Hacker News Reader

Comment by bmelton | Hacker News Reader

Color me critical, but it seems like, basically, the point of this article was to show off exactly how informed in her 'hard-nosed' critiques, and how that is proffered as justification for the obvious bias present in the article.

I also find it interesting that despite the apparent mountains of reading, the author cannot determine any good reason why one might oppose the Affordable Care Act, which tells me that either her bias refused to allow her to accept posed oppositions as valid, or that she simply doesn't care that other people do object.

I think there are plenty of valid reasons for opposing it, just as there are plenty of reasons to support it, and frankly, I think all of major justifications on either side of the argument fall into the category of fairly obvious.

That said, kudos on choosing to provide health care immediately. It is a tough decision, and it will affect the company's bottom line, but despite that, if you're an employer who believes that everybody should have affordable health care, it is the obviously correct choice.

View on HN

Every single objection you have to this article has nothing to do with either its content or form.

Help me to understand why you would post a comment like this:

>Color me critical, but it seems like, basically, the point of this article was to show off exactly how informed in her 'hard-nosed' critiques, and how that is proffered as justification for the obvious bias present in the article.

I'm not sure how to translate this other than "He thinks she's so smart, so he's asserting that he has an opinion worth listening to."

>I also find it interesting that despite the apparent mountains of reading, the author cannot determine any good reason why one might oppose ${THING_THAT_AUTHOR_SUPPORTS}, which tells me that either her bias refused to allow her to accept posed oppositions as valid, or that she simply doesn't care that other people do object.

Translation: "He has an opinion, and he thinks that there are no reasonable arguments against that opinion, so his opinion must be worthless." Remind me never to tell you what I think 3 times 5 equals, because my opinion will not pass this criterion.

>I think there are plenty of valid reasons for opposing it, just as there are plenty of reasons to support it, and frankly, I think all of major justifications on either side of the argument fall into the category of fairly obvious.

Now we know what you think - but you're not considering telling us why because it's "fairly obvious?" The author told us why he thought what he thought, and you attacked him for not telling us why everybody else thought what they thought, too.

>That said, kudos on ${ACTION_OF_AUTHOR_SUPPORTING_THING}. It is a tough decision, and it will ${COST_OF_SUPPORTING_THING}, but despite that, if you're ${WHAT_AUTHOR_IS} who ${HAS_AUTHORS_OPINION}, it is the obviously correct choice.

Do you think the author is searching for your vague tautological approval?

Comments like this trouble me. I don't understand why people take the time to make them. Color me honestly troubled.

Sorry to have been so troubling. What I meant to point out, and admittedly did a bad job of, is that I sensed a pattern of "thoroughly investigating" both sides of an issue as merely justification for calling someone a dick. I don't think that holds muster, especially as the same thorough investigation into health care reform led to absolutely zero evidence of why anyone could think it's a bad idea?

No matter which you you side on the issue of the Affordable Care Act, there are compelling arguments on both sides of the debate. I don't see how you can do thorough investigation and come up with the conclusion that it is wholly good, unless you're just happy to categorize everybody in opposition as either dumb, naive, uninformed or just wrong.

As for what I think, I did post reasons against in another thread here, which you're of course welcomed to find and/or respond to, but that's just a few of the rather obvious reasons against, and don't necessarily reflect my stance.

My real stance is that it's a complicated issue, and both sides have very compelling truths in support of their stance. The willingness to ignore those compelling truths, even after seeking them out, speaks to a greater bias, in my opinion.

You're correct in that perhaps I was overly harsh. I didn't intend to come off as negatively as my re-reading of my statement affirms that I did, but as there are currently more detractors of Obamacare than supporters, the assertion that the majority simply doesn't have a point at all, smacks of arrogance to me.

There is another argument at play, that I think more accurately reflects the author's viewpoint, which is that there are not any good arguments against universal health care as a concept, and has to ignore the specifics of the particular universal health care bill that's been introduced and enacted.

As a vague example, I'm betting you'd get pretty high poll numbers for a question that asked "Would you support a bill that could eliminate crime?", but would almost certainly be against any particular bill that sought to do exactly that as it would almost certainly entail the restriction of many of our American freedoms.

All that said, yes, I am sorry to have posted a response that didn't more accurately measure how I felt, or at least try to temper that response with more supporting evidence, but at the time I was in a hurry. I don't really see how your response is very different than mine either, so I'll just assume we both responded with too much knee-jerk response and hope to call it a day.

