Why do these people think it is such a bad thing that I get good insurance from my employer as a benefit. Why do they want to do away with that? What benefit is there for me to uncouple the insurance from my employer? Because I sure as hell wouldn't be able to afford the extra 15k/year that my insurance would cost if I were covering it alone.

And I sure as hell wouldn't qualify for any subsidies.

11/19/2014 8:20:58 PM

but but what if you were uncoupled, meybe git a raise, and healfcare wuz phree

11/19/2014 8:24:58 PM

^^

Quote :

"employer-provided insurance was precisely the problem, because it removes so much competition from the marketplace. Obamacare, however, doubled down on the employer-sponsored system. We need a system where people are purchasing their insurance on their own, and at most the employer is providing the dollars for the purchase, tax-free or not. Instead, we have a one-size-fits-none system, where men pay for gynecology exams, women pay for prostate exams, and fifty-year-olds pay for pre-natal care. With all of this indirect payment for services, it's no wonder that prices skyrocket, both premium AND provider prices."

-aaronburro
http://www.thewolfweb.com/message_topic.aspx?topic=639243&page=9#16154348

11/19/2014 8:51:56 PM

Employers could still earmark funds to go toward healthcare as a benefit, even pay their portion by direct payment to insurance company, they could even have a preferred insurer if they want. It would still be more free market because the end user would be the one making the decision who to go with.

11/19/2014 10:16:55 PM

The Burlington Free Press reported earlier today that Gruber will finish his consultant work for the state, but the paychecks will be cut off. As the state health reform chief Lawrence Miller explained, “I have told Mr. Gruber that I expect his team to complete the work that we need to provide the legislature and Vermonters with a public health care financing plan.”

http://www.mediaite.com/online/vermont-to-stop-paying-gruber-for-health-care-consultant-work/

11/20/2014 2:44:57 AM

surprise that some powerful braniac is a conceded douchebag

11/20/2014 11:27:06 AM

What if it was Gruber's plan all along for these statements to leak, to force some of the reforms to be made?

11/20/2014 11:38:08 AM

Imma blow some minds here, but this is a good thing.
http://www.nytimes.com/2014/11/15/us/politics/birth-control-challenge-rejected-.html?action=click&contentCollection=Politics®ion=Footer&module=MoreInSection&pgtype=article

11/22/2014 7:45:30 PM

Quote :

"even aaronburro's op-ed agrees that the secretary can establish a 1311 exchange for the state"

It's not a matter of "for" the state, numbnuts; what matters is if the exchange was established BY the state. Thanks for continuing to prove your stupidity.

Quote :

"Hahahahhaha really now? Now the structure of the act is important, not just 5 words?"

So, again, your argument is that in order to understand the law, you shouldn't actually read it. This is SERIOUSLY your argument here.

Quote :

"Also, Exchanges now means "1311 Exchange established by the State", right?"

Not necessarily. Context matters, something that you don't seem to understand. You could certainly make the argument that "Exchange" when left completely unqualified, refers to any type of Exchange referenced by the law, suggesting that the distinction between a State-established exchange and a HHS-established exchange is not important to the context of the passage you are looking at. However, when you get to a point where it says "Exchange established by the State", the canons of legal construction suggest that "established by the State" has importance. Otherwise, if "Exchange" always means "exchange established by the state under section 1311," then why include "established by the State" in the first place? The fact that it was included in the sections which say who qualifies for tax subsides suggests that who established the exchange is, in fact, important. When coupled with several instances of Gruber saying that only plans purchased on State-created exchanges are eligible, as well as the fact that one of the original Senate bills on which the PPACA is founded unambiguously had the same restrictions (and they clearly weren't removed), we can only conclude that the intent of the law AND the letter of law are that tax-subsidies are only available to plans purchased on Exchanges which were established by States, and exchanges established by the Secretary of HHS are not eligible.

Quote :

"If it wasn't obvious before, it's pretty clear now ya'll are just making shit up to conveniently fit whatever argument you're trying to make."

Talking about yourself again?

Quote :

"Why do these people think it is such a bad thing that I get good insurance from my employer as a benefit."

Well, for starters, it couples your healthcare to your job. That's bad; it's a major component of the problems behind pre-existing conditions exclusions. Because if you could just buy a good plan and keep it, then it wouldn't matter if you got sick, because you'd just keep your current plan between jobs. Second, it reduces competition in the marketplace and ties you to plans which really don't fit you or what you need.

Quote :

"What benefit is there for me to uncouple the insurance from my employer? Because I sure as hell wouldn't be able to afford the extra 15k/year that my insurance would cost if I were covering it alone. And I sure as hell wouldn't qualify for any subsidies."

But that's the thing: if your employer stopped paying for your health-insurance, you wouldn't just say "oh well, better go buy it myself on my current salary, ho-hum". You'd say to your employer "you better fucking pay me the difference, or I'm going somewhere else where they will!" You're not stupid, and you don't look at a job and only evaluate the salary; you evaluate other factors, such as the benefits, so if the benefits are lacking, you will expect a higher salary to make up for it so you can purchase what's missing yourself. Think of it this way: if you took a job that offered a company car as a benefit, you'd be OK if your salary was such that you were making about a car-payment per month less than a comparable job that didn't offer a company car.

11/22/2014 8:24:43 PM

Quote :

"However, when you get to a point where it says "Exchange established by the State", the canons of legal construction suggest that [b]"established by the State" has importance.[b/] Otherwise, if "Exchange" always means "exchange established by the state under section 1311," then why include "established by the State" in the first place? The fact that it was included in the sections which say who qualifies for tax subsides suggests that who established the exchange is, in fact, important."

Of course it has importance, just as it does in section 1311 when an Exchange is defined as "established by a State". The rest of the law has importance too, like the part that establishes HHS's authority to establish an Exchange in place of a State. Or section 1411, which no matter how many times you say otherwise, is actually the section that determines who qualifies for tax subsidies (it's in the title of the statute!). All those sections have importance! So do the other "canons of legal construction", which defer to the executive for matters of administrative interpretations, and forbid any interpretation that makes the law contradictory or fundamentally unworkable. Hell, you want to talk about meanings of words? Where is State defined as "a state of the USA"? State could be referring to the entire country, as the word is often used!. Plain textual meaning right?

[Edited on November 24, 2014 at 12:06 PM. Reason : :]

11/24/2014 12:05:56 PM

Does Puerto Rico get subsidies? Or American Samoa? United States Minor Outlying Islands? These are not states but somehow are still in the US.

[Edited on November 24, 2014 at 10:37 PM. Reason : Just change the subject from 1311 1312. The horse is dead and the Courts will cook it.]

11/24/2014 10:35:00 PM

^ It seems territories are not eligible, but they also ended up be exempted from many of the provisions of the PPACA anyway. Oddly enough, they, too were defined as "States" by Section 1323 for the purpose of tax credits. Recent news articles seem to suggest that this has been rescinded, though I'm not sure how. Anyway, this, too, shoots holes in the notion that any and all references to an Exchange are defined as having been "established by a State"; otherwise, why would it need to be made explicit here?

Quote :

"Of course it has importance, just as it does in section 1311 when an Exchange is defined as "established by a State"."

