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Is Obamacare making the mass abuse of ERs worse?

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  • #61
    Originally posted by Joel View Post
    But if the same 'deal' is forced on me with the threat of physical force (e.g. prison),
    I've been thinking about your general claims that taxation is 'coercive', and I notice you almost always make reference to a perceived "threat of physical force (e.g. prison)". I understand that in the US, prison for tax evasion is quite a common thing. But here it isn't at all (to the point where I am not sure it has ever happened in my lifetime).

    What happens is that taxes are automatically deducted from salaries as they are paid. So what the vast majority of people receive is their payslip from their employer by email saying essentially "This fortnight you were paid $X. Taxes were $Y." It is simply not up to the individual employee to choose to pay taxes or not, their employer has already transferred the money to the government before even paying them. So in this system the government doesn't threaten anyone with physical force, the employer simply pays the relevant amounts to the employee and to the government.

    For those that actually do engage in deliberate tax evasion of some kind, the penalties are almost always fines, where the government simply goes ahead and deducts the money from their bank account. I think you would struggle to argue that an electronic deduction from a bank account is "physical force".

    So in general, I don't really buy your whole libertarian premise that government taxation is backed up by the use of coercive physical force.

    If the deal is really as good as you think--if virtually everyone would voluntarily "jump at the chance" to take the deal, then you would be better off actually making the deal a voluntary offer, and to force nobody into it (including the taxes).
    Okay, I don't see a problem with that in the case of healthcare.

    The fact that you need to force everyone into the deal seriously undermines your argument that it's a good deal. Likewise with all the other programs you favor. If they are really such great deals, then there's no reason to make them compulsory. Make them all voluntary. (In which case government would become superfluous.)
    It is nonsensical to try and make all roads, or clean air, or public parks, a voluntary user-pays thing. Either they exist, and therefore exist for everyone, or they don't exist. It would work okay for healthcare because they could check if you were a member of the scheme when you walked in the door, but for things that anyone can access (eg parks) or require universal participation to create (eg non-polluted air) it is not possible to have user-pays systems.


    But the fundamental problem with the libertarian ethic is it basically prohibits, by definition, any sort of taking from the rich and giving to the poor. So if one person happens to have ridiculous amounts of money, and one person happens to be dying of starvation due to being poor, and the remaining people have exactly enough food to survive on, the libertarian ethic claims that it is wrong for that society to vote to save the life of the poor person by taking resources from the rich person, and insists instead that the rich person must be allowed a voluntary choice to help the poor person. That's simply immoral. I find the entire libertarian 'moral' framework to be evil. It's evil, because it artificially puts 'freedom of choice' above all other goods, and potentially allows for any amount of suffering, hardship, pain, and death, so long as its absurd obsession with freedom of choice is preserved.

    Yes, freedom of choice is a good. But it's not the only good. There are dozens of goods - health, happiness, freedom, etc. In my moral view I think it is important to maximize good in general. But that needs to be done in a balanced way. It is wrong to privilege a particular good far ahead of the rest and then to sacrifice all other goods on its alter. So if the choice is between a tiny reduction in freedom for one person to save the life of another person, the moral choice is clear - a small amount of freedom is worth sacrificing for the greater good in that instance. Libertarianism simply gets morality very wrong by advocating immoral choices in such instances. As a result it ultimately has no solution to the problem of income inequality, and would if implemented, ironically, lead to a feudalistic society where the vast majority of people were desperately poor and essentially slaves (or 'serfs') to the few rich feudal overlords, thus resulting in much much less freedom for most people. If having money is considered to give freedom of choice, then given any amount of money and number of people, the monetary distribution that maximizes freedom would be one where everyone has an equal amount of money to spend (assuming the very reasonable premise of diminishing returns in freedom with greater money).
    Last edited by Starlight; 11-20-2015, 01:38 PM.
    "I hate him passionately", he's "a demonic force" - Tucker Carlson, in private, on Donald Trump
    "Every line of serious work that I have written since 1936 has been written, directly or indirectly, against totalitarianism and for democratic socialism" - George Orwell
    "[Capitalism] as it exists today is, in my opinion, the real source of evils. I am convinced there is only one way to eliminate these grave evils, namely through the establishment of a socialist economy" - Albert Einstein

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    • #62
      Originally posted by Starlight View Post
      I've been thinking about your general claims that taxation is 'coercive', and I notice you almost always make reference to a perceived "threat of physical force (e.g. prison)". I understand that in the US, prison for tax evasion is quite a common thing. But here it isn't at all (to the point where I am not sure it has ever happened in my lifetime).

