Individuals would be required to obtain insurance or pay a fine of as much as 2.5 percent of income.
This seems like a horrible violation of property rights, perhaps to the point of being a violation of the fifth amendment.
This seems like a horrible violation of property rights, perhaps to the point of being a violation of the fifth amendment.
Now there is something that could use some reform. I have a hard time picturing a good solution coming from a government though; something that looks like more like a union than an insurance company might be effective.
(It is, objectively, a wealth transfer from young people to old people. I find myself wondering if youth support for the bill would drop somewhat if youth realized what was being done to them. I'm not "old" but I'm past the age where I feel I can go without now, so I guess I'm out of this "youth", but I still don't like it. I am young enough that I don't foresee a single penny of this ever being around when I'm actually old enough to need it, since there's just no way in hell either the current system or this new one if it passes will hold up until 2045.)
One interesting scenario I saw (don't recall where, sorry) pointed out that the entire idea of forcing purchase of coverage like this is very Constitutionally dubious. (Where "dubious" means that I actually can't even come up with an argument I disagree with that the Federal government can do this based on the Constitution.) So it is possible this provision could be struck down, but leave the rest of the bill intact, committing to massive outlays with no way to pay for it.
Probably not since:
a) The youth are the least likely to have insurance.
b) The least likely to be able to afford it (they usually have jobs that make less money).
c) Since they meet both a & b, they'll likely be eligible for the credit/handout that they can use to buy the insurance (if that's still in the plan, hard to keep track of and I don't feel like reading through 80 different versions of a 2000 page bill).
Thus it's more a transfer of wealth into the insurance companies. Even with a public option (which I believe in the last rev of the bill, states could opt out of), most people will probably just end up with private insurance.
> So it is possible this provision could be struck down, but leave the rest of the bill intact, committing to massive outlays with no way to pay for it.
This is probably where this will be in 3-4 years. Which will give lots of opportunity then for the opposition to be able to point out how expensive this all is. sigh Not a really helpful attitude towards engineering a solution, but the GOP hasn't been on top of this issue at all in the last 30 years while every other industrialized country on Earth has at least given it a good go.
"Not a really helpful attitude towards engineering a solution, but the GOP hasn't been on top of this issue at all in the last 30 years while every other industrialized country on Earth has at least given it a good go."
Well, I've actually liked the GOP proposals that I've read. Yes, the ones that do in fact exist. (Claims that the GOP have offered no solutions are one of the most blatant lies of the entire process; it's simply objectively false. You may not like them but they exist. Another example of our media being either incredibly biased or totally unwilling to follow up on the statements of politicians.... reader's choice.) It's not particularly relevant because if they had to craft a bill that might actually pass in the real world it would get bogged down in all kinds of crap, but there's so much low hanging fruit in the system that the current bill still manages to fail to address in 2000 pages, such as tort reform.
It's funny, during these last few months of the debate, this topic has come up a large number of times among my social group (largely in a community and neighborhood messageboard startd as an alternative to my HOA board and in proper startup fashion now has advertisements).
There certainly are many examples of work done by the GOP in this area in the last administration (mostly around medication pricing), but as to this particular case the GOP has been very late to the party and has brought substantially no ideas to the table until very recently -- generally running and obstructive tactic vs. an alternative tactic.
I believe the alternative bill they presented a week or so ago was political theater mostly. There was no chance on it getting debated, voted on, or really seriously considered (particularly this late in the game), and the party knew that. That's why the opening portions of the bill didn't contain policy, but rather a stream of consciousness of party talking points. They simply wanted to be able to point to it and say "see? our ideas aren't even being considered!" knowing full well that most people won't have tracked the submission date of the bill. David Gergen offered a different but similarly minded analysis today.
What I thought was interesting is that, when I asked people, and threw out ideas almost a year ago now, the right leaning members of my community generally came up with some very good, feasible plans that addressed the bulk of this particular issues (no recision, no denial of coverage, must accept people for coverage even with preexisting conditions, balanced by an open market place, all insurance is moved nationally, breeding open competition etc.). But these weren't offered up by the Party (capital P) until many months later. Instead the Party chose to run a scare campaign that had very little to do with the actual contents of any of the proposed bills (including doing a Godwin and interjecting Nazis, which was clearly the point knew they had no appropriate counter argument in the wings anymore). It was wholly disappointing.
Consider http://thomas.loc.gov/cgi-bin/query/z?c111:S.1099: . Note the date. It may not run to 2000 pages, but I consider that a feature, not a bug.
Again, the idea that Republicans did nothing but run an obstructionist campaign is pretty much objectively a lie. What is true is that only their obstructionism was reported in the press. That said, it's not like anything they wrote had a chance of getting passed, I am aware of that, and frankly at this point I'm not a fan of either party on this point as it's pretty clearly a choice between dumb and dumber (reader's choice as to which is which), but the putative "coverage" of Republicans has been blindingly biased. Not that the press has done much more than sit there and twitch feebly every once in a while.
