Obamacare, Healthcare, etc.

[Demosthenes11]

but socialism

[Gwynplaine]

what

A person only has a few fundamental options in how to respond to laws:

a) Comply with the law.
b) Move to a country without that law.
c) Don't comply with the law and submit to punishment by force. (go to jail, have the time of your life wasted away. You have little choice how to live your life.)
d) Don't comply with the law and risk resisting force. (resulting in threat of violent force or harm by police, or jail security etc.)

[archibaldcrane]

A person only has a few fundamental options in how to respond to laws:

a) Comply with the law.
b) Move to a country without that law.
c) Don't comply with the law and submit to punishment by force. (go to jail, have the time of your life wasted away. You have little choice how to live your life.)
d) Don't comply with the law and risk resisting force. (resulting in threat of violent force or harm by police, or jail security etc.)

Um...it's just a higher tax for those who don't obtain insurance. People have to pay taxes for all kinds of things, this is just another one of them.

[Demosthenes11]

Um...it's just a higher tax for those who don't obtain insurance. People have to pay taxes for all kinds of things, this is just another one of them.

no the government is going to kill you.

Hitler.

[hey]

Nationalized health care and insurance is a deadly idea that Obamacare would take a huge step toward bringing about. The only possible function of a government is to protect people's rights and retaliate in measure when specific people have their rights violated. Obamacare does the opposite by compelling the entire country to make choices they don't want to make.

It's totally wrong morally and frankly twisted to try and compel people into doing what another person believes will be good for him. In this case it's the equivalent of saying "You have to be healthy and have insurance. If you disagree and resist, the government will arrest you or kill you by force" or more simply; "Do what I say is healthy or I'll kill you". Which is the alternative given to people when the "choice" is backed by fiat government law.

Because it's wrong, it's also impractical, misguided, and can't work in practice. And when it comes to nation-wide health care, a failed theory in practice means dead people who otherwise would have lived.

Even if the goal is supposedly to help people who are less well off (which I don't accept as a good reason) then Obamacare will only make the problem worse not better. It would lead to deeper political pressure on all sides where the people who get the best health care will get privileged priority by having the best friendly connections. Are you a in a politically connected union who donated to candidate X's re-election? Time to get your back scratched, you may get an insurance waiver to avoid the penalties. Are you a regular schmuck stuck working a job at Radioshack? Too bad, time to make friends fast. Better start working 3 jobs to pay for that insurance. Don't break an arm sucker.

If Obamacare is upheld it's much worse than the concrete issue of health care. It would set precedent where federal government has the power to compel everyone to sign contracts or purchase anything it wants. That would be the logical step down the road that upholding Obamacare achieves. Are people too stupid and ignorant to understand that Macs are superior to P.C.s? There's no logical or legal reason government shouldn't declare everyone buy only Macs. After all think of how much time and money is wasted having to remove viruses from windows P.C.s. It's only doing what's good for our modern society and the health of our internet infrastructure.

Holy fuck, no one wants the government to force people to sign contracts and pay for insurance. That is the most idiotici thing i've ever heard.

[Ksandra]

Did I just read that post right? Did Gwyn just imply that socialized healthcare kills people?

[Milkster]

Yes.

[archibaldcrane]

demos convinced me because hitler though

[Ksandra]

Yes.

Amazing.

[Talint]

Did I just read that post right? Did Gwyn just imply that socialized healthcare kills people?

Death panels.

[Gwynplaine]

While much of the Obamacare legislation (regulation of which is still being written) won't go into effect for a few years, it's already changing the way health and insurance are provided. Insurance companies, hospitals, and doctors are looking ahead and preparing for what's to come. Here's a good timeline that shows what aspects of Obamacare go into effect and when:
http://www.cms.org/strategic-priorit...visions-ppaca/

And here are just a few articles all about how private insurance is in the process of becoming more and more expensive and bureaucratic right now.

http://dailycaller.com/2012/02/11/ob...care-premiums/

“After the application of tax subsidies, 59 percent of the individual market will experience an average premium increase of 31 percent,” Gruber reported.
The reason for this is that an estimated 40 percent of Wisconsin residents who are covered by individual market insurance don’t meet the Affordable Care Act’s minimum coverage requirements. Under the Affordable Care Act, they will be required to purchase more expensive plans.

