there is a HUGE difference between that and "no medical innovation."

It is the national sport.

"if you have the government pay everything for everyone..." predicted results. If government (e.g. politicians) could be persuaded to use the power it actually has, by insisting on standard prices and using sticks rather than carrots on outfits who don't comply, health care costs would fall dramatically--many by as much as 90%. Of course a truly free market would have similar results, as can be seen by how the prices for purely cosmetic surgery are dramatically lower than those for other similarly complex operations. But we don't have a real free market in health care, and probably never did. People can make rational decisions about whether improving their appearance is worth the cost (even if enchanced job prospects figure into the equation) but it's superhuman -- or subhuman -- to expect the same to happen if saving a life is at stake.

Of course, persuading the politicians to exercise their power in the right way is the crux of the matter, and one I don't have a solution for either.

............it certainly is NOT because of our healthcare "system" is cheaper than theirs. In case you want to check, our system has "tiers" already. We (unlike Greece) can certainly afford to bring our tax rates up to what they were pre-st ronnie AND stop the two unnecessary wars we are waging. With those two things ONLY, we can have one of the best healthcare systems in the fucking world AND have money to fix some of our many, many problems.

Greece would be fine if it weren't for the fact that their government bailed out their banks, made secret deals with Goldman Sachs, just like ours, and now wants to pass the bill to the people. The rich in Greece just like here, have escaped paying their fair share of taxes.

Funny how there's always money for wars and the military, just like Greece, but not to provide for the people's needs.

There is absolutely no reason why this country could not have a National Health Care system. None. And the government doesn't pay for it. Nice of using the rightwing talking point that liberals 'want every for free'. That talking point has long ago been debunked. The people in other modern democracies pay for it the same way we pay for SS and in the end, they pay less even with higher taxes without having to provide profits, approx. 30% for Private Insurance Corps who do nothing that the government can't do for far less. That 30% can be spent directly on medical care, instead McMansions for the corrupt Private Ins. Indust.

We've done it your way, and as a result hundreds of thousands of Americans have died. Time to get some real HC reform which this bill certainly isn't, although it will further enrich the Private Ins. Industry, which is why they got to write it.

But we have to balance the need to be competitive on tax rates while at the same time managing entitlement programs so that they are more in line with some of the debt/GDP levels of the past. So if you start social security and life expectancy was roughly equal to the year it kicked in, if life expectancy goes up, you have to raise the retirement age to roughly match to keep the program viable. Similar things have to be done w/ medicare with co-pays and what kind of care is eligible to better balance out the tax inflows with the entitlement outflows. And Greece had a lot more issues going against it than hiring Goldman to cook their books. Obviously the fact that they had to cook their books to enter the EU should give you a clue to that.

In many ways the managing of entitlements vs revenues is an effort to save the patient.. the patient being medicare and social security. If you dither until it reaches a crisis point, you suddenly run out of options and the remedies are much more severe both to whatever gets slashed thru austerity legislation and the economic consequence of the government slashing spending on a dime has on GDP.

Mechanization requires less and less manual input, thus less workers. Rather than increasing the retirement age it would appear that due to the workers increased productivity that they should be able to have more leisure time like the plutocrats that own everything.

"There are no studies or evidence to prove that big insurance will suffer in the least by being forced to cover pre-existing without the mandate, just idle speculation from industry types about "Actuarial Tables", with no real substance."

Try looking at the New York state individual health insurance market. Just take a quick glance. You will find that they have exactly what you are proposing. Insurance reform, but no mandate. They used to have nearly a million individual policies. They now have 33,000. This is because health insurance on the individual market is now so expensive that only the richest can afford it. Insurance premiums in New York state have increased over 15 times the rate of increase of the rest of the nation. 15 TIMES!

So while you claim there are no studies or evidence, that claim is directly contrary to reality. We have an entire state as the evidence. It couldn't be clearer.

Of course, the fact that you can't have a ban on denial of pre-existing conditions without a mandate is obvious enough that a 6th grader should understand why. You don't need to look at a single actuarial table. No one in their right mind would pay for insurance if they could get it on the way to the emergency room should they get sick, and cancel it on the way out of the hospital. The price of insurance would clearly have to be high enough to cover all of your claims, which is essentially an unlimited deductible. This is so obvious it should really go without saying to thinking people.



"If we are lucky enough that big insurance does indeed go belly-up, we can then institute single-payer and take these crooks out of the mix."

