Democrats' Health Care bill has been passed - SCOTUS ruling update

[Public'sTwin]

The penalty for not buying the insurance is a fine, for me it will be around $1,650 per year.

Would this be charged in the form of an end-year lump sum? (ie. income tax-style)

(For the most part, until now, I've been arguing on a moral basis for the implementation of universal healthcare.)

 

[Rocker]

There is in fact a working system. It is called pre-paid medical. There is no insurance. You pay a doctor's office $90. per month. If you need to see your doctor, you go.

Being relieved of insurance overhead nearly triples the doctors income. Medicare and Medicaid ditto, but by an even greater factor.

There are a few clinics that do this, and it works. You go see the doctor. He treats you. End of story. It does work, and the doctors that work there are quite happy. They don't need collectors and billing specialists, coding specialists, and hearings and legal filings just to get paid their due.

What the general public does not understand is that insurance companies do not pay your bill. They send it to a company that cuts the bill, and sends it to the doctor and the insurance company, who pays the doctor a reduced amount, and bluntly writes "Paid in Full" after writing a check of $148 for a treatment the doctor billed $480. The company that cut the bill pockets a tidy percentage of the difference, and the doctor must hire people to fight to get at least some of the money back, while the insurance company holds out, even going to hearings and sending on-staff attorneys to debate the courts on the remaining amounts.

It is heinous. Like I said, people don't understand how medical insurance works. Your doctor does not get all that he should. Even when the full amount is collected, it is only after extensive work by a specialist, a biller, a coder, and probably a hearing rep. Oh by the way, they don't pay anything for keeping the doctor strung out on a $3500 bill they took two years to pay.

 

[Rocker]

Would this be charged in the form of an end-year lump sum? (ie. income tax-style)

(For the most part, until now, I've been arguing on a moral basis for the implementation of universal healthcare.)

It remains to be seen how it will be implemented. For one, it is not actually referred to as a "fine" because then I would have a right to due process.

What I have seen is the annual amount. However it is a month by month "fee" for the public option. It does mention the amount in relation to ones AGI, (i.e., 2.5% of income beyond a threshold of around 9,500) so presumably it will have some relation to a 1040, and presumably the IRS will be employed in collections. The IRS however does compute and compound annual or monthly depending on the situation, so... pretty hard to call.

I don't think that will matter too much in the end anyway. When the IRS knocks on the door, there is only one winning response: "How much are you here for?"

 

[James2097]

James2097 please read up:

The bill they have now FORCES ALL to purchase insurance.

I cannot afford that insurance.

The penalty for not buying the insurance is a fine, for me it will be around $1,650 per year.

If I cannot pay this, I am subject to a much, much larger fine. More than my house. I also face up to 5 years in prison.

NOW lets talk about human rights, ok?

I had come at this assuming most were in agreement that forced health insurance purchasing at great expense is a terrible idea (totally against the concept of universal health - and yes totally at odds with what I was getting at regards human rights, but I was *never* arguing for the proposed bill).

I was responding on the issue in general. My point was more that a system similar to what Australians or Canadians enjoy is very workable, and Americans shouldn't get dismayed with the issue just because its clearly going to be a huge transformation with some very ugly permutations along the way, especially coming from a far bigger mess than other countries had to deal with.

I'm just saying that to leave the system as is, isn't an option, and there are clear examples of systems that the USA might aspire to.

 

[niky]

There is no reason to assume that those who were skillful enough to get themselves into Congress or Senate are so obliviously obtuse. It is much more reasonable to conclude that their motivations are just ... different than our own.

👍 The ability to run an election campaign and win an election don't translate into the ability to properly legislate, once in office.

 

[Duke]

I've heard some hilarious arguments equating good public healthcare to socialism.

I'd be interested to hear your explanation of how public health care is not socialism.

I'm just saying that to leave the system as is, isn't an option, and there are clear examples of systems that the USA might aspire to.

Not a single one of us have said that we think the system is dandy and doesn't need change. We've just said that socialized health care is change in the wrong direction.

I will never aspire to live in a socialist country. I'm only happy here because it is less socialized than the acceptable alternatives.

 

[FoolKiller]

Have I been reading correctly that a number of people outside the US were under the assumption that Congress has been trying to give us a national health care system or single payer system like what you can find in England or wherever?

It is a system similar to what we have right now, only with government bumbling mishandling interference increasing some regulations on private companies, adding their own paid for system, and requiring everyone to pay for it out of pocket.

I quoted sections of the bill earlier. I thought it was pretty clear what was happening here. If it were just a purely social health care plan the merits of that alone could be argued. But in this current case the situation is significantly different. It is designed to force you to give money to the very industries that politicians demonized in order to get this far.

In other words, as President Obama was telling those that "caused the problems" to sit down and be quiet, he was handing them a stack of cash.

