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comment by 45usp
45usp  ·  4531 days ago  ·  link  ·    ·  parent  ·  post: Chief justice leads Supreme Court's support of healthcare law
I have to admit, I support the Affordable Care Act for a number of reasons but I was a little wary of the 'must purchase health insurance' clause. It makes perfect sense, but still.. government requiring us to purchase something? My crude understanding of the court ruling is that this requirement amounts to a tax, and I'm ok with that because that's how it's done in other 1st world countries. Additional taxes afford healthcare (and other social services). The difference here is that healthcare would still be managed by health insurance providers rather than one large governmental body. I'm ok with that as well.




mk  ·  4531 days ago  ·  link  ·  
My hope is that as each state needs to work out how they will run the insurance exchanges, a few states are going to figure out something that works quite well, then the others will copy it. However, I still believe that a low cost public option would be a powerful way to push prices down. If people could basically buy into Medicaid, that might be better than a lower cost private insurer. Insurance companies need to profit. The government can provide care at parity, or if it is for the poor, justifiably do so at a loss.
45usp  ·  4531 days ago  ·  link  ·  
I live in a GOP-controlled state, and our senators just announced that they have no intention of working on a plan to set up an insurance exchange for us. I take it we'll default to whatever the federal government works out.
mk  ·  4530 days ago  ·  link  ·  
That's pretty darn ironic. They don't want the Federal government controlling healthcare, so they will make the Federal government control their healthcare.

Here in Michigan we are heading towards a similar scenario. Our GOP Governor Rock Snyder (who is a reasonable guy) has been pushing to get out ahead of this and start setting up the exchange, but the GOP legislature hasn't done a thing. Now they are signaling that they want to wait until after the November election before they decide if they will do anything. To borrow a phrase from my grandfather: the Michigan legislature is as useful as tits on a bull.

IMO there is a real chance that the GOP is going to lose seats over this. It's wishful thinking of the GOP that not only will Romney win, but that he will have a House and Senate willing to throw the Affordable Care Act out. There comes a point where you just need to shut up and govern.

b_b  ·  4530 days ago  ·  link  ·  
Yeah, but the governor won't let them sit on their ass, apparently.
b_b  ·  4530 days ago  ·  link  ·  
They remind me of the child who is uncontrollably crying and just screams "no" at whatever their parents try to console them with. All they can talk about is obstruction and repeal. Its mind blowing. If they really want to do something then they should try to think of constructive, conservatively-oriented ways to work within the framework of the law. Just the the child at the restaurant, sooner or later everyone is gong to get fed up.
45usp  ·  4530 days ago  ·  link  ·  
I agree. People - pundits and politicians especially - have a tendency to shut out whatever doesn't fit their narratives. But you can't live like that. You definitely can't compromise with that kind of negative attitude. You have to go where the data take you, even if it challenges the foundations of your education and experience. Being unwilling to venture outside your comfort zone makes a person unfit for a position of leadership.
thenewgreen  ·  4531 days ago  ·  link  ·  
Today on Talk of the Nation, the question was posed "who lost by this decision" and really nobody had a good answer. I think in order for the Affordable Care Act to have any real impact from a cost perspective, the answer would have had to be "the insurance companies", but really they aren't opposed to it. Essentially it gives them a whole new crop of people to insure at a profit that otherwise would have never had insurance. Many of whom are young and low risk.
45usp  ·  4531 days ago  ·  link  ·  
I agree. As I understand it, insurance companies will have many more customers now; however, insurers cannot turn away any customers for any reason, and their profits are capped at 20%. In my view that means it's all a giant wash. There will be a period of adjustment and people will grouse about that, but it's a big step forward for us as a society.

The only real issue that die-hard tea partiers might still bitch about would be the fact that the government will help pay the costs of insurance depending on income relative to poverty level. But the way I see it, working taxpayers are going to subsidize the uninsured and the very sick one way or another. We may as well do it in a way that's more transparent, more direct, and confers more benefits to us.

thenewgreen  ·  4530 days ago  ·  link  ·  
    working taxpayers are going to subsidize the uninsured and the very sick one way or another. We may as well do it in a way that's more transparent, more direct, and confers more benefits to us.
I agree, it's six or one half dozen.

The cap at 20%, do you if that is net or gross profit? If it's net, I'd say that's pretty damned good. It's also something that is likely easily manipulated, especially at the net level.

45usp  ·  4530 days ago  ·  link  ·  
Not sure, I'd have to look it up. I recall the percent is different for independent insurers, and that if an insurer fails to hit their cap, they have to give rebates. I agree that the companies will try to skirt the rules any way they can.