United States Healthcare Reform

[TheTrunkDr]

That’s the point. People who earn low enough, will be better off with public healthcare while people better off can use private healthcare.

If you can afford it, you should be able to get better healthcare. The issue that those who can’t afford it, don’t get good enough healthcare.

You can’t promise everyone everything. There will be people who would be better off under this plans, such as the sickly and middle-class, or the poor, who would have cheap healthcare, and cost certainty. Those who make under the poverty level would have free healthcare, as they do now, and those who make Wal-Mart wages (say $20k a year)- would only pay about $45/mo for healthcare.

In return for this, employers would be out of healthcare- which actually sprouted due to socialist policies enacted during WWII. (employer healthcare came about because companies weren’t allowed to raise wages- so they had to give other bennies instead) This would improve the efficiency of the system, and raise wages.

Taxing the poor is just a stupid idea on its face. The tax code is expressly designed to be progressive (higher taxes on people making more money) and what you’re proposing is exactly the opposite, it’s regressive, putting the poor in even worse financial straits.

The entire point of a welfare program is that those who can afford to fund it while those who can’t get the benefits. The idea being that those benefits end up benefiting society at large by giving better opportunity to the poor. You’re idea is again the exact opposite by trying to make the poor pay for their own welfare. Here’s the problem, THEY’RE FUCKING POOR. If they could afford to contribute to the welfare programs they wouldn’t be poor and wouldn’t need the programs.

Either way $45 isn’t enough to pay for a person’s health care so the program will have to be subsidized. You couldn’t tax the poor enough to fund their own health care program as, again, they’re poor and don’t have the money.

[AlanQ]

However, it may not really change things much, since while the pharma companies spend tons of marketing, if their profit margins drop, it doesn’t mean they’ll cut marketing. Indeed, they’d likely need to market just as hard or harder to get their drugs into the marketplace.

Well in a single purchaser system where the government is the purchaser of drugs, which is one common way other nations keep prices pharmaceutical prices down, you would expect pharmaceutical marketing to all but disappear, since there would be little point advertising to people who weren’t buying the drugs anyways.

[JonRowe]

Pharma R&D costs have been disproved. Pharma marketing was shown to be like 3-4x what their R&D costs were in a recent study.

Just some anecdotal evidence. I work in a research lab.

I don’t see the money.

[Eric_T_Cheng]

Well in a single purchaser system where the government is the purchaser of drugs, which is one common way other nations keep prices pharmaceutical prices down, you would expect pharmaceutical marketing to all but disappear, since there would be little point advertising to people who weren’t buying the drugs anyways.

We see tv commercials for prescription drugs up here in Canuckistan, but they’re the “Go see your doctor if Erectiledysfunctionprin is right for you” type of ads.

[Mike_O_Malley]

Well, we don’t have that particular problem down here in the US.

[AlanQ]

We see tv commercials for prescription drugs up here in Canuckistan, but they’re the “Go see your doctor if Erectiledysfunctionprin is right for you” type of ads.

That’s true, but having lived in both Canada and the US the volume of ads is by no means comparable, in my experience at least.

[Eric_T_Cheng]

Canada prohibits the direct-to-consumer advertising of prescription drugs because it is up to the medical doctors to prescribe which drugs to be used. Also, family doctors tend to prescribe the generic brands (I think it’s because it’s illegal for doctors to prescribe something because they get some type of kickback from a supplier, so there’s no incentive for them to prescribe brand name drugs).

[Alstein]

Taxing the poor is just a stupid idea on its face. The tax code is expressly designed to be progressive (higher taxes on people making more money) and what you’re proposing is exactly the opposite, it’s regressive, putting the poor in even worse financial straits.

The entire point of a welfare program is that those who can afford to fund it while those who can’t get the benefits. The idea being that those benefits end up benefiting society at large by giving better opportunity to the poor. You’re idea is again the exact opposite by trying to make the poor pay for their own welfare. Here’s the problem, THEY’RE FUCKING POOR. If they could afford to contribute to the welfare programs they wouldn’t be poor and wouldn’t need the programs.

Either way $45 isn’t enough to pay for a person’s health care so the program will have to be subsidized. You couldn’t tax the poor enough to fund their own health care program as, again, they’re poor and don’t have the money.

Either I’m failing at explaining this, or you’re failing at understandingit.

a) The cost goes up for this as you make more money. Below poverty level you pay nothing. What I"m suggesting is progressive not regressive in nature. Generally, the lower middle class would benefit the most, as they’d get cost certainty (no matter what happened to them if they take the public option- no more then 15% of their income would go to healthcare)

Yeah- it may not be enough, but you can live on 85% of your income if you’re not really poor. Also, with employers out of healthcare- they can put that healthcare money into wages (though more likely they’d pocket at first, then wages would rise later due to competition)

b) Yeah, the program would need outside funding also. We’d be able to do it though, since this program would be a lot more efficient then what is set up now, as there would be no eligibility rules.

[charmtrap]

I’m not sure how much weight to give this story, but nevertheless:

Poll: U.S. Wants More Health Reform, Not Less

The poll found that about four in 10 adults think the new law did not go far enough to change the health care system, regardless of whether they support the law, oppose it or remain neutral. On the other side, about one in five say they oppose the law because they think the federal government should not be involved in health care at all.

