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(Seattle Times)   Insurer promises to keep some parts of Obamacare even if the law is struck down. What's the catch?   (seattletimes.nwsource.com) divider line 116
    More: Interesting, UnitedHealth Group, obamacare, health care law, insurance companies  
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2788 clicks; posted to Politics » on 11 Jun 2012 at 10:25 AM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-06-11 12:51:34 PM

slykens1: Dusk-You-n-Me: "Can you imagine if the opposition called Social Security "Roosevelt Security"? Or if Medicare was "LBJ-Care"? Seriously, have these guys ever heard of the long view?" - David Alexrod

He's right.

I don't understand Axelrod's complaint here. Obama and his supporters should be proud of the law they put in place and should want to be associated with it as much as possible.


You're right, you don't understand. Take a few minutes to try to figure it out, then read the rest of my post after this paragraph. This exercise might help you to one day be able to comprehend the English language.

Did you take a look? No? Well, I didn't actually expect you to, so that's not surprising. Here's a second chance if you want it. Since you don't, read the next line.

Axelrod is proud. He is not complaining. He thinks calling healthcare reform is a tactic that will backfire. He thinks the Republicans are stupid to hardwire the association of this health care law to Obama because one day it will be as popular as Social Security or Medicare, and people will be constantly reminded that Obama and, by extension, the Democratic Party was responsible for the now-popular law.
 
2012-06-11 12:58:52 PM

Epoch_Zero: Tyee: Epoch_Zero: Not true. Everything from car insurance to Macbooks are required purchases.

I don't have a Macbook and my brother is 63 and has never had car insurance.

Yes, and when your brother is involved in an accident he will not only be liable for the cost of all damages, but will be fined or possibly jailed for not having car insurance. As for the Macbook, that applied to the students of the MA school. But, you were stating that this is the first time - which is incorrect.

I am technically correct; the best kind of correct.


Maybe his brother lives in NH where it isn't required?

Auto insurance requirements =! health care requirements. Auto requirements are set up by the states while this would be a federal mandate. Not to mention the privledge of driving verses the necessity of health care.
 
2012-06-11 01:09:41 PM

thurstonxhowell: You're right, you don't understand. Take a few minutes to try to figure it out, then read the rest of my post after this paragraph. This exercise might help you to one day be able to comprehend the English language.


Posts like these make it easy to mark the dipshiats on Fark.

I apologize I didn't read the context - risks of visiting the Politics tab. :)
 
2012-06-11 01:11:24 PM

slykens1: I don't understand Axelrod's complaint here. Obama and his supporters should be proud of the law they put in place and should want to be associated with it as much as possible.


The term was created for derogatory purposes by people opposed to the law and looking for a way to refer to the law in a derisive manner. Some people don't think that supporting their childishness is a good idea.

Now you understand and you can move on to something else.
 
2012-06-11 01:12:52 PM
I've always said that the people out there who think they know what's best in health insurance should set up their own insurance company and run it just like they would run the government run health care system they want to force us all in to.

When it goes broke we won't laugh... Much.
 
2012-06-11 01:13:07 PM

Mentat: The catch is that people and insurance companies like the individual parts of ObamaCare, they just don't like ObamaCare all together.


ah People??

i beg to differ.

what you meant to say was that Insurance Companies like to pick and choose which ever parts will benefit them. the hell with "the people"

you actually believe that Insurance companies care about you?? lol

they care about profit and only profit.

they profit of off other people's illnesses.

you need to wake up. you aren't in Kansas any more.
 
2012-06-11 01:16:03 PM
Well, heath insurance companies are certainly a trustworthy lot.

I'm sure we can take their word for it.
 
2012-06-11 01:27:23 PM

sdd2000: Ned Stark: Mentat: The catch is that people and insurance companies like the individual parts of ObamaCare, they just don't like ObamaCare all together.

You know, except for the mandate.

The insurance companies actually like/love the mandate portion. They just don't like no pre existing coverage requirements. They would love to have the mandate, but no requirement that they cover pre existing conditions and that those must get their insurance from the government.


Who gives a damn what those cannibals think?
 
2012-06-11 01:29:16 PM

GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.


The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)
 
2012-06-11 01:34:32 PM

Zasteva: GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.

The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)


See, now there's a much better example of a valid argument than the one about truancy. Good jorb.
 