But you don't get it. If an Exchange is ALWAYS defined to be "established by a state," then why even mention "established by the State"? If there is no need to make the distinction or statement, then why was it made. When the canons of legal construction say "don't add extra words," this is precisely what they are talking about. The entirety of your argument falls completely flat on its face with this simple fact. In many places the law doesn't reference "established by the State," yet here it does. This fundamentally means that the distinction matters, and it matters precisely where the distinction is explicitly made, and that distinction is made in the sections that tell who qualifies for tax subsidies.

Quote :

"The rest of the law has importance too, like the part that establishes HHS's authority to establish an Exchange in place of a State."

For a state. The word is "for". Now, go to a dictionary, look it up. Then, look up "by."

Quote :

"Or section 1411, which no matter how many times you say otherwise, is actually the section that determines who qualifies for tax subsidies (it's in the title of the statute!)"

Except for the fact that 1401 plainly establishes that, too. You are completely ignoring the text again! 1411 speaks of people who are claiming a tax credit under "section 36B of such Code". Guess what section 1401 of the PPACA does? IT FUCKING AMENDS SECTION 36B OF THE TAX CODE. And how does it amend it? Why, it tells about tax credits available to people who "purchased a plan from an exchange, established by the State under Section 1311". Section 1411 is directing the Secretary of HHS to create a program for determining eligibility, but the actual eligibility is determined in section 36B of the tax code (as amended/added by PPACA Section 1401).

Quote :

"Where is State defined as "a state of the USA"? State could be referring to the entire country, as the word is often used!. Plain textual meaning right?"

Seriously, man? This is where you want to go now? The legally accepted meaning of "State" when used in a law is now up for interpretation? You are grasping at straws, and it's pathetic. But, hey just to destroy your absurd "theory," here ya go:
Section 1304(d): "STATE.—In this title, the term ‘‘State’’ means each of the 50 States and the District of Columbia."
Look at that, Congress KNEW how to include something else in the definition of "State", like it did with territories in Section 1323, yet it didn't include the Secretary of HHS. Hmmm...

11/24/2014 10:54:06 PM

Hahahahah figures, I honestly didn't even bother to that look that up. Poor example of the absurdity your interpretation of the law leads to, but frankly the examples I had already given written by actually law professionals were enough.

Anyway, you're just contradicting yourself now,

Quote :

" Don't take my word for it: go look it up. 1311 isn't defining an Exchange... It's saying it must be a fucking non-profit or governmental entity."

Quote :

"But you don't get it. If an Exchange is ALWAYS defined to be "established by a state," then why even mention "established by the State"? If there is no need to make the distinction or statement, then why was it made. "

Indeed, why was it made? Maybe because the statute is defining an Exchange as always "established by a state"? It can't simultaneously be an authoritative statement that overrides the clear intent of other sections of the law, and just extra words somewhere else.

In any case, the SOCTUS already agrees with mine and every rational observer's opinion, that section 1321 authorizes HHS to establish an Exchange on a State's behalf, one that would fulfill the required criteria for State's to receive tax subsidies for it's residents.

Quote :

"In their dissent from the 2012 decision upholding the law, Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito read the law exactly as its supporters do. They wrote: “Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State.” And they noted of the law’s structure: “That system of incentives collapses if the federal subsidies are invalidated.”"

Woops.

Here's a better one. That all powerful tax code mentions this requirement for Exchanges offering tax credits,

Quote :

"Each Exchange (or any person carrying out 1 or more responsibilities of an Exchange under section 1311(f)(3) or 1321(c) of the Patient Protection and Affordable Care Act) shall provide the following information to the Secretary and to the taxpayer with respect to any health plan provided through the Exchange:"

Now why in the world would the writers of the law, who clearly intended that tax subsidies be restricted to Exchanges "established by the state", care about fulfilling tax subsidy eligibility requirements from Exchanges authorized by section 1321(c)? Was this one a typo?

[Edited on November 25, 2014 at 8:00 PM. Reason : :]

11/25/2014 7:32:23 PM

most people are less concerned with the opinion on state run exchanges vs federal than how much their plan costs

11/26/2014 2:02:09 AM

Quote :

"Indeed, why was it made? Maybe because the statute is defining an Exchange as always "established by a state"?"

So you'll just continue to ignore the fact that interpretations should avoid surplus language, because it is inconvenient to you.

Quote :

"It can't simultaneously be an authoritative statement that overrides the clear intent of other sections of the law, and just extra words somewhere else."

Actually, it can. You, see, this is how the English language works. You can say, in general, A means something. And then, come along, and be more specific about what A is in a very specific case. That is what is happening here. As for the Supreme Court, they have NOT ruled on this, otherwise it wouldn't even be discussed. Are you so fucking stupid that you are now arguing that the Supreme Court is taking up the exact same case it ruled on no more than 2 years ago? Seriously?
And, you actually CAN override the clear intent of other sections of the law. You do so with clear verbiage to that very effect. This is frequently done, and a great example is the part where territories were made eligible for subsidies. Territories are clearly not a "State" by any definition of the word, much less by the expressly defined version of it in the Law. And yet, they were made eligible for subsidies.

Quote :

"Now why in the world would the writers of the law, who clearly intended that tax subsidies be restricted to Exchanges "established by the state", care about fulfilling tax subsidy eligibility requirements from Exchanges authorized by section 1321(c)? Was this one a typo?"

Seriously? This one is simply saying that people are told how much of a tax credit they are to be given, and the same info is to be given to the Secretary to reconcile the amount of subsidy paid. You still have to reconcile a zero with a zero. You are really grasping now. Likewise, if you MOVED, it would naturally be necessary to change policies, and as such, if you moved from a state where subsidies were available to a state where they are not, this section allows reconciliation of the advance tax credit that may have been paid. And, since you would have one exchange that was established under Section 1311 and another that was established under section 1321, BOTH entities would need to provide this information. This actually goes entirely against your argument, because it specifies BOTH types of exchanges. If they were truly one and the same, then there would be absolutely no need to specify both sections here. Yet, they do. Is this surplus language also to be completely ignored, simply because it is inconvenient to your wholly incorrect argument?

11/28/2014 11:35:14 PM

Quote :

"In their dissent from the 2012 decision upholding the law, Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito read the law exactly as its supporters do. They wrote: “Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State.” And they noted of the law’s structure: “That system of incentives collapses if the federal subsidies are invalidated."

Damn, you are REALLY reaching now. You quoted EJ Dionne, a known partisan hack, and then quoted his intentional complete misrepresentation of the Sebelius decision. The "backup" he refers to is simply making sure that exchanges exist, even if a State refuses to create one. And the second quote is even more insidious, especially when combined with the first which occurs in a completely different section of the opinion, talking about a completely different topic: the opinion is in NO WAY discussing state-versus-federal established exchanges. Instead, it's talking about why an INSURER would want to put its plans on an exchange, and, more importantly, it's talking about COMMUNITY RATING. We see that by, *gasp*, reading the opinion in context:

Quote :

"... Without the community-rating insurance regulation, however, the average federal subsidy could be much higher; for community rating greatly lowers the enormous premiums unhealthy individuals would otherwise pay. Federal subsidies would make up much of the difference. The result would be an unintended boon to insurance companies, an unintended harm to the federal fisc, and a corresponding breakdown of the “shared responsibility” between the industry and the federal budget that Congress intended. Thus, the federal subsidies must be invalidated. In the absence of federal subsidies to purchasers, insurance companies will have little incentive to sell insurance on the exchanges. Under the ACA’s scheme, few, if any, individuals would want to buy individual insurance policies outside of an exchange, because federal subsidies would be unavailable outside of an exchange. Difficulty in attracting individuals outside of the exchange would in turn motivate insurers to enter exchanges, despite the exchanges’ onerous regulations. See 42 U. S. C. §18031. That system of incentives collapses if the federal subsidies are invalidated. Without the federal subsidies, individuals would lose the main incentive to purchase insurance inside the exchanges, and some insurers may be unwilling to offer insurance inside of exchanges. With fewer buyers and even fewer sellers, the exchanges would not operate as Congress intended and may not operate at all."