      What happens is that taxes are automatically deducted from salaries as they are paid. So what the vast majority of people receive is their payslip from their employer by email saying essentially "This fortnight you were paid $X. Taxes were $Y." It is simply not up to the individual employee to choose to pay taxes or not, their employer has already transferred the money to the government before even paying them. So in this system the government doesn't threaten anyone with physical force, the employer simply pays the relevant amounts to the employee and to the government.
      In that case it is the employer who is threatened with force. What happens if the employer pays it all to the the employee?
      Economically, it makes no difference which of the people is forced to make the payment. The effect is the same. So, for example, my comments about the employee's choices being decreased still hold. The effect of the government's interference on the employee's life and choices is the same.

      For those that actually do engage in deliberate tax evasion of some kind, the penalties are almost always fines, where the government simply goes ahead and deducts the money from their bank account. I think you would struggle to argue that an electronic deduction from a bank account is "physical force".
      In that case it is the owners of the bank that are threatened with force. What happens if they don't make that payment? Laws are always ultimately backed up by the government's threat of physical force. Otherwise they are just suggestions.

      You might suggest that a state could confiscate property from someone by taking it stealthily in the dead of night. What if people then increase their security? I included such things as theft and vandalism in "physical force", but if you want to define "physical force" more narrowly, we can replace my use of "physical force" with something like "force against person or property".

      Okay, I don't see a problem with that in the case of healthcare.
      So the state becomes superfluous.

      It is nonsensical to try and make all roads, or clean air, or public parks, a voluntary user-pays thing. Either they exist, and therefore exist for everyone, or they don't exist. It would work okay for healthcare because they could check if you were a member of the scheme when you walked in the door, but for things that anyone can access (eg parks) or require universal participation to create (eg non-polluted air) it is not possible to have user-pays systems.
      What you are saying is that some goods are "non-excludable", so therefore it is impossible to fund them via non-coercive means? That's obviously false. Indeed you yourself were suggesting a way to fund them non-coecively. Also one may doubt whether your examples, or any, are actually non-excludable.
      But I'll stay on the topic of health care. The relevant point here is that making the system voluntary makes the state superfluous.

      But the fundamental problem with the libertarian ethic is it basically prohibits, by definition, any sort of taking from the rich and giving to the poor.
      Here you are changing the subject. The point I was making was not about ethics, but about the effects of coercive systems of providing "free" things. It does reduce choice. It does create the political objection to the system (the objection would vanish if it were voluntary). And if it were consensually done, then the state would be superfluous.

      You are also are changing the subject from provision of something "free" to taking from the rich and giving to the poor.
      But I would suggest that that is what the systems of "free" provision are really about. You try to disguise it behind fallacious arguments about how everyone would "jump at the chance" to take the deal that supposedly only increases your choices and doesn't decrease them. So I point out that the arguments imply that it can be done voluntarily and thus the state is made superfluous (with respect to that particular good). And so I ask why would the state even be needed for that. I believe that the only real, honest answer its supporters can give is, "Because if it were voluntary, then the system would no longer take from the rich and give to the poor." That's what it's really about.

      But suppose I/we have no choice but to have a state system of coercive taking from the rich and giving to the poor. In that case I would prefer that the state focus its program on that, and refrain from getting that mixed up with other things (like providing health care "free" to everyone). Make healthcare a voluntary system (as you say you don't have a problem with) and have a completely separate program for helping the poor.
      (I happen to think the same is applicable to most/all other social programs, e.g. education.)


      Your argument against libertarian ethics is flawed in many ways, but I'm going to refrain from responding to it, so as not to change the subject further. If you like I would be happy to take it to a different thread.

      Comment


      • #63
        Wow, a shocking statement from HuffPost.....
        "The Affordable Care Act has gotten some bad news lately. It's not a sign of impending disaster, as the law's critics say, but it may be a sign of some real problems on the horizon."

        Of course, they dance all around it, and try to explain it away, but that's like Japanese saying "things might not be going as well as we expected" after the Battle of Midway.
        The first to state his case seems right until another comes and cross-examines him.

        Comment


        • #64
          Time for a quiz!!!!



          The article is entitled "Obamacare Insurers Are Suffering. That Won't End Well."
          The first to state his case seems right until another comes and cross-examines him.

          Comment


          • #65
            Originally posted by Cow Poke View Post
            Time for a quiz!!!!



            The article is entitled "Obamacare Insurers Are Suffering. That Won't End Well."
            The same United HealthCare that is threatening to withdrawal from Obamacare after suffering massive loses?