:rofl: :rofl: :rofl:

Talk about no evidence. You know what would actually happen if big insurance went belly-up (as opposed to your pipe dream)? The ban on discriminating against pre-existing conditions would IMMEDIATELY be repealed, and its repeal would get 300+ votes in the house and 70+ votes in the Senate. The repeal would be advertised as a huge premium cut (1k/month +) to all healthy people, because that is what it would be. And guess what? Healthy people are the ones that vote. They vastly outnumber very sick people, they have a much higher turnout, and most people with high medical expenses already vote Democratic (so it is no skin off Republicans' back to hurt them). This is the reason we do not yet have single payer. Healthy people (for the most part) are not energized to vote solely for single payer candidates, because they don't need to use insurance much and therefore think they are happy with what they have.



"We will avoid the costly constitutional challenges from states Attorneys Generals, and dismantle their main arguments in their cases."

I actually relish the fight. These 10thers need a huge, spectacular defeat in court. And they will get it, because the constitutional argument against the mandate is so silly it is barely even worth discussing. MULTIPLE powers in the Constitution give Congress the ability to enact an insurance mandate. The challenges to the individual mandate are really just backdoor challenges to the supremacy clause as a way to dramatically curtail federal government's ability to enact social policy, and such challenges need to be defeated soundly and dramatically, once and for all.


There is a reason why no country in the WORLD bans denial of coverage to pre-existing conditions without a mandate (including all single payer countries and all non-single payer countries, of which there are several). While we should all fight to enact single payer (or a heavily regulated system like Sweeden or the Netherlands), playing make-believe about health policy is not productive and just causes people to be confused (as evidenced by the people that actually recommended this thread).

you have a great future ahead of you!

correct, but you are wasting your breath (and bandwidth) on the die-hard "experts" who are predicting doom and gloom.

business!

Excellent! I think you may be proving my point.

In fact, you seem to be saying the wealthy are now subsidizing insurance for the poor in NY - I see nothing wrong with this.

Assuming that everyone can walk into a hospital, buy insurance on the spot and get treatment (is this what you are saying is happening? Links?), I see nothing wrong with the plan.




If big insurance goes belly up - we will simply institute single payer like virtually every other civilized country; however, removing the mandate will simply force them to the negotiating table if you want a system like Holland or Switzerland.

Giving them trillions in a mandate will result in the removal of pre-existing clause and every other piece of reform you think is in the bill, IMHO.

Remember - MOST AMERICANS WANT A PUBLIC OPTION: http://www.reuters.com/article/idUSTRE5B20OL20091203.

How do you suggest we get to single payer or a public option if we give trillions to big insurance?




Wasting more money on constitutional challenges instead of helping sick people is the wrong way to spend taxpayers money, IMHO.

If you don't have THOUSANDS per month to buy insurance, then you can't buy insurance, can you?

Sure, the insurance companies are still in business. But their business has decreased by about 95%. Only the RICH can afford policies on the individual market because of the lack of a mandate. This is a system you WANT? REALLY?

HOW exactly do you propose we institute single payer? Should Obama disolve Congress? Should he use military force? Please provide me your plan. If we can't get single payer with our current majorities, what makes you think we will get it when Republicans control one or both houses of Congress in 2010 or 2012 or 2014, or possibly the presidency in 2012 or more likely 2016? What makes you think the insurance reforms won't simply be repealed? Unless you plan on instituting single payer by military force, I don't see how your logic holds.

A public option wouldn't even work if we got rid of the mandate. It would go belly up (or remain only for the rich) just like private insurance, because healthy people would not pay into it and they would need to charge thousands of dollars a month in premiums just to stay solvent. In your dream world with insurance reform but no mandate, you would really need single payer (a public option wouldn't suffice). Please provide me your plan to get there that doesn't involve disolving Congress. I think dumping insurance reforms is MUCH more realistic without a mandate, whether we like it or not.

Just because PTB may dredge up alternate, more tortuously reasoned "proof" from the Constitution that forced extortion of some citizens' money to support a private insurance co is OK, doesn't mean they're right. "Proof texting" of the Bible has a bad name, and so should this type of analysis as applied to the Constitution.

is a crank.

Right now, you pay less in taxes if you buy a house than you do if you don't buy a house (due to differential tax treatment of housing market behavior). Likewise, with the mandate, you would pay less in taxes if you buy health insurance than if you don't buy health insurance. You can call this slavery or facism or whatever you want, but please don't expect to be taken seriously.

from the insurance industry. I think it is good not to bite the hand that feeds you. The problem is how much damage that hand is doing to everyone else.

