Obamacare

Quit Playing Games With My Health Care System?

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In a completely predictable thoroughly shocking development, it appears that many Massachusetts residents are taking advantage of the state's strict health insurance regulations by buying insurance right before they need expensive procedures and then cancelling their policies soon after

Thousands of consumers are gaming Massachusetts' 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses. In 2009 alone, 936 people signed up for coverage with Blue Cross and Blue Shield of Massachusetts for three months or less and ran up claims of more than $1,000 per month while in the plan. Their medical spending while insured was more than four times the average for consumers who buy coverage on their own and retain it in a normal fashion, according to data the state's largest private insurer provided the Globe.

The typical monthly premium for these short-term members was $400, but their average claims exceeded $2,200 per month. The previous year, the company's data show it had even more high-spending, short-term members. Over those two years, the figures suggest the price tag ran into the millions.

Other insurers could not produce such detailed information for short-term customers but said they have witnessed a similar pattern. And, they said, the phenomenon is likely to be repeated on a grander scale when the new national health care law begins requiring most people to have insurance in 2014, unless federal regulators craft regulations to avoid the pitfall.

In theory, the state requires everyone to carry health insurance. But it also allows individuals to pay a penalty in order to opt out. And it seems that's just what many residents are doing. 

The problem is, it is less expensive for consumers—especially young and healthy people—to pay the monthly penalty of as much as $93 imposed under the state law for not having insurance, than to buy the coverage year-round. This is also the case under the federal health care overhaul legislation signed by the president, insurers say.

The state's rate-hike-denying governor, Deval Patrick, is apparently attempting to address the problem with rules that restrict health insurance enrollment to twice a year. But that still leaves substantial opportunity for gaming: Anybody who needs expensive procedures more than a couple of times each year is likely to benefit from (and already have) ongoing health insurance. And let's say that someone used up their two enrollments, then found themselves diagnosed with a serious illness. Are we really supposed to believe that state insurance regulators will heartlessly allow those people to be denied access to coverage or care? Tough-luck cases, even for those who may have taken advantage of the system, are what the state's health reforms were designed to prevent. 

Meanwhile, I suspect we can expect plenty of similar behavior nationwide once the ACA's insurance regulations kick in. And given that the individual mandate appears to be nearly unenforceable, such behavior may be even more widespread than in Massachusetts. 

More on problems with the Massachusetts health care system herehere, and here

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  1. I just Hope this doesn’t become a problem nationwide and that the HCR bill was Changed to ensure this won’t happen.

    1. I see what you did there.

    2. Yep. The right people are in charge now.

  2. Nothing to see here…move along. It will be different this time.

  3. Some senator was on Morning Joe today and he was saying that no one will be fined if they don’t buy insurance. He said there is no enforcement mechanism.

    1. I can’t wait to see this unfold! I’ll fire up the grill, put a 12-pack on ice, and watch the fun.

    2. He said there is no enforcement mechanism.

      Yet.

      1. The statists think nothing of a gun to the head… provided they’re the ones holding it.

      2. No, effectively, it’s already there.

        That is, when you write your check to the IRS, how do you specify that the amount you’ve shorted them is to be attributed to the supposedly non-enforceable health insurance tax Club USA membership fee insufficient-coverage penalty, and not to your regular AGI liability?

        Assuming, of course, that you write them a check in the first place; if you don’t, I assume the fee will simply be deducted from your annual interest-free loan to the state tax refund.

  4. Don’t worry … Obie Nation will just “make the rich pay for it all” and blame Bush when the costs skyrocket for all of us.

  5. How else can we run evil insurance companies out of business and then get single payer as a saving grace?

    But we TRIED to fix it through insurance and THAT JUST DIDN’T WORK! Premiums are still going up and millions of people still don’t have access to care and are dying in the street! What choice do we have now but to just take it all over? The free market is irretrievably broken when it comes to healthcare!

    Silly wabbit.

  6. Good. Fuck Massachusetts. Enjoy you’re healthcare shortage and impending bankruptcy, Massholes. You earned it.

    1. Yore. As in days of.

  7. “But under federal HCR the Right People will be in charge.”

  8. buying insurance when they need to cover pricey medical care, such as fertility treatments

    The “right” to a litter of whelps is in the Commerce Clause?

    I had no idea.

    1. What – I’m going to be forced to buy health care insurance so that some broad can get cheap fertility treatments?! Let them adopt a child. Aren’t there enough kids in this country who need someone to care about them without enslaving the rest of us to make more?

      1. Do you have any idea how many states already mandate coverage of in-vitro? Fertility treatments are not health care.

      2. They make adoptions so expensive, it’s cheaper, even out of pocket to get IUI. As for IVF, it may be comparable in cost. Really, why does adoption cost one red cent when a child needs a home? If you said a combination of regulations and racism, you’d be right.

    2. Statists: “Since the number of children someone has *might* possibly have some obscure, tangential connection to commerce… yes.”

    3. Insurance policy mandates to cover shit like this is what caused the problem they are trying to fix with more regulation in the first place.

  9. Some senator was on Morning Joe today and he was saying that no one will be fined if they don’t buy insurance. He said there is no enforcement mechanism.

    This has been covered already, by others, but there is a very real likelihood of “first dollar” vs “last dollar” gaming on the part of the IRS. The first dollar is payment of your insurance obligation, and any shortfall on the back end will be considered nonpayment of your tax liability, and subject to forcible collection.

    Many Senators are fucking imbeciles. The remainder are liars and thieves.

    1. Does the legislation give the IRS the power to enforce collection, or not? If they have the power, they will use it.

      1. I think that’s what Brooks is saying – that unless the legislation specifically specifies in what order the collected receipts are applied, the IRS doesn’t necessarily need the enforcement powers.

        It will just assume that the insurance fine has been paid and then use the collection powers it already does have to go after people for underpayment of their actual tax liabilities.

    2. …there is a very real likelihood of “first dollar” vs “last dollar” gaming on the part of the IRS.

      There is a very real danger of a tax revolt, too.

      1. Enough fools will comply. And those same fools will cheerlead going after the tax “cheats.”

  10. And let’s say that someone used up their two enrollments, then found themselves diagnosed with a serious illness. Are we really supposed to believe that state insurance regulators will heartlessly allow those people to be denied access to coverage or care? Tough-luck cases, even for those who may have taken advantage of the system, are what the state’s health reforms were designed to prevent.

    Wait a second – I thought healthcare was a right.

    If it’s a right, then there’s no such thing as “gaming the system”.

    In order for the concept of “gaming the system” to exist, you have to bring back the concepts of earning and deserving, as in “These people are getting benefits they don’t deserve by timing their enrollments”.

    Health care reform was supposed to get rid of the grossly unfair concepts of earning and deserving, because healthcare is a right. Right?

    1. I’d say, based on who voted for this mess, healthcare is a “left”, not a “right”.

    2. It can’t be a right, when it feels so wrong.
      You, you tax up my life.

      1. “It can’t be a right, when it feels so wrong” but that’s the way, I like it.

    3. Fluffy, your thinking is much too clear and logical; you know better than that.

    4. You’re absolutely right, Fluffy. See my comment below.

    5. fluff
      I’m guessing they are referring to people who are not actually in need of health care. Such people would be gaming the system if they tried to get it under the plan. The idea of the right to health care is whoever needs it should get it.

      1. So now rights are divvied up based upon need?

        So like free speech, right to bear arms, right to speedy jury trial, right to be free from unreasonable search and seizure?

        When the fuck did this country get here?

        1. The idea of the right to health care is whoever needs it should get it.

          From each according to his ability and to each according to his need?

          Come on, this isn’t even mildly original douchebaggery. You used to be a better troll than that.

          1. And you seem to have missed that my tying it to need was a limiting move…Hence the possibility of “gaming” that started all of this.

        2. Er, we get it, you don’t like positive rights. But just stomping your foot up and down and saying that isn’t convincing anyone. I happen to think need is not a bad justification for a right.

          1. I happen to think need is not a bad justification for a right.

            There were a hundred million dead human beings in the twentieth century who would disagree with you.

