hey, that's a funny coincidence
March 10, 2012 8:38 AM   Subscribe

Mary Brown, a 56-year-old Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama's healthcare law because she was passionate about the issue. Brown "doesn't have insurance. She doesn't want to pay for it. And she doesn't want the government to tell her she has to have it," said Karen Harned, a lawyer for the National Federation of Independent Business. Brown is a plaintiff in the federation's case, which the Supreme Court plans to hear later this month. But court records reveal that Brown and her husband filed for bankruptcy last fall with $4,500 in unpaid medical bills. Those bills could change Brown from a symbol of proud independence into an example of exactly the problem the healthcare law was intended to address.

Via Scott Lemieux at Lawyers, Guns, and Money, who also links to a piece he recently wrote about free riders and the mandate for the American Prospect.
posted by gerryblog (189 comments total) 28 users marked this as a favorite

 
Janis Joplin was right.
posted by Bromius at 8:41 AM on March 10, 2012 [2 favorites]


I'm surprised someone that is supposed to practice fiscal responsibility would declare bankruptcy over $5k. It's not a ton of money when most people I have heard declare it over medical costs usually have $100k or more racked up in a long hospital stay.

It also screws over the hospital and makes the government pay for the costs anyway.
posted by mathowie at 8:49 AM on March 10, 2012 [34 favorites]


You can't even consider yourself middle class without health insurance in my opinion.
posted by swooz at 8:49 AM on March 10, 2012 [8 favorites]


Doesn't the National Federation of Independent Business have somebody whose job is to check for things like this?
posted by box at 8:50 AM on March 10, 2012 [1 favorite]


> In a video interview, Brown said freedom from government was the issue. "I'm not fighting just for me," she said. "It's my choice to have healthcare, not theirs."

LIVE FREE AND DIE
posted by The Card Cheat at 8:50 AM on March 10, 2012 [94 favorites]


It could be the case that this Brown person is stupid beyond reason but I hope that someone has followed the money trail or at least made sure that she hasn't suddenly inherited a house or brand new car or something.
posted by Foci for Analysis at 8:52 AM on March 10, 2012 [4 favorites]


I'm surprised someone that is supposed to practice fiscal responsibility would declare bankruptcy over $5k.

She's not.

The article states: "Lawyers who represent Brown dispute the significance of her bankruptcy. They say her unpaid medical bills were only a small part of her debts and did not cause her bankruptcy. They say that she and her husband owe $55,000 to others, including credit card companies. And they say her financial troubles were caused by the failure of her auto repair shop............The couple owed $2,140 to Bay Medical Center in Panama City, $610 to Bay Medical Physicians, $835 to an eye doctor in Alabama and $900 to a specialist in Mississippi."
posted by OsoMeaty at 8:52 AM on March 10, 2012 [8 favorites]


The article explains that they had trouble finding a plaintiff. Obviously they needed someone without insurance for the optics, but also, I think, to have standing in the courts at all.

There just aren't many people out there who are proudly insuranceless not because of money but because of FREEDOM. It's practically a null set.
posted by gerryblog at 8:54 AM on March 10, 2012 [14 favorites]


It doesn't matter why she says she declared bankruptcy. She's a free rider, exactly the opposite of the rugged individualist the suit claims.
posted by gerryblog at 8:56 AM on March 10, 2012 [110 favorites]


It doesn't matter why she says she declared bankruptcy. She's a free rider, exactly the opposite of the rugged individualist the suit claims.

Exactly. Oh my God this is beautiful.
posted by jayder at 8:59 AM on March 10, 2012 [18 favorites]


It doesn't matter why she says she declared bankruptcy. She's a free rider, exactly the opposite of the rugged individualist the suit claims.

Deffinitely agree with you there. Just pointing out that their bankrupcty suit isn't over just 5k in unpaid medical bills.
posted by OsoMeaty at 9:00 AM on March 10, 2012 [2 favorites]


I'll lol if the court approves all the new restrictions on insurance companies, but rules the federal government cannot impose a regressive tax, i.e. asks congress for single payer.
posted by jeffburdges at 9:02 AM on March 10, 2012 [2 favorites]


The conservative case for healthcare reform's individual mandate.
In considering the individual mandate, conservatives need to address three questions. First, why is it so troubling that the government is requiring responsible individuals to purchase what they would purchase anyway? Second, is it fair or appropriate to make the responsible pay more in order to protect the rights of the irresponsible? Third, what should be done when the principle of limited government clashes with that of individual responsibility?

Or, put another way, is the principle of limited government so compelling that it should cause us to penalize the responsible and reward the irresponsible?
Bottom line, you can do whatever you want or don't want to do, but when your inactions force others to pay more, society had every right to say "Oh fuck no motherfucker, you're putting some damn money in the pool."
posted by Brandon Blatcher at 9:05 AM on March 10, 2012 [58 favorites]


Metafilter: Oh fuck no motherfucker
posted by thanotopsis at 9:07 AM on March 10, 2012 [12 favorites]


So she wants to be free of gummint intrusion w.r.t. health insurance, but runs screaming to the courts and gummint protection when she gets in a financial bind?

Worst kind of hypocrite.
posted by notsnot at 9:08 AM on March 10, 2012 [45 favorites]


Not to derail all the schadenfreude here, but isn't one of the main problems with the US healthcare system that people who have insurance often end up bankrupt, thanks to the unscrupulous actions and policies of insurers? Which is why the individual mandate that we all buy health insurance doesn't really address the problem in the same way that, say, a single-payer system would? I mean, aren't those stories we usually read about people filing for bankruptcy with hundreds of thousands of dollars of medical bills after a catastrophic illness usually about people who are insured?
posted by Hal Mumkin at 9:11 AM on March 10, 2012 [23 favorites]


Why is social healthcare--an idea that every other developed country in the world has embraced--a bad idea again?

Something about principles?

Something about a privilege not a right?

Or maybe its something about lobbyists.
posted by candasartan at 9:14 AM on March 10, 2012 [15 favorites]


Not to derail all the schadenfreude here, but isn't one of the main problems with the US healthcare system that people who have insurance often end up bankrupt, thanks to the unscrupulous actions and policies of insurers?

Yes. "Of those who filed for bankruptcy in 2007, nearly 80 percent had health insurance."
posted by dirigibleman at 9:15 AM on March 10, 2012 [2 favorites]


I am a 1000% in favor of a single payer system. It's terrible that anyone goes bankrupt over health costs. It should be provided to everyone out of taxes.

The reason you're seeing schadenfreude is because Mary Brown and her backers are trying to make that situation worse, not better, by bringing us even further from universal care.
posted by gerryblog at 9:16 AM on March 10, 2012 [2 favorites]


I hope some of the We Are The 53% people boasting about their self-reliance see this story and recognize their own self-delusion in it.

Not likely, but one can hope.
posted by El Sabor Asiatico at 9:17 AM on March 10, 2012 [3 favorites]


I think that having mandated insurance purchasing was a bad PR move, too -- not only did they completely fall down on the job of demonstrating to the general public why everyone having insurance is beneficial, but they also opened the door to this "freedom"-based argument whereby people can argue that they shouldn't be forced to buy something. It's not a good argument at all, but it resonates with the intellectually simple in a way that "socialist" medicine -- such as a single-payer system -- could also have, under another name. Uneducated folks have latched onto the "CAN'T MAKE ME" argument because (a) they can't see past that side of things and (b) the upside was never explained. Skipping straight ahead to a single-payer system, and coming up with a catchy name for the less progressive amongst us, would have brought new problems but also skipped over this line of reasoning. No one wants to be forced to pay. But who doesn't want "free" health care?

I think one of my biggest disappointments in the Obama administration is not what they haven't done, but how poorly they've sold their accomplishments.

I really hope someone comes along who can actually teach our citizens about the benefits -- for individuals! -- of being community-minded. I think it's the cause of many of our societal problems today.
posted by theredpen at 9:19 AM on March 10, 2012 [9 favorites]


There's a lot to the ACA besides the mandate, including cost-cutting, subsidies, and checks on insurer malfeasance. The right is attacking ACA at the mandate because they think the mandate is the legislation's weakest link, not because they think the mandate is actually uniquely bad. Remember, it was their own idea, back when they had no intention of taking health care reform seriously.

They're hoping SCOTUS kills the whole bill on severability grounds, even though their severability argument is actually logically self-defeating. It's a Hail Mary, in other words.
posted by gerryblog at 9:19 AM on March 10, 2012 [8 favorites]


Or, put another way, is the principle of limited government so compelling that it should cause us to penalize the responsible and reward the irresponsible?

The thing is, this isn't a conundrum for actual conservatives (of whom there are few). Ron Paul-type conservatives would happily have hospitals just deny care to the "irresponsible".

In their vision, no one would be able to rack up $100k in medical bills then default on the debt, because part of the hospital admission procedure would be a credit check and a hold on your bank account.

"Hello sir, you say you need an appendectomy? I'm sorry, unfortunately that procedure is contraindicated for people in your income bracket."

Problem solved, right?
posted by Salvor Hardin at 9:29 AM on March 10, 2012 [4 favorites]


Don't get me wrong - I certainly think this person is a first-class idiot.

But just because a medical concern SAYS you owe them money doesn't mean you REALLY owe them money. Our system is so corrupt and byzantine it's insane. There's at least something incorrect in almost every medical bill I receive. (And it's never in my favor.)
posted by Benny Andajetz at 9:30 AM on March 10, 2012 [3 favorites]


When you file bankruptcy don't you have to declare all your debts? Even if they could pay the medical bills do they have to include them in the bankruptcy?
posted by Danila at 9:32 AM on March 10, 2012


KEEP YOUR BIG GOVERNMENT OUT OF MY BANKRUPTCY PROCEEDING!
posted by localroger at 9:32 AM on March 10, 2012 [6 favorites]


"But by then, Brown's small auto repair shop near Panama City, Fla., had closed, and she and her husband had filed a Chapter 7 bankruptcy petition. Brown said in the petition that her only income was $275 a month in unemployment benefits.

Her bankruptcy came to light in December, when a Wall Street Journal reporter interviewed her about her role in the historic case. In a video interview, Brown said was the issue."
WTF? Then why did you accept unemployment benefits from your government?

What's next lady?

" I don't want government-run health care. I don't want socialized medicine. And don't touch my Medicare."
posted by ericb at 9:33 AM on March 10, 2012 [9 favorites]


I think one of my biggest disappointments in the Obama administration is not what they haven't done, but how poorly they've sold their accomplishments.


In the middle of the health-care debate, I remember a story came out about a person/family who lived in a community with a strange fire protection system. In that community, people had a choice...they could pay (I believe it was about $70) to get coverage or they could choose to not pay. You know where this is going...Person/Family X didn't pay, their house caught on fire, and the story was about how the firemen came to the site and watched as the house burned (if I recall, they were there in case the fire spread to other houses with coverage).

The mandate issue couldn't have been more clearly portrayed, and this made national news. Yet...here we are, still hearing about some people complaining about this mandate's assault on freedom.

The point I am trying to make is that while there are legitimate reasons to complain about the Obama Administration, I don't think you can blame them for "bad narrative creation". We've seen MeFi posts about this, some people will not change their minds in the face of the truth, and this intransigence seems to be correlated more strongly with people who identify themselves as conservatives.
posted by Hypnotic Chick at 9:34 AM on March 10, 2012 [6 favorites]


The annoying thing is that the mandate was the right wing's idea in the first place. The whole ACA is based on proposals from the Heritage Foundation. They're just mad that a Democrat enacted it, if Bush had proposed the exact same program, they would have all lined up right behind it.
posted by octothorpe at 9:34 AM on March 10, 2012 [12 favorites]


What I want to know is, why didn't the Republican party indirectly have a few bucks kicked her way so she could keep trying to embarrass Obama with her "don't need no gubmint" schtick? Seems like a few well-placed phone calls could have helped her out quite a bit.
posted by ctmf at 9:36 AM on March 10, 2012 [1 favorite]


WTF? Then why did you accept unemployment benefits from your government?

To be fair, don't you pay into your own unemployment insurance? I think she'd be fine with that, working with the same logic that allowed Ayn Rand to accept Social Security.
posted by Sticherbeast at 9:36 AM on March 10, 2012


WTF? Then why did you accept unemployment benefits from your government?

The same reason wealthy liberals don't voluntarily pay extra taxes. You might think the system provides you benefits that it shouldn't, and you might even be a public advocate for changes to the system that would deny you those benefits, but that doesn't make it hypocritical to accept those benefits while the present system is in place.
posted by escabeche at 9:39 AM on March 10, 2012 [7 favorites]


Janis Joplin was right.

Fuck health insurance, I wanna buy me a Mercedes Benz?

Bankruptcy's just another word for nothing left to lose?

Medical insurance grabbed ahold of me honey, felt to me just like a ball and chain?
posted by PeterMcDermott at 9:40 AM on March 10, 2012 [9 favorites]


don't you pay into your own unemployment insurance? I think she'd be fine with that, working with the same logic that allowed Ayn Rand to accept Social Security.

You do pay into your own unemployment insurance, but it's (in every state where I've looked into it) a non-waivable requirement of employment, and your employer also pays into it. Yes, it's your money going into the risk pool, but you don't have a choice about whether to put that money into the risk pool or not, and some of it's not your money, either.

In other words, unemployment insurance is a lot like how I understand the ACA to work. You're buying health insurance but you really don't have a choice whether to buy it or not.

