If you don't do what the government wants, you will find a new "tax" will appear to make you do it.

Yes, especially when the government (AKA "we the people") wants you to stop freeloading on the health insurance system we're paying for.

Medical insurance is not only incredibly frustrating to deal with, but a huge unnecessary expense in the system.

Because half the country is convinced that allowing giant corporations to profit off the sick is the only non-"socialist" option.

Yeah, this is a loser for all Americans. The majority of the country didn't want this legislation. It was voted down in congress and they had to resort to some trick to pass it. The entire time the Obama Administration kept saying that this was NOT A TAX ... that it was a Mandate. Now the SCOTUS says that it is unconstitutional as a Mandate, but it's ok at a TAX. So the bill that was passed was not only against the wishes of the majority of the people, it doesn't even work the way the minority said it would when it was voted upon.

As the mandate is to give money to private insurers, and not the government itself, it does not fall under the Constitutional definition of a legal tax. I'm a bit shocked to see the SCOTUS uphold the law under an obvious and blatantly false definition of taxation, although after Citizen's United, nothing those berobed assholes do is really all that surprising.

So, the real question is: Our government is imposing an illegal tax on the people in direct violation of the Constitution; what do we do now?

I'm already taxed for not having a mortgage, not producing "clean" coal, not having children, and numerous other things that we as a culture have decided should be incentivized. The former two items in your list would be a clear violation of the first amendment, which this case did not rest on, whereas the third would be constitutional(but also kind of silly).

You were already doing that before, partly through your taxes, partly through effectively paying higher amounts to hospitals, in order to compensate hospitals for the all the ER visits they get from people without insurance (and thus likely never pay). You potentially could have ended up in the situation you were worried about if the Supreme Court struck down the individual mandate, but kept the rest of the law.

What ever happened to the public option? You know, cutting the profit motive out of funding health care, so that people do not have to fight with their insurance companies or with hospitals just to get the treatment they need?

What we need is a public option for food. You know, cutting the profit motive out of fending off starvation, so that people do not have to fight with their grocery stores just to get the sustenance we need. Also a public option for housing, so that people don't have to fight with their landlords or builders just to keep from dying from exposure. And a public option for transportation, just so I don't have to fight with the auto retailer just so I can perform useful work for this great civilization. And a public option for clothing, but I already mentioned exposure. And a public option for entertainment, because life will be awfully dreary with no entertainment.

~Loyal

Well, fundamentally, you'd have to blame American fear of socialism. In a more "what really could go wrong" sense, politicians(and to be fair, economists too) were scared of what would happen if they unmade an entire industry in a matter of a few years.

Carrot or Stick, you have your choice.

Don't like it? Blame those broad powers granted through phrases like "provide for the general welfare" in the Constitution.

Nonsense.

There are all sorts of contingent taxes.

Most people don't know what's in the ACA.

Most people like what's in the ACA.

typical americans. like everything about it except the bill. I'm in favor of everything about it except that "I have to pay for it" part....

Chief Justice Roberts: “It Is Not Our Job to Protect the People From the Consequences of Their Political Choices”

There you go... bring on the consequences!

So who's job is it to look out for the best interests of the country? Is that one of those mystery jobs that Americans just don't want to do?

carrot for the top 1%, stick for the rest.

your argument is the same kind of argument as "if gays can marry, soon you can marry dead people and animals!"

or "if marijuana is legal, soon meth and coke will be too!"

it's bullshit fearmongering. your point of view depends upon the fact that people don't think and can't tell the difference between different subject matter and weigh them separately

of course they can. well, maybe you can't

The penalty comes in the form of a tax, which can be deducted in full if you have insurance. Two options, one of which is a tax. It's functionally not any different from the fact that the government deducts mortgage payments from your income tax. You can buy a house, giving into the evil housing industry, or you can not, and pay a higher tax rate.

Ta-da.

First, Obama and the Dems sold this as not a tax. So they lied. Obama is now responsible for raising taxes on all Americans to the tune of over a trillion dollars.

Second, it's a tax on you. Not what you earn, not where you live, not what you own, but you.

So they got their technical win. Doesn't make it right though.

No, they'll go up faster because the insurance companies can say "We have to pay for Obamacare," when in fact they are benefiting from it as you mentioned. This is the way most corporations, especially insurance corporations, work.

the military is being paid by the state. how is that for a socialistic scheme ?

Probably so--the individual mandate was a Republican idea to begin with.

I admire the Democrats for helping to tackle health care reform. There are some really good things in there--preventing insurance companies from rescinding coverage, allowing parents to insure kids up to 26, etc. But as a Democrat, I have mixed feelings about today's decision. I do not like the individual mandate, as like you, I feel that Congress shouldn't have the power to make you buy something from a private company.

I was actually hoping that the law would stand as-is, except for the individual mandate, which I was hoping would be overturned. At that point, insurance companies would be screwed--they'd still be forced to cover those that they traditionally worked so hard to drop off the rolls, but without money coming in from those who are statistically healthier and less likely to pay for insurance. At that point, one of two things would happen: either 1) the insurance companies would lower prices on their policies to reasonable levels to be more conducive for healthy people to buy, or 2) the insurance industry would basically petition government to expand Medicare to cover those that they don't want to. Either way, it would be win/win.

