Jump to content
Objectivism Online Forum
Sign in to follow this  
CrowEpistemologist

What exactly is wrong with Obamacare?

Rate this topic

Recommended Posts

Crow:

Yes, its only another step. Yes, its just more of the same. This doesn't make it less evil than the antecedent.

It's not some gateway mandate; that is invalid. It is quite literally armed robbery.

 

So you too are convinced its "another step [in the wrong direction]". Do you have evidence for this, or do you just go along with the (obviously politically motivated) Republican narrative like so many others here? Are you sure they aren't concocting a crisis to get votes? Sure?

Share this post


Link to post
Share on other sites

Medicare and Medicaid are a separate issue from the medical costs of ERs.  ERs are required to provide care to anyone coming in, regardless of their ability to pay.  Thus, they treat many people that are ultimately unable to pay their medical bills, and are simply forced to take a loss on these people.  This inflates medical costs for other patients of that hospital.  This is a separate issue from Medicare and/or Medicaid, which are certainly paid for through taxes.

 

Also, that wasn't me that mentioned choosing hospitals that don't take Medicare/Medicaid.  You're confusing me with another poster.

 

Thanks for that clarification. This is complicated stuff, and clearly our answer here is deep in the details.

 

So having less deadbeats with no insurance will certainly help hospitals save money, and thus reduce my costs when I go to the hospital. So OC is a win in that regard. Moreover, a key argument for OC seems to be that ER care is the most expensive kind of care, and converting a lot of routine care that deadbeats can only get from ERs to ordinary day-clinics etc. will drastically reduce overall costs.

 

Again, I'm open to be proven wrong here with more details, but based on these factors, it would appear that OC will mean less deadbeats (more paying at least something instead of nothing) and a cheaper way to pay for the terminally deadbeaten. This sounds like it will save me (and the rest of us non-deadbeats) lots on taxes.

 

Again, unless somebody has a clear reason why this scheme will actually cost us a lot more... I'm all ears...

Share this post


Link to post
Share on other sites

You mentioned above that I can choose a hospital that doesn't take deadbeats, but clearly they exist in a competitive marketplace and clearly they can and do charge a lot more compared to a system that was totally free, so I'm getting hit that way regardless.

 

It would have been more accurate of me to say that you can choose a healthcare provider that doesn't take "deadbeats". And no, they are not necessarily more expensive. They work fantastically. Really, it would sound like I'm making shit up if I told you how much some of these practices save their patients. Since you're unfamiliar, please check out Ari Armstrong's interview with concierge practitioner Dr. Josh Umbehr. From that interview:

 

Our model could potentially save trillions in health costs nationwide. Health care is a $2.8 trillion industry. I believe we can potentially take out more than $1 trillion of that cost. I know that sounds extreme. But, again, if you take a model with family doctors, unlimited visits without co-pays, and wholesale pricing on medications and lab tests, dramatic savings are possible.

 

Bold mine. Like I said, numbers like that sound like this is just made-up feel-good nonsense. But if you take the time to read this interview I think you'll see how cost-savings approaching that magnitude are possible if this became the popular model for patient care. It's really exciting, actually. Earlier in the interview:

 

Whereas a standard office might charge upwards of $70 for a blood test, we get it for $1.87and that’s the price our patients pay. Why would you ever pay insurance for that? That would be like paying insurance for windshield wipers or gasoline. Such things are affordable. You just buy them when you need them. That’s not properly an insurable product or an insurable risk.

 

This is the proper solution to the nation's healthcare woes. Empowered doctors serving empowered patients and earning money while lowering costs. Obamacare penalizes this activity. The smart shopper's costs just went up.

Edited by FeatherFall

Share this post


Link to post
Share on other sites
 

Again, unless somebody has a clear reason why this scheme will actually cost us a lot more... I'm all ears...

 

I assume you consider a loss of quality to be a cost. If that's not right, please tell me. Before I take a stab at this I'd like to know how familiar you are with accountable care organizations (ACOs).

Share this post


Link to post
Share on other sites

It would have been more accurate of me to say that you can choose a healthcare provider that doesn't take "deadbeats". And no, they are not necessarily more expensive. They work fantastically. [...]

