The Glade 4.0

A point of view not espoused by Locke or Hobbes.

So? Are you afraid they're going to come back and haunt us in revenge or something? They wouldn't have been too into the idea that health care is a right either.

Taly's got a strong point - anything we think is a natural right is always codified into law (The Constitution is law, you'll remember). It's largely irrelevant if the rights are natural and merely described by writing or are created as a result of the writing - law ultimately describes the extent of rights. Then of course we turn around and argue what the law says, but either way it's written. It's always open to interpretation and argument - which we can tell because someone is always appealing back to some writer or other.

That said, it's well-accepted that you have a right to something you pay for; no matter your philosophy of rights that seems pretty uncontroversial. The point was made here a while back that in Germany (I think it was) people just go to the hospital or doctor on the basis that they already paid for it. That's part of what makes it viable as a right - people pay their taxes up and down the chain. That creates investment in the system, rather than entitlement.

Americans don't want that. We want some people to pay, and other people to get the benefit because we're addicted to the idea that treating everyone the same is the same as disadvantaging some people. It isn't poor, sick people voting themselves healthcare; it's middle-class people doing it because they feel like they're being charitable with someone elses' money. This is why we're always hearing about "<group_x> health" concerns. We want to split everything into identity groups.*

On top of that, we eat too much and don't exercise enough. This isn't something government action can solve - gigantic fatasses now have their own breed of SJW. We don't want to invest in our own health - we want the rich to buy it for us.

*Obviously there are some health issues that ARE group oriented, such as children, the elderly, and sex-specific issues, but that's a medical reality and treating those as victim groups helps no one.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

I'm not telling anyone anything. I'm pointing out that squealing about fairness to someone that can afford to pay your healthcare for you but giving a pass to someone that can't is mind blowingly hypocritical.

Telling folks on the up side of the median income level that they should be "paying their fair share" yet ignoring the folks on the down side is totally disingenuous. Say what you mean. Tell folks that have bank you don't **** care what they think, you're only going to feel satisfied about yourself when this country goes socialist. Own it.

My family was "poor" (as you would figure it, not how I would), and I was one of five kids that lived, one of eight in total. We lived on someone else's property, and ate meat only a couple of times a week. Rice was the primary component of most dinners. I wore 3 and 4 X hand-me-downs till I was in the army. I busted the ball of my shoulder through the socket, through the muscle sheath and it wound up in my armpit, and I didn't have insurance for medical assistance or drugs to kill the pain. I popped that sucker back in then, and a dozen additional times over the next few years till I was able to get insurance through employment, which was after I gained an education (not a college degree) that allowed employment that provided insurance.

Yeah, it sucks. Boo **** hoo. Not once did I figure that someone owed me ****. You don't **** know "extraordinarily cruel" from **** 'cause you've been a privileged, pampered child all your life.

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In time, this too shall pass.

This.

Further, if you want something to be a right, then follow the process and make it a right the way it's been designed to be changed.

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In time, this too shall pass.

Umm.. that's exactly what Obamacare is doing now. Let me tell you about how many extra lawns Carlos has to cut each week to pay for his mandated insurance.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

This is *not* what I'm talking about, you are completely missing the point. The pre existing condition rule is not the same as the mandate or the subsidies. Yes, the subsidies are an entitlement handout that takes from the upper middle class/rich and gives to the poor, but the rule about pre existing conditions is not.

If you are an upper middle class person working for an employer that provides health insurance, you are immune from being discriminated against due to any pre existing conditions you may have. It is illegal for the employer to discriminate in hiring or firing against you due to your medical conditions, and the group plan is required to offer the same set of coverage options at the same prices to all employees of the company, regardless of how healthy/sick they are. This was the law even before Obamacare was passed.

The pre existing condition rule added with Obamacare simply required the individual marketplace to treat its customers exactly the same way the employer marketplace was already required to do, namely that both must now charge everyone the same price for any given coverage plan. If the rule were to be repealed, then the individual marketplace would be allowed to charge sick/hurt people more money for coverage, but the employer marketplace would still be barred from doing so. An upper middle class person would remain free to demand that healthier, more responsible people subsidize his medical problems, but the working class person would no longer be able to do so. The net result is that the poor would end up subsidizing the health insurance of the rich. This is the inequity to which i am referring.

Then let me repeat back to you what I hear and you can tell me where I get it wrong... seems like half the time you're taking "what is", the existing plan, the other half you're taking about how you think things will play out, pure speculation. So, here goes -

You take from Peter to give to Paul for healthcare

Then you see Tom, Dick and Harry aren't getting what Paul is for healthcare, so you want to dive back into Peter's wallet to make up the difference. Then you figure out that Tom has a pre-existing condition, so you want Peter's wallet to make up that difference too.