            Source: Biggest Insurer Threatens to Abandon Health Law

            Source

            © Copyright Original Source



            Source: UnitedHealth Weighs Leaving Obamacare Marketplace, Stock Drops


            UnitedHealthGroup Inc. said it expects major losses on its business through the Affordable Care Act's exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers' struggles with the health law's marketplaces.

            The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment's prospects, will sharply boost worries about the sustainability of the law's signature marketplaces, amid signs that many insurers' losses on the business continue to mount.

            UnitedHealth Group's chief executive, Stephen J. Hemsley, said it made the move, which included a downgrade of its earnings projections for 2015, amid reduced growth expectations, the expected shutdowns of the majority of the health law's nonprofit cooperative insurers, and signs that its own enrollees continue to increase their use of medical services, raising costs.

            As a result, UnitedHealth said it is pulling back on marketing its exchange products, as open enrollment is currently under way for plans that will take effect in 2016. And the insurer said it is "evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017." UnitedHealthhad previously expanded its exchange offerings to 11 new states for 2016, and said in October it had around 550,000 people enrolled.

            UnitedHealth said it was revising its 2015 earnings projection to $6 a share, from a previous range of $6.25 to $6.35. The move reflected "pressure" of $425 million, or 26 cents a share, tied to individual plans sold under the health law, it said. The $425 million includes $275 million related to the "advance recognition" of losses it expects to incur in 2016. UnitedHealthalso said it expects its 2016 earnings to be between $7.10 and $7.30 per share in 2016; previously, the company said it thought next year's earnings would be within the range of analysts' projections, then around $7.09 to $7.55.

            Chris Rigg, an analyst with Susquehanna Financial Group, wrote that it was likely "this is more of an industry issue," and if the exchanges don't stabilize, he would expect UnitedHealth to "exit this business line."



            Source

            © Copyright Original Source


            I'm always still in trouble again

            "You're by far the worst poster on TWeb" and "TWeb's biggest liar" --starlight (the guy who says Stalin was a right-winger)
            "Overall I would rate the withdrawal from Afghanistan as by far the best thing Biden's done" --Starlight
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            • #66
              Even Hillary admits that Obamacare has failed to control costs.

              Source: Breitbart

              http://www.breitbart.com/big-governm...dmits-hillary/

              © Copyright Original Source


              So how long can this continue until the government simply can't afford to "subsidize" everyone's healthcare and has to put more drastic cost control measures in place (such as strict rationing of services)?
              Some may call me foolish, and some may call me odd
              But I'd rather be a fool in the eyes of man
              Than a fool in the eyes of God


              From "Fools Gold" by Petra

              Comment


              • #67
                For once I agree with MM. Health Insurance will not remain insurance for long if it is wasted on operations for people too old, too sick and dying (cancer, wasting hundreds of thousands on chemotherapy).
                Yet ironically it was the Repubs who claimed to get all alarmed about "Death Panels". Inevitable.
                Near the Peoples' Republic of Davis, south of the State of Jefferson (Suspended between Left and Right)

                Comment


                • #68
                  "OK", you're saying, "Why are you here with the top seven postings in Civics when you're supposed to be in Church?"
                  Well, I'm sick. And it's relevant to everyone. I was in the hospital in the first place because of medical malpractice (way too high a starting dose) that made me twice think I was having a heart attack. So they rushed an in-hospital Angiogram, and in being in the hospital for three days I got sepsis in my IV hook-up. Not a great recommendation for Kaiser.
                  Near the Peoples' Republic of Davis, south of the State of Jefferson (Suspended between Left and Right)

                  Comment


                  • #69
                    Originally posted by Adam View Post
                    For once I agree with MM. Health Insurance will not remain insurance for long if it is wasted on operations for people too old, too sick and dying (cancer, wasting hundreds of thousands on chemotherapy).
                    Yet ironically it was the Repubs who claimed to get all alarmed about "Death Panels". Inevitable.
                    How is it ironic that Republicans accurately predicted what would happen if Obamacare was passed into law?

