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Night Phoenix Jul 3, 2009 12:21 AM

Senate bill fines people refusing health coverage
 
Quote:

Source: Associated Press | Google News

Senate bill fines people refusing health coverage

By RICARDO ALONSO-ZALDIVAR – 7 hours ago

WASHINGTON (AP) — Americans who refuse to buy affordable medical coverage could be hit with fines of more than $1,000 under a health care overhaul bill unveiled Thursday by key Senate Democrats looking to fulfill President Barack Obama's top domestic priority.

The Congressional Budget Office estimated the fines will raise around $36 billion over 10 years. Senate aides said the penalties would be modeled on the approach taken by Massachusetts, which now imposes a fine of about $1,000 a year on individuals who refuse to get coverage. Under the federal legislation, families would pay higher penalties than individuals.

In a revamped health care system envisioned by lawmakers, people would be required to carry health insurance just like motorists must get auto coverage now. The government would provide subsidies for the poor and many middle-class families, but those who still refuse to sign up would face penalties.

Called "shared responsibility payments," the fines would be set at least half the cost of basic medical coverage, according to the legislation.

In 2008, employer-provided coverage averaged $12,680 a year for a family plan, and $4,704 for individual coverage, according to the Kaiser Family Foundation's annual survey. Senate aides, who spoke on condition of anonymity because they were not authorized to speak publicly, said the cost of the federal plan would be lower but declined to provide specifics.

The legislation would exempt certain hardship cases from fines.

The new proposals were released as Congress neared the end of a weeklong July 4 break, with lawmakers expected to quickly take up health care legislation when they return to Washington. With deepening divisions along partisan and ideological lines, the complex legislation faces an uncertain future.

Obama wants a bill this year that would provide coverage to the nearly 50 million Americans who lack it and reduce medical costs.

In a statement, Obama welcomed the legislation, saying it "reflects many of the principles I've laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."

The Senate Health Education, Labor and Pensions bill also calls for a government-run insurance option to compete with private plans as well as a $750-per-worker annual fee on larger companies that do not offer coverage to employees.

Sens. Edward M. Kennedy, D-Mass., and Christopher Dodd, D-Conn., said in a letter to colleagues that their revised plan would cost dramatically less than an earlier, incomplete proposal, and help show the way toward coverage for 97 percent of all Americans.

In a conference call with reporters, Dodd said the revised bill had brought "historic reform of health care" closer. He said the bill's public option will bring coverage and benefit decisions driven "not by what generates the biggest profits, but by what works best for American families."

The two senators said the Congressional Budget Office put the cost of the proposal at $611.4 billion over 10 years, down from $1 trillion two weeks ago.

However, the total cost of legislation will rise considerably once provisions are added to subsidize health insurance for the poor through Medicaid. Those additions, needed to ensure coverage for nearly all U.S. residents, are being handled by a separate panel, the Senate Finance Committee. Bipartisan talks on the Finance panel aim to hold the overall price tag to $1 trillion.

The Health Committee could complete its portion of the bill as soon as next week, and the presence of a government health insurance option virtually assures a party-line vote.

In the Senate, the Finance Committee version of the bill is unlikely to include a government-run insurance option. Bipartisan negotiations are centered on a proposal for a nonprofit insurance cooperative as a competitor to private companies.

Three committees are collaborating in the House on legislation expected to come to a vote by the end of July. That measure is certain to include a government-run insurance option.

At their heart, all the bills would require insurance companies to sell coverage to any applicant, without charging higher premiums for pre-existing medical conditions. The poor and some middle-class families would qualify for government subsidies to help with the cost of coverage. The government's costs would be covered by a combination of higher taxes and cuts in projected Medicare and Medicaid spending.
It's no longer a debate of should we or are we, it's when and how, so let's leave that by the wayside. In some form or fashion, barring some political circumstances that I, this board's resident political scientist, haven't forseen, we'll have some form of government-run/subsidized/socialized medicine by at least 2010.

But what I can't really wrap my head around is the fines being charged by the government for not buying what the article describes as 'affordable medical coverage.' Why fines? If you don't want to buy health insurance, why should you be forced to?

Araes Jul 3, 2009 03:18 AM

As noted in the article you quoted, the reasoning is similar, although not quite identical idea as forcing insurance on motorists. In a system where public tax dollars are being used to set up and help cover health care, those who don't want to get it, but then get sick or hurt and use emergency facilities are a drain on the system as a whole. Unlike the motorist case, there's not a direct person to person tradeoff, where their lack of insurance primarily affects you or I, but instead that lack of contribution to the pool is spread over everyone.