Reading in context, we see about the incentive for an individual to purchase a plan an on exchange as opposed to outside of it, NOT the incentive for a State to establish an exchange, and it is done in the context of talking about how much extra money the federal gov't would have to pay if community-ratings were not upheld.

11/29/2014 12:57:53 AM

Do you realize that there is no internal consistency to your entire argument?

Quote :

"So you'll just continue to ignore the fact that interpretations should avoid surplus language, because it is inconvenient to you."

So again, "Established by the State" is surplus language where I noted it as defining an "Exchange" but quite literally the most important 4 words in the entire document where it supports your case. You do realize that's what you're saying, right?

Quote :

"Actually, it can. You, see, this is how the English language works. You can say, in general, A means something. And then, come along, and be more specific about what A is in a very specific case. That is what is happening here. A"

Lol no it isn't, that's what you say is happening, big difference. Let me remind you that the entire basis for the invalidation of tax subsidies on federally established Exchanges are the 4 words "established by the State" appearing in a subsection of the IRS tax code describing tax subsidies. Describing them mind you, more specifically describing how the premium amount for each applicable taxpayer is calculated. Hell, if anything applying your logic, it's actually section 1321 that "comes along" and is very specific about what happens when a State fails to establish it's own Exchange. No where in any of the relevant sections describing eligibility requirements for "applicable taxpayers" or "qualified health plans" or "eligibility for tax credits" does it restrict tax credits in the way you describe. Again, it's all based on a specious interpretation of those 4 words appearing in the tax code.

Quote :

"And, you actually CAN override the clear intent of other sections of the law. You do so with clear verbiage to that very effect. This is frequently done, and a great example is the part where territories were made eligible for subsidies. Territories are clearly not a "State" by any definition of the word, much less by the expressly defined version of it in the Law. And yet, they were made eligible for subsidies."

You mean the clear verbage that defines an Exchange throughout the entirety of the title as "established by a State" and the clear verbiage which authorized HHS to establish "such Exchange"? That clear verbage or only the clear verbage (again, 4 words) without which the plaintiffs have no case.

Quote :

"Seriously? This one is simply saying that people are told how much of a tax credit they are to be given, and the same info is to be given to the Secretary to reconcile the amount of subsidy paid. You still have to reconcile a zero with a zero. You are really grasping now. Likewise, if you MOVED, it would naturally be necessary to change policies, and as such, if you moved from a state where subsidies were available to a state where they are not, this section allows reconciliation of the advance tax credit that may have been paid."

Ok, so by your logic, the law is instructing the parties responsible for operating federally established State exchanges (HHS) to report back to the agency determining subsidy amounts (HHS) that no one enrolled through their exchange is eligible. Right? Hell, the law only explicitly requires residence in the State that established the Exchange for enrollment, not for continued receipt of subsidies. That part is implied by the fact that health insurance does not operate across state lines, and it would be up to the individual to cancel their policy, receive a refund for the remaining months from their existing provider, and report/repay any money owed for credits received on their next tax return. Just another reason why restricting subsidies only to residents of States that established their own exchange, especially in such a vague way, is totally illogical. Have you ever even done your own taxes?

Quote :

"This actually goes entirely against your argument, because it specifies BOTH types of exchanges. If they were truly one and the same, then there would be absolutely no need to specify both sections here. Yet, they do. Is this surplus language also to be completely ignored, simply because it is inconvenient to your wholly incorrect argument?"

Nope, it only notes that the responsible parties for operating Exchanges eligible for tax credits can be found in multiple sections of the law. It's not surplus language at all, it actually very clearly includes Federally established exchanges as having the same requirements for the doling out of tax credits as State ones.

^Reading in context those statements were made in a dissent of the decision that upheld the ACA even in light of the requirement for State's to accept the Medicaid expansion being struck down. They were made to establish that availability of tax subsidies through Exchanges is of the utmost importance to the operation of the law, and invalidating them would cause the law to operate in a way Congress did not intend. I don't give a fuck who EJ Dionne is, but he's clearly smarter than the partisan hacks you follow to form your opinions.

Also, none of this is to say that the SCOTUS won't still strike down the law. Politics and law have become toxically intertwined in this country, the conservative justices may very well just want to get back at Obama for the immigration executive action. This is simply pointing out the blatant hypocrisy if they do.

[Edited on December 2, 2014 at 2:01 PM. Reason : :]

12/2/2014 1:45:54 PM

tl;dr

12/2/2014 3:40:49 PM

Quote :

"So again, "Established by the State" is surplus language where I noted it as defining an "Exchange" but quite literally the most important 4 words in the entire document where it supports your case. You do realize that's what you're saying, right?"

Where in your "definition of 'Exchange'" is the phrase "Established by the State"? And you accuse me of no internal consistency. Your original argument was that every Exchange was a 1311 exchange and so every reference to them should be treated as such. If this is true, however, then any reference to an Exchange that is followed by "established by the State" or has a reference to Section 1311 would, by definition, contain surplus language.

Quote :

"No where in any of the relevant sections describing eligibility requirements for "applicable taxpayers" or "qualified health plans" or "eligibility for tax credits" does it restrict tax credits in the way you describe."

Except for the part that actually tells you what a "covered month" is, namely the addition of section 36B into the tax code, and that covered month is a month for which you are eligible for the tax credits. Did you forget that already?

Quote :

"You mean the clear verbage that defines an Exchange throughout the entirety of the title as "established by a State" and the clear verbiage which authorized HHS to establish "such Exchange"? That clear verbage or only the clear verbage (again, 4 words) without which the plaintiffs have no case."

Which, had those four words not been added, actually seven words, the extra three making it incredibly obvious, would give you a point. However, those words were added, and they make it clear that the general definition of "Exchange" is now being superseded by a more specific definition for this case. And they made it that specific TWICE. Both of those are to be ignored? Again, who isn't being consistent here? Well, I guess you are being consistent in one way: you are completely ignoring the bill when it's inconvenient to you.

Quote :

"Ok, so by your logic, the law is instructing the parties responsible for operating federally established State exchanges (HHS) to report back to the agency determining subsidy amounts (HHS) that no one enrolled through their exchange is eligible."

Or, maybe, the fact that the person is now enrolled in a different plan on a different exchange might be used to further prove that they are no longer eligible for the subsidies.

Quote :

"Just another reason why restricting subsidies only to residents of States that established their own exchange, especially in such a vague way, is totally illogical."