Ultimately, the only answer is a single-payer system. As long as you have private companies in the insurance business, there is a perverse incentive to screw their customers over. People whine and complain about government's incompetence, and I'd never say there's no waste or that government is perfect. However, I trust government a hell of a lot more than I trust the insurance industry, which has proven time and again that they're scum.

1. Canada and the UK have socialised medicine handled by the government. You don't have to buy insurance, you just pay taxes, fill out some paperwork, and voila, medicare (however, in Canada, different provinces have different schemes for drug insurance) I don't understand this idea of forcing Americans to BUY insurance. Isn't it usual that if the government forces people to BUY something for whatever reason (eg: you have to goto drivers school to get a drivers license), then the thing they are buying will suddenly sky rocket in price?

2. What are HMOs?

3. Why are Americans so convinced that amoral profit seeking corporations have their best interests at heart, and not an elected government whose power is given to them by the people?

Taxation has always been an instrument of social engineering how a society operates. By any other name, it's a behavior modifier. The fact many of you don't already know this is quite frankly, scary as hell!

The Supreme Court, under their own longstanding precedent is required to be constructive and evaluate the law under the entire Constitution before rejecting legislation as being unconstitutional.

This is exactly what happened.

Those whom are claiming this is a rewrite of the legislation are barking mad.

When buying and selling are controlled by legislation, the first things to be bought and sold are legislators. P. J. O'Rourke

Wow, are you likely to get an earful over this. Here's my perspective (not a neutral one):

The "individual mandate" part of the Affordable Care Act (ACA) requires you to carry health care insurance. However, supporters claim that because the risk associated to insurers is now spread out over a much larger segment of the population (those who would normally decline health insurance are obviously less likely to need it), the cost to individuals in terms of premiums is likely to decline. In other words, they're betting that the cost of your insurance is likely to decline. Personally, I think that's likely... for insurers, anyway. Whether insurers pass these cost savings to individuals is a craps shoot. When Massachusetts (under, ahem, Governor Romney) passed a law with an individual mandate, premiums fell something like 40% at the same time that it was rising nationally.

Another big part of the bill is the "pre-existing condition" clause: basically, an insurer cannot deny you coverage because you already have a medical condition that they don't want to cover. There was some worry among ACA boosters that the court might strike down the "individual mandate" part without the "pre-existing condition" part, which would have been catastrophic to the risk pools: seven states have tried passing pre-existing condition laws without the individual mandate, and it went very badly for all of them [americanprogress.org]. So if it turns out that you come down with some kind of chronic or severe condition, it can no longer be used as a reason for an insurer to deny you insurance.

I assume to know who will get 'taxed' on this? There are swaths of exemptions, eg if you already have your own insurance you won't to pay the monthly $286 per family tax, military is exempt, VA exempt, religious organizations who oppose are exempt, the poor are exempt etc. The people who the tax is targeted at are those who can pay but refuse because they'd rather be parasites on the rest of us who do pay, such as yourself I can only assume.

I have health insurance. It is not a tax on me. It is a tax on the irresponsible Americans who decide to leech off of the system instead of getting health insurance. If you get sick (or in an accident) and do not have health insurance then I have to pay for it (the hospital will still treat you, and the costs will be passed on to me as higher premiums when you cannot pay and file for bankruptcy). So yes, it is a tax on dumb/irresponsible people.

When put that way, this starts to sound like a really good idea. Maybe we can find a way to expand it to other areas.

Not really factually correct. A majority of Americans like a majority of the acts of this law. The 'no preexisting condition' portion is particularly popular as is the 'no lifetime maximum' and the 'no copay for preventative care' portions. The one part that more unpopular with most people is the 'must buy insurance part'. But the rest of it doesn't work without that.

You assertion that "general welfare" grants broad powers shows that you are willfully ignorant of the facts.

Other (most) western countries have programs very much like this.

I'm so confused with my American brethren. You, the people, were absolutely fine with the previous president firing up the war machine on false pretenses to bomb the shit out of countries he couldn't even pronounce all in the name of contractor profits (of which you, the tax payer gets to foot the bill), yet little Johnny gets to sit with a broken leg in the emergency room because y'all think his parents are losers.

Sometimes I think the only people in the world that really hate Americans, are other Americans.

I shake my head in sadness. Love thy neighbour, indeed.

While I agree that not having health insurance is really risky and dumb, taxing someone for not buying / wanting something goes against freedom.

The government does has the right to tax, but that should only apply for the things that the government should take care of, which is 1) providing national defense and 2) the legal system, not telling us which insurances to get.

...why did we need the law?