(Further, I'd point out that as a minority, "obstructionism" is pretty much their job. The idea that this is evil rather suspiciously dates to January of this year, for mysterious reasons.)
But to be honest, the legal documentation is so voluminous and it's a moving target such that I can't keep track of all this. So I may be mis-remembering. The size is certainly a bug.
I would say that it's also bad thinking to think that none of the Republican proposals didn't find their way into the present legislation. I think that there were some good ideas put up by the Party that the Democrats also latched onto pretty fiercely. They claimed it was for bi-partisanship, but I think it's more to appear that they owned all the ideas in this debate.
>(Further, I'd point out that as a minority, "obstructionism" is pretty much their job. The idea that this is evil rather suspiciously dates to January of this year, for mysterious reasons.)
I pretty much agree with you on everything you wrote here except for this and that the obstructionist agenda was purely of the media's making.
I think it's a matter of semantics. "Obstructionism" can be one of a number of things. It can be pure stonewalling and obfuscation, or it can be a presentation of alternatives.
The Republicans in this case were relatively transparent, on my plane trip today I saw no less than 20 Republican backed advertisements against "Health Care Reform" -- unqualified. Some of the advertisements asked questions that made absolutely no sense "will it guarantee I can keep my provider?". Well, lady-acting-like-a-concerned-citizen, I've got news for you, you have no guarantee of that now! And several other examples.
Now the GOP may have been taking a two pronged approach, addressing both senses of "obstructionism", but considering that the agenda I heard came from the GOP itself via paid advertisements and spokespeople/heads of the party like Steele, there really wasn't much made of the alternatives. I would say it was an 80/20 effort.
There is no direct way for it to be lawful. It has to be done indirectly using an actual authority of Congress. For instance, they could say "A person shall not engage in interstate commerce unless they buy a policy or pay the fine." I predict this is what they will do; those Congressmen really love that Commerce Clause.
But note that the nondiscrimination amendment requires them to treat all persons equally, regardless of place of residence or incorporation. This means foreigners! If a guy in Cincinnati can't call California without buying insurance, then neither can a Chinaman.
If enforced, this will instantly detonate the entire global economy.
If not enforced, then foreigners will be explicitly elevated over citizens. This is not a recipe for political tranquillity, to put it mildly.
Also, a point for consideration: you're pretty much required to own car insurance if you want to drive.
It's also noteworthy that in most states, you can demonstrate an ability to pay for a certain amount of damage in lieu of car insurance.
Seriously, this debate only makes sense in a context where you consider health insurance to be an "optional extra". It's not. Health insurance is as basic as roads and garbage collection, fire departments and a police force. Out of the whole developed world, it's only in America that something as fundamental as health insurance is considered an optional extra.
The rest of us, who can't treat ourselves without external assistance (and also those amongst the doctor who expect that they might at some point get ill enough to require assistance from another human being), the rest of us need health insurance.
As it turns out, doctors are actually human beings, who are able to form relationships and make arrangements with other human beings, whether or not this takes place within the scope of formal public policy or under the aegis of bureaucratic institutions.
I guess looking before you cross the road is also "optional".
Unless you're the kind of person whose plan to get rich is to play the lottery, you need health insurance. At some point, in your life, it is quite likely that you will get very sick, or have a serious accident, or have some sort of mishap that suddenly smacks you with a multi-tens-of-thousands-of-dollars-or-more medical bill. At that point, if you don't either a) have health insurance or b) have lots of money, you're basically fucked.
If you pay the insurance all your life and you never actually get to use it, you should count yourself lucky. Health insurance if the kind of thing you pay every month and fervently hope that you never actually need. But if you do need it, having (good, not the american "we'll drop you if you get too expensive" type) health insurance is quite literally a life-saver.
Finally, if you declare bankruptcy because you can't afford your medical bills (and huge medical bills can happen to anyone), society is paying for your treatment anyway, indirectly. Therefore, it is reasonable to mandate that everyone must have health insurance.
As for health insurance, the claim that it is necessary is absurd. One could make a much more reasonable claim than health care is necessary, but the question of the specific mechanism by which it is paid for is orthogonal to whether it should be considered a necessity in a modern society.
However, health insurance is in no way in the same category as any of the above - insurance is a financial tool, used as a means to achieve a desired end in a high-risk situation. Saying that insurance is absolutely essential is like saying that we can't live without zero-coupon municipal bonds. Sure we can, no matter how important the things they're intended to pay for are.
There are a lot of areas in the US (most I'd venture to say...) where driving is essentially a necessity once someone has a full time job. Its not like we have a great public transport system. So while you can technically opt out of driving, its not really realistic to do so in most places.
