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It's a tax

Change we can't believe in apparently.
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fry6beeu9.jpgJeremy - 8821 Posts
09/22/2009 @ 12:42:48 PM
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So if he made up another dept to handle processing these fines it wouldn't be tax? If every speeding ticket, code violation fine, or other such thing went through the IRS it would be a tax and not a fine?

So, it's bad that he's "raising taxes" but the solution would be to raise everyone's taxes, and then credit back the amount for which this fine would be to the people with insurance? Who processes it, or what one line out of 100,000 says about it doesn't make it a tax, in any meaningful "we're not looking for ways to bust his balls" sense. Splitting hairs, maybe, but there's a difference between my income tax, and a fine for driving with expired license plates, regardless of who the check is written out to.
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Jeremy screwed with this at 09/22/2009 12:43:51 pm
goodlooking.jpgcraig - 130 Posts
09/22/2009 @ 01:31:31 PM
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I don't see this as a tax, if anything having the IRS collect 'fines' for the government makes more sense than creating a new agency to collect it (though I imagine this program will result in a new agency anyway). Now, I'm not saying I'm crazy about this idea, I think simplifying taxes is the way to go, for most people without investments and a single source of income, 'doing your taxes' should be no more difficult than answering a few questions. Most peoples 'tax form' should fit on the back of a post card.

My real problem with Obama is he's the president, but he doesn't seem to be acting like he's president. Where's the White House leadership on the health care legislation? It seems like Obama is making a few vague speeches about health care reform, but waiting for the congress to actually decide what the bill will include. That's not the way to get things done. He needs to set the agenda, and work with the congress to get the bill he wants. The problem is beyond 'health care reform' he doesn't even seem to know what he wants. Many historians consider Lyndon Baines Johnson the most effective president when it came to passing legislation, unlike Obama he was integrally, arguably obsessively, involved in the contents of the bill, working with/pressuring congress, and getting the bills he wanted through congress. A 'wait and see what congress comes up with' approach is a recipe for disaster.
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craig edited this at 09/22/2009 1:45:48 pm
newalex.jpgAlex - 3610 Posts
09/22/2009 @ 03:30:45 PM
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Well, he's the president, not a dictator. He's not supposed to get to do whatever he wants and to hell with the rest of the government branches.

If you force people to buy something, it's the same as a tax. We're all forced to "buy" roads by paying income/sales tax. Your license plate fee is a tax. I'm not sure what that makes the fine, a double tax? Maybe it's just a fine.

There is a difference between your income tax and a fine for not paying your health tax. You should be comparing fines for not paying your income tax to fines for not paying your health tax, right?

Also just because you get a benefit of health care for paying your health tax, that doesn't make it not a tax. Shouldn't we expect to get some benefit from paying any kind of taxes? There's a novel idea.
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jeremy.jpgJeremy - 8821 Posts
09/22/2009 @ 04:03:00 PM
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Well the effect might be the same (money out of the pocket), and either way you can certainly disagree with what is being proposed but forcing people to have heath coverage, and fining those that don't, is just that. It's not "raising taxes," it's forcing people to buy health care. If, instead of paying your income taxes, you got a bill for your portion of the roads, and another for your portion of the school system, and so on, then you'd have some point, but even then not really, because no one could say "Jeremy owns this 3 foot stretch of sidewalk, and 2 of the computers in the computer lab at Longfellow". As it stands this is no more a tax than "forcing" people to upgrade their TV, or get a converter, was.
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images.jpgcraig - 130 Posts
09/22/2009 @ 04:06:34 PM
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Alex Wrote - Today @ 03:30:45 PM
Well, he's the president, not a dictator. He's not supposed to get to do whatever he wants and to hell with the rest of the government branches.


No one said Obama should make all the laws himself without consulting congress, just that he SHOULD consult with congress and let his desires be known. He seems to be actively avoiding getting involved in the crafting of his own health care bill.

As for the tax/non-tax thing, you're just arguing semantics. If it's collected by the police is it still a tax? Is all money the government collects a tax? Maybe, but I doubt most people think of a speeding ticket as a tax, it's a penalty for violating the law. If the law says you have to have health insurance, and don't, then you pay a fine, how is that any different? The fact that it's being collected by the IRS doesn't, in itself, make it a tax.
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craig messed with this at 09/22/2009 4:13:43 pm
fry6beeu9.jpgJeremy - Always thinking of, but never about, the children.
09/22/2009 @ 04:13:31 PM
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craig Wrote - Today @ 04:06:34 PM
The fact that it's being collected by the IRS doesn't, in itself, make it a tax.


Well, it probably would in definitional terms, but not in any meaningful way.
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fry6beeu9.jpgJeremy - 8821 Posts
09/22/2009 @ 04:32:32 PM
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I guess put it this way: You can call any red cent the government ends up with a "tax" if you want, but the issue at hand is what Obama meant by taxes when he promised they wouldn't go up at all, and I think we all know what those are. I know this sounds like a lame cop out, but it really isn't. You can't really tell me when Obama said he wouldn't raise taxes on the middle class that he meant he wouldn't raise, or allow to be raised, anything the middle class might end up paying. No raises in the cost of permits, speeding tickets, fines for DUIs, costs of drivers licenses/plate registration, hunting/fishing licenses, any fines involved with not paying any of those, tuition to public schools, etc.