It is a trend we are seeing now.
Blame bankers solely for the housing and mortgage crash: Then hand them money.
Blame bad executive decisions for car companies failing: Then hand them money and implement the cash for clunkers.
Blame capitalists industries for exporting jobs: Then create a "stimulus" to give them money to do jobs that barely require new hires (assuming the company you claim you gave it to exists).
Blame health insurance companies for the health care system: Then force every American to give them money out of pocket.

What further compounds this problem is that they are tying this to employment even stronger (employers are also forced to offer insurance). See, I buy insurance through my employer. As such that money comes out of my paycheck before the taxes do, thus reducing my overall tax burden. If I bought it any other way it would come out after taxes and so I would pay more in taxes, plus the health care costs. If the system allowed all insurance costs to get a tax deduction similar to the pre-tax savings I get now it would increase the affordability to everyone. Instead, the 10+% of people without jobs or the ones who work for a small enough employer to be exempt, will have to pay for this after taxes, meaning more taxes are taken out of their check than if they were in my situation.

But President Obama swears this is not in anyway a tax increase of any kind on the poor or middle class. I swear he had to have failed math.

 

[Rocker]

Foolkiller: Excellent analysis and reply! 👍

 

[Joel]

I am just simply flabbergasted by this bill. I would like to change my vote to against it. Seriously. Doesn't Obama understand that the reason we love our health care here is that there aren't any tangible "health bills"? I mean sure, we probably have higher taxes, but i'd rather lose a couple bucks of each pay check than have a huge lump sum.

It just makes no sense. I think what people wanted was Free health care.
Not Government health care. I just can't see someone thinking, "hey, instead of paying my insurance company, i'd rather pay the government too!" Urrgh. I don't even live in the US and this pisses me off.

 

[Duke]

I think what people wanted was Free health care. Not Government health care.

Well, duh. Of course people want free health care. What people prefer not to understand is that it isn't free. Somebody pays for it. It's just a matter of how many people are in the target group who get to subsidize everybody else. So the government is called into play to force the targets to cough up their cash.

Note: the "duh" comment is NOT directed at you personally, it's directed at the world.

 

[Joel]

Well, duh. Of course people want free health care. What people prefer not to understand is that it isn't free. Somebody pays for it. It's just a matter of how many people are in the target group who get to subsidize everybody else. So the government is called into play to force the targets to cough up their cash.

Note: the "duh" comment is directed at you personally, it's directed at the world.

I understand that it isn't free. But it's a lot nicer IMO to have a couple bucks off every pay cheque, rather than a lump sum payment at the end of the year.

The way it works out, is if i see a doctor, i show my health card, and i don't have to pay a cent. As of now, I'm being subsidized, as i am a minor working part time, and i'm waaaaaayyyy under the tax free limit.

And i will assume you meant the "duh" isn't directed at me personally.

 

[Duke]

And i will assume you meant the "duh" isn't directed at me personally.

D'oh!

 

[Joel]

D'oh!

Haha, no problem.

 

[YSSMAN]

And by the way, COMPULSORY coverage is a MAJOR tenet of the bill. It is a primary objective. Unless you have heard specifically that it has been removed, then you are essentially assuming the gun is not loaded. This is beyond foolhardy, and something I cannot risk.

I'm not sure if we're shooting off at the same level, but perhaps you've missed my point. If you cannot afford private insurance, or your employer does not offer it, you are able to attain "free" (that is not the best way to describe it) healthcare through the government program otherwise known as the "Public Option." This has been my understanding of the way in which the bills have been written, as both the House and Senate versions include a "Public Option" that offers extra coverage to millions of Americans... But otherwise you are correct in saying that coverage is required by either a private company or the federal option (me personally, I will be taking government care most-likely).


EDIT: Internet Searches are Helpful When Curious

According to FactCheck.org:

Q: Could somebody be imprisoned for not purchasing health insurance under the House health care bill?

A: Both House and Senate bills would levy a tax on persons who refuse to obtain coverage. Willfully evading that tax could result in jail time under the bill passed by the House – but not the bill approved by the Senate Finance Committee.

Full Answer
The letter attached to our reader’s question was written by Thomas Barthold, chief of staff of the House Joint Committee on Taxation, to Rep. Dave Camp of Michigan, on the subject of enforcing the individual health insurance mandate of H.R. 3962, the House-passed bill. That mandate requires people to have health insurance, unless they are below a certain income threshold ($9,350 for singles, $18,700 for couples in 2009). Those who don’t get coverage will be subject to a tax of 2.5 percent of their adjusted income beyond that threshold, up to the cost of the average national premium.