I'd bet a lot of donuts that this woman doesn't think her unemployment insurance is socialism.
posted by gauche at 9:41 AM on March 10, 2012 [6 favorites]


The problem with the "I don't want to be forced to pay for health insurance" position, is the Reagan-era law that forces hospital emergency rooms to accept anyone who shows up at the door with or without insurance. This government intervention distorts the market.

You don't want to pay for health insurance. Fine. Good. But when you show up at the hospital without it, don't demand that they treat you. If you really believe in free market solutions, let the market work.

Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.
posted by three blind mice at 9:43 AM on March 10, 2012


Say what you will but the Republicans (and the Right in general) have done a masterful job at convincing Americans to agitate for things in direct opposition to their best interests.
posted by tommasz at 9:44 AM on March 10, 2012 [33 favorites]


The thing is, this isn't a conundrum for actual conservatives (of whom there are few). Ron Paul-type conservatives would happily have hospitals just deny care to the "irresponsible".

You must be thinking of someone else. Ron Paul believes in private charity for people who can't afford care. He frequently has to explain that the medical community does not turn people away because of the assumption you make about conservatives and charity.
posted by michaelh at 9:46 AM on March 10, 2012 [1 favorite]


The same reason wealthy liberals don't voluntarily pay extra taxes.

this is one of those stupid things i keep hearing when complaining about liberals. It's so misguided it's not even funny any more. Liberals are fine paying taxes, and also give to charity. Right wingers don't want to do either, unless it benefits them, charity only if it cuts their taxes, which they do their damnedest to get as close to 0 as possible, then also complain that social services aren't how they want if they need them. You want to complain about social services for people not like you, then don't take it, medicare, SS, bank bailouts, etc.
posted by usagizero at 9:46 AM on March 10, 2012 [4 favorites]


WTF? Then why did you accept unemployment benefits from your government?

To be fair, don't you pay into your own unemployment insurance? I think she'd be fine with that, working with the same logic that allowed Ayn Rand to accept Social Security.


Wait a minute. She is described as the *owner* of a small business, not an employee. How on earth is she even entitled to unemployment benefits?

We need a new word for "hypocrisy combined with stupidity combined with venality and seasoned with hate." Oh wait, we have one. "Republican."
posted by spitbull at 9:46 AM on March 10, 2012 [8 favorites]


And this just occurred to me: I have no problem at all exempting people from the individual mandate for any reason they wish, religious or political or whatever, so long as they post a bond for at least a million dollars to cover catastrophic healthcare costs.

How's that for a free market solution? Put up or shut up.
posted by spitbull at 9:48 AM on March 10, 2012 [8 favorites]


Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.

Unfortunately for you, a lot of people think that this kind of sink-or-swim approach to health care -- in particular, not all social goods, but health care -- is not a mark of the civilization in which we want to live, particularly when you consider that some of those "deadbeats" are children who have made no decisions at all, or are people who are just plain priced out of buying health care.
posted by gauche at 9:53 AM on March 10, 2012 [15 favorites]


Not to derail all the schadenfreude here, but isn't one of the main problems with the US healthcare system that people who have insurance often end up bankrupt, thanks to the unscrupulous actions and policies of insurers? Which is why the individual mandate that we all buy health insurance doesn't really address the problem in the same way that, say, a single-payer system would? I mean, aren't those stories we usually read about people filing for bankruptcy with hundreds of thousands of dollars of medical bills after a catastrophic illness usually about people who are insured?

Sure, but that's why the ACA forgids those participating in the insurance exchanges from playing all the games that kick people off their insurance. I.e there's no pre-existing condition exclusions etc. But the only way to make that viable is to guarantee a sufficiently large risk pool--hence the individual mandate.
posted by yoink at 9:53 AM on March 10, 2012 [5 favorites]


It's just not right that the government makes me carry car insurance. It violates my right to drive a car without it. I'm just going to stop sending checks to Progressive. If I get into a car accident, I'll just file bankruptcy. It's foolproof.
posted by double block and bleed at 9:53 AM on March 10, 2012 [6 favorites]


But when you show up at the hospital without it, don't demand that they treat you. If you really believe in free market solutions, let the market work. Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.

Where "let the market" work = suffer and die, and "deadbeats" = poor people. You're a real humanitarian.
posted by Popular Ethics at 9:54 AM on March 10, 2012 [5 favorites]


It's unclear from the facts given how much of her debt is healthcare related, as it's entirely possible that credit cards were used to pay off some of that debt (or that purchases were made on credit that wouldn't have otherwise been made had they not been saddled with medical costs). So it's a mistake to dismiss the role of medical costs here.
posted by allen.spaulding at 9:54 AM on March 10, 2012 [4 favorites]


Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.

Don't you live in Sweden?
posted by sevenyearlurk at 9:55 AM on March 10, 2012 [9 favorites]


Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.

Single payer means everyone is paying, and paying less, than the way we are currently doing it. Win/win.

And the children of deadbeats? What of them?
posted by ambrosia at 9:56 AM on March 10, 2012 [2 favorites]


I think tbm was being sarcastic. Swedish hamburger has perhaps a different flavor from North American hamburger.
posted by rtha at 9:57 AM on March 10, 2012 [14 favorites]


ambrosia: And the children of deadbeats? What of them?

They don't lobby, vote or contribute to the republican party. Fuck 'em.
posted by double block and bleed at 9:59 AM on March 10, 2012 [5 favorites]


Being forced to pay for health care is one thing. Being forced to pay it to for-profit, anti-trust exempt corporations who own Congress is something else.

But hey, they fixed all the things that were wrong with NAFTA, right?
posted by Trurl at 9:59 AM on March 10, 2012 [7 favorites]


Swedish hamburger has perhaps a different flavor from North American hamburger.

BORK BORK BORK!
posted by ambrosia at 9:59 AM on March 10, 2012 [9 favorites]


I really hope someone comes along who can actually teach our citizens about the benefits -- for individuals! -- of being community-minded. I think it's the cause of many of our societal problems today.

Sadly, I think we have a worse problem. Americans can be very community-minded -- in what they perceive to be their communities. When the poor are The Other, then the hell with them. Back in the early part of this century, progressive ideals had remarkable popular success. But then, in the popular imagination, the face of poverty became black, not white. Thence the "welfare queen."

This isn't conscious racism, not for most of the people who truly believe it. But if more Americans truly believed that the people who need assistance were part of the fabric of their society, I don't think we would have this kind of resistance to the construction of a social safety net.
posted by Countess Elena at 10:01 AM on March 10, 2012 [29 favorites]


Maybe someone could code a greasemonkey that detects irony around here.
posted by Foci for Analysis at 10:01 AM on March 10, 2012 [3 favorites]


Where "let the market" work = suffer and die, and "deadbeats" = poor people. You're a real humanitarian.
posted by Popular Ethics at 9:54 AM on 3/10
[+] [!]


You get an F in reading comprehension.
posted by jayder at 10:04 AM on March 10, 2012 [3 favorites]


Ron Paul believes in private charity for people who can't afford care. He frequently has to explain that the medical community does not turn people away because of the assumption you make about conservatives and charity.

Of all people, Ron Paul (a doctor who practiced in Texas) knows this is not true. The federal law was passed in part because of an incident that happened in Houston. A man was turned away from a hospital, and he sat down on a park bench outside the hospital and died. The uproar over this terrible case (and other similar cases around the nation) forced the passage of the law that prevents it.

When left to their own devices, charity does not step in and take care of all people who need medical attention. Instead, people are turned away and left to die within several steps of a fully staffed hospital.
posted by Houstonian at 10:04 AM on March 10, 2012 [46 favorites]


sevenyearlurk: "Single payer? No way. Not in America. Let the deadbeats suffer their own choices - don't force me to pay for them.

Don't you live in Sweden?
"

I've heard fellow Americans who couldn't find Sweden on a map say exactly the same thing.
posted by double block and bleed at 10:04 AM on March 10, 2012


Schadenfreude? If you please, I prefer to indulge in morose delectation. Also--and this is for the record--I'm with those independent MeFi thinkers who wish to keep government interference away from our bankruptcy proceedings. It's a matter of principle.

Okay, never mind, I get it. Mrs. Brown doesn't want to be told to do something that she most probably would do if she had not been told to do it. This part of the issue is not rocket science.

However, an actual problem seems to be in play here. Anybody got any ideas what it is? I used to think it was them long-haired commie hippie America-hating peaceniks, but then Disco came along and, POOF, they all went away. Now I don't know what to think.

For you post-boomers, I'm sorry about Disco. It wasn't my fault, but I'm sorry anyway. Please get back to me when you come up with the new paradigm.
posted by mule98J at 10:07 AM on March 10, 2012


OH DIP!! Sorry Republicans!
posted by edheil at 10:07 AM on March 10, 2012


The article states: "Lawyers who represent Brown dispute the significance of her bankruptcy. They say her unpaid medical bills were only a small part of her debts and did not cause her bankruptcy. They say that she and her husband owe $55,000 to others, including credit card companies. And they say her financial troubles were caused by the failure of her auto repair shop............The couple owed $2,140 to Bay Medical Center in Panama City, $610 to Bay Medical Physicians, $835 to an eye doctor in Alabama and $900 to a specialist in Mississippi."

I fucking love this. Shorter version: "No, no, it's not JUST MEDICAL bills she couldn't pay, she couldn't pay other bills too!"

And blaming the bankruptcy on her business failing? Does she think the free-rider problem is mainly caused by people who are too lazy to work and therefore aren't paying their medical bills, but as for HER, she's a red-blooded small business owner, dammit, albeit of a failed business, and dammit, the rest of us should be honored to swallow the cost of her medical treatment in the form of higher bills for those of us who do pay? Something like that?
posted by jayder at 10:09 AM on March 10, 2012 [5 favorites]


Let's do the math here people

For someone who is 56 years old, they'd likely spend about $7000 a year on healthcare, in 2006. Probably even more now. So if they only had to pay $4.5k, they're probably a head in terms of not buying insurance.

Secondly, even if you have insurance you still have to pay a lot for healthcare. That may also be true once Obamacare gets going all the way. We'll have to see. Most medical bankruptcies occur in people who already have health insurance.

So I think the claim that somehow this woman would have not ended up going bankrupt had Obamacare been fully implanted at the time of her medical problem is not correct.

Secondly, let's keep in mind that The healthcare bill had already passed in 2010. The problem is that the implementation was delayed. Why was it delayed? In part to keep the ten year budget projects under $1t, in order to make it easier to pass. So there is a problem here: The healthcare bill had been passed, and it didn't help her. It didn't help her because some accounting gimmicks in service of political gimmicks.

This isn't to say that the Healthcare bill isn't a good thing. It's probably a step forward. But it's false to claim that Obamacare could have prevented this, because Obamacare was already law when this happened, and it didn't prevent it. It also may not be true that obamacare, once fully implemented, will prevent medical bankruptcies, because you can still have co-pays and deductibles. There may be a cap on out of pocket expenses, but I'm not sure what that is.

But with the current situation, even if you have insurance, a medical problem can leave you bankrupt. It's not clear that that will be fixed in 2014, when the exchanges go online.

This isn't to say conservatives aren't all crazy and hysterical about this law. The "Mandate" to get insurance is actually just a tax-break for people who get insurance.
I think that having mandated insurance purchasing was a bad PR move, too -- not only did they completely fall down on the job of demonstrating to the general public why everyone having insurance is beneficial, but they also opened the door to this "freedom"-based argument whereby people can argue that they shouldn't be forced to buy something.
In fact, it was the biggest point of disagreement between Obama and Clinton during the campaign, with Obama opposed to the mandate. Both of them, on the other hand, were in favor of the public option.
You do pay into your own unemployment insurance, but it's (in every state where I've looked into it) a non-waivable requirement of employment
A mandate, if you will...
It's just not right that the government makes me carry car insurance. It violates my right to drive a car without it. I'm just going to stop sending checks to Progressive. If I get into a car accident, I'll just file bankruptcy. It's foolproof.
Car insurance isn't a mandate. It's a condition of being licensed to drive on the roads. What is health insurance a condition of, having a body? Is being alive a privilege that the government provides, rather then a right? Should the government be allowed to regulate human bodies the way they do cars, revoking your right to one if you drink too much of if it doesn't pass inspection?

The car insurance/health insurance metaphor doesn't really work, IMO, since driving is a privilege, and having a human body is not.
posted by delmoi at 10:11 AM on March 10, 2012 [3 favorites]


...driving is a privilege, and having a human body is not.

I guess it depends on the body.
posted by Floydd at 10:17 AM on March 10, 2012 [4 favorites]


The car insurance/health insurance metaphor doesn't really work, IMO, since driving is a privilege, and having a human body is not.

Driving is a privilege, but it's a privilege almost universally adopted by Americans, especially by those who don't live in a city. According to the Straight Dope, in 2006, there were 226 million adults in America with driver's licenses. If you live in a state that requires car insurance, then it is effectively a mandate.
posted by Sticherbeast at 10:17 AM on March 10, 2012 [1 favorite]


> According to the Straight Dope, in 2006, there were 226 million adults in America with driver's licenses. If you live in a state that requires car insurance, then it is effectively a mandate.

I have a driver's license, no car, and no car insurance, and I live in the US.
posted by lupus_yonderboy at 10:31 AM on March 10, 2012 [4 favorites]


Being forced to pay for health care is one thing. Being forced to pay it to for-profit, anti-trust exempt corporations who own Congress is something else.

This is the entire argument in a nutshell.

While I hate the name Obamacare, it's not just the name that's horrible, it's the fact that it's a forced handout to an industry that absolutely didn't need it under the guise that this would be anything approaching a solution for anyone except the Healthcare Industry.