            But lets take your premise. I need some shit. I will be over in the morning to see what you have that I might need. I am sure you consider it my right, and I don’t even have to thank you for exercising it. So the first four words of the above quote are clearly a lie.

            1. I’m not sure how “I happen to have some stuff in my possession right now” entitles any person to that stuff more than “I am in need of that stuff.” it seems to me if we care about human beings and their wanting the latter has more moral force, at least immediately…

              1. And let’s drop the “communism” meme. Whatever they wrote the various communist regimes certainly did not allocate resources based on need, so to pooh-pooh the latter principle by pointing to those regimes is quite silly indeed. It’s like arguing against doing God’s will by pointing to some evil person or regime who used God’s will as rhetoric to defend their awful actions.

                1. MNG|4.5.10 @ 7:04PM|#
                  “And let’s drop the “communism” meme. Whatever they wrote the various communist regimes certainly did not allocate resources based on need, so to pooh-pooh the latter principle by pointing to those regimes is quite silly indeed.”

                  Of course they didn’t because it’s impossible; the ‘knowledge problem’.
                  Given that it’s impossible to accomplish, your argument is interesting; ‘I’d like you to ignore the facts since they conflict with my ideology.’
                  In case it’s not clear, outside of specific, rare cases, there is no way to establish a “need” independent of a “want”.

                  1. Wants are things you’d like, that would be nice, needs are, well, needs, they are requisite to survival, or even just flourishing. You may want what you need, but they are clearly not the same thing.

                    Either way, communist regimes gave most of their citizens neither what they wanted or needed. Pointing to their rhetoric and actions does not undercut the validity of need as a basis of right.

          2. MNG|4.5.10 @ 5:41PM|#
            “Er, we get it, you don’t like positive rights. But just stomping your foot up and down and saying that isn’t convincing anyone. I happen to think need is not a bad justification for a right.”

            I need your paycheck. Please tell me where I can pick it up.

            1. Needs ain’t wants.

              1. MNG|4.5.10 @ 7:37PM|#
                “Needs ain’t wants.”

                Beat ya to it; they are nearly universally interchangeable.

                1. Let’s go further.
                  I bought a nice Ipod, and now I need your paycheck for food.

                2. Only for a person without a dictionary…

                  1. MNG|4.5.10 @ 7:44PM|#
                    “Only for a person without a dictionary…”

                    As opposed to an ignoramus who has no way to tell the difference in fact?
                    Sorta like that?

          3. I “need” my septic system fixed. When can you come over?

    6. “”Health care reform was supposed to get rid of the grossly unfair concepts of earning and deserving, because healthcare is a right. Right?””

      Our society already believes it’s unfair to deny people health care and has for some time.

      The funny thing is even under Obamacare, some people will still be denied. Eventually, it will be those who won’t play ball with our nanny overlords. Yeah, we do lung cancer surgery, but if you smoke, you have to pay out of pocket.

      1. Our society already believes it’s unfair to deny people health care and has for some time.

        Correct, but even the recognition of ‘fairness’ and compassion stop very far short of declaring it a right. You do see the difference, right?

        1. I wouldn’t call health care a right.

  11. No seriously guys… Health care is different. Predictable economic reality just doesn’t apply to it…. Right, Massachusetts??

    1. Paul Krugman: That’s exactly right, Sean. That’s what I have been trying to tell people. Duh! It’s not like other things such as electronics. And people cannot be expected to pay for their own health care. We need a 3rd party system. Sooo glad people are getting it now.

  12. While I was running errands at lunch today, I had Rush on the radio . . . .

    /ducks/

    and he had a very interesting discussion about whether America was, in fact, too full of lazy, immature, “entitled” deadbeats to get rid of the healthcare bill and turn the corner on entitlements.

    1. I have been wondering this for a while. The real question is, “how many is too full”?

      I think there’s probably a solid 25-30% of the population who’s absolutely opposed to this kind of stuff, but many of those don’t take much interest in politics (no surprise there, since individualists’ mode of thinking wouldn’t be prone to seeking the approval or help of the collective, right?)… So I wonder that even if it was only like 10% of people who really demanded entitlements but who are all politically active, would that be enough to drain the rest of us anyway? And what if it’s really like 70%?

      Screwed? I think so.

    2. Here’s the problem. The more you provide, and the longer you provide it, the less people will take responsibility for themselves. We’ve been training people to be lazy. I expect that we are past the tipping point, despite the amount of objection to the HC bill.

      It is really easy to just let the state care for you, and if that stops, people don’t pick up the slack, they bitch. We’ve been on a steady march away from personal responsibility for quite some time. We are now just accelerating the pace.

      1. “”We’ve been training people to be lazy. “”

        Not necessarily’s government fault either. Some people today just couldn’t imagine getting off the damn couch to turn the tv channel, getting out of their car to open the garage door. The idea that you have to spend most your day hunting a meal is long gone.

        But yes, I do believe we are getting lazier. We are not too far from being George Jetson. Pushing buttons is a hard days work.

        1. I’d put a huge amount of blame on public entitlement programs and that whole mentality – that said, people get what they vote for to some degree.

          1. Public entitlement is only a small portion of the lazy public.

            1. No reason to not also blame the fact that we’re about 5 generations in on being fabulously rich as a nation, and the pattern of such things is that the great grand-babies of hard working producers of wealth tend to be spoiled brats who’ve never worked a day in their lives.

    3. America was, in fact, too full of lazy, immature, “entitled” deadbeats to get rid of the healthcare bill and turn the corner on entitlements

      The shorter question, as I see it, is “Can the republic be saved?”.

  13. Rhetorically, I think it’s funny that you crossed out “completely predictable” and replaced it with “thoroughly shocking”, rather than the other way around. The joke of self-correction wasn’t enough; you wanted sarcasm on top of it!

    1. suck a Reason reporter day?

  14. Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses.

    Duh. And this will obviously happen with the new system, too.

    Even if people only carry “Bronze” plans most of the time and then upgrade them to “Gold” as soon as they get ill.

    The funniest (if it weren’t so depressing) aspect is the way the Democrats repeatedly proclaim how awesome it is that they’ve prohibited insurance companies from turning people down for pre-existing conditions.

    WHAT ARE YOU GUYS A BUNCH OF TOTAL FUCKING MORONS? Of course if you force insurers to “cover” pre-existing conditions people are going to wait until they get sick to sign up. Its so obviously predictable that an 8-year-old could figure it out.

    Like anyone would buy car insurance if you could phone them from the road side and buy coverage after an accident.

    “Hello, GEICO, I just totaled my monster truck while running into a bus full of school children. Can I upgrade my coverage from the state minimum? What’s that? The screaming is making too much noise, shut up kids! bunch of whiners… hello, yeah, I now want the maximum coverage …. oh you say state law requires you to have no upper limits on payments. Awesome.”

    1. Of course if you force insurers to “cover” pre-existing conditions people are going to wait until they get sick to sign up. Its so obviously predictable that an 8-year-old could figure it out.

      Either Matt Yglesias or Ezra Klein had a post recently about how most people aren’t cynical enough to do this. Draw your own conclusions about the Yglesilein.

      1. People feel a moral obligation not to game the system when the communal insurance is provided voluntarily, e.g., how in Amish communities, if you break your leg, you can expect the entire community to help pay for your medical bills. No Amish person would be cynical enough to behave recklessly as a result of that (taking turns in their horse and buggy at breakneck speed?), knowing that any negative consequences would be paid for by the community.

        But when the communal insurance is mandatory, people feel no such moral obligation, because there is no real community there. One of the biggest problems here is that the government is trying to take the individual insurance system and trying to turn it into a communal insurance system when no community exists.

        1. It’s amazing to me that the Obama folks are actually counting on the New Socialist Man emerging in America even though it hasn’t done anywhere else in the world – and especially in the places that actually have a thoroughly unified cultural history & identity.

        2. FUCK THE AMISH!

          1. Self sufficiency is the hobgoblin of free people…

          2. The President means this in a metaphorical sense.

          3. You saw Witness too.

        3. By the way, I’m curious if anyone knows this: Is there anything in the bill that lets the Amish opt out of the individual mandate? I know they don’t have to pay into Social Security. Plus, Amish people have religious objections to commercial insurance, since they consider it a form of usury. Will we be seeing Amish Tea Partiers?