The letter from the JCT includes a list of civil and criminal penalties. These aren’t penalties for not buying insurance, however. They’re penalties for refusing to pay the resulting tax. Barthold’s letter says:

Barthold letter, Nov. 5: Depending on the level of the noncompliance, the following penalties could apply to an individual:
Section 7203 - misdemeanor wilful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.
Section 7201 - felony wilful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.
These are not sections of the House bill itself. Rather, they are sections of the current Internal Revenue Code, laying out the consequences of willful tax nonpayment. (Here’s section 7203, section 7201, and an additional section that sets a higher fine than 7201, as noted in the letter’s footnotes.)
As Barthold points out in his letter, "the majority of delinquent taxes and penalties are collected through the civil process," without resort to criminal penalties. Prison terms are relatively rare. Barthold notes that in 2008 a total of 498 persons were incarcerated for federal tax crimes, while the Internal Revenue Service assessed 392,000 civil penalties for inaccurate tax returns. Imprisonment would require the government to prove, beyond a reasonable doubt, that the tax evasion was "willful" and the accused had the ability to pay.

In the Senate, the Finance Committee’s health care bill was amended to nullify the possibility of jail time for not paying the penalty tax. It stipulates that in the case of nonpayment, "such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure." Instead, the Senate measure would allow the government to collect the tax by deducting it from any IRS tax-refund checks or other government payments. Should the full Senate approve that language, a House-Senate conference committee would have to wrestle with the question of whether or not a person who refuses to obtain coverage and refuses to pay the penalty can be charged with criminal tax evasion.
-Jess Henig

Again, however, I am unaware of the current status via the Senate bill that is ready for debate starting in the upcoming weeks.

If it were not so personally threatening, I would spend some time illuminating what a travesty of Constitutional Intent this really is, and add a few Jefferson, Jackson & Adams quotes for good measure.

Constitutional challenges are bound to happen in this case, and as I've discussed in another thread, I do hope that it happens. They're good for the political process, and they're good to help shape public policy.

EDIT:

What the general public does not understand is that insurance companies do not pay your bill. They send it to a company that cuts the bill, and sends it to the doctor and the insurance company, who pays the doctor a reduced amount, and bluntly writes "Paid in Full" after writing a check of $148 for a treatment the doctor billed $480. The company that cut the bill pockets a tidy percentage of the difference, and the doctor must hire people to fight to get at least some of the money back, while the insurance company holds out, even going to hearings and sending on-staff attorneys to debate the courts on the remaining amounts.

Just to let you know, you just legitimized a point that liberals love to make about the private insurance companies. Administrative costs are too high in order for them to be efficient, especially compared to a government run option or a single-payer system. I seem to recall some of the facts quoted being as wild as 3% for Medicare, as much as 30% for some private insurance systems.

 

[FoolKiller]

EDIT: Internet Searches are Helpful When Curious

According to FactCheck.org:

In other words, if you refuse to be forced into paying for health care you go to jail. It is still compulsory health care with penalties and possible jail time as a maximum penalty (in the House Bill). By the way, not sure why you needed to quote fact check, I already directly quoted all bills and laws involved earlier in this thread, including the Internal Revenue code.

Nor does willful failure to pay the penalties negate the fact that unwillful inability to pay still results in penalties. Unable to buy health care, but make over $9,350 a year? Penalty added on to your taxes. Unable to pay that penalty? Failure to pay taxes penalty. Failure to pay that, courts, bigger penalties, and money taken in one way or another.

While the Senate bill does appear to have had an ounce of intelligence used in specifying that willful failure to receive health care, and then pay the penalty should not have the same punishment as any other willful tax evasion
it is still the equivelant of a baby step toward climbing Mt. Everest.

Compulsory, out of pocket expense, health care is wrong. You can't justify it by saying that you won't possibly face prison for it. The compulsory system has two reasons behind it, that no one who supports it will mention because it shows hwo flawed the system is. 1) It prevents the public option from collapsing in debt, either resulting in those who are using it being left SOL or taxes being raised even more. 2) It also guarantees more customers for the insurance companies (can we just go ahead and call it a bribe?), keeping them from bring about major legal cases and delaying the enactment of the reforms by years of Constitutional challenges in courts.

I challenge anyone who supports these bills to explain why it must be forced. No one has done that, not even the authors of the bill(s). Surely, out of the 25 who voted that they support the bill one can explain why this is in there.



And now I conclude with a video of Dr. Rand Paul explaining the real issues of health care, and how a free market system can work.

 

[YSSMAN]

By the way, not sure why you needed to quote fact check, I already directly quoted all bills and laws involved earlier in this thread, including the Internal Revenue code.

Mainly because its good to cite a non-partisan source, but also because I don't care to keep track of everything that happens with a lot of the cyclical arguments that unfold in these threads. People want to complain about why no one cares what their government is doing? Its situations like these that cause people to give up on politics and public policy altogether. I find these threads incredibly frustrating, personally, as they often divulge into very narrow discussions of policy, and the generally snarky nature of responses are not conducive to any kind of rational, enlightened discussion. My participation has been cut significantly because of it, mainly because it is getting far too personal... Despite my own preferences in policy, I'm likely to stick to analytical perspectives for the meantime.

I challenge anyone who supports these bills to explain why it must be forced. No one has done that, not even the authors of the bill(s). Surely, out of the 25 who voted that they support the bill one can explain why this is in there.