Single payer is really the only solution.
posted by Sphinx at 10:33 AM on March 10, 2012 [36 favorites]


I have a driver's license, no car, and no car insurance, and I live in the US.

Good point, but could you really disagree that many, many, many people in the US drive cars, and that they do not regard their ability to drive as a mere option?
posted by Sticherbeast at 10:34 AM on March 10, 2012


You must be thinking of someone else. Ron Paul believes in private charity for people who can't afford care.

He can believe in whatever he wants, that doesn't make it appear when poor people need it.

Ok, so basically, he thinks hospitals should deny people care if they can't pay AND no one else is willing to pay for them. What a freaking humanitarian.
posted by Salvor Hardin at 10:35 AM on March 10, 2012 [1 favorite]


Oh you liberals, thinking about these things rationally, as if this were a serious discussion about facts and their implications for policy.

Right-wing politics is properly understood as metaphor. It should be read like poetry not your narrow-minded prose. This is not about health care or bankrupcy or small business; the American right has risen above all that and is practicing a kind of political surrealism... a chance encounter of power and money on an irony-free board, if you will.

Don't try to understand it. Just give in to how it makes you feel: how it plucks at the heart strings of your resentment; how it stiffens your spine with righteousness and patriotism to see your fellow citizens rip off their college-educated chains and tell the world that they don't care what impact their actions will have on this beautiful country and they don't care who knows it; how your heart fills with awe and solidarity when you hear the anguished cry of the oppressed American, no longer a teenaged, but still not afraid to whine, "you're not the boss of me, Mr. Big Government!"

There. Doesn't that feel better than that icky thinky thinky stuff you were trying to do before?
posted by RandlePatrickMcMurphy at 10:35 AM on March 10, 2012 [30 favorites]


michaelh: "Ron Paul believes in private charity for people who can't afford care."

He's so adorable.

I like a single-payer medical system that treats all citizens of all races and classes, and pays for everything from stents to gender reassignment. I can't imagine a world where "givers" can chose which pot they put their charity dollars into. If it worked at all (it wouldn't) You'd end up with billions of dollars in surplus for marketable treatments (breast cancer) and nothing at all for unpopular ones (mental illness.)

Now, try to tell conservatives that their donations are going into a black box and will be paid out at the discretion of "experts." Not going to happen.
posted by klanawa at 10:37 AM on March 10, 2012 [7 favorites]


Don't make me break out the hamburger tag.
posted by double block and bleed at 10:41 AM on March 10, 2012


Ok, so basically, he thinks hospitals should deny people care if they can't pay AND no one else is willing to pay for them. What a freaking humanitarian.

In my opinion, it has the opportunity to be even worse than that. Try googling these terms:
- religious conversion for medical care
- medical evangelists
- conversion by allurement

Understand, I'm saying it could go much further than just religious conversion. The will to survive is pretty strong in living things. Thus the need for everyone to pay into a pool for medical costs -- it's all fine and well to say that you will only take medical care that you can afford and that you're an island, a rugged individualist, a pay-your-own-way no-handouts kinda person. But it's quite another to turn off the thing that says in all living things, "SURVIVE!" just because you can't foot the bill.

Will you take medical care and then walk on the bill? Absolutely. Will you change how you believe, vote, act, for that medical care? Sure. Let's face it -- we'd pretty much all take some medical care when we need it. That reality is why we all need to pay into a pool.
posted by Houstonian at 10:49 AM on March 10, 2012 [2 favorites]


> Good point, but could you really disagree that many, many, many people in the US drive cars, and that they do not regard their ability to drive as a mere option?

Of course not. Why would I?

That's irrelevant to the legalities. Mr. Obama's national healthcare mandate requires you to purchase private health insurance if you are alive. If you drive, most states, but not the Federal government, require you to have private health insurance. Not every state does this, and not every resident chooses to drive - there are many people such as myself who've chosen where to live based on their unwillingness to drive (don't get me wrong, I like driving, but then I like eating bluefin tuna too...)

If the Federal government forced every citizen to get car insurance, it would likely also be un-Constitutional.
posted by lupus_yonderboy at 10:49 AM on March 10, 2012


"If you drive, most states, but not the Federal government, require you to have private health insurance."

Gah. Not health insurance, but car insurance. Sorry!
posted by lupus_yonderboy at 10:51 AM on March 10, 2012


Ron Paul believes in private charity for people who can't afford care. He frequently has to explain that the medical community does not turn people away because of the assumption you make about conservatives and charity.

I've read that he backed this up, giving away a lot of charity care and refusing Medicare and Medicaid, and have no reason to doubt him. Awesome on him. But I think he's making the mistake a lot of hippie idealists (Diggers, etc.) made.

A lot of great anarcho/libertarian/communal situations can work -- for a while -- while run by the unusually cool and talented people launch them. But they don't scale. You can't keep replacing them with other unusually cool and talented people, and the theory that the awesome new situation breeds cool people never seems to work out.
posted by msalt at 10:57 AM on March 10, 2012 [8 favorites]


"Say what you will but the Republicans (and the Right in general) have done a masterful job at convincing Americans to agitate for things in direct opposition to their best interests."

posted by tommasz

"How can wealth persuade poverty to use its political freedom to keep wealth in power? Here lies the whole art of Conservative politics in the twentieth century."

Aneurin Bevan 1952

(here.)
posted by marienbad at 11:10 AM on March 10, 2012 [17 favorites]


i question the logic of a system where you're a "freeloader" for not being able to afford an essential service. i wonder what situation the poor were in before widely available insurance, and a government that pays when the individual couldn't. did doctors simply not serve the poor? or did they accept a bag of potatoes or whatever produce they had?
posted by camdan at 11:12 AM on March 10, 2012 [1 favorite]


I fucking love this. Shorter version: "No, no, it's not JUST MEDICAL bills she couldn't pay, she couldn't pay other bills too!"

I was just quoting what the article said in response to a comment that the bankruptcy was solely over the 5k in medical bill. I thought this one of those places where you're expected to read the article in its entirety before commenting. But I'm new.

I was not trying to make excuses for her hypocrisy.
posted by OsoMeaty at 11:15 AM on March 10, 2012 [1 favorite]


When left to their own devices, charity does not step in and take care of all people who need medical attention. Instead, people are turned away and left to die within several steps of a fully staffed hospital.

I'm aware of that sad story. Perhaps I should have said "nearly all," just like when you imply the law can do better you would have to also say "nearly all," as I assumed you meant. Perhaps we can agree to take each other's words in good faith from now on.
posted by michaelh at 11:18 AM on March 10, 2012


BORK BORK BORK!

Well, they are hoping it makes it to the Supreme Court.
posted by joe lisboa at 11:18 AM on March 10, 2012 [1 favorite]


You might think the system provides you benefits that it shouldn't, and you might even be a public advocate for changes to the system that would deny you those benefits, but that doesn't make it hypocritical to accept those benefits while the present system is in place.

Um, yes it does. Logical? Yes. Hypocritical? Absolutely.
posted by adamdschneider at 11:22 AM on March 10, 2012 [1 favorite]


$55,000 is pocket change for the forces opposed to this healthcare bill. None of them would hand over the money to avoid this embarrassment to their cause?
posted by the christopher hundreds at 11:24 AM on March 10, 2012


I owe tens of thousands of dollars (possibly more) for health services given to me when I was uninsured that I never intend to pay because I simply don't make enough money. There are a lot of people like me who just can't pay their health bills, and it ruins their credit, thus making it difficult to spend money anywhere else. It seems like universal healthcare would be a win-win situation - the money gets removed in taxes, the health care companies get paid, everyone gets the care they need.

My step-mother was diagnosed with colon cancer last week that has spread to her lymph-nodes. She has no health care, because my father's company won't cover family members or spouses.

There's supposedly a radiation pill (or something) she can take to help beat this thing, but every single pill is thousands of dollars. Treatments are pretty expensive too. So at this point she's either going to refuse treatment and pass away to spare my father the expense (much to his extreme disapproval, but she is very independent and has paper work done without his consent) or my father will lose everything he has worked years building up to own - his small house, his truck, everything - just to pay a portion of the medical bills.

Plus, he has to go back to work 16 hours a day practically to help pay for these things and the surgery she's already had, kicking their time together completely out the window.

Their situation is not special. This happens daily, to people all over the United States. I just do not understand the selfishness of fighting health care for all.
posted by Malice at 11:24 AM on March 10, 2012 [48 favorites]


If the Federal government forced every citizen to get car insurance, it would likely also be un-Constitutional.

This is abject nonsense. Please try again.

Off the top of my head, I can think of two ways that Congress would be able to require car insurance. The Spending Power and the Commerce Power. As to the first, have a look at South Carolina v. Dole, in which it is held that Congress could easily use its spending power (in the form of highway spending) to further just such an end (in that case, the establishment of a uniform drinking age of 21).

As to the second, have a look at Gonzalez v. Raich, which is only the most recent in a long line of cases establishing Congressional power under the Interstate Commerce Clause to regulate activities which have merely a remote impact on interstate commerce.

You may disagree with these holdings, but that's not the same thing as them being unconstitutional.
posted by gauche at 11:29 AM on March 10, 2012 [3 favorites]


- Being forced to pay for health care is one thing. Being forced to pay it to for-profit, anti-trust exempt corporations who own Congress is something else.

This is the entire argument in a nutshell.

While I hate the name Obamacare, it's not just the name that's horrible, it's the fact that it's a forced handout to an industry that absolutely didn't need it under the guise that this would be anything approaching a solution for anyone except the Healthcare Industry.

Single payer is really the only solution.


I'm kind of a fan of single payer as well, but wouldn't a public option be sufficient to address this particular concern?
posted by naoko at 11:34 AM on March 10, 2012 [1 favorite]


Americans already pay for much care using private charity, the charities being the hospitals, who obtain the funds by raising everybody else's prices. It doesn't work so great though because they won't provide preventative care this way.
posted by jeffburdges at 11:51 AM on March 10, 2012


I really sometimes wish the PP/ACA had a provision that allowed individuals to opt out of the personal obligations in exchange for giving up all of the protections. And if I were running for office, I'd probably make it part of my platform. You don't want to be part of the risk pool and you don't want to pay your fines? That's great: for the rest of your life, insurers can deny you, or they can sell you any old plan (rather than a plan with regulated/required benefits), you're completely ineligible for sliding scale supplementary support on your premiums, and for good measure, the laws requiring treatment don't apply to you any more. You can be as free as you like, but you won't be a free rider.
posted by weston at 11:58 AM on March 10, 2012 [3 favorites]


But, weston, wouldn't the problem then be healthy young people voluntarily removing themselves from the pool (shortsightedly, yes, but regardless), thus greatly driving up the cost for people with pre-existing conditions who choose to remain? You need as many people as possible to sign up in order for the cost AND the benefit to be, well, socialized.
posted by Bromius at 12:02 PM on March 10, 2012 [4 favorites]


Let me be clear - I believe that it is un-Constitutional for the Federal government to pass legislation directly requiring the purchase of private health insurance.

This is abject nonsense. Please try again.

gauche: Why be so rude? I can't imagine it helps your argument.

As to the first, have a look at South Carolina v. Dole, in which it is held that Congress could easily use its spending power (in the form of highway spending) to further just such an end (in that case, the establishment of a uniform drinking age of 21).

I remember this case well. The Federal Government, for the very reason that it is prohibited from directly setting such a drinking age, used indirect means to force the states to make this change. And not every state did.

As to the second, have a look at Gonzalez v. Raich,

This seems completely inapplicable to me, but then I'm not a lawyer.

The Supreme Court, however, is full of lawyers, and they will be considering this issue very soon, so clearly they believe that this is not as obvious as you do. It might be that you have some secret source of legal knowledge that the Supreme Court does not; considering you're willing to be rude to a random stranger, I have another theory...
posted by lupus_yonderboy at 12:19 PM on March 10, 2012 [1 favorite]


It's always interesting to see what kind of plaintiffs they chose for these large social issue / constitutional law type cases. This week's new yorker has an article about Lawrence v. Texas, the case that eventually deemed sodomy laws unconstitutional. The defendants' attorneys weren't exactly thrilled with situation handed to them, basically a drunken lovers' quarrel. And then you have the plaintiffs in the Washington D.C. and Chicago handgun ban cases, where their stories are so compelling that they almost make a gun control proponent such as myself want to join the NRA.
posted by Mr Mister at 12:22 PM on March 10, 2012


And actually, I'm overstating myself.

I have serious doubts about the Constitutionality of the health care mandate - I think it's likely that it's un-Constitutional, as I said before.

The fact that the Obama administration did not make the health care bill severable boggles my mind. It seems like a novice error! This means that if any part of the bill is rendered un-Constitutional, the whole thing goes down the toilet. In my darker moments, I wonder if this was in fact deliberate.
posted by lupus_yonderboy at 12:24 PM on March 10, 2012


Deliberate, you say?

Thought experiment: the ACA is overturned before the election. Wanna bet that drives massive turnout for the dems, especially an ever-growing legion of young (18-26) people who would instantly lose extended coverage under their parents' plans (and who otherwise seem a little less motivate to vote than in 2008), and denies the GOP their one red meat issue with any traction beyond their most insane base?

Roberts and Scalia, I invite you to Bring It On. Knocking down the ACA, followed by a massive Dem win across the board (Obama wins, both senate and HoR go dem), and we get a different plan with a public option and an "opt out at your own risk" clause.

