Arizona passed some legislation to place a vote on the 2010 ballot recently that overrules the US Healthcare plan, basically saying that NO additional penalty tax can be collected on people who refuse to buy insurance. The people of AZ will vote on this in 2010 and I find it very difficult to believe that it wont pass. Let's hope other states follow this.
nycll said: So free loading is a basic right, I guess.
State's Rights are a basic right.
Xnarg
Senior Member - 5K
posted: Nov. 19, 2009 @ 8:34p
nycll said: So free loading is a basic right, I guess.There are other alternatives to cutting back on freeloading besides adding another huge entitlement plan.
Plus, the current proposal does not address freeloading by the many millions of illegal immigrants.
UncaMikey
Happy Member
posted: Nov. 19, 2009 @ 8:45p
tripleB said: State's Rights are a basic right.
Sheesh. Like allowing slavery, segregation, and anti-miscegenation laws?
As for the illegal immigrant "problem": excluding them means, in essence, that ONLY illegal immigrants will receive completely free health care. Since they can't pay for/receive insurance coverage, they will continue to show up at ERs when very ill/injured and local governments will have to pick up the tab. Until and unless we are prepared to let people die in the streets -- I hope we are not at that point -- everyone will still receive health care.
Everyone here legally will have to pay something for health insurance, but illegal immigrants won't be covered, but they will still get sick and injured.
More states need to sign onto this and other causes like it... States need to stand together, the 10th Amendment is the last best hope to save the republic.
UncaMikey
Happy Member
posted: Nov. 19, 2009 @ 8:54p
Xnarg said: [There are other alternatives to cutting back on freeloading besides adding another huge entitlement plan.
I am no fan of this proposal, not least because there has not been a clear statement of the problem and possible solutions.
The reality is that everyone in this country gets health care. Whether you're a CEO with a golden insurance plan or a homeless (illegal immigrant) drifter who shows up at an ER, you will receive health care. The problem is how we pay for and deliver it.
Our country pays much more per capita for heath care, but we get less. We have a higher rate of infant mortality, we don't live as long, we're not as healthy as countries that pay far less per person.
Any proposal that results in higher total system costs is a step in the wrong direction.
tripleB said: nycll said: So free loading is a basic right, I guess.
State's Rights are a basic right.
So what if a state passes a law that says "no one in this state has to pay any federal taxes". Signed into law by governor Borkus. Should that also fall under states' rights?
dshibb
Senior Member - 2K
posted: Nov. 19, 2009 @ 9:00p
Nope interstate commerce provision, and "congress has a right to charge income taxes" amendment.
Or what if a State passes a law 'Public Education cannot be mandated by Federal Government', we will only teach who we want. Federal Government can F themselves.
Xnarg
Senior Member - 5K
posted: Nov. 19, 2009 @ 9:03p
UncaMikey said: ...Our country pays much more per capita for heath care, but we get less. We have a higher rate of infant mortality, we don't live as long, we're not as healthy as countries that pay far less per person...There are some interesting reason why we have a higher infant mortality rate, and those reasons are unrelated to income levels.UncaMikey said: ...Our country pays much more per capita for heath care...We pay more for a lot of things (like houses, for example).
One of the reason that some other countries pay less for health care is because the US market subsidizes R&D for the rest of the world. If the countries that tightly control what they pay for pharmaceuticals were required to pay their fair share, their systems would collapse in short order.
Also, note that not all is well in those other countries, many of them realize they are facing collapse even if they don't have to pay their share of R&D.
Xnarg
Senior Member - 5K
posted: Nov. 19, 2009 @ 9:05p
HumDoHamaraDo said: Or what if a State passes a law 'Public Education cannot be mandated by Federal Government', we will only teach who we want. Federal Government can F themselves.The states and not the federal government currently set curriculum, so indeed the states are already saying "we will only teach what we want" and the federal government is saying, "fine with us."
One of the reasons for this was because states typically provide about 95% of K-12 education costs and the feds provide only about 5%.
At least the feds used to leave curriculum up to the states. We'll see about the future.
dshibb
Senior Member - 2K
posted: Nov. 19, 2009 @ 9:06p
HumDoHamaraDo said: Or what if a State passes a law 'Public Education cannot be mandated by Federal Government', we will only teach who we want. Federal Government can F themselves.