2012-06-11 01:35:33 PM

Zasteva: GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.

The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)


Yeah, but that doesn't count because [insert some reason I can't think of right now because I can't read Karl Rove's mind].
 
2012-06-11 01:35:37 PM
It is ultimately, and beyond anything else, a good public relations move. "See?" it says, "we care."

Good PR is good money.

Dusk-You-n-Me: Twigz221: Anyone who uses the term Obamacare is a partisan hack. It's such a terrible term and is a great example of the poison that has infected modern US politics.

I used to think the same thing, now I don't mind the term as much. Kind of bounces off the tongue. Also,

"Can you imagine if the opposition called Social Security "Roosevelt Security"? Or if Medicare was "LBJ-Care"? Seriously, have these guys ever heard of the long view?" - David Alexrod

He's right.


And this. The use of an epithet can quickly grow into a compliment. Given the tendency for human filth to rage about "Get your government hands off my Medicare," can you imagine the rage and the fury if they had to concede that these were Democratic innovations?
 
2012-06-11 01:36:40 PM

Zasteva: GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.

The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)


Point the first, the governments power to raise militia has nothing to do with the power to regulate commerce.

Point the second, the people who wrote the constitution thought black people were property, so fark their opinions anyway.
 
2012-06-11 01:48:16 PM

Ned Stark: Zasteva: GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.

The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)

Point the first, the governments power to raise militia has nothing to do with the power to regulate commerce.

Point the second, the people who wrote the constitution thought black people were property, so fark their opinions anyway.


Rebuttal to point the first, Congress's power, in that one sentence of Art I Sec 8, is to use its own money to raise and support an army, not to require able-bodied males to use their money.

"To raise and support Armies, but no Appropriation of Money to that Use shall be for a longer Term than two Years;

To provide and maintain a Navy;

To make Rules for the Government and Regulation of the land and naval Forces;

To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions;"
 
2012-06-11 01:48:59 PM
To provide for organizing, arming, and disciplining, the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress;
 
2012-06-11 01:54:42 PM

Close2TheEdge: Doc Daneeka: Is it bad that part of me wants Obama's health care reform to be overturned so that we can move on to the inevitable plan B, i.e. expansion of Medicare leading ultimately to universal single-payer? Which should have been the goal from the outset.

Because honestly, the GOP hasn't thought things through. They haven't thought past repeal. But the fact is, if health care reform is overturned, the nation's healthcare system will still be broken and in need of major reform. If something can't go on, it won't - and eventually we will have universal health care. One way or another.

Do you really, really think that is what will happen? How many years have we gone without a comprehensive, simple solution? Do you really think the light bulb will magically go off, and our government will recognize the solution that's been staring them in the face forever?

No, we are going to muddle along while Congress dithers, health care costs contiue to spiral, the population ages and demands more for less, and things just go from bad to worse.

//Cynical today.


A system in which costs continue to spiral far faster than inflation, and which causes the majority of personal bankruptcies, even among the insured, is not sustainable in the long-term.

If the GOP is simply gunning for repeal but refuses to do anything to reform the current employer-based private-insurer health system and address its deep structural flaws, then eventually it will simply collapse. At which point it will be replaced by something else.
 
2012-06-11 02:02:48 PM

LesserEvil: Tort reform can also help


Impeccable logic says it should. Empirical evidence (as in the majority of US states where various levels of tort reform have been in place for years now... and 99.9% of medical torts are filed in state courts) says it didn't.

Wish in one hand. Empirical evidence in the other. See which fills up first.
 
2012-06-11 02:12:17 PM

Ned Stark: Zasteva: GentDirkly: The mandates in your examples are codified at the state level. The Federal government has given the state governments various incentives to have the mandates, and all states have them, but the mandate itself isn't written or enforced at the federal level. If you let your kid be a truant, city/county cops will get you and if convicted you will be in state prison. Now, this doesn't make a big difference to me, because state prison and federal prison both suck, but it does to the courts.

The Second Militia Act of 1792 is an example of a Federal mandate that applied to everyone nationwide. So it would seem that the people who wrote the Constitution thought this was legal.

Link (new window)

Point the first, the governments power to raise militia has nothing to do with the power to regulate commerce.


If your argument is that they have the power to require people to buy muskets as part of their power to raise the militia, then why don't they have the power to force people to buy insurance as part of their dual powers under the commerce clause and general welfare clause?