I'd love to see it happen.
posted by spitbull at 12:30 PM on March 10, 2012 [4 favorites]


Indeed, as I think about it, this seems like more of the "11 dimensional chess" version of President Obama -- making sure the extension of coverage to age 26 under your parents' plan was one of the earliest provisions to go into effect, along with prohibiting denial of coverage for pre-existing conditions. Those are benefits people understand and are already using. Take them away, please, oh mighty SCOTUS.
posted by spitbull at 12:33 PM on March 10, 2012


And not every state did.

Except that one of the states that did was Louisiana -- in direct violation of its own state constitution. Because a sensible person might think that this "indirect method" is blackmail, which might have other legal issues.

However, it was all upheld; our state SC struck down the law the first time it passed but then after some sternly worded messages they did a backflip and a pirouette and approved the exact same law on the theory that "all the rights and privileges of adulthood" doesn't mean what we all know Napoleon Bonaparte meant when his Code gave those rights and privileges to 18 year olds.

In any case I like the ACA by comparison to the status quo and I doubt the government will pass up this opportunity to grab some more power no matter what the words on that dusty ole piece of paper in Washington, D.C. say. If the State of Louisiana can bar 18 year olds from drinking, the US can force you to buy health insurance.
posted by localroger at 12:36 PM on March 10, 2012


The fact that the Obama administration did not make the health care bill severable boggles my mind. It seems like a novice error! This means that if any part of the bill is rendered un-Constitutional, the whole thing goes down the toilet.

This is not in fact how laws work. SCOTUS can strike down the individual mandate and leave the rest intact.
posted by gerryblog at 12:39 PM on March 10, 2012 [1 favorite]


Driving is a privilege, but it's a privilege almost universally adopted by Americans, especially by those who don't live in a city. According to the Straight Dope, in 2006, there were 226 million adults in America with driver's licenses. If you live in a state that requires car insurance, then it is effectively a mandate.
There are 300 million people in the U.S. So a little less then 25% without driver's licenses. And you can get a license without insurance, if you don't have a car registered in your name.
While I hate the name Obamacare, it's not just the name that's horrible,
Ever notice how people say democrats run away from their accomplishments. This is an example of that. If the democrats were proud of Obamacare, they would be calling it Obamacare all the time. If they thought people would like obamacare, it would be the best branding for democratic policies ever

People don't call Medicare LBJ Care. But imagine if they did. Would there ever be a "get the government out of my LBJ care!" quote? Everyone would know that Medicare had been signed into law by an iconic democratic president. When they thought good things about medicare, they would think good things about LBJ and the democrats.

Really it's just mind blowing. It shows how pathetic the democrats are that they don't call it Obamacare. The first is that they are so scared and pathetic that they're not even willing to claim credit for something arguably was a good thing. The second is that they were so scared and pathetic that they didn't pass something they felt they could be proud of.

Anyway, that's why I like calling it Obamacare. I actually hope it sticks over the long term. Because, duh, if it's actually any good then calling it Obamacare should be good for Obama. Besides, what else are you supposed to call it "The Healthcare Law"? The actual title is the "Patient Protection and Affordable Care", or PPACA Do you call it "pee pee acca" or "Puh-paca"? Clearly that's a worse name then Obamacare. And it was actually passed in two parts, with the Health Care and Education Reconciliation Act of 2010 passed via reconciliation. So it's technically PPACA/HCERA.

Really, by "branding" Obamacare, the republicans actually could have given the democrats, and Obama a huge gift. But the democrats are too cowardly to accept it, and too weak to have created a law that they would have been proud to have their leader associated with.
posted by delmoi at 12:40 PM on March 10, 2012 [21 favorites]


I think the vastly more important question to ask, and the key answer to have is: "How do you get it done?"
posted by seanmpuckett at 12:44 PM on March 10, 2012


Still, by not embracing the name"Obamacare", it does hold out hope for some of us that, if forced to go back to the drawing board, he'd come up with something he COULD be prouder of.
posted by oneswellfoop at 12:45 PM on March 10, 2012


lupus_yonderboy: “Mr. Obama's national healthcare mandate requires you to purchase private health insurance if you are alive. If you drive, most states, but not the Federal government, require you to have private health insurance. Not every state does this, and not every resident chooses to drive - there are many people such as myself who've chosen where to live based on their unwillingness to drive (don't get me wrong, I like driving, but then I like eating bluefin tuna too...) If the Federal government forced every citizen to get car insurance, it would likely also be un-Constitutional.”

You're missing the massive, massive problem this causes – the problem that the health care mandate is the only solution to.

The thing is – my personal beliefs aside, I'm willing to see your side of it. Society is better when people are granted the liberty not to pay for certain things they don't want to pay for. Don't want to pay for car insurance? Fine, you are not required to if you don't drive. Like you said, that makes sense. This is an ideal we as Americans hold dear: the ideal that we ought to be free to do whatever we want.

The trouble is that that ideal contradicts flatly another ideal which we as a society hold dear: the notion that people should be treated medically if their lives depend on it, regardless of whether they can pay. And if you've thought at all about how health care works, I think this is an ideal you have to uphold.

So how would you resolve this contradiction? It's not a cosmetic difference. Upholding emergency health care to those who need it regardless of their ability to pay is bankrupting this country. So what would you do?
posted by koeselitz at 12:50 PM on March 10, 2012 [4 favorites]


The blowback against Obamacare by conservatives -- self-declared Christians, many of them -- has confirmed for me that there is no such thing as a common decency in this country.

To see an initiative to ensure health care for everyone, a goal that is uncontroversial in the rest of the advanced world, being written off as villainous and contemptible shows the complete malleability of people's opinions in the face of propaganda.

What has happened to this country in the last fifty years? We have regressed.
posted by jayder at 12:50 PM on March 10, 2012 [6 favorites]


lupus_yonderboy: &lduqo;I have serious doubts about the Constitutionality of the health care mandate - I think it's likely that it's un-Constitutional, as I said before.”

To put it more bluntly –

Do you have "serious doubts" about the Constitutionality of taxes in general, or just this tax in particular?
posted by koeselitz at 12:52 PM on March 10, 2012 [1 favorite]


The actual title is the "Patient Protection and Affordable Care", or PPACA Do you call it "pee pee acca"

Well, I didn't before.
posted by dirigibleman at 1:02 PM on March 10, 2012 [4 favorites]


koeselitz - the mandate was deliberately not structured as a tax. It could have been done that way, but for political reasons, the Democrats were worried that they'd be accused of creating a new tax. So you can't look to save it that way.

This is fairly new constitutional territory, so most guesses are just that. Personally, I think a document as regressive as the Constitution probably can only be stretched so far. We like to pretend that there's this long march towards justice and progress and blah, but the document itself is just not that flexible or suitable for advancing principles of equality in a modern society.

See, US V Morrison, DeShaney v. Winnebago County, and so on. Also, look around you.
posted by allen.spaulding at 1:06 PM on March 10, 2012


The car insurance/health insurance metaphor doesn't really work, IMO, since driving is a privilege, and having a human body is not.

Additionally, the car insurance mandate is for liability, ie the damage you might cause to society at large. Whether you insure your own vehicle is up to you and your lender. It really isn't a good analogy. Social security and unemployment are probably a better match, but wouldn't do much to convince conservatives who protest both of those as well.
posted by pwnguin at 1:06 PM on March 10, 2012 [1 favorite]


Here in Massachusetts -- ‘Romneycare’ — A Revolution That Basically Worked.
posted by ericb at 1:12 PM on March 10, 2012 [1 favorite]


Massachusetts' insured rate hits 98.1%: Analysis
"The percentage of residents enrolled in a health care plan continues to increase in Massachusetts, the only state to achieve near-universal health insurance coverage, according to a report.

As of June, 98.1% of state residents had coverage compared with 97.3% in 2009, according to a report released Monday by the Massachusetts Division of Health Care Finance and Policy.

... The Urban Institute report found that 65.1% of state residents received coverage from employers; 16.4% obtained coverage from Medicare; and 16.6% were insured through public plans, such as Commonwealth Care, the Massachusetts program that subsidizes health premiums for the lower-income uninsured."
posted by ericb at 1:15 PM on March 10, 2012 [2 favorites]


Really, by "branding" Obamacare, the republicans actually could have given the democrats, and Obama a huge gift. But the democrats are too cowardly to accept it, and too weak to have created a law that they would have been proud to have their leader associated with.
In the long run this *could* be a strong plus. But in the short term, it is almost certainly very negative.

Very solid majorities of Americans favor the major constituent parts of the health care law (e.g. eliminating pre-existing conditions, lifetime caps, allowing parents to cover their children into their 20s, etc.). And yet roughly half of Americans dislike the law itself.

There's a big disconnect between what the law does, and how it's perceived. Most of that is political marketing. The value of "Obama" as a brand is only as helpful as his latest approval rating. And among Republicans, "Obama" is a permanent and guaranteed negative brand. If you're a Republican opponent who wants to repeal the bill, you don't discuss the merits of the bill, you slander it. They'd call it "bin laden care" if they care; "Obamacare" is the next worse thing in Republican circles.

And so long as it is branded "Obamacare", it will have a political bullseye on it. So long as it bears the name of a Democrat, Republicans will be motivated to weaken it, cripple it, and destroy it.

(You can see shadows of this with the schizophrenic Republican attitudes on things like Medicare and Social Security. Social Security is very popular, by itself. If you point out that it's the work of FDR -- the evil, America-hating, traitor to his class, communist FDR -- it is reflexively reclassified as "Socialism")

And if you want to talk about 11 dimensional chess, credit should go to conservative think tanks that have been churning out talks, papers, and even books bashing FDR and the New Deal, especially notable in the few years leading up to the current economic downturn. They knew they were destroying the economic stability of our nation, knew there would be backlash, and so they busily went about prejudicing their political base against the kind of change that would be needed to set things right before anybody had even whiffed the first hint of smoke.
posted by Davenhill at 1:17 PM on March 10, 2012 [10 favorites]


As to the second, have a look at Gonzalez v. Raich, which is only the most recent in a long line of cases establishing Congressional power under the Interstate Commerce Clause to regulate activities which have merely a remote impact on interstate commerce.

Wickard v. Filburn, on which that case rests, is terrible law and a precedent that a lot of people would like to see overturned. I think it easily could, and should, be overturned on textual, intentional, and policy grounds. So I think the individual mandate can and will be found unconstitutional.

koeselitz - the mandate was deliberately not structured as a tax. It could have been done that way, but for political reasons, the Democrats were worried that they'd be accused of creating a new tax. So you can't look to save it that way.

Correct. Also, Ted Kennedy died during the legislative session and Scott Brown got elected to his seat, breaking the Democrats' filibuster-proof senate majority. The individual mandate was never meant to be more than a legislative placeholder; the original gameplan was to replace it with a public option as a step towards single-payer.

Now bear in mind that a lot of conservatives (not necessarily Republicans) would actually be OK with a tax-based system. I'm against the mandate on legal grounds but for single-payer on policy and economic grounds. The same is true of some of the mandate's leading opponents.
posted by anigbrowl at 1:20 PM on March 10, 2012


allen.spaulding: “koeselitz - the mandate was deliberately not structured as a tax.”

The Democrats may not have wanted to call it that; but what's the difference? You say there's a difference in "structure." It seems to me that "structure" is irrelevant here.

Besides, I was answering lupus_yonderboy's sense that a requirement that any taxpayer pay for something is likely unconstitutional. This is clearly false, no matter what you may think of this particular requirement.
posted by koeselitz at 1:22 PM on March 10, 2012


Still, by not embracing the name"Obamacare", it does hold out hope for some of us that, if forced to go back to the drawing board, he'd come up with something he COULD be prouder of.
Pretty unlikely during Obama's term, IMO.
You're missing the massive, massive problem this causes – the problem that the health care mandate is the only solution to.
Everything else that's mandated, the government provides. The government mandates kids go to school, and provides free schools. Most (but not all) countries that have single payer don't let you opt out. But you don't pay for health insurance directly, you just pay taxes and the government provides health insurance, or in some cases hospitals and doctors, for everyone.

And in theory you can "opt out" of taxes by not having a job, nor earning any interest on stocks. Property taxes and sales taxes apply, but those are state taxes.
The trouble is that that ideal contradicts flatly another ideal which we as a society hold dear: the notion that people should be treated medically if their lives depend on it, regardless of whether they can pay. And if you've thought at all about how health care works, I think this is an ideal you have to uphold.
No other country has a problem with this, why should we? In fact, if you go to France, the UK, or wherever to visit, get sick or injured, they will have no problem treating you without collecting the equivalent of a years taxes from you. Yet, if someone comes here and gets sick/injured it's quite possible the fees might be greater then their contribution to their countries healthcare program.
koeselitz - the mandate was deliberately not structured as a tax. It could have been done that way, but for political reasons, the Democrats were worried that they'd be accused of creating a new tax. So you can't look to save it that way.
I believe it was structured as a tax. Maybe that's not correct.
In the long run this *could* be a strong plus. But in the short term, it is almost certainly very negative.

Very solid majorities of Americans favor the major constituent parts of the health care law (e.g. eliminating pre-existing conditions, lifetime caps, allowing parents to cover their children into their 20s, etc.). And yet roughly half of Americans dislike the law itself.
It's only a negative because the democrats suck at life. Anyway, they deserve it. Maybe in the future they'll try to suck less hard.
And so long as it is branded "Obamacare", it will have a political bullseye on it. So long as it bears the name of a Democrat, Republicans will be motivated to weaken it, cripple it, and destroy it.
So what? If it was popular, they would get destroyed in the polls over it, just like they are for trying to fight contraception.
As to the second, have a look at Gonzalez v. Raich, which is only the most recent in a long line of cases establishing Congressional power under the Interstate Commerce Clause to regulate activities which have merely a remote impact on interstate commerce.