          1. The Amish had to go to the Supreme Court to get out of SS, so I would be pretty shocked if the law exempts them.

        4. Also, even if what you say about the Amish is right, the American community — hell, even the Masshole community — is much, much larger than a little inbred Amish village. I imagine the closeness of the community has mucho grande to do with those feelings.

          1. Precisely, and that’s why attempting to cram a communal health insurance system down the throats of the citizens of Massachusetts, let along the citizens of the United States, is doomed to failure. Communal health insurance simply doesn’t scale to that size, especially when it’s the result of a government mandate. People in Amarillo, TX just don’t care enough about people in Portland, OR to pay for their allergy medicine.

          2. x,y|4.5.10 @ 4:41PM|#
            “….I imagine the closeness of the community has mucho grande to do with those feelings.”

            Which is exactly the reason that charity should be local.
            Right now, a large percentage of government charity costs are administrative; determining that the case meets ‘means’ tests.
            Local charity is based on local knowledge. Hence ‘Bob is going through a bad time; he needs some help’, vs ‘Jill is a drunk who can’t hold a job; let’s cover her husband and kids. They won’t blow it on the bottle’.

        5. I imagine that social ostracism pays a very strong role in Amish society. If you did game the system by (say) monopolizing the doctor’s time with trivial complaints, you’d most likely to be exposed to public shunning at the very least.

          However, in the modern medical system, there are no such incentives to avoid abusing the system. Everything is anonymous by design, and if anything costs are actively hidden from patients lest they refuse a treatment.

      2. Right. It’s a system that relies entirely on the good nature of it’s participants to work. Because that kind of thing always works so well in practice.

    2. Hazel,

      We are so sorry, but your policy only covers damages to normal school buses. In fact, the bus you hit was a short bus full of special needs children.

      Because of the additional pathos involved in media reports showing the charred remains of these special children still strapped in their wheelchairs it is impossible for us (the Heartless Insurance Co.) to pay your claim.

      In the future if you happen to run over some snotty high schoolers, we would be happy to pay your claim.

  15. This is just a form of advantage gambling, like jumping onto a progressive slot machine once the jackpot has crossed a certain threshold. There are always ways to turn a profit when people are making bets, you just have to get on the right side. Ordinarily, people winning their bets against insurance companies is a good thing. Their bets were won fairly, in a private marketplace. Now it’s not so good, since their money is coming from people who were forced by the government to make bets that were guaranteed to lose. It’s as if the entire country was forced to pour money into slot machines, and then people who understood how the game worked swooped in to take the jackpot.

    That being said, I’d sooner be the guy who knows the odds and games the system than be part of the group that bends over and makes the sucker bets the government tells them to. It’s unscrupulous, but so is the individual mandate.

    1. Scrupulous? Duh, what’s that?

    2. “bets that were guaranteed to lose” or to win. Depending, if you needed the coverage in a catastrophic situation. Of course that never happens.

      1. That’s the other aspect of insurance, of course. People are willing to pay more than they expect to get out of it because they’re buying peace of mind. Under this model, though, the price of peace of mind is significantly higher than its market value, so it’s still a losing proposition for the buyer.

        1. (A similar dynamic is at work with casino games: People make bets knowing that they are more likely to lose money than win money, because of the entertainment value of gambling. They pay for the entertainment, like insurance buyers pay for peace of mind. Both the entertainment value of gambling and the peace of mind value of insurance are subject to market fluctuations, which affects how high casinos and insurance companies set the odds against the player.)

          1. peace of mind is a valid point but not the only reason to have health insurance. Financial catastrophe is real and there is a reason why no one says, after a disaster: I knew it COULD happen to me. Gambling is playing with money you can afford to to lose and insurance is playing with money you CAN’T and in fact, most likely not have.

            1. That’s true about insurance that’s bought to hedge against unlikely catastrophes, which is what the insurance market dealt with initially. But it doesn’t really apply to the insurance market that we have now, especially when it comes to health insurance. Depending on the policy, health insurance covers things like prescription drugs, doctor’s visits, vaccinations, and so on. These are all predictable expenses, and wouldn’t really be the subject of an insurance policy except for the fact that, because of various government policies, it’s more cost-effective for people to pay for these things through insurance premiums than through savings. These are not catastrophic expenses. Things like broken limbs and even some fairly serious diseases wouldn’t necessarily be catastrophic expenses, either, provided the family or individual had adequate savings.

              But again: The current system punishes saving money and rewards paying these expenses through insurance, so most people use insurance. These relatively predictable events can become catastrophic if you don’t have insurance. That doesn’t have to be the case, but we would have to overhaul the system to make saving money worth the effort again and separate routine health care costs from insurance.

              If people were buying health insurance only as a hedge against financially catastrophic events (early-onset cancer, paralysis, brain damage, life-threatening and debilitating diseases), the price of insurance would be much lower than it is now. Insurance costs so much because it has to cover all medical costs, not just catastrophic events. There’s no element of “hedging” when you and the insurance company both know that you will need to buy (x) medication (y) many times a year, and it’s not really appropriate that insurance companies would be involved in that at all. It’s just an accident that came about because of the current system, and it increases costs by adding a middleman to routine purchases. Imagine if you could only obtain food through “food insurance” thanks to a somewhat ridiculous accumulation of government policies: You’re covered in the event of a catastrophic economic event that renders you penniless and unable to purchase food, but you also have to pay through the insurance company under ordinary economic circumstances where you ought to be able to pay your own way. This is what weird government distortions have given us in the health care market, and that’s part of why it’s broken.

              1. I really don’t see how the current system punishes for saving money. I’m not sure, I buy the argument that you use more hc because it is available. Do you want to spend more time at the doctors than necessary? Is it that you are referencing patients unwilling to use generic vs. brand medications? Insurance offers discounts on drugs that make it foolish not to avail yourself of the savings. I think your food analogy fails but exemplifies why health care is unique. Consumers have the option of growing their own food and that is not the case with medical care. I agree that heath care is distorted but the vast majority of people won’t break their insurance addiction. I prefer to have only catastrophic heath coverage with income protection, dump the AMA, have physicians and hospitals publish rates, give hospitals some control over patients who abuse emergency room services, tort reform and most important to me, the protection of those in our society who cannot fend for themselves.

                1. @chances r:

                  The tax code favors employer-provided health insurance as employees are not taxed on the benefits and employers are able to deduct their contribution to the premiums.

                  If you would prefer to pay for routine medical bills out of pocket and save for a rainy day, you of course have to do so with after-tax dollars.

                  The only exception to this is with HSAs and who knows what will happen to them…

                  1. the tax issues completely slipped my mind but then, I use a HSA.

    3. How is it unscrupulous?

      1. It’s unscrupulous because the money you gain from gaming the insurance market is money that was put into that market by a government mandate. Relatively healthy people who obey the mandate are losing more money when they buy insurance than they would have in a free market, so people who game the system (including insurance companies themselves, obviously) are sucking up money that was put in there by force.

        It’s more of a gray area that something like, say, straight-up welfare fraud, but you’re still taking advantage of a government policy that scams people who don’t know better. It’s like a bank deliberately setting the payout rate on a CD to below the inflation rate, so that they turn a greater profit on people who don’t realize that they’re actually losing money in the long run. It’s not the most egregious thing to do, but there’s still something a little wrong about it.

  16. given that the individual mandate appears to be nearly unenforceable

    1) given that the income tax mandate appears to be nearly unenforceable

    2) Could it *possibly* be enforced by not covering people who do not purchase the mandated insurance?

    1. Not if the politicos want to keep their jobs and not get into scandals of millions of people not covered even after a year & a half of claiming that this legislation would cover everyone in the US.

      1. I do think both parties will fight over who get to make the fixes. Republicans are generally pro-responsibility. That’s why I think they will propose tighening up the mandate so people can get around it. Many dems will complain that it hurts the poor, lower, and middle clasess. That’s something they should have thought about before handing the country’s health care to politics.