"you are in insurance company shill blah blah blah." Your talking points are actually not very original.

If you want to actually refute ANYTHING I said, you should feel free to do it with facts and evidence. You are of course free to impugn my motives or anyone else's motives, but your lack of ability to find ANY evidence that refutes any of my points is quite telling.

I've seen them over and over. They are like the talking points that the parties give to their network mouthpieces. The data is cherry picked. Sure one fact is correct and "Irrefutable" when viewed in isolation. In context it proves pointless. Mostly the "evidence" is off the point of the discussion and meant to lead the thread into a he said/she said circle. Yours fall mostly in this last category. So go peddle your distraction elsewhere. Most here on DU know where this type of corporate nonsense comes from.

We just don't need insurance companies to make health care better or more affordable. Now that would be a nice thing for your public relations department to work on. Show me how insurance companies are required to improve the quality of health care. Then show how paying the profit margins for insurance companies will reduce the cost of health care. Oh. And factor in the fact that all doctors and hospitals have to have enormous collection and billing departments to handle the paper work and redundant forms that the insurance corporations require.

What is quite telling is your defense of this nasty business. I have nothing against the idea of insurance in general. I have friends and relatives in the business. But none sink so low as to deal with the health end of the industry.

You can't just claim that hard data is cherrypicking without actually providing the rest of the data you accuse me of leaving out, and still expect to be taken seriously by any thinking person. If the fact that New York's individual market dropped by 95% is "off the point of discussion," as opposed to DIRECTLY on point, you should say why it is the slightest bit off point.

By not providing evidence and only making ad-hominum accusations, you are peddling the VERY DEFINITION of talking points. It doesn't surprise me. You can't make a single reply to data without accusing me of being an employee of an insurance company. That's all you have -- false accusations. If you had actual data contradicting mine you would have posted it. You clearly don't, and this gaping hole in everything you write speaks much louder than your pathetic accusations.

The talking-point nature of your ad-hominum accusations is further shown by your questions in the second paragraph. You ask me to show you how insurance companies are required to improve the quality of healthcare? They aren't, if we have single payer. You ask me to show how paying the profit margins for insurance companies will reduce the cost of health care? They won't, if we have single payer. I NEVER CLAIMED OTHERWISE.

You act as if I don't support single payer. However, just because I support single payer doesn't mean I have been left on a desert island, so divorced from reailty that I think single payer is currently politically feasible (like you and many others here). Given that single payer is NOT currently politically feasible and would probably get no more than 10 votes in the most Democratic Senate we have had in decades, I FULLY support imperfect measures to improve the system we have.

Unlike you, I actually support enactable policies that help people. I don't just constantly and incessantly bloviate about how imperfect policies are compared to a politically infeasible utopian ideal. I honestly don't know how you and others in the latter group call yourselves progressive.

capitulated to the insurance industry. It was hard to find in there, but I was glad to see it.

I guess there are two kinds of progressives. Those who want change and those who think maybe it would be good if it's not too hard.

"Of course, the fact that you can't have a ban on denial of pre-existing conditions without a mandate is obvious enough that a 6th grader should understand why. You don't need to look at a single actuarial table. No one in their right mind would pay for insurance if they could get it on the way to the emergency room should they get sick, and cancel it on the way out of the hospital. The price of insurance would clearly have to be high enough to cover all of your claims, which is essentially an unlimited deductible. This is so obvious it should really go without saying to thinking people."

Why did it take Obama until after the primaries to figure this out?

just stopped paying their insurance premiums all at the same time. The whole industry would collapse overnight.

Single payer will not come out of the heavens. Instead, lawmakers would repeal the law that requires insurance companies to cover pre-existing conditions. So while people might feel good about not paying for health insurance, they would not feel good as soon as they needed any healthcare.

need it. Three-quarters of all the medical bill-related bankruptcies last year were for people who HAD HEALTH INSURANCE.

During the high pitch of this whole debate I decided I was finally tired of pointing out to people the difference between having health insurance and getting health care. This system that we have is a complete bloody disaster that works for NO ONE except insurance cartels. Why NOT have everyone cut off their premiums all at once? Is it because the insurance companies might deny them the care that they deny them now?

If there was ever a nothing-to-lose-but-your-chains moment, this is it. Gandhi's fed up with British rule in India. Rosa Parks' feet are tired. What are people so afraid of?

Health insurance DOES NOT EQUAL health care.

I brought up the bankruptcies and all that other stuff.