Well giving a the Carrot in terms of Tax Breaks for the poor isn't that useful.
1. A lot of them pay small amount of tax, so the carrot would be small. For the Rich, it is a sizable increase, perhaps worth a changing a behavior.
2. Poor in general (yes they are exceptions) don't tend to focus on long term planning, or how taxable their habits are.
3. The poor will tend (yes they are exceptions) to get more support federally then the rich (Per dollar payed in taxes)

However giving them the stick, Would encourage a behavior change, because it is money that will go away vs money you will get back.
Myself included, When I get my paycheck I see 1/3 (Federal and State Taxes) go away, That in my mind is money I never had, so I don't think about it, if I get some back at tax time, it is just a bonus to me.
However If I am told that I don't do X then I will need to pay later, (Say out of my pocket) that is money that was given to me that I have to pay back.

yeah it's a real loser for everyone with a pre-existing condition that would otherwise go lay down and die. i'm sure painful death is preferable to affordable health care. also, those people who lose their coverage because they get sick will now really suffer with continued treatment. I have health insurance through my employer and i keep it. that really sucks for me. this is a real loser for ALL Americans. you nailed it pal.

sometimes leaders get to take the country where it doesn't want to go at great political expense because they believe it will make the country stronger. in my view this is exactly why we elect them. if you want someone with zero conviction whose liberal vs. conservative leanings sway with the polls and whatever demographic he happens to be speaking to, then there is an obvious choice for you in November. make it. welcome to democracy.

[citation needed]

Odds are your taxes will go up to support enforcing this program, as will your health insurance costs as they struggle to compete with it.

Given that those who currently cost many times more for health coverage by visiting the emergency room will now have such insurance, the average unexpected costs of health care will actually go down. Other than throwing some unsupported politicized catch phrase out there, why not throw out some supporting arguments or facts?

Given that an insured family shells out an estimated additional $1000 dollars for uninsured patients who visit the emergency room, what do you think willl happen when the majority of those will now be covered?

Remember the number of 'families' in the U.S., multiple that by $1000 each for every family with insurance, and you begin to understand the scope of the unplanned costs that the uninsured add to every responsible persons budget.

I'm floored that the Republicans, who originally championed this idea, were so quick to do an about face simply because it was pushed through by a Democrat. This is a good thing, and necessary to control costs. Anyone who runs a budget or does accounting would always prefer a controlled (known) costs to an unknown cost. it's common sense and makes planning easier, as well as smooths out any financial distress to the system.

Yeah, this is a loser for all Americans. The majority of the country didn't want this legislation.

The majority of Americans did not want civil rights, social security, or interracial marriage.

All Americans win when everyone has health care coverage. The lower income people win because they will be healthier and more productive. Everyone else wins because the lower income people are not getting their primary care via emergency rooms and pass the cost on to the government and people with health insurance.

The only people I hear complaining about this are people with health insurance paid for by someone else (their employer, medicare/medicaid, and the VA). Try paying the full cost of insuring yourself and your family.

And now...well, there is really nothing the feds can't tell us to do anymore....

When they can force you to buy something from a private company, game over.

Tax code is where most political power resides. Companies buying political favors are usually looking for tax breaks. States use dueling tax incentives to lure people/companies/film production to their state. Individuals receive various tax breaks for being good little wind-up-robots and doing what they are told.

Anyone who believes we will ever have a flat tax doesn't understand they are asking government to neuter itself. It just isn't going to happen.

Good.

Insurance on universally needed services works best that way, as your high deductible plan makes it harder for others to afford insurance. By forcing gamblers like you to be more responsible, costs for more responsible people are lowered.

And please stop deluding yourself into believing that your high deductible plan won't leave the rest of the people in the insurance pool on the hook if you come down with a catastrophic illness that costs millions of dollars to treat.

You'd be surprised by the large number of "younger, poorer, healthier people" that find their way to an emergency room simply because they can't afford a doctor.

Also while statistically younger people do not have chronic illness, they make up for it in emergency care resulting from accidents. It's the overnight stay in the hospital from an emergency that bankrupts most young people. More so when combined with their inability to work and the lack of short term disability benefits.

I could also mention that in addition to accidents, younger people are prone to pregnancies, assaults, and sickness due to acute substance abuse.

is they can't get cheap preventive care

now they can

so they get $100 worth of care and stay healthy and stay working, rather than $100,000 worth of care later when they are already sick, because they don't have the financial resources to attend to their healthcare

sanity prevails

thank you justice roberts, you have a human conscience

we'll talk about the citizens united thing later

Which is counterpoint to granting tax breaks to get people to do something.

The point of taxation either way...should be to fund the govt to work....NOT to alter behavior. You should be free to live and behave as you wish...that is a part of freedom and the govt should play no part in trying to coerce you in any way...

Vote for someone else? What someone else?

This is like saying "You can always pick up the turd by the clean end."

As opposed to going up every year for no particular reason, like it has been...

Somehow I think your insurance rates would continue to climb no matter what, now they just have a convenient excuse. "Not our fault, blame Obama!"

Some high deductible plans will become illegal under the health care law and the GP will be forced to purchase a lower deductible plan which will cost more.

And it is a good thing.

These high deductible plans can be great for the individuals who choose them, but they shift cost to those who either choose lower deductible plans, or are forced to get lower deductible plans through their employers.

It's only freedom if no-one else has to pay when you get sick or are in an accident. Otherwise you are just saving yourself some cash at other people's expense, taking away their freedom.

How do you know? Did it ever cross your mind that more people in the pool will lower your premiums? Why don't you wait for them to actually triple before griping about it?