Edit: And I realize a difference here is that you don't HAVE to have a fishing license, as you can just choose to not fish. Admittedly, that blurs the lines a little bit, but this still is different than a tax.

Which I guess leads me to:
Alex Wrote - Today @ 03:30:45 PM
Also just because you get a benefit of health care for paying your health tax, that doesn't make it not a tax. Shouldn't we expect to get some benefit from paying any kind of taxes? There's a novel idea.

I think what most people mean by that, and certainly what I would mean by that, is that you get something, directly. Your empire has value added. We all get the indirect benefits of roads, police, and a public school system, but those are public goods. Healthcare is something that adds a more of a direct asset to you. If I gave you the option of paying $3000 a year for healthcare, or $3000 a year to keep the roads in a neighborhood across town in shape, you'd chose the healthcare.
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Jeremy screwed with this 2 times, last at 09/22/2009 4:54:06 pm
newalex.jpgAlex - I was too weak to give in Too strong to lose
09/22/2009 @ 05:12:05 PM
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Jeremy Wrote - Today @ 04:03:00 PM
If, instead of paying your income taxes, you got a bill for your portion of the roads, and another for your portion of the school system, and so on, then you'd have some point, but even then not really, because no one could say "Jeremy owns this 3 foot stretch of sidewalk, and 2 of the computers in the computer lab at Longfellow".


So what can I say? I own x amount of health insurance out of the national pot? That's still somewhat nebulous.
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Alex screwed with this 2 times, last at 09/22/2009 5:36:36 pm
newalex.jpgAlex - 3610 Posts
09/22/2009 @ 05:15:14 PM
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Jeremy Wrote - Today @ 04:03:00 PM
As it stands this is no more a tax than "forcing" people to upgrade their TV, or get a converter, was.


I'm not seeing the parallel here.
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newalex.jpgAlex - But let history remember, that as free men, we chose to make it so!
09/22/2009 @ 05:19:59 PM
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craig Wrote - Today @ 04:06:34 PM
Maybe, but I doubt most people think of a speeding ticket as a tax, it's a penalty for violating the law. If the law says you have to have health insurance, and don't, then you pay a fine, how is that any different?


I'd like to think we could agree that laws saying you can't do certain actions are fundamentally different than laws which say you have to buy something even if you don't want it.
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2887.gifAlex - Refactor Mercilessly
09/22/2009 @ 05:22:36 PM
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Jeremy Wrote - Today @ 04:32:32 PM
I guess put it this way: You can call any red cent the government ends up with a "tax" if you want, but the issue at hand is what Obama meant by taxes when he promised they wouldn't go up at all, and I think we all know what those are. I know this sounds like a lame cop out, but it really isn't. You can't really tell me when Obama said he wouldn't raise taxes on the middle class that he meant he wouldn't raise, or allow to be raised, anything the middle class might end up paying.


If we're going that route, then what exactly did he mean? Only that federal income tax wouldn't go up? He should have explicitly stated that then, no?
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newalex.jpgAlex - Refactor Mercilessly
09/22/2009 @ 05:36:07 PM
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Jeremy Wrote - Today @ 04:32:32 PM

Which I guess leads me to:
Alex Wrote - Today @ 03:30:45 PM
Also just because you get a benefit of health care for paying your health tax, that doesn't make it not a tax. Shouldn't we expect to get some benefit from paying any kind of taxes? There's a novel idea.

I think what most people mean by that, and certainly what I would mean by that, is that you get something, directly. Your empire has value added. We all get the indirect benefits of roads, police, and a public school system, but those are public goods. Healthcare is something that adds a more of a direct asset to you. If I gave you the option of paying $3000 a year for healthcare, or $3000 a year to keep the roads in a neighborhood across town in shape, you'd chose the healthcare.


Hmmm....I'm just going to 100% disagree with this. I use my health care plan less than 5 times a year currently. I drive on the road every day, the food I eat and goods I consume are mostly trucked around the country. A lot of good my healthcare plan is going to do if the roads are so deteriorated that I can't even drive to the doctor. Clearly money for the roads is the wiser choice.
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jeremy.jpgJeremy - No one's gay for Moleman
09/22/2009 @ 08:07:39 PM
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Alex Wrote - Today @ 05:22:36 PM
Jeremy Wrote - Today @ 04:32:32 PM
I guess put it this way: You can call any red cent the government ends up with a "tax" if you want, but the issue at hand is what Obama meant by taxes when he promised they wouldn't go up at all, and I think we all know what those are. I know this sounds like a lame cop out, but it really isn't. You can't really tell me when Obama said he wouldn't raise taxes on the middle class that he meant he wouldn't raise, or allow to be raised, anything the middle class might end up paying.


If we're going that route, then what exactly did he mean? Only that federal income tax wouldn't go up? He should have explicitly stated that then, no?


Well, ignoring the fact that he did, we could also pretend that we live in a country of reasonable people not looking to argue for the sake of arguing over stupid matters of semantics. Well, that would be nice anyway.

Alex Wrote - Today @ 05:36:07 PM
Jeremy Wrote - Today @ 04:32:32 PM

Which I guess leads me to:
Alex Wrote - Today @ 03:30:45 PM
Also just because you get a benefit of health care for paying your health tax, that doesn't make it not a tax. Shouldn't we expect to get some benefit from paying any kind of taxes? There's a novel idea.