        Worst friggin piece of legislation in my lifetime since the P.A.T.R.I.O.T. Act.

        1. “”That’s why I think they will propose tighening up the mandate so people can get around it.””

          Ooops, that should say tightening up the mandate so people can’t get around it.

        2. Worst friggin piece of legislation in my lifetime since the P.A.T.R.I.O.T. Act.

          Give it time, it is still early.

    2. Hmm, could it *possibly* be enforced by not covering the uninsured with preexisting conditions? That’s an interesting question. If only there were some type of system that encouraged people to be responsible and purchase coverage before they need it…

      1. What a fescinating novel concept. Give people an incentive to purchase an insurance *before* they get sick. Why didn’t anyone think of that before?

        1. I’m telling you, this is groundbreaking stuff. Rich is on the bleeding edge of healthcare reform ideas. You saw it here first, folks.

  17. In a completely predictable thoroughly shocking development, it appears that many Massachusetts residents are taking advantage of the state’s strict health insurance regulations by buying insurance right before they need expensive procedures and then cancelling their policies soon after.

    To the progressive, this is a feature, not a bug. So you’re not going to convince anyone that the Mass. plan is bad because of this revelation.

  18. why does adoption cost one red cent when a child needs a home?

    Just put them in a cardboard box with a “FREE KIDDIES” sign, in front of the grocery store.

    1. I’ll give them a good home.

      I promise.

    2. By “cardboard box” I assume you mean “fertility clinic.”

  19. In a completely predictable thoroughly shocking development, it appears that many Massachusetts residents are taking advantage of the state’s strict health insurance regulations by buying insurance right before they need expensive procedures and then cancelling their policies soon after.

    To the progressive, this is a feature, not a bug. So using this as a revelation the the Massachusetts plan is bad is a non-starter.

    1. Even though it means that the plan is completely unsustainable from day one and it leads to a quick consumption of resources, no incentive to supply more and thus an end result of poorer quality and lower access to health care for all? Oh… No, you’re right.

      1. See posts by MNG.

        1. Dude, one can think health care can be a right and oppose Obamacare. I do for instance.

          To take an analogy, just because you think trespass is wrong doesn’t commit you to any proposed scheme for combating it…

  20. I live in Mass. I have Blue Cross Blue Shield. Between myself and my empolyer we pay about $1800 a month in premiums! so $1000 a month a claims and they’d still be doing good. I haven’t been to a doctor in 4 years. I’m used to getting screwed though.

    1. Why do you pay for that ?

      At $1800/month, it’s much cheaper to pay out of pocket, except for extreme circumstances you can cover with a cheaper policy.

      Shit, for $1800 you could get a fucking MRI once every month or two out of pocket.

  21. Insurance companies could make you sign a contract for a few years. That’s wouldn’t help much, but some.

    Hey, if you cable or phone company can lock you in for a couple of years, why can’t an insurance company?

    “”and he had a very interesting discussion about whether America was, in fact, too full of lazy, immature, “entitled” deadbeats to get rid of the healthcare bill and turn the corner on entitlements.””

    That fits Rush’s narrative. He doesn’t want to acknowledge that there are many supporters that are middle class struggling for health care.

    Of course when the republicans take office again, he will hail the republicans’ modifications to the law as a victory against Obama and socialist.

    I would be curious what Rush said about health care mandates when the republicans suggested it in the early 1990s. Most republicans don’t really hate it for its content. They hate it because of Obama. That will become evident within the next 10 years.

    1. That’s why we don’t vote for republicans either.

      1. Why is it that so many posters never seem to pick up on that.

        BTW, where’s Scotch Hamilton/MNG today? I wonder if that’s the person starting a sentence via their handle? (e.g., https://reason.com/blog/2010/04…..nt_1643556 )

  22. Adding to Fluffy’s very spot-on comment above, I’d like to point out that if we agree that healthcare is a “right” then costs be damned. This is the corner that progressives have painted themselves into…

    They can’t complain about rising costs, as long as everyone gets healthcare.

    Britain (to just name one) has in essence, made the libertarian argument for us.

    You can be denied coverage based on cost. So therefore, healthcare can’t be a right because, as fluffy so aptly put it, that reintroduces those dirty concepts such as earning and deserving.

    Furthermore, the bullshit notion of ‘rationing’ that progressives have collectively decided isn’t a bad thing also proves that healthcare isn’t a right. You don’t ration ‘rights’. Everyone gets them equally. ONce you start rationing, it’s no longer a right– it’s something that is earned or deserved based upon status.

    1. I’m sorry, but there’s simply not enough money left for you to be able to speak your mind and exercise your right to speak your mind.

    2. Oh that’s silly, just because something is a right doesn’t mean costs-be-damned. Private property is a right but there are times where we will draw the line at public expenditures to protect it (think of a natural disaster, and if we spent a hundred times what we do we may be able to save x amount of damage, but the costs is just too high so we let it happen).

      1. * sigh *

        sticks head in oven

        1. What, you don’t think you a right to property? Do you think this means that public funds could be limitlessly expended to prevent a small part of your land from eroding under a flood?

          1. Individuals have a right to own property. Individuals do not have a right to others paying for protecting or providing property.

            1. a property right deserves only negative respect from others?

              So you’re against a police force then?

              1. Well, the police are supposed to enforce that negative respect. But since the police seem to have benefits to my liberty and property in a negative direction…

                They are of extremely low utility in getting my stuff back anyway.

              2. An extortionist one, yes. That granted, I’d be happy to let the chips fall where they may and to let things sort themselves out over time. The vote — people choosing between two or three different thugs — can hardly be described as an effective feedback mechanism.

          2. Right are to protect your property and your body against aggression and theft, MNG, not to supply you with “stuff” at all costs.

            You don’t have a right to have whatever property you want, you have a right *not* to have that property taken from you by force.

            Natural disaster doesn’t qualify. This is why those of us in libertarian world do not support things like federal flood insurance which subsidizes people doing stupid things with their private property at the expense of others.

            Fail, MNG… Fail.

            1. Look, we don’t need to stick with natural disaster. If someone comes and squats on my land he violates my property right. We should call the cops to have them come defend my right. The cops are funded by us all, this demonstrates some recognition that it’s ok to compel people to support the rights of others.

              But we don’t expect limitless support by the cops for our rights, just as the believer in health care as a right doesn’t expect limitless support for health care as a right.

              1. How is any of this related to the right to healthcare? Squatting on another’s property is tantamount to theft. That’s what the government does, it keeps other citizens and the government itself from stealing that which belongs to other people. That’s how it protects our rights.

                But providing healthcare is not protecting a right. It may be compassionate, it may be fair, and heck, many libertarians have no problem with various state laws which mandate emergent care for people entering an E.R.– even if those things distort the costs as well.

                But once you declare something like healthcare- or the provision thereof a right, then how do you limit the provision of said right without violating that right?

                Even the Canadian Supreme court slapped the Canadian government down on its own healthcare system on this VERY SAME argument. Canadian government declared healthcare a right. Because of the crushing waiting lists, they were essentially not providing healthcare, thus violating the right of Canadians. So the Supreme Court ruled that they either clean up their nest, or they legalize access to private care options. That’s the point.

                1. It’s tanamount in this sense: you think there is a property right that might require a positive response in its protection/assertion, and I say that for those who think health care is a right the same thing applies.

                  Yes, yes, we get that you think the first right is valid and the second one is not, but we’re on a second order argument here dude.

                  If you want to debate why we have a right to property and then I tell you why we have a right to health care, then let’s roll on that. My point was that given people like me see a health care right we can treat it like you guyd do your rights…

              2. Except that I would, and many people do privately pay for security services. Banks do, casinos do, rich people in Beverly Hills do… People out in Montana with shotguns can do it on their own.

                I expect that my property is secured either with the help of the police which my taxes fund, and failing that, that I have the right to secure my property on my own through alternative means such as the above mentioned options.

                The fact is that the right to my property is unlimited – although like any rights, that can be violated through the initiation of force by some other person.

                Health care is the OPPOSITE of this.

                Providing a good or a service as a “right”, is directly contradictory to the very notion of property rights. Since now, I expressly don’t have the right to my property if I happen to be a doctor or a manufacturer of health care-related products.