For what it's worth, the proverbial straw that tipped me into a frenzy was the line about Reddit - asserting that Reddit has never been excellent, and that despite this one particular case in which it obviously delivered excellence, the author assures us that it will never reach those heights again. Reddit is a big place, and there are pockets of excellence hidden amongst the mass of everything else. One man's trash being another man's treasure, the likelihood of a particular subreddit being considered universally good is of course slim, but to assume that this one particular thread is the very best that Reddit ever has, ever can, or ever will do just smacked too much of bullshit to me to let the rest go.

That was one of his points: There are no good reasons to be against the Act. I can't really judge if that is true, but basically, the idea that it is absolutely right to try to get as many people as possible insured is pretty powerful. And most of the opposition one noted was on the level of "that is socialism!" (which it isnt, and socialism isn't bad).

There are many americans working at medical device companies that will be affected by the 2.3% medical device tax. Zimmer, for example, cited the medical device tax as the reason for firing a thousand workers a few years ago.

I don't know that case. Normally, such claims are a lie (using an opportunity to reorganise the company to exploit the workers more) and it seems highly unlikely that 2,3% on anything could lead to that. So the margin before was that thin that the tax lead to thousand workers being more expensive than productive? That is highly unlikey, especially with medical device companies.

And besides, it doesn't invalidate the ethical point that it is right to privide medical insurance, even if true.

To clarify: it is an excise tax and applies to the _gross sale price_, not the profits (so even if the division runs at a loss, they still have to pay). http://www.irs.gov/uac/Medical-Device-Excise-Tax:-Frequently... I'd agree with your skepticism if it were affecting net (after employee salaries etc).

> And besides, it doesn't invalidate the ethical point that it is right to privide medical insurance, even if true.

Your original point was "There are no good reasons to be against the Act", so my response was pointing to a reason why someone would be against the act: I'm pretty sure that being laid off due to a regulation is a pretty good reason to be unhappy

> To clarify: it is an excise tax and applies to the _gross sale price_, not the profits (so even if the division runs at a loss, they still have to pay). http://www.irs.gov/uac/Medical-Device-Excise-Tax:-Frequently.... I'd agree with your skepticism if it were affecting net (after employee salaries etc)

AKA a sales tax. Which don't generally lead to broad-scale layoffs when they're imposed. Did California have massive layoffs when they raised their tax on everything in the entire economy in January? How about when Canada introduced a brand new 7% across the board sales tax in 1991?

As a business, the standard way of responding to that kind of tax is to raise your prices correspondingly (to an appropriate level set by your supply/demand curves of course).

There are lot's of good reasons to be against the Act. How about it forcing the young and relatively poor to subsidize the old and relatively rich -- it's a giant intergenerational wealth transfer mechanism.

Young adults will pay higher premiums under Obamacare because of its age rating system. The law stipulates that the maximum variation allowed in adult premiums is a cost ratio of 3 to 1. But as Heritage research shows, “The natural variation by age in medical costs is about 5 to 1—meaning that the oldest group of (non-Medicare) adults normally consumes about five times as much medical care as the youngest group.” Obamacare’s “rate compression” causes insurers to charge artificially low premiums for older adults and higher premiums for younger adults. Moreover, “Actuaries estimate that the effect will be to increase premiums for those ages 18–24 by 45 percent and those ages 25–29 by 35 percent while decreasing premiums for those ages 55–59 by 12 percent and those ages 60–64 by 13 percent.”

http://blog.heritage.org/2012/03/21/obamacares-2nd-anniversa...

Remember the perfect is the enemy of the good.

Don't oppose the Act because it doesn't bring about the best possible world. Oppose it only if it's worse than the currently existing situation.

I oppose it because I think it will make the situation much worse. I prefer working in the direction of freeing healthcare not regulating it further.

The Heritage Foundation may be slightly biased on these issues...

When those young people get old, they will have paid their fair share. The transition is of relatively minor importance.

I'm genuinely interested in your positions of opposition to the Affordable Care Act, if any. You're right in saying the OP did not provide any, and I'd be curious to hear some cohesive argument against it that doesn't necessarily tow a party line.

As far as the general timbre of the article, I would say it's pretty plainly stating that 'whether to provide healthcare?' offers no moral gray area whatsoever, and that it's a plain obligation on behalf of the employer.