Ah, the old "purpose-based" argument that says we should ignore the actual text and go with what "feels right". Too bad that's rejected at basically every level of judicial scrutiny. If the text says you calculate 2+2=5, then you must do so. Don't like it? Amend the law and don't fuck it up so badly next time.

Quote :

"Again, it's all based on a specious interpretation of those 4 words appearing in the tax code. "

Yeah, a "specious interpretation," namely the ACTUAL LITERAL MEANING OF THE WORDS.

Quote :

"Nope, it only notes that the responsible parties for operating Exchanges eligible for tax credits can be found in multiple sections of the law."

But if the exchanges are the same, why specify both? That is the very definition of "surplus language," and it undercuts your entire argument. My argument, however, remains consistent: they referenced both there because it was needed (because the people who are responsible are given that responsibility in different sections), while in other cases, they reference neither for the general case, and in the case where they only want it to apply to 1311, they specifically reference 1311. In yours, we just make it up as we go along and ignore words as needed.

Quote :

"Reading in context those statements were made in a dissent of the decision that upheld the ACA even in light of the requirement for State's to accept the Medicaid expansion being struck down."

"Reading in context"? What the fuck? In context, one of the quotes is background of the arguments being made BY THE LAWYERS ARGUING THE CASE. It was NOT the opinion of the judge. The other was talking about fucking MEDICAID. THAT'S WHY THE TWO QUOTES ARE DECEPTIVE, much less when you combine the two. For a guy you claim is "clearly smarter," he sure is making some egregious mistakes in reading that opinion.

12/3/2014 12:31:35 AM

Quote :

"Where in your "definition of 'Exchange'" is the phrase "Established by the State"? And you accuse me of no internal consistency. Your original argument was that every Exchange was a 1311 exchange and so every reference to them should be treated as such. If this is true, however, then any reference to an Exchange that is followed by "established by the State" or has a reference to Section 1311 would, by definition, contain surplus language."

I think this is my favorite part of your whole argument, where you appeal to a notion of statutory interpretation conservatives themselves blame for decades of judicial activism. It even goes against Scalia's own thoughts when he said,

Quote :

"the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme"

meaning that you can't interpret words in a way that conflict with the overall intent of law. So yeah, it's perfectly reasonable to interpret instances of certain words as "surplus" (or maybe erroneous?) if they would otherwise conflict with the "overall statutory scheme".

Quote :

"Except for the part that actually tells you what a "covered month" is, namely the addition of section 36B into the tax code, and that covered month is a month for which you are eligible for the tax credits. Did you forget that already?"

Hahahah sure, if you buy the challengers interpretation of "by the State". Otherwise all it does is render the actual section most commonly referenced by the challengers as totally redundant. Again, sloppy drafting.

Quote :

"Which, had those four words not been added, actually seven words, the extra three making it incredibly obvious, would give you a point. However, those words were added, and they make it clear that the general definition of "Exchange" is now being superseded by a more specific definition for this case. And they made it that specific TWICE. Both of those are to be ignored? Again, who isn't being consistent here? Well, I guess you are being consistent in one way: you are completely ignoring the bill when it's inconvenient to you."

Actually it's just "by the State", because there is no ambiguity over HHS's authority to create a 1311 Exchange (not even to the challengers). And again, since section 1311 already defines an Exchange using those exact same words, what exactly is being superceded?

Quote :

"Yeah, a "specious interpretation," namely the ACTUAL LITERAL MEANING OF THE WORDS."

Yes, that's what specious means, superficial and misleading. You forget that the legal bar to be cleared here is quite high, that in order to overturn the IRS rule the challengers must show that it unambiguously conflicts with the text of the law. Deference to agency interpretation means if any other interpretation of the law could be valid, then they lose. Neither you in this thread, nor the challengers, nor anyone on their side of the issue have come close to invalidating alternate interpretations. The sheer arrogance required to even do so, on the basis of 3 words, should honestly be offensive to anyone in a legal profession. Especially given that the majority of the federal judges who've ruled on this case agreed with the IRS's interpretation.

Quote :

"My argument, however, remains consistent: they referenced both there because it was needed (because the people who are responsible are given that responsibility in different sections), while in other cases, they reference neither for the general case, and in the case where they only want it to apply to 1311, they specifically reference 1311. In yours, we just make it up as we go along and ignore words as needed."

Or, you know, they put it there to ensure individuals enrolled through any Exchange would be able to receive subsidies? Unambiguous conflict with the IRS's interpretation remember? This alone at the very least makes the statute's intent ambiguous. When combined with all the other points I've raised, it would be far easier to claim the IRS's interpretation as unambiguously correct than the challengers. Which is kind of the whole point, and the reason why they've latched on to comments by a consultant, and completely ignored all the actual legislators who wrote the law and say it was never their intent to deny subsidies to State's who failed to establish their own Exchange. Anything they can do to distract from the law itself or the process by which it was written.

Quote :

""Reading in context"? What the fuck? In context, one of the quotes is background of the arguments being made BY THE LAWYERS ARGUING THE CASE. It was NOT the opinion of the judge. The other was talking about fucking MEDICAID."

Not the opinion of the judge? Ok, I really don't mind spelling this out for you. Yes, he was talking about Medicaid, and said that if Congress thought that States wouldn't accept the Medicaid expansion, they would have included a backup scheme to ensure the law met it's stated goal of near UHC. He's actually saying a lot more here than just how he feels about the Medicaid expansion, he's saying that Congress explicitly designed the law in a way to ensure everyone would be covered. Then he goes on to talk about how compromising the operation of the Exchanges or distribution of subsidies would ruin the whole scheme, and that striking down the parts of the act he thought were unconstitutional would do just that. It follows that any reading of the law which would also ruin that scheme is invalid.

12/4/2014 11:26:19 AM

By the way, if it were up to me, not only would subsidies in States that didn't establish their own Exchanges be disallowed, they should be exempt from the whole law. Let their residents wallow in the muck of the pre-ACA healthcare industry, until they (literally) get sick of it and replace the assholes who don't want to play along. Right now, Republican politicians can rail against Obamacare with almost no real consequences or backlash from the people of their States, since they enjoy most of the benefits anyway.

..

http://www.modernhealthcare.com/article/20141203/NEWS/312039948

Quote :

"The uninsured rate nationwide was 12.4% in September, down roughly 30% from 17.5% a year earlier. "

But hey, let's scrap the whole thing because it's either not perfect (liberals) or it's socialism (conservatives). All ya'll are fucking stupid.

Hahahaha holy shit and the hits keep coming for the detractors,

http://www.vox.com/2014/12/3/7328423/health-costs-lowest-growth

Quote :

"The 3.6 percent growth that the Centers for Medicare and Medicaid recorded in 2013 is the smallest increase the agency has ever seen since it started tracking medical spending in 1960."

The spin cycle is going to fun to watch on this one. Has there been one single prediction made by detractors of the law that came true? Even one?

[Edited on December 4, 2014 at 12:24 PM. Reason : :]

12/4/2014 12:14:30 PM

In terms of policy, I am not willing to accept a lower uninsured rate at the cost of increased economic inequality.