                You’re severely confused on what does and does not constitute a right, MNG.

                I’ll say it once more – my right to property is *not* defined by using up police resources, but by my moral authority over the things I own. It’s about whether or not I have the legal and moral ability to defend myself and my property from aggression – NOT whether or not one means or another of accomplishing that is unlimited.

                1. You claim to have moral authority over what you own, and I claim to have moral authority to get needed health care. We can do this all night. You’re right is no more defensible than mine.

                  And you’re right to control your property is limited. You can’t shoot someone for stepping onto your property. And while you agree we can compel people to support a police force to enforce negative rights, and while you agree that those rights are not somehow incoherent because scarce resources mean we don’t defend these rights in an unlimited way, yet you still think there is some problem with people claiming health care as a right in the fact that limits will have to be recognized. Again, this is a problem any system of rights faces, positive or negative.

                  1. Except that for me to maintain my right, all I need do is exist on my own terms without imposing anything on anyone.

                    Your “rights” require you to become an aggressor and take from others.

                    Thus, your sense of “rights” come into direct contradiction of human beings as autonomous masters of their own bodies the product of those bodies’ labor – i.e. property.

                    You don’t get to have it both ways MNG, and you don’t have a higher moral justification than I have because your conception ends with theft & slavery and an increase in the amount of violence & force being applied to human interactions rather than less, as negative rights do.

                    1. Well, it’s true I don’t think “force and theft”, i.e., coercion to be the ultimate sin. If it ameliorates human misery then it’s justified. Increase in violence is outweighed by decrease in human suffering, at some point…Because I care about human beings like that.

                      And of course, if you think there should be any governmental effort to combat violations of negative rights, then I can fit my positive rights in the same place. You compel X to pay officer Y to protect Z’s property, I compel X to pay doctor Y to provide Z with health care…

                    2. First off, again… No, forcing people to pay for other people’s health care isn’t the same thing as paying for police services. Look up the definition of “public good”, and you will find that a big chunk of that definition is the whole “non-excludable” bit, which applies to police (since they can’t protect some people in emergencies and not others) and does NOT apply to the vast majority of health care… AND… the “non-rivalrous” part also doesn’t apply to health care.

                      Regardless, you already know – and I mentioned above – that I don’t support coercion in the funding of police protective services and rather favor multiple, competitive private options for protection of property & life ranging from the carrying of firearms & installing locks and security alarms on one’s doors, to hiring companies such as On-Star or Lo-Jack to keep track of big but mobile property like your car, to paying for insurance to hedge against catastrophic loss due to theft or natural disaster… All the way up to hiring private security and forming community groups, depending on what your needs are.

                      There are a thousand ways to deal with property protection voluntarily, but you’ve still managed to skirt the fundamental issue – which is that of *rights*, not of how you pay to protect them, but what they are at root.

                      They are most definitely not synonymous with “giving people free shit”.

              3. MNG|4.5.10 @ 4:59PM|#
                “If someone comes and squats on my land he violates my property right. We should call the cops to have them come defend my right. The cops are funded by us all, this demonstrates some recognition that it’s ok to compel people to support the rights of others.”
                OK, there are those few areas where we, as individuals cannot provide the service we need.

                “But we don’t expect limitless support by the cops for our rights,”
                We should; but they’re wasting time busting the kid with an ounce of dope. Shame on them.

                “just as the believer in health care as a right doesn’t expect limitless support for health care as a right.”
                Wrong.
                You can no better define “healthcare” than you can separate “need” from “want”.
                Any supposed “right” to “healthcare” is a blank check on the treasury.
                So you’ve both failed on defining “need”, and you failed by comparing an unlimited “right” to an economic good to the process of enforcing property rights.

                1. What are the limits to the property right? We can compel people to pay for a police force to eject squatters and arrest robbers. But should we pay to provide protection from natural disasters or mass riots which destroy property? The support this “right” can compel is limited.

                  The same with health care. The right to health care simply means that people are going to get some help on that, some limited help, like we do all rights.

                  Of course need I repeat that anyone with a dictionary already knows the difference between needs and wants. Needs are objectively related to survival and/or flourishing, wants are not, they are mere preferences. At times they may overlap, but they are not the same thing.

                  A person needs air to live. A person can want an ipod. If the person doesn’t get the former he dies, the latter, it’s all good…

            2. “”This is why those of us in libertarian world do not support things like federal flood insurance which subsidizes people doing stupid things with their private property at the expense of others.””

              Your not saying it’s people’s fault they get flooded are you? RI has experienced the worst flooding in over 200 years.

              But I was shaking my head when I heard residence of Riverhead Long Island want FEMA to buy their flooded homes. The first thing in my mind was, have flood insurance?

              But in a way, what can you expect. The government bails out muli-billion dollar companies, so natural those with less await their bailout when they are in need..

              1. Your not saying it’s people’s fault they get flooded are you? RI has experienced the worst flooding in over 200 years.

                What he’s saying is that the government subsidizes flood insurance premiums and makes them cheaper than they otherwise would be.

                In a perfect world, if someone wants to build a house next to a river and also wants insurance, then the cost of that insurance should be astronomically high and should, theoretically, cause the person to choose to build his house elsewhere.

                People not having flood insurance in areas that don’t traditionally flood is not quite the same thing.

              2. You’re missing the point entirely.

                You don’t have a “right” to flood insurance, and you certainly don’t have the “right” to force other Americans to pay for your flood insurance.

                You have a right to protect your property – and as a result, one way some people will elect to do that is by A. Not building in flood (or earthquake, volcano, hurricane, erosions, etc.) prone areas, and B. By creating risk pools and insuring against possible (though hopefully unlikely) future disasters.

                Those are only two of many ways though – and you have the right to explore those options uninhibited by government. Likewise, you (should) have the right to build a hurricane/flood proof house, to fortify walls around your property, to clear out trees in the event of a tornado, etc. etc. etc.

                This is NOT the same thing as forcing other people to pay for your protection… The government’s job is fundamentally to protect people’s bodies & property from damages caused by other people. Helping people out during floods and other natural disasters may be more broadly defined as part of that too – but in and of itself, that protection paid for by the taxpayer isn’t what constitutes the concept of the “right” to life & property.

                I hope this is clear enough for everyone – but real rights must be “negative”, in that they are things you are free from. In this case, you are free to own property and do with it what you will without having other people take it from you – that doesn’t mean you are “free” from having to deal with reality and mother nature when you make bad decisions with that property.

                For example – I left my MP3 player in my pocket this weekend and ran it through the laundry. It doesn’t work now. Just because I had the right to protect that property from theft, doesn’t mean I have the right to demand that you all buy me a new one.

                1. The threading makes this unclear, but the above comment was to TrickyVic.

                  1. Really, I didn’t mention anything about rights. And I was, in a way, complaing about people who are either not insured or under insured wanting the feds to buy their house so they can move.

          3. MNG you’re conflating the right to private property with the right to have your private property repaired at public expense.

            Your right to private property doesn’t guarantee you a right to the maintained value of said property.

            However, if ‘healthcare’ is a right, then what are the limits to that right? And if you say ‘cost’, who sets that value?

            The debate that will ultimately ensue will prove the libertarian skepticism with ‘positive’ rights.

            Rights are largely limits placed on government to curtail your liberties.

            If we say you have a right to healthcare at public expense, how do you limit that without creating an entire governmental structure of lawyers and ethicists to determine your worth as a human being as compared to your unique healthcare needs?

            And if your answer includes “make sure the right people are in charge” then we’re done here.

            1. But Paul we regularly set limits on the extent we will work to enforce negative rights (we don’t spend every dollar in the nation to solve every murder, property violation, etc). So my positive right has no more problem here than your negative only ones…Just like the police enforcing negative rights any administration of health care rights will involve priority setting within limited budgets and manpower…

      2. God damn, you don’t even get what property rights mean.

      3. I’ll just go ahead and explain it.

        If it’s real property (ie your land), it’s still yours after the storm/earthquake/flood. And in situations where the storm/earthquake/flood change the boundaries or conditions of your ownership (e.g. the vegetation line on the beach has moved), the burden is on the state, at least under our system, to prove in court (what we call due process) that it’s no longer yours.