No, you don't. If you're in a low enough income bracket, you don't have to pay the penalty, and in fact get a subsidy to purchase insurance.

These aren't mysterious hidden details, unless you spend all of your time watching Fox News. They've been right up front about this the whole time. It amazes me how much general ignorance there is about the Affordable Care Act. There are legitimate gripes about the bill, but usually the people griping about it are just spewing complete bullshit like Grishnakh and sycodon here.

--Jeremy

Yes, especially when the government (AKA "we the people") wants you to stop freeloading on the health insurance system we're paying for.

*sighs*...you're conflating "healthCARE" and "health INSURANCE". They're not the same thing, no matter what Obama says.

Note that "freeloading on the health insurance system" wasn't possible BEFORE Obamacare, but it is now.

Because now, anyone can blow off getting health insurance till they have some expensive medical bills, get health insurance and have it pay the medical bills, then cancel insurance. Used to be that was impossible....

"Obamacare" has a provision that forces insurance companies to spend at least 85% of their premiums on providing health care and limiting overhead to 15%. So even if the companies raise their premiums they're still stuck with spending it instead of just increasing profits. So any increase in premiums is probably related to increases in the underlying cost of health care. That may go down some or at least stop increasing so fast since there will be less unpaid for care in the first place. Did you know that about 60% of personal bankruptcies in this country are due to medical bills? Hopefully that will drop too.

Apparently you haven't been paying attention. Health care has gone up in cost every year, well over the cost of inflation. The only difference is that this year your insurer has a convenient scapegoat.

--Jeremy

This specific part is about fixing the pre-existing loophole that someone who decides not to pay for insurance but piggy backs on the healthcare system by using the ER (which is more expensive than regular visits and pushes the burden on the rest of us through higher medical and insurance costs). As costs got higher, more and more people made this decision (or it was made for them). This isn't the primary reason for health care costs going up, but it's contributing to it.

At some point in time, this gap was going to need to be filled in some way (otherwise you and I will continue to pay for their insurance). I would have preferred a carrot rather than a stick (or a stick disguised as a carrot), but I personally can't think of a better solution. Can you?

+5, Insightful? Sigh.

I'm as critical of income inequality as anyone (the core rhetoric of the "99%" talk), but the Affordable Care Act offers subsidies to those who can't afford insurance or have difficulty affording it. The tax penalty is specifically designed not to punish the poor, and yet you are here to portray it as though it is. Your brand of intellectual dishonesty does no one any good.

Biggest piece of social legislation since FDR and it survives, which means we start moving people back into healtcare. Back when I started my first full-time job, the healtcare coverage was excellent and 60%+ americans had healthcare coverage though their employers. Then we dropped to about 30%, with ever increasing premiums and deductables, further, the grantors of coverage were weeding out the expensive applicants because of Pre-Existing conditions (and we now have technology available for them to spot people higher risk of certain conditions, that's stacking the deck against people if ever it were.) Now, with the full weight of law we return to First World Status, looking after our people (even if some don't think they want it, everyone really does benefit in one or more ways here.)

While I felt it was a Frankenstein bill, when going through the House and Senate, because one party chose to hold their breath until they turned blue rather than participate (even with provisions they once championed), we at least have something.

If you "can't afford a doctor", you also can't afford to pay for a fancy "everything" health plan. Healthy young people need cheaper, catastrophic insurance plans that protect them from huge unexpected bills, not expensive benefit plans to pay for routine care. Insurance is for large unforeseen expenses, not routine bills.

Not even close. The expenses for younger people are a tiny, tiny fraction of the total.

That's what insurance is for. But governments mandate hundreds of benefits in health plans, so most of them don't qualify as insurance. They're just a wealth transfer to people who have lobbyists for their health problems.

... which are rare, and therefore easy to get inexpensive insurance for ...

...which is voluntary, and therefore not an insurable event. And which also does not happen to about 50% of the population, even though the government mandates their health benefit plans pay for it ...

... which are rare and insurable, like accidents ...

...which is also voluntary, like pregnancy.

The Supreme Court inadvertently just gave me a reason to vote Romney. Prior to this point I was planning to stay home, because both Romney and Obama are corporate puppets & anti-Bill of Rights dicks. They suck near-equally.

But now I would like to see Romney win the presidency & appoint some limited-government constitutionists to the Court (and the lower level courts). It is a bunch of bullshit that the Congress can order us around like puppets, else punish us with a tax (fine). With this precedent set, pretty soon I'll be paying $3000 in penalties because I don't have insurance (catastrophic doesn't count), I don't drive a "green" hybrid car, don't have a tankless heater, don't have a programmable thermostat controllable by the government or the utility, et cetera.

exactly. it's a religion based on myths that depends upon human beings behaving in ways they never have and never will. there is no such thing as a self-regulating marketplace. to be truly free and fair, a marketplace must be regulated. if it is not, the biggest players abuse the smaller ones. always have, always will. in societies with strong governments and regulated marketplaces where the largest players still get away with murder, this is a corruption of our government by those large players that is an argument for curing the sick patient, our government, rather than removing it and handing over the car keys to the sickness that is our enemy: entrenched rent seeking parasitical financial interests

i am a capitalist

i just understand it is simply a mindless beast for generating capital. the mindless beast must be harnessed, or it runs roughshod over your society

the choices in this world are not between ayn rand capitalism and stalinesque communism. these are absurd extremes that do not represent real world choices, only bloviating propaganda that no one serious really believes, except for committed WHARGARBBBLE victims like our friend the free market fundamentalist troll roman_mir

the real choices, for thinking people, is moderation: capitalism with social safety nets, or socialism with a capitalist engine grafted on

but don't let prudence, moderation, and careful thought, interfere with your partisan hysteria

(rolls eyes)

doing those things, then why shouldn't you have to pay it?