Some people got it, some people didn't.

The law doesn't provide subsidies for junk insurance. It provides subsidies for insurance with a strong minimum benefits package and minimum actuarial value, with strict regulation and limitations of denials of claims. And on top of that, the law states that insurance companies must either pay 85% of all premiums to medical care or rebate the difference to the customer. While the law won't completely end medical bankruptcies, it will DRASTICALLY reduce them compared to what they are now.

So while the idea that this is just a "handout" to insurance companies is really just peddled by know-nothings who want to further their agenda, it bears no actual resemblance to reality.

I have a question. You are asking what people are so afraid of. Have you ever considered that maybe the fact that people are NOT rising up is a point against your argument? Most people are perfectly happy with what they have, because they are healthy and don't need to use it. This is just a fact. This will always be a fact -- the healthy will always vastly outnumber the very sick who need to use insurance. This is why getting ANY healthcare reform bill is so difficult. People are afraid of losing what they have (even if it can't be used upon request). The bill that passed will be a HUGE benefit to the poor and middle classes, notwithstanding what people who know NOTHING about the law continue to peddle on DU.

$1500 deductible with a max out of pocket of $5,960 for a single - amounts that can go up annually. And those amounts do not include premiums, dental or vision coverage or anything else your insurer decides isn't covered. These limits are even higher than the piece of crap, "Consumer Driven Health Plan" my employer switched to allows.

These limits are high enough to keep a person from getting care and, for someone with a chronic condition who faces the max out of pockets (plus uncovered costs) every year - high enough to drive them to bankruptcy.

Do you really think the insurance companies aren't going to find ways around the 85% requiement - they manage to do just that now in states that already have limits. Sure, there will be "regulations" but if the fines aren't anything more than a slap on the wrist the crooks will just write them off as a business cost. And that's assuming these regulations will be enforced at all. Given how seriously worker safety laws are taken, I'm not holding my breath.

This bill was nothing but a gift to the insurance companies and will not help the middle class who will continue to see access to care get more difficult every year while their insurance premiums continue to go up.

The subsidies are on a sliding scale.

That is opposed to the current status quo, where there are no subsidies for premiums OR deductibles and out-of-pocket expenses.

You are seriously claiming that giving subsidies for premiums and out-of-pocket expenses (and preventing denial of coverage based upon pre-existing conditions) will raise medical bankruptcies? No one is saying the law will completely eradicate the concept of a medical bankruptcy. But it is clear that with generous subsidies for those with low income and somewhat less generous subsidies for those with middle income (both for premiums and deductibles/cost-sharing), the number of medical bankruptcies will decrease.

In fact, one group of people who would no longer go bankrupt are those with pre-existing conditions who could afford normal premiums/deductibles but can't afford 20-30 times normal premiums due to their condition. These people will (by definition) not go bankrupt under the new law.

As for the 85% rule, they might be able to slightly game the system (such as putting services such as a health hotline under medical care instead of administrative benefits). That might lower the 85% to an effective 80% (let's say). But they CERTAINLY won't be able to apply profits/bonuses to the 85%. No court could possibly read the law that way, even without any additional clarifying regulations (of which there will be plenty). The point is, even a slightly-gamed 85% rule is FAR different than the 0% rule in existance today in much of the US. Insurers will not be able to raise rates without bound, as they will have to rebate the differences to consumers.

It seems that you have two main arguments with the law. One is that it is not as good as your utopian vision of society (as opposed to comparing it to the status quo, which is the only meaningful comparison). The second is that while some parts of the law may be great, they are just laws, and laws can be broken without consequence. This is such wildly fanciful baloney that I am not going to waste more time responding to it.

it says out of pocket expenses are subsidized because I haven't been able to find it and so far no one has been able to link me to the part of the bill that says this or even just the section number. All I've gotten are links to other threads where someone says this same thing.

As far as the premium subsidies go, the income limits for subsidies are way too low. And, the closer a person gets to the income cap, the smaller the subsidy will get. This massive transfer of tax dollars is just another bail out of a crooked industry that will collapse if it isn't handed billions of dollars - either from tax funds or from the millions of new victims being handed over to it who will pay their own premiums. If it's permissible to use tax dollars to pay premiums to private insurers you have to wonder why we can't just cut out the middle man and have a single payer system.

By passing a bill that only reinforces the status quo we're guaranteed that we're going to right back in the same place in a few years. The CBO says that in 2014 there will still be 19 million uninsured and that number will continue to grow (again). Forcing people to buy insurance may temporarily lower the number of uninsured but all it does is increase the number of underinsured. No where does the bill do anything to guarantee access to care - and that's what we needed.