12/4/2014 12:25:14 PM

You're going to have to explain how mostly poors having their healthcare costs lowered increases income inequality. That's 90% of what this law does, make healthcare accessible to a bunch of poor people, mostly minorities. Yes, young healthy adult males have in general seen their healthcare costs increase under Obamacare, but they were doing pretty well off to begin with. That's not increasing income equality, it's just decreasing it in a way that adversely affects one specific demographic. Even that's unclear, because in the case of that healthy young adult male ever suffering a medical emergency, he'll be in much better shape today than he would have been 5 years ago.

[Edited on December 4, 2014 at 12:34 PM. Reason : :]

12/4/2014 12:33:28 PM

Quote :

"Yes, young healthy adult males have in general seen their healthcare costs increase under Obamacare, but they were doing pretty well off to begin with."

Are any of those words statistically meaningful? What does being male have to do with any of this? While there were some gender cost differences, I did not think these were particularly significant. Plus, on the inter-generational basis gender differences even out, unless people have a gender preferences when dolling out inheritance. Growing economic inequality is unconcerned with age and gender, because family wealth lineages are both genderless and immortal.

I do like the subsidies, but they don't come from the government's general fund. They have no claim to the general fund. Because of this, the only inter-class wealth transfers that can be achieved are those prescribed within the law. Those are almost certainly insufficient and the Democrats hoped from the beginning to build a system closer to the ideal using perpetual legislative band aids, which I doubt they'll have the clout to get through anymore.

Lower rate of bankruptcies are also a boon to creditors. Mostly hospitals in this case. I'm all for collectivizing costs, and this was a particularly insidious type of cost burden which needed fixing, but the mechanism by which we collectivize it is bad. It's not sufficiently progressive, we don't have a means of adjusting how progressive it is, and in large part we don't even understand what it's doing. It's nice to think that more even health care and fewer bankruptcies will be better for people's quality of life in general, but this isn't clearly an outcome to me. Severely economically disenfranchised people will still be excluded. In a perfect world all homeless people would be on medicaid but we all know this isn't the case. In other words, there's still plenty of cracks for people to fall into if the job pool isn't there for them. Unless the direction of inequality is reversed, this is our future as a mathematical fact. Quality of life today doesn't matter compared to this hazard. The people losing economic control of their nation is the worst possible thing that can happen.

[Edited on December 4, 2014 at 2:34 PM. Reason : ]

12/4/2014 2:32:57 PM

Age matters, people our age are underwriting old people (via spending ratio caps) even though old people are better positioned economically/financially

[Edited on December 4, 2014 at 3:22 PM. Reason : .]

12/4/2014 3:03:38 PM

Quote :

"meaning that you can't interpret words in a way that conflict with the overall intent of law."

So you're back to the fallacy of "intent" over actual words, even though we know what the original intent was and we know they are now changing their story. Got it.

Quote :

"Hahahah sure, if you buy the challengers interpretation of "by the State". Otherwise all it does is render the actual section most commonly referenced by the challengers as totally redundant."

You mean, if you read the actual words in the law. What a crazy way to interpret laws. And remember what we said about surplus language. Woops! Are you going to make an argument, or just continue to cling to discredited ones?

Quote :

"Again, sloppy drafting."

Was it sloppy drafting to say it twice? Was it sloppy drafting to reference that exact section no less than 5 other times? Was it sloppy drafting not to correct the error immediately after passing the bill and recognizing the mistake? Was it sloppy drafting to include the same text in this bill as was included in one of the parent, original bills? Was it sloppy drafting not to use any language that Congress normally uses for situations like this in order to handle legal fictions? And, even if it is "sloppy drafting," the text still plainly means what it means, and that can't be ignored. It has to be amended; that's how laws work.
http://thefederalist.com/2014/07/23/no-halbig-did-not-gut-obamacare-because-of-a-drafting-error/

Quote :

"Actually it's just "by the State", because there is no ambiguity over HHS's authority to create a 1311 Exchange"

Actually, no, the section matters, too. The Secretary only establishes an exchange under the authority of Section 1321. You simply aren't going to win any arguments in the Supreme Court when you argue that the federal government acts as a State. They will laugh you out of the building. Moreover, it is the failure of a State to establish an exchange which causes the Secretary to act, and she is authorized to do so not under Section 1311, but under Section 1321. There is literally ZERO text in the law that supports creating and endorsing the legal fiction that an Exchange established under the authority of Section 1321 was actually established under the authority of Section 1311. There is also zero text in the law that supports creating and endorsing the legal fiction that the Secretary of HHS is a US State. Because there is no such text, these legal fictions are not supported, and they cannot be relied upon as you so desire. Any exchange established by the HHS Secretary was plainly not established by a State, because the only reason the Secretary established it (or even could establish it) is because the State did not.

Quote :

"Yes, that's what specious means, superficial and misleading. You forget that the legal bar to be cleared here is quite high, that in order to overturn the IRS rule the challengers must show that it unambiguously conflicts with the text of the law. Deference to agency interpretation means if any other interpretation of the law could be valid, then they lose. Neither you in this thread, nor the challengers, nor anyone on their side of the issue have come close to invalidating alternate interpretations. The sheer arrogance required to even do so, on the basis of 3 words, should honestly be offensive to anyone in a legal profession. Especially given that the majority of the federal judges who've ruled on this case agreed with the IRS's interpretation."

SHEER ARROGANCE? You mean like the arrogance of saying that the ACTUAL FUCKING WORDS should be ignored? That words all over the bill should be completely ignored? You are a joke at this point. "Deference" to the agency is only allowed when there is ambiguity. There is literally NOTHING ambiguous about "Established by the State under Section 1311." It's as specific as you can get! What the hell is "misleading" about "read the actual text"? Oh, right, it doesn't help your argument. Moreover, the challengers don't need to "invalidate" any other crackpot interpretations. All they have to do is show that the a normal reading of the actual literal text in the law is a valid interpretation, and any other "alternative interpretations" are thrown out. Every other "alternate interpretation" relies on ignoring text, a cardinal sin in legal interpretation that is only to be used when absolutely necessary; Obama needs this to work doesn't qualify as "absolutely necessary." And they all use other methods of interpretation that are to be used when there is actual ambiguity. Saying and referencing something ten times is not ambiguous: it's explicit.

Quote :

"Or, you know, they put it there to ensure individuals enrolled through any Exchange would be able to receive subsidies?"

Which would be a crazy thing to do when you then go on to limit those subsidies, in explicit language, TWICE, to plans purchased on exchanges established by a State under section 1311. Crazy, as in, your interpretation is absurd. Just because you drank enough whiskey to make it sound like a good idea, doesn't mean it is actually a valid interpretation.

Quote :

"Which is kind of the whole point, and the reason why they've latched on to comments by a consultant, and completely ignored all the actual legislators who wrote the law and say it was never their intent to deny subsidies to State's who failed to establish their own Exchange."

The absurdity of this argument is so incredible that I don't even know where to begin. First, you belittle the role of Gruber, because his statements, made both BEFORE and shortly AFTER the law was passed completely contradict anything and everything you are trying to say. Second, the legislators are only now making the claim to their intent, long after the conflict in question was raised, and they are desperately trying to defend the law at all costs, making their statements of dubious value. Third, these same legislators have ALL previously praised Gruber extensively, with Obama even going so far as to say that he "stole ideas" from Gruber. And did I mention that these same legislators are now trying to claim that they don't even know who he is? And not one of them had the wherewithal to correct his supposedly erroneous statements when they were being made, not even in the heat of the debate before its passage. It's only now that they disagree. Well, Pelosi and her buddies have been caught lying about even knowing who he was, so I'd say we should take her and others statements about their "intent" to be exactly what they are: bullshit. Gruber wasn't a lowly consultant; he was a major architect of the bill, and the only reason Pelosi and Reid are marginalizing him now is because he was caught saying the actual intent of the law and it destroys their claims.