Or do you think the rest of us should have to subsidize your desire to save a few bucks by destroying the earth and not pay a cent for your health care? Because I guarantee that when you have some devasting health problem you will show up at an ER and demand quality care.

You just don't get it.

EVERY ONE except the 1% has trouble affording health insurance these days. An unfunded mandate that helps only the desperate is not going to help anything.

It's not even a band-aid on a bullet wound, it's some rouge.

It is a bunch of bullshit that the Congress can order us around like puppets, else punish us with a tax (fine).

Congress can draft you, and send you to the front.

that's awesome

so when you break your arm, and you have no insurance, and you go to the hospital, and avoid the bill because you don't have a $50,000 healthcare fund in your checking account and you live paycheck to paycheck like most americans, the rest of us will have to pay that $3,000 to fix your arm

to people like you, freedom means freedom from responsibility

you're a freeloader

go ahead, vote for romney. and if enough vote for romney for the same reason, that they don't want to take responsibility for financing their own healthcare, then this country is doomed to ever increasing healthcare costs

i however have faith that most americans are more intelligent and responsible than you are, and with single payer, we will eventually bring our healthcare costs in line with most other modern countries in this world, who have unviersal healthcare, and spend far less per capita than the usa does. because how they finance their healthcare system is predicated on common sense and economies of scale, and not predicated on satisfying corporate rent seeking parasites like healthcare corporations, whose talking points you apparently swallow hook line and sinker like a good little faithful propagandized moron

You notice how much of the criticism of the law comes from sheer ignorance about what it actually does? Even on Slashdot.

Seriously?

Please name me the US Federal Government Car Insurance Mandate. Oh wait, there isn't one... because the Federal Government mandating car insurance would be unconstitutional. A mandate for car or health care insurance is properly the right of States, not of the Federal government.

Even 5 Supreme Court justices said the US Federal Government Medical Insurance Mandate is unconstitutional. The only reason this slid by is because A) CJ Roberts wanted to use this as a platform to tell Congress to quit using the SC as an alternative to a vote to repeal, and B) magical hand-waving by which the practical implementation of a tax burden to cover health care was enough to not strike down the underlying theory behind the Affordable Care Act.

Obama and the Democrats were idiots for not implementing the "insurance individual mandate" as a tax break / monetary payout to buy health insurance anyways. They could have avoided this entire debate by doing so.

Look, shit head, if you want to have that attitude, then wear a big wrist band that says "DO NOT PROVIDE ME WITH MEDICAL CARE UNDER ANY CIRCUMSTANCES". Add something about religious beliefs or some such nonsense so that when you get in an accident/get seriously sick/have a heart attack/whatever, you aren't forced into participating in the health care system to which you do not want to contribute.

The difference here between health care and auto insurance is that you can opt out of owning a vehicle and driving and not increase the cost for the rest of us. You can't opt out of ever getting sick or injured or otherwise needing medical attention for your entire lifetime. Society generally will not allow you to bleed to death on the side of the road just because you refused to pay for health insurance (or pay the fine/tax imposed by the new law). So whether you like it or not, you *are* participating in the health care system, and you *are* being a selfish asshole for refusing to acknowledge that.

And irony of ironies, getting yourself thrown in prison for refusing to pay for health care (or aforementioned fine/tax) provides you with a government-paid health care plan.

Brilliant of you to play roulette with your health, but I guess no big deal as you can declare bankruptcy if you can't afford a major health catastrophe, or go to the hospital ER if you have no coverage.

Liberty.
Self-rule.
Pro-choice.
A Freman not a Serf to be ordered about by the Congressional lords' random wishes.

>>>you're a freeloader

Last year's income: $130,000.
Last year's paid taxes: $41,000.
Really?
Freeloader?

BTW under Obamacare a new panel is asking doctors to produce lists of obese people (BMI>30). Why? Because these people will be signed to counseling and diet programs, generously paid by either the government or the insurance company. In other words, rates are going UP not down.

It is called a surplus when you are talking about governments. And we actually had one in recent history.

But then we decided to go shopping at the war and tax cuts for the ultra rich shop.

You've got two choices.

Choice 1) You need hospitals and doctors who will throw you out and let you die if you can't pay for your care, and will do a credit check or check your bank account before they begin providing care.

Choice 2) Some form of universal insurance, whether it's a 'tax', an individual mandate in a private system (What we have now), or a true public option (More like what you have in other countries).

