getting about time to take up arms

3/27/2012 5:33:27 PM

Yeah, fuck helping other people.

3/27/2012 5:40:09 PM

Electricity is price-controlled to protect citizens from what would otherwise be an entirely unregulated monopoly. Similarly, hospitals are usually complete monopolies in an area. Therefore the price of every service they offer should be set by the government.

I'll be glad when this weak healthcare law is overturned so we can get busy really regulating things.

3/27/2012 5:51:23 PM

Quote :

"It's amazing to me how many people think that voting to have the government give poor people money is compassion. Helping poor and suffering people is compassion. Voting for our government to use guns to give money to help poor and suffering people is immoral self-righteous bullying laziness. People need to be fed, medicated, educated, clothed, and sheltered, and if we're compassionate we'll help them, but you get no moral credit for forcing other people to do what you think is right. There is great joy in helping people, but no joy in doing it at gunpoint."

-Penn Jilette

3/27/2012 5:52:00 PM

Quote :

"Yeah, fuck helping other people."

No one is going to pay for my higher premiums when I'm older. Where is that written in the contract?

They'll make us pay now and the rest of society can ditch my age group at some later point whenever they feel like it. The baby boomers are a large voting block, we won't have the same luxury when we're older. If you want to write a formal agreement that we always distribute the cost, guaranteed for a whole god dammed generation, then we might have something to talk about. But until then, paying into the "shared risk" pool means you are a



That's right. That's what our age group is right now.

3/27/2012 5:55:47 PM

@disco_stu

What are we supposed to take from the quoted article? That people give health insurance will have health insurance? If anything, it is a condemnation of the group that was provided access to Medicaid. Only a quarter of them took it.

Quote :

"I'm having a hard time accepting the claim that being healthy young has absolutely no causal relationship with being healthy old. Or that being unhealthy young has absolutely no causual relationship with being unhealthy old."

Agreed. That isn't what I was trying to say. I was attempting to put the short-term benefit of having healthy people "on the books" in context with the potential long-term benefits of regular health screenings in a group that may not otherwise have those screenings. I would suggest that the former is much more important to the validity of the ACA. I also think you are missing the point a bit here, overestimating the potential benefit of those regular screenings, even if people would, in fact, receive them.

Quote :

"Seems like common sense to me. Isn't the point of physicals to establish whether your current lifestyle will result in the kinds of health problems to which you're referring?"

Sure, but people who work in the health care field will tell you that patients regularly simply do not take their health care providers advice on such matters. It isn't that people are unaware of the benefits of being at a healthy weight, having controlled cholesterol levels, or not smoking ...

3/27/2012 5:59:24 PM

Students should be drafted from the general populace to undergo medical training with no right of refusal.

Anyone accepting government healthcare assistance should be required to submit to dietary monitoring and daily physical training.

[Edited on March 27, 2012 at 6:05 PM. Reason : .]

3/27/2012 5:59:53 PM

http://www.npr.org/2012/03/27/149465820/transcript-supreme-court-the-health-care-law-and-the-individual-mandate

There's no way this shit doesn't get overturned. Verrilli is a bumbling fool.

3/27/2012 6:27:22 PM

Supreme court justices sit around and have shitty arguments all day just like we do. Only they are GODS.

[Edited on March 27, 2012 at 7:56 PM. Reason : .]

3/27/2012 7:47:40 PM

one justice hinted at this today, but the absurdity of claiming that "healthcare isn't like other industries because you are already in the market" is due to the fact that CONGRESS MADE IT THAT WAY. Congress fucked up the market in a way that everyone knew would fuck it up, so now the only solution is for the gov't to tell you you now have to buy something. The only solution to a law being in existence is not to repeal the law, but for Congress to make a massive power grab. what. the. fuck.

3/27/2012 8:22:27 PM

Quote :

"What are we supposed to take from the quoted article? That people give health insurance will have health insurance? If anything, it is a condemnation of the group that was provided access to Medicaid. Only a quarter of them took it."

The study suggested that having insurance meant more trips to the doctor for preventative care than otherwise. It also suggested that having insurance meant more healthy than otherwise. Your claims that there will be sweeping underutilization of insurance don't hold water.