I think what most people mean by that, and certainly what I would mean by that, is that you get something, directly. Your empire has value added. We all get the indirect benefits of roads, police, and a public school system, but those are public goods. Healthcare is something that adds a more of a direct asset to you. If I gave you the option of paying $3000 a year for healthcare, or $3000 a year to keep the roads in a neighborhood across town in shape, you'd chose the healthcare.


Hmmm....I'm just going to 100% disagree with this. I use my health care plan less than 5 times a year currently. I drive on the road every day, the food I eat and goods I consume are mostly trucked around the country. A lot of good my healthcare plan is going to do if the roads are so deteriorated that I can't even drive to the doctor. Clearly money for the roads is the wiser choice.


I'll give you a call when the roads in my neighborhood start to go bad then, since you suddenly have this great affinity for spending your money on public works projects that offer you no, to slight indirect, benefits.
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Jeremy screwed with this 2 times, last at 09/22/2009 8:08:43 pm
2887.gifAlex - But let history remember, that as free men, we chose to make it so!
09/22/2009 @ 08:52:54 PM
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What?! I just explained how roads are directly beneficial to me. And I've never said that I didn't want to pay any taxes at all. A decent road system is essential to our way of life (unless you live in the woods and never buy anything from anyone that was ever transported by road), and I don't think anyone's come up with a better way to pay for them yet. Forced health care plans that cover everything for everyone is not essential.

Plus are we talking about health insurance or a health care plan? Is there even a difference anymore? Health insurance I at least want. I don't want a health care plan that pays for everything, because I'm going to pay more in than I'm going to get back. I fail to see how that is beneficial for me.
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2887.gifAlex - 3610 Posts
09/22/2009 @ 09:00:49 PM
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Jeremy Wrote - Today @ 08:07:39 PM
Well, ignoring the fact that he did, we could also pretend that we live in a country of reasonable people not looking to argue for the sake of arguing over stupid matters of semantics. Well, that would be nice anyway.


My bad then if that's what he said.

Let's ditch semantics then. It's still an increase in fixed out of pocket expenses on the middle class right? Tax or no tax, people who don't have health insurance right now will be forced to either spend money on it or pay a fine. Individuals will be losing control of more of their money.
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scott.jpgScott - You're going to have to call your hardware guy. It's not a software issue.
09/23/2009 @ 07:21:35 AM
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Alex Wrote - Yesterday @ 10:00:49 PM
Jeremy Wrote - Yesterday @ 09:07:39 PM
Well, ignoring the fact that he did, we could also pretend that we live in a country of reasonable people not looking to argue for the sake of arguing over stupid matters of semantics. Well, that would be nice anyway.
My bad then if that's what he said. Let's ditch semantics then. It's still an increase in fixed out of pocket expenses on the middle class right? Tax or no tax, people who don't have health insurance right now will be forced to either spend money on it or pay a fine. Individuals will be losing control of more of their money.


So if someone who "chooses" not to have health insurance gets in a horrible accident with tens of thousands of dollars in hospital bills, do you really think that person is going to just be like "oh, don't worry, I'll pay for every penny of this". No, the rest of us who do have health insurance will cover the bill in the form of higher premiums and higher cost of other health care needs. As probably the guy among the higher up nutcanners who makes the least amount of money, I have no problem with people being required to buy health insurance of some kind; it is your social responsibility anyway. If your choice of not buying health insurance causes you to become a burden to society (which I believe it does), then your choice is not a personal decision.
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goodlooking.jpgcraig - 130 Posts
09/23/2009 @ 09:24:08 AM
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Alex Wrote - Yesterday @ 09:00:49 PM
It's still an increase in fixed out of pocket expenses on the middle class right? Tax or no tax, people who don't have health insurance right now will be forced to either spend money on it or pay a fine. Individuals will be losing control of more of their money.


It can be argued that by forcing everyone to pay for insurance, those that already have insurance will no longer have to pay (in the form of higher costs from medical care providers) for the, generally expensive since it tends to be non-preventative or emergency, care of those without insurance. So, for the middle class, most of whom already have and will continue to have health insurance, the costs of medical care would go down since everyone has insurance and the cost of uninsured patients won't be passed on to them. Since most of the middle class has insurance already they potentially stand to benefit from this as some of the costs would now be shifted to those without medical insurance - generally the poor and the young.

That's the theory anyway, but this being a government program (and with all the lobbying and interest groups involved) I've got my doubts that it will actually work out that way.
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2887.gifAlex - Refactor Mercilessly
09/23/2009 @ 01:18:35 PM
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Thank you Scott for emphasizing my point, which in that post was that whether or not it's technically/semantically a tax, it would essentially function as a tax. All people being forced by the government to chip in for the common good.
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jeremy.jpgJeremy - 1.21 Gigawatts!?!?
09/23/2009 @ 02:19:50 PM
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Just because it's "forced" and makes things better for everyone, doesn't mean it's a tax. Sometimes it just falls into common sense. You are living irresponsibly at the cost of those around you if you aren't covered. Lots of places "force" you to have auto coverage too, and, while you do have the, usually impractical, option of not driving, the only thing that really gets you is disaster coverage. With healthcare you're covered for disasters, and you can actually make an appt with the doctor, instead of being brought to the er via Ambulance 5 months later when your condition gets out of control.

Do you count everything you pay for your clothes as taxes? By not allowing you to walk around naked, the government is mandating clothing, are they not?