Quote :

"Then he goes on to talk about how compromising the operation of the Exchanges or distribution of subsidies would ruin the whole scheme"

Yes, but it is doing so in the context of Severability with regards to the already invalidated Medicaid expansion. Even given this, the opinion isn't saying anything about who is eligible for the tax credits. It's just saying that given that we know there are credits, if the credits themselves are invalidated (as he has just finished saying they should be, ALL OF THEM, not just ones for Section 1321-established exchanges), the act would fail. This, then, is why it concludes the ENTIRE bill should be struck down.

Quote :

"It follows that any reading of the law which would also ruin that scheme is invalid."

Unless, of course, that's what the actual law says. Dude, you are NOT going to win in court on a "do what we mean not what we say" defense. Otherwise, why bother writing the laws down? Why having them at all? Just do whatever the fuck anybody says and be done with it, right? And this, of course, still relies upon an out-of-context reading of that section of the opinion

12/6/2014 12:10:33 AM

Stop posting "Got it" at the end of sentences. You sound like an uneducated hack when you do that. Or, was that your intent?

12/6/2014 1:04:13 PM

Didn't mean to upset you. Got it.

12/6/2014 2:18:23 PM

Got it.

12/6/2014 2:48:09 PM

Got it.

12/6/2014 5:10:02 PM

http://www.nationalmemo.com/republicans-still-think-youre-stupid/

for those who were outraged!1!1 at that Gruber dude

12/11/2014 1:00:18 PM

I don't know if the ACA will do much of anything other but for fucks sake the present 2 payer system is just dogshit. Go to any doctors office, clinic, or hospital in America at any time and someone is in there in varying states of being mystified about the fucking insurance and payments.

I have been fortunate enough to be really healthy in my first 30 years. I also had great jobs where if I did need health care the copay was low as hell so I didn't have to think about it. At my present employer the plan we have is a consumer focused high deductible + HSA, which is still a good plan but not a Cadillac by any means. Twice this year I have been burned by bullshit regarding coverage. The first was mostly my fault I suppose. We had a child this year and one of the tests were for CF and DS. The clinic folks gave us the codes to see if it was covered and I read the damn doctors clinical text of a description on Aetnas website and thought it was covered. The folks at the ObGyn said that most insurances covered the test. Well, $900 later out of my pocket it was covered. Yes, it was my fault for not calling and confirming but for fucks sake why is this shit left up to the consumer to navigate the complexities of health care? It is beyond stupid that I have to be on the god damn phone for 15 minutes in the middle of my work day and ultimately speak to an ESL on how a procedure that is recommended will cost.

Example two. I tend to grind my front teeth in my sleep and the dentist recommended getting some composite added to the tops to build them back up and to provide 10-15 years of protection. They should me an estimate ahead of time that had me paying like $200 bucks and I said let's do the treatment. Afterwards I ended up paying $235, which is still a pretty good deal for 10+ years of keeping my teeth from self destructing. I get the bill from the dentist and it says "The insurance company paid $527 LESS THAN WE HOPED"? WHAT IN THE FUCK IS THIS SHIT?. Certainly, this sounds like the insurance company fucked up somewhere. Now, I get to spend who knows how many minutes playing phone roulette to figure out how this is screwed and I can guarantee you that I'll ultimately have to pay regardless because the consumer is just fucked regardless.

And this shit happens over and over and over 10,000 times a day across the only industrialized nation in the world and we had idiots in DC vote how many times to try and kill the only real attempt in decades to fix this fucked up piece of shit? Holy fuck. We really are screwed.

12/13/2014 10:45:49 AM

i think it's pretty fucked up that you can get billed by 3rd parties that you had no involvement in selecting and know nothing about. if the doctor sends off stuff for lab work, the lab should bill the doctor and then the doctor should bill you; it shouldn't be a patient's responsibility to identify any 3rd parties used by the primary doctor and then have to follow up with them to make sure they have been paid. the doctor should include all of those 3rd party costs in any estimates they give, they shouldn't be a surprise to a patient who knows nothing about them. in any other industry that shit would not fly.

12/13/2014 1:22:56 PM

^^ now, imagine how much better it would have been if the dentist could have said "we charge X for this". Welcome to the stupidity of insurance "covering" piddling things.

12/14/2014 10:14:59 PM

Unfortunately I agree with burro to some significant extent. However, the rhetoric I was reading about the ACA was that burro and the ACA are also on the same page here. The logic was that higher deductibles will create a mass of consumers who will have a direct incentive to negotiate prices and shop around, and this will keep prices under control.

I remain skeptical. I agree that they've likely shifted higher deductible and co-pay costs to the consumer, but it doesn't necessarily follow that doing so makes the system less byzantine. It's entirely plausible that the practices will now use even more convoluted systems because a) there's poor regulation for consumer price-awareness and b) the consumer themselves will spend less time fighting.

Essentially, price transparency is unlikely to happen by just moving to a model of people directly paying for all their own health care. If businesses aren't strictly held accountable for charging what the consumer consented to, then the profit motive simply dictates that they overcharge as much as possible. Even if it comes from the patient's pocket.

My own impression is that such a system isn't even compatible with the workplace culture of our medical system (or in any nation for that matter). Mandating something like signed agreements for all costs in advance would be taken as an affront to the purpose and independence of the medical profession.

12/15/2014 10:40:27 AM

wtf, BCBS.


HC.gov says a plan gets XXXX coverage (drug and hospital and ER max payment) and the pdf on BCBS's website says something different, for the same plan.

12/15/2014 2:53:09 PM

Quote :

"Mandating something like signed agreements for all costs in advance would be taken as an affront to the purpose and independence of the medical profession."

Heck, just being able to get a good faith estimate up front would do wonders. I can (and did) walk into my vet's office, and get a quote good for 60 days for an amputation, and barring unforeseen complications, get that surgery done for the quoted price. And when it's all done, I go to the cash register, they hand me an itemized invoice and I pay the whole thing on once invoice. None of this "get billed by the hospital, then the follow up doctor, then the surgeon, then the nurses all on separate invoices weeks or even months apart". And frankly speaking, my vet is quite a bit more "independent" than just about any physician or hospital in the area.

12/15/2014 2:57:43 PM

^

12/16/2014 1:54:55 PM

Quote :

"now, imagine how much better it would have been if the dentist could have said "we charge X for this". Welcome to the stupidity of insurance "covering" piddling things."

There is nothing preventing us from making the system a lot easier than "they covered less than we hoped". We have computers more powerful than flew the shuttle in our pockets that we throw away every 6 months and yet we don't have push button "this is what it all will cost, this is who is paying for it, and how much" down to a tee within seconds of the doctors recommendation.

No, this is about the insurance companies doing as much as they can to obfuscate the system to maximize their profit and the government being thoroughly and utterly inept to do anything about it because free market uber alles morons like yourself scream so loud the instant the word Government is used in any other way besides blowing up or killing anything that isn't white.