Point the second, the people who wrote the constitution thought black people were property, so fark their opinions anyway.

While I agree that they were obviously not correct about everything, the discussion was about whether the mandate is constitutional or not. In that matter, the intent of the people who wrote it seems at least some what relevant. And, it should be pointed out that (to our great shame) black people could be property under the constitution until it was (thankfully) amended to prohibit it.

So, if you want to reduce the powers of the Federal government, you need to amend the constitution, not falsely claim historical precedent.
 
2012-06-11 02:32:23 PM
Tort reform is the GOP's favorite red herring.

Not saying it's necessarily bad or wrong to enact tort reform depending on the circumstances.

But it won't actually make a dent in the escalating costs of health care.
 
2012-06-11 02:35:28 PM
Because raise does not mean the same thing as regulate.


And its not about limiting the governments power, tbh. Its about torpedoing a terrible terrible piece of legislation. Since liberals have once again failed us all the only hope is the court or the teabaggers.
 
2012-06-11 03:10:15 PM

Ned Stark: Because raise does not mean the same thing as regulate.


Good point. However, if you look up the definition of the infinitive verb "to regulate" in a dictionary that was around during the late 1700's, you will see that part of the definition of "to regulate" includes "to command." This was pointed out quite forcefully by Judge Laurence Silberman in his opinion that the individual mandate is constitutional.
 
2012-06-11 03:15:15 PM
Insurer promises to keep some parts of Obamacare

See, the free market works just fine.
 
2012-06-11 03:23:33 PM

Ned Stark: Because raise does not mean the same thing as regulate.


What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".
 
2012-06-11 03:30:03 PM
Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.
 
2012-06-11 03:34:22 PM

Polyhazard: Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.


A) They can always pull themselves up by their own bootstraps and pay for care out-of-pocket.

B) That's what private, voluntary charity is for. If they only belonged to a church, they'd be taken care of.

/trying to figure out which of those two ridiculous responses is more likely to be the teabagger "solution" to your question.
 
2012-06-11 03:38:50 PM

Doc Daneeka: Polyhazard: Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.

A) They can always pull themselves up by their own bootstraps and pay for care out-of-pocket.

B) That's what private, voluntary charity is for. If they only belonged to a church, they'd be taken care of.

/trying to figure out which of those two ridiculous responses is more likely to be the teabagger "solution" to your question.


Actually, I believe the solution they prefer was pointed out at one of the debates in September where a few blowhards cheered when Wolf Blitzer asked Ron Paul if we should just let sick people die.
 
2012-06-11 03:40:45 PM

randomjsa: I've always said that the people out there who think they know what's best in health insurance should set up their own insurance company and run it just like they would run the government run health care system they want to force us all in to.


And how do you propose a private company mandate that everyone carry coverage since everyone will eventually be a consumer? You know. The key part of the plan that allows the insurers to remain profitable while keeping premiums from skyrocketing. How would a private company go about that?

Or do you just not actually think about your opinions before you let them dribble out the front of your face?
 
2012-06-11 03:41:13 PM

Doc Daneeka: Polyhazard: Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.

A) They can always pull themselves up by their own bootstraps and pay for care out-of-pocket.

B) That's what private, voluntary charity is for. If they only belonged to a church, they'd be taken care of.

/trying to figure out which of those two ridiculous responses is more likely to be the teabagger "solution" to your question.


No need to speculate. I've personally walked right up to Gadsden flag-waving "Obamacare" protesters and asked about this specific issue. Their answer: it doesn't matter, because a consequence of living in a free society is that sometimes bad things happen, and that trying to do something about those things leads to tyranny.
 
2012-06-11 03:44:16 PM

Zasteva: Ned Stark: Because raise does not mean the same thing as regulate.

What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".


Raise implies creating something where there was nothing before. Congress can create a militia either through paying for it or a mandate or whatever.

Congress cannot forcibly create commerce though. Only establish regulations that govern it.
 
2012-06-11 03:48:34 PM

Serious Black: Doc Daneeka: Polyhazard: Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.

A) They can always pull themselves up by their own bootstraps and pay for care out-of-pocket.

B) That's what private, voluntary charity is for. If they only belonged to a church, they'd be taken care of.

/trying to figure out which of those two ridiculous responses is more likely to be the teabagger "solution" to your question.