I'll be happy to say that I don't know, but I'd be happy to talk to my friend who works for Senator Levin (D-MI) to see if he has any insight on the issue.

 

[Joel]

I have to tip my hat to Rand Paul there. That was an excellent speech, and it highlights the real issues with health care. I think he's a very smart man, and i believe for a country like the US, that would be a better solution. However, Good luck trying to do something like that here.

 

[FoolKiller]

Mainly because its good to cite a non-partisan source,

I assume the partisan source you refer to is myself, since I was linking to the Library of Congress.
http://thomas.loc.gov/cgi-bin/query/D?c111:2:./temp/~c111gKFvJE::

 

[YSSMAN]

No intended knock on you sir, I didn't recall your previous post whatsoever.

 

[James2097]

I'd be interested to hear your explanation of how public health care is not socialism.

Of course, it is socialism in the sense of all citizens making sure everyone can get treatment if needed - but I'm not sure how this constitutes a concern in terms of a country becoming a 'socialist' state or anything as absurd as that. For instance, Australia feels very capitalist, and very similar to America in nearly every way despite medicare being included in our taxes! It doesn't really affect in any sense our overall freedom or ability to get ahead in life. Of course, if one wants to pay to receive private care of a higher level, that is of course allowed within the system also (Australia has public hospitals and private hospitals for instance).

If supporting a good base level of care (so people don't die or suffer from disease when it could be easily prevented etc) is too socialist for some strict idealogues out there, then perhaps some basic questions need to be asked. Do we wish to live in a 3rd world country or a 1st world one? There are socialist elements (I'm branding 'socialism' as loosely as the scare-mongerers do - to include anything that is publicly funded) in many things that are absolutely necessary - public roads, defense, core infrastructure, schools etc. I know how strongly ideas of freedom, rights, liberty etc are ingrained in the American psyche, I realise that IS what makes America one of the better countries to live (and I incidentally enjoy all of those things as an Australian citizen), but I also believe in basic human rights. To live in a country that allows folks to simply die because they can't afford or have access to appropriate medical care would make me extremely uncomfortable, especially when one isn't necessarily at fault for their own health problems - the human body is extremely fickle, and good health favours neither the rich nor poor necessarily. The idea that a decent level of public health is a road to a more socialist country overall or threatens personal freedom or liberty in any meaningful way is getting things out of proportion - and are concerns ONLY raised in America. I think there's just a lot of fear of the unknown. As someone who does live in a society where public health is a great asset (it still isn't totally free anyway) to those who are sick or need life saving surgeries, I can assure any American that an appropriately funded public health system is very much worth the small proportion of tax that goes into it. Hard line conservatives might say its too charitable, or throw loaded words like socialism around, but I'd rather have pride in my country because it treats it's citizens like human beings, and not cattle. I'm not saying anyone in America advocates this - but its the current reality and I believe there should be consensus it can't continue. To hold out for a system that works well and adheres entirely to a non-socialist ideaology is effectively condoning the current system by stalling all realistic workable efforts.

Not a single one of us have said that we think the system is dandy and doesn't need change. We've just said that socialized health care is change in the wrong direction.

I will never aspire to live in a socialist country. I'm only happy here because it is less socialized than the acceptable alternatives.

Good to note that you're for change, but I'd like to know what you think is a humane and workable system that has no elements of what you deem socialist? I'm certainly not advocating socialist ideas willy nilly, and you're right - in most situations capitalism works best, its the pillar of modern society. But, I'm also willing to accept that a free market doesn't create a humane and workable health system.

There are very clear moral dangers when one adheres to a strict ideaology that will never completely work in all situations for all issues. I would of course love to live in a country where nothing bad happened, people had 100% total freedom to do anything they wished, minimal tax, no forced collective organisation for the progress of civilised society... but that is a reality that would implode immediately, and of course everyone knows that. So I think those who are just fear-mongering and throwing around loaded terms like socialism need to acknowledge the issue in a serious way and basically grow up, and offer some realistic ideas.

 

[FoolKiller]

Of course, it is socialism in the sense of all citizens making sure everyone can get treatment if needed - but I'm not sure how this constitutes a concern in terms of a country becoming a 'socialist' state or anything as absurd as that.

It is one symptom of an overall trend. At the same time our government is taking controlling interests in automobile companies and banks, and handing money out to various people in an attempt to create pointless jobs that will be unsustainable in the long run. All of these are steps toward socialism.

For instance, Australia feels very capitalist, and very similar to America in nearly every way despite medicare being included in our taxes! It doesn't really affect in any sense our overall freedom or ability to get ahead in life.

There are other issues too. I point you to my thread regarding Australia's Internet censorship plans and how it may affect your ability to get games refused classification in your country. It is a conversation for a different thread, but from the outside, seeing people like Atkinson working in your government doesn't sound the same as what we have here.