Theoretically I think they could. But then the federal government would unconstitutionally bring in the Military to that state, or cutoff all of its federal funding, etc.
tester99
Member
posted: Nov. 19, 2009 @ 9:06p
States rights depend on how the Court interprets the constitution at any given moment.
dshibb
Senior Member - 2K
posted: Nov. 19, 2009 @ 9:07p
who not what
UncaMikey
Happy Member
posted: Nov. 19, 2009 @ 9:08p
Like it or not, this country has already made health care a "right". No one is guaranteed a nice car that runs, a brick house in the 'burbs, a job, or even clean water and air. But every sick or injured person that gets to a clinic or ER will be treated.
Unless you pass laws mandating that some people can be turned away, that they be allowed to suffer and die without care, you will not avoid the cost of treating them.
The real problem is thus how to pay for and deliver health care in the most efficient and effective way.
True, income tax was at least ratified to the Constitution, by all the states... Seems like now DC thinks they can do whatever the hell it wants and treat the constitution like an antiquated annoyance. When asked about where they get the constitutional authority most legislators react with something between open hostility and confusion.
The Feds openly disregard state laws on a multitude of subjects. A majority of states need to stand together against federal tyranny.
EDIT: Is anyone else getting annoyed at how the "freeloading emergency care" mantra is hijacking the argument of mandated health care? It's a small portion of spending, let's not pretend people injured and getting ER care without insurance is buckling the system.
Fine, I'll do it for you... <40 seconds on google> Here's ya go, from American college of emergency physicians. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures"
Wow, that 3% sure has yall's panties in a bunch.
TexasRob
Member
posted: Nov. 19, 2009 @ 9:20p
Xnarg said: UncaMikey said: ...Our country pays much more per capita for heath care, but we get less. We have a higher rate of infant mortality, we don't live as long, we're not as healthy as countries that pay far less per person...There are some interesting reason why we have a higher infant mortality rate, and those reasons are unrelated to income levels.
It boils down to how the statistics are calculated. The reason our infant mortality rate is higher is because the US has a more stringent definition of what constitutes an infant mortality. If all countries calculated them the same way, there would be a drastic change in the list. So do everyone a favor and do not quote statistics unless you know how they are calculated. For that matter do not quote anything that politicians tell you without first researching it for yourself, you will be more informed and less likely to come off as a moronic sheep. Here are some info on how different countries calculate infant mortality rates. You can do the intelligent thing and confirm it for yourself, or you can get angry, call me a liar, or ignore the question, which is the response I would expect from someone who quotes the biased media.
The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths.
In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long.
In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth.
Rathipon
Greedy Member
posted: Nov. 19, 2009 @ 9:31p
nycll said: So free loading is a basic right, I guess.
California has more extensive social programs and entitlements than any other state. Enormously expensive. It will default soon and the rest of us will have to pay for it. New York probably isn't far behind. Yet Arizona is the freeloader?
As far as I can tell the most rational thing for a state legislature to do in this bailout age is to try and get it's share of the Federal pie by hook or by crook. If only to protect it's constituent's wealth relative to those in other states that will be getting Federal bailouts in the near future. Arizona's position seems perfectly reasonable to me under the circumstances.
but if it is going to be discussed --- the discussion needs to start with whether this is even legal or if it is just grandstanding nonsense
if there is no legal basis --- then no use discussing it
UncaMikey
Happy Member
posted: Nov. 19, 2009 @ 9:50p
TexasRob said: If all countries calculated them the same way, there would be a drastic change in the list. And you know this because you have access to a methodology that erases the differences? Could you provide the list showing the drastic changes and tell us where the corrected numbers come from?
For that matter do not quote anything that politicians tell you without first researching it for yourself, you will be more informed and less likely to come off as a moronic sheep. Here are some info on how different countries calculate infant mortality rates. You can do the intelligent thing and confirm it for yourself, or you can get angry, call me a liar, or ignore the question, which is the response I would expect from someone who quotes the biased media. I admit, yours is an interesting attitude. Either I can do the intelligent thing by accepting your superior wisdom and insight, untainted by the vulgar media, or I am a moronic sheep.
I spent a lifetime working with statistics and data analysis. I am well aware of differences in methodology, and would be shocked otherwise. But you either work with what you have and move on the best you can, or you give up because things don't exactly square up.