You danced around all sorts of conditions and situations and make crap up, but you never touch on the fact that 45% of folks (Paul, Tom, Dick and Harry) don't pay a net positive into federal taxes. They ("the poor" you're talking about) don't contribute to the federal healthcare kitty, so no, they don't subsidize crap. If, heaven forbid, they have some cost at all, you promptly forget they are getting a free ride and start whining about how cruel it is to expect them to pull their own wagon.

When everybody pays their fair share, we can revisit your argument.

The plans from the GOP include high risk pools to take care of those.

http://thehill.com/blogs/pundits-blog/h ... tions-myth

source for the 45% thing:
https://www.forbes.com/sites/beltway/20 ... ncome-tax/

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In time, this too shall pass.

No, you are immune to being discriminated against in the way you cite (stipulating, for the moment, that it is discriminatory, an argument to which I am willing to listen) any time you have employer provided health insurance. My daughter works full-time for $10 an hour - but due to being a full-time employee she's entitled to health coverage under the rules you cited. $10 an hour, however, is not a middle-class wage, upper or lower, even for a single adult with no kids. When I was making $17 an hour as a police officer (which is a major reason I quit being a city cop) I got health coverage under those rules as well, but $17 an hour is not a middle class wage for a man with a wife and 2 kids.

Being upper-middle-class has nothing to do with it whatsoever. It's full-time employment that matters, and that is not limited to the middle class. It is a route to the middle class - my daughter will most likely be well into the middle class by the time she's my age, but she isn't now and won't be for some years.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

I'm not speculating about anything, I'm explaining how it works now and how it would work if the pre-existing condition provision were to be repealed. That's not speculation because that's how it used to work before Obamacare was passed.

At no point was I talking about the moral rightness or wrongness of the mandate or of the subsidies.



We're talking about how we have an overall progressive taxation system in the United States now? This is out of left field, I was talking about healthcare. Yes, you are correct, overall the rich still pay more than the poor overall regardless of what happens with healthcare.

The "working poor" I was talking about are people who have jobs, but don't receive health insurance from their jobs, because these are very low level jobs that don't pay much. They're all part of that 45% that don't pay federal income tax, but they're a much smaller subset of that group.

I'm not making up anything, repealing the pre-existing condition provision of Obamacare would result in the poor subsidizing the rich in that instance. Now, if you consider overall all the other areas of our progressive taxation system, you're right that if you add those in it's still the rich subsidizing the poor overall, but I kind of thought that was obvious. Yes, it's well known that the US has one of the most progressive tax systems in the world, the rich pay far more than the poor do overall. That all has little to do with healthcare, however.



Here is what the TheHill article says:



Yes, this is 100% correct. My point, the one I have been making from the beginning, is that the employer market already works this way. Medicare already works this way. You are complaining that Obamacare causes the individual market to work in this manner, when all other healthcare in the country already functions this way already. The pre-existing condition provision in Obamacare simply caused the individual market to function the way it functions everywhere else. Why should the individual market, the one that serves the generally poorest individuals, be the special snowflake exception where the healthy do NOT subsidize the sick?

Well, you're right that it's linked to having employer-provided health insurance and not being "upper-middle class." Like, you could make a totally reasonable argument in favor of not having any pre-existing discrimination protections at all, in any of the healthcare markets. That would also be fair and equitable, because everyone would be getting treated the same. What's ridiculous, however, is returning to the pre-Obamacare status quo where the individual market did not have these protections while the employer market still did, that is what is grossly unfair.

X, I've tried to create a post that addresses each and every individual item you touched on, but it resulted in so many diversions to previous comments that it quickly became unwieldy. I'll just hit on the salient remarks -

You said it yourself, and I agree with you on this:

It's ludicrous, but it's today's reality. You've touched on my issue nicely.

Then, you seem to take particular exception with the prior condition issue, and how the employed have it better than the unemployed.

Employer sponsored group plans and Medicare are earned benefits. Medicaid isn't, and Obamacare IS medicaid. It's not discrimination that you have more when you earn it. There's a really old saying that's politically incorrect these days, but that's just another indication of what's wrong with the system... "beggars can't be choosers".


https://www.medicaid.gov/affordable-care-act

Please, though, let me apologize for my comments in that earlier thread. They weren't called for. I can't take them back, and removing them wouldn't be honest.

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In time, this too shall pass.

If a person earns money and goes out and buys health insurance with that money rather than purchasing it through their employer, I don't see why it's any less of an earned benefit than Medicare or an employer group plan. They earned the money that's going to pay for the health insurance.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

You may have a point here. However, I would also point out that individuals cannot wait until they get sick, then decide to purchase employer health coverage. Such coverage can usually only be purchased A) upon initial hiring, or a substantial job change (promotion, for example), B) upon a qualifying life event such as marriage or birth of a child, or during a designated "open season" period. Therefore, the insurance company has some protection against people not paying into the system until they are already sick or injured. There is an incentive to purchase it when it's available, not only when you need it.