I know how strongly ideas of freedom, rights, liberty etc are ingrained in the American psyche, I realise that IS what makes America one of the better countries to live (and I incidentally enjoy all of those things as an Australian citizen), but I also believe in basic human rights. To live in a country that allows folks to simply die because they can't afford or have access to appropriate medical care would make me extremely uncomfortable, especially when one isn't necessarily at fault for their own health problems - the human body is extremely fickle, and good health favours neither the rich nor poor necessarily.

Somoene didn't watch my video I posted earlier. Everyone in America has access, and the cost issue is a problem created by government intervention, not a lack of it. To say otherwise is scare mongering perpetuated by those who wish to paint those in favor of true free market ideals (not what we have now) as greedy and heartless.

The idea that a decent level of public health is a road to a more socialist country overall or threatens personal freedom or liberty in any meaningful way is getting things out of proportion - and are concerns ONLY raised in America. I think there's just a lot of fear of the unknown.

I see a lot of fear of the unknown too. I see it every time I mention a free market proposal and people freak out with "but you'll let the poor die" type comments. It shows a combination of fear and lack of understanding of what a free market proposal for health care actually is.

I'm not saying anyone in America advocates this - but its the current reality and I believe there should be consensus it can't continue. To hold out for a system that works well and adheres entirely to a non-socialist ideaology is effectively condoning the current system by stalling all realistic workable efforts.

How is saying this is a mistake and that they should be doing a completely different form of reform condoning the current system? If you think our goal is or has been to just stop the current proposal (which is not remotely close to the national system you have in Australia) then you aren't paying attention. Telling someone that turning right is the wrong way and they should turn left instead is not the same as telling them to just hit the brakes.

Good to note that you're for change, but I'd like to know what you think is a humane and workable system that has no elements of what you deem socialist? I'm certainly not advocating socialist ideas willy nilly, and you're right - in most situations capitalism works best, its the pillar of modern society. But, I'm also willing to accept that a free market doesn't create a humane and workable health system.

Why do you so readily accept that? Have you watched any of the videos we have posted or followed any of the links? Do you even know what the current proposal in the US is that we are opposed to? It is not what you are talking about. It isn't giving coverage to everyone, rather it is forcing everyone to buy it in a system not much different than the current one.

Yes, we are opposed to the idea of a public/national/social health care system too, but we have the ability to point at the current systems and its flaws and say "do not want." You are saying that Duke's idea won't work, while asking him what it is. You can't ask how it would work, and then deny it in the same paragraph.

I would of course love to live in a country where nothing bad happened, people had 100% total freedom to do anything they wished, minimal tax, no forced collective organisation for the progress of civilised society... but that is a reality that would implode immediately, and of course everyone knows that.

You make a blatant misrepresentation of what we are talking about like this and then say:

So I think those who are just fear-mongering and throwing around loaded terms like socialism need to acknowledge the issue in a serious way and basically grow up, and offer some realistic ideas.

Indeed. Since no one has proposed an idea based on a fantasy realm where nothing bad ever happens or even that people can do anything they wish, heck not even a lack of forced collective organization (aka government), I am pretty sure that Duke and those of us who share a similar opinion are not the ones with an unrealistic idea.

Honestly, you act like you think we are a bunch of immature kids thinking up crazy ideas, and not proposing ideas based on decades of economic theory and research.

 

[Danoff]

If supporting a good base level of care (so people don't die or suffer from disease when it could be easily prevented etc) is too socialist for some strict idealogues out there, then perhaps some basic questions need to be asked. Do we wish to live in a 3rd world country or a 1st world one?

False Dilemma.

There are socialist elements... in many things that are absolutely necessary - public roads, defense, core infrastructure, schools etc.

Yes roads, defense, and schools are necessary. So is food. But food is not provided to us by the government. Many people argue that gasoline is necessary - it is also not provided by the government. If you list the basic necessities of life:

- Food
- Water
- Shelter
- Clothing

None of those are provided by the government. Government was not created to provide the basic necessities of life, and in the US it is not allowed to. Government was created to establish law. When I try to imagine what grocery stores would be like if the government ran them, I come up with something that looks an awful lot like today's healthcare system.

(I'm branding 'socialism' as loosely as the scare-mongerers do - to include anything that is publicly funded)

You're not going to find anyone here who will tell you that a judicial system, a presidency, a military, or police are socialist. This is another logical fallacy known as a straw man.

 

[FoolKiller]

OK, since those who support this health care bill obviously can't answer a simple question (without researching their answer first - it is your answer, why do you need to research someone else's thoughts? YOU support it), even though they support it, "Why is a mandate necessary?" I have chosen to seek out an answer on my own.

I think I found the most likely answer, and it is one that I assumed.
http://articles.latimes.com/2009/jun/07/business/fi-healthcare7

Private insurance companies push for 'individual mandate'

As momentum gains for reforms, insurers hope to turn it to their advantage by supporting a proposal that everyone buy coverage. It would be a boost for the industry, which has seen enrollment decline.

