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Subject: Hey BJ and Drew (etc.)! A question.for you rss

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Moshe Callen
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You claim to have a principled objection to the ACA AKA "Obamacare". So how does this fit in with your objections?

A loved one of mine who lives in the US supports the ACA because before the law she was entirely unable to get any insurance from any company at any price. Both she and her husband work but she had had a benign tumor. It was removed but her insurance company refused to continue insuring her afterwards, and no company would take her on thereafter.

Why do you fundamentally object to not allowing health insurance companies to refuse to cover people? If you have no fundamental objection, then why act as if the ACA is only terribly bad for America?
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In summary, I will start off with a list of general responses

1) I believe that existing conditions should be covered
2) I believe that some form of health care should be provided to all citizens
3) I believe that the current cost of health care is/was on a non-sustainable rate
4) I believe that the government is less efficient than private enterprise
5) I believe the idea of coercing/forcing citizens to enter into a transaction with no way out
6) I believe that the ACA is going to incent lots of unintended behaviors (29 hour work weeks for example)

I could probably list a bunch more...

So, where does that leave things...

Some kind of overhaul/change in the way healthcare was needed in America - and the ACA is a step in that direction (i.e. it addresses the first two points) - but it fails to address the third - so effectively, we have replaced one set of problems with a more expensive set of slightly smaller problems.

Thus, I think the GOP plan to defund/delay/destroy the ACA is juvenile and ultimately doomed to fail - but if their behavior gets both sides to the table to have and adult conversation about fixing the MANY issues with the ACA - then I am happy for it.

So, my objection to the ACA has nothing to do with its motives or its intents - but with the actual wording/implementation - and if that can be fixed, I could support the ACA.
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whac3 wrote:
You claim to have a principled objection to the ACA AKA "Obamacare". So how does this fit in with your objections?

A loved one of mine who lives in the US supports the ACA because before the law she was entirely unable to get any insurance from any company at any price. Both she and her husband work but she had had a benign tumor. It was removed but her insurance company refused to continue insuring her afterwards, and no company would take her on thereafter.

Why do you fundamentally object to not allowing health insurance companies to refuse to cover people? If you have no fundamental objection, then why act as if the ACA is only terribly bad for America?


I am not BJ or Drew but I think these type of situations needed to be addressed via insurance regulation not via the ACA.

That insurance companies are legal gambling that lets the house change the rules when the odds shift in a way they don't like is a fundamental problem with all insurance that should be addressed rather than society trying to cover for the gaps it creates by finding other ways to help the people these gaps leave high and dry.

That insurance companies made record profits the year OF Katrina for example, while refusing to rebuild millions of houses destroyed by it is shameful... that we the people and our government LET THEM get away with shit like that is beyond stupid on our parts.



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Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


You may have missed the second word - and ultimately it has very little do with this thread. But tell you what - if you give want it a go in another thread and show that government is more efficient than private enterprise, I would read what you throw together.
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To the initial question: getting sick and buying insurance is not insurance. It's just asking someone to pay for your health care. Discriminating against PECs is literally critical to insurance working. Otherwise, your best bet is to not be insured until you get sick.

Yes, I understand that people don't choose to get sick, and some are even born with horrible problems. I don't know the right answer, but that doesn't mean that outlawing PEC discrimination is right either.

Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


Seriously? What government agency do you believe to be anywhere near as efficient as its private counterparts? This is almost false on principle, since inefficient private businesses fail unless they're propped up by government, and inefficient public agencies usually get *more* money.
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ignorantpenguin wrote:
What government agency do you believe to be anywhere near as efficient as its private counterparts?

NASA during the decade of the moon landing.
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jmilum wrote:
ignorantpenguin wrote:
What government agency do you believe to be anywhere near as efficient as its private counterparts?

NASA during the decade of the moon landing.


Sort of; there was no incentive for a private company to go to the moon. Now that at we're seeing incentives for private companies to go to space, they're doing just fine.

Aha! You say. Private companies wouldn't have don't it. I win.

Except that all that means is nobody thought it was worth their money.
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jmilum wrote:
ignorantpenguin wrote:
What government agency do you believe to be anywhere near as efficient as its private counterparts?

NASA during the decade of the moon landing.