Private plans do not, as far as I know, have such limited opportunities to purchase or alter coverage.

This seems to address the idea that it's "grossly unfair". I'd be willing to entertain the idea that this isn't sufficient to make the two situations fully equitable, but I think the dissimilarities are such that "grossly unfair" is an overstatement. After all, when a person claims they can't get coverage for a pre-existing condition there's a legitimate question of "why didn't you get it before the condition arose?"

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

It's a benefit as compensation for a voluntary association. Someone wants veterans benefits, they need to join one of the branches (a loose example, since folks were drafted, but still). If you wanted something equivalent to employee benefits prior to the ACA, you had to work for an employer that offered them. It's not discrimination if you didn't have them because you couldn't or didn't want to do what you had to do to get them, nor is it discrimination if you weren't chosen by an employer or the military even if you really really wanted to be. Also, prior to the ACA, an employer didn't have to offer insurance at all. Still not discrimination.

HIPAA changed the rules a bit in 1996 by requiring employee health insurance plans to offer insurance for pre-existing conditions - a group health plan could not impose a pre-existing condition exclusion if the person had creditable medical coverage for at least 12 months as long as the person had no more than 63 days with no coverage.

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In time, this too shall pass.

How is getting paid for doing work not a benefit of a voluntary association?

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

It is. So is paid vacation, perhaps a company car, or other monitary compensation. An insurance benefit is distinct from your pay, just as those other benefits are distinct. Still not discrimination if they're offered or not, and an employer can offer different benefits to different employees, still not discrimination. People get differing amounts of pay, still not discrimination.

The "voluntary" aspect of the relationship is significant because you aren't, and your employer isn't, compelled to engage in it (until HIPAA and ACA, anyway, and only then in certain circumstances). I have a pension with the company I work for, as well as a matched 401k. Most others don't have those same benefits, still not discrimination.

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In time, this too shall pass.

Actually no - the voluntary aspect is not significant at all since all employment in this country (with the possible exception of punishment for crime) is voluntary. That's a baseline assumption. We don't need to even reference it.

In every job I have had*, money you pay for health insurance is withheld from your paycheck by your employer and forwarded to the company along with their portion of the payment. If you opted out of it, you would have a larger net paycheck.

I am not clear on how that is meaningfully different from insurance purchased directly without the intervention of the employer - or more specifically, I already pointed out the difference. Employer health insurance can't just be picked up whenever the employee wants to buy it, but only at designated points in time. There is incentive, therefore, to purchase it before it is needed.

But I don't see why it being a "benefit" should subject it to different government rules than being purchased by the employee. I wasn't referring to whether they are offered in the first place, nor the relative pay of different employees and I don't see what they have to do with the matter at hand.

While I'm not yet convinced by Xeq's point, the fact is that he is bringing up an argument that deserves serious consideration and examination, not outright rejection as leftist nonsense. This is true both on the merits of the argument and as a matter of the general improvement of Xeq's quality of argument, so I'd like to hear why it matters that health insurance was bought directly rather than through an employer program.

*I'm exempting the military, both active and reserve here, since the provision of healthcare by the employer is a necessity, and entails the power to compel the employed to accept it. Medically fit personnel are absolutely necessary to generate combat power, and therefor military healthcare never enters the debate.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

The main reason the pre-existing condition discrimination protections work on the employer market but don't work on the individual market under Obamacare is not because employer based health insurance can only be purchased at specific times, but because the mandate under Obamacare is insufficiently punitive to force healthy people into the exchanges. The penalty for "opting out" of health insurance in the employer marketplace is enormous, that's why even healthy people don't do it.

My job charges a single person $28/pay period for health insurance. $60/month does not, to put it mildly, come anywhere close to covering the average annual cost to the company to pay for the health care of a single person, it probably doesn't even cover 10% of the cost. So as a person in the employer marketplace I get to pay $60/month in order to receive a benefit that has an average value of (for example) $10k/year. I can opt out if I want and keep my sixty bucks, but to do so I have to leave $10,000/year in value on the table, and thus pay a "penalty" of $9,280 that year for not having health insurance. Obviously, I'm not going to do that.

Now, $10k/year is just the average value of the healthcare when all the sick people are included. However, the deal is so good I'm still going to take it even if I'm healthy. Let's say for an extreme example that for a very healthy person, the healthcare is only worth $1k/year instead of $10k/year because they're so healthy and don't expect to get sick. Well, they're only paying $60/month for it, it's still a good deal so they still do it.