The idea that people should have access to care is hardly utopian when you consider that every other western country manages to do it.

By what stretch of the imagination does insurance equal health care?

You are describing the problem - that the insurance industry stands between the pubic and health care - not the solution.

So if there were no insurance companies, then all of the health care professionals would stop working and have no commitment to taking care of people anymore? Or they would only help the wealthy?

Or might not many health care workers, perhaps the majority, freed up from this nightmarish system, find ways to set up clinics and get out there and help the people who need help?

We are being threatened and extorted by the most powerful people at every turn now.

"Nice country you have here. It would be a shame if something were to happen to it. You had better cooperate, or else."

The insurance companies are saying "better do things our way, or no one will get medical care and then you'll be sorry."

Wall Street says "fork over the money and no one gets hurt. Otherwise we will destroy the economy and you will ALL be out of work and starving, and then you'll be sorry."

The mortgage industry says "you are lucky we let any of you have houses. We would rather let them stand vacant then to give in an inch to you dumb suckers. Play ball or you are on the street. We will put some of you on the street even if you do play ball, just to show you we mean business."

The pharmaceutical industry says "look, you will buy what we tell you to buy at the prices we tell you to pay. We run the FDA, got it? Any talk about health care alternatives that cuts into our profits will be dealt with ruthlessly."

The oil industry says "ya want gas? Want to be able to get to work? How do you feel about keeping your home warm in the winter? You had better not stand in our way if you know what is good for you. We'll raise prices on your ass until you get with the program here. WE decide if you stay warm or go anywhere or have a job. Got it?"

And of course we are being asked to accept a police state, lest terrorists kill all of us, or lest immigrants steal all of our jobs and force us to all speak Spanish.

Health insurance is (for the most part, with some exceptions) necessary for most to receive healthcare in this country. I'm not saying you agree with this or have to like this -- I'm just saying that this is reality, whether we like it or not. The costs of providing expensive operations and healthcare would overwhelm anyone if forced to pay it on their own. You can continue to repeat "health insurance does not equal care" till the cows come home, and you would be correct, but that does NOT mean that health insurance is not NECESSARY for care in this country. Something can be NECESSARY even if it isn't sufficient.

If there were no insurance companies, then health care professionals would either need to charge the actual cost of healthcare to people who need it (which would bankrupt anyone with a serious illness) or the health care professionals THEMSELVES would all go out of business, one by one. This includes all healthcare clinics, who would immediately go out of business if they were the only method of care for everyone in this country (or would have to start charging the full cost of the healthcare). The only way to abolish basic insurance is for the government to institute a single payer system. It is FAR more likely that the government would remove resrictions on private insurance covering pre-existing conditions than enact a single payer system.

Absent a single payer system (which is politically impossible for the near future at the very least, whether we like it or not, as it has been since 1940), insurance is needed for anyone to afford healthcare. The abscence of private insurance would cause healthcare to be a benefit only for the rich EVEN MORE than it already is today (much more so). Healthcare does not grow on trees.

Excellent post thank you. That was perfect.

You say that we must have insurance companies because:

1) Either the doctors, nurses and technicians would have to charge so much that we, the patients, would all go bankrupt, or...

2) They would have to charge so little that they would all go out of business.

Exactly! That is exactly what we are being told. You expressed it perfectly.

Now, how about this: We, the patients, give the health care people everything they need to live a good life in exchange for them providing health care?

In the rural county I am in, we have a small hospital with doctors, nurses and technicians, and we have lots of farms, carpenters, electricians, plumbers, well diggers, clothing makers, tool makers and everything else needed for living.

Now, if that hospital and staff provided medical care for all of us here in this county, which they could do, the rest of us would be HAPPY, more than happy to build them big ass houses, provide them with all of the furnishings they could ever want, and make sure they had great food in tremendous abundance. We even have a farmer with a winery here. We even have natural gas wells (all of the money from that is being drained off into the pockets of those on Wall Street, as is all of the wealth being produced by the farmers - the farmers are paid a penny, the consumers in Chicago pay a dollar - someone is raking a lot off the top, that is for sure.)

So clearly it can work without any insurance company, in fact it would work much, much better. All would be much better off than they are now.

As it is now, all of those people are out of work, can't afford insurance, the farms are struggling and going under, and the doctors are moving away. Why would that be?