June 07, 2009|Lisa Girion

Some may find it hard to believe that the U.S. health insurance industry supports making major changes to the nation's healthcare system.

The industry, after all, scuttled President Clinton's healthcare overhaul bid with ads featuring "Harry and Louise" fretting about change.

But this time, it turns out, the health insurance industry has good reason to support at least some change: It needs it.

Private health insurance faces a bleak future if the proposal they champion most vigorously -- a requirement that everyone buy medical coverage -- is not adopted.

The customer base for private insurance has slipped since 2000, when soaring premiums began driving people out. The recession has accelerated the problem. But even after the economy recovers, the downward spiral is expected to continue for years as baby boomers become eligible for Medicare -- and stop buying private insurance.

Insurers do not embrace all of the healthcare restructuring proposals. But they are fighting hard for a purchase requirement, sweetened with taxpayer-funded subsidies for customers who can't afford it, and enforced with fines.

Such a so-called individual mandate amounts to a huge booster shot for health insurers, which would serve up millions of new customers almost overnight.

"I think that's why we've seen the industry basically trying to play the administration's game," said Jane DuBose, an analyst with industry tracking firm HealthLeaders-InterStudy. "They really could be licking their chops over the potential here."

The industry says its interest in change flows not from narrow self-interest but from broader concerns.

"What's driving this is we have 47 million people who don't have access to the system, who get help through emergency rooms, and that results in higher costs and inefficient care," said Robert Zirkelbach, a spokesman for industry trade group America's Health Insurance Plans. "There's both a social and economic reason to get everybody in the healthcare system."

Jay Gellert, chief executive of Woodland Hills-based Health Net, said industry support for certain changes is driven by "a recognition that public frustration with many of the problems in the system [is] increasing pretty significantly. So I think there's as much of a commitment to this because we've seen other industries where they haven't dealt with issues early enough, like financial services and auto, and that's not a happy place."

This continues on for another two pages, but I think we get it.

And this:
http://www.ama-assn.org/amednews/2009/11/09/bisb1109.htm

Individual mandate proposals driving insurers to expand offerings
Plans are preparing for millions more customers to enter what has been a declining marketplace.
By Emily Berry, amednews staff. Posted Nov. 9, 2009.

Health insurers are preparing for an influx of customers expected from a federal individual mandate by broadening offerings and rethinking the way they sell insurance directly to consumers.

Analysts say that, baring a dramatic shift, some form of a requirement for health insurance will be in the final health system reform bill that passes Congress. Health insurers have pushed for an individual mandate to accompany other regulatory changes they expected to come with reform, including a national guaranteed-issue requirement.

Consultants say the companies have been preparing for this scenario for months and even years: introducing lower-cost individual plans; targeting subsets of the uninsured; marketing directly to customers rather than through brokers who sell to groups; and trying out new partnerships with physicians and hospitals that would expand the profit margin for individual business.

The growth in the marketplace is expected to be dramatic. Estimates for how many will sign up for individual insurance, if it's required, range from 15 million to 25 million. The most recent estimates, from 2007, showed that about 6.6 million people carry individual health insurance.

And finally, The Washington Post
http://www.washingtonpost.com/wp-dyn/content/article/2009/07/21/AR2009072103410.html

For the vast majority of Americans who have health insurance, the change would mean little more than submitting a form with their tax returns proving that the plan they carry meets certain minimum standards. Many of the nation's 47 million uninsured people, however, would be required to purchase a health policy or face financial penalties, though waivers or discounts would be provided for lower-income Americans.

The concept is modeled after a requirement instituted in Massachusetts three years ago as part of that state's broad health-care overhaul. And like the Massachusetts law, the individual mandate proposed by congressional Democrats would be paired with a much more controversial new requirement that nearly every employer contribute to the total cost of care.

"Without an individual mandate, you're never going to get to universal coverage," said Bradley Herring, a health economist at Johns Hopkins University.

Bringing everyone into the insurance pool -- particularly young, healthy customers -- spreads the risk and lowers overall costs. "That will make it more affordable for everyone," Herring said.

So, five pages into a Google search for "why is there a mandate in the health care plan?" (quotes not part of the search) this is all I could easily find explaining it, and it looks like my assumptions are correct:

1) Grease the wallets of the insurance industry and they won't fight you.

2) It is they only way to make it affordable without Obama breaking his no taxes on the lower and middle class promise. No new taxes, but you have to buy insurance now.

So, there it is: it would be illegal to not have health insurance because: You have to bribe insurance companies just to get the bill passed.

Now, for everyone who supports this bill, scoffs at libertarian ideas in regard to health care, and claims to understand the difference between corporatism (looters and thieves backed by government power) and true free market capitalism: This is corporatism. This is the government using their unconstitutional power to force you to pay corporations for something, whether you want/need it or not. This is the system you all claim is the problem, just being perpetuated even further, extended beyond just tricking you into thinking you need and can afford to have something you don't (the way they did with the housing and mortgage crisis) and now being forced upon you with the full force of law. If you chose to fight it you will have a criminal record. You will be a criminal for the blatantly inhumane act of choosing not to have health insurance.