Now let's say I don't get insurance from my job and need to buy it on the individual marketplace. Now instead of paying $60/month, I have to pay a fair price for that $10k/year in average value so I'm going to be stuck paying $600/month instead. If I'm a healthy person such that my annual average healthcare costs are only $1k, I'm obviously not going to buy in. I'm going to eat my $300 mandate penalty and spend $1,300/year on my health care rather than spend $7,200/year. The mandate just isn't anywhere near punishing enough to force me into the insurance market. Even if I am a very poor person and get an 80% Obamacare subsidy on my premiums, it's still not worth it. This is why the exchanges are unstable, healthy people just aren't buying in. Trumpcare would have been even more of a disaster in this regard. Now instead of that 80% subsidy (which might make it worth it to buy in) I get a $2,000/year flat tax credit, and the mandate is gone. With health care costs being what they are, a mere $2,000 annual subsidy means I'm going to nope right the **** out of buying health insurance if I'm even slightly healthier than the median. The idea of providing pre-existing condition discrimination protection without a mandate is so absurd I could not believe the Trumpcare bill actually attempted to do this, it's total nonsense. Obamacare is failing because the penalty wasn't harsh enough, they wanted to try it without one.

So, now the question is, why do employers cover >90% of the health care costs of their employees? Well, it's because the government provides absolutely massive incentives in the form of tax breaks and outright handouts to the employers in order to get them to do so. This is why I don't regard "fairness" arguments complaining about the Obamacare subsidies as being very credible, because everyone else is already being massively subsidized. I find it quite awful when a person on the employer marketplace, who due to massive government handouts and corporate tax breaks receives his healthcare at less than 10% of the cost of providing it, then proceeds to complain that poor people also get healthcare subsidies. Before Obamacare, the employer marketplace got huge government handouts to bolster it, as well as discrimination protections, while the poor people on the individual marketplace got jack ****. How is it "unfair" for Obamacare to also provide them with subsidies, considering everyone else was already getting them?

The same goes for the characterization of Medicare as an "earned" benefit and Medicaid as an "unearned" one. To a very limited extent that's true, as Medicaid is a pure handout and Medicare is something you did pay SOME money toward, but the fact of the matter is Medicare is >$500 billion/year in the hole for a very good reason, and that's because that 2.9% taken out of everyone's paychecks to pay for it doesn't even pay for 25% of Medicare's total costs. Medicare is very much an unearned handout borne from the redistribution of wealth from rich to poor people and federal deficit spending, just like any other entitlement handout.

It's the most relevant part of the issue, since it's the crux of the change the HIPAA/ACA laws introduced, and what X claims will amount to discrimination if/when repealed. There's no more "voluntary" employment insurance benefits, there's government regulated benefits. Yeah, of course you think it doesn't need to be referenced, it totally undermines your argument.

So, pre HIPAA/ACA:

Employers negotiate with insurance underwriters to provide group insurance policies they provide to their employees. Those are part of the total compensation package, not a "right" government requires be provided, it's an earned benefit. It's the result of negotiation using the leverage the company can bring to the table because of the scope of the dollar amounts involved. Big companies have greater leverage and as a result can offer better policies to their employees. If you want to bring rights into it at all, it's a benefit of right of association.


You as an individual don't have that leverage, so you don't get that same deal. You may earn your money, but you haven't earned it in association with someone who provides you the benefit of sweetening your compensation by making a group insurance policy available. Other than the regulations required from employer offerings such as this, the government wasn't involved, and those regulations don't require that everyone gets the same compensation package - there are regulations saying you have to offer identical compensation frameworks to categories of employees... if you offer one full time employee insurance, you have to offer all full time employees insurance, but an employer can offer different packages to part time employees, or the officers of the company than it does the rank and file, for instance. None of that is discrimination.

So, an employer could offer policies that allowed pre-existing conditions - or not - and/or the insurance companies could offer - or not - to cover pre-existing conditions.

Thing is, your personal experience (pre 1996) was exactly the same. You could have negotiated for pre-existing conditions with an insurance company, and they could - or not - offer you a policy. It's a business transaction. If you wanted a contract that offered to cover more costs than you pay for premiums though, I doubt that you'd have gotten it.

And that's the bottom line, isn't it? People who are sick with conditions that cost a lot of money want someone else to carry their load. They want something of value for little or no exchange of value, and they want the government to provide the economy of scale they don't have for themselves.

My gripe is, when you do the math and point out the facts, you're considered cruel by those that aren't on the resource side of the equation. It's all "you have to pay your fair share" when the other guy is handed the dirty end of the stick, crickets otherwise.

Post HIPAA/ACA:
The jury is still out. The entirety of ACA won't kick in till 2020, and that legislation is under review. Nobody knows what's in store.