[bago]

Canada prohibits the direct-to-consumer advertising of prescription drugs because it is up to the medical doctors to prescribe which drugs to be used. Also, family doctors tend to prescribe the generic brands (I think it’s because it’s illegal for doctors to prescribe something because they get some type of kickback from a supplier, so there’s no incentive for them to prescribe brand name drugs).

That almost sounds reasonable. Almost as if it’s preferable to have drugs ingested based on the recommendation of professionals, as opposed to the feelings you have while watching yuppies running through a field.

Almost.

[inactive_user]

I want the drug that gives me the sexy dual sunset bathtubs in the field. Who can prescribe that shit?

[Guido_Jones]

No mention that a Federal Judge in VA struck down the individual mandate on constitutional grounds yesterday?

http://news.yahoo.com/s/ap/20101213/ap_on_re_us/us_health_care_overhaul_virginia

[Houngan]

No mention that a Federal Judge in VA struck down the individual mandate on constitutional grounds yesterday?

http://news.yahoo.com/s/ap/20101213/ap_on_re_us/us_health_care_overhaul_virginia

My question is then how can it be constitutional to require emergency rooms to treat anyone that comes in, regardless of ability to pay?

H.

[Brian_Seiler]

It’s not a particularly exceptional event - I’m pretty sure that everybody has been presuming that this was coming since the bill was passed, because the most legally controversial concept is the notion that the federal government can require a particular specific commercial activity from the nation’s public. I don’t know how long it will take for this to bubble up to the Supreme Court to have anything substantive done to it, though.

[Brian_Seiler]

My question is then how can it be constitutional to require emergency rooms to treat anyone that comes in, regardless of ability to pay?

H.

Different issue, and it’s on a local level. I only know how it works in Texas, but in Texas, the local law is that the whole state is divided up into Hospital Districts, in addition to the eight billion other cuts people put on the map. One hospital in every Hospital District is designated as the primary hospital, and that hospital has to treat anybody who comes into the emergency room. Other hospitals in the district are free to tell you to go pound sand (I think they’re supposed to wheel you over to the public one). In return, I want to say that those hospitals receive some kind of public support or funding, but I’m honestly not a hundred percent on that.

[Guido_Jones]

There’s still the case in Florida with 20 states as well (but according to Volokh Conspiracy it doesn’t look good for the Government in that case either)

[TheTrunkDr]

Should just go single payer and fund it through taxes or regulate the industry rather heavily.

[jeffd]

I’m hesitant to wade into the legal side of things because it’s not an area of expertise for me. But I do love to run my mouth, so here are my impressions on why this is not a Big Deal:

1. It’s expected. One of the little-commented upon stories over the past twenty years is the politicization of the judiciary; specifically with conservative activist judges. This judge was one such. Two other federal judges have ruled on the mandate and found it to be perfectly A-OK.
2. The opinion itself doesn’t seem to be very well regarded; most legal commentary I’ve glanced at says it’s not likely to withstand appeal. I may be vulnerable here due to my sources; I tend to stick to the more liberal side of the blogosphere and the conservative blogs I do follow haven’t said much about this case.
3. The case itself doesn’t seem to have much merit; you can view the individual mandate as a tax & tax credit (700 dollar tax levied against everyone; 700 dollar tax credit for purchasing health insurance). While I’m sure conservatives would love to have the concept of taxation be ruled unconstitutional; it just isn’t happening.

That being said, I’m not a legal mind so I have no idea if these impressions are way off or not.

[JeffL]

I’m hesitant to wade into the legal side of things because it’s not an area of expertise for me. But I do love to run my mouth, so here are my impressions on why this is not a Big Deal:

1. It’s expected. One of the little-commented upon stories over the past twenty years is the politicization of the judiciary; specifically with conservative activist judges. This judge was one such. Two other federal judges have ruled on the mandate and found it to be perfectly A-OK.
2. The opinion itself doesn’t seem to be very well regarded; most legal commentary I’ve glanced at says it’s not likely to withstand appeal. I may be vulnerable here due to my sources; I tend to stick to the more liberal side of the blogosphere and the conservative blogs I do follow haven’t said much about this case.
3. The case itself doesn’t seem to have much merit; you can view the individual mandate as a tax & tax credit (700 dollar tax levied against everyone; 700 dollar tax credit for purchasing health insurance). While I’m sure conservatives would love to have the concept of taxation be ruled unconstitutional; it just isn’t happening.

That being said, I’m not a legal mind so I have no idea if these impressions are way off or not.

It is to be expected. What’s funny but predictable, the conservatives are saying the judges who ruled it to be constitutional are all Clinton judges, the liberals are claiming this guy is ruling via political bias, etc.

I have had a difficult time finding the detailed legal arguments. I understand where this judge is coming from: it is expanding the commerce powers beyond their constitutional limits to force you to purchase a product from a private company. The arguments I’ve seen on TV so far (admittedly the worst place to look, but been busy!) and the response from the White House has been “but this won’t work if you don’t require people to buy insurance” - which is true, but not a legal argument.

Everyone expected this part to be challenged in the courts, and it will undoubtedly require a Supreme Court ruling. But as much as I want health care reform, even if all we got was some insurance reform, it seems to my admittedly ignorant understanding of the Commerce powers that it is at least debatable whether the federal government can require an individual to purchase a product from a commercial company.

[Guido_Jones]

Well, not exactly conversvative (they’re more libretarian), but http://volokh.com has a bunch of posts on it. The only part of the opinion that there is much complaint about (from some early morning skimming) is the necessary and proper evaluation that Judge Hudson did.