All because the politicians you support in this wanted to bribe the insurance companies.

As for the Constitutionality of this; I found an op-ed piece that addresses the issue and how Congressfolk have responded to questions regarding it. hint: Pelosi won't even take it as a serious question.
http://www.cato.org/pub_display.php?pub_id=11003

Obamacare Is Unconstitutional
by Gene Healy

As Harry Reid's health care bill moves to the Senate floor, the debate over Obamacare finally begins in earnest. Shouldn't the Constitution be part of that debate? By what authority, after all, could Congress force all Americans to buy health insurance?

In a recent press release, House Speaker Nancy Pelosi, D-Calif., argues that constitutional objections to the individual mandate are "nonsensical," because "the power of Congress to regulate health care is essentially unlimited." We eagerly await your orders, ma'am!

Pelosi is wrong, but that doesn't mean the court can be counted on to strike down Obamacare. Legislators have an independent obligation to consider the constitutionality of the laws they're debating — and the individual mandate is flagrantly unconstitutional.

Legislators have an independent obligation to consider the constitutionality of the laws they're debating.
In answer to the question "by what authority?" Reid's bill offers the Commerce Clause — the go-to provision for friends of federal power. That clause gives Congress the power "to regulate Commerce ... among the several states."

It was a modest measure designed to regularize cross-border commerce and prevent interstate trade wars — so modest, in fact, that Madison described it in the Federalist as a clause that "few oppose, and from which no apprehensions are entertained."

The Founders would have worried more had they known that the Commerce Clause would eventually become a bottomless fount of federal power. In 1942's Wickard v. Filburn, the court held that the Commerce Power was broad enough to penalize a farmer growing wheat for his own consumption on his own farm.

That farmer, Roscoe Filburn, ran afoul of a New Deal scheme to prop up agricultural prices. The fact that he wasn't engaged in interstate commerce — or commerce of any kind — was quite beside the point. If "many others similarly situated" engaged in the same behavior, it would substantially affect interstate commerce, and frustrate Congress' designs.

In its "Findings" section, Reid's bill hits all the jurisprudential buzzwords: The individual mandate "substantially affects interstate commerce," and regulates "activity that is commercial and economic in nature." Activity like standing around without health insurance? Apparently so.

Yet, as the Congressional Budget Office noted in a 1994 evaluation of Clintoncare, an individual mandate would be "unprecedented. ... The government has never required people to buy any good or service as a condition of lawful residence in the United States."

Even the Supreme Court ought to recognize the "you exist, therefore you're regulated" rationale as a bridge too far. But court-watchers have learned never to underestimate the justices' creativity in inventing new rationalizations for constitutionalizing the unconstitutional.

If the court eventually has to rule on the mandate, don't be surprised if the rationalization goes something like this: "Encouraging" people to buy a product is really nothing new. Wickard shows that Congress can use the Commerce Power to force people to carry out transactions they'd rather avoid.

In Gonzales v. Raich in 2005, the court reaffirmed Wickard, noting that "Congress can regulate purely intrastate activity ... if it concludes that failure to regulate" would frustrate the comprehensive regulatory scheme Congress has in mind.

The individual mandate surely counts. Since Obamacare also bars insurers from denying coverage for pre-existing conditions, without a requirement to purchase insurance, the healthy would have an incentive to drop their coverage, and enter the market only when they got sick.

But members of Congress swear an oath to uphold the Constitution — not the court's funhouse-mirror version of it.

Supporters of national health care are counting on congressmen not to take that obligation very seriously. Their attitude toward the rule of law echoes that famously expressed by FDR in 1935. Trying to push through a key New Deal measure, Roosevelt wrote to an important congressman: "I hope your committee will not permit doubts as to constitutionality, however reasonable, to block the suggested legislation."

Barack Obama fancies himself Roosevelt reincarnated; in this, at least, he has a legitimate claim to FDR's legacy.

Oh, so Congress has unlimited powers huh? I guess they have never heard of Article 1, Section 9 of The United States Constitution: Limits on Legislative Power.

I'd also bring up the 14th Amendment but the eminent domain cases obviously show that no one cares about that.

 

[Encyclopedia]

I'm just curious, what would be a good healthcare system to you?

This question is meant first and foremost for the American members of this board.

 

[Duke]

I'm just curious, what would be a good healthcare system to you?

This question is meant first and foremost for the American members of this board.

A good healthcare system to me would be one where a wide variety of patients are served by a market-driven system that is free from government-subsidized (and often government-mandated) excess.