Wickard v. Filburn, on which that case rests, is terrible law and a precedent that a lot of people would like to see overturned. I think it easily could, and should, be overturned on textual, intentional, and policy grounds. So I think the individual mandate can and will be found unconstitutional.
The Raich case extend Filburn in that, with Filburn you had a guy growing wheat. The effect on commerce could be easily quantified, since every pound he grows, is a pound he doesn't buy. But how you "quantify" the impact on commerce with medical marijuana grown for personal use? It doesn't make much sense, because there's no mathematical correlation between her consumption and "legal" sale and distribution of weed.

There was another case where the 9th circuit found that it was legal to make your own machine guns, even if illegal under federal law. However, after the Raich case apparently that got reversed.
posted by delmoi at 2:10 PM on March 10, 2012


delmoi: “Everything else that's mandated, the government provides. The government mandates kids go to school, and provides free schools.”

I thought about that, but I'm not so sure; not at this point, anyway. This is the age of government contractors, isn't it? Even a big chunk of our wars – the wars that we pay for with tax dollars – are fought by contractors.
posted by koeselitz at 2:23 PM on March 10, 2012


Now bear in mind that a lot of conservatives (not necessarily Republicans) would actually be OK with a tax-based system. I'm against the mandate on legal grounds but for single-payer on policy and economic grounds. The same is true of some of the mandate's leading opponents.

Yep. I think the individual mandate is probably unconstitutional, but a government health care system like Britain's might not be. I'm not convinced it's a good idea though.

Federalism is arguably part of what makes "Romneycare" different from "Obamacare". It's not at all surprising that something might be OK as a state program and not OK as a federal program.

Liberals are fine paying taxes, and also give to charity. Right wingers don't want to do either, unless it benefits them, charity only if it cuts their taxes, which they do their damnedest to get as close to 0 as possible, then also complain that social services aren't how they want if they need them.

What? "Right wingers" don't give to charity? I'm sure you have statistics to back this up right?
posted by Jahaza at 2:28 PM on March 10, 2012 [1 favorite]


The problem with the "I don't want to be forced to pay for health insurance" position, is the Reagan-era law that forces hospital emergency rooms to accept anyone who shows up at the door with or without insurance

God bless the liberal historical Regan, the Hollywood union boss turned politician who signed COBRA and the Emergency Medical Treatment and Active Labor Act into law, embraced direct diplomacy with enemy states, increased payroll taxes to help shore up Social Security and rolled back recession-time tax cuts when it was clear that they were contributing to a ballooning deficit.
posted by eddydamascene at 2:50 PM on March 10, 2012 [9 favorites]


What is health insurance a condition of, having a body?

Citizenship?
posted by five fresh fish at 3:00 PM on March 10, 2012 [2 favorites]


To see an initiative to ensure health care for everyone, a goal that is uncontroversial in the rest of the advanced world, being written off as villainous and contemptible shows the complete malleability of people's opinions in the face of propaganda.

Obamacare is NOT designed to ensure healthcare for everyone. They threw that tiny detail out before the first draft of the first page. Obamacare IS villainous and contemptible, and unConsitutional.

"The couple owed $2,140 to Bay Medical Center in Panama City, $610 to Bay Medical Physicians, $835 to an eye doctor in Alabama and $900 to a specialist in Mississippi."


That's at full list price, as charged to working people without insurance. For persons with government insurance, that insurance would pay maybe 75% of that, or maybe 50% of that, or maybe 25% of that. For persons with private insurance, their insurance would pay more. For illegals, they wouldn't even be billed. Obamacare does not fix this antitrust violation, it legalizes it.

$55,000 is pocket change for the forces opposed to this healthcare bill. None of them would hand over the money to avoid this embarrassment to their cause?

GM, Chrysler, Solyndra, Fisker, etc etc etc la la la

----------

I am in favor of a basic healthcare coverage for every American Citizen. Obamacare isn't it.
posted by caclwmr4 at 3:07 PM on March 10, 2012 [2 favorites]


For persons with private insurance, their insurance would pay more.

You can't know this unless you know exactly what kind of private insurance a person has. As for me, no, my private health insurance would not pay more and in fact would not pay a single dime of those bills unless we'd already reached our $5,800 deductible for the year. And if any of those bills were for any sort of respiratory-related illness/episode, they wouldn't pay a penny even if we had reached the deductible.

Private health insurance mostly sucks for those of us who have to have it (versus not having any insurance at all, and since I have children, that would be unconscionable).
posted by cooker girl at 3:31 PM on March 10, 2012 [2 favorites]


Your $5,800 deductible is at full list price, right? And how do you know your private insurance would or would not pay more? My experience is it would pay more. Your experience may vary. I'm not sure of your overall point anyway.
posted by caclwmr4 at 3:33 PM on March 10, 2012


The fact that the Obama administration did not make the health care bill severable boggles my mind. It seems like a novice error!

You are confusing an nonseverability clause (as there is in the NY same sex marriage law) with the lack of an expressly-stated severability clause (most laws lack these, believe it or not).

[Raich] seems completely inapplicable to me, but then I'm not a lawyer.

Raich is but one of many perfectly applicable cases at play here.
posted by Sticherbeast at 4:06 PM on March 10, 2012 [1 favorite]


" There are 300 million people in the U.S. So a little less then 25% without driver's licenses."

Presumably many of whom are under 16.
posted by Eyebrows McGee at 5:44 PM on March 10, 2012


"There are 300 million people in the U.S. So a little less then 25% without driver's licenses.

Presumably many of whom are under 16."

300 million people (as of 2006), 74 million of which don't have driver's licenses.
~13% of the population is under 15, which is 45 million, leaving around 29 million adults without them. Still around 10%, which is enough people to show it's possible if necessary.
posted by zug at 6:44 PM on March 10, 2012


"So she wants to be free of gummint intrusion w.r.t. health insurance, but runs screaming to the courts and gummint protection when she gets in a financial bind? Worst kind of hypocrite."

"Brown said in the petition that her only income was $275 a month in unemployment benefits."

Aaaaand done.
posted by markkraft at 7:39 PM on March 10, 2012 [3 favorites]


Yep. I think the individual mandate is probably unconstitutional, but a government health care system like Britain's might not be. I'm not convinced it's a good idea though.

Federalism is arguably part of what makes "Romneycare" different from "Obamacare". It's not at all surprising that something might be OK as a state program and not OK as a federal program.
The biggest "socialist" program in this country is education, and that largely is run by the states. The problem is you're going to get crappy healthcare if you live in a crappy state, just like you're kids get a crappy education today.
What is health insurance a condition of, having a body?

Citizenship?
So you feel that the government should be able to revoke citizenship for people based on failure to fulfill bureaucratic conditions? And then what? Deport anyone who doesn't buy health insurance too... where, exactly? Make it illegal for them to get a job? Is that supposed to improve their health?

Plus the idea that you should be forced to pay some private, for-profit healthcare company in order to be a citizen is just ridiculous. What's to prevent any other random company from lobbying their products be purchased as a condition of citizenship? Maybe we should just start paying our taxes directly to Goldman Sachs, and cut out the middle man? (that is, after all, where the profits of these health insurance companies go)

Well, I guess it might. Mexico has universal, healthcare.
Public Health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency.
--
Presumably many of whom are under 16.
And who don't have car insurance. But, their parents would be required to Also, lots of people have driver's licenses, but don't own cars, and thus don't have insurance on any particular vehicle. In fact, I'm not even sure it's actually mandatory in all states. I know in the past, it wasn't.
posted by delmoi at 7:48 PM on March 10, 2012


er, sorry their parents would be required to buy health insurance for them. Obviously having kids uninsured is a bad thing, but what happens when their parents can't afford it? IMO children should all get the same baseline standard of care regardless of who their parents are.
posted by delmoi at 7:50 PM on March 10, 2012


As I try to find, solely on the internet, more about Mary Brown and her auto repair business which failed, there isn't much to find. None of the "news" articles about her bankruptcy and the court case made any attempt to investigate her business or her life. There is nothing about that in any of several articles, which are only rewrites of each other and clearly originating from a single source. It does not appear that any "reporter" has done anything at all to look at her history, not even finding what I have found:

There is an indication that she was in business since 1993 which she wrote herself, in an amateurish attempt to promote her business.

The BBB lists the business as incorporated in 2006. That's not necessarily a contradiction to the 1993 date.

Her business failed in 2011, like many businesses, and she didn't get a bailout.

Perhaps there was some effect from the worse than worthless "cash for clunkers" program which took many operating vehicles off the road at taxpayer expense--older vehicles which would need servicing in shops like hers.

Possibly or presumably she and her husband covered their own health care costs fully all that time, and always expected to.

But not one news article points that out (that I noticed).

She would have had to file bankruptcy sooner if she was forced to buy insurance or pay the mandate penalty/fine/tax. ("It's not a tax" "It is a tax")

In the news articles I have found snarking at her involvement in the court case, I do not see reasons for snarking at Mary Brown, who was chosen by others to be the plaintiff and did not seek out that position, or for snarking at this legitimate court case against Obamacare.

If there are 27 news articles about this (as news.google counts at this moment), all deriving from one single source (wonder who?), I have just done more research than at least 26 of those "reporters".

The first article linked to open this topic claims "she would prefer that the taxpayers pay her medical bills". There is no such thing and I think that statement constitutes slander against her. I am sure she would prefer to continue paying her own way herself directly or by insurance she could freely afford. Obamacare insurance and mandates would not have prevented her problem.

That's the problem.
posted by caclwmr4 at 8:51 PM on March 10, 2012


gauche: Why be so rude? I can't imagine it helps your argument.

I apologize. I have a short fuse around constitutional law issues, in part because I have a lot of conservative friends who seem to think that "it's unconstitutional" is a foregone conclusion whenever they don't like something that government does. I took your comment in that vein and perhaps I should not have.

I remember this case well. The Federal Government, for the very reason that it is prohibited from directly setting such a drinking age, used indirect means to force the states to make this change. And not every state did.

Okay, if you want to stick to the language, you're actually right: your original statement was that Congress could not force people to purchase auto insurance. The Federal government could not establish a federal drinking age directly. It could, as you note, use the spending power to require States to establish a uniform drinking age, and I have no doubt that it could use the spending power to require states to require auto insurance, which is a distinction without a difference.

Nevertheless, I continue to believe that your near-certainty about whether a federal mandate on auto insurance could never be implemented is so unwarranted as to border on the absurd. Read the case. Do you really think that Congress couldn't figure a way to require near-universal auto insurance under the test Renquist sets out?

Wickard v. Filburn ... is terrible law and a precedent that a lot of people would like to see overturned. I think it easily could, and should, be overturned on textual, intentional, and policy grounds.

Relative to the likelihood of a Ron Paul presidency, how likely do you think it is that Wickard v. Filburn would be overturned? Let's define the likelihood of a Paul presidency at 1.0.

I'd put overturning Wickard at 0.0001 Paul presidencies, in light of all of the things that would have to happen, in order, to bring such case before a Supreme Court inclined to overturn a sixty-year-old case upon which -- and I don't think I'm exaggerating here -- a majority of the Federal administrative state rests. Not gonna happen.

I say this, for what it's worth, as someone who has been professionally critical of both Wickard and Raich.

And, for that matter, the notional overturning of Wickard merely proves my point about what is constitutional under the Commerce Clause right now. If you think a government action is unconstitutional, your argument should not, in ordinary circumstances, involve overturning a long line of SCOTUS jurisprudence.
posted by gauche at 8:57 PM on March 10, 2012 [2 favorites]


Overturning Wickard would certainly be a seismic change, but we have survived such before. By the way, don't get the idea from my opposition to it that I'm against the idea of an administrative stae or regulation in general. I just think WvF rests on really, really weak foundations.
posted by anigbrowl at 9:11 PM on March 10, 2012


"If the Federal government forced every citizen to get car insurance, it would likely also be un-Constitutional."

"Nevertheless, I continue to believe that your near-certainty about whether a federal mandate on auto insurance could never be implemented is so unwarranted as to border on the absurd."

It seems to me there's a difference between hypothetical federal mandates (1) a person must purchase car insurance to drive, and (2) a person must purchase car insurance or pay penalties. Are there any actual implemented examples analogous to (2)?
posted by cheburashka at 10:56 PM on March 10, 2012


The government shouldn't require you to purchase insurance. The government should be providing you access to healthcare. You shouldn't have to think twice about seeing a doctor or getting required care.

WTF is the point of being a citizen if it doesn't come with benefits? Might as well move to a place that will appreciate your civic participation.
posted by five fresh fish at 11:39 PM on March 10, 2012 [2 favorites]


In the news articles I have found snarking at her involvement in the court case, I do not see reasons for snarking at Mary Brown, who was chosen by others to be the plaintiff and did not seek out that position, or for snarking at this legitimate court case against Obamacare.

She agreed to be the plaintiff.
posted by jayder at 1:48 AM on March 11, 2012 [1 favorite]


"Perhaps there was some effect from the worse than worthless "cash for clunkers" program which took many operating vehicles off the road at taxpayer expense--older vehicles which would need servicing in shops like hers."

Or perhaps not. Businesses vary, and you have put forward no evidence to suggest that this was the case, so I'll gladly dismiss that argument offhand, or at least say that the government doesn't owe their business a pile of old POS's on the road to fix up.