When you do the math, please include the result of compound interest on folk's contribution. People have been paying for medicare since 1965, and today it only provides about half of the medical costs of folk's over 65, who are projected to draw from the program a total of about $120,000 for the average person. So, go ahead, figure out what you'd have to put in every year for 50 years to get that $120,000 back. Your theory that people haven't earned every bit of that is bunk.

the numbers:
http://www.ncpa.org/pub/ba660
http://pages.stern.nyu.edu/~adamodar/Ne ... retSP.html

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In time, this too shall pass.

You're not, however, actually leaving anything on the table if you don't take the offered health insurance other than the health insurance. There's no way for you to convert that value into anything else. In fact, even if you do take it you don't actually get that value unless you use enough services to cost at least $10,000.

If there were no limitations on the ability to sign up, you could have it both ways. You could keep your $60 a month and sign up as soon as you had some medical issue that was going to cost more than a trivial amount.

Also, $60 a month seems remarkably low to me even for a single adult, but not so low as to change the nature of the discussion so...



Which you're going to do because if you don't take it now, you may not be able to get it when you actually do end up needing it. Obviously, some people would take it up front just to keep the hassle to a minimum, but a lot of people would opt out of the coverage until they needed it.



Yet there's not a mandate for employer insurance, and as I just explained, if there was no limitation on ability to purchase you'd have a lot of people opting out of coverage until they needed it.

We already understand why people aren't taking the mandated insurance and choosing to eat the penalty. The problem isn't with pre-existing conditions per se; it's with the ability to sign up when you get sick rather than having to wait for "open season". If people knew that open season was in October and only October and they might end up in a wreck or with cancer in January, they'd be more inclined to take it while they could get it.


Well, first of all the subsidy isn't his. It's his employer's. The employee has a chocie - pay 10% or so and get (potentially) 10x that much in health services value, but only in health services, and only if he actually needs it. The health coverage is compensation just like any other benefit is; if he foregoes the benefit he's foregoing some compensation. The company gets to keep that money then, essentially as a windfall, because it was part of the cost of having the employee that they lucked out and didn't have to pay if he decided to do without.

Second, the employer-provided healthcare person can't - as I pointed out - freely come and go from his insurance. The public buyer can. Public buyers tend to suddenly appear wanting to pay when they need the service, just like that idiot a few years back who only wanted to pay his fire fee when his house was burning down.

These people jack up the prices for everyone. Money is money to the insurance company. When costs go up because a bunch of sick people can suddenly get insurance when they need it and not before, they have to make up that cost somewhere - out of the pockets of the employers and employees buying plans. This is why, if you liked your plan, you could not, in fact, keep it.

The unlimited ability to sign up when you have a pre-existing condition is the problem. People used to complain that pregnancy was a "pre-existing condition" as if that were somehow absurd. Well, the reason is that it can cost $15,000 to have a baby, or more, and that's just for the hospital birthing stay. Otherwise healthy women would be able to sign up as soon as they got pregnant, and even at $600 a month over 9 months that'd be a cost of $5,400 versus $15,000 for the hospital before we even talk about pre-natal care, then drop the coverage when the baby was born or shortly thereafter. This is just one example; any high-cost pre-existing condition causes this problem. Unless the problem is permanent. In that case, the person may stay on the plan but the company is stuck paying the costs.

"Pre-existing condition" is a highly misleading term because it lumps all pre-existing conditions together. I have a pre-existing thyroid condition, which can be treated with a dirt-cheap medication; it's about $12-$15 a month without health coverage. An insurance company looking at me isn't looking at the same thing as "hundreds of thousands of dollars in cancer treatments" and it isn't like I'd get insurance just to cover this cost - I can pay for an annual checkup and the medication just fine. But, in the public debate, my pre-existing condition is the same as "hundreds of thousands in cancer treatments."

This could be solved by limiting the ability to purchase upon discovery of a major medical condition. What, specifically, that limitation would look like is up for debate, but the only other real solution would be ruinous, absurd tax rates of the kind Europe has, and can only maintain because they aren't paying the bills for defense. That $300+ billion bill for NATO that Trump didn't actually hand to Angela Merkel should have been paid before anyone was allowed to set foot in a hospital for publicly-paid healthcare, and the fact that it wasn't is how Europe is able to maintain this fiction that a welfare state can actually work.



If you want to argue that 2.9% is too low, there's room for that argument (it's low enough that it could be raised a bit without Euro levels of tax absurdity) but the fact is that there's a huge difference in "redistribution" and "entitlement" you are paying something for and one you are paying nothing for.

"redistribution" is a dirty word on the Glade, but in reality the average American is fine with redistribution towards those who A) can't work or B) did work, but not towards those who C) won't work. Medicare is limited to B), and there's no way to cheat into it - you can't make yourself old any faster. Medicaid is for A). The problem results from people who fall into C)* trying to represent themselves as belonging to A). Any time you put a benefit out there, people look at the rules and try to figure out how to get the free ****, and there's an endless stream of reporters, virtue-signalling activists, and concerned suburbanite soccer moms ready to demand they be given access so they can feel like they "made a difference".

