5 ms·

You are asking how fines are enforced? Ideally you wouldn't have to pay for health insurance but this is what was able to be passed at this time. It has provid

by Kequc 13y ago

You are asking how fines are enforced? Ideally you wouldn't have to pay for health insurance but this is what was able to be passed at this time. It has provided insurance to millions and largely reduced costs across the board. Everyone gets sick or at the very least eventually old. It isn't gambling, it isn't a risk, it's certain. You need to be insured. I'd just suggest it's better than what you had before.

ctdonath 13y ago
It has provided insurance to millions It has cancelled the insurance of more millions. You're not just required to have insurance, you're required to have insurance meeting higher standards than many can afford and/or were living just fine without (ex.: not paying for birth control coverage when there is absolutely zero chance of pregnancy).
- cujo 13y ago
  It also gave a lot of us the ability to get insurance. Pre-existing conditions prevented an awful lot of people from getting insurance or changing jobs. This fixes that huge hole. No one is saying it's perfect, but it's going in the right direction.
  - bmelton 13y ago
    That's my biggest problem with the ACA, actually. I think it's great that insurance providers now have to accept pre-existing conditions, and while I'm against the ACA in general, I see that as the biggest good that it's doing. My dislike for it is that one provision could have been its own separate law that would have been passed easily, with more bipartisan support, and would have fixed much of what ails the system. We could quibble all day over whether or not the ACA is the best way to get there (and I think very few would suggest that it is), but there are parts of it that I would support in isolation that didn't require the individual mandate, which I believe wholly violates the Constitution, regardless of what Justice Kennedy maintains.
    - cujo 13y ago
      I agree that the ACA needs work, and has some questionable elements. The conflict I have is that I see as so much better than the previous non-system that it's hard to argue about it's crappy parts without someone jumping on the NObama train and killing any chance of discourse.
      - bmelton 13y ago
        The position I've maintained since before its enaction is that at best, the ACA is a temporary measure. This is just my theory, and it's very possibly wrong outright. There are a variety of problems with medical coverage in the United States, in large part, because most of our medical coverage is handled by insurance. Insurance, at its core, is not good at complete coverage, and if we expect it to be, it's always going to be more and more expensive, especially as the payer is abstracted away from the true cost. Medical insurance arose as a response to the wage freezes enacted by the government during the war. Wages were frozen to 'stabilize' the economy and money could be dedicated to fighting the war. The unintended consequence here was that businesses, leveraging 'benefits' to compete for top talent, petitioned the IRS to allow for medical coverage to be pre-taxable income. The result is that we have a system where largely, other people are footing the bill for medical costs. This was, IMO, the genesis of our failing health care system. This got worse and worse and worse until the ACA. Now, the ACA appears to be fixing the problem with more of the same. More people abstracted further away from the actual cost of health care. (Again, IMO) this is not a long-term fix, and I'll be very surprised if we don't see rates escalating dramatically in the next few years. Before insurance became pervasive, insurance was for catastrophic purposes. E.g., cancer. For general health care needs, the flu, a cold, a pulled muscle, a broken wrist, etc., people should be paying for their medical expenses out of pocket, while paying into their insurance to buffer against bankruptcy from something like cancer, leukemia, etc. If that were the case, we'd see the free market work. People wouldn't get three X-rays and two MRIs to determine whether or not a wrist had a very minor fracture or a very major sprain -- they'd just slap a cast on it and wait a few weeks until it was better. That cast costs a small fraction of the cost of an X-ray, or an MRI... but because the insured don't generally pay those costs out of pocket, they get all the X-rays that are needed, because they're free -- and then they're surprised at the cost of health care. I have objections to the ACA on grounds of politics, and I have concerns with the ACA on grounds of pragmatism. I certainly don't begrudge those who have needed insurance but didn't have it until now, but if we really want to lower the cost of routine health care coverage, I find the current approach to be the least likely way to address it, and foresee rising health care costs in the future. Again, just an opinion (though I think it's informed), and I could be proven completely wrong in a few years.
- happyscrappy 13y ago
  Not only that. Former arrangements when running multiple companies were deemed invalid, all employees having their healthcare through a holding company were dumped and forced to navigate the morass individually, leading to a three month lapse of coverage. Allegedly my family's healthcare restarts tomorrow. It is a little disconcerting that tomorrow is April Fool's Day.