And yes, I'm required to get car insurance if I want to drive. Driving is optional. Living is not.
Sorry, I'm not sure I see the difference. At the worst, this is an increase of 2.5% in your taxes unless you do something (buy insurance) to avoid it. They might well call it a fine but in both cases its just paying a percentage of what you make. You might not like this increase, but thats a separate point.
Let me know if I'm missing something though...
Edit: I think they are calling it a fine so that people will avoid it as much as possible in an effort to make sure people purchase health insurance.
The labels seem unnecessary here. You could've said "(there are many people here obviously do not)" - there's plenty of smart people who think this bill is going to be bad for the American federal government and American citizens.
The equivalent would be saying something like, "those internet left-wingers who think everyone should be taxed all the time" -> "internet left-wingers" is unnecessary, as is "internet libertarians". The people who oppose this are just people, not internet people, not labels.
http://www.washingtontimes.com/news/2009/nov/07/obamas-hidde...
My understanding is that you need to be able to cover any damage you cause someone else, not to cover your own car damages.
This doesn't kill the analogy though. If someone goes into the emergency room and can't pay for their service, the taxpayers pay the bill. So, by the analogy, the requirement should be to cover anything that the doctor must do because the cost could fall to the taxpayer.
Part of the argument in defense of the bill is that the mandate will save taxpayer money because the uninsured will now be forced to pay their own way. Yet despite this claim, I don't seen any provision for returning this savings to the taxpayer? Where is this supposed savings going? Either it is mythical or it's just going to be eaten up by the bureaucracy.
And also, if the person cannot afford their emergency room bill, they won't be able to afford the insurance either, and thus will get subsidized insurance. So one way or another, the taxpayer pays.
As for your second point, I'm not sure thats true, but I don't have any statistics off hand. It would be interesting to see some comprehensive statistics about how much tax money goes to paying for these things vs. how much money the person makes (adjusted for whatever you want to adjust for).
What you get for it is the knowledge that you'll never have to budget for medical expenses. I did have to pay occasionally, like when I wanted a better yearly checkup, but it's never been an amount I couldn't just take out of my pocket.
Anyways, I always felt that if there's something worth paying for it's a healthy society. At least as much as all the other givens: police, military or emergency services.
It's so well-entrenched and forgettable (comes out along with tax and student loan repayments - but I shouldn't stir that hornets' nest!) that hardly anyone realises what it is, or its origins as, quite descriptively, a nationalised form of healthcare and unemployment insurance.
Don't buy the myths of government-run health care. It increases corruption and political control of our lives, the new taxes hurt entrepreneurs, and it will reduce overall health care innovation.
The US system needs reform but the bill passed last night does nothing to address the drivers of higher costs. Instead it forces more people and resources into the current system.
Two possible reasons spring to mind:
1) this is the fault of public healthcare
2) this is because Romania was basically a Soviet
principality for fifty years
I do agree with the corruption being rampant, though. But I'd blame this on particulars of the Romanian society - there's hardly any aspect of it that's not touched by corruption.
Strange enough the system encouraged a lot of private medical practice which is both good and corruption free. Their income is both public insurance and direct pay.
I find this assertion strange... my wife and I lived for several years on a cash-only basis with little trouble. Granted, there were no catastrophic expenses, but we never had any trouble paying cash for ordinary doctor's visits and the occasional minor emergency.
The downside is, that it is wide open to abuse by those who only wish to profit themselves from society. Many countries in Europe introduced universal healthcare after the World Wars, because they learned the hard way, that health and lives and peace are the most important in [to] the world (and ie. not getting rich from online pr0n trade). A great wealth has been amassed, and it has become too tempting to chip off bits and pieces (as always with any huge value) hoping it will go unnoticed. This has happened in most countries (.de, .uk) along with the pension funds (think Enron: the millions who lost their pension savings). Currently there are little safeguards against these white collar crimes (no coincidence either, the politicians don't really make laws against their own interests).
1) You die? 2) They take you to the hospital and treat you
If it's (2), who pays for you? If the answer is the taxpayers then that's a reason for making not having insurance illegal.
It's the same reason why car insurance isn't optional.
In the end, passing a law that create more demand for private insurance services has little chance of driving the price down.
Edit: that also includes liability insurance etc.
You can choose not to drive.
I'm still trying to wrap my head around that sentence.
Are you saying it's bad for government to take away all those freedoms? Or are you saying that it's a little bad for government to come strip you of your property, but hopefully they won't do it too much?
