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tommi teardrop



Joined: 12 Apr 2007
Posts: 2216
Location: Las Vegas
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Do you fuckers not comprehend the fact that this act, as shitty as you think it is, was extremely difficult to get passed? Democrats had to have their hand forced to even get it passed in the first place. Then it is taken to the supreme court, where it is found constitutional by smallest of margins. And now republicans will do everything in their power to defy it and get it repealed.

All these great ideas you have will not be adopted. We can bitch about that all day. But it is what it is.

As it stands this act will allow millions of people that could never afford insurance to be able to finally have coverage. It will allow young people to delay the burden of healthcare until their careers are further along.

You public option assholes have come with this all or nothing stance which is not rooted in the reality of American politics at all.

Had this thing been deemed unconstitutional, we would be back to where we were, where millions less would be able to afford healthcare. So yes, this is something to celebrate, at least for those of us that realize that it's not as easy as saying, "the whole system needs an overhaul and until that happens, I oppose any act that tries to make things better in the meantime."

Look at me I called the supreme court nine pigs in robes. Smmfh.

It's so short sighted and selfish.
Post Sun Jul 01, 2012 12:14 pm
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Mark in Minnesota



Joined: 02 Jan 2004
Posts: 2010
Location: Saint Louis Park, MN
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The time to celebrate, or not, was when the law got passed.

The fact that we almost lost the law but didn't isn't a cause for celebration, it's a cause for somber reflection about the seriousness of each individual Supreme Court appointment in an environment like this.

Four justices of nine on the court were ready to throw out the entire law wholesale on some ends-justifies-means shit, overturning more than half a century of precedent about what the Commerce Clause actually empowers Congress to do.

Whether the health care law is good or bad on its own merits, the fact that we came this close to losing it this way is really bad.
Post Sun Jul 01, 2012 12:48 pm
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name



Joined: 12 Nov 2002
Posts: 955
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futuristxen wrote:

There are millions of people who will die or experience financial ruin because of how inadequate this bill is at addressing the real problem.

It is so profoundly shortsighted and ignorant to celebrate this like it means something great.


So therefore, we're better off without it. That right there is some unassailable logic.

Say, I'm really pissed that out gun laws don't prohibit semiautomatics, so why don't don't we just repeal all gun laws and let people use anything they want? At least until someone crafts a magical perfect piece of legislation, which of course will pass both the house and the senate unanimously!

How much more time do we have to waste arguing with the ostentatiously sanctimonius "all or nothing" crowd? Really. Anyone who thinks single payer could have been passed in either of the last 2 congresses isn't interested in actually fixing any of our problems.
Post Sun Jul 01, 2012 6:10 pm
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Mark in Minnesota



Joined: 02 Jan 2004
Posts: 2010
Location: Saint Louis Park, MN
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CBS News has a good long article on Roberts changing his vote, which reads like the sources were either conservative justices or clerks for the conservative justices.
http://www.cbsnews.com/8301-3460_162-57464549/roberts-switched-views-to-uphold-health-care-law/

This is a pretty bad and internally inconsistent ruling, and increasingly I'm thinking that part of the reason the court's consevatives refused to co-sign any part of the majority opinion (and, implicitly, forced the liberals to sign in spite of dissent within their ranks) was to maximize the chances that the opinion itself (that Congress can use taxes to coerce citizens into doing things that it cannot directly compel them to do using its other powers) will be challenged in the future.
Post Mon Jul 02, 2012 6:32 pm
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futuristxen



Joined: 01 Jul 2002
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One would certainly hope so. It's a very dangerous precedent to set, that congress can make citizens purchase products from private companies. Especially given how broken the campaign finance system is. I absolutely do not trust congress to wield that sort of power responsibly.
Post Mon Jul 02, 2012 7:55 pm
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Mark in Minnesota



Joined: 02 Jan 2004
Posts: 2010
Location: Saint Louis Park, MN
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The precedent was that they _can't_ -- but that they can tax people who don't make the purchase, as long as the tax itself is not inherently coercive.