You give me several options: a) look up something I already knew; b) get angry; c) call you a liar; or d) ignore the question. Do you mind if I instead select e) smile bemusedly at your condescension?
cgoody29212
Member
posted: Nov. 19, 2009 @ 9:52p
tripleB said: Arizona passed some legislation to place a vote on the 2010 ballot recently that overrules the US Healthcare plan, basically saying that NO additional penalty tax can be collected on people who refuse to buy insurance. The people of AZ will vote on this in 2010 and I find it very difficult to believe that it wont pass. Let's hope other states follow this.
germanpope said: ...but if it is going to be discussed --- the discussion needs to start with whether this is even legal or if it is just grandstanding nonsense if there is no legal basis --- then no use discussing it You're right... better call up Washington and ask for permission. How would this be illegal? Last time I checked my state's constitution I didn't see any clauses to unconditionally and unquestioningly obey federal authority.
Edit: yes, there is precedent (below). But there is a battle brewing between states and feds.
JTFH said: germanpope said: ...but if it is going to be discussed --- the discussion needs to start with whether this is even legal or if it is just grandstanding nonsense if there is no legal basis --- then no use discussing it You're right... better call up Washington and ask for permission. How would this be illegal? Last time I checked my state's constitution I didn't see any clauses to unconditionally and unquestioningly obey federal authority.
I hope arizona residents are ready to just die if they don't have insurance and can't afford treatment while visiting my state.
mmm red. don't take up space in my ER if you have means to buy insurance but don't.
dougfresh
Member
posted: Nov. 19, 2009 @ 10:24p
Remember kids, insurance companies are your friend. They would like nothing more then to spend as much money as possible to make sure you and your family are healthy. They would never deny anything my Dr recommends or use the money I give them to coerce politicians to make sure they stay in business. 90% of my health care costs are going to be spent in the last ten days of my life, so I want to make sure the insurance companies don't have to pay that. Instead I will be using the public option called Medicare. I know they take 50% of my health care dollars and buy big houses, planes, and hookers. But that's OK because they provide such a great service. I hope they stay in business forever so I can give them even more money.
I think they should take out the penalty for not having insurance. I fully support your right to not carry health insurance. However... you should then get a tatoo that would alert hospitals and doctors that you made that choice and refuse any service unless you can pay for it up front.
California has more extensive social programs and entitlements than any other state. Enormously expensive.
Just wait for the next round of bailouts. The irresponsible states will get bailed out, unemployment benefits will be extended a third time, and if you can't afford to pay your mortgage then the government will pay it for you.
Can you tell me what the health care expenditures is?
Is it healthcare delivery? Healthcare Information Systems? healthcare Insurance? Healthcare supplies? Drugs?
You know, just asking to clarify a few things because at most hospital, up to 60% of the patients seen in the ER are self-pay. And the overall average of self-pay is around 20-25% of the total population of patients...
JTFH said:
Fine, I'll do it for you... <40 seconds on google> Here's ya go, from American college of emergency physicians. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures"
Wow, that 3% sure has yall's panties in a bunch.
newyork4me
Senior Member
posted: Nov. 20, 2009 @ 12:15a
UncaMikey said: Unless you pass laws mandating that some people can be turned away, that they be allowed to suffer and die without care, you will not avoid the cost of treating them.
I wish we did that now. Can't pay, won't be treated. I can guarantee you that is the quickest way to get everyone insured. Yes, poor people might have to share bedrooms, and cut the cable tv, but I'll bet they'll find a way to buy catastrophe insurance.
There is no constitutional right (nor should there be) to healthcare. You want, find a way to pay for it.
thescott
Broke Member
posted: Nov. 20, 2009 @ 12:38a
Sorry Arizona...Article 6 wins. Also known as the supremacy clause,
"This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; ... under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwith-standing."
US Const., Article 6
aeiouy
Senior Member - 1K
posted: Nov. 20, 2009 @ 1:22a
State passes laws saying minorities and non-land owners can't vote.
Woohoo.
I am all for states rights... but it is a tricky issue. If it were not going to twist things up in other states, I would all for this being decided by individual states. But since it would cause an imbalance that impacts other states, this is not something states should be able to decide on their own. Their decisions impact too many other people that are not in their state.