The VA is like this too - even more so. It's not an accident that the most screwed-up part of the veteran's system is the healthcare. There's those sweet disability payments you can get if you just go to the doctor and claim the right parts of your body hurt. The system that is there for those that tore themselves up badly over 20 or 25 years or who got a leg crushed by a 5-ton truck or six concussions in Iraq or a leg blown off is overrun with kids who were in for 3 or 4 years trying to qualify for disability payments. When I take my PT test I'm surrounded by people 10 or 20 years younger than me, and a huge number of them have a profile saying they "can't do pushups", "can't do situps" or "have to take an alternate event rather than the run"**

The system, therefore, is overrun with people who are really just there to try to claim the disability payments. For all the jumping up and down and screaming about the VA's ineffectiveness and incompetence (both of which are legendary), it's only exacerbated by caseload and cost from people trying to game the system.

This is what people like Taskiss do not want in the non-Veteran's healthcare system - people gaming the system and not legitimately putting in at all. If we jacked the penalty up to the point that it was punitive enough that people were really economically forced to get health insurance, we'd have a new source of outrage, that poor people were having to make this "horrible choice" of a massive tax penalty or a massive insurance bill, particularly those people just not-poor enough to not quite get subsidized***. Instead, we have people waiting until they need the insurance because something happened, then claiming the subsidy, or else just buying the coverage as long as they needed and then ditching it, and sticking the company with the bill which gets passed on to Taskiss in the form of him not, in fact, getting to "keep his plan".

No system will ever work until and unless the public has some obligation to it. That could be a larger penalty, a purchase restriction, an understanding that they need to do their part to stay healthy and keep costs down, something, but any system is going to be a disaster as long as we allow individual people to parade on TV whining about how tough it is that the whole thing isn't completely free of both cost and hassle, and to show up at town halls pretending they'd "be dead without Obamacare" (They would not, in fact, be dead. Bankrupt perhaps, but they would physically still be alive.)

*By "won't work" I don't mean literally won't work at all, ever, but rather "don't take the steps to obtain consistent, gainful employment and improve that employment over the working years of one's life." People fall into C to widely varying degrees. The short-order cook at Waffle House who has been doing it for 40 years may be a person with developmental issues who had no hope of anything better and genuinely needs help - or he may be an ex-convict who decided he was too cool for school at 14, and now thinks he's a "victim" and got "screwed over" because it turns out that life kind of sucks when your career plan is breaking into garages and spending the proceeds on beer and cigarettes.

**(and if they do run, they **** dog it all the way around the track. I'm 41 and on the heavier side and I can still outrun most of these little shits. If you're under 30 and you can't maintain a 7 minute mile, whether you're in the military or not you're, a **** disgrace. Put down the goddamn pringles can and go to the gym, you **** fat whale. If there's ever a revolution, the first people up against the wall better be anyone who waddles, has to go sideways onto a bus, or who snores when they're awake. Fortunately, most of them are likely to be already dead because they'll act as decoys for anti-ship missiles.)

***I strongly suspect that the designers knew damn well the penalty was too low, and the idea was to either ensure it was a disaster and force the system to single-payer, or else get the Republicans to be the ones to raise it and then dress the whole affair up as them "taking the side of the rich and the insurance companies". Remember, we're talking about a bill the public was "too stupid to understand" and that we "needed to pass to see what was in it." The idea was likely "pass something that won't actually work, then blame the Republicans for it. when they try to change anything."

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

Are you actually suggesting that there is any sort of involuntary employment going on in this country that isn't either A) illegal or B) the result of a conviction for a crime? I'm not sure how you think "all employment is voluntary" undermines anything at all. The 13th Amendment has been around a very long time now.



As Xeq has pointed out, these sorts of benefits and packages are not solely a result of corporate leverage - they're subsidized by tax incentives to the company. That's a large part of what makes them economically feasible to begin with. The government is already privileging one sort of association over another - not only does the company have more leverage, but it has a tax break as well. What Xeq is arguing is that the individual should be treated (fundamentally) the same way by the government.

Furthermore, this is a tacit admission that pre-HIPAA, the right of association didn't have the same value to everyone. If John and Jim (all other factors being equal) get hired to do the same job and John has condition A but Jim doesn't and John's condition isn't covered because it's "pre-existing", he isn't getting the same compensation as Jim. Now, one could argue that each of them should be free to negotiate their own compensation, but that's really neither here nor there. Once they have agreed to a certain form of compensation, that compensation should work the same way for both of them.