I would not be surprised to see someone subject to the tax challenge it on equal protection grounds.
Post Mon Jul 02, 2012 8:09 pm
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AdamBomb



Joined: 05 Mar 2004
Posts: 3183
Location: Louisiana
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The whole tax argument was an excuse to get the Supreme Court to get rid of it. Are we pretending that was the basis of the issue of the whole thing?

If prices stayed the same, I could see how this wouldn't be bad...totally obvious good things if you are in a rut. However, the very logic of the act is guaranteed to make premiums skyrocket, putting us on a delicate course of hurting businesses that are already having trouble with health coverage, not to mention the individual burden of those who are already burdened from high costs. Can someone explain to me how insurance companies are going to quit being businesses and just hook everyone up? Also, can someone explain to me how this isn't going to cost us a shitload of tax revenue at a time when we are bigger in the hole than ever?
Post Mon Jul 02, 2012 8:29 pm
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GrantherBirdly
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Joined: 05 Jun 2004
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AdamBomb wrote:
Can someone explain to me how insurance companies are going to quit being businesses and just hook everyone up? Also, can someone explain to me how this isn't going to cost us a shitload of tax revenue at a time when we are bigger in the hole than ever?


The rationale behind the mandate is that by compelling young and otherwise healthy people to buy insurance, insurers will have a lot more people paying premiums but not filing claims (i.e., not using health services). Ideally this will allow:

- insurers to accept people with pre-existent conditions (without going bankrupt)

- Insurers to drop prices since there will be a greater number of people in the system, and a smaller percentage of these people will be sick (since healthy people will have been forced to buy in as well).
Post Mon Jul 02, 2012 9:19 pm
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redball



Joined: 12 May 2006
Posts: 6871
Location: Northern New Jersey
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Congress has been penalizing people for not buying mortgages for what, 30 years now? This isn't any different, except that the end result is more people having health care which is an incremental step towards socialization.

Please reconcile the arguments that we should have single payer but we shouldn't force people to buy insurance. The two are one and the same.
Post Tue Jul 03, 2012 8:22 am
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Mark in Minnesota



Joined: 02 Jan 2004
Posts: 2010
Location: Saint Louis Park, MN
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If you are of the opinion that privately owned and operated health insurance is a corrupt and broken system because it creates a profit motive (as opposed to simply a cost-control motive) to deny sick people health care, then an individual mandate is a huge giveaway to the operators of inherently evil businesses. In contrast, even if the tax burden for a single-payer is identical to the cost of private premiums, the private system is grossly inferior because it has fiduciary responsibility to shareholders, not statutory responsibility to patients. Even if PPACA works as advertised and lowers real costs for everyone including the currently uninsured and underinsured, distaste for the moral result is an internally consistent position to have--especially given the tyranny-of-the-majority stuff that goes into whether a given medical treatment is covered under those policies.

Forget the fact that these companies gladly deny life-saving cancer treatment over slim technicalities, routinely cut deals with certain medical device providers, drug companies, and hospitals in ways that limit patient choice without lowering costs or improving quality of care. Forget that these companies support legislation to make themselves immune from class action lawsuits, and that they by and large opposed the same reforms which just added tens of millions of new customers to their rolls.

Just look strictly at whether or not we want the people in charge of rationing our health care subject to market forces. Remember a few months ago when the NASCAR and talk radio set got all up in arms over the possibility that their insurance premiums or tax dollars might somehow pay for an abortion or a birth control pill? Remember how the entire left basically stepped up en masse to make sure the abortion costs wouldn't become the tip of a spear on making women's reproductive health an uncovered medical treatment, not due to legitimate debate about the necessity of the treatments but due to regressive politics masquerading as market force?

Those same regressive politics masquerading as market force are causing insurance companies to deny gender reassignment treatments--both surgery and hormone therapy--with much less controversy, in spite of well-understood mental health effects associated with leaving the basic body/gender dysphoria issues untreated. Many of the mental health issues themselves are also poorly covered. Private insurers have real concern that if they pay for those treatments their plans will be swamped by people who need the medicine and abandoned in droves by more populous and profitable bigots. This wouldn't be the same degree of concern in a single-payer system as it is in the mandatory-participation-in-private-markets system--and creation of the latter system has made a subsequent shift to the former system far less likely. PPACA also left certain reforms such as policies that function across state lines (which could have helped transgendered people negotiate from a position of greater collective power) off the table. Had we left the mainstream system broken for another decade or so, perhaps support for single payer would have emerged--but the solution we got probably guarantees that reforms to our medical system's treatment of trans people will not improve for half a century or more. Speaking as someone who has trans friends who have been hospitalized or even dead of suicide under the current status quo, and who expect to be beggared by the costs of uncovered medical treatment in their own private best case scenario: A "shut up and celebrate the partial victory" argument is not that compelling in some lights.