One of the major factors of the objection to what was called Socialized Medicine was the fact that 36% of work force was unionized and had won this as a benefit. The majority of the rest of industry, if they didn't want to be unionized had to match the benefits. If the workers hadn't cut their own throat they would have gone for 100% unionized work force and you would still be producing goods and have full employment and a viable health insurance plan. We all know that insurance companies are the biggest rip off or rip offs. They take 30% off the top and provide absolutely NOTHING to health care except scandalous compensation for their top management. The politicians are crooks and the citizens are spineless.

Bravo! Says is all.

We can't handle reality any more. It's a pre-existing condition, don't you know.

Regarding point 3...

"No one in their right mind would pay for insurance if they could get it on the way to the emergency room should they get sick, and cancel it on the way out of the hospital."

I can't understand why so many people haven't figured this out.

2) It takes more than a few hours to sign up for insurance.

3) Do you have ANY evidence to support your claim?

4) The worse thing that could happen is big insurance goes belly-up and we institute Medicare for ALL.

HOWEVER, if we continue down the path of mandated private insurance what will happen is big insurance will take the trillions you are mandating to them and use the money to crush the weak reforms in the bill. Eventually, we will be covered for almost nothing while being forced to pay.

emergenct room?

Let's say I find a lump and go to the doctor (I pay this out of pocket because I have no insurance). The doctor examines the lump and tells me that I have lymphoma. It will cost $250,000 to treat. I call my friendly neighborhood insurance company and insist that they sell me a policy.

See how this works? Why would anyone buy a policy until they actually got sick? And why would anyone continue to pay for the policy ater they got well?

they are unconscious when they are brought to the emergency room.

So, in this case, you DO NOT need a mandate to get people to buy insurance if they really want them and their families to be safe.

The original argument was "No one in their right mind would pay for insurance if they could get it on the way to the emergency room should they get sick, and cancel it on the way out of the hospital."

I just want to make sure that we both agree that this argument is invalid in the case of one being unconscious.

Please don't move the goal-posts again before this point is addressed.

I'll address your other points in turn.

In the end, you'll find that the need for a mandate is a manufactured fantasy based on PR and propaganda and speculation, not real facts.

agree that people will voluntarily buy insuarance on the off chance that they may be unconscious on the way to the emergency room.

Look. I have worked with engineering contractors my whole life. To the last man and boy among them, not a one of them bought health insurance.

When they got sick, they went to the emergency room. End of story.

You seem to be an intelligent enough fellow, so I can only assume that your failure to understand that a mandate is needed to ensure that people will purchase policies is either a) an attempt to defend your original defective point 3, or b) a manifestation of extreme cognizant dissonance.

Either way, I can't help you see this.

"people will need to buy insurance if they want to be covered in the event that they are unconscious when they are brought to the emergency room."?

Further:

"Heart disease is the leading cause of death in the United States and is a major cause of disability. The most common heart disease in the United States is coronary heart disease, which often appears as a heart attack. In 2009, an estimated 785,000 Americans had a new coronary attack, and about 470,000 will have a recurrent attack. About every 25 seconds, an American will have a coronary event, and about one every minute will die from one." (http://www.cdc.gov/features/heartmonth/)

If one wants to be covered in the event of a heart attack (or stroke or many other common debilitating conditions) then one would have to have insurance prior to the event.

This is good motivation to purchase insurance, it does not require a mandate.

The most likely reason for your engineering contractors not buying insurance was cost. The mandate will do nothing to bring down costs. Nor will the mandate guarantee that big insurance will pay out their claim if they do get sick. Further, if they still do not buy insurance, they will still wind up at the emergency room.

The real solution is to cover everyone through a program like Medicare that is paid for with tax dollars and operates on a non-profit basis. In the case of a public option or single-payer, a mandate makes sense.


Mandating big insurance trillions could well prevent us from ever being able to institute true reform, as they will take the money and use it to lobby against reforms in congress, and fight every individual claim with a team of lawyers.

The mandate in the context of private insurance will fail because big insurance will NEVER use their mandated trillions to pass the cost savings on to the consumer.

3) Do you have ANY evidence to support your claim?

Evidence doesn't apply since we don't have a non-mandated plan that covers pre-existing conditions. However, let's use car insurance as an example to predict what would happen. Did you know that you can't buy car insurance after you've had an accident and expect the company to pay? Can you figure out why? It's because no one would waste money buying expensive insurance if they could wing it and still get the mean greedy insurance company to pay for their claims. If you can't see this, than nothing I can say will help you.

