How Confident Are You That Whatever HCR Bill is Passed Will Be a Net Gain?

[Lief 🗽]

Guys, most things that end up passing will be a net gain. Obviously something with the public option or the medicare buy-in would be a bigger net gain than something without, but whether or not those are included, some thirty million people who couldn't afford health insurance will be able to after this bill passes. That's a net gain. Insurance companies won't be able to suddenly take away coverage when you get sick or deny you coverage because of a pre-existing condition. That's a net gain. Some ten million more poor/working class people will be covered by medicaid. That's a net gain. Some Harvard economists calculated that 45,000 people a year die from lack of health insurance. That's half a million people's lives saved in the next decade. How is that not a net gain?

Is this bill perfect? Obviously not. But it's so, so much better than nothing. And for the past fifty years, Democrats have been trying for perfect and giving up when they'd had to settle for only just "good." And each time we fail, we get a little less ambitious, until one day we'll give up:

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So, at the very least, let's get our foot in the door. Yes, insurance companies won't be as punished as we'd like them to be. But I don't think some desire to make insurance CEOs suffer is worth improving the lives of millions of Americans and saving the lives of hundreds of thousands. Progressives haven't really won anything since LBJ passed the Great Society. For the next forty years, all we've done is try to preserve the status quo or prevent the country from lurching too far to the right. But this bill is actually a good, solid progressive step forward in the right direction.

[Lief 🗽]

Lief I read Ezra's blog too, every day, and it makes me feel warm and fuzzy inside when nothing else in the world does, but is this bill really going to result in thirty million people being covered who were not covered previously? 

Well, the CBO says it will and independent studies say it will. I mean, you could be skeptical about these calculations, sure, but if you're not going to trust anyone, what's the point of even passing legislation? Maybe it'll fail, and then we're all probably fucked, and I mean both the Democratic majorities, President Obama, liberals, and probably the country as a whole. But I think we're also pretty fucked if we don't do anything at all. I think it's reasonable to have at least some faith in these people.

[Lief 🗽]

Whatever is passed will make things worse

why?

[Lief 🗽]

I'd rather not be forced to pay a tax if I make the individual choice not to purchase health insurance.  That's my damn fcuking right as a human being.

[Lief 🗽]

Please stop murdering the English language by misusing words like "fascism." And in case you can't read (which would actually explain quite a bit...) I've made it clear on this forum that I'm actually relatively happy with the bill.

And Winston, I know that having original thoughts are really difficult, but surely you could try and post a couple of them, in between parroting whatever dreck you read in Ayn Rand or whatever random libertarian blog you get your nonsense from and quoting Libertass' posts verbatim.

[Lief 🗽]

Objectivism, whatever you call being an entitled brat with no perspective, they're both stupid and childish ideologies.

He "summed up what needed to be said" by misusing the word "fascism" and accusing me of feelings I do not feel?

[Lief 🗽]

Objectivism, whatever you call being an entitled brat with no perspective, they're both stupid and childish ideologies.

He "summed up what needed to be said" by misusing the word "fascism" and accusing me of feelings I do not feel?

Thanks for that, you've really enlightened me as to the advantage of your system. Not.

No, he just summed up you posting a image rather than actually responding to genuine complaints about Obamacare. Why the hell should anyone have to pay tax for something they might not even use?

Because that's the entire basis of a social insurance system. Everyone pays in a small amount, so that there is a large amount of money to help people when they need it. For the system to work though, you can't have free-riders. What the mandate does is prevent free-riding. The free-riding problem is even worse if you regulate the industry so that they cannot deny coverage for pre-existing conditions. If there was both this regulation and a lack of a mandate, then people would wait until they were sick to purchase insurance and stop paying for it after they were healthy again. This would punish the responsible people who don't abuse the system, by forcing insurance companies to ask for higher premiums. What the mandate is, is a question of fairness and shared responsibility. Through mutual cooperation and responsibility (everyone paying into the insurance pool), we can keep these costs down for everyone AND protect people in case they actually do need some expensive procedure.

[Lief 🗽]

Why should people be forced to pay for insurance? It's their choice whether they want to or not.

Because if they do not pay for insurance, if they are not responsible and instead free ride on the system, then they are hurting the people who are responsible and pay into the insurance system, as they will have to pay higher premiums. 

[Lief 🗽]

Actually, Mint and Vepres, premiums have gone down massively in Massachusetts since they implemented an individual mandate, along with other reforms similar to the ones in the Senate and House bills:

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source: http://voices.washingtonpost.com/ezra-klein/2009/11/massachusetts_provides_evidenc.html

Still higher than U.S. averages, yes, but not because of health reform. In fact, before health reform, Mass. premiums were over three times the national average; now, they are only about 1.7 times the national average.