Me, I'm too much of a pragmatist to take that stance wholeheartedly--but neither am I glad to see responses calling disappointment with the SCOTUS decision short sighted or selfish. Progressives left some people behind on this one, and the PPACA decision last week pretty much killed any possibility of those people getting a do-over. Heaping scorn on people who wish we had been given that do-over is not an act of thoughtful debate, regardless of whether our political climate would support a single payer outcome or not.

On the mortgage analogy: Giving people a powerful incentive to participate in a market is different than creating a penalty for people who refuse to participate in a market. Even if in practice the incentive drives up costs for non-participants and the penalty drives down aggregate costs for participants and non-participants alike.
Post Tue Jul 03, 2012 9:23 am
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AdamBomb



Joined: 05 Mar 2004
Posts: 3183
Location: Louisiana
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GrantherBirdly wrote:
AdamBomb wrote:
Can someone explain to me how insurance companies are going to quit being businesses and just hook everyone up? Also, can someone explain to me how this isn't going to cost us a shitload of tax revenue at a time when we are bigger in the hole than ever?


The rationale behind the mandate is that by compelling young and otherwise healthy people to buy insurance, insurers will have a lot more people paying premiums but not filing claims (i.e., not using health services). Ideally this will allow:

- insurers to accept people with pre-existent conditions (without going bankrupt)

- Insurers to drop prices since there will be a greater number of people in the system, and a smaller percentage of these people will be sick (since healthy people will have been forced to buy in as well).


So, basically...in order to stave costs you have to effectually have a pyramid scheme with sustained population growth. And we just have to trust that the insurance companies will lower rates?

As you can see in this chart, the "young" (statistically healthy) people are also the most unemployed: http://bls.gov/web/empsit/cpseea10.htm
Post Tue Jul 03, 2012 9:31 am
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GrantherBirdly
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Joined: 05 Jun 2004
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AdamBomb wrote:
GrantherBirdly wrote:
AdamBomb wrote:
Can someone explain to me how insurance companies are going to quit being businesses and just hook everyone up? Also, can someone explain to me how this isn't going to cost us a shitload of tax revenue at a time when we are bigger in the hole than ever?


The rationale behind the mandate is that by compelling young and otherwise healthy people to buy insurance, insurers will have a lot more people paying premiums but not filing claims (i.e., not using health services). Ideally this will allow:

- insurers to accept people with pre-existent conditions (without going bankrupt)

- Insurers to drop prices since there will be a greater number of people in the system, and a smaller percentage of these people will be sick (since healthy people will have been forced to buy in as well).


So, basically...in order to stave costs you have to effectually have a pyramid scheme with sustained population growth. And we just have to trust that the insurance companies will lower rates?

As you can see in this chart, the "young" (statistically healthy) people are also the most unemployed: http://bls.gov/web/empsit/cpseea10.htm


I think calling it a pyramid scheme is a mischaracterization. It's just how insurance works. If the pool of insured individuals is largely sickly, premiums will have to skyrocket, hitting healthy and unhealthy people alike. A pyramid scheme needs an ever-growing base to make things work at the top, which I'm not sure is the case here. If the current population of the U.S. was all insured, I think the system would be rendered more stable, even with present distribituion between old and young in the population.


Last edited by GrantherBirdly on Tue Jul 03, 2012 9:47 am; edited 4 times in total
Post Tue Jul 03, 2012 9:44 am
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GrantherBirdly
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double post.
Post Tue Jul 03, 2012 9:44 am
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redball



Joined: 12 May 2006
Posts: 6871
Location: Northern New Jersey
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Mark,

On your first point, I'd like to hear how you think those political incentives would play out differently in a single payer system. I understand how bigotry and profit motives influence the market, but they also strongly influence politics. If you want to boil it down, I think you'd find that profit motives are what mess up many good social needs programs, and bigotry and partisan politics are what defund them.