Yeah... 50 years ago.... so let's not forget Eisenhower building the interstate either, that was 60 years ago. No doubt we could go even further back in history, when the US government was smaller and find plenty it was capable of doing better at the time than private citizens. Hey! I know! World Wars! They do a much better job there also.

I actually am not in the "governments are all shit" camp. Mostly though I think once the federal government gets too far away from what it was originally chartered to do it becomes increasingly inefficient.
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ignorantpenguin wrote:
Now that at we're seeing incentives for private companies to go to space, they're doing just fine.

They haven't been to the moon yet.
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DWTripp wrote:
jmilum wrote:
ignorantpenguin wrote:
What government agency do you believe to be anywhere near as efficient as its private counterparts?

NASA during the decade of the moon landing.


Yeah... 50 years ago.... so let's not forget Eisenhower building the interstate either, that was 60 years ago. No doubt we could go even further back in history, when the US government was smaller and find plenty it was capable of doing better at the time than private citizens. Hey! I know! World Wars! They do a much better job there also.

I actually am not in the "governments are all shit" camp. Mostly though I think once the federal government gets too far away from what it was originally chartered to do it becomes increasingly inefficient.


The interstate system was built on government land via eminent domain. And actual private roads are illegal. How is this a comparison between the public and private sector?
 
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jmilum wrote:
ignorantpenguin wrote:
Now that at we're seeing incentives for private companies to go to space, they're doing just fine.

They haven't been to the moon yet.


Because there's no reason to. There never was except to give the soviets the middle finger.
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ignorantpenguin wrote:
jmilum wrote:
ignorantpenguin wrote:
Now that at we're seeing incentives for private companies to go to space, they're doing just fine.

They haven't been to the moon yet.


Because there's no reason to. There never was except to give the soviets the middle finger.


And since that time we haven't been back and now rely on private enterprise and soviet I mean Russians to do the heavy lifting for us.
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Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


USPS postal service is lost $16 billion in 2012 because of Government mandates vs FedEx and UPS which actually turned a profit.

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Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


Work for the government or even a government contractor for awhile and you can see the insanity first hand.

At the national lab I was required to keep an expensive, had to have somebody on call 24/7 in case of leaks, inspected weekly, double contained "Hazardous Waste Disposal Area" in place to hold a 2 gallon heavy duty jug of salt (NaCl - yep table salt) water that was weaker than what I gargle with when have a sore throat, for over 3 years because "salt" is a regulated substance at 10 wt% or above in water and cannot go down "government" sinks.

No place for common sense... just rules written for specific needed situations (like a food processing facility dumping thousands of gallons of waste water daily directly into a fresh water stream/river needs to not have salt higher than 10% by weight) applied EVERYWHERE with no understanding of why the rules were written or when they need to apply.

Or that a box of lab gloves that cost $10 would cost my project over $150 by the time I got them. Because the paperwork I had to fill out to buy them took 15 min or more, then a purchasing agent would have to get X competitive bids and check to see if a minority owned or local small business could be used to procure them etc. I get having these kinds of safeguards in place for large government contracts, but standard off the shelf products below a certain threshold should be able to be purchased without jumping through 2 hours worth of hoops for every purchase requisition. (Luckily some strides have been made to fix this.. but even the improved process still adds a lot to purchasing costs) But since we would have to jump through the hoops we would buy cases of consumables like gloves, beakers, test tubes etc so that we wouldn't run out and have to spend a fortune to get just a few at a time ... which then 6 months or a year later before some inspection a lab monitor would freak about how it "looked" and would then dump 3 cases of brand new unused stuff into a dumpster. Which because of more government rules we couldn't even donate to a local school to use.

You have no idea how many MILLIONS of dollars of perfectly usable, often still brand new stuff has gone into just our lab's local land fill because donating stuff wasn't allowed and just taking it home is "stealing". Office supplies, janitorial supplies, and lab equipment by the literal dumpster full several times a year.

I was one of the dedicated crazy people who donated my FREE TIME to making lists and posting them around the lab to try to find other projects that needed or could at least use the things left over from some project we had just finished rather than see them go into a dumpster. Something that the management and the government didn't think was even worth paying me for... though they will happily pay me for hours required to fill out complicated forms to re-buy the stuff exactly like I just gave away or threw away 4 months later when working on a new different project.