Since you asked for points of opposition, I'll assume you have arguments in support readily available. The most obvious ones I can think of are:

1) The health care system is really broken, very expensive, and should be fixed outright. Letting the government foot the bill isn't a fix, and is just a waste of citizen tax dollars.

2) It isn't the American way. Instead of taxing Americans for health care, cut taxes, give them more money back, and let them spend it how they want, whether on health care or on preventative care. Create legislation that puts reasonable caps on health care expenses instead, and actually make health care affordable.

3) The federal government is woefully inefficient at getting things done, and that is by design. Managing this at the federal level just makes it even more expensive than it already is, because now in addition to all the costs associated with the medicine, care, hospitals and doctors, you've also got to pay the government middle-men as well.

4) It's a further abuse of the Commerce Clause of the Constitution. The commerce clause allows the federal government to regulate interstate commerce, not dictate commands to citizens in states. Allow states to implement their own health care acts if they so choose, and let the money stay closer to the people who need it, which should lower the administration costs.

It's pretty easy to see how these "criticisms" may seem less obvious (and less valid) to someone who a) is not deeply invested in American party politics and b) comes from a state with a well-functioning universal health care system.

Or in other words, those work as reasons for a political enemy of health care to oppose the bill; they don't fly so well as reasons for a reasonable person to think everyone shouldn't have access to affordable health care.

I don't necessarily disagree, but that also doesn't discount them as valid critiques of the bill as it exists.

I mentioned elsewhere that, upon reflection, I think what the author meant to suggest is what you just said, which is that if you divest this particular bill from the situation, there should be no valid critiques against affordable health care. That I think almost everybody would agree with.

So then the question evolves into whether or not the Affordable Care Act actually meets that measure. We do not currently know, and only time will ultimately tell, but again, there are many very obvious arguments suggesting that it won't actually deliver affordable health care, or that even if it does, that cost is masked by all the other costs.

If, in an extremely hypothetical example, Americans went from paying 35% in income taxes in general to paying 75% in income taxes, but all health care were free, then it might have succeeded in making health care affordable, but at the expense of making everything else you might want to spend money on more expensive.

Anyway, just food for thought. It's obviously a very complicated issue, and one on which I can easily see both sides of the argument. I tend to be against the particular implementation for various reasons of cost and efficiency, but that doesn't mean that supporters of the Affordable Care Act have no valid arguments either.

Of you think the debate has only two major sides, you never understand it.

I don't.

And more importantly why does it have to be at the Federal level, clearly MA thought it was a good idea and passed it -- it's not working well, but hey that's there choice. Why must everything be a national policy?

1) Isn't an argument, but a series of assertions of fact completely unsupported by any argument.

1a) health care system is broken

1b) health care system is very expensive

1c) health care system should be fixed outright

1d) government footing the bill for the health care system isn't a "fix." [what is a "fix," then, and what distinguishes them?]

1e) government footing the bill for the health care system is a "waste of citizen tax dollars." [what wouldn't be a "waste of citizen tax dollars," then, and what distinguishes them?]

-----

2) No "true" Scotsman, and the presentation of the author's opinions as the description of an actual "true" Scotsman.

-----

3) Starts with extremely controversial statements of fact mixed with conspiracy...

3a) The federal government is woefully inefficient at getting things done [where, and in comparison to who?]

3b) The federal government is woefully inefficient at getting things done by design [now, I'm afraid.]

-----

3 cont.) ...then presents its first argument to back an assertion:

3c) Managing health care at the federal level just makes it even more expensive than it already is [ASSERTION]

3d) in addition to all the costs associated with the medicine, care, hospitals and doctors [costs(MCHD)], you've also got to pay the government middle-men [costs(GMM)] as well if you manage health care at the federal level [MFL]. [Summary: costs(MCHD) + costs(GMM) = costs(MFL)]

That's three premises:

(3d1): the only costs associated with health care unmanaged at the federal level [costs(~MFL)] are costs(MCHD) [i.e. costs(MCHD) = costs(~MFL)]

(3d2): managing health care in general [HCIG] requires that MCHD be paid for [i.e. costs(HCIG) = costs(MCHD)]

(3d3): for health care MFL, GMM must be paid in addition to the costs of MCHD [i.e. costs(MFL) = costs(MCHD) + costs(GMM)]

-----

3c-d: commentary) 3d2 and 3d3 are fairly uncontroversial as premises, but in 3d1, you assume the conclusion by defining MCHD both as the minimum necessary costs, and equivalent to the costs of the status quo [i.e. costs(HCIG) = costs(~MFL)]. If costs(~MFL) - costs(HCIG) > 0 is true, then this statement reduces to costs(~MFL) - costs(HCIG) <= costs(GMM) which is simply a naked assertion, not an argument.

