List of things that were also law until they were repealed:
2. 3/5 Compromise which meant slaves were only 3/5 of a person
4. A man can beat his wife but only once a month
5. All Hawaii residents must own a boat or face a fine
6. Japanese-Americans, regardless of citizenship, were legally interned in California during WWII
7. Voter knowledge tests
8. Oral sex is illegal in Maryland
9. Slave catchers were allowed to go north and kidnap blacks, regardless if they were free or not, in the Fugitive Slave Act of 1850
So, you arrogant son of a bitch, something being law doesn’t mean it can’t be repealed.
Or that it’s moral.
This is the part where we say “told you so”.
If only I could go back to my old friends and say that to them. That’d be nice.
Yes, the opinions of the United Union of Roofers, Waterproofers and Allied Workers should matter more than doctors, healthcare professionals, researchers, independent health organizations, and economists who helped create the bill. Nice to know.
The Affordable Care Act isn’t perfect, but it is certainly a step up from our current healthcare system in several ways. At least it is an actual attempt at dealing with the issues we face with our nation’s health care.
Actually, their opinion should matter more. They are paying for it. Doctors are overwhelmingly opposed to it, but the fact that consumers don’t like it is very important. Trust the experts? Since they’ve done since a bangup job to this point? Do they know how to spend my money better than I do? Doubtful. I wouldn’t want them to spend it anyhow, and when a labor group can see that the ACA is detrimental, we should all pay attention, because that is an unusual thing.
Healthcare is a particularly opaque industry. It’s difficult to see what things will cost, what’s actually effective, what the best treatments truly are, because the free market hasn’t really existed in healthcare for a very, very long time, and it’s one of the most regulated markets in the US.
How is the ACA an improvement? Are you just saying that, or do you have facts to back that up? Because you can look anywhere and see that it’s much more expensive, and that alone is reason enough to abandon something that can’t even guarantee access to care for everyone. A spot in line is not the same as treatment.
Sure, they’re opinions should matter. However, it is also important to know that this group has an interest and isn’t evaluate the expansiveness of the law, but the part that pertains to them. I find it absurd to use the opinions of one group, which the OP was doing, to validate the hatred towards the Affordable Care Act.
The Affordable Care Act is not giving government the power to spend your money. This misconception is probably the source of your hostility towards the bill. I implore you to read the Affordable Care Act, or maybe even read about the lesser known provisions of the act.
Healthcare is one of the most regulated markets in any developed nation actually. And I will assume this is because we have believe there is a moral obligation to provide individuals with access to health care. I honestly don’t understand that point you were trying to make with that statement. Please explain, sincerely.
Yes, I have the facts to back up my statements. I have read the bill and studied the policies. Which aspect of the Affordable Care Act would you like to talk about? Closing the doughnut hole for Medicare patients? Paying for residency programs for doctors? Offering subsidies for small businesses to get health insurance for their employees? Setting up individual insurance market exchanges for individuals who do not receive health care from an employer? Preventative health programs and initiatives? Bringing healthy individuals into the insurance pool in an effort to lower premium costs? A comparison of the provisions of the ACA to the successful Massachusetts health plan? Offering tax credits to low income individuals to buy health insurance? Regulations for insurance companies who spend too much on overhead costs? Ending lifetime limits on health insurance? Preventing insurance companies from denying insurance for individuals with pre-existing health conditions? The Cadillac tax? Rewarding hospitals for improved quality of care? Reducing the number of uninsured individuals?
I wanted to give a proper response to this, I know you blogged about it a week ago.
Regarding your first paragraph, I find it useful to give a comparison to another industry. One that’s easiest is probably car insurance. It’s similar because we all have to have it if we want to legally drive a car in this country. Let’s say instead that Obama was rolling out the ACIA - the affordable car insurance act, and that car insurance was something as impenetrable and complex as our health insurance act, but finally everyone will have car insurance. At first it sounds really nice, because those of us that really need to drive are finally able to do so, right? We’re told it will be affordable, even though the majority of us won’t read the law, we just kind of trust it. If a union that helps to negotiate insurance and such for its members finds issues - some members will have worse insurance, some will lose their cars, others will have to pay more, etc - it is important to listen. Especially if that union had previously been a big proponent.