There is no other option. Medical care isn't free. Someone has to pay for the doctors, for the drugs, for the operating rooms, for the sterilization, all of it. This is not a theoretical problem, either. We've waited long enough with our current slapdash system - where the insured subsidize the uninsured - that it's already in the midst of collapse, and is slated to collapse within 15 years. The bills are too high. Giving care to everyone without insurance for everyone is just wrecking us, especially because the only care you get while uninsured - emergency care - is the most expensive kind.

Do you want to die on the hospital floor, do you want to be forced to show the minimal planning that health insurance -is- (Providing for your ability to continue living), or do you want to continue to throw a tantrum like a five-year-old?

If you took the money you are spending on health insurance and put it into safe long term investments, you'd have no trouble affording health care and you'd be far better off.

And if we got rid of some of the other monopolies, such as limits on medical degrees, restrictions on drugs, restrictions on importation of drugs, requirements for prescriptions, etc., health care costs would plummet.

Health care in the US is expensive because it's a system designed to funnel money from Americans to a small group of special interests (doctors, drug companies, drugstores, insurance companies), and instead of fixing that problem, Obama locked it in even tighter.

you're not very bright

cable tv is an unnecessary luxury

healthcare is absolute necessity

no but the government isn't some other body. it is based on a simple idea that we all need certain things that we can't or shouldn't pay for individually. (say fire department). we each pitch in and that makes everybody's life better.

if you want to live in town, we ask you not to shit all over everything and to keep your dog from biting the small children. if you can't deal w/ that move into the woods.

If you aren't moving into the woods (stop using roads, police protection, medical, etc.) realize that you are either chipping in or you are a mooch (who should be kicked out of town)

It was shredded long before this mandate issue.

And they've added lots of other bonus things to the legislation. That's why overall I've been opposed to it from the start.

you see the legislative package and Pelosi's plea "we have to pass so you can know what's in it." [youtube.com]

Is one of the most troubling pieces of legislation ever passed in any democracy. Aside from the mandate and the insurance things having to do with affordable care, there's a litany of other little tidbits in
the ACA that most Americans have glossed over.

Deep down I believe that most of us won't be feeling all giddy if and when these other things kick in. It happens all the time in DC, a piece of legislation will get past but these little riders show up and now they're past as part of the same legislation. It's bullshit and it's been done too long especially in the light of the backroom deals that were done with the Drug Companies to protect their financial interests package [blogspot.com] as well.

Affordable Care? No, this whole legislation takes a lot of free market pressure off of providers, insurers and the drug companies because you have to pay them regardless and you can't go anywhere else. On the plus side HealthCare related spending will increase not because of market pressures but because it will be a self-perpetuating engine feeding itself off of more premium dollars and no competition. More double digit cost increases in healthcare so it'll be a great growth industry for the economy right? So premiums will rise to cover those costs and it will be the same like it is now, with millions of Americans unable to afford quality care. Oh and there's also another big benefit if you live in DC, NOVA or Montgomery or Prince Georges County: the size of our bureaucracy in Washington will just get bigger.

gasoline is already taxed (eventhough this tax doesn't cover the full society cost of gasoline): so isn't that tax an unfair imposition on your freedom in the same way that this health care tax is?

> If he doesn't have a tankless heater, he's the one paying the gas bills for the heater.
> If he doesn't have a programmable thermostat, he's the one paying the utility bills.

The taxes on those items don't cover their societal cost. If you think they do then you are naive.

> Yes, you mentioned the ER. The fix to that isn't to impose insurance, it's to remove the requirement that the ER treat those who won't pay their bills.

Now you've crossed from naive to stupid. I would bet every dollar I have that your opinion on this changes as soon as you or a loved one is in the position of needing emergency health care.

Why, with all that extra money, you could pay to send your kids to school, hire a policeman to protect you, hire some firemen to keep your house from burning down, build some roads (if you can get your neighbors to chip in)...

Hey, ignoramus. It's possible to pay for medical care without insurance. I do it. Rush Limbaugh does it.

Insurance companies make a lot of money, as is their right. But they are middlemen using their customer's money for their overhead, and that increases prices compared to customer-pays. If the government takes over insurance/health care, the incentive against waste disappears. Either cost increases, quality declines, or some are denied service; there is no other possible outcome.

You mean the freedom for you to make choices which I have to pay for? Nope.

Move to Somalia, Libertarian paradise with no taxes. Enjoy.

Or maybe we notice exactly what is going on, and since we voted Obama in, are quite happy with it. It's a grand day for those of us who voted in Obama...or maybe you forgot we exist?

Of all the lies spewed about this law, this is the most disingenuous. You can choose not to drive. Unless you put a gun to your head, you can't choose not to live.And that's precisely what this law is: a government mandated fee (NOT a tax, that's also BS) for simply being alive.

Except that it isn't public health care. It is private health care, mandated publicly. You'll notice private companies handle health insurance like Aetna, Blue Cross, and so on. And they still will. These companies are not going away.

Which is, ironically, why this legislation sucks.

Americans pay 16-18% of our per capita GDP in health care costs. France and Switzerland, the two consistently highest rated health care systems on planet Earth, which both offer true universal coverage to all their citizens, cost their people around 11% of per capita GDP.