Quote :

"Agreed. That isn't what I was trying to say. I was attempting to put the short-term benefit of having healthy people "on the books" in context with the potential long-term benefits of regular health screenings in a group that may not otherwise have those screenings. I would suggest that the former is much more important to the validity of the ACA. I also think you are missing the point a bit here, overestimating the potential benefit of those regular screenings, even if people would, in fact, receive them."

addressed above

Quote :

"Sure, but people who work in the health care field will tell you that patients regularly simply do not take their health care providers advice on such matters. It isn't that people are unaware of the benefits of being at a healthy weight, having controlled cholesterol levels, or not smoking ... "

While we're having anecdotes, both my father and father-in-law quit smoking and changed their diet at their doctor's behest.

To d357r0y3r: I know you and Penn Jilette want to make a world where if for some reason the altruism of people can't cover poverty, then fuck poor people. Do you think they'll just quietly die somewhere?

Additionally, if you're throwing a fit about having to pay money for social programs now, why should I be convinced you'll donate a penny unforced? Being against the way our government spends our taxes to kill people is one thing, but being against our government spending our taxes to help the disadvantaged? I don't think you nor Penn Jilette have the moral high ground on this issue.

The key in that quotation is "if we're compassionate". Funny, he doesn't say what will happen if we're not.

3/27/2012 8:26:52 PM

Quote :

"Additionally, if you're throwing a fit about having to pay money for social programs now, why should I be convinced you'll donate a penny unforced?"

so, you are saying that you should be able to dictate that he pay because you don't trust that he, or someone else, will? that's straight up tyranny there, dude. The whole point of charity is that it is given freely, not coerced at gunpoint. What you are saying is that you feel entitled to his paycheck, and you will do whatever the fuck you can to take it. FUCK YOU.

Quote :

"To d357r0y3r: I know you and Penn Jilette want to make a world where if for some reason the altruism of people can't cover poverty, then fuck poor people. Do you think they'll just quietly die somewhere?"

Well, what happened before? Right, people did engage in charity. doctors found ways to deliver treatment to people, as did hospitals. People were able to give care to those they felt were truly needy while refusing those who were just looking for a handout. Instead, you had Congress get in and try it your way, and prices, predictably, skyrocketed, making the situation WORSE. But yes, let's have more of the problem, that'll surely work this time!

Quote :

"Your claims that there will be sweeping underutilization of insurance don't hold water."

Except for the fact that we see exactly the opposite in Medicaid. Those getting free care don't give a fuck, because they aren't paying for it. Instead, what we may well see is more people making appointments and never showing up, thus leading to MORE scarcity in healthcare for the people who are actually paying for it.

3/27/2012 8:58:15 PM

Yes, taxes are tyranny.

Quote :

"Well, what happened before? Right, people did engage in charity. doctors found ways to deliver treatment to people, as did hospitals. People were able to give care to those they felt were truly needy while refusing those who were just looking for a handout. Instead, you had Congress get in and try it your way, and prices, predictably, skyrocketed, making the situation WORSE. But yes, let's have more of the problem, that'll surely work this time! "

I mean, I'm not an expert on history, but didn't people die a lot earlier "before"? Wasn't there rampant crime in the frontier "before"? Was life so much better "before"?

Quote :

"Except for the fact that we see exactly the opposite in Medicaid. Those getting free care don't give a fuck, because they aren't paying for it. Instead, what we may well see is more people making appointments and never showing up, thus leading to MORE scarcity in healthcare for the people who are actually paying for it."

One of us cited their claim.

3/27/2012 9:45:09 PM

Ha ha. The penalties in the law are largely voluntary because the law specifically prevents the IRS from any recourse when someone refuses to pay the penalty other than deducting it from your refund check. As such, everyone, just refuse to get insurance until you are sick, adjust your withholding to make sure you owe every year, and then refuse to pay the penalties to the IRS. Bravo.

http://reason.com/blog/2012/03/27/if-the-penalty-for-uninsured-taxpayers-s

3/27/2012 11:00:47 PM

Ha! Yes so funny. Let's pretend to be safe because of some loophole that can be filled later on.

3/28/2012 1:17:58 AM

No really, how is this different from raising everyone's taxes, then giving tax breaks to people with insurance? Doesn't that sort of thing happen all the time?

3/28/2012 8:04:31 AM

Apparently it costs $600 to get tested for a few common STDs. Holy hell

At least I know I don't have the clap.

3/28/2012 9:23:32 AM

Quote :

"Well, what happened before? Right, people did engage in charity. doctors found ways to deliver treatment to people, as did hospitals. "

The vast majority of the population lived in squalor and died before the age of 40...

3/28/2012 10:05:34 AM

Quote :

"Apparently it costs $600 to get tested for a few common STDs. Holy hell At least I know I don't have the clap."