Quote :

"Mandating something like signed agreements for all costs in advance would be taken as an affront to the purpose and independence of the medical profession. "

Maybe in emergency situations or situations where the plan of care can't be known in advance. This is just more reason for the cost to simply be shouldered directly by society with some pretty clear rules on what constitutes reasonable care (OMG, is he...is he going to refer to death panels?).

12/22/2014 9:52:35 AM

It's just fucking stupid.

I call the dentist and they say : "we don't really know what the insurance company is going to pay until we submit the charges"

I call the insurance company and they say : "the provider can call in and see if a procedure is covered"
I ask is that what most providers do : "well, they do it as a courtesy"
And if they don't it's up to me to call : "yes sir..."
And I'm supposed to know how to communicate to you what a given procedure is they are recommending : "well, you can fax in the treatment plans which should have the information we need to give you an accurate estimate"

And in this case, why didn't my plan cover the procedures : "sure you have a preventative treatment plan at in network providers, like basic cleanings, but not fillings, crowns, etc"
The dentist said this procedure would prevent me from grinding my teeth to a pulp and wouldn't need to be done again for 15-20 years, does this preventative treatment not count as preventative : "well sir I meant that just basic cleanings are covered"

This happens every fucking day to probably 10s if not 100s of thousands of us...this is what the free market is.

12/22/2014 3:41:45 PM

even among the low bar set for insurance, dental insurance finds a way to be consistently terrible

12/22/2014 5:20:11 PM

^^^ But insurance companies aren't doing this on their own. They are doing it with the protection and enabling of the government. That enabling comes in the form of mandates on insurance coverage and a reliance on the insurance model to cover basic medical costs. I agree that it's absurd that we can't get a decent up-front estimate, and I wouldn't be opposed to fixing that, but passing a law that says doctors have to do that won't accomplish anything. You have to get rid of the layers of stupid in our healthcare system, and then doctors will gladly provide those kinds of estimates, without a law saying they have to.

^^ Calling our current healthcare system a "free market" is absurd in almost every sense of the word. Practically nothing about the status quo is "free market."

12/22/2014 10:29:14 PM

How is it NOT a free market? Are you drunk?

Quote :

"They are doing it with the protection and enabling of the government. That enabling comes in the form of mandates on insurance coverage and a reliance on the insurance model to cover basic medical costs."

This has nothing at all to do with what my post is about. The insurance companies being for profit have a vested interest in making it extremely difficult to understand how much anything is going to cost. It would be stupid simple for all of the major corporations to set up automated systems where with the push of a button a provider and individual would know how much given treatments costs.

If this weren't a free market, the government would have already forced pricing into the clear where providers actually had to compete against each other. The insurance companies have this information and if this weren't a free market then the government could force the insurance companies to publish the information also.

Quote :

"You have to get rid of the layers of stupid in our healthcare system, and then doctors will gladly provide those kinds of estimates, without a law saying they have to."

Don't be ridiculous. The market will dictate how transparent any given service provider will be. The problem is health care is an altogether different animal than the rest of our commodity life.

12/23/2014 5:57:32 PM

How is it not a free market? I dunno, for starters, the government mandated that EVERY FUCKING PERSON IN THE COUNTRY MUST BUY AN INSURANCE PLAN. In what world is forced participation a "free market?" Second, there is massive gov't regulation on both the state and federal level which mandates what each and every plan must cover, at a minimum. Third, you have two gov't run plans (medicare and medicaid) covering a large percentage of the population. Fourth, the federal gov't is forcing employers to pay for the vast majority of health insurance plans. In what way is ANY of these a "free market" at work? And these don't even begin to get in to arbitrary restrictions on the supply of doctors via residency funding, the FDA's stranglehold on medical R&D, mandating that ERs treat anyone and everyone who comes into the door, and so on and so forth. To call what we have in the US a "free market" is an insult to the intelligence of anyone who has even the most remote understanding of economics.

Your argument that "if it weren't a free market, the gov't would do such and such" is patently absurd. You are suggesting that, despite the possible existence of any other intrusions into the market by the gov't, the fact that it hasn't intruded in one specific particular way that you want it to means it's a totally laissez faire system, and that's completely ridiculous. We have copious examples of shitty and ill-advised government regulation in all kinds of markets and glaring examples of sorely needed regulations that are completely absent; what makes this situation any different in your mind?

And the gov't collusion has EVERYTHING to do with you not being able to get a realistic estimate. The insurers lobby the gov't for regulations that favour them, many of which obscure the true costs and others which make it impossible for a doctor to offer you a cash price. Why would insurers want to have a system where they are the middleman providing payment? I think the answer is patently obvious. If anything, the fact that it isn't a free market is why the pricing isn't clear, and is why it's so damned confusing. Neither the gov't nor the insurers have an incentive to make the costs to the consumer clear, so they don't fucking do it. If it were a free market, then you would have doctors falling all over themselves trying to provide that information so they could actually compete. Instead, they can't provide it, because they don't know what the insurers are going to do, much less what the insurers are going to do at each level of service (doctor, labs, radiology, etc).

And I do think providers, if given the option and the ability to do so, would gladly provide estimates. Every other business in the world does so. Why in the hell would healthcare be any different than the rest? If a doctor can perform a procedure at price X and everybody else is doing it at the same quality but at price 2X, you can be damned sure that first doctor is going to advertise the hell out of that price. Healthcare might be different in some ways, but it's not going to buck the trend of price transparency absent any other forces making it do so. It just so happens we have massive layers of bureaucracy and red tape which insulate and hide consumers from costs, and then we walk around shocked that consumers can't find out the potential costs of a procedure.

12/24/2014 12:38:11 AM

Hahahahaha this is great,

Quote :

"But after the Supreme Court's ruling, Republican governors and legislatures in state after state rejected the expansion. Rejecting the Medicaid expansion, however, doesn't exempt a state from the taxes and spending cuts Obamacare uses to fund the Medicaid expansion. A September analysis from McClatchy estimated that "if the 23 states that have rejected expanding Medicaid under the 2010 health care law continue to do so for the next eight years, they’ll pay $152 billion to extend the program in other states — while receiving nothing in return." That's a helluva gift from (mostly) red states to (mostly) blue ones."

Quote :

"Now the Supreme Court will take up King v. Burwell, in which the plaintiffs argue that the text of the Affordable Care Act makes it illegal for subsidies to flow through federally-run exchanges. If they're successful, then it will be possible for a state that opposes to Obamacare to withdraw from both the Medicaid expansion and the exchange subsidies — that is to say, from pretty much all of Obamacare's benefits. But they will still pay all of its costs. They will still pay the law's taxes and their residents will still feel the law's Medicare cuts. Obamacare will become a pure subsidy from the states that hate the law most to the states that have embraced it.It's like a fiscal version of reverse psychology."

Voting against your own interests has never been so literal.

[Edited on December 24, 2014 at 1:54 PM. Reason : :]

12/24/2014 1:53:17 PM

reminds me of when Congress promised to take away federal highway funding if states didn't criminalize alcohol for people under 21

...while the motive might be more admirable in the case of ACA, the method is the same

12/29/2014 4:51:57 PM

Quote :

"In what world is forced participation a "free market?""