Health insurance is inherently a scam, as the idea of all insurance is making a profit based upon the statistical likelihood of events occuring in a large enough group. To consistently make the 20%+ profits that the companies often do, they need to charge you a significant enough premium that the sum of your collective risk and cash outflow, along with profits, doesn't overwhelm your payments. This provides a secondary reason for why the government would fine you, as it helps to ensure that they achieve the highest rate of coverage possible, since larger pools produce more normalized rates of outflow.

Finally, larger pools also allow the group greater leverage when bargaining with service providers and lobby representatives to negotiate prices / rates / benefits. Think Walmart in health care. By fining John Doe, or 1000 like him, and adding them to the pool, they are then theoretically able to negotiate improved benefits which are passed on to the other members.

Night Phoenix Jul 3, 2009 10:12 AM

Quote:

As noted in the article you quoted, the reasoning is similar, although not quite identical idea as forcing insurance on motorists. In a system where public tax dollars are being used to set up and help cover health care, those who don't want to get it, but then get sick or hurt and use emergency facilities are a drain on the system as a whole. Unlike the motorist case, there's not a direct person to person tradeoff, where their lack of insurance primarily affects you or I, but instead that lack of contribution to the pool is spread over everyone.
See, I reject this argument because of one thing: The person being fined is already paying into the system with his tax dollars.

In essence, you're DOUBLE taxing someone for not wanting to purchase health insurance, which really makes no fucking sense to me other than to force someone into the gov't system, which I find to be inherently wrong.

This whole plan doesn't even promote choice, its just a power grab.

Radez Jul 3, 2009 11:25 AM

http://www.nytimes.com/2008/04/05/us...ewanted=1&_r=1

So Massachusetts did this back when. I had personal experience recently just trying to get a doctor within the Boston area. I guess the biggest problem being touted by the article here is the availability of primary care physicians. Everyone's becoming a specialist. It'll be interesting to see what happens when the entire nation is forced to get insurance.

Also a year later: http://www.nytimes.com/2009/03/16/he...cy/16mass.html

Dark Nation Jul 3, 2009 01:18 PM

The fuck? I'm trying to just find A job and now they want to fucking fine my ass because I'm unemployed and without health insurance? OH GREAT, ONE MORE FUCKING THING I GET TO WORRY ABOUT :mad:

Quote:

The government would provide subsidies for the poor and many middle-class families
Subsidies probably means a percentage discount, because I cannot imagine them cutting the cost by 100%... which means I'll STILL be drained of income, and suppose they shovel me into some plan where I can't use the health insurance for a certain period, or it comes with pre-conditions? FUCK THIS BILL.

Quote:

The legislation would exempt certain hardship cases from fines.
Oh and suppose they decide I'm not a 'hardship' case? What's the criteria? Suppose I get a minimum wage job somewhere, am I suddenly no longer a hardship case? FUCK THIS BILL.

I cannot believe its come to this. I'm all for revamping the health care system but this is more of the rich punishing the poor and trying to 'squeeze a little more blood out of a rock' kind of crap. Excuse my language but at present this is making me very pissed off.

Fluffykitten McGrundlepuss Jul 4, 2009 09:52 AM

Quote:

Originally Posted by YOU MAD (Post 712277)
I like how this bill will be on the floor before any of the so called bills to safeguard citizens against bullshit practices from health insurance companies. Namely taking your money then refusing you coverage. Insurance lobbies must have vice grips on congress's balls.

Er, but surely if this bill passes and the Government launches it's own not-for-profit health insurance scheme then nobody will ever need to give health insurance companies money ever again? I mean, if they go ahead with that part of the plan then they're effectively fucking the entire insurance industry. I'd suggest that vice grip isn't nearly as tight as you think, unless I'm seriously missing something here?

mortis Jul 4, 2009 10:36 AM

I can't even see this going far as I can already see the lawsuits. Dark Nation's situation is exactly what I am looking at. "So I have no income, and can't get a job due to the recession, and you are fining ME for it because I can't pay for health insurance?"

I also see the situation that Dark is talking about. What happens if you are making just barely enough to survive but that amount is too high to be exempt? The cost of living in certain cities is higher than others and/or if you have a family, then this could happen. And the bill will have steeper fines for those who have families.