If you paid yourself a $300 insurance premium every month, that would only cost you 2 months premium and no deductible.

[Edited on March 28, 2012 at 10:58 AM. Reason : .]

3/28/2012 10:58:15 AM

At only $300 a month, you too could afford a single round of cancer treatment after only 2 years! Self-insure today!

3/28/2012 11:06:06 AM

Nobody said you have to pay your medical bills all at one time.


If you ring up a $1,000,000 bill, you don't pay yourself a premium, you just pay the bill $300 for the rest of your life. As long as you make a valiant effort to pay your bill based on your income, you'll be safe from the hospital suing you.

3/28/2012 11:13:22 AM

And how do you think the hospital will go about making up the costs you can't pay despite your "valiant effort to pay your bill based on your income" ?

3/28/2012 11:17:12 AM

Overcharging.

3/28/2012 11:20:48 AM

Simple. Communize the entire medical labor field, revoke all medical patents, collectivize pharmaceutical manufacturing and the costs will simply disappear. If it drives innovation overseas, so be it. We have sufficient medical technology now in most cases that is simply wasted because the majority of patients can't afford it. Let the foreigners do the R&D, we'll just steal it like communists have always done.

3/28/2012 11:20:52 AM

Quote :

"Overcharging."

Oh okay, cool, your model sounds way more cost-effective and manageable than people simply pooling their risk together through public or private insurance programs. Definitely.

3/28/2012 11:26:48 AM

Quote :

"people simply pooling their risk together "

What do you not get about the resistance to this? Your idea of pooling risk together means one group of people paying less than the value of the product they receive and the other group paying more.

Let me reiterate my reaction to this: "no"

[Edited on March 28, 2012 at 11:38 AM. Reason : ]

3/28/2012 11:37:16 AM

Quote :

"What do you not get about the resistance to this? Your idea of pooling risk together means one group of people paying less than the value of the product they receive and the other group paying more."

That is literally the definition of "pooling risk". If you knew in advance which group you'd be in, there would be no risk to pool.

3/28/2012 12:12:38 PM

I'd rather pool my risk with people will help bring down my premium. I don't want to pool risk with obese people, old people, smokers, etc. Those people are likely to be very costly to the insurance company.

You do have some idea of what group you're in. No, you don't know if you're going to get hit by a bus or get cancer, but these are low risk, high cost scenarios. If you're fat, you smoke, and you never exercise, you're going to get diabetes or heart disease on a long enough timeline. Those people should have to pay higher premiums. I want to shop for insurance that calculates the risk I present and charges me an appropriate premium.

Yes, you could make the argument that everyone will be old, therefore everyone will benefit from paying in. It's just not true. Old people do have more health problems, but these problems can be the consequences of a lifetime of bad choices. You can sometimes get away with being obese for the first 40 or 50 years of your life. After that, shit will go downhill fast. There are 80 year olds that are healthier and actually present less of a liability to the insurance company than 35 year olds.

I know - it's just not fair that healthy people pay less. Everyone should pay the same premium and the same costs, even if they're 500x the burden on the system than others.

[Edited on March 28, 2012 at 12:38 PM. Reason : ]

3/28/2012 12:35:17 PM

Quote :

"If you knew in advance which group you'd be in"

We know this in some senses and don't in others. Insurance sets prices based on the known information about your medical risks, not based on the unknown information. That unknown information about your medical cost liability is the very purpose of insurance.

However, I know if I'm young versus old. There is also no real way to buy insurance (other than "self insurance") for my risk later in life now. Such lifetime insurance does not exist and never has. When I get older my premiums will rise and there is nothing I can do about it.

Again, when I get older my premiums will rise and if I don't like this fact I am SOL. I perceive your argument to be that I pay more under the promise of lifetime guarantees that I don't believe.

The state of health insurance is truly very sad today. It wouldn't be such an insult that administrative costs take up so much of the premium if not for the fact that even when they pay, it's not more than like 80% for most people with normal insurance plans. People who are insured are still at risk for the same things, and our government has increased the price of health care so much across the board.

It's not that I have a problem with the idea of paying premiums to mitigate risk. My perception is of that the money is mostly just wasted, and at the end of the day the system won't take care of us when we need it.

In the end everybody dies alone

3/28/2012 12:37:58 PM

Quote :

"I'd rather pool my risk with people will help bring down my premium. I don't want to pool risk with obese people, old people, smokers, etc. Those people are likely to be very costly to the insurance company."