Here's a study that surveys employers and their plans for how to handle insurance:
http://www.galen.org/2012/a-radical-...lth-insurance/

A major survey of employer plans provides evidence. McKinsey & Company surveyed 1,300 employers across industries, geographies, and employer sizes, and concluded that the Patient Protection and Affordable Care Act (PPACA) will lead to a “radical restructuring” of job-based health coverage. McKinsey found that 45 to 50 percent of employers say they will definitely or probably pursue alternatives to employer-sponsored health insurance in the years after it takes effect in 2014. One-third of employers say they “will definitely or probably drop coverage after 2014.” Among employers who knew most about the new health law, half said they were likely to drop coverage.


Since an estimated 156 million non-elderly Americans get health insurance at work, according to the Employee Benefit Research Institute, that means as many as 78 million people could be forced to find other sources of coverage.

[Demosthenes11]

THEY ARE LITERALLY KILLING PEOPLE THAT DONT GET OBAMACARE

[Gwynplaine]

One ironic hypocrisy of statists is that a lot of them claim to be counter-culture; against "the man" and the establishment. However they're the ones who do are now doing the establishing. Case-in-point, this great blog post over at KevinMD.com explains how the kind of impossible to handle beaurocratic regulations imposed by Obamacare are dividing medical practice. It has the effect of intensely polarizing the field into very big organizations, or very small with one or two doctors. The medium, middle-sized practices are being killed by regulatory paperwork.

http://www.kevinmd.com/blog/2012/01/...super-big.html

I am a little fish in a big sea. And so are most of us. Or used to be. For better and for worse, the era of private-practice, outpatient medicine as we know it is coming to an end.
And faster than we thought. The choice now: down size or super size. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. We are getting swallowed up very quickly now by the bigger fish in the sea.


...


So the choice becomes this: will you down size and choose to limit how many patients you can take care of, reducing your staff and all of the administrative burden. Maybe even choosing to not file insurance any more?
Or will you super size and join a big group or corporation or hospital practice where there are lots and lots of staff and lots and lots of doctors to treat lots and lots of patients?
You really can’t choose both and it is becoming clear that you have to make a decision.

Basically the sheer amount of paperwork and manpower required by so much subjective regulation drives doctors into needing many workers all in one place to handle it. Those are the A.C.O.'s such as big hospitals have. The only other option is to have totally drop insurance and paperwork out of the equation and make the processes comprehensible on your own, as a small doctor to patient service.


If you want to read more about A.C.O.'s here's an interesting roundtable published at the WSJ:
http://online.wsj.com/article/SB1000...hare_tweet_bot

On the opposite end, the very small, there are what are called "concierge medicine" doctors. For example here's a news story about one such doctor who's business is all small enough to be clear and open to her local patients:
http://www.aapsonline.org/index.php/...ost_12-07-2011

She sees patients the same day they call if she's not booked up, spends at least a half-hour per visit — compared to the more typical 15 minutes — and usually charges only $50 for a consultation. She takes cash or check, but no insurance — and sometimes accepts gratuities of a dozen fresh eggs or a pie.

...

In an era of high overhead, ever more byzantine regulations and payment models, cuts to Medicaid and Medicare benefits, and large medical systems swallowing independent practices, Rutten Wasson relishes her straight-forward manner of practicing. Since many federal health care reforms — such as those requiring electronic medical records — are tied to Medicare, they tend not to apply to her.


Her practice serves as a critique of the modern health care system, the complexity of which has pushed some providers and clinics to find dramatic work-arounds, despite the fact that it can be tough to make a living outside the mainstream. A small but growing number of physicians practice "concierge medicine," charging patients annual retainers for basic medical care. A 2010 nationwide survey commissioned by a congressional agency pegged the number of concierge doctors at 756, up from 146 in 2005.

[Gwynplaine]

THEY ARE LITERALLY KILLING PEOPLE THAT DONT GET OBAMACARE

In terms of literal harm, I was talking about attempting to resist complying with laws and resisting arrest. You're either going to submit, get hurt, or possibly even killed. All law is backed up by authority to use government force at root.

In terms of nationalized health care people aren't literally killed; taken out back and shot. Although that would probably be more honest. Instead people who would have lived a healthy life under a freemarket wind up dying, their lives cut shorter than could have been, or simply inhibited and worsened to the extent freedom of choice is suppressed. This happens due to a multitude of reasons all stemming from politicized decisions. Either rigid and unthinking bureaucratic rules that don't fit, or the "tragedy of the commons" where increased demand means rationing goods and deciding which human beings life is worth public money.


http://www.kevinmd.com/blog/2011/12/...ient-care.html

This post talks all about how politicized policy sets obedience instead of thinking as the standard. Good health care requires independently thinking about the unique situation and the unique patient. Instead fear of checking the wrong box off some paperwork will ensure following rigid rules are more important than you.