This is switching gears a bit to more on the issue itself, but look at it this way. A person with a medical condition is going to usually wind up in the hospital one way or another. It doesn't get more expensive than waiting until it's too late, but even if someone has heathcare and that happens, we're no worse off, the "system" pays for it either way. There's no way around this. It pretty much has no where to go but cheaper or the same in the long run, and all this is proposing is that people pay for their own healthcare and take responsibility for themselves, instead of riding on the backs of those of us that do pay. It's the exact sort of thing you would be arguing FOR in different circumstances.
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Jeremy messed with this at 09/23/2009 2:20:47 pm
2887.gifAlex - 3610 Posts
09/23/2009 @ 09:22:40 PM
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Jeremy Wrote - Today @ 02:19:50 PM
Do you count everything you pay for your clothes as taxes? By not allowing you to walk around naked, the government is mandating clothing, are they not?


I don't pay a fee for clothing care (that more than likely would be more than I would spend on clothes otherwise) and then go to the government run clothing store to pick out some clothes. Although I'm sure that plan isn't too far down on the Democrats' list.
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newalex.jpgAlex - 3610 Posts
09/23/2009 @ 09:27:05 PM
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At some level isn't forced auto insurance the same as if Best Buy forced everyone to buy the extended warranty on everything they sell?

Edit: I guess what I meant was if the government forced you to buy Best Buy's warranty, not Best Buy forced you.
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Alex edited this at 09/23/2009 9:28:06 pm
newalex.jpgAlex - 3610 Posts
09/23/2009 @ 09:38:16 PM
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Jeremy Wrote - Today @ 02:19:50 PM
With healthcare you're covered for disasters, and you can actually make an appt with the doctor, instead of being brought to the er via Ambulance 5 months later when your condition gets out of control.


If I actually had a little bit of a savings fund I could pay 1/5th the price for my health care and pay the occasional $200 or whatever for a doctor appointment. Having health care cover everything is like mandatory budgeting. If you really think this is a good idea, then I'm assuming you've responded to those TV adds that offer to cover ALL your vehicle repairs for a "small monthly fee". This isn't the one I've actually seen on TV, but close enough.

http://www.youtube.com/watch?v=c0dgJx_Wi1Y
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Alex edited this at 09/23/2009 9:42:17 pm
images.jpgcraig - 130 Posts
09/25/2009 @ 11:11:20 PM
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Alex Wrote - 09/23/2009 @ 09:27:05 PM
At some level isn't forced auto insurance the same as if Best Buy forced everyone to buy the extended warranty on everything they sell?

Edit: I guess what I meant was if the government forced you to buy Best Buy's warranty, not Best Buy forced you.


No states only require you to buy liability insurance to cover for you getting drunk, high, stupid, or just unlucky and running into bus load of people. You need to have coverage for anyone you hurt, either in your car, or hit by your car, not FOR your car. They don't care if you cover your loss or not (e.g. you can get a policy that only covers people you hit/injure/etc but doesn't cover hail damage to your car or you running into a tree). Whoever you got your car loan from may require you to get compressive insurance, but the government doesn't care about that. Best Buy's extended warranty isn't going to cover anyone you happen to kill with your iPod. So, no they aren't even remotely the same.
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images.jpgcraig - 130 Posts
09/25/2009 @ 11:51:00 PM
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Alex Wrote - 09/23/2009 @ 09:38:16 PM
Jeremy Wrote - 09/23/2009 @ 02:19:50 PM
With healthcare you're covered for disasters, and you can actually make an appt with the doctor, instead of being brought to the er via Ambulance 5 months later when your condition gets out of control.


If I actually had a little bit of a savings fund I could pay 1/5th the price for my health care and pay the occasional $200 or whatever for a doctor appointment. Having health care cover everything is like mandatory budgeting. If you really think this is a good idea, then I'm assuming you've responded to those TV adds that offer to cover ALL your vehicle repairs for a "small monthly fee". This isn't the one I've actually seen on TV, but close enough.

http://www.youtube.com/watch?v=c0dgJx_Wi1Y


Well, sure, but what if that $200 doctors appointment ends up telling you that you've got cancer or some other expensive disease? Then who pays?

Health care is ridiculously expensive. I don't think you realize how expensive it is. I know I didn't until I actually encountered it. Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose. If you (or any other reasonable person) goes to the doctor with a real problem it will almost certainly be over $200 dollars. I don't know what the right answer is, but what we're doing now isn't working.
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scott.jpgScott - 6216 Posts
09/28/2009 @ 09:11:07 AM
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Getting cancer could result in over $1 million in health care costs in less than 2 years.
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2887.gifAlex - I don't need to get steady I know just how I feel
09/28/2009 @ 01:14:19 PM
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craig Wrote - 09/25/2009 @ 11:51:00 PM
Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose.


That's my point though, those kind of very minor issues shouldn't be covered, but things like cancer treatment should. It's one thing if we all pitch in to buy insurance so that if one of us gets cancer that person isn't royally screwed, but I don't want to pay for every hypochondriac's weekly doctor visits.
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newalex.jpgAlex - Refactor Mercilessly
09/28/2009 @ 01:16:20 PM
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craig Wrote - 09/25/2009 @ 11:11:20 PM
Best Buy's extended warranty isn't going to cover anyone you happen to kill with your iPod. So, no they aren't even remotely the same.