 

Interesting. Sounds like this might be a short-term solution. Of course, the feeling I get when I see this is, "they won't let it happen" in the medium to long term. If more and more people switched to this model, then there would be fewer and fewer providers to take the deadbeats, and they'd blow up and die--at which point they'd be forced to put a stop to this, or tax us some other way, or something. To be sure, the interview you linked talks about primary care physicians doing routine stuff, not (from what I understand) where the meat of the money is spent on health care, which is acute treatment, right?

 

As one poster here is fond of saying, there's no such thing as a free lunch: insofar as they are giving away health care right now, somebody has to pay for it, and that somebody basically must be the "rich" in one form or another.

 

 

I assume you consider a loss of quality to be a cost. If that's not right, please tell me. Before I take a stab at this I'd like to know how familiar you are with accountable care organizations (ACOs).

 

 

Certainly a loss of quality is a big loser, sure. If that's a threat of OC, then I'd be interested in how they'd pull that off. Remember that I don't particularly care about costs personally, and I can just buy whatever I need price-no-object. I care about costs in terms of my taxes, wherein a point or two more is worth a whole lot more than any medical bills I might rack up. Hence I'm concerned about the costs for deadbeats (as in, I want their costs to diminish so I don't have to pay as much for them) but my own bills aren't relevant to me.

 

And no, I have no idea what an ACO is :-).

Share this post


Link to post
Share on other sites

I think Crow's approach to this topic makes a little more sense to me now ( as in why HE would think this way). One of the the things I have thought of in this OC issue, is how its usually only the very rich/successful business men who are feeling the huge weight of redistribution. OC seems to spread that weight out across the income continuum so as to make the burden felt by others that don't normally notice the buried costs of things like ER freeloaders now a factor. Taxes however are a stark reality when one is paying them and particularly when one is paying them in such a lopsided redistribution.

So, someone who's taxes are considerable in comparison to any health care cost would be focused on that primarily.

Share this post


Link to post
Share on other sites

Insofar as OC (or anything else) makes our system of taxation less progressive, then that's a huge win for liberty. No, you won't hear that from any of your latter-day t-party numbskulls since that would be self-immolating to virtually all of them.

 

This is why you advocate capitalism on principle. To do it any other way is self-defeating.

 

Case and point, a gigantic holy war--assisted by so-called Objectivists--against a new scheme which would actually loosen the chains on those of us whose chains are the tightest.

 

To me, the biggest irony here is that OC could very well have been a Republican initiative (like it was in NH) and the Objectivists-come-Republican-lap-dogs arguably would have held their hands the whole way, no doubt underscoring what I have underscored in this thread.

Share this post


Link to post
Share on other sites

Alright, crow.

The aca will push some people into health insurance while essentially obliterating private insurance, correct? Because I'm assuming that much.

If so then it's nothing more than a drastic expansion of Medicaid [using it to refer to all legion programs in which one persons medicine is paid for with someone else's taxes].

So the political value of the aca stems from the broader category of Medicare.

Now Medicare spends peoples tax money on medicine without the consent of the taxed, meaning it removes production from value (since value requires choice) and thereby impedes Americans from living morally. This makes it profoundly evil.

Now if you really want to get specific the evil of Medicare stems primarily from its funding by coercive taxation because that's where effort is removed from value, but that doesn't change anything; robbery is robbery regardless of how you spend the loot.

But if we examine all of the secondary and tertiary effects this will have on the lives of countless people, all of the jobs and money and value (and MEDICINE!) which will be destroyed, it becomes quickly apparent what sorts of insults are being added to literal injuries.

No, I'm not saying that the world is ending; most people probably won't even notice it. Most people, except for those who get laid off just in time to become parents; those who die at the hands of exhausted surgeons, who never make it to the surgeons; those may have to find a different career, smaller house, less children, longer hours; those who will die just a few years sooner.

Countless people, who may never even realize why, will have to work just a little bit harder.

Now you could point out that similar effects are caused by any government interference by either party, and you'd be right. Obamacare was modeled after romneycare.

But that's not a valid justification; "they're doing it too" is for the playground, NOT the presidency.

Share this post


Link to post
Share on other sites

And as someone who has to spend $300 a month, every month, on ADD medication, because some REPUBLICAN years ago decided there should be a federally enforced monopoly on its production, I'm frankly sick and tired of hearing "it's only a little more"!!!

Share this post


Link to post
Share on other sites

 

Interesting. Sounds like this might be a short-term solution. [...] To be sure, the interview you linked talks about primary care physicians doing routine stuff, not (from what I understand) where the meat of the money is spent on health care, which is acute treatment, right?