Actually, I believe the solution they prefer was pointed out at one of the debates in September where a few blowhards cheered when Wolf Blitzer asked Ron Paul if we should just let sick people die.


The specifics of that question made a difference, though. The question was about a hypothetical young man with a good job that provided access to insurance and the ability to pay, but chose not to. Basically, someone who decided they were going to take a gamble, and whether it was our duty as a society to subsidize the risk he chose to take.

That's why I wished Wolf would have asked the much stickier question about the person who has done everything right but has no recourse under our current regime. Because this is the question that not a single Republican has sought to even acknowledge since thye designed the Individual Mandate back during the Clinton era.
 
2012-06-11 03:51:52 PM

Splinshints: randomjsa: I've always said that the people out there who think they know what's best in health insurance should set up their own insurance company and run it just like they would run the government run health care system they want to force us all in to.

And how do you propose a private company mandate that everyone carry coverage since everyone will eventually be a consumer? You know. The key part of the plan that allows the insurers to remain profitable while keeping premiums from skyrocketing. How would a private company go about that?

Or do you just not actually think about your opinions before you let them dribble out the front of your face?


I do have an idea. They could all cartel and agree to backcharge everyone for gaps in coverage starting Jan 1, 2014, and the government could decide to turn a blind eye to that.
 
2012-06-11 04:05:53 PM

Ned Stark: Zasteva: Ned Stark: Because raise does not mean the same thing as regulate.

What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".

Raise implies creating something where there was nothing before. Congress can create a militia either through paying for it or a mandate or whatever.

Congress cannot forcibly create commerce though. Only establish regulations that govern it.


As I previously stated above, an original meaning interpretation of the verb "to regulate" includes "to command" and makes absolutely no distinction between pre-existing commerce and created commerce.
 
2012-06-11 04:20:41 PM

Polyhazard: Our healthcare system is broken until those with pre-existing conditions have access to options for care.

The end.


Our healthcare system is just broken, period. We have a system where virtually all the incentives are misaligned so that we get higher costs and less patient control. The problem is for 50 years we've had the wrongheaded assumption that the only way to provide care is to get insurance to pay for it. The worst way of paying for something is to have a third party paying for another third party's care. Then there's no natural incentive to get the best quality at the best price.

You want to fix healthcare in this country. This seems to be the most sensible way to do it.

If you get rid of the notion that you have to pay for everything through insurance, then preexisting conditions becomes less of an issue. You still have to deal with catastrophic insurance, but then it just becomes a matter of pricing - and if you get costs under control you can have insurance policies specifically for a given preexisting condition at a reasonable cost.

Our fundamental problem is that we've created a healthcare system with a massive third-party payor problem, and that just does not work well.
 
2012-06-11 04:22:01 PM

Serious Black: Ned Stark: Zasteva: Ned Stark: Because raise does not mean the same thing as regulate.

What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".

Raise implies creating something where there was nothing before. Congress can create a militia either through paying for it or a mandate or whatever.

Congress cannot forcibly create commerce though. Only establish regulations that govern it.

As I previously stated above, an original meaning interpretation of the verb "to regulate" includes "to command" and makes absolutely no distinction between pre-existing commerce and created commerce.


As I previously stated above, authors intent is unpersuesive.
 
2012-06-11 04:26:13 PM

Ned Stark: Serious Black: Ned Stark: Zasteva: Ned Stark: Because raise does not mean the same thing as regulate.

What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".

Raise implies creating something where there was nothing before. Congress can create a militia either through paying for it or a mandate or whatever.

Congress cannot forcibly create commerce though. Only establish regulations that govern it.

As I previously stated above, an original meaning interpretation of the verb "to regulate" includes "to command" and makes absolutely no distinction between pre-existing commerce and created commerce.

As I previously stated above, authors intent is unpersuesive.


Not intent, but meaning. As Justice Scalia has noted over and over again, there is a big difference between the two. The original MEANING of regulating commerce includes making commands regarding commerce, and no portion of that original meaning makes any distinction between pre-existing and created commerce.
 
2012-06-11 04:29:00 PM

palelizard: And, aside from pregnancy, the 25 and under crowd don't often have particularly expensive ailments. Combine that with free preventative care, which means they're more likely to get something checked out early rather than wait until it gets bad, and there's good odds the positive PR will make this profitable.

It looks like a sensible move on United's part, a win-win decision. Let's see how they screw it up.