So what happens if I'm out in public somewhere and I chuck my iPod at someone and bust their face up? Who pays for that?
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jeremy.jpgJeremy - 8821 Posts
09/28/2009 @ 01:24:29 PM
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Alex Wrote - Today @ 01:14:19 PM
craig Wrote - 09/25/2009 @ 11:51:00 PM
Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose.


That's my point though, those kind of very minor issues shouldn't be covered, but things like cancer treatment should. It's one thing if we all pitch in to buy insurance so that if one of us gets cancer that person isn't royally screwed, but I don't want to pay for every hypochondriac's weekly doctor visits.


But either that hypochondriac already has coverage, or you already are paying for it. All this does it require that they pay for at least some part of their healthcare themselves.
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images.jpgcraig - 130 Posts
09/28/2009 @ 01:34:28 PM
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Alex Wrote - Today @ 01:16:20 PM
craig Wrote - 09/25/2009 @ 11:11:20 PM
Best Buy's extended warranty isn't going to cover anyone you happen to kill with your iPod. So, no they aren't even remotely the same.


So what happens if I'm out in public somewhere and I chuck my iPod at someone and bust their face up? Who pays for that?


Not Best Buy and their extended warranty. I'm not sure what you're getting at with this line of argument. My point is that making people buy insurance to protect others from their negligence is not at all the same as forcing you to pay to protect yourself against mechanical defects in a product you purchased.
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newalex.jpgAlex - 3610 Posts
09/28/2009 @ 01:43:18 PM
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I'm not sure what I'm getting at, and you made very valid points. I think what I've never understood is why you need special insurance for driving a car. You don't have to buy "throwing my iPod" insurance, or gun insurance, etc.
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reign_of_fire.jpgMicah - 584 Posts
09/28/2009 @ 01:51:45 PM
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This is a pretty good article from the recent Atlantic. It makes some good points and even has things that the resident tea-baggers will probably like. It is a little long though, so pony up some time to read.

http://www.theatlantic.com/doc/200909/health-care
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fry6beeu9.jpgJeremy - 8821 Posts
09/28/2009 @ 01:52:39 PM
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Alex Wrote - Today @ 01:43:18 PM
I'm not sure what I'm getting at, and you made very valid points. I think what I've never understood is why you need special insurance for driving a car. You don't have to buy "throwing my iPod" insurance, or gun insurance, etc.
Because it's way easier to accidentally hurt someone with a car. If everyone had a gun there probably would be such a thing.
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jeremy.jpgJeremy - Pie Racist
09/28/2009 @ 04:42:17 PM
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Micah Wrote - Today @ 01:51:45 PM
This is a pretty good article from the recent Atlantic. It makes some good points and even has things that the resident tea-baggers will probably like. It is a little long though, so pony up some time to read.

http://www.theatlantic.com/doc/200909/health-care


That was a good, and long, read. He has my vote, but I imagine it would be a tough sell at this point, for one of the reasons he touches on, and others. Right now "insurance" covers everything, and we pay accordingly. We know we'll cash in eventually, and maybe big time, so the cost doesn't seem like such a big deal. Likewise, with employers covering the insurance, that constitutes a large percentage of our cost to them, in other words, our wage. I have a feeling if all they had to cover next year was true insurance, it would be like homeowners insurance, practically nothing. However, I don't think I would all of a sudden get a 20% raise, I would just be left to spend that much more on my healthcare.

I have a feeling he's oversimplifying things, but I definitely agree that much of what he says needs to be done. The "books" should be opened. Hospitals do have a point about needing to subsidize the ER with something, but his point about their accounting tricks probably has a lot of merit to it, and ultimately his plan would cover most ER visits one way or another.

It's a long article, so maybe I glossed over it, but this would also give people a true incentive to exercise, not smoke, and all that jazz.

We've talked about it on here a few times and reached pretty much the same conclusion he did. (HSAs plus true insurance for disasters.) But I wasn't aware how hard it was to get to get the prices.

I think a lot of the reason for costs is basically what he said, but with less of a conspiracy twist. Sarah's doctor has prescribed a few different migraine meds trying to land on some that work. Sarah doesn't know the price until she goes to pick them up. Some have been $4 a bottle, others are $10 a pill*, and would end up being a major monthly expense if we stuck with it, which isn't really much at our discretion. I don't think that the person prescribing Sarah meds has any sort of ill will in mind, any sort of kickbacks, or whatever, in mind, I just think that for a lot of the medical world the concept of even thinking about the price is foreign.

We have an attitude as a society about healthcare of "whatever it takes." Surely it seems obvious anyone prescribing pills for a condition that has multiple sure-fire treatment options, and especially conditions on a "well, let's see what you respond to" basis, should start with the cheapest options, and go up from there. On the flip side, since being a consumer is hard, if not outright discouraged, we've created a situation where you look cheap, almost on a taboo level, if you inquire about the costs of healthcare. The moral hazard situation, combined with a situation where rational decisions are discouraged by our mores seem to be a perfect storm for rising heathcare costs.

Hospitals can charge $10k a day for the stay, the length of which is entirely at their discretion, and often indefinite, not only because most of the costs are hidden, but also because the idea of NOT paying for something is an idea that we've been conditioned to think is barbaric, when it seems like it's almost inevitable to address the elephant in the room. I don't think anything anyone has proposed thus far is really a "death panel," and I don't think that's the solution. I don't know of there is a solution, or if the solution is to stand pat on end of life care, and other such things, but I do know that the very idea of having a discussion about it shouldn't be off the table.