Oh, and btw, "cash for clunkers" was hardly worthless for my wife and I. Contrary to the claims of the critics, we had no plans prior to C4C to get a new car anytime soon. If anything, we might've considered a used one over our old gas guzzler... but C4C made buying a new car an attractive opportunity. And indeed, the actual government statistics show this to be the case. It was, in fact, a very successful economic stimulus, and it reduced overall demand for gas quite significantly. It also had the added benefit of making the government loans to US automakers more reliable, and quite likely helping those industries to turn around months quicker than they might otherwise have done.

"She would have had to file bankruptcy sooner if she was forced to buy insurance or pay the mandate"

No evidence to support. Dismissed offhand. Would likely have saved them money had it been in place earlier, especially if her only source of income was unemployment.

"In the news articles I have found snarking at her involvement in the court case, I do not see reasons for snarking at Mary Brown, who was chosen by others to be the plaintiff and did not seek out that position"

So, you're suggesting she was a plaintiff against her will..?! Did she, or did she not, choose to put herself forward as a prospective plaintiff? And why *shouldn't* the fact that she was chosen above others be more than a bit damning to the case?

I don't think she necessarily wanted others to pay her bills. When it comes to people's health, sh*t happens. Catastrophic, bankrupting sh*t, quite often... and it happens to people, regardless of their political orientation.

...which, incidentally enough, is why the health insurance law exists and applies to everyone in the first place.

The idea that the healthcare law is a mandate/tax is kind of a misnomer. It's really more akin to industry regulation in practice than anything else. in that it defines a new type of insurance available to consumers, and then regulates how that insurance functions, so that excessive instability, unfairness, and risk is reduced. The regulations exist so that the system itself cannot be "gamed".

But here's the big point: if you hate the idea of paying for this type of insurance plan -- even if it's likely to save you money -- then don't. And don't try to use that plan. Buy your insurance elsewhere instead. Be prepared to pay whatever premium they might choose to gouge you with for your preexisting condition, though. Or put it all on your credit card. Or visit a free clinic. Or try alternative medicine. Or travel to a different country, if you'd prefer. (Lots do, nowadays, because the old system of healthcare is being priced out of people's reach.) That is your option. Nobody is making you choose an insurance option you don't want. Maybe at some point, an employer might choose not to offer other alternatives, perhaps... in which case, be a good free thinking Libertarian type and find a job with a different employer... or start your own company and pay for insurance elsewhere.

You have that right, rather than entering into a contract you disagree with. You also have the right to put your savings somewhere that is FDIC insured... or not. Your choice. Just don't expect others to cover you when you're gambling your money. Which is pretty much what you are doing when you don't have health insurance.

I'm not saying that those opposed to this new system aren't being oppressed. However, it needs to be made abundantly clear that their source of oppression lies in their own unreasonable fear and blind ignorance.
posted by markkraft at 3:46 AM on March 11, 2012 [2 favorites]


Perhaps there was some effect from the worse than worthless "cash for clunkers" program which took many operating vehicles off the road at taxpayer expense--older vehicles which would need servicing in shops like hers.
It took work away from auto repair shops by helping people buy nice cars, many of which would have been more fuel efficient and less likely to cost them a lot to repair over the long term.

Why is that a bad thing? Should we, as a government policy, try to get people to drive around in crappy cars that break down all the time so that local car repair places can rip them off in order to keep car repair places in business? That seems like a bad idea, certainly for the customer.

A lot of the arguments for 'creating jobs' really just mean creating economic inefficiencies that people can use to make money off of. Rather then have people do stuff in China for less money, we should have people do things here. Rather then leverage massive logistics infrastructure created by a company like Walmart, we should make everyone buy stuff from local shops, which means more money in the community, but also way less selection and higher prices.

But with the China thing, there is a plausible global benefit: avoiding stuff that's produced under crappy conditions, and avoiding massive pollution in China. But opposing cash for clunkers in order to keep mechanics at work is terrible. In order to qualify as a clunker, a car had to get less then 18mpg. So a 1995 Toyota Corolla wouldn't qualify. So not doing cash for clunkers would have been bad for the environment.

The other problem, though is that the 'clunker' problem tends to fall most heavily on the poor, who can't typically afford a new car and end up paying for repair after repair because they can't afford to just replace the damn thing. So in this case the 'inefficiency' falls most on the poor and working class, in order to benefit slightly richer auto mechanics.

Plus, there is the fact that a dead car can be catastrophic for a poor person. It's not like the lottery where poor people pay a small amount each month in order to benefit schools, or whatever, at least with that they're in control. If their car breaks down it's something that's random, that they have no control over, and can potentially seriously mess up their lives.
No evidence to support. Dismissed offhand. Would likely have saved them money had it been in place earlier, especially if her only source of income was unemployment.
Not necessarily, the fees she paid could easily have been under the deductible, and the rates she paid could easily have been more then what she owed.

In fact, how exactly can a 55 year old even buy health insurance on $275 a month? How is that possible?
posted by delmoi at 4:37 AM on March 11, 2012 [1 favorite]


Your $5,800 deductible is at full list price, right? And how do you know your private insurance would or would not pay more? My experience is it would pay more.

I don't understand this. My insurance won't pay anything, at all, zilch, until we reach the yearly deductible, which is $5,800. Everything up to $5,800 is on us to pay. So, taking Mary's medical bills into account, no, my private health insurance would not have paid those bills. I know this because I know the terms of my insurance. Once we've reached the deductible, they pay most or all of the bills, depending on what the services are for. Broken foot that requires surgery? Sure. Respiratory distress that requires anything? Not for me. That's an exclusion on my policy because of a pre-existing condition.

Are you confusing private health insurance with group health insurance?
posted by cooker girl at 7:33 AM on March 11, 2012


It seems to me there's a difference between hypothetical federal mandates (1) a person must purchase car insurance to drive, and (2) a person must purchase car insurance or pay penalties. Are there any actual implemented examples analogous to (2)?

Sure. The second Militia Act of 1792 forced every adult white man into the militia, and compelled him to own either a musket or rifle and assorted accoutrement. Reading the statutes, it looks like showing up without your required gear would get you court-martialed.
posted by ROU_Xenophobe at 7:58 AM on March 11, 2012 [2 favorites]


I had to look up Wickard v. Filburn. Interestingly, this is what wiki says:

"The U.S. government had established limits on wheat production based on acreage owned by a farmer, in order to drive up wheat prices during the Great Depression, and Filburn was growing more than the limits permitted. Filburn was ordered to destroy his crops and pay a fine, even though he was producing the excess wheat for his own use and had no intention of selling it."

Lousy Communists!!

(Also, editing in the Preview window doesn't work.)
posted by marienbad at 8:00 AM on March 11, 2012


Here's our situation. Our insurance, through my husband's job costs about $900 a month. Our deductible is $3000 per person, or $12,000 per family. I just finished doing our taxes, and our out of pocket medical expenses were almost 20,000. Plus the almost 12k insurance cost. Medical insurance and subsequent costs are why we drive an 11 year old car, and can maybe budget in a vacation every 3 years.

The new insurance law doesn't do a Damn thing for us. It won't lower costs, we are still required to buy our insurance from employers, who don't have the bargaining power of a large corporate pool.

What insurance primarily does is negotiate down the price. Example, my thyroid cancer checkup VIA sonogram was billed @ $600. Insurance said the "allowable charge" was $300. If the hospital is willing to accept $300 for the procedure, and I'm going to pay that $300, then what I'm paying for with my $900 premium is for someone to get me a discount. It's absurd. The whole system is a complete mess. And I don't see how the new law is going to fix the stuff that is broken.
posted by dejah420 at 8:05 AM on March 11, 2012 [2 favorites]


Are you confusing private health insurance with group health insurance?

Your first $5,800 is at full list price. If insurance paid those claims or part if you had a lower deductible, insurance would pay only 75% or 50% or 25% and the doctor/hospital would accept it as payment in full. Just sample percentages but insurance would pay less than full price. That is discriminatory and actionable under a thousand antitrust and discrimination laws but The Government never attacks that, nor does Obamacare.

In my earlier message I meant that private insurance generally pays higher rates - higher percentages of full price - than government provided employer health insurance. Even if both are thru BC/BS or what have you. This also is an antitrust violation.

I am not confusing private and group health insurance. Perhaps you can attempt to explain why "private" individual insurance costs you more and is forced to pay higher rates/percentages of full list price than private employer group insurance, which itself is forced to pay higher rates/percentages of full list price than government group insurance, even if all go through BC/BS (for example).

Perhaps you can explain why there is a "full list price" in health care which nobody but private working American Citizens are forced to pay, while any kind of insurance pays only a percentage of that full list price and while illegals, criminals, and welfares pay nothing (you pay for them but you get nothing).

I know enough of the answers to those questions but I'd like you to consider those questions. I still can't tell if you are for or against Obamacare or why.

I am for a basic healthcare for all American Citizens through taxes, but Obamacare is a hideous corrupt abomination which solves few problems, creates many others, and will have to be voided or removed to correct the real problems.
posted by caclwmr4 at 8:20 AM on March 11, 2012


"Not necessarily, the fees she paid could easily have been under the deductible, and the rates she paid could easily have been more then what she owed. "

Given that the argument was that "she would have had to file bankruptcy sooner, if...", with absolutely no evidence to support that statement, well... it just doesn't hold water.

Given a complete lack of supporting evidence on his part, logically, all he could reasonably say was that she *may* or *may not* have had to file bankruptcy sooner.

That said, given the facts as stated in the article:
- she was on unemployment
- she was 55 years old with had multiple medical debts

I think it reasonable to suggest that she would very likely benefit if she had access to the full insurance program in question.

Why?

1> Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).

2> Small business health care tax credits -- a part of the healthcare legislation package -- are available to over 4M small businesses in the US.

3> Given the $4500 or so in outstanding medical bill, it seems reasonable to wonder how much in medical bills they had already paid off before declaring bankruptcy. Those in their mid-50s with numerous medical bills, including referrals to specialists are going to be statistically more likely than not to spend an above-average amount on their medical expenses. If the big question is, "did she pay in more than she took out?", then obviously, you have to base that not just on the bills she defaulted on, but on all the bills she had over presumably at least a year or so while she was racking up debt due to the failure of her business. Given how low premiums can be for someone in her category who joins an insurance exchange, it doesn't seem particularly likely.
posted by markkraft at 8:22 AM on March 11, 2012 [1 favorite]


The "cash for clunkers" program removed and destroyed working, productive, cars. Those cars would have been used literally much farther. Many of those cars would have entered the used car market. Many of those cars would have been affordable to very lower income people, in fact is those persons' usual first car.

The destruction of those cars led to decreases in services, revenues, at auto repair shops, and decreases in inventories in the used car market, driving up all used car prices and even all new car prices.

The "cash for clunkers" program was only to help prop up failed car companies but caused more problems and DESTROYED USEFUL CARS.

Incredible.

I thought the "Broken Window Fallacy" was always taught in Remedial Economics 099, but apparently not for many years.
posted by caclwmr4 at 8:34 AM on March 11, 2012


...sliding scale if they choose to purchase insurance via an exchange...

What is this "exchange"?

Is it a store?

Is it a website?

Is it modeled after an open air market with free haggling over price?

It is NONSENSE. The dictates of Obamacare make such "insurance" a specific policy, where the price will rapidly or instantly converge on a single exact price, which will become a monopoly.

"Health Insurance Exchange". B.S.
posted by caclwmr4 at 8:43 AM on March 11, 2012


"that insurance would pay maybe 75% of that, or maybe 50% of that, or maybe 25% of that."

Or maybe 100%, less a co-pay for the visit. (BTW... found the WMDs yet?)

It's amazing to me that you can hate the evils of Obamacare so much, without having actual facts to support your anger.
posted by markkraft at 8:44 AM on March 11, 2012


The dictates of Obamacare make such "insurance" a specific policy, where the price will rapidly or instantly converge on a single exact price, which will become a monopoly.

We've got a live one.
posted by allen.spaulding at 8:49 AM on March 11, 2012 [1 favorite]


1> Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).

2> Small business health care tax credits -- a part of the healthcare legislation package -- are available to over 4M small businesses in the US.

more more more


And you think all that simplifies the system and makes it more fair?

But nobody should have to have an ID to vote, huh.
posted by caclwmr4 at 8:57 AM on March 11, 2012


I am not confusing private and group health insurance. Perhaps you can attempt to explain why "private" individual insurance costs you more and is forced to pay higher rates/percentages of full list price than private employer group insurance, which itself is forced to pay higher rates/percentages of full list price than government group insurance, even if all go through BC/BS (for example).


I wish I knew. I do know that every single healthcare provider we've ever worked with since getting private insurance has worked with us w/r/t the negotiated insurance rate. So we rarely, if ever, pay full price for medical stuff. I think the bigger question then is why do they charge these "full" rates if they're willing to take the lower payment; probably because someone will pay them.

I hate the health insurance industry as it exists today. My then-three-year-old son had to go without any sort of insurance at all for a full year before the only company who would work with us would insure him (and yes, we made too much money to qualify for state programs for him). I had to go a full year without any respiratory incidents, including receiving medications that would allow me to actually live (because I have severe asthma), before they'd even give me catastrophic insurance (thank god for a fantastic family doctor who probably broke several laws by giving me meds and treatment while keeping it all of my charts).

I still can't tell if you are for or against Obamacare or why.


And I can't see that it's relevant but okay. I love the idea of government insurance but I think the current plan is flawed in several ways. I would love to be able to have my medical condition, which I have through no fault of my own, at least partially covered; I have to get my medications from Canada because I cannot afford to pay the US prices for the same damn meds. So I break laws to keep breathing. I'd like to not break laws and still stay alive. I'd like for every single child in this country to have stellar medical care, regardless of their families incomes. I think it's a moral imperative to do so.
posted by cooker girl at 9:04 AM on March 11, 2012 [1 favorite]


That said, given the facts as stated in the article:
- she was on unemployment
- she was 55 years old with had multiple medical debts


No, the articleS, and I read about 10 of the 27 I found, said she owned her auto repair business. The unpaid medical charges were for her husband, not herself.