The only tests that I can think of that would validate this would be if Medicare had more overhead than the US private insurance system [VERIFIABLY FALSE], or if foreign systems with socialized health care were in any case more expensive than ones without [VERIFIABLY FALSE.]

-----

4a) Federally managed health care is a further abuse of the Commerce Clause of the Constitution [APPEAL TO AUTHORITY]

4b) The commerce clause allows the federal government to regulate interstate commerce, not dictate commands to citizens in states [NAKED ASSERTION]

4c) Allow states to implement their own health care acts if they so choose, and let the money stay closer to the people who need it [CALL TO ACTION]

4d) Allowing states to implement their own health care acts if they so choose should lower the administration costs [NAKED ASSERTION, and a strange one too. Having health care administered by 50 different state government administrations should have a lower cost than a having health care administered by a single federal administration? You don't think an argument is necessary for this assertion, or are you relying on "The federal government is woefully inefficient at getting things done, and that is by design" to do the heavy lifting here?]

-----

Honestly, I don't even think you're trolling. This thinking is just murky.

In breaking down my posts to bullet points and responding paratactically, I don't really have any way to rebut. If your goal is to win the argument, then kudos, you're doing well. If it's to understand 'the other side' of the argument, then you're failing miserably.

1d) what is a "fix," then, and what distinguishes them? I don't know. I didn't claim to have a fix.

1e) what wouldn't be a "waste of citizen tax dollars," then, and what distinguishes them? Well, there's the list of responsibilities enumerated to the federal government that they are obligated to perform. It's arguable whether those things are a waste of tax dollars, but the federal government is obligated to perform than either way. That would include interstates, highways, the postal service, etc. Further, another federal government job is to protect against the abuse of individual freedoms by the state, so clearly the Supreme Court isn't a waste of tax dollars.

Regarding 2, I wasn't aware of the author's Scottish heritage, but certainly I didn't mean any bigotry, however much you might wish to impart that upon me.

3c-d The only tests that I can think of that would validate this would be if Medicare had more overhead than the US private insurance system (VERIFIABLY FALSE), or if foreign systems with socialized health care were in any case more expensive than ones without (VERIFIABLY FALSE.)

There are other tests, like how efficiently the VA performs in caring for its patients, and whether or not the quality of that care is good or efficiently administered. You could also look to the many other programs that the federal government controls. USPS, Fanny Mae, FEMA, etc.

I think the part that you're overlooking in your response is that I haven't asserted that the Affordable Health Care Act is bad. I'm just saying that ignoring the many, many arguments in critique against it requires willful blindness. The author wasn't able to find "one good reason" why "anybody" would oppose the act, after having performed "thorough" research into "both sides" of the argument. I find that nearly impossible to believe.

There are things that I staunchly support, and admittedly, I have seen many red-herring arguments against them, but effectively what the author is suggesting is just.. nonsense. If she were talking about a programming language, instead of the Affordable Health Care Act, maybe it would be more relatable to dev and engineering types, but just as though I can see valid reasons why my preferred development stack is not the best in the world ever, I wish the author was able to see past her own bias. It seems she isn't able to.

Oh, and since I didn't respond to your points on 3, it's widely understood that the federal government is an adversarial process, with checks and balances. It isn't meant to operate quickly, or even efficiently. The process is meant to ensure that the actions of the men in elected office are always subject to oversight, which should help mitigate its ability for abuse. It's meant to ensure that no single branch of the government has more power than the others, so that we can't enter into a dictatorial regime. It's meant to ensure that a lot of really thorough discussion occurs on a bill before it can be enacted, and that both representatives and senators can get signoff to most accurately reflect the interests of its people.

Federal agencies, as an extension of the federal government, seldom run very efficiently. Having consulted for many of them, I have a unique insight into how they actually run and operate, and above and beyond the average 'big company' bureaucracy, there are additional levels of red tape that simply prevent them from running lean, or agile, or any way in which might vaguely resemble such a concept.

Reply on news.ycombinator.com