Also, I am curious on what they do for people overseas, especially if they do charity work. They get little to no money. Is the government suggesting that those people be 'punished' for helping out others? Or at they exempt?

Then there are the lawsuits just going on free choice. I mean, just look at any of the lawsuits that have went after way more controversial topics and WON and you can only imagine how this would go.


Finally, what about people who are just deadbeats. You aren't going to get money from them anyway, so how is fining them even more (as they obviously won't pay for health insurance) going to help? Zero income means you get zero from them. Adding the amount expected doesn't change things, and sending them to jail for a longer term means WE have to pay more.

gren Aug 9, 2009 11:38 PM

Poor and those without income and assets will get subsidies, of course. It's misguided to think that you choose not to

And health insurance should be mandatory. Why? Because the health system will pay for you when you need it in an emergency. If we had a system where you can't pay you get no service then not being insured wouldn't be a big deal, but as it stands now you have the freeloader dilemma. Now, for my ideal plan Dark Nation's problem would be a non-issues because health care would be social insurance like in Europe--you pay based on your income and assets. But, America because of our political climate, will have a messy system to make everyone in Congress happy.

This has everything to do wit keeping costs down. Insurance is only successful when it can pool risks. This is why states that force insurance companies to take patients with prior illnesses but don't mandate insurance suffer from high insurance rates and sometimes insurers leaving the state because it creates a situation where the most at risk patients get certain types of insurance and those who think they are healthy don't drastically driving up costs for everyone in the system.

Now if only people would take Len Nichols' suggestion of social insurance where Americans get vouchers for care a little more seriously this debate would be on the right track...

Rangel Aug 10, 2009 12:17 AM

Dark Nation, I really feel for you on this one. It's a situation I'm about to be in. I just recently have finished college and I have no idea what I'm going to do for work. Right now I do have two part time jobs, but having those I am probably exempt from any subsdies or help.

and I'm definitely not a hardship case. At 23, whenever I have a problem doctors just laugh and tell me I'm healthy even though I know something is clearly wrong.

But that is beside the point.

I really don't understand why we can't use a plan like gren proposed. Are we, in America really this greedy? People complain about the steal from the rich and give to the poor theory, but what does stealing from the poor and giving to the rich do? Who does that help? Not those who need it.

Revamping health insurance needs to be on an income basis.

Radez Aug 10, 2009 05:01 AM

Quote:

Originally Posted by gren (Post 719198)
Now if only people would take Len Nichols' suggestion of social insurance where Americans get vouchers for care a little more seriously this debate would be on the right track...

Massachusetts mandated health insurance coverage and as I recall there were still a ton of people uninsured at the end of 2008. Further, the budget's so upside down that they're looking to scale back the subsidies now because the state can't afford it.

I already posted articles about how health care availability has gone down.
The state hasn't been able to successfully pay for people's health insurance. I shudder to think what would happen if we tried to give people an allowance for health care directly.

I'm not saying it isn't a problem, because it is. But there aren't any simple solutions, and I'll really resent it if I wind up in a worse position because people want one.

Bradylama Aug 10, 2009 10:40 AM

Obama's healthcare bill is corporatist garbage and nothing resembling the public healthcare option this country should have.

Gechmir Aug 10, 2009 03:45 PM

I'm sure this whole thing is sunk, anyhow. Given the public outcry, this won't be nearly as close as Cap & Trade (which should die a horrible death).

Dullenplain Aug 10, 2009 06:29 PM

Quote:

Originally Posted by Gechmir (Post 719320)
I'm sure this whole thing is sunk, anyhow. Given the public outcry, this won't be nearly as close as Cap & Trade (which should die a horrible death).

Have you heard? This isn't a "public outcry" but a well orchestrated battle from the Right Wing machine. This is manufactured dissent from the FOX Propganda Channel and really is just another channel from the Republicans to express their entrenched racism.

There's nothing genuine about the response against the healthcare bill from those town hall meetings. Don't these people know what's good for them?

The unmovable stubborn Aug 10, 2009 06:46 PM

This bill sounded pretty bad

But then I saw Dull & Gech both agreeing that it is bad

So now I think maybe it is pretty good? :(

Tails Aug 10, 2009 06:55 PM

Devo not fully understanding the TRUE WEIGHT of Pangs current moral dilemma.

