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But people complain about this too. No one seriously talks about not treating people in the ER with gun wounds, but Obamacare explicitly introduced the mandate

But people complain about this too. No one seriously talks about not treating people in the ER with gun wounds, but Obamacare explicitly introduced the mandate that you get insurance or pay a penalty to address this very issue. Everyone is entitled to a basic level of care, but the mandate says that you should have to pay for it.

P5fRxh5kUvp2th 4y ago
it's fire, if they're ever not doing it with the same fervor then we have a problem. It's one thing to declare something too dangerous and work on containment, but what's being described here isn't that.
vkou 4y ago
The Obamacare penalty for not buying insurance was eliminated by Trump, because reintroducing the free rider problem is a cornerstone of GOP health policy. Reinstating the penalty is going to cost political goodwill, which is why the Dems aren't doing it. Regardless of whether the penalty is or is not in place, I wouldn't recommend being poor and sick, regardless of whether you are insured, or are freeloading.
- djbebs 4y ago
  There is no free rider problem.
  - yamtaddle 4y ago
    Elimination of pre-existing condition exclusions, and restrictions on which factors can be used to set pricing for policies—both wildly popular—create a free rider problem.
    - dmitriid 4y ago
      Funny how it's a problem only in the "richest country in the world". It also pales in comparison to the burden and costs of existing system in the US.
      - yamtaddle 4y ago
        Well, right, because most other advanced-economy states require you to carry insurance (more-or-less the solution we were going for, before the penalty for failing to have insurance was eliminated) or cover everyone under a government-provided healthcare scheme of one sort or another. If your point is just that the US healthcare system is far more-broken than most, and in some unique ways, all for no good reason—sure, yeah, of course that's true.
  - jjeaff 4y ago
    Of course there is. You aren't denied service at a hospital even if you don't have health insurance. That is a free rider problem.
- colechristensen 4y ago
  It wasn’t the Trump administration but the 5th Circuit Court of Appeals which struck down the mandate as unconstitutional and being liberal and a supporter of health care reform I think they had a point. I can’t see in the constitution where the federal government has the power to force me to buy health insurance. I like my constitutional rights being protected even when the thing being compelled (me having insurance) is a good idea. It means that things which are not quite so good of ideas have less chance of being forced on me later.
  - vkou 4y ago
    Trump's government repealed the individual mandate penalty, and then the court ruled ruled that in it's new form, it no longer qualified as a tax and was unconstitutional. (Not that this meant anything, since the legality of a fee of $0 doesn't matter.) The court case as a whole argued that because the GOP changed the ACA in a manner that made part of it (the $0 fee) illegal, the entirety of the ACA should be made illegal. The fifth circuit agreed with some of the arguments in the case (the fee one), but did not practically change anything about the ACA. And then SCOTUS, surprising ~everyone, ruled that actually the whole of the ACA is constitutional. Look at this timeline, and you tell me - who spent years trying to re-introduce the free rider problem, and to break the ACA? Congress, the president, and the plaintiff states... or the fifth circuit, which when presented with a singular, narrow question, ruled that a $0 fee (whatever that is) isn't a tax? Now, as of 2022, we are in a world where the ACA has been thoroughly litigated, and is still here, with the free rider problem hanging like a millstone over its neck.
    - P5fRxh5kUvp2th 4y ago
      calling insurance a tax is about as strong an indication of regulatory capture as I can think of. It should have never been a tax specifically because it's an unconstitutional act. Calling it a tax is the letter vs the spirit of the constitution. If you and others like yourself want to ensure everyone has health insurance then __make it mandatory for the state to pay for it__. Anything else and you're just taxing the poor for being poor.
mhalle 4y ago
The Reagan administration, I believe, imposed the unfunded mandate on emergency rooms to treat patients using EMTALA: https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... This mandate makes sense from a moral point of view, especially for true emergency situations. However, the act didn't take care of the cost of care, which was placed on hospitals and ultimately passed on to other patients and the government. Obamacare attempted to address this issue. EMTALA also distorted US healthcare be redirecting poorer people to expensive emergency care rather than preventive or primary care, which might well serve many of their needs better. That's also something that Obamacare was designed to fix.
- bombcar 4y ago
  https://healthcostinstitute.org/emergency-room/ouch-new-data-reveals-er-spending-increased-by-52-from-2012-2019-with-patient-out-of-pocket-payments-increasing-by-88 https://healthcostinstitute.org/emergency-room/ouch-new-data... $80 billion of 3.4 trillion. A rounding error.
someweirdperson 4y ago
"Gun wound" as in a wound caused by (actively) using a gun, or a bullet wound, typically caused by someone else using a gun? I could understand the former (like excluding accidents while skiing, skydiving, whatever), but excluding the latter seem pretty cynical.
- dmoy 4y ago
  The vast majority of gun wounds in the US are purposeful crimes or suicides For deaths, there's maybe 300 accidental deaths, 10,000 - 15,000 homicides, and like 60,000 suicides. Non-death injuries scale similarly, with the caveat that like 6,000 ish people per year try to kill themselves with a gun and fail, but still injure themselves.