The last four days have provided a sharp glimpse into the future that awaits those of us in the health care profession, physicians in particular. Over the last few years physicians have been burdened with mountains of paperwork, most of which contributes little to patient care, but does take time away that could be better utilized caring for our patients. However, the last four days have demonstrated that the administrative load that has encumbered us is now become a hindrance to proper patient care. The following occurrences are all actual events, each happening at the same hospital over a four day period.

...

A 13-year old boy was admitted at about 5:00 am with an uncomplicated appendicitis. The OR was busy at that time, so the boy was scheduled for surgery later that morning, around 11:00 am. I saw the patient about an hour before surgery and, during my evaluation noticed that IV fluids were not being administered. I asked the nurse why and she informed me that pharmacy had not sent her the proper fluids. The fluid ordered was Lactated Ringers, one of the most commonly utilized IV solutions in the hospital. The nurse stated that they did have that particular fluid on the floor, but policy was that pediatric patients had to receive their IV fluids from 500cc bags and they only had 1000cc bags on their unit. This makes perfect sense if the pediatric patient is a baby, but this patient was adult sized. He had been in the ER for several hours, had been on that particular unit for five hours and had eaten very little the previous day. All this made for a significantly dehydrated patient; one who was to be going to surgery a short while later. The nurse informed me that she was not allowed to go against policy.

...

In each instance, however, there was real potential for injury. Administering unnecessary antibiotics opens the door to potential side effects, some of which can occur after only a single dose. Disruption of normal, symbiotic bacteria by the administration of antibiotics can cause transient diarrhea or severe colitis, while allergic reactions are always unpredictable. And, of course, the whole purpose of the SCIP program is to administer appropriate antibiotics in the appropriate manner. Yet, here is an example of the SCIP administrators, who are not physicians, insisting on inappropriate antibiotics.

...

Withholding IV fluids because the right bag wasn’t available caused this necessary surgery to be delayed; waiting for the patient to be adequately hydrated. The appendix in this case was very inflamed, about to rupture. The nurse should have informed me or her superior of the difficulty she was having with pharmacy so that the situation could have been remedied in a more timely manner.

...

Doctors now are forced to follow an ever growing list of rules and protocols which have never been shown to improve patient outcomes, but do carry the potential to be a detriment to patient care. Nurses are threatened with a variety of sanctions if they deviate from these protocols; protocols that have never been adequately explained, the rationale for each protocol remaining a mystery to many of these nurses. Indeed, I have been to meetings where the administrators who formulated these policies have demonstrated that they are totally clueless as to the reasons each protocol was established in the first place. Provisions in the Affordable Care Act call for the creation of more protocols and policy, attempting to standardize health care delivery. Such a plan can only be successful when humans are built in the same way we build cars and computers, everyone the same and with identical, interchangeable parts.

[Darus Grey]

You make it sound like what we have in this country isn't already worse than the scenario you're describing.

That's why it's a foolish argument, what you're describing is an IMPROVEMENT.

We already have the extreme rationing, the death panels, and the obscene paperwork and obedience, it's called the insurance industry. Literally anything is an improvement.

[kuronosan]

COMMUNIST! FASCISM! CHINA! WAL-MART!

[hey]

We already have the extreme rationing, the death panels, and the obscene paperwork and obedience, it's called the insurance industry. Literally anything is an improvement.

When insurance companies decide who lives and who dies, that's called free market. When the government does it, it's death panels.

[Kohan]

Basically the sheer amount of paperwork and manpower required by so much subjective regulation drives doctors into needing many workers all in one place to handle it.

Jobs will be created as a result of these changes? Magnificent.

Truthfully, I must agree—everything you're attempting to spin in a negative light sounds marvelous, and your explanations provide great entertainment. I can't find it frustrating, as fantastic delusions are providers of mirth.

[Acturus]

Gwynplaine, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

[Gwynplaine]

You make it sound like what we have in this country isn't already worse than the scenario you're describing.

That's why it's a foolish argument, what you're describing is an IMPROVEMENT.

We already have the extreme rationing, the death panels, and the obscene paperwork and obedience, it's called the insurance industry. Literally anything is an improvement.

I'll take you up on that then. If literally anything is an improvement then repealing regulations and making the market more free would be a great start.


What kinds of problems do you consider that PPACA would fix or improve? I don't see how as it fails to address any of the actual problems and only seeks to make them exponentially worse while creating many new ones.

Problems such as linking insurance to work, mandating even more wasteful and unnecessary insurance coverage that certain people don't need, driving out competition, and suppressing free choice and rational decisions even further.