[Winstonm]

I have to say the arguments against health care law are getting weird.

[mike777]

to be fair people who die without burial insurance are free riders also.



I guess at some point we need to take away some peoples freedom to stop these free riders.

You either want to limit the central gov. powers or you dont.

I note they never seem to explain just where the limits are.....just that social justice is more important.


This all gets back to the central debate, do you think the central govt should have limited powers and do you think the central govt will do a better job at asset allocation than the marketplace.

[Winstonm]

mike777, on 2012-March-28, 21:23, said:

to be fair people who die without burial insurance are free riders also.



I guess at some point we need to take away some peoples freedom to stop these free riders.

You either want to limit the central gov. powers or you dont.

I note they never seem to explain just where the limits are.....just that social justice is more important.


This all gets back to the central debate, do you think the central govt should have limited powers and do you think the central govt will do a better job at asset allocation than the marketplace.

I thought this argument was resolved first around 1776, and then re-argued and re-resolved around 1865.

[mike777]

Winstonm, on 2012-March-28, 21:31, said:

I thought this argument was resolved first around 1776, and then re-argued and re-resolved around 1865.

Yes you make clear in all of your posts that you think the issues were settled hundreds of years ago.

[PassedOut]

mike777, on 2012-March-28, 21:23, said:

to be fair people who die without burial insurance are free riders also.

How so?

[mike777]

PassedOut, on 2012-March-28, 21:52, said:

How so?

think about it....


think about other free riders in other markets.

[Cthulhu D]

mike777, on 2012-March-28, 22:04, said:

think about it....


think about other free riders in other markets.

Not sure we need a one size fits all solution. Sometimes the market is better, sometimes the government is better, sometimes you need a both. Even Adam Smith acknowledge this, it's hardly a revolutionary position. The best rule of thumb imho for considering whether you need government intervention or not is negative externalities generated by an individuals actions or failure to act.

This is assuming you buy into the idea that everyone should have a full franchise in society.

[billw55]

The "free rider" issue might be handled if we had the resolve to say "tough luck" to those who voluntarily go without insurance.

By comparison, there was a case a few months ago in the news, from rural Kentucky I believe. The county had implemented a voluntary fire protection tax for homes in their district. Those who chose not to pay, were not eligible for protection. Sure enough, eventually one such person's home caught fire. The firefighters showed up, protected adjacent properties from spreading and .. let the home burn to the ground. I think there were actually two events like this IIRC.

Is this sort of practice good for society? I bet it motivated a lot of other non-payers to sign up ("Holy crap, they were serious??"). On the other hand it seems a little callous. Is this something we want to attempt for healthcare?

[Winstonm]

mike777, on 2012-March-28, 21:45, said:

Yes you make clear in all of your posts that you think the issues were settled hundreds of years ago.

Yes, and reviving those arguments won't affect the outcome.

[Cthulhu D]

billw55, on 2012-March-29, 06:34, said:

The "free rider" issue might be handled if we had the resolve to say "tough luck" to those who voluntarily go without insurance.

This is functionally impossible. Hypothetical: You've been stabbed in a mugging gone wrong. Your wallet has been stolen and with it your source of ID. You are brought to hospital delirious from blood loss and are unable to identify yourself in a way that can be validated. Do you want:

A) The doctor to treat you right now
B) The doctor to let you bleed for a bit while he tries to work out if you have insurance or not. This might take a while, and you may die.

As long as the answer is A (and from my perspective it better bloody well be A thank you very much), suggesting that treatment should be refused to those without insurance is a joke. It's not workable. Note that the fact that you refuse non emergency treatment to the uninsured is actually the cost driver here, because if the guy's a diabetic or whatever you wait until he goes into diabetic shock (when it's super expensive to treat him) rather than deliver preventative care.

[hrothgar]

mike777, on 2012-March-28, 21:23, said:

to be fair people who die without burial insurance are free riders also.

I've seen the concept of burial insurance bought up several times in recent days, most notably by Scalia during Q+A a couple days back.
The comparison is apt, but there are still major differences

Here's the difference:

Health care spending current comprises something like 15% of the US GNP and is growing extremely rapidly.
The amount of money required to shove a dead body in a crematorium is trivial in comparison.