        And if it’s personal property (i.e. your stereo), unless the evil Dick Cheney created the storm, then your property rights haven’t been violated by anyone or any agent of the state. That’s why it’s called an act of nature, because shit happens that nobody can control.

        The state not having the resources to protect your property is not the same thing as the state taking it away. This little gem is the one nig thing that you statist morons just can’t seem to grasp. There are some things that preexist and supersede the power of government.

        This is why they are called “natural rights” because they always belong to you, in the “state of nature”, irrespective of government.

        Another man’s labor – let’s say, ummmm, a doctor, is not one of those things.

        1. Again, you don’t believe in a police force? One that would, in Libertopia, defend violations of property and personage rights?

          Or what, this force is going to be funded and organized as a non-profit? Gimme a break. You think its OK to compel people to support the protection of rights, you just disagree with me on what those rights justly are.

        2. Your life and property don’t belong to you in some fantasy state of nature, in fact they are at their most precarious there. Government makes these things tenable.

          1. turns on gas

            1. In a state of nature people have the “right” to take and keep what they can. It’s in the formation of governments that certain property is deeded, backed by government force, to certain individuals. Property systems are creations of governments: this is why nations like Somalia suck. Any nation that doesn’t secure property systems is going to be a terrible nation. But there is no free-floating, pre-existing “right” to property; governments create such rights positively, and the justification is the utilitarian good such systems do.

              1. There certainly are property rights in Somalia.

                Go try and steal some warlord’s AK-47 and then tell him that since there is no functioning government it’s not really his.

                1. Oh, so “property rights” means you have the right to whatever you can take and keep.

                  So you’re fine with Obamacare, eh? Because they are going to “take and keep” your money for health care for others. Somehow I don’t see you pulling a Wesley Snipes there patriot…

                  And remember, you can’t complain, because one has the right to what one can take and keep.

                  And you smugly lecture others on their understanding of rights? That’s Richie Rich buddy.

                  1. Oh cripes. Piss off. You’re hopeless.

                    1. Oh lord, run and hide and enjoy the fetal position with the hands over the ears…

              2. The existence of government force and deeds do not enforce the right of property, either. Property ownership starts with a claim to something that no one else is exercising claim to, enforced by the continual usage of the property and preventing those who do not have a valid claim from using it. If the property no longer has anyone practicing ownership of it, it is available for the next person to claim. Simply possessing a deed does not give one the right to claim a piece of land. Deeds were used in the days of early settlement to claim land that had not even been settled yet, often by people who never even set foot on the land they held the deed for. There is nothing necessarily libertarian about government granted deeds.

                1. Property rights, like contract rights, are meaningless abstract fairy-dust without a government enforcing them.

                  In the state of nature people take and hold what they can. You standing over and pointing to a theft and yelling “unfair” is all very nice, and if that’s all you mean by “natural rights”, that it’s “cosmically” wrong, that somewhere Jesus is crying at the theft, then OK, but whatever. But meaningful systems of property and contract rights rely on government enforcement in the real world. And governments set up such systems not because of their inherent good, but because they promote the general welfare of actual human beings.

              3. MNG|4.5.10 @ 5:55PM|#
                “It’s in the formation of governments that certain property is deeded, backed by government force, to certain individuals. Property systems are creations of governments…”

                False; you’re assuming the result is the cause.
                Governments are merely the aggregation of individuals to protect those individual ‘rights’, not the originator of those ‘rights’.
                Individuals owe nothing to the government; the government is the servant of the individuals.

                1. No government, no laws, no laws, no rights, just people taking what they can. Property rights in a state of nature? Hilarious.

                  To the extent you have any property in your life right now it is property which will be defended in a court of law. Otherwise all you have is possession and some abstract, cosmic sense of it “belonging” to you. And the former, without government enforcement mechanisms, could change the first time you sleep or meet a stronger guy. Then all you are left with is your “cosmic” sense of entitlement, as another enjoys your property…

                  1. Rights are a moral concept, MNG, and one intrinsic to all human beings equally – and in fact, property rights do exist in nature… You don’t have to look very far before you can easily see that theft is almost universally recognized as a bad thing. Governments can be (conceivably) used to protect rights from violations – but the government you propose and endorse does the opposite.

                    YOU are the one constantly advocating “might makes right” here, by asserting rights that cannot exist without first *initiating* force against another person. But again, you are still failing to understand the basic ideas here.

                    My right to life has no bearing on the method used to enforce said right. I maintain that I can protect myself or pay others to protect me completely voluntarily. But your assertion that everyone deserves “health care” for free cannot be accomplished that way according to your schema.

          2. This is actually correct, but not in the way you think it is.

          3. MNG|4.5.10 @ 4:57PM|#
            “Your life and property don’t belong to you in some fantasy state of nature, in fact they are at their most precarious there. Government makes these things tenable.”

            False enough that there’s no reason go bother.
            Just false.

            1. Governments create pacts and systems to provide POSITIVE protection of one’s life and property. Prior to this, in this vaunted “state of nature”, one only has the ability, effort and luck to try to preserve their life and any claims to objects.

              Systems of property law are creations of the state…

              1. Please learn the definition of the terms “positive” and “negative” rights.

      4. Coming from you MNG, the same smug bastard who suggested it was morally correct for a physician to be forced at the point of a gun to provide services, you are the most ill-equipped to lecture anyone about property rights. I truly loath your mindset.

        Shouldn’t you be busy coveting your neighbor’s goat and wishing it dead?

        1. Indeed I do think it morally correct to force a doctor to save another person’s life. You see, I value human life and you don’t. A final, painful end of a life outweighs a brief coercion. You’ve fetishized coercion so that it excludes all other sane human values. What can we say about psychopaths/pharisees such as yourself?

          1. Science you are a douche.

            There is a chasm, larger than the one between your ears, between “health care is a right” and “saving another person’s life”. How did you come to be such an absolute turd?

            1. Ah, so you admit we can coerce someone for the imminent saving of another?

              Take my hand my crazy right wing friend, we are about to take a walk.

          2. Logic FAIL MNG.

            Please don’t light a match as your fetish for strawmen may deprive you of your orgasmic release involving your fetish for them.

            I provide medical services for who need them and those that can pay, as I am entitled to receive compensation for my services. It is up to me to provide charity service for those in need, AT MY DISCRETION.

            Since the state in which I practice still has “Good Samaritan” law on the books, I would assist in the event of an emergency for someone in emergent need. I’ve done it before. But I’ll be damned if you are going to hold a gun to my head to force me to do it.

            You have no business telling me whether I value human life or not. When you can personally attest to the difficulty of giving a patient or family bad news or when a family member expires unexpectedly, then and only then you may lecture me on medical ethics.

            And you my friend with your 120 H&R personalities is the pot calling the kettle black attempting to DX a mental pathology in ANYBODY.

            You truly sicken me.

            1. So you would do it because a law is on the books, which is just coercion, but not with the gun at your head?

              It doesn’t matter, the point is that if you, at your mere discretion, allowed a fellow human being to needlessly suffer and die, then you would be a moral monster. And it would be my duty to kick your ass until you did the right thing. And it would be the right thing for me to do. And this is because imminent threats to human well being trump minor restrictions on autonomy. Only an anti-human monster who cares not for actual human welfare can hold otherwise.

              1. No MNG.

                The “Good Samaritan” law protects me from lawsuits and legal ramifications that may arise from a poor outcome in response to emergent intervention, i.e. mortality or morbidity.

                That is an INCENTIVE. I would be much more hesitant to intervene if the threat of a lawsuit was hanging over my head for intervening and a poor outcome results without the benefit of that legal incentive and protection. This is in the context of intervention in a non-clincal environment, discovering, say, a blunt force trauma victim on the street, an MI victim in a restaurant, or driving past a motor vehicle accident (all three scenarios I have personally responded to).

                The most glaring flaw in your logic is the the threat of “kicking my ass until I did the right thing” while attempting to kick my ass (and you just try it buddy boy) would prevent my intervention anyway. Not to mention that what described is a crime against my person.