 

There's no reason this has to be a short-term solution. That is, unless you've changed your mind about single-payer (or some other totalitarian takeover) being the ultimate goal of Obamacare. The article may have focused on primary care, but I remember Umbehr saying he was able to leverage his practice to negotiate lower costs for specialist referrals. The costs savings for specialists aren't as dramatic as prescription or test savings, but they are still impressive.

 

 

Certainly a loss of quality is a big loser, sure. If that's a threat of OC, then I'd be interested in how they'd pull that off. Remember that I don't particularly care about costs personally, and I can just buy whatever I need price-no-object. I care about costs in terms of my taxes, wherein a point or two more is worth a whole lot more than any medical bills I might rack up. Hence I'm concerned about the costs for deadbeats (as in, I want their costs to diminish so I don't have to pay as much for them) but my own bills aren't relevant to me.

 

And no, I have no idea what an ACO is :-).

 
As an aside, I wonder if it will be easier or harder for young people to become rich people when their costs are front-loaded on medical care rather than investments.
 
Earlier you voiced skepticism about cost savings; you seemed to be arguing that this wasn't relevant because it wouldn't be affordable to most people. I'm starting to feel like you're moving the goal posts. But if your purpose here really is to see how this law effects people like you and to hell with everyone else, fine. On to ACOs (that's an accountable care organization, not affordable as I wrote earlier). I'll link to what the state has to say about them first. Here is a short piece by Paul Hsieh. The short argument for why ACOs may affect your care goes like this: 

Doctors and small hospitals are incented to join ACOs to create efficiencies of service. The electronic medical records system will track their services, compare them to other ACOs, and medicare will adjust payouts accordingly. ACOs that don't spend as much money will receive higher per-service payouts, ACOs that spend more will receive lower per-service payouts. The danger for you is that your doctor's ACO administrator will lean on him to offer cheaper services rather than better services. You may not even know you need that expensive service you're willing and able to pay for (heck, medicare may even pay for it if your doctor would recommend it). Sure, you can avoid shitty doctors or ACOs by spending more time vetting your doctor or his advice, or spending time searching for a non-ACO provider when your current practitioner joins one, etc. In short, you could spend more of your own time ensuring you get quality care. But you're super rich. Your time is more valuable than the time of others.
 
I think we've proven pretty well that this law represents a huge expansion of state interference in the lives of a significant portion of US residents. I can't fault you for supporting a plan that you know will reduce state interference in your life. But as you've said many times, you don't know how your bills will change. It may even reduce your quality of care or waste your time. In light of that, it's hard for me to understand why you would dismiss the egregious rights violations for others and say something like this:

 

 

the Objectivists-come-Republican-lap-dogs arguably would have held their hands the whole way, no doubt underscoring what I have underscored in this thread.

 

I imagine your social circle gives people immense visibility and status for ridiculing conservatives. To me it comes off as petulant. We were having a good discussion until now. You've dropped this trash in another thread, only to disappear when asked for specific names. It's time to put up or shut up. Who are these Republican insurgents that are so influential or numerous to warrant comment?

Edited by FeatherFall

Share this post


Link to post
Share on other sites

Let me get this straight.

Are you saying that you don't care how coercive this is, how much it's going to hurt aspiring young people like me, so long as you're given PERMISSION to keep a little more of your own money?

Funny; that's the same reasoning being used to take the rest of your money.

Share this post


Link to post
Share on other sites

Crow, do you agree with the premise that a single payer system, such as run by Canada, is the logical outcome of ACA? From what I understand, the Individual Mandate will progress to an increased tax for all, which is to say, a Centralized Health Care System. Isn't it sadly a matter of time before a significant portion of our income will be generally taxed?

 

Here are the guiding principles of NHS:

  • that it meet the needs of everyone
  • that it be free at the point of delivery
  • that it be based on clinical need, not ability to pay

Share this post


Link to post
Share on other sites

There's no reason this has to be a short-term solution. That is, unless you've changed your mind about single-payer (or some other totalitarian takeover) being the ultimate goal of Obamacare. The article may have focused on primary care, but I remember Umbehr saying he was able to leverage his practice to negotiate lower costs for specialist referrals. The costs savings for specialists aren't as dramatic as prescription or test savings, but they are still impressive.