In the end healthcare isn't much different than many other things you'd consume, with the exception that there are a lot of emotions tied up in it. Just like there's a price that cable tv can be set at where you can no longer justify it, there's a cost for heathcare where that's true, if it's something like chronic pain, there would be a number where it's worth it and a number at which you'd just live with it, or if it's something like end of life care, where money is just being spent because no one wants to be the asshole.**

*I don't know the exact costs here, it's quite possible I'm exaggerating, but there is a significant range for pills intended to treat the same condition, and it's not a matter of just getting the generic or not.

**And trust me, just typing that makes me feel like an asshole. Also, for the record, I might be misusing "end of life care" which could be an actual term that applies to nursing homes and all that. I'm not proposing a Logan's Run type society, when I say "end of life care" I mean the person is bedridden, only alive because of machines, and for all intents and purposes, is already gone.
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Jeremy edited this at 09/28/2009 4:43:45 pm
2887.gifAlex - Ignorance is bliss to those uneducated
09/28/2009 @ 09:02:43 PM
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That guy knows what I'm talking about. The existing system (and further government programs/intervention) are so illogical that it makes my brain hurt.

Jeremy Wrote - Today @ 04:42:17 PM
However, I don't think I would all of a sudden get a 20% raise, I would just be left to spend that much more on my healthcare.


He does suggest a phased transition approach that would take a while to get to the goal. And in this economy you probably wouldn't get all that money in a raise right away. But as soon as 1 or a couple or few companies started offering that much higher wages other companies would have to follow suit.
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fry6beeu9.jpgJeremy - As Seen On The Internet
09/28/2009 @ 09:43:21 PM
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Yes, but surely as a programmer you can understand that for reasons, be they financial, practical, good, or stupidly arbitrary, you can't always just junk a system. Sometimes you have to take the approach, "ok, given this rat's nest, where can we go from here to improve it." Making it so everyone has to have some coverage, and be somewhat responsible for their own coverage, is a step toward what the author is proposing, especally since, without a doubt, it would be about 30 seconds after the "you have to have some sort of health insurance" bill was signed into law that companies would offer ultra cheap "disaster only" type coverage to try and nab those people's money.
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Jeremy screwed with this 2 times, last at 09/28/2009 9:44:13 pm
scott.jpgScott - 6216 Posts
09/28/2009 @ 10:36:48 PM
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Alex Wrote - Today @ 02:14:19 PM
craig Wrote - 09/26/2009 @ 12:51:00 AM
Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose.


That's my point though, those kind of very minor issues shouldn't be covered, but things like cancer treatment should. It's one thing if we all pitch in to buy insurance so that if one of us gets cancer that person isn't royally screwed, but I don't want to pay for every hypochondriac's weekly doctor visits.


I had the h1n1 virus, and I caught of within 12 hours of noticing the symptoms. At the doctor's, he basically said that the people who get in trouble with this are those who ignore the symptoms and don't go see their doctor. I was prescribed a medicine developed quickly for this illness and it wasn't cheap. Had I not had insurance, my medical bill for this visit and the medication would have been close to $300. I don't make a lot money and my wife right now doesn't work (and, I don't have three kids to worry about). An expense like this would have busted a pretty big hole in our monthly budget. So, yes, insurance helps cover for the big things, but to a low income family, just trying to protect your family from the flu can have enormous consequences without insurance.
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newalex.jpgAlex - 3610 Posts
09/28/2009 @ 10:55:29 PM
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Jeremy Wrote - Today @ 09:43:21 PM
Yes, but surely as a programmer you can understand that for reasons, be they financial, practical, good, or stupidly arbitrary, you can't always just junk a system. Sometimes you have to take the approach, "ok, given this rat's nest, where can we go from here to improve it." Making it so everyone has to have some coverage, and be somewhat responsible for their own coverage, is a step toward what the author is proposing, especally since, without a doubt, it would be about 30 seconds after the "you have to have some sort of health insurance" bill was signed into law that companies would offer ultra cheap "disaster only" type coverage to try and nab those people's money.


You're still fighting the marketplace. If companies would just offer it, the people that don't have coverage now that could afford it would probably buy it. Offer people something they want, don't jam it down their throats with government mandates.

As a programmer, I also know that the sooner you bite the bullet the better. Refactor Mercilessly!
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newalex.jpgAlex - But let history remember, that as free men, we chose to make it so!
09/28/2009 @ 11:02:47 PM
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Scott Wrote - Today @ 11:36:48 PM
Alex Wrote - Today @ 02:14:19 PM
craig Wrote - 09/26/2009 @ 12:51:00 AM
Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose.


That's my point though, those kind of very minor issues shouldn't be covered, but things like cancer treatment should. It's one thing if we all pitch in to buy insurance so that if one of us gets cancer that person isn't royally screwed, but I don't want to pay for every hypochondriac's weekly doctor visits.


I had the h1n1 virus, and I caught of within 12 hours of noticing the symptoms. At the doctor's, he basically said that the people who get in trouble with this are those who ignore the symptoms and don't go see their doctor. I was prescribed a medicine developed quickly for this illness and it wasn't cheap. Had I not had insurance, my medical bill for this visit and the medication would have been close to $300. I don't make a lot money and my wife right now doesn't work (and, I don't have three kids to worry about). An expense like this would have busted a pretty big hole in our monthly budget. So, yes, insurance helps cover for the big things, but to a low income family, just trying to protect your family from the flu can have enormous consequences without insurance.