As a wise man (Will Rogers) once said: "It's a damn good thing that we don't get all the government we pay for." In the case of health care, Medicare/Medicaid (government-subsidized health care for the poor and elderly) has generated a huge industry designed around making money by working the system. I'm not even talking about the recipients themselves; I'm talking about companies set up to sell medical products that they know will be covered by government subsidy. Since the consumer is not paying the cost themselves, competition does not have any bearing on the the price, and so the government (meaning the taxpayers) pays through the nose for these products and services.

If people were paying themselves, competition would keep prices low and a huge spectrum of services would be available with a corresponding range of prices. Last I heard, Wal-mart was making money selling basic stuff cheaply, just as much as a Rodeo Drive boutique was selling expensive stuff expensively. There's no reason to believe that regular, staple medical services would not be available at affordable prices in a clean, competition-driven medical marketplace.

And no matter how much the left tries to guilt me into it, I'm never going to believe that every human being has a right to be taken care of at others' expense, if they cannot afford it themselves. Just because we all have basic human needs - food, shelter, medical care - does not remove the responsibility of providing those things for ourselves.

Some people are going to die because they cannot afford treatment. My father died rather than bankrupt his family with cancer treatments. I will die if I cannot provide for myself. That's NOT unfair.

 

[Pupik]

I'm just curious, what would be a good healthcare system to you?

There isn't a lot wrong with the present way of doing things, but like any complicated system, there's a lot right and some things wrong with it.

In short, something that allows free market capitalism to thrive, and works within the confines of supply and demand. There's already free and reduced healthcare in this country, and even the poorest can still get emergency care, just not necessarily great care. Unfortunately, there's those who work/milk/cheat the system for their own personal gain, or to aid the gain of others through graft and corruption: Guess what? It happens in all market systems: Socialism, communism, anarchy, and free market capitalism.

Insurance is available to many people, so as long as they have a job, or are married to someone who has one. My only gripe is that a tiny percentage of people are un-insurable for reasons beyond their own past and present control, and are faced with a tremendous financial hill to climb (or getting donations). Gee, some of use would probably donate a few bucks, but there's so many con-(wom)men out there, that many of us lose faith in that sort of thing.

To be honest, I see it as a typical middle class struggle*; wanting all the benefits of upper-class health care (resort-style, without waiting for a bill), but not resorting to a "low-class" wait for 5 hours in a free/reduced-cost clinic. Many of the things we gripe about are present in other healthcare systems around the world.

I think many of us have become so demanding of instantaneous service and products, that we expect medical services and the processes henceforth to be as simple as flashing a card -- you walk in and walk out with a remedy. Paperwork, seeing other specialists, waiting, seem to be lingering archaic flaws, but they are part of a system** that cannot easily advance itself beyond the scope of the law (and potential lawsuits).

Not to mention, it is still a business of people helping other people. People get tired, make mistakes, errors in judgment, et cetera, so there are still potential for flaws regardless. Oh, and hypochondriacs would really muck things up.

I dunno, there's my three cents***.


* = Yeah, I'm on one end of middle class.
** = Insert just about any service not completed by robots.
*** = Short for "I probably won't have time to answer you rebuttal, but fire away anyhow."

 

[Danoff]

I'm just curious, what would be a good healthcare system to you?

I think first you have to understand how this question sounds to Americans that understand the constitution. It sounds like "what would be a good electronics industry to you?" or "what would be a good car industry to you". "What of food service system would you prefer?". These are all roughly equivalent questions.

A good healthcare "system" is one that doesn't exist. Just like we have no food service "system", and we have no "system" for car production. A good healthcare industry is one that competes in a marketplace of demands. Parts of the healthcare industry today do this. Lasik is a good example. Generally where you find sought-after services that are not covered by insurance, you find that the market has driven prices and supplies - and when you find that, you find an industry that is thriving. Why do you think the government wants to tax plastic surgery to pay for its enormous healthcare system?

A good healthcare industry (much like a good food service industry, and a good electronics industry) is one that thrives, innovates, and competes on efficiency, service, and price. I have never seen a government program that does those things well - whether it's public schools, the military, welfare, the department of transportation, NASA, the FDA... none of them. Don't get me wrong, some government services are necessary, but government innovation AND efficiency? No. And there's an inescapable reason for that.

 

[YSSMAN]

I'm just curious, what would be a good healthcare system to you?

Without a doubt, something similar to Australian Medicare would be my preference. Its fair, affordable (less than 3% tax levy), offers universal coverage and still allows for plenty of room for private insurers.

 

[Encyclopedia]

Thanks for answering guys.

 

[Dotini]

I'm just curious, what would be a good healthcare system to you?

This question is meant first and foremost for the American members of this board.

The best healthcare system would be the one in which the population was largely free of disease, where alcoholism, obesity, diabetes, ADHD, depression, breast cancer, indeed most cancers didn't exist. In this system, all that would be needed would be the medicine man to stitch up minor nicks and cuts and midwives to assist at birth. That was the system that existed in much of America before the appearance of white, European males.

Okay a little reductio ad absurdum here, but you get the drift.