Eh, as far as no co-pays on preventative screenings, large hospital conglomerates are the primary force behind it. The day of the private practice primary care physician is coming to the end. The future is hospital systems using primary care physicians as loss leaders (like discounted toilet paper at Walmart) to get you in the door and then reap the benefits from booking outpatient procedures and specialty consults within their system.
 
2012-06-11 04:43:28 PM
To command still isn't to create.
 
2012-06-11 04:47:32 PM
That's Obamunism, subby.
 
2012-06-11 04:50:43 PM

WombatControl: ou can have insurance policies specifically for a given preexisting condition at a reasonable cost.


If a pre-existing condition can't be treated at a reasonable cost, how can you deliver insurance specifically for it at a reasonable cost? In fact, what's the point of insurance if you just get insured for each individual condition? The insurance company can't look at a $10000/month treatment plan, sell you insurance that covers it for $1000/month, and make money.
 
2012-06-11 05:09:22 PM
Want HC costs to come down? Step 1: Eliminate these.
 
2012-06-11 05:30:36 PM

WombatControl: If you get rid of the notion that you have to pay for everything through insurance, then preexisting conditions becomes less of an issue. You still have to deal with catastrophic insurance, but then it just becomes a matter of pricing - and if you get costs under control you can have insurance policies specifically for a given preexisting condition at a reasonable cost.


Your bolded caveat just killed the rest of the theory.

Sniffles, wellness exams, broken bones, and scripts for Lipitor and a blood-pressure drug? Possibly consumer-driven decisions. And bloody-well rounding errors in the cost of medicine. Medical costs *are*, by and large, catastrophic costs. Heart attacks, cancer, major trauma, stroke, and a handful of other conditions.

You want to attack the somewhat consumer-manageable costs? Fine. HSA/high-deductible plans are more common each and every year. We could push more of them, like Libertarian-dream Singapore (though the Cato-reading Libertarians don't want to talk about the fact that nanny-state Singapore sets price caps on medical treatments... it's illegal to overcharge).

But, you're swatting at flies here, not the bulk of the problem.
 
2012-06-11 05:31:17 PM

jigger: Want HC costs to come down? Step 1: Eliminate these.


Actually, health care in many cases suffers from supply-driven demand, so building tons of hospitals could result in increasing costs as doctors try to keep their beds filled.
 
2012-06-11 05:31:40 PM

thurstonxhowell: WombatControl: ou can have insurance policies specifically for a given preexisting condition at a reasonable cost.

If a pre-existing condition can't be treated at a reasonable cost, how can you deliver insurance specifically for it at a reasonable cost? In fact, what's the point of insurance if you just get insured for each individual condition? The insurance company can't look at a $10000/month treatment plan, sell you insurance that covers it for $1000/month, and make money.


That assumes that you can't treat a pre-existing condition at a reasonable cost. We're not talking about getting insurance when someone's already dying of cancer, we're talking about hedging against a relatively known, quantifiable risk. Yes, you'd have a relatively costly high-deductible policy, but that's cheaper than having our current system where you either lose coverage or pay even more.

Basically, it should work that most common medical expenses are paid for either out-of-pocket or on credit, and things like catastrophic illnesses, accidents, or preexisting conditions are treated as the insurable events they are. Right now we have a system where all medical spending is handled by insurance, even when it makes very little sense to treat it as an insurable event.
 
2012-06-11 05:33:48 PM

Ned Stark: To command still isn't to create.


Anonymous internet commenter, or well-respected DC Circuit Judge Laurence Silberman? I think I'm going to agree with the guy that has almost 50 years of legal experience personally.
 
2012-06-11 05:35:02 PM

WombatControl: thurstonxhowell: WombatControl: ou can have insurance policies specifically for a given preexisting condition at a reasonable cost.

If a pre-existing condition can't be treated at a reasonable cost, how can you deliver insurance specifically for it at a reasonable cost? In fact, what's the point of insurance if you just get insured for each individual condition? The insurance company can't look at a $10000/month treatment plan, sell you insurance that covers it for $1000/month, and make money.

That assumes that you can't treat a pre-existing condition at a reasonable cost. We're not talking about getting insurance when someone's already dying of cancer, we're talking about hedging against a relatively known, quantifiable risk. Yes, you'd have a relatively costly high-deductible policy, but that's cheaper than having our current system where you either lose coverage or pay even more.