P5fRxh5kUvp2th 4y ago

it's fire, if they're ever not doing it with the same fervor then we have a problem. It's one thing to declare something too dangerous and work on containment, but what's being described here isn't that.

vkou 4y ago

The Obamacare penalty for not buying insurance was eliminated by Trump, because reintroducing the free rider problem is a cornerstone of GOP health policy. Reinstating the penalty is going to cost political goodwill, which is why the Dems aren't doing it. Regardless of whether the penalty is or is not in place, I wouldn't recommend being poor and sick, regardless of whether you are insured, or are freeloading.

djbebs 4y ago
There is no free rider problem.
- yamtaddle 4y ago
  Elimination of pre-existing condition exclusions, and restrictions on which factors can be used to set pricing for policies—both wildly popular—create a free rider problem.
  - dmitriid 4y ago
    Funny how it's a problem only in the "richest country in the world". It also pales in comparison to the burden and costs of existing system in the US.
    - yamtaddle 4y ago
      Well, right, because most other advanced-economy states require you to carry insurance (more-or-less the solution we were going for, before the penalty for failing to have insurance was eliminated) or cover everyone under a government-provided healthcare scheme of one sort or another. If your point is just that the US healthcare system is far more-broken than most, and in some unique ways, all for no good reason—sure, yeah, of course that's true.
- jjeaff 4y ago
  Of course there is. You aren't denied service at a hospital even if you don't have health insurance. That is a free rider problem.
colechristensen 4y ago
It wasn’t the Trump administration but the 5th Circuit Court of Appeals which struck down the mandate as unconstitutional and being liberal and a supporter of health care reform I think they had a point. I can’t see in the constitution where the federal government has the power to force me to buy health insurance. I like my constitutional rights being protected even when the thing being compelled (me having insurance) is a good idea. It means that things which are not quite so good of ideas have less chance of being forced on me later.
- vkou 4y ago
  Trump's government repealed the individual mandate penalty, and then the court ruled ruled that in it's new form, it no longer qualified as a tax and was unconstitutional. (Not that this meant anything, since the legality of a fee of $0 doesn't matter.) The court case as a whole argued that because the GOP changed the ACA in a manner that made part of it (the $0 fee) illegal, the entirety of the ACA should be made illegal. The fifth circuit agreed with some of the arguments in the case (the fee one), but did not practically change anything about the ACA. And then SCOTUS, surprising ~everyone, ruled that actually the whole of the ACA is constitutional. Look at this timeline, and you tell me - who spent years trying to re-introduce the free rider problem, and to break the ACA? Congress, the president, and the plaintiff states... or the fifth circuit, which when presented with a singular, narrow question, ruled that a $0 fee (whatever that is) isn't a tax? Now, as of 2022, we are in a world where the ACA has been thoroughly litigated, and is still here, with the free rider problem hanging like a millstone over its neck.
  - P5fRxh5kUvp2th 4y ago
    calling insurance a tax is about as strong an indication of regulatory capture as I can think of. It should have never been a tax specifically because it's an unconstitutional act. Calling it a tax is the letter vs the spirit of the constitution. If you and others like yourself want to ensure everyone has health insurance then __make it mandatory for the state to pay for it__. Anything else and you're just taxing the poor for being poor.

mhalle 4y ago

The Reagan administration, I believe, imposed the unfunded mandate on emergency rooms to treat patients using EMTALA: https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... This mandate makes sense from a moral point of view, especially for true emergency situations. However, the act didn't take care of the cost of care, which was placed on hospitals and ultimately passed on to other patients and the government. Obamacare attempted to address this issue. EMTALA also distorted US healthcare be redirecting poorer people to expensive emergency care rather than preventive or primary care, which might well serve many of their needs better. That's also something that Obamacare was designed to fix.

bombcar 4y ago
https://healthcostinstitute.org/emergency-room/ouch-new-data-reveals-er-spending-increased-by-52-from-2012-2019-with-patient-out-of-pocket-payments-increasing-by-88 https://healthcostinstitute.org/emergency-room/ouch-new-data... $80 billion of 3.4 trillion. A rounding error.

someweirdperson 4y ago

"Gun wound" as in a wound caused by (actively) using a gun, or a bullet wound, typically caused by someone else using a gun? I could understand the former (like excluding accidents while skiing, skydiving, whatever), but excluding the latter seem pretty cynical.

dmoy 4y ago
The vast majority of gun wounds in the US are purposeful crimes or suicides For deaths, there's maybe 300 accidental deaths, 10,000 - 15,000 homicides, and like 60,000 suicides. Non-death injuries scale similarly, with the caveat that like 6,000 ish people per year try to kill themselves with a gun and fail, but still injure themselves.