(still lollin)

The unmovable stubborn Aug 10, 2009 07:16 PM

I guess you could call it an injoke in that Dull is saying things that are mostly objectively true but you know he is like scowling when he says them because they are all dirty, dirty lies from the Obamessiah-controlled Zionist MSM

Bradylama Aug 19, 2009 10:44 AM

YouTube Video

Cirno Aug 19, 2009 03:14 PM

I don't think most people even know what the fuck's going on with healthcare right now.

Jessykins Aug 19, 2009 03:34 PM

Barney Frank is pretty much the best fat gay guy since Brady.

Dark Nation Oct 12, 2009 09:16 PM

Wow... just... wow.

Question: It appears I may be eligible for ACCESS, which is for low-income families and is paid for by (drumroll) state taxes, I wonder if this would exempt me from that ungodly idiodic provision as Devo quoted (Also, source of that?).

But seriously, if they include any sort of 'mandate' like that in the bill, I'm ... well I'm sure what I'm going to do. I AM going to, however, call my reps and senators to oppose this particular rider (and push for supporting a public option but LOL REPUBLICAN SENATORS).

I said it months ago but it bears repeating: FUCK THIS BILL

Max POWER Oct 12, 2009 10:27 PM

Quote:

Originally Posted by Dark Nation (Post 729369)
LOL REPUBLICAN SENATORS

More like LOL DEMOCRATIC SENATORS WHO AREN'T REALLY DEMOCRATS. The Republicans make up the majority of the opposition, but damn it, we should have been able to pass this thing without fear of a filibuster.

And yes, this mandate is definitely in the Baucus bill, and that's being voted on tomorrow. It was actually worse before it got amended a bunch of times. The fine for not buying into private insurance used to be double what is being proposed now, and because of this health insurance companies pulled a 180 today on their faux stance for health care reform.

Dark Nation Oct 12, 2009 11:31 PM

I meant LOL REPUB SENATORS as in the two asshats "representing" Arizona. John's Kyle and McCain, but it seems LOL POLITICIANS is more accurate.

Lord Styphon Oct 12, 2009 11:53 PM

Have those of you unhappy with what's coming out of Washington on healthcare reform considered contacting your state governments to push them towards giving you what you want? If you want a public option and Washington isn't going to give you, there's nothing that says that, say, Sacramento can't provide one independent of whatever the federal government does.

Lord Styphon Oct 13, 2009 01:58 AM

Quote:

Originally Posted by YOU MAD (Post 729389)
Sacramento can't even write up a budget on time.

Which is actually a good argument that turning over any amount of control over the healthcare system to government is probably a bad idea. But it doesn't change the fact that if you want government involvment in it, such as a public option, the federal government isn't the only government in this country you can get it from. And, given the nature of states and state government, you're more likely to actually get what you want, and get it sooner, than relying on Washington to do it for you.

Dark Nation Oct 15, 2009 05:56 PM

And now Pelosi seems to have done a 180 on her stance and now supports the Public Option, apparently:

Pelosi makes case for government-run health option - Yahoo! News

Quote:

WASHINGTON – House Speaker Nancy Pelosi said Thursday that the case is growing stronger for allowing the government to sell health insurance in competition with private companies, contending recent attacks from the industry should dispel any doubts.

Whether the Senate bill will include a public plan in any form is a major question mark, but "our House bill will have a public option," the California Democrat declared.

Pelosi supports that version though she said a final decision hadn't been made. She said that if people are going to be required to purchase health insurance — as all the health bills on Capitol Hill contemplate — they need to have access to the cheaper rates government insurance could offer.

"If you are going to mandate that people must buy insurance, why would you throw them into the lion's den of the insurance industry without some leverage with a public option?" she asked.
Bolded for emphasis on the problem I'm currently worried about, concerning this overall bill.

Dark Nation Aug 12, 2011 07:14 PM

Two years later, a major update to the topic appears.

*ahem*

A U.S. Appeals court strikes down the health insurance individual mandate requirement from the Healthcare Legislation.

Appeals court strikes health insurance requirement - Yahoo! News

Quote:

ATLANTA (AP) ? A federal appeals panel struck down the centerpiece of President Barack Obama's sweeping health care overhaul Friday, moving the argument over whether Americans can be required to buy health insurance a step closer to the U.S. Supreme Court.

The divided three-judge panel of the 11th Circuit Court of Appeals concluded Congress overstepped its authority when lawmakers passed the so-called individual mandate, the first such decision by a federal appeals court. It's a stinging blow to Obama's signature legislative achievement, as most experts agree the requirement that Americans carry health insurance — or face tax penalties — is the foundation for other parts of the law.