I think it's a short term solution because if people like myself somehow bail out of the system, they will hunt us down and start charging us again. It's simple math: without soaking us "rich" (income over $200k?) then there isn't enough money to pay for the socialized medical care system that we had before OC and will have after OC.

 

 

As an aside, I wonder if it will be easier or harder for young people to become rich people when their costs are front-loaded on medical care rather than investments.

 

Gee, maybe it will be harder. Tell me again why I should care about them? They should pay for their own damn medical insurance regardless.

 

 

I think we've proven pretty well that this law represents a huge expansion of state interference in the lives of a significant portion of US residents. I can't fault you for supporting a plan that you know will reduce state interference in your life. But as you've said many times, you don't know how your bills will change. It may even reduce your quality of care or waste your time. In light of that, it's hard for me to understand why you would dismiss the egregious rights violations for others and say something like this:

 

But I don't see how it's proven anything of the kind. It's a large amount of interference, yes. Is it a major expansion of said interference? I've not been given any evidence one way or another. Yes, you've presented an alternative to both systems which might be better, but that doesn't prove OC is worse than what we already have. If I'm dismissing egregious rights violations in the new system, are you dismissing egregious rights violations in the old one? I don't think I'm dismissing either, and I'm trying to weigh the two, and I'm being rational by being cognizant of the limits of my own knowledge.

 

 

I imagine your social circle gives people immense visibility and status for ridiculing conservatives. To me it comes off as petulant. We were having a good discussion until now. You've dropped this trash in another thread, only to disappear when asked for specific names. It's time to put up or shut up. Who are these Republican insurgents that are so influential or numerous to warrant comment?

 

 

Well that's just weird. My "social circle"?

 

Anyhow, I suppose as evidence I'd point to The Objective Standard and every anti-OC article written by somebody calling themselves "an Objectivist" in prominent publications. I'd point to the same rushing in to defend the gun nuts, simplifying an issue that is not simple, but simplifying it in a way that oh-so-conveniently fits perfectly into Republican talking points. I'd point to the defense of Ted Cruz, who staged a "filibuster" so phony that even his fellow Republicans rebuked him for it. I'd point to repeated appeals for an immediate return to the gold standard by the same even though real Objectivists don't believe in any interference by the government at all with respect to currency. I'd point to the operational priorities of these groups wherein there are thousands of issues they could attack on a principled basis but they seem to use Fox News as north star by and large (with notable exceptions, certainly).

 

Yes, many Objectivists (hello) are not given to supporting one particular party to win over friends, but some are, and that's who I was talking about.

Share this post


Link to post
Share on other sites

 

Crow, do you agree with the premise that a single payer system, such as run by Canada, is the logical outcome of ACA? From what I understand, the Individual Mandate will progress to an increased tax for all, which is to say, a Centralized Health Care System. Isn't it sadly a matter of time before a significant portion of our income will be generally taxed?

 

Here are the guiding principles of NHS:

  • that it meet the needs of everyone
  • that it be free at the point of delivery
  • that it be based on clinical need, not ability to pay

 

 

I don't know. You could make the case that OC is a stepping stone to that, or you could make the case (as the Republicans who invented OC did) that such a system will delay the demand for single payer. Who knows.

Share this post


Link to post
Share on other sites

I agree that everyone should pay for their own insurance. I find it difficult to believe that you haven't thought to apply that to the aca or that you've honestly failed to apply it properly, to the extent that you have.

The fact that you would consider appeals to return to the gold standard as unobjectivist (and somehow contrary to a nonmanipulable currency?) is quite interesting; these Republican agents would include Alan Greenspan and ayn rand, herself.

If you want a selfish reason to oppose the aca then stop and realize the fact that, by playing these insipid little games of "it hurts you but not me" you are shaking hands with the devil- not in any moral or literal sense, but with regards to your own safety.

Thieves, looters and con men make poor houseguests.

Share this post


Link to post
Share on other sites

And you're not even trying to find the aca's relation to idealized collectivism! Your last post wasn't a response; that's an excuse not to respond!!

So you come here, accusing those who hold opinions expressed by Rand herself of being secret Republicans, advocating MORE coercive governance and then BLATANTLY refusing to acknowledge it for what it is?

Check your premises.

Share this post


Link to post
Share on other sites

I agree that everyone should pay for their own insurance. I find it difficult to believe that you haven't thought to apply that to the aca or that you've honestly failed to apply it properly, to the extent that you have.