The dollars we spend from our own pocket are like tiny little votes. I vote for Apple products, I vote for Baldwin jeans, I vote for Red Bull, I vote to buy Sram bike parts. Fortunately, my votes for these companies don’t infringe on anyone else. My best friend could vote his dollars toward HP computers, Acne jeans, Orange Fanta and Shimano bike components. His choices would not interfere with mine at all.
I say this to point out the difference between that and the lot we’re stuck with regarding the ACA. I have a choice will all the things I just mentioned, but with the ACA, I don’t. In fact, starting in 2016, I’ll have to pay nearly $700 a year if I choose not to have insurance (http://101.communitycatalyst.org/aca_provisions/individual_requirement). I don’t like the ACA. In your response, you said that the ACA doesn’t give the government the ability to spend my money. Well, what would you call that sort of tax? Isn’t that exactly what it is, the government stealing my money (because I certainly would not give $700 up for something I do not want, that’s 2 months’ rent for me) and then spending it? That’s what all taxes are.
There are lots of ways the government spends my money, or the money of others. It’s not that the government is coming to my doctor and paying the bill. I’m not on medicaid, which would be the closest thing for someone my age and income level. But it is spending my taxable income on setting up exchanges (at least in states with democratic governors: http://www.foxnews.com/politics/2013/02/17/gop-governors-stand-ground-on-obamacare-health-exchanges/). It’s giving subsidies to big pharmaceutical companies, especially in the form of preventing international competition (Paul Starr, Remedy and Reaction). It’s keeping the current outdated and expensive healthcare model alive. The government doesn’t have to directly raid my wallet and spend it somewhere I can see for it to be spending my money and subsidizing practices with which I don’t agree. My objections to the ACA are numerous, and come from both pragmatic and philosophical issues.
When I buy service from a doctor or any other healthcare provider, I’d prefer to do it with my own money, and not pay for a bunch of administrative or governmental overhead. But with something like the ACA, every doctor bill will include a type of tax that includes the need to pay for all of this extra stuff that isn’t actually healthcare. I’m paying my doctor, the facility, the nurses, the meds and such, but I’m also paying for billing, for government employees in charge of enforcement, regulation and other such things, for administrators who have to work with doctors and government officials to get it all figured out and working properly, for all those little bits. I don’t want to pay for that! If I break my hand, I want to go to the doctor, pay the money for him to give me some Novocain, have him set the bone, wrap me in a cast and send me on my way. It doesn’t need to be more complicated than that, but it is a dense and obfuscatory process through and through. The ACA doesn’t remove any of that, it just adds more burden. Whether the bill is paid upfront through my wallet or through insurance and a copay, it still is something I have to pay for, or that someone else who is subsidizing me has to pay for.
A lot of people have criticized healthcare in the US because they claim the free market failed it, and I wanted to clear the air on that. The free market never had much of a chance to get things done with healthcare. But if we can agree that the free market never existed, not really, with healthcare, then that’s to know.
However, no one has a moral obligation to provide care. And the ACA doesn’t provide that care, either. Healthcare is a scarce resource, like any resource that we buy and sell. That can’t be changed by switching to single payer systems (Canada struggles constantly: http://hotair.com/archives/2010/06/01/canada-reconsidering-health-care-model-in-face-of-soaring-costs/) or by subsidizing it through the government. There just isn’t really enough for everyone at the price they want. That’s the nature of markets. As far as moral obligation goes, I have no obligation to provide any service to someone in need. I can certainly choose to do so, though. Many do. I have volunteered at a hospital for an extended period and regularly donate to charity. But the real issue is forcing doctors and nurses to provide care. A doctor is under no obligation to give care to a patient who can’t compensate him for his services, because that would basically amount to theft if the doctor were unwilling or unable to provide it. If the doctor needs to charge a certain amount of money for his procedures in order to afford his student loan that’s as much as his mortgage, his food for his small but growing family, his car payment so that he can get to work, his phone so that he can be reached when he is on call, and for all the other things that burden his finances, that is his right. He is not under a moral obligation to give his services away for free, no matter how much the other person may need them. He may choose to, though. But the reality is that what the government really asks him to do is take less money. Take 60% here, 75% here, 92% here, 12% here. I can’t find a source quickly, but a central body decides what medicare payments should be for all procedures, and that’s what doctors have to take, whether or not those are reflected in the actual cost of the procedures. This is worse for medicaid than medicare, and coverage in general, which is why so many doctors won’t take medicaid. If this doctor keeps having to take less money for things that are actually worth more, that amounts to theft, because he has earned his skill set through hard work and can charge as he pleases. If patients choose not to see him, he will undoubtedly lower his fees until they hit the market clearing price. But this is not what happens in our system. And regarding your claim that we are under a moral obligation to provide healthcare for each other, the ACA doesn’t even accomplish this. These 29 million uninsured people will not suddenly be able to see a doctor. Especially if they have bad, frustrating insurance that doctors don’t want to deal with (ahem, medicaid). They’d be better off paying cash.