Chief Judge Joel Dubina and Circuit Judge Frank Hull found in a 207-page opinion that lawmakers cannot require residents to "enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."
This requirement was one sticking point that I had a personal and strong disagreement with. Its one thing to want to have everyone covered, but to make it legally binding that you MUST buy insurance or be fined? FUCK THAT, imo. Also, since its only an Appellate court, it doesn't mean the fight is over, but its a start. Thoughts?

Sarag Aug 12, 2011 07:59 PM

What is the functional difference between that and universal health care paid by tax dollars?

value tart Aug 12, 2011 10:06 PM

The functional difference is that with universal health care there's a government rate for it, while the individual mandate could leave people in a shitty position of having to choose between multiple avenues of coverage that doesn't fit them.

So in the end, sure, everyone has health care, but in one case you're just given it and in the other you're told to get it OR ELSE.

No. Hard Pass. Aug 12, 2011 10:20 PM

Being forced into choosing which of the most corrupt, non-functional health companies you deal with isn't universal health care. Universal health care is regulating the health companies so they aren't a for-profit business, but rather exist purely to provide care.

Shorty Aug 13, 2011 03:42 AM

Maybe it's the innate Asian in me that thinks this way; doctors should be paid to keep you healthy, not grip out all your savings and your grandchild's Morgage to pay for your care when they fuck up and don't prevent you from getting sick. I think that's also another problem with health care cost, we talk a lot about how fucking expensive it is to keep our sick medicated or cared for or how many kids need Ritalin, but nearly or barely not enough talk about investing in methods of *keeping* people healthy. That includes investing in educating people to eat better and such.

Sarag Aug 13, 2011 12:35 PM

Quote:

Originally Posted by Spectacularge (Post 789017)
The functional difference is that with universal health care there's a government rate for it, while the individual mandate could leave people in a shitty position of having to choose between multiple avenues of coverage that doesn't fit them.

So in the end, sure, everyone has health care, but in one case you're just given it and in the other you're told to get it OR ELSE.

Well I agree that universal health care w/ a not-for-profit system would be the best, and that's what I want, and I'm totally willing to pay more in taxes to make it happen. In lieu of that though,

actually honestly scratch that thought, really the only thing that should be done (and that can be done to benefit the taxpayer) is to end the for-profit medical institution. I have no interest in protecting the profit margin of companies that have no interest in protecting my profit margin (or take-home pay, you know, whatever).



apropos to this conversation: Open enrollment is going on with my employer. I have the option of picking up their health insurance, or staying on COBRA for the next year. My COBRA payments are $600 a month, for one person; the monthly payments for my company are significantly cheaper but the coverage is such that my COBRA coverage is actually cheaper in the long run. It has nothing to do with doctors being out of network, and I'm not riddled with cancer, preggers, or supporting a family. This is such bullshit.

Zephyrin Aug 13, 2011 01:58 PM

For some time now, the individual mandate has been on appeal to the Supreme Court.

This 6th circuit decision had previously ruled it constitutional, and now that we have conflicting circuit decisions, only the Supreme Court can make a definitive ruling.

Given the nature of the legislation, they should take up the case soon enough to decide it before any of the mandates start to kick in.

RacinReaver Aug 15, 2011 09:49 AM

Quote:

Maybe it's the innate Asian in me that thinks this way; doctors should be paid to keep you healthy, not grip out all your savings and your grandchild's Morgage to pay for your care when they fuck up and don't prevent you from getting sick. I think that's also another problem with health care cost, we talk a lot about how fucking expensive it is to keep our sick medicated or cared for or how many kids need Ritalin, but nearly or barely not enough talk about investing in methods of *keeping* people healthy. That includes investing in educating people to eat better and such.
How many people do you know that actually go to the doctor when they're healthy?

That said, I do think it's kinda hilarious how health care companies only want to put money out once you're already sick. After my dad had a heart attack they gave him access to weight loss therapy classes for two months. He lost a bunch of weight, was eating better, and pretty much doing everything correctly. Insurance goes "Oh, you're doing fine now, go find somewhere else to exercise" and that pretty much knocked him off his momentum and he couldn't find another place with similar facilities nearby, so he regained most of what he had lost. Fast forward a year or so and there's another mild event, back in the hospital, and then insurance covers two more months of weight therapy (until it ended last month). He'd even be willing to pay for the stuff himself, but you can only get access to the place through insurance. :(


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