                Only a self-centered, self-righteous person with a slaveowner mentality conjure up such delusions of grandeur and moral arbitration.

                1. It takes no delusions of grandeur or moral superiority to know this: if you could end imminent, terminal suffering of another human being and you choose not to, then you have done an evil thing. And the use of force to prevent an evil act is justified (i.e., self defense laws). Your relatively minor claim to be free of coercion is outweighed by the welfare of the person who needs your help.

                  1. On what logical grounds then, do you justify the fact that you have more than you absolutely need? The spare resources you command could, and should by your above reasoning, be used to help people who are in dire need of help. I am truly curious — how are you drawing the line?

                    1. “On what logical grounds then, do you justify the fact that you have more than you absolutely need?”

                      er, that noone is perfect? I mean, are you doing everything, everything you possibly could to promote libertarianism? Sold your home, new car, going from place to place to gather petitions while sleeping in (privately owned of course) parks?

                      I doubt it. Heck, I bet you even drive on public roads funded by theft and coercion and sometimes go to your local library which is not described in the Constitution, yada, yada.

                      The inability of someone to live up to a creed does not invalidate the creed…

                    2. I was not referring to your personal ability in this; that is a question for private charity. You are being very opaque in the preceding discussion as to your reasoning — it is not the black & white question you present, and I am looking to learn some of the subtleties to your thinking regarding where the limits to government takings ought to be, and why.

                      So, to make it as clear as possible: you have basically argued above that (a) if ‘human well being is imminently threatened’, then (b) forcible expropriation with the object of rectifying the situation is generally justified. My question is: as many persons currently exist who satisfy requirement (a), and as you and I are both currently in possession of resources which qualify for seizure under (b), then, to which extent and on what grounds do you or do you not support such seizure?

                  2. And people accuse doctors of having a God complex.

                    So, with your logic let’s examine a very real scenario. Let’s say I have a patient who is in a nursing home, skilled care, languishing from an advanced case of cancer, terminally inoperable. Said patient will be excruciating pain even with the pain management techniques and drugs at my prescriptive discretion. The patient has expressed a desire to die, with witnesses and in writing countersigned with licensed witnesses. However, the law prevents me from doing so; I cannot execute a suicide legally. Now, I could prescribe a lethal dose of opiates to end her suffering. It would certainly be quicker than pharmacological comfort measures and letting her expire of starvation and dehydration. I opt not to because it’s against the law and to jail I would be going because of immoral laws (IMO) against euthanasia.

                    Are you positing that I should administer the lethal dose because of your righteous moral indignation? Yes, you would. I refuse. Then do-gooder MNG says I should have a gun stuck to my head and administer said lethal dose, resulting in a lost license to practice and assured jail time. Since you are of such impeccable moral fiber MNG, you should cut through the middle man and shoot the cancer patient yourself.

                    So, really MNG, who is the real anti-human monster here? By your logic, I have every right to expect of you to take a semi automatic gun and hop yourself to a local hospice and pull reenact the shoot out scene from Scarface.

                    You are beyond contempt MNG.

                    1. *pull a reenactment of*

                    2. This is a bizarre analogy even for you Groovy. You keep backpedaling from the original example: there is a man in terminal illness, suffering, you could save him with a minimal amount of your time and effort. It’s wrong for me to force you to do so if you choose not to? That’s inhuman.

                    3. and, er, since part of what we are debating is what the law SHOULD be you probably should not cite what the law IS as a convincing reason to counter whether you SHOULD do x or y…

                    4. In my opinion, yes it is wrong for you force me to do so. If the man has a terminal illness, suffering, and suddenly goes into cardiac arrest or renal failure, yes (absent a DNR and AD specifically stating what end of life care is to be administered) of course I will employ heroic measures to do so. It’s my responsibility and contractual obligation to do so; I accepted the responsibility to treat the patient and that’s what I do. That’s a de facto standard of ethics. You are arguing in bad faith MNG; you are trying to impose force (physical force) to an over simplistic model uniformly and guess what, medicine doesn’t always work that way.

                      BTW, if you physically threatened me while I was pursuing my course of duty, within a clinical environment, I can opt to terminate a patient/doctor relationship faster than you can say assault. You are then free to find another physician.

                      Douche.

                    5. As for law, I might suggest you look up the “Good Samaritan Laws” in your state.

                      If it is Mass. where licensed providers (Docs, Nurses, EMT’s) are required to respond to emergent situations, such as a multi vehicle accident, off hours, then you have legitimate grounds to gripe as the licensee agreed to those terms upon being granted licensed status.

                    6. My analogy is not bizarre. It is a quite real situation. Hundreds of thousands of patients are receiving treatment for chronic and terminal illnesses every day experience this. My job is to help alleviate their pain and suffering and cure disease when possible in the clinical environment.

                      The point is it is my responsibility to provide care to the best of my ability as I see fit within accepted ethics and guidelines. One that I freely choose to do and not at the point of a gun. IF you are so concerned about imposing your will and medical judgment upon others MNG, maybe you should apply to medical school and you can save the world.

                      Somehow I doubt you have the constitution for the sight of blood.

                    7. “And people accuse doctors of having a God complex”:-(

                    8. That hurt. I think you know better than that.

                      However, many do.

                      I don’t.

                    9. & corrected the written record

                    10. Thank you, it means much to me. You are a treasure among treasures. I think very highly of you.

                    11. un lien en Bolivie. Je n’?tais pas s?r vous l’avez trouv?, car vous avez laiss? sans r?ponse

          3. MNG, [i]Indeed I do think it morally correct to force a doctor to save another person’s life. You see, I value human life and you don’t.[/i]

            I went into engineering though I could’ve gotten into med school. Am I a moral monster that doesn’t value human life? After all, how many people would’ve lived if only I had pursued the training to save them–instead of wasting time learning how to make stuff out of concrete and steel to keep them dry? If a patient has a moral claim to a doctor’s time–i.e., if the doctor should be forced to treat him–then should I also be forced to learn to save lives since I have an aptitude for it? If nobody voluntarily went to med school anymore, should I then be coerced to go for the greater good?

            1. Even engineers increase overall welfare in their own way, so yes, it’s just fine you went to school for that…

              1. Anybody can design a building that’ll stand up and stay up–just look at the old cathedrals and castles scattered around Europe. Engineers are valuable because they are able to apply the principles of mechanics in order to deliver safe buildings with fewer materials at lower prices, but legal requirements aside they’re hardly essential to the construction process. What I’m trying to get at is that if push comes to shove, should I be forced to provide medical services instead of engineering services since the former has a more direct influence on social welfare, whereas the primary function of the latter is simply to save rich people’s money? Isn’t it even immoral for me to cater to the wealthy while there are still people that are in critical need of medical care?

              2. We’re all thankful for your laudable permission for fsuenginerd to go to engineering versus medical school.

                Now if you would please assign the other 7 billion of us humans living on planet earth our job-chips, that would be great…

                Asshole.

              3. fsuenginerd could have saved lives by constructing stable buildings in Haiti. But he didn’t value human life, resulting in massive casualties, the evil cocksucker him.

                1. Holy hell, you’re right…I’m doubly immoral. Not only do I allow people to die by not being a doctor, but I also allow them to die by only delivering stable building plans to people with money. Clearly I’m evil and suck the cock of life. Somebody needs to put a gun to my head pronto and force me to value human life–please, think of the children.

              4. You know what? Some unethical academic piece of shit never seemed to be able to get around to putting down the god damned scholarly journals about altruistic utilitarian ethics, and instead use his great gun pointing talents to make fsuenginerd travel on humanitarian missions to Zimbabwe. What a fucking selfish lazy autofellating bastard.

                1. Jesus, you’re saying it’s not just me–that others are morally bankrupt from their inaction, too? This is worse than I thought. MNG is going to need more guns.

                  1. Its worse than that, I hear MNG is the most immoral one of all. Here he is with his terminal degree, and all this vast knowledge on how everyone should best be forced to serve the welfare of mankind. But he just sits on his computer, totally not using his guns to force us to design septic tanks for playgrounds in India.