4) The worse thing that could happen is big insurance goes belly-up and we institute Medicare for ALL.

No, the worst thing that would happen is that hundreds of thousands of Americans would go bankrupt trying to pay for medical bills as insurance companies slowly go bankrupt and people continue to get sick and require medical treatment that someone has to pay for.

And certainly the spirit in which you say it. K & R.

That is because the money paid buy those who are young, earn good salaries and don't voluntarily buy insurance will go to buy insurance not electronic gadgets. If everyone who can afford it buys insurance, the government will not have to step in to cover the emergency care for those people. People 30 and younger think they don't need insurance. When they get cancer or some other illness, the government ends up paying their bills.

Further, a lot of people try to use the emergency room doctors as primary care doctors. The mandate will hopefully encourage more people to seek primary care since they are insured anyway. \

The Supreme Court is not likely to overturn this bill. The so-called "mandate" is a normal exercise of the government's power to impose taxes. It is not really a "mandate" so much as it is a tax incentive to buy the insurance. Those who buy the insurance pay lower taxes than they would pay if they did not buy the insurance. That's all the "mandate" is. It's your choice.

The tax code has lots of similar incentives but they are not called "mandates." You pay lower taxes if you have children. But that is not a mandate or even an incentive to have children. It is meant to help you pay for the costs of raising children.

in the form of care.

In fact, the opposite is true - the more money they make, the less care they provide: http://docs.google.com/viewer?a=v&q=cache:k2pZl0sNatwJ:hcfan.3cdn.net/578b1f7456962bfa7a_r6m6bhcjn.pdf+health+insurance+profits+statistics&hl=en&gl=us&pid=bl&srcid=ADGEESh56pwmgB8l5InQ2t3oc7xLJEKE_v3HcGcpjJCFRUUVoHvN6YTCn6HsoZB-XIB7BDtzTUy3op8sk6yRKSvOOFylzqT7CYnyUNhj_f0IcKrGMcOH5CF8C1c4sVZeG1T1b3E4dYGK&sig=AHIEtbSW2Ts_zshh87DW8WRvqIlk4XlaFA

Spot On! Mandatory health insurance is a perfect example of how the democratic process has been corrupted by corporate control of our government. It appears that our representatives have nothing better to do than to rent their puppet strings to the highest bidder--usually large corporate interests. The health insurance mandate is just another milking machine, and we are the cattle. Of course, favoring one industry over another, or using the legislative process to destroy one industry in favor of another, usually at the expense of the citizens, is not what our founding fathers had in mind.

The problem is that this derailing of democracy by powerful special interests is so pervasive that it now appears like a thicket of thorns. For the time being, I'll support the blue milking machine, not the red one. And I'm not sure where they hid the green one. Moo!

You just don't want to pay. You want to skate along until you get sick, then buy insurance and drop it as soon as you're well. Then the rest of us that keep paying into the system as part of the diversified risk system pay just a little more because you are basically being very selfish and self-centered. Your reasons above are nothing more than a diversion and redirect from your real motives.

The mandate will simply provide large insurers trillions of dollars that they will use to crush the meager reforms in the bill, as well as create hundreds of fly by night companies that that provide a policy that skirts the mandate while providing no real coverage.

If people don't need to get health insurance until they are sick, why in the world would healthy people get insurance with the public option? They wouldn't. The premium death spiral would affect the public option just as much as private insurance, and premiums would have to be thousands per MONTH just for it to stay solvent. The mandate is absolutely essential to have an affordable public option that doesn't immediately go bankrupt (or become unaffordable).

it is against the law to provide those mandated products on a for profit basis. To mandate contributions to for profit companies is criminal, and in our peer nations, such profits are actual crimes.

It is the for-profit aspect of the mandate that is unacceptable which has been stated over and over again.

Those who argue against a National Healthcare System claim 'we can't afford it'. Well, if we can force people to pay protection money to a private business, then if they can't afford it, subsidize them with the very same money that COULD have gone to REAL HC costs instead of now being funnelled through a Private Corp with 20% profit disappearing in the process, we can do what we do with SS. Deduct a HC tax from people's income and let that money be managed by the government the same way SS is managed, with none of it going to Private Corps (YET! although I think this is on the agenda of this administration}.

The money IS there, or if it's not, then it's not there for the subsidies supporters keep talking about.

private insurance.

Viola! We have single-payer, while destroying the companies that allow people to die rather than pay out legitimate claims.