- cgaudreau 13y ago
  "Cancelled insurance" has mostly meant that you would lose your current plan and be automatically enrolled in a new plan by the same insurer, not that you would be uninsured. Some people did in fact lose their insurance or face higher premiums, but that number is now considerably smaller than the amount of people who have gained insurance.
  - bmelton 13y ago
    Citation?
- aestra 13y ago
  >not paying for birth control coverage when there is absolutely zero chance of pregnancy The argument here is.... It is in our best interest as a society as a whole to have a society that controls its fertility. We have less children born that aren't wanted, less teen pregnancy. Les children in hardship. That's a plus for society. It is also beneficial to society to have children who are born healthy. That's why we are all required to pay for maternity care. It is also beneficial to society to have a well educated populace, that's why we are all required to pay for primary education (through property taxes) even if we have no children, and can't have children. Educating the women in society and giving them access to birth control is one of the best ways to pull a society out of poverty.
  - marknutter 13y ago
    > It is in our best interest as a society as a whole to have a society that controls its fertility. Conjures up images of other societies who have controlled their fertility..
    - aestra 13y ago
      http://www.prb.org/Publications/Datasheets/2012/world-population-data-sheet/fact-sheet-us-population.aspx http://www.prb.org/Publications/Datasheets/2012/world-popula...
- panarky 13y ago
  Please cite your source claiming more people cancelled insurance than obtained insurance. A recent study from Rand Corp. debunks these claims: Researchers found that the share of adults ages 18 to 64 without health insurance has declined from 20.9% last fall to 16.6% as of March 22. http://www.latimes.com/nation/la-na-obamacare-uninsured-national-20140331,0,5472960.story http://www.latimes.com/nation/la-na-obamacare-uninsured-nati...
  - ctdonath 13y ago
    Why the limiting of proffered statistics to ages 18-64? I'd expect those outside that range are most in need of coverage, yet are curiously excluded from statistics touting progress toward the goal of "health insurance for all".
    - hga 13y ago
      Errr, everyone over 64 years of age is automatically enrolled in Medicare.
  - ctdonath 13y ago
    Rand Corp. Their next study showed just 858,000 enrollees out of 7.1M were previously uninsured. Not sure yet what percentage of the difference were entirely voluntary transfer of services, but methinks most were signups due to cancellation of existing policies. http://www.dailymail.co.uk/news/article-2594309/President-plans-victory-lap-strong-Obamacare-enrollment-Sebelius-faces-unpopular-law-blank-stare-tough-questions-remain-whos-signing-up.html http://www.dailymail.co.uk/news/article-2594309/President-pl...
    - panarky 13y ago
      It is logically impossible for there to be more cancellations than enrollments, while the percentage of uninsured falls dramatically. Methinks you've got your facts wrong.
emidln 13y ago
It isn't gambling, it isn't a risk, it's certain. You need to be insured. Why? I have money to pay my family's medical expenses. I've done very well investing it. Giving it to an insurance company whose primary goal is to not pay my medical expenses while collecting premiums over versus investing it myself for future payment of services rendered seems like a really bad trade. I realize this isn't a trade that every person is in a position to make, but why do I need the insurance? If I don't need the insurance, then why do I have to pay a fine to opt out of taking it from an insurance company? I don't know many who are making an argument against lowering health costs or enabling access to more people. Neither of those things necesitate compulsory purchase of an insurance product.
- jamroom 13y ago
  I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt.
  - emidln 13y ago
    I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. Why do I need to carry a card? What purpose does the card hold other than to tell the medical provider to treat me differently (as if I could either not pay (unfair to me, how do they know my assets) or could pay for better treatment (unfair to everyone else, why are some suffering through mere insurance while I have the good stuff that daddy greenbacks bring))? If you are differentiating for those without insurance, you surely must do the same for those with the comically legal 60/40 plans that have no practical out of pocket cap. 40% of a 100k bill is practically the same as being uninsured when looking at the effect of causing a bankruptcy to most of the country. The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt. Would you prevent people who signed up for 60/40 co-insurance from Aetna or Blue Cross to file for bankruptcy when they cannot afford to pay their 40%? If not, why? They choose* to not pay for better plans that limit their out of pocket liability. Making bankruptcy harder isn't the right solution. Complete nationalization is only solution that doesn't leave uninsured and underinsured individuals who need to take a bankruptcy after an illness or accident. If that is truly the goal, then that is what should be worked at.