She filed bankruptcy in part because of the medical bills she couldn't pay and is on unemployment now.

It appears you did not read the original article or any other.
posted by caclwmr4 at 9:06 AM on March 11, 2012


I have to get my medications from Canada because I cannot afford to pay the US prices for the same damn meds. So I break laws to keep breathing.

Yes - and the medications you get from Canada are likely made in the exact same US factories as the ones you would purchase in the US if you could afford to. The huge difference in the price is protected by US laws. Obamacare keeps those laws in force. Obamacare protects all other countries having significantly lower drug costs than US Citizens for exactly the same drugs invented and Made In USA.

I feel for you and wish you the best.

Obamacare is a disaster.
posted by caclwmr4 at 9:12 AM on March 11, 2012


It appears you did not read the original article or any other.

You're continuing to make presumptions that aren't supported by the facts. All you know is the extant of outstanding medical debt. You don't know what she's paid so far in medical bills, nor do you know what percentage of her credit card debt is related to medical bills.

You're veering way out of control in this thread. Constantly repeating that Obamacare is a disaster is not an argument.
posted by allen.spaulding at 9:49 AM on March 11, 2012


It's a disaster of an argument.
posted by box at 9:58 AM on March 11, 2012 [1 favorite]


But nobody should have to have an ID to vote, huh.

What the hell does that have to do with anything?
posted by rtha at 10:04 AM on March 11, 2012


caclwmr4: “What is this ‘exchange’? Is it a store? Is it a website? Is it modeled after an open air market with free haggling over price? It is NONSENSE.”

You didn't really answer the question at all. What is the exchange?
posted by koeselitz at 10:18 AM on March 11, 2012


caclwmr4: “Obamacare is a disaster.”

In what sense is 'Obamacare' significantly worse than the $160 BILLION DOLLARS we're throwing into a hole annually with the current system?
posted by koeselitz at 10:20 AM on March 11, 2012 [5 favorites]


What the hell does that have to do with anything?

But what does pointing out that non sequitur have to do with freedom, I ask you?
posted by Sticherbeast at 10:20 AM on March 11, 2012 [2 favorites]


Are you kidding? Orange!
posted by rtha at 10:29 AM on March 11, 2012



The "cash for clunkers" program removed and destroyed working, productive, cars. Those cars would have been used literally much farther. Many of those cars would have entered the used car market. Many of those cars would have been affordable to very lower income people, in fact is those persons' usual first car.

The destruction of those cars led to decreases in services, revenues, at auto repair shops, and decreases in inventories in the used car market, driving up all used car prices and even all new car prices.

The "cash for clunkers" program was only to help prop up failed car companies but caused more problems and DESTROYED USEFUL CARS.

Incredible.

I thought the "Broken Window Fallacy" was always taught in Remedial Economics 099, but apparently not for many years.


Not the broken windows fallacy at all. The program didn't force anyone to do anything, it simply put a floor on what some older, fuel inefficient vehicles were getting as trade in value. Some quick googling shows that it removed 600,000 cars from the US fleet, which is 255,000,000 strong. Or 0.2%. All it did was give an incentive for people who wanted to buy new cars, at a time when that marketplace needed some stimulation. While at the same time removing fuel inefficent cars from the roads.
posted by gjc at 10:49 AM on March 11, 2012 [4 favorites]


Yeah, what gjc said. Cash for Clunkers is no more an example of the Broken Windows Fallacy than, say, tax deductions on mortgage interest.

The Broken Windows version of Cash for Clunkers would have been more along the lines of suddenly declaring "clunkers" to be no longer road safe, thereby forcing people to buy new cars. Nothing like that happened.
posted by Sticherbeast at 10:58 AM on March 11, 2012


"Sure. The second Militia Act of 1792 forced every adult white man into the militia, and compelled him to own either a musket or rifle and assorted accoutrement. Reading the statutes, it looks like showing up without your required gear would get you court-martialed."

Fascinating. What effect this might have on the jurisprudence is probably best left to those who make a living pondering such things, but if that's the best available example it does not seem very compelling. Though it does make you wonder how the opposing sides on the constitutionality issue would rearrange themselves if, instead of health insurance, the federal mandate was for every person to purchase a gun.
posted by cheburashka at 11:21 AM on March 11, 2012


cheburashka: "Though it does make you wonder how the opposing sides on the constitutionality issue would rearrange themselves if, instead of health insurance, the federal mandate was for every person to purchase a gun."

But a federal mandate does require every person to buy a gun. Last I checked I wasn't allowed to opt out of paying taxes just because I don't like the wars we happen to be fighting.
posted by koeselitz at 1:56 PM on March 11, 2012 [2 favorites]


What is this "exchange"?

Here, in Massachusetts, it's:

Commonwealth Health Insurance Connector Authority

The Health Connector is designed as a clearinghouse for insurance plans and payments. It performs the following functions:
It administers the Commonwealth Care program for low-income residents (up to 300% of the FPL) who do not qualify for MassHealth and who meet certain eligibility guidelines.

It offers for purchase health insurance plans for individuals who:
-- are not working.

-- are employed by a small business (less than 50 employees) that uses the Connector to offer health insurance. These residents will purchase insurance with pre-tax income.

-- are not qualified under their large employer plan.

-- are self-employed, part-time workers, or work for multiple employers.
It sets premium subsidy levels for Commonwealth Care.

It defines "affordability" for purposes of the individual mandate.

Commonwealth Care Health Insurance Program

Commonwealth Care is one of the newest subsidized health insurance programs offered by the Commonwealth, and is a key part of Health Care Insurance Reform in Massachusetts. It is designed primarily for income-eligible Massachusetts adult residents who are not otherwise eligible for MassHealth (Medicaid), who either do not work or who work for employers that do not offer health insurance. Specifically, it allows eligible residents access to certain subsidized private insurance health plans – currently a choice of five plans – for individuals without health insurance who make below 300% of the federal poverty level. There are no deductibles. For individuals below 150% of the federal poverty level, no premiums will be charged; for those below the poverty level, dental insurance is also provided. For those above 150% of the federal poverty level, a sliding scale premium schedule based on income is used to determine the amount of money a person contributes to their policy. Commonwealth Care for those below poverty has been available through the Connector since October 1, 2006. Plans for those between 100% and 300% of the poverty line have been available since January 1, 2007. As of June 2009, 177,000 people had enrolled in Commonwealth Care according to the Massachusetts Department of Healthcare Finance and Policy. The five Massachusetts health plans contracted with the state to serve the Commonwealth Care population as of April 2010 include: Boston Medical Center HealthNet Plan, CeltiCare, Fallon Community Health Plan, Neighborhood Health Plan, and Network Health. Celticare is offered by a for-profit insurance company, Centene, of St. Louis, MO and the rest are offered by Massachusetts-based non-profits.

Young Adult Coverage

Beginning in July 2007, the Connector offers reduced benefit plans for young adults up to age 26 who do not have access to employer-based coverage.
posted by ericb at 2:22 PM on March 11, 2012 [2 favorites]


Romneycare and Obamacare Differ Only in Inconsequential Ways.
posted by ericb at 2:29 PM on March 11, 2012


Mitt Romney's Advice For ObamaCare: Look At RomneyCare -- "Mitt Romney was once touting his plan to Obama as a model for health care reform."
posted by ericb at 2:34 PM on March 11, 2012


Proper link for 'Romneycare and Obamacare Differ Only in Inconsequential Ways.'
posted by ericb at 2:49 PM on March 11, 2012


"But a federal mandate does require every person to buy a [nuclear warhead]. Last I checked I wasn't allowed to opt out of paying taxes just because I don't like the wars we happen to be fighting."

It seems you are being deliberately disingenuous. Taxing and spending is not the same as requiring every person to purchase item/service X or face penalties. Even if these are equivalent in your mind, they are not equivalent under the law, which is why the controversy exists.
posted by cheburashka at 3:32 PM on March 11, 2012


Maybe this is the wrong place to write it, but for all the frustrated liberal Americans out there: the functioning healthcare in every other western and quite a few non-western societies weren't built in a day. There were different models of private insurance etc. In the end, the reality of economy got the politicians to the table, and universal healthcare was constructed, in a multitude of ways. It'll be that way in the US eventually, I'm certain.
posted by mumimor at 3:49 PM on March 11, 2012


"while any kind of insurance pays only a percentage of that full list price and while illegals, criminals, and welfares pay nothing"

I'm willing to wager that you didn't mean to sound like a tremendous asshole, but referring to people as "illegals, criminals, and welfares" sure makes you sound like one, irrespective of the merits of your argument.
posted by klangklangston at 4:09 PM on March 11, 2012 [7 favorites]


I hope so, mumimor. In the meantime, though, it's agonizing to watch the wheel be reinvented repeatedly.
posted by rtha at 4:29 PM on March 11, 2012


"the price will rapidly or instantly converge on a single exact price, which will become a monopoly."

That's why it's no longer worthwhile to buy anything online via those price comparison engines. What's the point, when you're stuck paying the same low price all the time?
posted by markkraft at 5:27 PM on March 11, 2012 [2 favorites]


illegals, criminals, and welfares pay nothing

Where are you getting this from? Convicts receive some medical care in prisons, sure. But do you think hospitals just wave illegal immigrants, "criminals" and welfare recipients through admission without provision for payment?
posted by msalt at 6:43 PM on March 11, 2012 [1 favorite]


Perhaps you can explain why there is a "full list price" in health care which nobody but private working American Citizens are forced to pay, while any kind of insurance pays only a percentage of that full list price and while illegals, criminals, and welfares pay nothing (you pay for them but you get nothing).

Wow, there's so much wrong with that once sentence, I don't even know where to start. First of all, that's some seriously dehumanizing language that you're throwing around there. The phrase "illegals, criminals, and welfares" is seriously, seriously offensive; those are human beings you're casually dismissing with one-word labels. How about undocumented immigrants, people in prison and people on public assistance? And sure, people in prison get some sort of health care usually (although not always) and very poor people can get medicaid but illegal aliens? They don't get anything free. Where did you get that idea?

But it's probably the last part of that sentence that annoys me the most, "you pay for them but you get nothing." If everyone in the country were actually getting decent health care and I was paying for it with my taxes, I would get the satisfaction knowing that I lived in a just and civilized country where no one would die for lack of money. That seems like a pretty good deal to me.
posted by octothorpe at 7:57 PM on March 11, 2012 [4 favorites]


cheburashka: “It seems you are being deliberately disingenuous. Taxing and spending is not the same as requiring every person to purchase item/service X or face penalties. Even if these are equivalent in your mind, they are not equivalent under the law, which is why the controversy exists.”

I am not being disingenuous. I genuinely don't see the difference. I talked about this with someone else upthread. Seriously, I don't get it. People keep saying that if this had been "structured" as a tax (someone actually claimed it was, incidentally) then this wouldn't be an issue.

Why not? It would cost precisely the same amount of money. You would still be penalized if you didn't pay it. And your money would go to the same people for the same service. Hell, it would probably cost less given the government overhead for collecting taxes.

I assure you I don't understand why this is different. People keep saying it's unconstitutional for the government to force people to buy things. Why? Really, how is that different from taxes?
posted by koeselitz at 9:17 PM on March 11, 2012


(And, cheburashka, please feel free to assume I'm just being really dumb about this and need it explained in detail, because that's how I feel here. I really do not get it, and wish someone would clear this up for me. How are taxes different in any substantial way from the government forcing people to pay for something?)
posted by koeselitz at 9:21 PM on March 11, 2012


"...while illegals, criminals, and welfares pay nothing"

Not only grossly offensive, but also just plain wrong.

From the Health Care legislation:
"Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

In fact, current US law prohibits it entirely.

As it stands, most very poor families *already* have free healthcare under Medicaid.

As for criminals getting free healthcare... well... that depends on the state. This is from Minnesota law, for example:

The county is entitled to reimbursement from the prisoner for payment of medical bills to the extent that the prisoner to whom the medical aid was provided has the ability to pay the bills. The prisoner shall, at a minimum, incur co-payment obligations for health care services provided by a county correctional facility.
posted by markkraft at 9:28 PM on March 11, 2012 [1 favorite]


Of course, prisoners <> criminals. The former include some people in Guantanamo and elsewhere who have not been charged with crimes. The latter include a number of wealthy executives who pay a lot of money for their health care.
posted by msalt at 9:34 PM on March 11, 2012 [2 favorites]


koselitz: Taxes are collected by and then disbursed by the government. (State, federal, city, whatever.) In this case, you are being asked not to pay a tax (to the government, to be spent by the government), but to purchase a corporation's product -- being mandated by the government to use your cash to buy a product from a private entity. Private entities are managed differently -- not subject to FOIA, for example -- and taxed different (well, governmental entities just aren't taxed).

Another version would be a "fee." In my state, fees can be imposed by city governments without a popular vote -- an increase in property or sales tax requires a vote and has to adhere to certain guidelines about public notice, etc. Fees, the city council can just decide they want to collect them. Certain kinds of fees can be collected against other governmental bodies. For example, our city council decided to start collecting a "use fee" for natural gas, which every user of natural gas, including charities and other governmental entities, have to pay. The school district now has to pay a $30,000 natural gas FEE to the city. The city could not collect taxes from the district, but it can collect fees. This also allows the city to say, "We didn't raise taxes! But the school district did!" And that's perfectly true -- the city levied a $30,000 FEE on the school district, which in turn had to raise that $30,000 in taxes. To the regular citizen, it costs the same as if the city had raised property taxes, but they get to displace that tax and force other governmental entities to raise taxes.