Not sure if you read the article, but half the point is that if you only had major medical you would pay less for your healthcare and be able to save more money up for these types of expenses, and if you have insurance through your employer it would cost them less which in theory means they would pay your more wages.

"Let’s say you’re a 22-year-old single employee at my company today, starting out at a $30,000 annual salary. Let’s assume you’ll get married in six years, support two children for 20 years, retire at 65, and die at 80. Now let’s make a crazy assumption: insurance premiums, Medicare taxes and premiums, and out-of-pocket costs will grow no faster than your earnings—say, 3 percent a year. By the end of your working days, your annual salary will be up to $107,000. And over your lifetime, you and your employer together will have paid $1.77 million for your family’s health care. $1.77 million! And that’s only after assuming the taming of costs! In recent years, health-care costs have actually grown 2 to 3 percent faster than the economy. If that continues, your 22-year-old self is looking at an additional $2 million or so in expenses over your lifetime—roughly $4 million in total."

If you're smart with your $1.77 million, you could pay a $300 bill. And his plan includes forced HSA contributions to make everyone "be smart".
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scott.jpgScott - If you aren't enough without it, you'll never be enough with it.
09/28/2009 @ 11:05:45 PM
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Wait a minute, you guys get pay increases every year? I gotta get me one of those kimds of jobs.
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scott.jpgScott - Ma'am, can you make sure your computer is turned on?
09/28/2009 @ 11:12:03 PM
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But forced health savings accounts would be the government forcing me to save for things I don't want to spend my money on. Why are you attacking my liberties. Plus, I'm not convinced that HSAs alone would help the low income families who have jobs that either don't provide health care or if they do, not very good insurance.

Part of the point of health care reform I always thought was not to help those who already can afford insurance, but those who can't. And those who can't probably don't choose not to.
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Scott perfected this at 09/28/2009 11:15:57 pm
jeremy.jpgJeremy - 8821 Posts
09/29/2009 @ 12:03:55 AM
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Alex Wrote - Yesterday @ 11:02:47 PM
Scott Wrote - Yesterday @ 10:36:48 PM
Alex Wrote - Yesterday @ 01:14:19 PM
craig Wrote - 09/25/2009 @ 11:51:00 PM
Your mythical $200 doctors appointment is very unlikely - unless you're in there just to waste the doctors time with your sore bunion, or sniffley nose.


That's my point though, those kind of very minor issues shouldn't be covered, but things like cancer treatment should. It's one thing if we all pitch in to buy insurance so that if one of us gets cancer that person isn't royally screwed, but I don't want to pay for every hypochondriac's weekly doctor visits.


I had the h1n1 virus, and I caught of within 12 hours of noticing the symptoms. At the doctor's, he basically said that the people who get in trouble with this are those who ignore the symptoms and don't go see their doctor. I was prescribed a medicine developed quickly for this illness and it wasn't cheap. Had I not had insurance, my medical bill for this visit and the medication would have been close to $300. I don't make a lot money and my wife right now doesn't work (and, I don't have three kids to worry about). An expense like this would have busted a pretty big hole in our monthly budget. So, yes, insurance helps cover for the big things, but to a low income family, just trying to protect your family from the flu can have enormous consequences without insurance.


Not sure if you read the article, but half the point is that if you only had major medical you would pay less for your healthcare and be able to save more money up for these types of expenses, and if you have insurance through your employer it would cost them less which in theory means they would pay your more wages.

"Let’s say you’re a 22-year-old single employee at my company today, starting out at a $30,000 annual salary. Let’s assume you’ll get married in six years, support two children for 20 years, retire at 65, and die at 80. Now let’s make a crazy assumption: insurance premiums, Medicare taxes and premiums, and out-of-pocket costs will grow no faster than your earnings—say, 3 percent a year. By the end of your working days, your annual salary will be up to $107,000. And over your lifetime, you and your employer together will have paid $1.77 million for your family’s health care. $1.77 million! And that’s only after assuming the taming of costs! In recent years, health-care costs have actually grown 2 to 3 percent faster than the economy. If that continues, your 22-year-old self is looking at an additional $2 million or so in expenses over your lifetime—roughly $4 million in total."

If you're smart with your $1.77 million, you could pay a $300 bill. And his plan includes forced HSA contributions to make everyone "be smart".


Well, one thing he glosses over, I think, by his oversimplified "it would be like our auto insurance paying for our gas" analogy is that part of what you're paying for is to be in a group that has larger buying power. However, it's hard to say if that's a plus, or only a necessity because things are the way they are. Food Coops exist, but price-wise you're still probably better of going it alone to Walmart.

Even casting the point that the healthcare would hopefully be cheaper aside I still think $300 is something people should be able to handle. I'm not saying I don't get that times can be tough, but things go wrong, just like how the TV/Refridgerator can break, you can get sick. The point of the article is is that you have a system that adds overhead costs to a system that "insures" inevitability. If you have insurance that covers everything, then it has to charge you as if you're kind of sick pretty much all the time.

Let's say you want to start an insurance plan to cover household items in case of flood, lightning, etc. You could come up with the various costs of that coverage based on the likelihood my refrigerator will break because of a limited amount of rare occurrences.