by Kequc 13y ago

ctdonath 13y ago

It has provided insurance to millions It has cancelled the insurance of more millions. You're not just required to have insurance, you're required to have insurance meeting higher standards than many can afford and/or were living just fine without (ex.: not paying for birth control coverage when there is absolutely zero chance of pregnancy).

cujo 13y ago
It also gave a lot of us the ability to get insurance. Pre-existing conditions prevented an awful lot of people from getting insurance or changing jobs. This fixes that huge hole. No one is saying it's perfect, but it's going in the right direction.
- bmelton 13y ago
  That's my biggest problem with the ACA, actually. I think it's great that insurance providers now have to accept pre-existing conditions, and while I'm against the ACA in general, I see that as the biggest good that it's doing. My dislike for it is that one provision could have been its own separate law that would have been passed easily, with more bipartisan support, and would have fixed much of what ails the system. We could quibble all day over whether or not the ACA is the best way to get there (and I think very few would suggest that it is), but there are parts of it that I would support in isolation that didn't require the individual mandate, which I believe wholly violates the Constitution, regardless of what Justice Kennedy maintains.
  - cujo 13y ago
    I agree that the ACA needs work, and has some questionable elements. The conflict I have is that I see as so much better than the previous non-system that it's hard to argue about it's crappy parts without someone jumping on the NObama train and killing any chance of discourse.
    - bmelton 13y ago
      The position I've maintained since before its enaction is that at best, the ACA is a temporary measure. This is just my theory, and it's very possibly wrong outright. There are a variety of problems with medical coverage in the United States, in large part, because most of our medical coverage is handled by insurance. Insurance, at its core, is not good at complete coverage, and if we expect it to be, it's always going to be more and more expensive, especially as the payer is abstracted away from the true cost. Medical insurance arose as a response to the wage freezes enacted by the government during the war. Wages were frozen to 'stabilize' the economy and money could be dedicated to fighting the war. The unintended consequence here was that businesses, leveraging 'benefits' to compete for top talent, petitioned the IRS to allow for medical coverage to be pre-taxable income. The result is that we have a system where largely, other people are footing the bill for medical costs. This was, IMO, the genesis of our failing health care system. This got worse and worse and worse until the ACA. Now, the ACA appears to be fixing the problem with more of the same. More people abstracted further away from the actual cost of health care. (Again, IMO) this is not a long-term fix, and I'll be very surprised if we don't see rates escalating dramatically in the next few years. Before insurance became pervasive, insurance was for catastrophic purposes. E.g., cancer. For general health care needs, the flu, a cold, a pulled muscle, a broken wrist, etc., people should be paying for their medical expenses out of pocket, while paying into their insurance to buffer against bankruptcy from something like cancer, leukemia, etc. If that were the case, we'd see the free market work. People wouldn't get three X-rays and two MRIs to determine whether or not a wrist had a very minor fracture or a very major sprain -- they'd just slap a cast on it and wait a few weeks until it was better. That cast costs a small fraction of the cost of an X-ray, or an MRI... but because the insured don't generally pay those costs out of pocket, they get all the X-rays that are needed, because they're free -- and then they're surprised at the cost of health care. I have objections to the ACA on grounds of politics, and I have concerns with the ACA on grounds of pragmatism. I certainly don't begrudge those who have needed insurance but didn't have it until now, but if we really want to lower the cost of routine health care coverage, I find the current approach to be the least likely way to address it, and foresee rising health care costs in the future. Again, just an opinion (though I think it's informed), and I could be proven completely wrong in a few years.
happyscrappy 13y ago
Not only that. Former arrangements when running multiple companies were deemed invalid, all employees having their healthcare through a holding company were dumped and forced to navigate the morass individually, leading to a three month lapse of coverage. Allegedly my family's healthcare restarts tomorrow. It is a little disconcerting that tomorrow is April Fool's Day.
cgaudreau 13y ago
"Cancelled insurance" has mostly meant that you would lose your current plan and be automatically enrolled in a new plan by the same insurer, not that you would be uninsured. Some people did in fact lose their insurance or face higher premiums, but that number is now considerably smaller than the amount of people who have gained insurance.
- bmelton 13y ago
  Citation?
aestra 13y ago
>not paying for birth control coverage when there is absolutely zero chance of pregnancy The argument here is.... It is in our best interest as a society as a whole to have a society that controls its fertility. We have less children born that aren't wanted, less teen pregnancy. Les children in hardship. That's a plus for society. It is also beneficial to society to have children who are born healthy. That's why we are all required to pay for maternity care. It is also beneficial to society to have a well educated populace, that's why we are all required to pay for primary education (through property taxes) even if we have no children, and can't have children. Educating the women in society and giving them access to birth control is one of the best ways to pull a society out of poverty.
- marknutter 13y ago
  > It is in our best interest as a society as a whole to have a society that controls its fertility. Conjures up images of other societies who have controlled their fertility..
  - aestra 13y ago
    http://www.prb.org/Publications/Datasheets/2012/world-population-data-sheet/fact-sheet-us-population.aspx http://www.prb.org/Publications/Datasheets/2012/world-popula...
panarky 13y ago
Please cite your source claiming more people cancelled insurance than obtained insurance. A recent study from Rand Corp. debunks these claims: Researchers found that the share of adults ages 18 to 64 without health insurance has declined from 20.9% last fall to 16.6% as of March 22. http://www.latimes.com/nation/la-na-obamacare-uninsured-national-20140331,0,5472960.story http://www.latimes.com/nation/la-na-obamacare-uninsured-nati...
- ctdonath 13y ago
  Why the limiting of proffered statistics to ages 18-64? I'd expect those outside that range are most in need of coverage, yet are curiously excluded from statistics touting progress toward the goal of "health insurance for all".
  - hga 13y ago
    Errr, everyone over 64 years of age is automatically enrolled in Medicare.
- ctdonath 13y ago
  Rand Corp. Their next study showed just 858,000 enrollees out of 7.1M were previously uninsured. Not sure yet what percentage of the difference were entirely voluntary transfer of services, but methinks most were signups due to cancellation of existing policies. http://www.dailymail.co.uk/news/article-2594309/President-plans-victory-lap-strong-Obamacare-enrollment-Sebelius-faces-unpopular-law-blank-stare-tough-questions-remain-whos-signing-up.html http://www.dailymail.co.uk/news/article-2594309/President-pl...
  - panarky 13y ago
    It is logically impossible for there to be more cancellations than enrollments, while the percentage of uninsured falls dramatically. Methinks you've got your facts wrong.