You will not hear these numbers being touted by Democrats, Republicans, or the media. It isn't in there interests for you to understand how bad things have really gotten in the USA.

Public health care similar to socalled "Obamacare" is commonplace in most of Europe, where the costs are lower and quality is higher (citation needed? LMGTFY).
Why would costs rise and quality decrease in the US? Is there something inherently wrong with the US that they can't make this work as well as in Europe.

This actually made me laugh. Yes, that's true in a statistical sense, on average you'll come out ahead (how else are the insurance companies making money?). Reality is that you'd be living your life one car accident, heart attack, or cancer diagnosis away from being financially ruined for life, and screwing over the rest of us when you fail to pay your multi-hundred thousand dollar bill to the hospital.

Well of course they're not actually forcing you to buy anything. They're just taxing you if you decide to be an irresponsible fuck and plan to freeride on the rest of us if you ever get sick. But don't let reality get in the way of your paranoia.

so freedom doesn't include the freedom to live?

riddle me this batman: why do more modern countries than the usa, the ones with universal healthcare, spend LESS and live LONGER?

but if you really want to go out when you still have some oomph in you, go ahead, go to your garage and swallow your shotgun, you have my blessing

oh, i'm sorry, do i sound cruel?

i believe i'm responding to a comment that just basically advocated for "grandma's joints sound creaky, might as well leave her out in the snow"

i understand that the right wing is basically advocating cruelty, meanness, ignorance, and selfishness to the point of self-destruction

but i won't let you define the rules of the american society i am proud to be a part of, which considers human dignity a lot higher than you do

says me, says the majority of americans, and says the us supreme court

we don't like your "freedom" to be live short brutal ignorant lives. we advocate for education for all, healthcare for all, and yes, we are going to fucking pay for it, because i wish to live in a rich society of healthy, educated people who actually are able to exercise their freedoms

go to move to somalia if you wish to have the society you desire, because the society you desire is most certainly unamerican and anti-freedom

Oh I agree. But even the little baby steps we're taking with Obama's health care reform act are being met with all kinds of illogical resistance. It boggles me. People standing in the streets with signs wanting to repeal Obamacare. Even though it has provisions like how you can't be dropped or denied for a pre-existing condition. [thanksobamacare.org] How in the world could someone be against that? I could see a CEO of a health care company not liking it, but the rest of us? How?

We're so screwed up in this country that you can actually get nearly half the people in the streets shouting that this is a bad idea. I have no idea how you accomplish that, but there you go.

So yeah, anything more invasive like what France has and it's ARRGH SOCIALISM and people would totally lose their minds. Even though it would be in their best interests.

- tell me, who provided anybody with health insurance before free market capitalism based and industrialisation. Do you know? People went to their local doctors, yes? no? yes?

The poorest in the society always got their charity from somebody, and they knew exactly who was giving them charity, which is the way it should be. Gov't took upon itself to steal from some and give to others, call it 'charity'. It's not charity, people now EXPECT that type of 'charity', they now understand it as their 'right' for some reason.

I do not see it as a right.

It is an entitlement and gov't shouldn't be allowed to do that - steal from some to give to others.

Charity always exists, doctors used to do work pro-bono, churches and other groups took care of people, it was known as charity and it should stay that way.

There shouldn't be an idea that just because you are born, you are entitled to something - you didn't do anything yet to deserve anybody's productivity, anybody's wealth.

The type of system that I advocate is a system where people are served by the free market capitalism, which is the best system known in this world to people to produce the most wealth in this world in the shortest time span.

The kind of world I advocate is the world where everybody is so productive that they don't have a problem paying for their healthcare out of pocket, that's my preferred method, but I will never advocate a welfare world.

I call shenanigans. While the bill may raise demand relative to a perfectly free market, it has has no provisions that reduce competition. On the contrary. If it increases costs as you say it will (a distinct possibility) the one would think that more companies might want to get in on the action. Healthcare insurance has an enormous number of competitors. And, ultimately, you still have a choice: pay the fine rather than buying insurance.

Name 3 tidbits if you can. I'm genuinely curious.

Why don't you quote your hero, and the author of this legislation, Obama about this. Look for where he told a woman that her grandmother should just take some aspirin and die instead of getting lifesaving medical care, because she's just to old to spend taxpayer money on.

Obama and his cronies have lied about this legislation from the start. They rammed it through reconciliation because it wasn't a tax bill. Now that they need it to be a tax bill, it is. It was supposed to be under a trillion dollars, and it's already double that, even before much of it has been implemented, and expected to double yet again before it actually starts to do anything. there's not supposed to be "death panels", but they have a panel that can deny lifesaving treatment for any reason they want.

Oh, and those "shovel ready jobs" weren't so "shovel ready". Har har har! Hilarious!

No, no, no, no, no! Read the Constitution and Declaration of Independence. They aren't long.