While I won't argue that single payer is an inferior system, I will argue that it is not so superior that we should consider this law a misstep. Especially before most of the substantive regulations of the law go into effect.

On your second point, you are only right psychologically. There is no difference between a tax credit and a tax penalty. If you pay a mortgage then you pay less taxes than I do because I rent or own. I am penalized for not buying into a private industry and giving them my money. Sure, psychologically it seems different, but financially it is not at all.

I'd even argue that the mortgage tax credit is something we should be fighting against wholeheartedly, as it is a poison pill that has been used in conjunction with market forces to make home ownership impossible for many Americans and it disproportionately favors the rich. It goes to support the vary industries that recently destroyed our fragile economy.
Post Tue Jul 03, 2012 9:54 am
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Mark in Minnesota



Joined: 02 Jan 2004
Posts: 2010
Location: Saint Louis Park, MN
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There isn't a tax credit for mortgage interest, there's a tax deduction. The only tax credits related to home ownership are usually things like first-time homebuyer credits, one-time incentives to make homes more energy efficient, etc. -- none of which are concerned with whether you mortgaged instead of buying outright. As someone who has a mortgage, it's true that I pay less in taxes than I would otherwise, but I pay more in taxes and interest combined than you would be paying as someone who owned an equivalent-cost property outright--and although I'm not going to get into the math of it here, it has almost always been better to pay down a mortgage early than it was to continue carrying those interest costs to free up capital for outside investments.

My understanding of the problem with our housing law with respect to taxes and mortgage interest is that ownership of primary residences is not subject to the same kinds of tax law with respect to capital gain, capital loss, and depreciation as commercial properties are. The interest paid on any debt a business carries can be deducted from the business's income as a business expense, which includes any mortgage they carry on commercial property. The commercial property also depreciates in value as the building ages and businesses can take this (and the costs of maintaining the building against that depreciation) into account as part of carrying costs for the investment. When the business sells the property at the end of its use, they realize a capital gain or a capital loss net of those carrying costs, depreciated value, etc.

Private home ownership via mortgage could work the same way, but it doesn't. The mortgage interest deduction is sort of a halfway measure which is much simpler to manage from a taxation perspective, but really just creates parity with the way commercial real estate investment continues to work. Without it, there would be an active disincentive to buy a property (either outright, or via mortgage) versus renting that same property from a business operating it as rental housing. The difference (in my county/state, at least) between a homestead property tax rate, a non-homestead property tax rate, and a commercial property tax exists for the same reason: to simplify the tax requirements for individual citizens without penalizing them in exchange for that simplicity. This structure (plus the related laws allowing banks to lend families high multiples of their annual income to purchase properties secured by liens) was set up to make individual ownership of property possible in an emerging urban environment where the majority of landowners were no longer assumed to be businesses in their right. Without this, when our country transitioned from being more than 50% agrarian to being less than 10% agrarian, we would have become a nation of renters.

Our housing market and our economy are screwed up, but it isn't the mortgage interest deduction which caused that. Rather, it's that the people lending the money started trading and lending against speculation value of property (and against the assumption that a residential property will always appreciate in value, even as the condition of the building on that property depreciates due to age and use) rather than the real value of the property, evaluated in the same kinds of terms that commercial property might have used.

At any rate, none of this has much to do with whether the mortgage interest rate deduction is in any way equivalent to the penalty for refusing to purchase health insurance. You and I disagree here but we're coming from very different assumptions about how the tax system works and what it's attempting to do.

On the other point: Our government is, at least in theory, set up to defend against the most egregious tyrannies of the majority; private industries are not only not constrained by some of the civil rights rules which impact our government, they are actually in some cases obligated to cave to those tyrannies through their duty to protect shareholder value. Legislators managing a single-payer system would at minimum have to write a law explaining why a given class of people (e.g., trans people) should be denied treatment that their doctors deem to be medically necessary. Concepts like due process and equal protection under the law apply to those laws in ways that they do not necessarily apply to coverage decisions being made by a private company.
Post Tue Jul 03, 2012 11:46 am
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