                    1. Oh god, Indian children are playing on playgrounds without septic tanks because MNG is a lazy fuck that won’t use his guns? What kind of world do we live in? Who’s going to force him to put his knowledge to work by using his guns to force the rest of us to serve the welfare of mankind?

                    2. MNG has gone to bed

          4. MNG|4.5.10 @ 5:48PM|#
            “…You see, I value human life and you don’t…”

            Did they cover ‘poisoning the well’ in your post-grad classes?

  23. goddammit, I meant to hit preview

  24. “”I’d like to point out that if we agree that healthcare is a “right” then costs be damned. This is the corner that progressives have painted themselves into…””

    It’s a horrible corner too. Because costs can’t be damned. That’s the lesson from every country, and state in the US, is learning. Then you need corrective measures, which I don’t think exists, at least not one that doesn’t screw it up in a different way. You either cut services, raise revenue, or both. Neither serves the goal of universal affordable health care.

    This isn’t over, it’s just the beginning, we will see modifications for years to come.

    1. Healthcare — It’s the new abortion.

      1. Abortions are a right.

        1. Reply Here.

      2. So much so it will probably be illegal in Kansas.

  25. Bitch, bitch, bitch. Look, even if you don’t care that 45 million other Americans don’t have health care coverage, if you DO care about our deficits then you should support health insurance reform because it’s cheaper in the long run as opposed to the old system. No, the new system is not perfect. Yes, it will have to be tweaked for years to come. But what the heck are YOU suggesting instead? Nothing, that’s what. You’ve got a better idea? A way to improve matters? Then say it. Penning an article just complaining for the sake of complaining is self-indulgent and intellectually lazy.

      1. C. Maybe a C+.

        Really? I thought it was pretty weak. Where is the railing against the rich? He didn’t even mention profit or use the word greed. He included the way over-used “what are you suggesting? Nothing!” tripe and the absurd “it saves money” as well. Jacking the number of uninsured by 50% is worth a few trollpoints but still only a D, D+ at best.

        1. Jacking the number of uninsured by 50%…

          The number of uninsured mentioned in polite company has dropped by a third because there is no attempt by the HCR legislation to cover that third.

          When campaigning about the problem of uninsured Americans, there are 45 million of them. When campaigning about the solution, there are 30 million of them.

          Pay no attention to those goalposts behind the curtain!

    1. then you should support health insurance reform because it’s cheaper in the long run as opposed to the old system

      Reform probably is cheaper, by definition.

      “Reform” (aka Obamacare) is not.

      But thanks for playing.

    2. But what the heck are YOU suggesting instead? Nothing, that’s what. You’ve got a better idea? A way to improve matters? Then say it.

      Read the fucking archives. It’s too late to keep yourself from looking like a dumbass, but you might still learn something.

    3. But what the heck are YOU suggesting instead?

      Gary Becker has enunciated the gist of the politically possible reforms very well

      “The health-care legislation? It’s a bad bill,” Mr. Becker replies. “Health care in the United States is pretty good, but it does have a number of weaknesses. This bill doesn’t address them. It adds taxation and regulation. It’s going to increase health costs?not contain them.”

      Drafting a good bill would have been easy, he continues. Health savings accounts could have been expanded. Consumers could have been permitted to purchase insurance across state lines, which would have increased competition among insurers. The tax deductibility of health-care spending could have been extended from employers to individuals, giving the same tax treatment to all consumers. And incentives could have been put in place to prompt consumers to pay a larger portion of their health-care costs out of their own pockets.

      “Here in the United States,” Mr. Becker says, “we spend about 17% of our GDP on health care, but out-of-pocket expenses make up only about 12% of total health-care spending. In Switzerland, where they spend only 11% of GDP on health care, their out-of-pocket expenses equal about 31% of total spending. The difference between 12% and 31% is huge. Once people begin spending substantial sums from their own pockets, they become willing to shop around. Ordinary market incentives begin to operate. A good bill would have encouraged that.”

      1. Becker’s right. There are many ways to tweak the cost curve but really only two to bend it. One is rationing and denial of care. The other is for the individual consumer (including those in public programs) to have considerable skin in the game.

        Insurance policies that cover routine care with little to no out-of-pocket cost for the individual are not sensible. Back in the 70’s, few policies covered routine care. But, they didn’t need to as such care was reasonably priced and quite affordable for the average individual/family. Say, wait a minute, do I detect a correlation here?

        The first order of business is to determine what happened between then and now to make everything so crazy expensive. I think I know what’s probably at the very bottom of it: the infusion of vast amounts of public monies into the marketplace with the advent of Medicare and expansion of the welfare state that took place in the 60’s. Every time government goes large into something (like, say, higher education), it becomes more expensive. So, how can the answer possibly be to throw in even vaster amounts of public money?

        Something else to keep in mind is that we’ll never be able to get our spending percentages per GDP down to the levels of other nations. (Just as we’ll never be able to get our defense spending down to those levels.) Like it or not, America is the one indispensable nation.

        I read recently that the US is the only country in which pharmaceuticals are sold at a profit. I don’t know if that’s exactly true (it was a respectable publication), but it sounds about right. Other nations are constrained by national health budget concerns and/or poverty. Most drug and medical R&D is done right here. We pay and the rest of the world gets it at cost or below. When we’re no longer capable of funding all this R&D, who will?

        A European dignitary speaking anonymously said that while they over there are always publicly agitating for America to be more like them, they, in fact, don’t want that at all. They know the truth of what I said just above.

        1. “I read recently that the US is the only country in which pharmaceuticals are sold at a profit. I don’t know if that’s exactly true (it was a respectable publication), but it sounds about right.” Did you read this in a Marvel comic book?

          1. Yes.

            1. the boys usually cry:-)

    4. Look, at least we’re not fucking retarded enough to
      A) make a moral issue out of the number of people without insurance
      B) implement a law that increases that number, while also negatively affecting cost and quality for everyone who manages to retain insurance (despite such an outcome being suggested by the historical record)
      C) Congratulate yourselves as champions of virtue because, gosh darnit, you at least tried to make things better, results be damned.

      Progressivism is just a high-functioning form of mental retardation.

      1. It’s just the labor value theory of legislation.

        “Hey, the problem’s worse now!”
        “Yeah, well, at least I did something about it.”

        Come to think of it, that may also explain the length of these bills.

    5. Thomas|4.5.10 @ 5:08PM|#
      “Look, even if you don’t care that 45 million other Americans don’t have health care coverage,…”
      Uh, care to show that number actually *means* something other than a propaganda tool?

      “…if you DO care about our deficits then you should support health insurance reform because it’s cheaper in the long run as opposed to the old system….”
      Pure assertion; unsupported by *any* evidence.
      To put it simply, you used a false claim to make an ever worse assumption.
      It’s possible to be more ‘wrong’, but it would take some effort.

  26. “”because it’s cheaper in the long run as opposed to the old system. “”

    That’s probably not true. There is no proof it is so. Nothing about the law really addresses cost in a reasonable way. For most of us, if you totalled the dollar amount of your health care from cradle to grave, you probably couldn’t afford it. If you can’t afford yours, how can you afford to contribute to anyone elses.

    This law is nothing but a gift to the insurance lobby disguised as a historic acheivement for mankind.

    I would have been happier to pay an extra 3% in taxes to shore up Medicare than the bullshit law we got.

  27. Imposing on others to pay for them isn’t.

  28. Does HCR pay for funerals?

    It jolly well better, because isn’t a dignified funeral the right of every American?

    1. Only the living ones.

  29. “In 2009 alone, 936 people …”
    Dude; there are 6.5 MILLION people in Mass. WTF difference does 1000 make, NO MATTER WHAT THEY DO???
    This is lamest whining shit I ever saw. Leave it to the pros, bra, and hang this shit up. You’re Not Helping.

    1. That’s just the tip of the iceberg, JerryB… The incentives are such that 1000 people in Massachusetts will become a much bigger problem over time, as more and more people realize that those 1000 figured out how best to save money and push costs onto others.

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  31. I guess there are two sides to prevent this bad phenomenon.firstly,the citizen quality have to be improved.after that,the policy hole should be focused on.

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