Or when I was on travel I was supposed to stay a 1.5 hour drive away from where I needed to be daily, and pay MORE in actual costs for the hotel in the larger city (higher per diem allowed), to not pay $4 per day over per diem at the hole in the wall CHEAPER actual cost hotel only 10 min from where I needed to be. Oh and there were rules in place to keep me from just paying the $4 myself out of pocket or taking $4 out of my eating budget too. So pay me and my team members for 3 hours a day of our time (overtime galore for the 2 hourly techs with me), and gas for the rental car AND pay more for the hotel room itself to not "appear" on paper to be letting us stay someplace over budget by $4 per room.

And those are a few quick off the top of my head stories... I have many many more.

This kind of stuff just doesn't happen at privately run labs with the same FREQUENCY because there are not as many hoops/barriers and even drivers to make such stupid things happen.

And this is just one small set of examples... people in social services, or the military or workers from any of a number of other groups working for the government directly or indirectly could tell you of similar stories that apply to their experiences.




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Shushnik wrote:
ignorantpenguin wrote:
To the initial question: getting sick and buying insurance is not insurance. It's just asking someone to pay for your health care. Discriminating against PECs is literally critical to insurance working. Otherwise, your best bet is to not be insured until you get sick.

Yes, I understand that people don't choose to get sick, and some are even born with horrible problems. I don't know the right answer, but that doesn't mean that outlawing PEC discrimination is right either.

Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


Seriously? What government agency do you believe to be anywhere near as efficient as its private counterparts? This is almost false on principle, since inefficient private businesses fail unless they're propped up by government, and inefficient public agencies usually get *more* money.


I was asking Utrecht for facts and figures. Thanks for your input, but that was neither.


I will happily supply them when I get home to a real computer.

I'd suggest though that it's irresponsible to totally disregard the quick point I made. Empiricism is important but if it's all you're interested in you'll find yourself discarding things like math.
 
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Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


You are asking the wrong question. The question isn't "Who is more efficient?" but rather "When is efficiency the most desirable outcome?"

Take "government death panels." Right now, we are on the verge of a massive, unwieldy bureaucratic mess where people will be covered, but at a mammoth cost. But then there are the "privatized death panels," which the OP presented as the impetus for this discussion. They are greatly efficient from the standpoint of "money in vs money out." But in the name of profit (i.e. efficiency), we get people excluded for pre-existing conditions along with all other sorts of snafus which leave the "undesirables" uninsured.

So... at what cost, efficiency?

There are real and significant problems with the way both insurance and medical services are supplied in this country. The system before the ACA was broken. The system -with- the ACA is broken. But any politician who cares about his job won't touch the underlying causes of this. Or any other problem in our country. Everyone is just out to find the best way to implement the most appealing non-solution, and then make sure they don't have oregano in their teeth for the photo op afterward.
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Dispaminite wrote:
Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


USPS postal service is lost $16 billion in 2012 because of Government mandates vs FedEx and UPS which actually turned a profit.



Look at the profitability of the USPS of ten years ago compared to how it is now that congress is micromanaging it into the ground.

Also, FedEx and UPS wouldn't be nearly as profitable if they couldn't piggy-back off postal planes.
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GameCrossing wrote:
Dispaminite wrote:
Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


USPS postal service is lost $16 billion in 2012 because of Government mandates vs FedEx and UPS which actually turned a profit.



Look at the profitability of the USPS of ten years ago compared to how it is now that congress is micromanaging it into the ground.

Also, FedEx and UPS wouldn't be nearly as profitable if they couldn't piggy-back off postal planes.


But they would still be profitable.
 
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Shushnik wrote:
Utrecht wrote:
Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


You may have missed the second word - and ultimately it has very little do with this thread. But tell you what - if you give want it a go in another thread and show that government is more efficient than private enterprise, I would read what you throw together.


Oh, so you hold a belief you'd like the rest of us to disprove for you. No thank you. I'm good.


No, I hold an opinion that my observations have constantly upheld and I am willing to listen to facts that disprove it - but in my 42 years of life have seen very little of it - you are the one coming in with the minority position here and the onus is on you to demonstrate this.