The fact that you would consider appeals to return to the gold standard as unobjectivist (and somehow contrary to a nonmanipulable currency?) is quite interesting; these Republican agents would include Alan Greenspan and ayn rand, herself.

If you want a selfish reason to oppose the aca then stop and realize the fact that, by playing these insipid little games of "it hurts you but not me" you are shaking hands with the devil- not in any moral or literal sense, but with regards to your own safety.

Thieves, looters and con men make poor houseguests.

 

Alan Greenspan yes, but Ayn Rand, no. Ayn Rand, wisely, never weighed in on business issues. Alan Greenspan, meanwhile, changed course in his latter years:

 

"So that the question is: Would there be any advantage, at this particular stage, in going back to the gold standard? And the answer is: I don't think so, because we're acting as though we were there." -- Alan Greenspan, Hearing on Monetary Policy Report, US House Committee on Financial Services, 20 July 2005, Washington D.C.

Share this post


Link to post
Share on other sites

Alan Greenspan yes, but Ayn Rand, no. Ayn Rand, wisely, never weighed in on business issues. Alan Greenspan, meanwhile, changed course in his latter years:

 

"So that the question is: Would there be any advantage, at this particular stage, in going back to the gold standard? And the answer is: I don't think so, because we're acting as though we were there." -- Alan Greenspan, Hearing on Monetary Policy Report, US House Committee on Financial Services, 20 July 2005, Washington D.C.

 

I seriously doubt that he would make that same statement today, in the wake of all the radical and unprecedented actions that the Federal Reserve has taken in the past five years, and the expanded role that the Fed has basically granted itself.

Share this post


Link to post
Share on other sites

I seriously doubt that he would make that same statement today, in the wake of all the radical and unprecedented actions that the Federal Reserve has taken in the past five years, and the expanded role that the Fed has basically granted itself.

 

I'm not convinced he would have done anything different than Bernanke. His precepts about world economics proved drastically wrong, and I think he would have adjusted his models accordingly.

 

Moreover, regardless of the crisis and all of the Feds actions, one thing that is completely absent from the ensuing 8 years is any sign of inflation. AG clearly was proud of himself in the way that he controlled inflation, and the statement above about gold is case and point. He's basically saying, "don't worry, the Fed is run by smart people like me and we're not going to let inflation happen".

 

At very least, he'd wait until there was actual evidence of significant inflation occurring and it getting out of control of the Fed in order to change his stance. 

 

(But we digress. I have written elsewhere that I don't believe US dollar inflation will be a "threat" to anybody ever again based on the new realities of global banking technology).

Share this post


Link to post
Share on other sites

Crow, of course the young should pay for their healthcare choices. Under the current law, however, they are paying more in taxes and premiums to fund the healthcare of the elderly and the sick. That was the whole point of the law. I don't care if you care about these people. But if you want to judge this law, you must take into account the rights of others as well as your own. You can't evaluate how this affects others without looking at how it interferes with the choices they make. Despite your dismissals, we know that the law further interferes with the choices people make to provide for their own care, we know that it further interferes with a doctor's decision to run his own practice (not to mention the care decisions of doctors who accept medicare), and we know that in order to implement this law the rule of law itself suffered significant injury (SCOTUS redefining the penalty as a tax, the creation of federal exchanges without legal authority, the regulation of non-activity as commerce). Given all of this, you continue to level base insults at defenders of individual rights because you think this law might provide you tax savings for which you have no evidence.

Speaking of which, those insults serve as an end-around meaningful discussion  They amount to cowardly ad hominem, and they aren't even true. For counter examples, see Immigration and Individual Rights, Morality and Sanity Demand an End to Drug Prohibition, Toward a Free Market in Education; School Vouchers or Tax Credits?, and Planned Parenthood and Others Admirably Fight Texas Anti-Abortion Bill. Your opinions on gun rights are flat wrong (they involve a Zeitgeistian appeal to broad statistics while dismissing principles and real-world examples), so it doesn't surprise me that you would resort to more ad hominem on that issue. I'd be willing to accept a single criticism of yours (their support for the gold standard) as valid if you can show that they advocate a return to it for it's own sake, rather than as a meaningful step toward free banking. But even then, it's not like Republican talking points demand a return to the gold standard. Far from just "notable exceptions," these examples are proof positive that those who write for the Objective standard are carving a path toward a society that respects individual rights regardless of Republican talking points. 