It boils down to how the statistics are calculated. The reason our infant mortality rate is higher is because the US has a more stringent definition of what constitutes an infant mortality. If all countries calculated them the same way, there would be a drastic change in the list. So do everyone a favor and do not quote statistics unless you know how they are calculated. For that matter do not quote anything that politicians tell you without first researching it for yourself, you will be more informed and less likely to come off as a moronic sheep. Here are some info on how different countries calculate infant mortality rates. You can do the intelligent thing and confirm it for yourself, or you can get angry, call me a liar, or ignore the question, which is the response I would expect from someone who quotes the biased media.
The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths.
In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long.
In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth.
So your theory is because countries calculate everything differently, the numbers are automatically invalid and you throw out the entire argument? Poor, poor reasoning. I am no statistics expert but one would think that groups like the WHO and OECD would adjust for differences.
JTFH said: True, income tax was at least ratified to the Constitution, by all the states... Seems like now DC thinks they can do whatever the hell it wants and treat the constitution like an antiquated annoyance. When asked about where they get the constitutional authority most legislators react with something between open hostility and confusion.
The Feds openly disregard state laws on a multitude of subjects. A majority of states need to stand together against federal tyranny.
EDIT: Is anyone else getting annoyed at how the "freeloading emergency care" mantra is hijacking the argument of mandated health care? It's a small portion of spending, let's not pretend people injured and getting ER care without insurance is buckling the system.
Fine, I'll do it for you... <40 seconds on google> Here's ya go, from American college of emergency physicians. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures"
Wow, that 3% sure has yall's panties in a bunch.
It may not be a huge percentage of expenditures, but it is a major reason why persons without insurance end up filing for personal bankruptcy because they can't pay healthcare costs. Not to mention emergency care is tremendously expensive - lots of equipment, staffing, and costs from keeping the unit running 24/7. The proportional numbers (i.e. total number of persons treated) is probably staggeringly low.
People are looking for a magic bullet (as usual) which will fix the entire system. However, the debate is hideously complex and reform will have to happen in dozens of areas - not just emergency care. End of life, early intervention and prevention, tort reform, fee-for-service, prescription drug costs, and so forth. One bill isn't going to do it because of the virtual guarantee of failure. Instead, reform is going to come in pieces. This current bill is only the first step.
biomedeng
Senior Member
posted: Nov. 20, 2009 @ 5:55a
JTFH said: EDIT: Is anyone else getting annoyed at how the "freeloading emergency care" mantra is hijacking the argument of mandated health care? It's a small portion of spending, let's not pretend people injured and getting ER care without insurance is buckling the system.
Fine, I'll do it for you... <40 seconds on google> Here's ya go, from American college of emergency physicians. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures"
Wow, that 3% sure has yall's panties in a bunch. I want to know how much of unreimbursed medical care is from emergency care. Your statistic is total health care expendatures which includes people who pay their bills either through insurance or cash. A functioning ER system is important for public health. However, I would strongly argue that our ERs are barely functioning and are at near capacity on a normal day. I also am concerned that as a person who pays my access to care is being slowed down by people who are not paying as well as hospitals who refuse to build new or expand exisiting ERs because they loose money on them. Sorry to get my underwear bunched up over something like this. Actually I don't know for sure if freeloading the ER is bucking the system. So far I have seen no credible information on the precise cause of exactly why health care has become so expensive.
Xnarg said: HumDoHamaraDo said: Or what if a State passes a law 'Public Education cannot be mandated by Federal Government', we will only teach who we want. Federal Government can F themselves.The states and not the federal government currently set curriculum, so indeed the states are already saying "we will only teach what we want" and the federal government is saying, "fine with us."
One of the reasons for this was because states typically provide about 95% of K-12 education costs and the feds provide only about 5%.
At least the feds used to leave curriculum up to the states. We'll see about the future. States cannot decide that they will teach only some kids and not others. States cannot ignore laws about EEOC, OSHA, ADA, minimum wage or SOX for that matter, they are not free to do whatever they want to their people. If the Federal Goverment draws a line in the sand and says, this is the MINIMUM you have to provide for your people, will not be easy for states to ignore it. Whether Healthcare is a MINIMUM right of the people is an entirely different debate.