But again, this thread was not intended to discuss government efficiency - but rather what the objections to the ACA are. I would encourage you to start a new thread to get answers to your question.
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ignorantpenguin wrote:
To the initial question: getting sick and buying insurance is not insurance. It's just asking someone to pay for your health care. Discriminating against PECs is literally critical to insurance working. Otherwise, your best bet is to not be insured until you get sick.

Yes, I understand that people don't choose to get sick, and some are even born with horrible problems. I don't know the right answer, but that doesn't mean that outlawing PEC discrimination is right either.

Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


Seriously? What government agency do you believe to be anywhere near as efficient as its private counterparts? This is almost false on principle, since inefficient private businesses fail unless they're propped up by government, and inefficient public agencies usually get *more* money.

The person had insurance when the condition-- which was a benign tumor arose. After that, no one would insure her anymore and so what are you on about?

One more time: She HAD insurance and then didn't even get sick but had a medical issue. As a result, she LOST coverage and couldn't get anyone else to insure her when her previous insurance company gave her the boot.

This is not having no insurance and then getting it only hen a medical condition arises.
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bjlillo wrote:
Moshe, does she or her husband work for a company that offers a group health insurance plan? I would recommend that as a course of action for them rather than attempting to purchase insurance on the individual market.

Quote:
Why do you fundamentally object to not allowing health insurance companies to refuse to cover people?


Why don't we let people buy homeowner's insurance when their house is on fire or auto insurance the day after they wrecked their new vehicle?

Quote:
If you have no fundamental objection, then why act as if the ACA is only terribly bad for America?


I don't think I've ever said "only terribly bad." It helps some people at the expense of others. The old and sick are helped at the expense of the young and healthy. Insurance companies are hurt in that they have to cover things they wouldn't otherwise cover but helped in that they will most likely be getting new customers because of the various mandates.

On balance Obamacare is demonstrably bad because it increases costs, decreases freedom, and increases the size and scope of government control over our lives. Like any government program though, there will be winners and losers from it as it directs money from one group of people to another.

She's self-employed (runs a small store) and I'm not sure her husband is covered by his employer.
 
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bjlillo wrote:
whac3 wrote:
The person had insurance when the condition-- which was a benign tumor arose. After that, no one would insure her anymore and so what areyou on about?


The same thing happens to the car insurance of people who get into car accidents or get a bunch of traffic citations. She is, in the eyes of the people who do this for a living, a higher risk than they are willing to insure at the individual level. She'll have no problem getting coverage with a group plan though.


Like the group plans on the exchanges?
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Quote:
The person had insurance when the condition-- which was a benign tumor arose. After that, no one would insure her anymore and so what areyou on about?


Got it. I misunderstood. My apologies. I agree with you then that there's just as big a problem with that as what I said. In fact it's the opposite: sure we'll cover you, until you get sick.

Now that's a problem. Seems to me an insurance company could charge a substantial amount for a contract guaranteeing that won't happen. No tome-like law required.

And I'd followup that the "you can't be dropped" is by a wide margin the least offensive piece of the ACA to me.
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Dispaminite wrote:
GameCrossing wrote:
Dispaminite wrote:
Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


USPS postal service is lost $16 billion in 2012 because of Government mandates vs FedEx and UPS which actually turned a profit.



Look at the profitability of the USPS of ten years ago compared to how it is now that congress is micromanaging it into the ground.

Also, FedEx and UPS wouldn't be nearly as profitable if they couldn't piggy-back off postal planes.


But they would still be profitable.


And the USPS would still be profitable if Congress let them run themselves the way they used to instead of using them as a political pawn.
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bjlillo wrote:
Dispaminite wrote:
Shushnik wrote:
Utrecht wrote:

4) I believe that the government is less efficient than private enterprise


This one gets thrown around constantly, yet I've never seen it actually proven through facts or studies. Care to give it a go?


USPS postal service is lost $16 billion in 2012 because of Government mandates vs FedEx and UPS which actually turned a profit.



And that's with a government-enforced monopoly on non-critical (can't remember the exact term, forgive me if I've gotten it wrong) letter delivery.


And all it would require is to take the cost of mailing in a electric bill and price it out of range of those who can't afford a computer.

I mean, I guess they could always go to the library and use the computers there, but those are next on the chopping block. Free books? Easy access to self-education? Sounds pretty non-essential to me.
 
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