They are costly to the insurance company whether they are insured by it or not. When uninsured sick people go to emergency rooms and can't afford it, you pay for it. If you really, really cared about keeping costs down, you'd either want to end the policy of emergency rooms not turning away people, or insure everyone for at least basic preventative care. Knowing you, I'm absolutely positive you prefer the former.

Quote :

"Yes, you could make the argument that everyone will be old, therefore everyone will benefit from paying in. It's just not true. Old people do have more health problems, but these problems can be the consequences of a lifetime of bad choices. You can sometimes get away with being obese for the first 40 or 50 years of your life. After that, shit will go downhill fast. There are 80 year olds that are healthier and actually present less of a liability to the insurance company than 35 year olds."

Yes, and I once saw a dog that lived to be 25. That doesn't mean I'm going open a 25-year-old-dog-birthday-cake business. You're focusing on what you know to be outliers because it buffers your argument. Any old person who dies from anything except a self-inflicted gunshot wound is going to cost a shitload of money to anybody insuring them, period.

Quote :

"I know - it's just not fair that healthy people pay less. Everyone should pay the same premium and the same costs, even if they're 500x the burden on the system than others."

I never said anything of the sort. You might understand my arguments a bit better if you didn't fill in the blanks in your understanding with strawmen.

[Edited on March 28, 2012 at 12:50 PM. Reason : .]

3/28/2012 12:40:51 PM

I'm tired of paying for people that don't pay for their own insurance.

When an uninsured freeloader shows up at an emergency room, they still receive healthcare that isn't paid for by them.

It gets paid through tax-supported public programs, the health care provider lose profits who then shift the cost to private insurance companies which result our premiums going up!

3/28/2012 12:47:32 PM

Health care costs less than people think.


I just got a minor outpatient surgery done.
I also had an ER visit
I also had a doctor's visit.
I also has a preliminary doctors visit.

I got a varicose vain fixed from my kidney to my leg. I had sedation.

I was uninsured the whole time.


Sentara Hospital sent me a bill for $743. I called today and said I was ready to pay, but before I do, were there any pay in full discounts or cash discounts by paying directly so the hospital could bypass the credit card fees.
She told me there were no cash discounts, but there was a 20% uninsured discount. So it only cost me $592 for the hospital costs.

It only cost me $170 for the ER visit for a separate incident altogether.

My physician/doctor charged $352 for the surgery

The preliminary check up to a physician to get surgery set up was $183.

The preliminary ultra sound was $110 performed at the major hospital.


Grand Total: $1400.

That is only 4.6 monthly payments to yourself for $300 for an invasive outpatient surgery.

While I was on the phone, I was typing this and they gave me another 20% the $170 ER visit for an uninsured discount. More than likely, I can get 20% off all the bills.

It's not as intimidating as people make it out to be.

In fact, even my doctor quoted me $5000 for this whole procedure. That is pretty far off the mark.

3/28/2012 12:53:17 PM

They would have charged insurance $10,000, who would have then paid $5000 as predicted.

Communism is the only answer.

3/28/2012 12:55:35 PM

Communism is not the answer.

The abolishment of insurance is an answer.

It will force pricing wars, like normal competition, competing for your business.

3/28/2012 12:59:14 PM

For anyone who wants more data on medical costs than GeniuSxBoy's self reported anecdote:

http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=274

Quote :

"The abolishment of insurance is an answer. It will force pricing wars, like normal competition, competing for your business."

"In order to create a free market, we must first destroy a free market!"

[Edited on March 28, 2012 at 1:02 PM. Reason : .]

3/28/2012 1:02:05 PM

Quote :

"Health care costs less than people think. I just got a minor outpatient surgery done. I also had an ER visit I also had a doctor's visit. I also has a preliminary doctors visit. I got a varicose vain fixed from my kidney to my leg. I had sedation. I was uninsured the whole time. Sentara Hospital sent me a bill for $743."

This is absurdly disconnected with reality. Go over to Rex Hospital and get these things done, I guarantee you it will be 5 figures. That is, if you can manage to see a doctor in the first place without insurance.

3/28/2012 1:05:24 PM

Based on the arguments today, it sounds like the SCOTUS doesn't feel like going through the entire 2700 page law to decide what else stays or goes if the mandate is struck down. That means it'll be an all or nothing decision and I just don't see them ruling against two centuries of precedent by wiping the entire law out. It'll be 6-3 in favor of the mandate.

3/28/2012 1:05:59 PM

Quote :

"This is absurdly disconnected with reality."