Xnarg said: nycll said: So free loading is a basic right, I guess.There are other alternatives to cutting back on freeloading besides adding another huge entitlement plan. Except according to the article:
"This past Monday, the Arizona State Senate voted 18-11 to concur with the House and approve the Health Care Freedom Act (HCR2014). This will put a proposal on the 2010 ballot which would constitutionally override any law, rule or regulation that requires individuals or employers to participate in any particular health care system."
All this Act does is to keep the free-loading loophole open. It says nothing about new entitlements.
It is a "Free Loaders Unite Act". You can still support it, just don't mistake it as the "Anti Entitlement" act.
Xnarg said: One of the reason that some other countries pay less for health care is because the US market subsidizes R&D for the rest of the world. If the countries that tightly control what they pay for pharmaceuticals were required to pay their fair share, their systems would collapse in short order.
Also, note that not all is well in those other countries, many of them realize they are facing collapse even if they don't have to pay their share of R&D.
I once attended a seminar where a PowerPoint slide of the level of government control over pricing, etc. was plotted against the number of new pharmaceutical products introduced into the market. I think at that time France has the tightest control and one single product intro. Obviously the United States has the most. We can argue if that is good or bad. The drug companies, wanting to make a profit, are not going to enter a tightly controlled market to sell a new product. Do their citizens know? Do they miss out on a potentially breakthrough drug? Well, it's up to their government to decide.
Yes, we foot the bill for R&D. All they want is to dictate price or make a drug company enters into a joint venture and share the technology/trade secret asap.
nycll said: Psycho41 said: And your example of the reduced client pool doesn't really apply to the health care companies, because the sample sizes are already sufficiently large (Aetna, for instance, has 13 million members). So using your example of one out of every 1000 people getting cancer, if there are a million members, then 1000 out of the million will "win", and the rest pay 1/1000th the cost. But if the size is reduced to 500,000 people, then only 500 of them will get sick, and the other 500,000 people still pay the same; 1/1000th the cost.In the 100% participation case, everyone pays 1/1000 of the cost. In the 50% participation case, only 500,000 people pay. But the cost that needs to be paid is still for the 1000 people, because the current system does treat everyone. This part is actually covered in the other thread. Michal1980 asked a lot of questions but eventually he got it (but his solution is to let the free loader die). You read more along that discussion you will get it.
Assuming we don't let a fellow citizen die of a treatable condition only because he has no insurance nor money, there are only 2 solutions:
1. mandate everyone to have insurance, or
2. tax everyone and cover everyone with a minimal national health plan
In both cases the real poor and disabled have to receive welfare coverage. But the not-so-poor who have been free loading will either need to pay a premium or be taxed. Option 1 is what congress chose, because Option 2 is too drastic a change from our current health care system. OK I see what you're saying now. So it basically boils down to "How do we pay for all this?". Here are the options as I see them:
1. Make the middle class pay for most of it by forcing them to buy coverage they don't want, don't need, and can't afford. This is an unfair way to raise taxes (disclaimer: yes, I'm a middle class, young, healthy person that doesn't want or need health insurance).
2. Make the rich pay for most it by increasing taxes. This is how we pay for every other social program, by spreading the burden among all taxpayers. This is how we pay for food stamps for the poor, so why not pay for health care the same way?
3. Public option. Yes, this has been debated to death, but it's really the only affordable, realistic way to get universal health care. If people are concerned that it will undercut existing insurance policies, how about making it only available to low-income individuals? You know, the people who don't have insurance anyway? If I didn't have insurance, I would be wiped out due to 2 different reasons: 1. the procedure is indeed costly (not everyone can perform surgery). 2. Kleenix will be $100, like you said, because I don't have the bargaining power AETNA has while lying on the OR table. Like I said before, the majority of the people who have insurances from group plans don't pay $100 for Kleenix. Kleenex wouldn't be $100 if we outlawed and cracked down on abuses like that. And if everyone were insured, hospitals wouldn't have to worry about covering the cost of uninsured patients who can't pay their bill. As a country, we spend twice as much in health care as the average of other rich countries. That is because our patients and doctors do order and "consume" lots of care, some of them are wasted. It is not because individual items (like an appendectomy or a box of Kleenix) are sold to us at ripoff prices.And why do doctors order so many extra tests? Because they're afraid of getting sued if they miss something, so they waste money on extra tests because it's cheaper than getting sued, even if they win the case.
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