 

Anyhow, I suppose as evidence I'd point to The Objective Standard and every anti-OC article written by somebody calling themselves "an Objectivist" in prominent publications.

Every article? Do better, man. You have to know that lazy dismissals like this evidence a broader lack of intellectual rigor.

Edited by FeatherFall

Share this post


Link to post
Share on other sites

This is known as “deficit financing.” It is made possible by the fact that the government cuts the connection between goods and money. It issues paper money, which is used as a claim check on actually existing goods—but that money is not backed by any goods, it is not backed by gold, it is backed by nothing.

-Ayn Rand:  Egalitarianism and Inflation  (Philosophy: Who Needs It?)

 

Gee, maybe it will be harder. Tell me again why I should care about them?

Government control of a country’s economy—any kind or degree of such control, by any group, for any purpose whatsoever—rests on the basic principle ofstatism, the principle that man’s life belongs to the state. . .
To be put into practice, this belief has to be implemented by the political doctrine that the government—the state—has the right to initiate the use of physical force against its citizens. How often force is to be used, against whom, to what extent, for what purpose and for whose benefit, are irrelevant questions.

-Ayn Rand,  Conservatism: an Obituary

-Ayn Rand, America's Persecuted Minority: Big Business

 

I don't know. You could make the case that OC is a stepping stone to that, or you could make the case (as the Republicans who invented OC did) that such a system will delay the demand for single payer. Who knows.

The statists’ epistemological method consists of endless debates about single, concrete, out-of-context, range-of-the-moment issues, never allowing them to be integrated into a sum, never referring to basic principles or ultimate consequences—and thus inducing a state of intellectual disintegration in their followers. The purpose of that verbal fog is to conceal the evasion of two fundamentals: (a) that production and prosperity are the product of men’s intelligence, and (B) that government power is the power of coercion by physical force.

-Ayn Rand, "Let Us Alone!"

 

So you too are convinced its "another step [in the wrong direction]". Do you have evidence for this, or do you just go along with the (obviously politically motivated) Republican narrative like so many others here? Are you sure they aren't concocting a crisis to get votes? Sure?

 Since need, not achievement, is held as the criterion of rewards, the government necessarily keeps sacrificing the more productive groups to the less productive, gradually chaining the top level of the economy, then the next level, then the next. (How else are unachieved rewards to be provided?)

There are two kinds of need involved in this process: the need of the group making demands, which is openly proclaimed and serves as cover for another need, which is never mentioned—the need of the power-seekers, who require a group of dependent favor-recipients in order to rise to power. Altruism feeds the first need, statism feeds the second, Pragmatism blinds everyone—including victims and profiteers—not merely to the deadly nature of the process, but even to the fact that a process is going on.

-Ayn Rand, A Preview

 

---

 

I'm tempted to start pulling quotes out of Atlas Shrugged, but. . .

Share this post


Link to post
Share on other sites

Crow, of course the young should pay for their healthcare choices. Under the current law, however, they are paying more in taxes and premiums to fund the healthcare of the elderly and the sick.

 

The "current law" being OC, or pre-OC? That I don't know is sorta the point...

 

 

You can't evaluate how this affects others without looking at how it interferes with the choices they make. Despite your dismissals, we know that the law further interferes with the choices people make to provide for their own care, we know that it further interferes with a doctor's decision to run his own practice (not to mention the care decisions of doctors who accept medicare), and we know that in order to implement this law the rule of law itself suffered significant injury (SCOTUS redefining the penalty as a tax, the creation of federal exchanges without legal authority, the regulation of non-activity as commerce).

 

Now we're getting somewhere. Details.

 

How exactly does OC interfere with the choices people make? As I understand it, you still get to pick from the same insurance companies (and plans) you do now, right?

 

How exactly does it interfere with a doctor's decision to run his own practice?

 

The SCOTUS thing was (was) a step backwards, no doubt. I'm not sure what those other things mean.

 

 

[...] You have to know that lazy dismissals like this evidence a broader lack of intellectual rigor.

 

Absolutely. And a lack of sleep and the bitchiness that comes with it. Withdrawn. I'll stop generalizing (but specifically, the Ted Cruz thing was totally retarded :-) ).