emidln 13y ago

It isn't gambling, it isn't a risk, it's certain. You need to be insured. Why? I have money to pay my family's medical expenses. I've done very well investing it. Giving it to an insurance company whose primary goal is to not pay my medical expenses while collecting premiums over versus investing it myself for future payment of services rendered seems like a really bad trade. I realize this isn't a trade that every person is in a position to make, but why do I need the insurance? If I don't need the insurance, then why do I have to pay a fine to opt out of taking it from an insurance company? I don't know many who are making an argument against lowering health costs or enabling access to more people. Neither of those things necesitate compulsory purchase of an insurance product.

jamroom 13y ago
I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt.
- emidln 13y ago
  I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. Why do I need to carry a card? What purpose does the card hold other than to tell the medical provider to treat me differently (as if I could either not pay (unfair to me, how do they know my assets) or could pay for better treatment (unfair to everyone else, why are some suffering through mere insurance while I have the good stuff that daddy greenbacks bring))? If you are differentiating for those without insurance, you surely must do the same for those with the comically legal 60/40 plans that have no practical out of pocket cap. 40% of a 100k bill is practically the same as being uninsured when looking at the effect of causing a bankruptcy to most of the country. The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt. Would you prevent people who signed up for 60/40 co-insurance from Aetna or Blue Cross to file for bankruptcy when they cannot afford to pay their 40%? If not, why? They choose* to not pay for better plans that limit their out of pocket liability. Making bankruptcy harder isn't the right solution. Complete nationalization is only solution that doesn't leave uninsured and underinsured individuals who need to take a bankruptcy after an illness or accident. If that is truly the goal, then that is what should be worked at.