Neither John nor Jim can simply elect to purchase health insurance at any time they please - they must do so at initial hiring or other designated points in time. The insurance company might plead that it shouldn't have to take care of pre-existing conditions for John, but by doing so it is ignoring that Jim is under the same rules and has to purchase his insurance or run the risk of being without. Jim might develop expensive cancer 20 minutes after getting hired, or he might never need anything but routine checkups. Without the mandate to cover pre-existing conditions, the insurance company gets to enjoy the benefit of Jim paying for health coverage he may or may not need but doesn't have to pay John's expenses. Furthermore, it had a strong incentive to find a reason why any significant medical condition was really "pre-existing." If John developed his condition a week after starting work and it was going to be expensive to cover, they were going to find a reason not to cover it. Part of the reason HIPAA provisions exist is so that the insurance company can't play these games.



Again, you're missing the fact that the government wasn't treating all associations the same way. Not only did you get the benefit of group leverage, you got the benefit of the tax incentives provided to your employer. You're quite right - people DO want something for nothing, and they do play victim and plead poor-mouth to get it and demand someone else pay for it. However it isn't just individuals lining up at the Medicaid office who do that. Pretending you're not getting a subsidy when you're getting a tax break is the same thing. So is not covering people's health costs when you've assumed group risk because they're "pre existing", but at the same time reaping the benefits of people needing to buy up front or risk not being able to buy when it's needed.

This is the AMTRAK argument, famously used in the Senate to shut John McCain (who loves commuter air because Arizona loves commuter air, but hates AMTRAK because reasons) up. Every other form of transportation gets public subsidies in various forms - public roads, government airports, tax breaks, airline bailouts, etc. AMTRAK has to rent its right of way from freight railroads, or else pay maintenance on its own tracks, and numerous other expenses. Claiming that AMTRAK is surviving only on government subsidies is dishonest - the same applies to every other form of transportation. AMTRAK represents a national passenger transportation reserve and surge capacity, and pretending its getting some sort of pork-barrel subsidy just because its more direct than getting to drive on the taxpayer-funded highways is a stupid argument.



As I pointed out to Xeq, I think that ACA was intentionally designed to fail, either to force single-payer, or to make the Republicans bear the political costs of fixing it and telling the public "yeah.. you' can't have it all, and free. Sorry." HIPAA really can't be accused of that.



I don't see what Medicare has to do with any of this. It pre-dates both ACA and HIPAA, it's designed for people who are past working age, and there's no way to cheat into it by getting old early or something.

Some people might whine that it's "redistribution". Yes, ok, it is. We can argue the specifics of how we go about it - no one claims Medicare is perfect - but you're right, people do pay into it and taking care of those who can't work because of advanced age is part of not being **** barbarians.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

The benefits of employment are voluntary and the focus of our conversation touched on earned benefits, right? You wanted to know how the difference between an earned benefit from an employer is different than your cash in hand when purchasing an insurance policy. Well, those benefits aren't voluntary anymore since ACA. Keep in mind, my argument with you and X is the referring to the differences in categories of insurance policies and employment benefits as discriminatory. The fact that there are differences isn't relevant to my argument, it's the claim that those differences constitute discrimination that is.That's irrelevant, since not every company gets subsidized tax incentives and that isn't considered discriminatory. Tax incentives are put in place to benefit all parties involved. There's no "corporate welfare" going on, no matter how much folks want to claim there is. Even the automaker bailouts don't qualify - there's a reason different businesses are deemed "too big to fail", because the negative affects on the economy outnumber the positives.If every company got the same incentives you might be able to use that as an argument, but they don't, so you can't. Well, you can try, but it falls apart quickly.There's no doubt that it didn't. Associations with larger groups provide more clout than smaller groups, and that clout is used to gain negotiation advantages. Still not discrimination.And how's that different from the ACA? Those with long erm healthcare requirements get greater compensation than the poor guy that dies at his desk from a heart attack the day before he retires. Still not discrimination...and it still isn't discriminationTe government isn't guilty of discrimination for providing incentives to different companies at different rates, nor is it a requirement that the government provide incentives. Today, however, the government IS requiring insurance benefits to the point that I am forced to purchase a policy for myself that includes birth control. Insurance is a gamble, people gamble that they'll get more from it than they pay in, and the insurance companies gamble they'll take in more than they pay out. It's the nature of the industry. Still not discrimination. Yeah, I only included HIPAA 'cause it was the beginning of regulation requiring coverage for pre-existing conditions and the circumstances surrounding insurance companies dropping coverage because of projected costs of continuing to provide policies to people with projected high medical costsI was replying to X's comment that folks got more out if it than what they put in.

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In time, this too shall pass.