                    You know why other countries with government controlled healthcare were so happy when Obamacare was shoved down our throats? Because they saw it as taking America down a peg. "Finally, those arrogant Americans have the same crappy healthcare we do! That'll knock them off their high horse!"
                    Some may call me foolish, and some may call me odd
                    But I'd rather be a fool in the eyes of man
                    Than a fool in the eyes of God


                    From "Fools Gold" by Petra

                    Comment


                    • #70
                      Originally posted by Adam View Post
                      "OK", you're saying, "Why are you here with the top seven postings in Civics when you're supposed to be in Church?"
                      You're apparently projecting your own guilt onto others, because I'm pretty sure nobody is saying that.
                      Some may call me foolish, and some may call me odd
                      But I'd rather be a fool in the eyes of man
                      Than a fool in the eyes of God


                      From "Fools Gold" by Petra

                      Comment


                      • #71
                        Originally posted by Starlight View Post
                        Given they literally print the money, and define what even is money, they actually literally have as much money as they like.
                        fc,550x550,orange.jpg
                        My Amazon Author page: https://www.amazon.com/-/e/B0719RS8BK

                        Comment


                        • #72
                          Originally posted by Mountain Man View Post
                          How is it ironic that Republicans accurately predicted what would happen if Obamacare was passed into law?

                          You know why other countries with government controlled healthcare were so happy when Obamacare was shoved down our throats? Because they saw it as taking America down a peg. "Finally, those arrogant Americans have the same crappy healthcare we do! That'll knock them off their high horse!"
                          Actually, most people with crappy government healthcare are actually deluded enough to believe that it is preferable to private healthcare. I mean there are still people in the UK who think that the NHS is the 'envy of the world' and you see political slogans like 'save our NHS'.
                          My Amazon Author page: https://www.amazon.com/-/e/B0719RS8BK

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                          • #73
                            I'm feeling guilty about hogging all the posts, but reflected that my "competitors" for attention are busy getting even more attention at church.
                            Near the Peoples' Republic of Davis, south of the State of Jefferson (Suspended between Left and Right)

                            Comment


                            • #74
                              Originally posted by Truthseeker View Post
                              Is Obamacare making the mass abuse of ERs worse?

                              Once Obamacare took full effect, supporters aver, people abusing emergency room (ER) service would be much, much fewer, because many more poor people than before would have insurance. But no, so far, the ER imbroglio is worse, Dr Marc Micozzi said in an op-ed piece today (2015 11 16).

                              It's not clear to me why the problem is much worse than before Obamacare. Sure, socialism is not supposed to work in the economic sphere, but I want specific explanation in this case.
                              In two words: deductible and coinsurance. For most plans these are insanely high. The only recourse is to hit the ER until the deductible is met assuming you can afford the coinsurance.
                              "He is no fool who gives what he cannot keep to gain that which he cannot lose." - Jim Elliot

                              "Forgiveness is the way of love." Gary Chapman

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                              • #75
                                Originally posted by rogue06 View Post
                                The same United HealthCare that is threatening to withdrawal from Obamacare after suffering massive loses?

                                Source: Biggest Insurer Threatens to Abandon Health Law

                                Source

                                © Copyright Original Source



                                Source: UnitedHealth Weighs Leaving Obamacare Marketplace, Stock Drops


                                UnitedHealthGroup Inc. said it expects major losses on its business through the Affordable Care Act's exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers' struggles with the health law's marketplaces.

                                The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment's prospects, will sharply boost worries about the sustainability of the law's signature marketplaces, amid signs that many insurers' losses on the business continue to mount.

                                UnitedHealth Group's chief executive, Stephen J. Hemsley, said it made the move, which included a downgrade of its earnings projections for 2015, amid reduced growth expectations, the expected shutdowns of the majority of the health law's nonprofit cooperative insurers, and signs that its own enrollees continue to increase their use of medical services, raising costs.

                                As a result, UnitedHealth said it is pulling back on marketing its exchange products, as open enrollment is currently under way for plans that will take effect in 2016. And the insurer said it is "evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017." UnitedHealthhad previously expanded its exchange offerings to 11 new states for 2016, and said in October it had around 550,000 people enrolled.

                                UnitedHealth said it was revising its 2015 earnings projection to $6 a share, from a previous range of $6.25 to $6.35. The move reflected "pressure" of $425 million, or 26 cents a share, tied to individual plans sold under the health law, it said. The $425 million includes $275 million related to the "advance recognition" of losses it expects to incur in 2016. UnitedHealthalso said it expects its 2016 earnings to be between $7.10 and $7.30 per share in 2016; previously, the company said it thought next year's earnings would be within the range of analysts' projections, then around $7.09 to $7.55.

                                Chris Rigg, an analyst with Susquehanna Financial Group, wrote that it was likely "this is more of an industry issue," and if the exchanges don't stabilize, he would expect UnitedHealth to "exit this business line."



                                Source

                                © Copyright Original Source

                                "He is no fool who gives what he cannot keep to gain that which he cannot lose." - Jim Elliot

                                "Forgiveness is the way of love." Gary Chapman

                                My Personal Blog

                                My Novella blog (Current Novella Begins on 7/25/14)

                                Quill Sword

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