Again "If people don't need to get health insurance until they are sick, why in the world would healthy people get insurance with the public option? They wouldn't." There is no evidence to support this claim. Let's try it and see what happens if it doesn't work - ` WE CAN FIX IT LATER.

Pre-existing conditions without mandate. 95% reduction in numbers of individual policies. Rates growing at 20 times the increases in the other states. How is this not evidence?

types of coverage. Your FT article states, "New York combined guaranteed issue and community rating in 1993, and destroyed the individual insurance market", this however resulted in INCREASED COVERAGE as of 2004:

"In a majority of states, the percentage of residents who are uninsured was significantly higher in the 2003-2004 period than in 2000-2001. The 26 states in which UNINSURANCE rose are: Colorado, Delaware, Florida, Indiana, Iowa, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia and Wisconsin.

In one state, New York, the percent uninsured fell.<1>" http://www.cbpp.org/cms/?fa=view&id=631

Be careful of industry spin, these guys are good at conflating!

Of course in a single year policies can fluctuate. The point is that the number of individual market policies dropped 95 PERCENT since 1994 (when community rating/guaranteed issue were enacted without an individual mandate).

That's right. 95 percent. A factor of 20.

You could of course find that on one day there are more policies than the day before, or even one year compared to the previous year. But over a 15 year period, the number of policies droped by a factor of 20.

But on top of your small-interval cherrypicking, you aren't even looking at the right metric. I am talking about the INDIVIDUAL MARKET. The group markets are very different. In the group market, healthy people (for the most part) are automatically enrolled by their employer. Both healthy and sick people are insured in the group markets (by their employer), so rates are more reasonable and there is a correspondingly higher rate of the insured.

The entire POINT is that in the individual market (as opposed to the whole market that you are talking about), there is NO mandate or employer auto-enrollment, so healthy people don't purchase insurance and all that is left are sick people. That's why it costs thousands PER MONTH to purchase full insurance for a family in the New York individual market, which is MUCH higher than the national average.

Looking at the whole market (including the group markets) is very misleading, because someone in the individual market can't join the group market. They are in the individual market because they are self employed, or unemployed, or their employer doesn't offer insurance. Without a mandate, you are forcing these people into a market that has dropped by a factor of 20 with prices in the range of thousands per month.

So in summary, you are looking at the wrong metric and even if you were looking at the right metric your year over year statistic doesn't show anything. Policies in the individual market dropped by 95% over a 15 year period, and similar behavior would occur if we guaranteed insurance without a mandate nationwide (in the individual market). The evidence, far from being non-existant (as you keep saying), is actually ironclad and (for the most part) undisputed.

It does not matter if they are covered by an individual plan, a public plan or a group plan - they are covered.





Costs are also normal:



Therefore, there is no reason for a mandate which will only serve to funnel trillions to big insurance that they will use to crush what little reforms are in the bill, IMHO.

kick!

smiles his Yue Minjun (http://www.nytimes.com/2007/11/13/arts/design/13smil.html?_r=1) SMILE while sticking us with a Health tax.

after this,sheeple, wait till the VAT kicks in (another 10% on EVERYTHING you buy, rich or poor, a true "flat tax").

insert flag waving here.

A crop of anti-HCR posts on DU, a spate of anti-HCR newzitorials in the MSM, what a coinkydink.

It will only guarantee big insurance enough cash to crush the reforms in the bill.

..so I'm going to whine about it.

Yes, a private company collects the money and, for a fee, administers the program. It pays employees, monitors costs, pays doctors, etc..

Alternatively, we could have a government agency collect the money (IRS) and have another one administer the program. This would still involve administrative overhead. Would that be less than the capped and regulated profit margin of the private companies? Probably. A single agency might have less duplicated overhead than the state-by-state insurers would. Medicare typically has less overhead per subscriber than most insurers. But is that difference in overhead such a big deal that we ought to let folks opt out of the mandate? Would we let them opt out of a tax? No, we wouldn't.

So simply because a private company gets an administrative cut, the whiners can cry foul and try to undermine the foundations of a pooled risk insurance program?


Some people hoping for a single payer free ride. Now they are upset they'll have to pay something. Initiate tantrum...

In the end, you will be giving them trillions of dollars so that they can fight every rightful claim with a team of lawyers, and use the money to lobby congress until the eliminate every reform in the current bill.

"Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($8,160 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 46.3 million completely uninsured and millions more inadequately covered.
Health Profits Cartoon

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The links below will lead you to more specific information on the details of single-payer: http://pnhp.org/facts/single-payer-resources"