I actually have done the math on this one. First of all, your own source says the projected draw is $240k, I don't know where you got $120k from. It clearly says that out-of-pocket costs are $240k on average and that Medicare on average pays 50% of the costs, so that would mean Medicare pays $240k. Personally, I think Medicare pays more than 50%, I've seen sources that claim as high as 80%, but we can go with this. 2.9% of the mean income in the US in each year invested at 7% interest for 45 years starting in 1966 does not reach $240k, it's not even close. This also discounts the fact that the Medicare payroll tax was a lot lower than 2.9% in 1966.

There are definitely people out there that earned enough money over their lives that 2.9% of their income actually does cover their expected Medicare outlays, but they are a small minority. Medicare spending in 2015 was $646.2 billion, but the revenue collected from the payroll tax was only $227.2 billion.

They are definitely still voluntary. You don't have to get health insurance at all; you just have to pay a nominal tax penalty.



It is a matter of open debate whether the negatives of such companies failing outweigh the positives and in fact this IS corporate welfare. Now, it's fair to say that corporate welfare isn't automatically bad just because it's a corporation getting it rather than some fat lady with nine kids and a GED, but it is still a form of welfare, or perhaps "social safety net" if you prefer.

Furthermore, it's arguably even MORE discriminatory (understanding that 'discriminatory' is Xeq's argument, not mine) to hand out benefits to some companies and not others, since the government is privileging some companies over others, not merely one category of entities (corporations) over another (individuals). One might argue that in some cases it serves a public good or interest to do so, but it can hardly be argued this is always the case. In many instances it serves some other political end.

If every company got the same incentives you might be able to use that as an argument, but they don't, so you can't. Well, you can try, but it falls apart quickly.[/quote]

Not really. If some companies can qualify for such benefits, why should no individual ever be able to do so?



No one has claimed that the inherent leverage of a larger group is discrimination; Xeq has claimed that giving the larger group a government-mandated privilege on top of its inherently greater clout is discrimination.



No, actually they don't get any greater compensation. They get more healthcare, but they get the same compensation. The compensation is having their health issues taken care of regardless of what those issues may be. If he was getting more compensation, it would be to his benefit to have more health issues, and there would be a (perverse) incentive to invent them. Where people DO get more compensation for more health issues is at the VA, where you can get a larger disability check for more health issues. This is why you see 25 year old veterans claiming to have "back pain" so much.

The health care providers get more compensation for the guy with the long term condition because they do more work treating him, but they aren't germane to the conversation.

When you're selling a group plan to a company and ensuring you get the benefit of increased sales by saying "ok, you have to purchase it up front, or when we give you the opportunity, or else you might not have it when you need it" it is, in fact, discriminatory to then turn around and not cover some employees' health issues because they were "pre-existing". That employee is earning what everyone else is earning, and bought under the up-front rule like everyone else. If you're the insurance company, you should have included in your risk calculations that some pre-existing conditions will appear in the employee pool - but you don't have the same worries as with the public at large, because the people have to be at least sufficiently healthy to work. Most of the truly devastating conditions preclude getting hired in the first place.



discrimination



And yet, it is, under 3 of the 4 definitions. What you're really saying is that it's not an unfair form of discrimination, but by just repeating "not discrimination!" over and over, you're distorting the issue into a terminology nitpick. I realize that "discrimination" is a loaded word with connotations the dictionary definition avoids mention of, but if the government is privileging some associations over others, the term is accurate. The question is, does it, and to what extent, serve the public interest?



I just demonstrated that it is. The details of what policies must cover are really not important here - we're talking about the general principle, not the details. Would you really be ok with all this if they just dropped birth control from your policy? You're perfectly ok with the government providing different subsidies to different companies at different rates, but not ook with individual subsidies at all because...? What reason, beyond that you think "association" is supposed to come with certain benefits. It doesn't. It comes only with the benefits the weight of numbers gives it. When we create special privileges for association, we get unions, which have both the clout of numbers and considerable legal privilege. We don't live in a lazzis faire economy and aren't likely to, so the best we can do is minimize the amount of special circumstances the government creates. Some discrimination is inevitable, but it needs to serve the public interest in general, not just "lol I work for a big company get **** if you don't"



If by those costs you mean the costs of having to actually provide what they were selling, sure. See, the thing is that the existence of insurance drives up costs - insurance companies have deep pockets. Doctors and other sources of actual care can bill a lot more when the payers are insurance companies. Medical schools can charge more for tuition against those higher earnings, etc, etc. This stuck anyone with a pre-existing condition with the prospect of having to work at a job to get health coverage AND then pay for the costs associated with anything pre-existing on top of it. This isn't even considering the cases where they just tried to argue something was pre-existing when it wasn't to avoid paying.



Fair enough. They actually do (though as you point out not to the degree Xeq is claiming), but that's not automatically problematic. What's problematic is the absolute cost of it, and the burden it places on the public at large.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

Bro do you even math? Check your arithmetic.



Why are we having to guess at this?

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."