Basically, it should work that most common medical expenses are paid for either out-of-pocket or on credit, and things like catastrophic illnesses, accidents, or preexisting conditions are treated as the insurable events they are. Right now we have a system where all medical spending is handled by insurance, even when it makes very little sense to treat it as an insurable event.


Question: what do you consider a high enough deductible for insurance to qualify as "catastrophic"?
 
2012-06-11 05:47:24 PM

Lawnchair: Sniffles, wellness exams, broken bones, and scripts for Lipitor and a blood-pressure drug? Possibly consumer-driven decisions. And bloody-well rounding errors in the cost of medicine. Medical costs *are*, by and large, catastrophic costs. Heart attacks, cancer, major trauma, stroke, and a handful of other conditions.


That's what I used to think too - but emergency spending is only 2-3% of total health care spending. It's the emergency spending that's basically a rounding error. Which makes sense when you think about it - yes, catastrophic care is expensive, but you get the sniffles a hell of a lot more than you have a heart attack.

Again, the point of insurance is to hedge against the risk of a catastrophic event. I don't pay for my car's gas or oil changes by submitting an insurance claim. I have insurance in case some idiot T-bones me at an intersection.

So why do we treat health care differently? It just doesn't make sense to finance regular, knowable purchases with a system that's not designed for it. You can treat catastrophic events like the insurable events they are - but even then there needs to be a system of price transparency to make sure that the moral hazard problems we have now don't continue.
 
2012-06-11 05:48:24 PM

Serious Black: Ned Stark: To command still isn't to create.

Anonymous internet commenter, or well-respected DC Circuit Judge Laurence Silberman? I think I'm going to agree with the guy that has almost 50 years of legal experience personally.


Only 9 judges actually matter.
 
2012-06-11 05:50:27 PM

Serious Black: Question: what do you consider a high enough deductible for insurance to qualify as "catastrophic"?


I don't think there would be one figure - that would depend on what the consumer ultimately wanted. It could be $5,000, it could be $10,000, it could be $20,000. It all depends on the amount of risk you wanted to assume and your means to do so.
 
2012-06-11 06:06:51 PM

Ned Stark: Zasteva: Ned Stark: Because raise does not mean the same thing as regulate.

What is it about the word "to raise" that offers the government the power to force an individual the power to buy something as a private purchase, as opposed to a collect taxes and spend them?

Also, in the case of the general welfare clause, I believe the operative verb is "to promote".

Ned Stark: Raise implies creating something where there was nothing before. Congress can create a militia either through paying for it or a mandate or whatever.


True, but what they were given the power to raise was a militia. They weren't given the constitution power to raise the number of sales of muskets to private individuals. They took that power on themselves as a way to accomplish the raising of a militia; by forcing individuals who were not participating in the commerce of muskets to participate in that commerce.

Ned Stark: Congress cannot forcibly create commerce though. Only establish regulations that govern it.

Congress is not creating commerce where there was nothing before. There is already a large amount of commerce for both medical care in general and health insurance as a means of paying for that care. Arguably, every single person in this country participants in commerce for medical care, even if many of them don't use the health insurance market as a way to pay for it. So congress, under it's constitutional power to regulate commerce used it's power to regulate the health care market via taxes on those who don't have health insurance. Yes, this creates new sales of health insurance as a side effect. So what?

Congress has regulated national parks too, such that national parks require fees to get in. That creates new sales of park passes. Is that unconstitutional?
 
2012-06-11 06:08:57 PM

WombatControl: Serious Black: Question: what do you consider a high enough deductible for insurance to qualify as "catastrophic"?

I don't think there would be one figure - that would depend on what the consumer ultimately wanted. It could be $5,000, it could be $10,000, it could be $20,000. It all depends on the amount of risk you wanted to assume and your means to do so.


There's the catch. The people who are most easily able to assume a huge amount of risk in their health care costs have the most money readily available. The people who can only assume a small amount of risk (if any at all) tend to have very little money available. This means that the people who can assume the most risk pay the least into the system and preserve more of their income and wealth, and the people who can assume very little risk pay the most into the system and drain much of their income and wealth in the process.

Oh, and even if you could make such a system work, it doesn't even get into the issue of how you make insurance coverage offered to people with PREX actuarially sound so that private companies can cover sick people without going bankrupt.
 
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