Share this post


Link to post
Share on other sites

Current law is Obamacare. I understand if there is some confusion on this, since it is still being phased in piece by piece. I'll also lay off of you on the Ted Cruz thing, because I think the Objective Standard's article about it was poorly thought out after learning more about it. It was a mistake, but I wouldn't call it totally retarded.

 

 

How exactly does OC interfere with the choices people make? As I understand it, you still get to pick from the same insurance companies (and plans) you do now, right?

 

 

Not quite. Obamacare hasn't outlawed specific plans or anything, but they have saddled the most sensible plans with two kinds of penalties. They use tax and fine sticks to beat people into a group of plans that cover a wide variety of highly personal risks (counseling, rehab, etc.) or conditions that aren't properly considered insurable risks (prenatal care, for instance). The first penalty, the individual mandate, is a "tax" that is incurred if you lack a plan that meets minimum coverage requirements (rehab, prenatal, etc.). This penalty incents the individual to insure for things he normally wouldn't, and therefore use healthcare he normally wouldn't, because doing so is now just as expensive as what I call a "sensible plan." Sensible plans insure an individual against risks for which he thinks he needs insurance. The other plans insure him for more. Specifically, the penalty looks like this:

 

Under the new rules, individuals choosing not to carry insurance are subject to a penalty of $95 per person each year, or 1% of household income, whichever is greater, beginning in 2014. Over time, the penalty increases, so that by 2016 the penalty is $695 per person, or 2.5% of household income. Subsequent years will be calculated based on a cost-of-living formula.

 

Please note that the article wrongly describes the event that triggers the penalty; penalties are not incurred for being uninsured, but rather for not having a state-approved insurance plan. So yes, you can keep your plan. But they'll tax you. The second penalty, called the employer mandate, more directly speaks to people losing their plans. As far as I know, the SCOTUS saw no problem with leveling a penalty against business, so there is no pretense that this is a tax. It may still be administered by the IRS. I could be wrong. What we call it is really irrelevant, but I digress.

The employer mandate penalizes businesses like so. Let's pretend you are a business owner (maybe you really are, I don't know). Your business employs 50 people, and one of them makes 399% of the poverty level. That employee chooses not to incur a "tax" penalty, so he decides to insure himself against things he otherwise wouldn't, and he calls up the state (or extra-legal federal) exchange. The exchange navigator asks him to provide all of his employment info and, lo and behold, it turns out that he is eligible for a subsidy because his family income is less than 400% of whatever the hell the bureaucrats who decide things decide to call the poverty level that year. The employee says, "Sweet, now I won't have to pay for all of that new medical care I didn't need! I'll take it!"

*Poof* Your business now owes the state $40,000 because he got a few grand in subsidies. Magic is fun.

So, being a business owner, you have lots of extra hours of time to devote to sorting through new government laws (or maybe you have a crystal ball), and you foresee your single employee costing you $40,000. So you change your plan, insuring him for more than he'd prefer, and take it out of his paycheck. Maybe you'll get lucky and he'll choose not to take the plan and pay a "tax" penalty (fat chance). Or maybe you just say, "Screw it. $40,000 is less than I'm paying now for insurance. I'm dropping everyone, they can go get their subsidies on." Well, Mr. Business owner, I'm with you. To hell with letting them keep their plans!

Now consider the fact that the employer mandate refers to family income. That's something an employer couldn't possibly know without invasive (possibly illegal?) questions... So how the hell are they supposed to make sound business decisions? More magic, I guess. The ACA fucks with your choices via "monetary incentives" and then makes an informed decision impossible. But have no fear. Not to have bureaucracy outdone by the SCOTUS (what the hell is constitutional authority, anyway?), the IRS has saved the day with another extralegal change to the law.

I'd love to be able to go on and examine every iteration of the employer mandate, but my head is spinning. You get my point, though. We aren't making decisions like we used to.
 

 

 

How exactly does it interfere with a doctor's decision to run his own practice?.

 

I covered that earlier. Post 60, to be exact. ACOs. But to be fair, a doctor could choose not to accept medicaid... But that would be a choice brought about by the new electronic medical requirements, wouldn't it? If I went back in time to kill this law, I wouldn't have a reason to go back in time, but if I don't go back in time this law will exist, so I'd have to go back...

I think a lack of sleep is getting to me now. Good night.

Edited by FeatherFall

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
Sign in to follow this  

  • Recently Browsing   0 members

    No registered users viewing this page.

×
×
  • Create New...