It sounds like you are equivocating. Either it's more bad than good or not. Right? And -- assuming you reply -- if it's just a little bad, where is the line where you know the government is overstepping where it should go? If your party does a little bad this year, and the other guy's party does a little bad next year, after 100 years we're not going to be in such a good spot, are we? (Made even worse by having nobody to actually blame for our predicament) But hopefully nobody will enforce all those laws too much? (scratches head)
You had 7-8 figures in your brokerage account, and that was when you decided you didn't need health insurance?
You have millions to lose.
I'm not making a moral judgement. It just seems crazy that you'd risk losing so much money just to avoid an expense that had to have been a rounding error to you at the time.
The underlying philosophy is that health care is such a basic part of human life politicians must be in control of it. So from now on (assuming passage) when you have a health care problem, you'll be going to your Congressman to fix it. Insurance not covering something? Go to your congressman. Public plan not covering something? Go to your Congressman. More people need coverage? Go to your Congressman. Rich folks getting really cool benefits while poor folks don't have them available? Go to your Congressman.
Trying to balance the budget? Thought Social Security was impossible to change? You haven't seen anything yet. Try touching national health care once it's rolled out.
It's not "solving the problem" that sucks. We all know there are problems with the free market when it comes to paying for health care and we all know insurance pooling isn't optimum. The problem is the side-effects a huge national solution is going to have.
And those side effects sure look like they make Congressmen even more powerful than they are now.
How could 2000 pages not have some sort of design? Have you seen the diagrams of all the things the bill creates?
I'll grant you that perhaps for many members they are so inept as to have this design be implied instead of explicit, that doesn't make the underlying pattern go away.
This is like the discussions we have with programmers who say they have no time for design. Look - you can't code without designing. The question is whether you're upfront about it, haphazard about it, or whatever.
You can't have 2000 pages of law without implementing some kind of design, no matter how you went about getting it.
You go from a report on SSRI anti-depressant medication not working to claiming no anti-depressant medication works?
Worth it!
I also don't think suggesting that this violates the Fifth Amendment is very convincing. 2.5% of the average American income isn't very much, if you do the math! Even a family making 100k per year (well above average) would be penalized $2500, which is fairly light when you compare fines for other crimes.
No person shall be held to answer for a capital, or otherwise infamous crime, unless on presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger
Not applicable
nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb
Not applicable
nor shall be compelled in any criminal case to be a witness against himself
Most people express this as "You can't incriminate yourself," but this is a much more specific clause and pertains only to criminal cases.
nor be deprived of life, liberty, or property, without due process of law
This deprivation of money would be within due process of law
nor shall private property be taken for public use, without just compensation
Not applicable
(end of text)
In terms of self-incrimination, the Fifth is used entirely in situations relating testimony and criminal proceedings. Furthermore, were it unconstitutional to incriminate yourself through inaction, "duty to rescue" laws (http://en.wikipedia.org/wiki/Duty_to_rescue), though often unexercised, would also fail to be Constitutional.
With taxation if you wanted to exclude yourself from a world of currency and live a "simpler life" without any form of modern money (and somehow found land to do it on, which I acknowledge is a tricky aspect) you could. With this new bill, for the first time ever, this way of life is closed for all Americans.
Or not really, since the penalty simply appears to be (I'm getting all my information third-hand.) that if you don't buy the mandated insurance you won't get care, which seems semi-reasonable enough to me. Not optimal, but hardly the violation of rights I was worried about.
This penalty is apparently supposed to be a source of funding for the bill, the logic being that many people will choose to pay this fine rather than buy (presumably more expensive) insurance.
This seems contrary to the purpose of the bill... it can only be properly funded if people aren't covered, but it's goal is to expand the number of people covered...
My understanding is that the more people that are insured the less money the bill needs. If you get private insurance, government money isn't needed. Obviously there is some overhead cost, etc... that means this won't out when few enough people are insured, but if we get to that point we'll need to rethink things anyway.
[0]I'm aware of various claims that the income tax really isn't legal, but I don't think any of them attack its constitutional authority.
I couldn't agree with you more. On a related note, there is apparently a religious conscience exemption:
http://www.pajamahadin.com/?p=1376
Reminds me of the Amish exemption from Social Security:
http://www.amishnews.com/amisharticles/amishss.htm
And so it came to pass that in 1965, the Medicare bill was passed by Congress. As Wayne Fisher writes in The Amish in Court, "Tucked into the 138 page bill was a clause exempting the Old Order Amish, and any other religious sect who conscientiously objected to insurance, from paying Social Security payments, providing that sect had been in existence since December 31, 1950. After Senate approval in July, the signing of the bill by President Lyndon B. Johnson on August 13, 1965, made it official and canceled tax accounts of some 15,000 Amish people amounting to nearly $250,000."
Who needs to add value to the economy and satisfy your customers when you can just point a gun to someone's head and say, "buy my product or I'll just take your money anyway, and then strip you of your other rights."