Anyway. The point is, whether something is a fee, or a tax, or a mandatory purchase may cost the same on the consumer/citizen's end, and may even look the same on the consumer/citizen's end, but it matters a whole lot for other purposes. Forcing citizens to purchase a product from a private corporation may not be legal, where taxing them to pay for the same universal service from the government may be. Private corporations are generally not subject to the same extensive sunshine laws (transparency rules) that the government is. Private corporations may be allowed to levy a large enough fee to make a profit; the government usually can't.

I actually think the purchase mandate is probably Constitutional, but it would be a less-murky question if we were simply taxing people to provide health care and then paying for it via taxes, a la Medicare and Medicaid, on a grander scale. Forcing people to purchase goods or services from private corporations is a trickier question than forcing them to pay taxes for shit they think is stupid or useless. Probably the most important practical point is that taxes are far more transparent and far more subject to pressure by the electorate, at least in theory. With taxes, citizens have more control. (In theory.)
posted by Eyebrows McGee at 10:06 PM on March 11, 2012


Taxes are collected by and then disbursed by the government. (State, federal, city, whatever.) In this case, you are being asked not to pay a tax (to the government, to be spent by the government), but to purchase a corporation's product -- being mandated by the government to use your cash to buy a product from a private entity.

Actually, the mandate is structured as a tax, for which you receive a credit if you already have insurance. That's the only sense in which the mandate has any force.
posted by gerryblog at 11:47 AM on March 12, 2012 [1 favorite]


Actually, the mandate is structured as a tax, for which you receive a credit if you already have insurance. That's the only sense in which the mandate has any force.

Even the government's brief before SCOTUS refers to the mechanism as a penalty, one which is collected by the IRS alongside taxes, but a penalty. Perhaps I'm missing something, but it seems sensible to rely on the government's own brief in support of the statute as the most favorable reasonable interpretation.


People keep saying it's unconstitutional for the government to force people to buy things. Why? Really, how is that different from taxes?

I will continue to refrain from offering an opinion on constitutionality, but I'll offer an opinion on the difference. Perhaps it is an unsatisfying answer, but taxation is a special case. Even assuming the same outcomes, the process matters. Is there a meaningful difference between the government forcing you to buy item X, or taxing you the cost of that item, buying it, and then giving it to you? It might be difficult to find, but I think it would be easier to find the difference between the government taxing 25% of your paycheck and forcing you to spend 25% of your working time on something it needs. Historically what the government does is taxation. The mechanisms that the government uses matter, even if you can conceive of a situation where the outcomes are the same.
posted by cheburashka at 6:34 PM on March 12, 2012


Are we reading the same brief?

2. Congress’s taxing power provides an independent ground to uphold the minimum coverage provision. In “passing on the constitutionality of a tax law,” a court is “concerned only with its practical operation, not its definition or the precise form of descriptive words which may be applied to it.” Nelson v. Sears, Roebuck & Co., 312 U.S. 359, 363 (1941) (citation omitted). The practical operation of the minimum coverage provision is as a tax law. The only consequences of a failure to maintain minimum coverage are tax consequences: non-exempted federal income taxpayers will have increased tax liability for those months in which they fail to maintain minimum coverage for themselves or their dependents. That additional tax liability will be calculated on the basis of the taxpayer’s household income (subject to a floor and acap), reported on the taxpayer’s federal income tax return, and collected by the IRS.

The fact that the minimum coverage provision—like longstanding tax provisions such as the exclusion of employer-paid health insurance premiums from employees’ taxable income—is intended to encourage health insurance coverage has no bearing on the taxing power inquiry. It is well settled that a tax “does not cease to be valid merely because it regulates, discourages, or even definitely deters the activities taxed.” United States v. Sanchez, 340 U.S. 42, 44 (1950).

Likewise, that Congress used the word “penalty” in the minimum coverage provision, 26 U.S.C.A. 5000A(b), rather than “tax,” is immaterial to whether it was a proper exercise of Congress’s power over taxation.
So too is the fact that Section 5000A includes the predicate for the penalty in a different subsection than those governing the penalty’s calculation, assessment, and collection.

posted by gerryblog at 7:56 PM on March 12, 2012


Get rid of the mortgage interest tax break and use that money for universal healthcare.
posted by five fresh fish at 10:56 PM on March 12, 2012 [1 favorite]


More government Obamacare gobbledygook, Or, never make something simple when it is simple, make it as complicated as possible for as long as possible for as many unelected lifetime bureaucrats as possible to write as many regulations as possible for as long as possible, for as long as possible
posted by caclwmr4 at 2:43 PM on March 14, 2012


That's your argument? That IRS regulations are opaque? Stop the presses! This has never before in the history of the nation happened before!

Also, I've skimmed the first four pages, and it's just not that opaque. It's less confusing than some of the IRS tax forms, that's for sure.
posted by rtha at 3:01 PM on March 14, 2012 [1 favorite]


"
Example 4: Part-time employee, hours of service requirement
Facts: Employer E hires Employee Z to work 20 hours per week. Employer E’s plan
requires part-time employees to complete 750 hours of service in order to participate. Solely for purposes of illustration in this example, it is assumed that upcoming guidance under PHS
Act section 2708 permits plans to require part-time employees to complete up to, but no more than, 750 hours of service in order to participate.
Conclusion: Part-time employees who work 20 hours per week will complete 750 hours
of service in 37 ½ weeks or just under 9 months. The waiting period under PHS Act section 2708 begins when Employee Z satisfies the cumulative service requirement, thereby becoming eligible (but for the waiting period) for coverage under the plan. Employer E must provide coverage to Employee Z no later than 90 days after Employee Z completes 750 hours of service, which is about one year after Employee Z is hired and begins working part-time.
(No Code section 4980H payment applies because Employee Z is part-time.)
"

Sure.

I actually do understand what that is saying.

I would FIRE EVERYONE INVOLVED in coming up with such bollocks.

Oh by the way, how is Employee Z covered until then, if ever, under this part of Obamacare?
posted by caclwmr4 at 5:50 PM on March 14, 2012


You're mad because government regulations are written in legalese?
posted by octothorpe at 5:56 PM on March 14, 2012


And 90 days after Employee Z's first minute after the 750th hour is going to be a killer, as in "Sorry, we have to let you go."

That is Obamacare.
posted by caclwmr4 at 5:57 PM on March 14, 2012


As I noted above, I was and am in favor of a basic healthcare plan for all American Citizens, and those in the US on legal visas. Not a thing for illegals.

Obamacare ain't it, and there will be a lot of trouble to get rid of and undo it if it survives.
posted by caclwmr4 at 5:59 PM on March 14, 2012


Not a thing for illegals.

"Good public health practices? Fuck that!"

Such pride in ignorance for the sake of ideology makes me sad. I'm sad a lot these days.
posted by rtha at 8:06 PM on March 14, 2012 [2 favorites]


caclwmr4: “That is Obamacare.”

Compare these passages side by side with the current insane disaster of a regulatory health care system, and then maybe we can talk about which one is more opaque, okay?

Your high-pitched whine about 'Obamacare' doesn't seem to take into account the fact that the current system is bullshit that is killing people. I don't think you'll find any sane person who thinks the Affordable Care act is the best solution ever – but good god is it better than the utter nonsense we have now. Can you at least address that? I mean, seriously, in what way is 'Obamacare' worse than the current situation?

“Not a thing for illegals.”

You do realize that banning the Hippocratic Oath would be a significantly difficult task? Not to mention the fact that so-called 'illegals' make up maybe one tenth of one percent of the $160 billion we currently waste every year on health care? You're going to have to face facts: it's not other people coming here and "stealing" our health care that's bankrupting us. It's good ol' Americans getting sick and dying.
posted by koeselitz at 10:16 PM on March 14, 2012 [1 favorite]


"Sure.

I actually do understand what that is saying.

I would FIRE EVERYONE INVOLVED in coming up with such bollocks.

Oh by the way, how is Employee Z covered until then, if ever, under this part of Obamacare?
"

So, how would you rewrite an example that shows that employees are required to have employer coverage within 90 days after working 750 hours?

"As I noted above, I was and am in favor of a basic healthcare plan for all American Citizens, and those in the US on legal visas. Not a thing for illegals.

Obamacare ain't it, and there will be a lot of trouble to get rid of and undo it if it survives.
"

Obamacare is a step forward from what we have, not a magic bullet that cures everything. So, in addition to still sounding like a racist asshole ("illegals"), you're letting the perfect be the enemy of the good and refusing to make a coherent argument against the health care reform act.

Luckily, Thomas Jefferson Slave Apartments will provide your catastrophic coverage.
posted by klangklangston at 10:51 PM on March 14, 2012


So, how would you rewrite an example that shows that employees are required to have employer coverage within 90 days after working 750 hours?


I would not have to. The first sentence of Caclwmr4care is this: "All American Citizens are covered in this National American Citizen Health Care Plan".

For the rest, you have to vote me in, then you Have to Pass the Bill So That You Can Find Out What Is In It.
posted by caclwmr4 at 11:02 PM on March 14, 2012


Just pointing out that, at least in Canada, you don't have to be a citizen to be covered by Medicare. Each province sets the rules, but they are fairly similar. In Ontario, citizenship applicants, permanent residents and landed immigrants, as well as those who have applied for those statuses and pass the first eligibility assessment are also covered. As are people on work permits > 6 months. As are visiting clergy, again, if the stay is over 6 months. In fact it's pretty hard NOT to be covered. Basically, you're only not covered if you're a tourist, a transient, or a visitor. That's it. And if you're not covered, the fees for service are a hell of a lot lower than they are in the US.

So, my advice to you when planning out your new medicare package.... don't be too particular about who it covers. "Everyone who probably doesn't have coverage somewhere else" is where you should start.
posted by seanmpuckett at 4:45 AM on March 15, 2012


"All American Citizens ...

So now you're excluding legal immigrants too? That's cute.
posted by octothorpe at 4:47 AM on March 15, 2012


Not sure this is the place for this insight, but it seems funny to me that we have basically universal education in the United States, but not universal health care. And it is universal not only for primary education, but college and graduate education as well. If I understand the U.S. student loan system, anyone who can get themselves admitted to an institution of higher education, who meets need criteria, is guaranteed student loans. Guaranteed, meaning there are no qualifying credit criteria you need to meet in order to get the loans, and if you default, the U.S. government pays the lenders.

So, all of us in the U.S. who pay taxes are guaranteeing these loans, and almost certainly we are paying for a large number of defaulted loans.

Yet I rarely hear conservatives decrying the universal availability of education in this country. I know there has recently been talk of a "higher education bubble," but that talk has been relatively muted.

It just seems very strange to me that there is this absolutely insane level of agitation over our gestures toward providing universal health care, but little outrage over universal education. Health care seems more fundamental, more essential to human dignity than education, as important as education is.

Are the differing levels of outrage accounted for by the fact that universal education is seen as benefiting a relatively privileged class of people? That is, are conservatives okay with universal higher education because it is the middle classes and up -- people perceived as responsible -- who are the primary beneficiaries of guaranteed higher education loans?

Furthermore, conservatives are the main proponents of charter schools, which give tax money to basically private enterprises that meet criteria for establishing a school. Why is there no outcry from conservatives about compelling taxpayers to pay for these private enterprises?

Conservatives have always, in my lifetime, extolled the value of private enterprise, and creative public and private partnerships. Their resistance to Obamacare seems to show that this affinity is a selective one, in that they endorse public/private partnerships that suit their ideological preferences.
posted by jayder at 10:11 PM on March 15, 2012 [2 favorites]


Are the differing levels of outrage accounted for by the fact that universal education is seen as benefiting a relatively privileged class of people? That is, are conservatives okay with universal higher education because it is the middle classes and up -- people perceived as responsible -- who are the primary beneficiaries of guaranteed higher education loans?

Maybe also their perception is that someone who's becoming educated is making the proper choice, living the proper way whereas by sharing healthcare costs they're being forced to pay for other peoples' poor choices, sometimes.
posted by cairdeas at 3:59 PM on March 16, 2012


This is not good news, especially for the mandate (emphasis mine):
Chief Justice John Roberts, Justices Samuel Alito and Justice Anthony Kennedy on Tuesday asked the Obama administration's lawyer questions about the limits of federal power if the health care law's individual mandate is upheld.

Roberts asked if Congress can require people to buy cellphones in order to make sure they can get emergency assistance when they need it. Alito asked a similar question regarding burial services, given that everyone will eventually need it in some form or another

Kennedy asked whether Congress has a "heavy burden to show" before requiring people to buy a product.

Both Roberts and Kennedy did, however, appear sympathetic regarding the proximity of health insurance regulation to the interstate market, which is critical to the constitutional question.

Meanwhile, following the end of oral arguments, CNN Legal Analyst Jeffrey Toobin said on CNN that based on what he heard inside the Court, things didn't look good for proponents of the law.

"This was a train wreck for the Obama administration," he said. "This law looks like it's going to be struck down. I'm telling you, all of the predictions including mine that the justices would not have a problem with this law were wrong... if I had to bet today I would bet that this court is going to strike down the individual mandate."
posted by zombieflanders at 10:26 AM on March 27, 2012


« Older One of the most popular stories on the Amazon Kind...  |  Trike drifting... Newer »


This thread has been archived and is closed to new comments