I admit I haven’t read the bill. I have studied the policies. I plan to read the bill when it is something I have to personally face, either as an employer or something similar. However, I have spent enough time to know that I don’t actually need to know every detail to know that it will not work. When Obama was campaigning, he promised that premiums would lower for people. Even Paul Starr, a big fan of the ACA, wrote about this falsehood in Remedy and Reaction. In fact, they’re going to go up a lot: http://www.washingtonguardian.com/study-health-overhaul-raise-claims-cost-32-pct-1
Everyone is obsessed with this idea of being insured, as though it’s the end goal. What do you think? Do you think being insured, especially with low-grade insurance, is going to get you quality care? Doctors don’t have to take bad insurance. The ACA doesn’t guarantee care whatsoever. Businesses are smart too. They’ll find ways around the ACA so that they don’t have to provide insurance for employees. And this will hurt employees. Just tonight I was talking to a friend who will have her hours cut at the restaurant she works at in June so that her employer doesn’t have to provide insurance. She wants to work more than 28 hours a week, so she’s going to have to work multiple jobs. How is that a solution? This isn’t happening to just my friend, either:
Lawmakers can sit in their ivory tower all day and come up with what seems like brilliant solutions to the healthcare issue. But the fact is, they will never have a good enough idea. There are too many interests pulling them different ways, too many regulatory agencies that they have to fight through, too many people who see the issue in a completely different way. I didn’t vote for the ACA. I didn’t vote for Obama. I never had a choice. Voting makes very little difference when it comes to the head of state for most of us. I live in Utah. I had a 0% chance of my vote affecting the election in even the smallest way. There are millions and millions like me. It’s not that we’re selfish. We want people to get healthcare. We may or may not have ideas for how to make that happen, but we’re certain that the ACA is not the right way. But there is hope. There are good things happening. I’d recommend checking out this blog:
Sherpaa is another really brilliant company that’s figuring out to navigate the tricky waters of healthcare and insurance, and they’re based out of NYC. The best ideas seem to come from the smallest sources, the ones who don’t have a lot of political gain to make from a new law. That’s how innovation pretty much always works. It’s how the PC became affordable, because Apple disrupted the incredibly expensive punch card computing market. Healthcare will transform the same way. It won’t come from the top players, because they have too much riding on things staying the way they are. It’ll come from a small team of doctors, or an entrepreneur and a group of nurses, or whoever is bold enough and intuitive enough to provide a solution that breaks down the current healthcare system. It will happen. It’s already happening. The ACA is certainly not affordable, but affordable healthcare is coming.
The inevitable realization that I can leave for four days and no one notices is really just depressing…
Recently, president Obama warned graduate students about libertarians, saying, “They’ll warn that tyranny is always lurking just around the corner. You should reject these voices.”
Mr. Obama, you completely misunderstood. Tyranny is not just around the corner. It’s here. When half of your earnings are taken from you and used for foolish or harmful purposes, that’s already tyranny. When a government tells you how much you can eat or drink, or how you can enjoy yourself, that’s already tyranny. When your money is used to fund immoral and unneeded wars that serve only to enrich crony corporatist defense contractors, that’s already tyranny. When you are not allowed to exercise your natural and fundamental right to defend yourself or your children, as is the case in “gun free” school zones, that’s already tyranny.
And when you are not allowed to exercise your fair and fundamental right to vote your conscience, because a two party duopoly won’t let any challengers on the ballot, that is most definitely, absolutely, unquestionably tyranny. Whether it’s Democrats in Maryland or Republicans in Pennsylvania, both agree that it’s appropriate to use immoral, underhanded tactics to keep Libertarians off the ballot.
President Obama, we weren’t warning about tyranny. We were describing the current tyranny.