FWIW, I think that the Solicitor General did a pretty piss poor job in front of the Supreme Court.
I no longer think that the Supreme Court slapping down the administration is beyond the pale.
(Last week, I would have been shocked if this were to happen)

With luck, we'll be able to push through single payer next time around...

[PassedOut]

mike777, on 2012-March-28, 21:23, said:

to be fair people who die without burial insurance are free riders also.

Not true all. No one in my family has burial insurance, and every burial and cemetary plot has been paid for completely. Same with everyone I know. The need for burial is not unpredictable (and is not necessary either). And it need not be expensive.

Insurance is for unpredictable events that can be expensive. Health care free-loaders and their republican apologists want the care but not the expense. It is the same irresponsible attitude that leads to war without tax increases, and on and on.

[kenberg]

PassedOut, on 2012-March-29, 08:40, said:

Insurance is for unpredictable events that can be expensive.

Such as the need for a condom?

I mean the above to be sort of humorous, but at least a little purposeful too.


Winston mentions 1776. But that scuffle was about tea or something. Not about free condoms anyway. Move ahead to 1787. What was it that was settled then? Let's skip over sex and think about free flu shots. Or free shots to ward off shingles. I keep forgetting to get my shots for that. I doubt Madison gave the issue of government imposed health coverage three seconds of thought.

I am a great fan of the Constitution, don't get me wrong, but the match between it and life in the twenty-first century sometimes is pretty stretched.

Maybe back in Kentucky they let a house burn down, I can see the logic. But there is a pretty large consensus, or I think there is, that if someone collapses on the street and he does not have health insurance you don't just walk on and say tough luck.

I expect that I, personally, will cope regardless of what happens with the ACA. As far as I know, the concept of health insurance didn't exist in my childhood c. 1940-1950, but now I have health insurance. And Medicare. I would like to see that the guy who collapses gets some care, and I would like people to pay into health care whether they want to or not because sooner or later they will need it and, when they do, I am not up for walking on by. I really am not clear on how this reconciles with the Constitution, I don't find the resolution so obvious. But I hope that it can be packed in there somehow.

[luke warm]

hrothgar, on 2012-March-29, 08:39, said:

FWIW, I think that the Solicitor General did a pretty piss poor job in front of the Supreme Court. I no longer think that the Supreme Court slapping down the administration is beyond the pale.
(Last week, I would have been shocked if this were to happen)

if i was a betting man, i'd bet it's 6 to 3 in favor or upholding the constitutionality of the law, with scalia, alito, and thomas voting nay

Quote

With luck, we'll be able to push through single payer next time around...

*if* the aim is universal healthcare (and that's a fine subject for debate in itself), there is only one way to do it correctly... it has to be single payer

[PassedOut]

kenberg, on 2012-March-29, 14:07, said:

Such as the need for a condom?

I mean the above to be sort of humorous, but at least a little purposeful too.

Are condoms covered by health insurance? Never heard of that, but if condom coverage is accounted for in the premiums, I suppose it would be the buyer's choice.

If folks can walk into a pharmacy in Maryland and get free condoms subsidized by those who do have condom insurance, then those folks are, as you suggest, free-riders of the type we are talking about. But I kind of doubt that happens. (Maybe kids in school get free condoms from the nurse, but kids tend to be auto-matic free riders).

I did read that the Oklahoma legislature passed a law that health insurers must subsidize Viagra, and that that was the fastest law ever passed there. But I don't believe that free-riders can walk into a pharmacy in Oklahoma and get Viagra subsidized by others. Don't know if they can do so in Maryland...

[PassedOut]

luke warm, on 2012-March-29, 15:40, said:

if i was a betting man, i'd bet it's 6 to 3 in favor or upholding the constitutionality of the law, with scalia, alito, and thomas voting nay


*if* the aim is universal healthcare (and that's a fine subject for debate in itself), there is only one way to do it correctly... it has to be single payer

Agree with both points (knock on wood for the former)...