Now let's say you had another plan that covered anything in the house breaking for any reason. Drop a mirror? Covered. Wiimote through the TV? Covered. Hard drive failure? Covered. Once you reach a point where SOMETHING happening, often, is inevitable, then you have to charge accordingly, and I'll pay you whatever it costs to replace everything in my house every few years, plus a hefty percentage because you need to pay your employees to track my account, and make a profit.

In otherwords, yes, you might not have saved that $300, but you almost certainly paid that $300 many times over indirectly, and probably a couple times over directly. You're basically pre-paying for your illness, except you might not actually get sick, and you're paying for someone to administer that. In almost every other system where you let people hang on to your money until you need it back later, they pay you.
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Jeremy perfected this at 09/29/2009 12:07:21 am
jon.jpgJon - infinity + 1 posts
09/30/2009 @ 11:28:38 AM
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Micah Wrote - 09/28/2009 @ 01:51:45 PM
This is a pretty good article from the recent Atlantic. It makes some good points and even has things that the resident tea-baggers will probably like. It is a little long though, so pony up some time to read.

http://www.theatlantic.com/doc/200909/health-care



I think posting a link to something that you say has appeal for both sides, but coupling it with a cheap joke about one side, probably doesn't result in any net gain for anyone.
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Jon perfected this at 09/30/2009 11:37:18 am
jeremy.jpgJeremy - Super Chocolate Bear
09/30/2009 @ 12:20:34 PM
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emoticon
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2887.gifAlex - I was too weak to give in Too strong to lose
10/01/2009 @ 08:04:03 PM
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Jeremy Wrote - 09/28/2009 @ 01:52:39 PM
Alex Wrote - 09/28/2009 @ 01:43:18 PM
I'm not sure what I'm getting at, and you made very valid points. I think what I've never understood is why you need special insurance for driving a car. You don't have to buy "throwing my iPod" insurance, or gun insurance, etc.
Because it's way easier to accidentally hurt someone with a car. If everyone had a gun there probably would be such a thing.


So if we all have mandatory health insurance, can we get rid of the liability auto insurance requirement? No reason to pay for coverage twice, right?
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newalex.jpgAlex - 3610 Posts
10/14/2009 @ 12:09:08 AM
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Apparently auto insurance wasn't actually required in Wisconsin until June 1st of this year, and instead of health insurance replacing it we're instead getting minimum limit increases that will presumably raise premiums for those who's coverage is forced to increase. Good times.

http://www.wiscnews.com/bnr/news/465493
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newalex.jpgAlex - 3610 Posts
10/29/2009 @ 01:46:24 PM
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Well, if this isn't a tax, then it's unconstitutional. Checkmate

http://cnsnews.com/news/article/55851
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newalex.jpgAlex - 3610 Posts
10/29/2009 @ 02:04:45 PM
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"“I’m sure the [Supreme] Court will find a limit,” Hoyer said. “For instance, if we mandated that you buy General Motors’ automobiles, I believe that would be far beyond our constitutional responsibility and indeed would violate the Due Process Clause as well – in terms of equal treatment to automobile manufacturers.”"

So mandating people to by GM vehicles would be "far beyond" the constitution, but mandating that we the people buy the majority of the actual company is ok. emoticon
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newalex.jpgAlex - Ignorance is bliss to those uneducated
10/29/2009 @ 02:08:19 PM
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http://news.yahoo.com/s/ap/us_health_care_overhaul

"Medical device makers also took a hit, with a 2.5 percent excise tax on sales of their products that is reported to cost the industry $20 billion over the next decade. A $40 billion fee on those businesses was included in a Senate Finance Committee-approved version of the legislation, but Reid is considering cutting it by as much as half."

So who do you think is going to end up paying this 2.5%? Or that $40 billion? The cash donkeys, that's who.
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scott.jpgScott - 6216 Posts
10/29/2009 @ 02:09:00 PM
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Alex Wrote - Today @ 02:46:24 PM
Well, if this isn't a tax, then it's unconstitutional. Checkmate http://cnsnews.com/news/article/55851


How do you explain this then?
Hoyer said that the insurance mandate was constitutional because Congress is not forcing Americans to buy one particular policy, just any health insurance policy.
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2887.gifAlex - 3610 Posts
10/29/2009 @ 04:17:38 PM
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Scott Wrote - Today @ 02:09:00 PM
Alex Wrote - Today @ 01:46:24 PM
Well, if this isn't a tax, then it's unconstitutional. Checkmate http://cnsnews.com/news/article/55851


How do you explain this then?
Hoyer said that the insurance mandate was constitutional because Congress is not forcing Americans to buy one particular policy, just any health insurance policy.


He's flat wrong is how I explain it.
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scott.jpgScott - Resident Tech Support
10/30/2009 @ 11:29:38 AM
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Alex Wrote - Yesterday @ 05:17:38 PM
Scott Wrote - Yesterday @ 03:09:00 PM
Alex Wrote - Yesterday @ 02:46:24 PM
Well, if this isn't a tax, then it's unconstitutional. Checkmate http://cnsnews.com/news/article/55851
How do you explain this then? Hoyer said that the insurance mandate was constitutional because Congress is not forcing Americans to buy one particular policy, just any health insurance policy.
He's flat wrong is how I explain it.


Well good, then. At least then I can disagree with you about whether or not he is wrong; I couldn't do that if you said "it's an indisputable fact", then I wouldn't be able to dispute it, which is what I'm doing.
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