It is not much different than being forced to buy car insurance and homeowners insurance.....pretty much everyone has to buy it or does voluntarily, which brings the rates down due to the large pool of insured.

Auto insurance has been determined to be for the greater good, and therefore required by law, if it wasn't poor people would not buy it and there would be no one to pick up the cost when they got faulted in a wreck...

Health Insurance is similar in that poor people do not buy it, but they still use hospitals, ambulances, and other medical resources they just do not pay the bill meaning the rest of us pick up the cost.

12/30/2014 1:15:33 AM

Oh, no it is majorly different than car insurance or homeowner's insurance. Homeowner's is not compulsory, unless you want a mortgage, and then it is the provider of the mortgage who requires it, not the gov't.

Car insurance, too is not compulsory, unless you want to drive a car on state-maintained roads. There are millions of people across the country who have no car insurance payment. Hell, you could buy a moped and also avoid insurance, IIRC. And then, the nature of the car insurance is not that it is covering you or your car. In fact, you can easily purchase insurance that would pay absolutely nothing if you rammed your car into a tree and totaled it (assuming the tree was not appreciably damaged). The reason we have car insurance mandates for drivers is not to cover the driver (and it's certainly not for a "greater good"), but rather to cover the damage the driver might do to others by virtue of driving a car on state-maintained roads and to force someone to be responsible for that risk. If you can't afford the insurance yourself or you can't convince someone to insure you, then you probably shouldn't be driving in the first place. It's not a matter of being noble or pushing for the "greater good." You crash your car into a school from a state-maintained road, and you better believe the state will want you to pay for it. it's the cost of having the privilege of driving on state roads. And, again, if you want to opt-out of car insurance, you can: just don't drive a car on state roads. Drive it in a field, in the woods, whatever, just don't drive it on state roads and you're good.

Contrast this with health insurance, where there is no "opt-out," other than to quit breathing. The ability to choose whether to be in or out of a market is a fundamental and necessary part of a market being free. The motivation for such a mandate is understandable, but that doesn't change the fact that the existence of such a mandate makes it laughable to call our healthcare system a "free market." Plus, the only reason we might even need that mandate is due to previous gov't intrusion in the healthcare market, where, regardless of whether you think it's a good idea or a bad idea, we mandated by law that hospitals treat any and all people who come into their doors, regardless if that person pays or not. There is nothing fundamental to the work of a hospital that makes this necessary. Name me any other part of our economy where you can refuse to pay and still consume a good or service, no questions asked. Any example you come up with is most certainly NOT a free market. Again, I don't care if you think this provision was a good idea or a bad idea, it is clearly another instance where our healthcare system is nothing resembling a free market. Moreover, it shows how, time and time again, gov't intrusions into markets beget more and more intrusions due to the side effects and disturbances caused by the previous intrusions.


As aside to the hospital mandate, I think it was only necessary due to previous gov't intrusions which helped entrench insurance as the primary method of payment, putting hospitals in a tough spot to price in the charity they would otherwise have performed, due to the difficulties of insurance providers and repayment calculations. We see similar problems with doctors not being able to offer discounts for patients paying cash due to the effects it has on insurance repayments. I think hospitals would gladly provide that charity if they could, and they would do it in a much better way than they now do under the mandates. Likewise, I think doctors would gladly provide similar services for free (as they have done so in the past) to the needy. And I think that the main reason that doctors and hospitals don't do it is because they can't price it into the current payment system without harming themselves, and they can't price it in because we have a market that has been so distorted by gov't intrusions, no matter how well-meaning those intrusions may have been. Likewise, I would have no problem going to a provider who priced things a little higher so that he could provide free services to those who needed it. I would likely seek such a provider out. But that is world's different than having gov't mandate such things, or attempt to do that itself through higher taxes or prices or whatnot; one is free market, and the other is not, and that affects how successful such a program could actually be.

12/30/2014 9:00:00 PM

Quote :

"Oh, no it is majorly different than car insurance or homeowner's insurance. Homeowner's is not compulsory, unless you want a mortgage, and then it is the provider of the mortgage who requires it, not the gov't. Car insurance, too is not compulsory, unless you want to drive a car on state-maintained roads."

Anyone with half a brain would stop reading right fucking here. This is the mental (infant) gymnastics that you're contorting yourself into to draw a distinction between what is compelled and what isn't? You're taking the next two NEEDS on the top of the American list after food and health and trying to say they are optional in our society? Get the fuck outta here with this tripe.

12/30/2014 10:46:37 PM

Quote :

"Health Insurance is similar in that poor people do not buy it, but they still use hospitals, ambulances, and other medical resources they just do not pay the bill meaning the rest of us pick up the cost."

They don't "use" it because that verb would imply that they made the decision. When a near-death homeless man is picked up by an ambulance, it was the bystander who called, the politician who wrote the law, the 911 operator, etc who made the decision to commit those resources.

In a much more limited sense, some people make decisions to not get minimal coverage because they have a societal assurance that their life will be saved when necessary. This is a trite fraction of the cases and a completely hollow argument.

Asking someone to pay the bill after you "save" them is false generosity.

Quote :

"And, again, if you want to opt-out of car insurance, you can: just don't drive a car on state roads. Drive it in a field, in the woods, whatever, just don't drive it on state roads and you're good."

And what does the state pay for the privilege of eminent domain power to build those roads? Citizens have rights to use of collective resources like this. By the end of this century I suspect that "privilege" will become a pejorative in all of its uses.

What burro gets wrong is that he thinks that he has a conservative position, but opposition to the individual mandate is the proper kind of collectivist stance. There is a flow chart, if you will, for how to deploy medical resources for people in peril. Either you accept a "no questions asked" approach to emergency services or you don't. If you accept the former, then you are a collectivist and you have no choice but to fund those operations from the general funds of the governments, NOT through other consumers of medical services. To say that we'll pick up anyone in an ambulance, but then demand that everyone support their consumption of these services... that is to fake left but veer right. The first part is collectivist/leftist/liberal/progressive but the mandate used as a band aid is rightist/conservative. In fact, it's a matter of restitution where the elites (those who control capital, infrastructure, means of production) demand the poor-off to pay for the services. People whose life is in danger and lack the ability to pay are clearly some of the worst off we have.

In fact, it is so difficult to get recognition of this point that I did make a flow chart.



The terrible option is the status quo. I don't strongly care which of the 2 consistent boxes burro wants, but if you're asking me, I have a slight preference for the liberal, collectivized option, which is the "left left" option. Burro articulates the "right right" option somewhat.

Quote :

"we mandated by law that hospitals treat any and all people who come into their doors, regardless if that person pays or not. There is nothing fundamental to the work of a hospital that makes this necessary."

Clearly this is opposed to the status quo with a favoring of rightist option. But given that we have the emergency services at all, given that democrats are going to pass a bill which lifts the burden from other hospital patients (which is clearly in the right), I think that there should be no choice but to accept genuine collectivization of the costs.

Quote :

"You're taking the next two NEEDS on the top of the American list after food and health and trying to say they are optional in our society?"

The only actual statement that came out of this comment actually proved the point it was arguing against. Home ownership is a need, ok, I'll accept that. Sure you can rent, freedom of ownership is necessary for economic freedom to establish a place of residence, yada yada. His entire point is that you are not forced to buy insurance on your house.

12/31/2014 10:39:13 AM