3/28/2012 1:09:53 PM

So, are you saying your claimed costs are roughly representative of those the uninsured can expect?

[Edited on March 28, 2012 at 1:21 PM. Reason : .]

3/28/2012 1:21:08 PM

Quote :

"You signed the social contract..."

lol are you one of those people who wants the ability to opt out of the social contract? have you invested in seasteading, by chance?

it's never free enough!

[Edited on March 28, 2012 at 1:31 PM. Reason : x]

3/28/2012 1:29:28 PM

Quote :

"It'll be 6-3 in favor of the mandate."

How the fuck are you coming up with this? Did you read the transcript?

3/28/2012 1:35:16 PM

Quote :

"So, are you saying your claimed costs are roughly representative of those the uninsured can expect?"

Well you have to do a little research and price shopping like any other case where spending your own money is involved, but generally yes.


Don't be stupid or ignorant when dealing with your money. Have every question answered with a solid foundation to fall back on.

3/28/2012 1:48:02 PM

Quote :

"Well you have to do a little research and price shopping like any other case where spending your own money is involved, but generally yes."

Why do you think "generally yes" ?

3/28/2012 1:48:32 PM

"Generally" because there are a lot of cons out there. The more people are confused about the system the more the con can get away with.

3/28/2012 1:49:43 PM

Explain the "yes" part. What data are you comparing your personal experience to? Typically when someone makes a general statement, they're doing so based on knowledge of...something general.

[Edited on March 28, 2012 at 1:53 PM. Reason : .]

3/28/2012 1:52:28 PM

My sister has a terminal illness, so it's covered by insurance and (my mom and her) don't ask questions about the price of things.

The cost of 1 pill is 20 times more than the cost a customer (us) can get the same pill at Rite Aid.

If you think about it, Rite Aid's regular price is already 2-4 times the price they, themselves buy the medicine. Therefore by the time insurance pays for it, insurance is paying 2 x 20 to 4 x 20 markup = 40times the mark up to 80 times the mark up for one pill.

For example. One pill at cost to insurance is $20. The price you can get the same one pill at Rite Aid is $1. The price Rite Aid buys the pill is 25 to 50 cents.



[Edited on March 28, 2012 at 2:05 PM. Reason : .]

3/28/2012 2:03:28 PM

Last trip to Rex a friend of mine took cost $9,000. That was for 10 minutes with a doctor and a non-ICU stay overnight.

GeniuSxBoY seems to be referring to a functional medical market, which is something I think most Americans are unacquainted with. Small practices offering reasonable and competitive prices for honest services is such a small fraction of the medical industry it's hardly even relevant to this discussion about the state of our national health care and health insurance industry.

3/28/2012 2:03:53 PM

Quote :

"Last trip to Rex a friend of mine took cost $9,000. That was for 10 minutes with a doctor and a non-ICU stay overnight."

Uninsured or insured visit?

3/28/2012 2:06:52 PM

Quote :

"For example. One pill that cost insurance is $20. The price you can get the same one pill at Rite Aid is $1. The price Rite Aid buys the pill is 25 to 50 cents."

There is a story an engineering professor told me. It went something like this.


A company had a specialized machine and it broke. There was only one person who knew how to fix it. They flew him in and he carried a small hammer in his tool chest. He looked at the machine and hit one part of it gently with the hammer and it started working again. He sent an invoice for $10,000 (I think this is an old story, lol) and the company thought it was high so they asked him to itemize it. He sent back an invoice that listed a hit with a hammer for $1, then on the next line, "knowing where to hit" for $9,999.

Quote :

"Uninsured or insured visit?"

Insured, again, I don't even know what you would do if you were uninsured. He still got boned really bad.

[Edited on March 28, 2012 at 2:10 PM. Reason : ]

3/28/2012 2:09:35 PM

I was asking what data you're comparing your experience with the doctor/ER/surgery to, not a tangential story about your sister buying a prescription drug.

That is, do you have any reason to believe that your costs were representative of the country at large aside from "Saying so bolsters my argument."

I have a few anecdotes too though, in addition to the average-cost consumer information on that page I provided before. My girlfriend, for instance, got 3 stitches about a month ago after stepping on some glass at a pool. She's uninsured and had to pay $1100 for a 2 hour visit to the emergency room plus $150 for an x-ray. Of course, we didn't really spend time shopping around, her foot was sort of pouring out blood.

[Edited on March 28, 2012 at 2:20 PM. Reason : .]

3/28/2012 2:19:45 PM