[Lief 🗽]

Dude, did you even read my post? It was 200% higher before any healthcare reform at all was passed! Healthcare reform made COSTS GO DOWN 40% while costs in the rest of the country INCREASED BY 14%.

Emphasizing prevention is good and so is aiding people in their attempts to get fit, but an even better way to emphasize prevention is to make sure that people can afford to go to the doctor for yearly checkups in the first place, so that they don't come in at the last minute when they're short of breath, dying of a heart attack.

[Lief 🗽]

Dude, did you even read my post? It was 200% higher before any healthcare reform at all was passed! Healthcare reform made COSTS GO DOWN 40% while costs in the rest of the country INCREASED BY 14%.

Emphasizing prevention is good and so is aiding people in their attempts to get fit, but an even better way to emphasize prevention is to make sure that people can afford to go to the doctor for yearly checkups in the first place, so that they don't come in at the last minute when they're short of breath, dying of a heart attack.

I did, prices went down, great. I hesitate to say that an individual mandate would lower the country as a whole. Keep in mind as to how high Mass. insurance was before.

Couldn't that drop have more to do with the exchange established in the same bill?

Surely, that's part of it, but it's just intuitive and logical that an individual mandate would lower prices, by expanding the risk pool and having a greater amount of people pay into the system.

[Lief 🗽]

Depending on the data, there might have been a temporary decrease in premium costs... But now the rates are projected to rise 7 to 12 percent. And the CBO's figures are disputed even by UHC advocates, PNHP for example found an increase of 9.4% since compulsory insurance was instituted. That might be a slowed increase, but it's still an increase.

Even increases of 7 to 12 percent or 9.4% percent, and the article says that the increase in costs has been attributed to "greater use of medical services by aging baby boomers and higher bills from doctors using more costly technology and prescribing more expensive drugs", not compulsory insurance or exchanges or more regulation or anything, that's still less than the national average of 14%. And the Senate bill especially has many other measures, in addition to the mandate and the exchanges, to bend the cost curve that Massachusetts did not.

[Lief 🗽]

An individual mandate is absolutely critical for health care reform. Or else we will have the healthy not buying insurance and since the sick will be able to purchase insurance now, it will raise costs on the rest of us who are responsible and buy insurance.

On that, I totally agree. That is not a close issue in my mind.

However, a mandate without any regulation, reform, or competition for the health insurance companies is a total give-away to them. The Senate bill is exactly what they want. They win. Everyone else loses.

Sorry, but those things are all in the bill. To the degree that you and I want? Probably not, but there's still plenty new regulation and reform, and the public option, the one the House had passed in its bill and the Senate was going to pass, wouldn't have done jack for competition.

And the idea that "everyone loses" is so goddamn ridiculous, and I have been incredibly disappointed that intelligent people, people who I usually agree with, have been using that idiotic line for the past few days. The thirty million new people who will be able to buy health insurance? They win. The people who can get insurance now, even with a pre-existing condition? They win. The people between 150% and 400% of the poverty line, who were having a hard time affording health insurance or couldn't at all and now get $100 billion in subsidies per year? They win. The 10 million new people on medicaid? They win. The seniors who will be able to spend less of their fixed incomes on medicine, because the Part D donut hole was closed? They win.

This isn't a mutually exclusive us-versus-them battle. Yes, the insurance companies will get new customers and probably make more money (though there'll also be new regulations on them, taxes, and laws mandating that they use most of the money from premiums for healthcare), but millions and millions of people will be better off. Should we not have passed the stimulus, because the construction companies won? Should we not have passed the bailout, and let the economy tailspin into an actual depression, because the banks won? Should we not pass cap and trade, because the windmill companies and nuclear power companies and car companies will win? Unless you're proposing nationalizing the entire economy, then to improve the well-being of the populace, sometimes you're going to need to give government money to private entities.

[Lief 🗽]

Every other western country has an individual mandate. Germans and Dutch and Swiss are doing just fine without that particular "civil liberty." And really, the freedom to not buy health insurance is a pretty silly one, supported mostly by selfish young people and stubborn anarchists.

[Lief 🗽]

"What if one would be financially better of paying out of pocket?"

That's not the point. The point is that the social insurance is funded by collective risk.


Germany pays half as much per person and ensures every citizen high quality healthcare. And has an individual mandate. Where's the problem here?

Yes. And, furthermore, even if you are better off now paying out of pocket, one day you will be old and sick. And then you will not be better off paying out pocket, and you buy insurance. And your insurance costs will, in large part, be paid for by the premiums of the young and healthy who are being responsible and paying into the insurance pool instead of out of pocket.