[kenberg]

PassedOut, on 2012-March-29, 15:45, said:

Are condoms covered by health insurance? Never heard of that, but if condom coverage is accounted for in the premiums, I suppose it would be the buyer's choice.

If folks can walk into a pharmacy in Maryland and get free condoms subsidized by those who do have condom insurance, then those folks are, as you suggest, free-riders of the type we are talking about. But I kind of doubt that happens. (Maybe kids in school get free condoms from the nurse, but kids tend to be auto-matic free riders).

I did read that the Oklahoma legislature passed a law that health insurers must subsidize Viagra, and that that was the fastest law ever passed there. But I don't believe that free-riders can walk into a pharmacy in Oklahoma and get Viagra subsidized by others. Don't know if they can do so in Maryland...

I thought that contraceptive coverage, including condoms, was the issue with the Church. At any rate I do get free flu shots. I don't always take them, but I can get them for free.

But I can withdraw all of that to get to what I thought it illustrated: The health insurance, at least as I understand it, will be covering many things that are neither unexpected nor horribly expensive contrary to "Insurance is for unpredictable events that can be expensive." Am I wrong?

It really makes a difference whether we are speaking of insurance against unexpected events that can be expensive, or rather a prepaid medical scheme. Not for the first time I find myself ill-informed, but I really had understood the ACA to be more like a prepaid medical plan than a catastrophic insurance plan.

[Winstonm]

PassedOut, on 2012-March-29, 15:45, said:

Are condoms covered by health insurance? Never heard of that, but if condom coverage is accounted for in the premiums, I suppose it would be the buyer's choice.

If folks can walk into a pharmacy in Maryland and get free condoms subsidized by those who do have condom insurance, then those folks are, as you suggest, free-riders of the type we are talking about. But I kind of doubt that happens. (Maybe kids in school get free condoms from the nurse, but kids tend to be auto-matic free riders).

I did read that the Oklahoma legislature passed a law that health insurers must subsidize Viagra, and that that was the fastest law ever passed there. But I don't believe that free-riders can walk into a pharmacy in Oklahoma and get Viagra subsidized by others. Don't know if they can do so in Maryland...

Oklahoma is my home state, and it is in the running for the most stupid state in the union, I'd put it about 4th in that contest behind Mississippi, Texas, and Louisianna.

I don't know about Viagra, but OK did have a law that a woman was forced to listen to the sound of the heartbeat of the fetus prior to an abortion - and it was struck down just in the past two days.

[mike777]

Of course insurance and even the actual medical decisions are just a part of the whole health care system.


You have the whole medical equipment and supply parts as well as drug companies.

You have real estate, location, staffing, education, equipment and many many other moving parts to the whole health care system. Asset allocation decisions need to be made as too what research or what equipment or training will be funded and which will not be.

I do understand that many posters feel the central govt will do a better job making all of these complex decisions than the marketplace.

That is alot of economic power combined with political power put in a very few hands inside the Beltway.

[PassedOut]

kenberg, on 2012-March-29, 16:07, said:

I thought that contraceptive coverage, including condoms, was the issue with the Church. At any rate I do get free flu shots. I don't always take them, but I can get them for free.

But I can withdraw all of that to get to what I thought it illustrated: The health insurance, at least as I understand it, will be covering many things that are neither unexpected nor horribly expensive contrary to "Insurance is for unpredictable events that can be expensive." Am I wrong?

It really makes a difference whether we are speaking of insurance against unexpected events that can be expensive, or rather a prepaid medical scheme. Not for the first time I find myself ill-informed, but I really had understood the ACA to be more like a prepaid medical plan than a catastrophic insurance plan.

I thought that the church flap was about birth control pills (not okay) versus Viagra (okay), but maybe condoms were included. Just never heard of that before.

I don't have a problem with folks buying insurance for foolish stuff, so long as they're paying the premiums for what they get. I do have a problem with free-riders getting emergency care (or Viagra, condoms, etc.) paid for by their more responsible neighbors.

Are your flu shots really free, or do you mean that you have no co-pay? If really free, does the state pick up the tab, or is it some charity?