The government does not exist on the simple idea that it should provide things we don't want to pay for individually. Nowhere in there does it say anything about that. The government exists for ONE reason. To preserve life, liberty, and the pursuit of happiness. And no, providing healthcare is not the government preserving life. That is the government FORCING others to preserve your life. The government is there to enforce simple laws: Don't kill, don't enslave, don't steal. Having fire protection is nice to have, but can just as easily be provided by private insurance. Or will the next government mandate be for car insurance, home insurance, eating vegetables, riding public transit, etc?

The power to take someone's livelihood for any reason whatsoever is just a few percentage points of taxes away from slavery.

More hysteria -- I often wonder where such thinking comes from. Now I've got a front row seat.

It's funny you mention that because Roberts covered that. He specifically said that the Anti-Injunction act says it HAS to be called a tax for it to apply. So in the very specific case of the Anti-Injunction act it does matter what it is called because the law specifically says that it does. But in regards to the constitutional ability to levy taxes, the constitution says nothing about what it has to to be called. He simply said it doesn't matter what they call it, it's meets previous supreme court precedent for a tax so it's a tax. (walks like a duck quacks like a duck)

It's a very well reasoned opinion and it scratches a very important itch of mine. Roberts has laid down important restrictions on the commerce clause in a majority supreme court precedent that can be cited in future cases! In fact I think this opinion is going to be cited in a whole bunch of future challenges of the commerce clause. He actually establishes a test of when a claim of commerce clause goes to far (though it's a vague test). IMO it would be hard for government to get past that test with a challenge to the drug laws.

I am seriously disappointed by the vast majority of comments here. Slashdot generally presents some semblance of caring about facts and citations supporting any claims, but as soon as the ACA comes up, it seems like everyone abandons reason and logic. I want to provide a viewpoint applying those two methods to this topic. Hopefully others interested in the same will chime in.

First, to all the foreigners chiming in claiming to have this same law in their countries, I want to reply, no, you don't, and it doesn't matter if you did. No two laws anywhere are exactly the same, so what you have is not going to be the same as what we have. If you are going to make that claim, I am going to demand you provide a citation for the one or more laws that have the exact same text as ours, along with supporting evidence that it is interpreted legally in the same way. Now, you may fairly claim the intent of the law is the same as the intent of the law in your country, which shifts the discussion to how well the law actually implements the intent, and I'll address that in a moment.

Next, I'll give foreigners the benefit of the doubt and assume the law is identical to one in their country that "works". A problem ignored by foreigners is that basically every other law this country has is different from their laws. The United States is governed by a Constitution that is different than the underlying laws of every other country. So even if it works in your system, we can't just wholesale "borrow" your law and magically expect it to work here. We need a law that is carefully crafted to respect the restrictions in the Constitution (or else pass amendments to the Constitution to provide an exemption in this case) as well as maintain our economy.

For a third point, I'm sick of the partisan whining from the Democrats and Republicans. No, the Republicans are not uncaring bastards who don't care if people die. Neither are the Democrats trying to set up a nanny state where they have complete control of other people's lives. Both parties set up a false dichotomy in which there are only two options when there are actually many more. Republicans value personal freedom as the highest value, where Democrats value livelihood. Both of these are valid viewpoints, and having a different opinion does not turn another person into a monster. If you can't talk about the other party without vilifying them, chances are you are a brainwashed servant of your political party.

Fourth, how well does the law implement the intent? This is the point that disturbs me most, and why I am largely against the law. The law ballooned from one hundred pages to over two thousand in an extremely short time period (something like thirty to forty-five days, if I recall correctly). Basically none of the legislature read the law before passing it. No one bothered to look into how well it met the intent. No one tried to run simulations to estimate how well it would work. No one knows what it will cost (we hear one trillion dollars, but that is just as much a guess as the eight hundred billion "needed" to bail out the banks). Even worse, no one knows what sort of side effects there are. Essentially, the government is gambling that this massive law is going to magically make things better, but given the lack of data about it, there is a fifty percent chance it is going to negatively impact the country, as well as a fifty percent change it will positively impact that country - and then only by drastically simplifying things to the level of American "news" organizations. A law this massive can't even be judged by such simplistic terms. Realistically, some things will work great - I am a big fan of the clause guaranteeing health insurance in spite of pre-existing conditions. Other things will be big problems - the time to see a doctor is likely to increase, something foreigners conveniently forget to mention (or just flat don't realize) in comparison to the current American standard (and what's more, the rich of other nations know it, which is why they traveled to

The thing that has people upset is that they will be required to buy health insurance.

People do not like not being excluded due to pre-existing conditions.
People do not like being force to buy insurance.
Sorry, you can't have it both ways. Otherwise young healthy people wait until they have a problem and then expect to start paying the same rate as everyone else. The function of insurance is to amortize the costs of unexpected (randomly occurring?) events over time and over population. This is broken both by people selectively participating and by companies selectively allowing people to participate. You must eliminate the cheaters on both sides or you really screw one side.

Not passing judgement, just pointing out one of the fundamental issues this law attempts to address.

Well two things.

First thing, if you don't have health insurance and you get sick, who pays? That's right - I do. And everyone else who contributes to the system. But you don't. It's not fair.

Second thing. Health insurance just got a whole lot less scammy now that the reform act is in place. Go read it - you'll see. There's a ton of lousy crap they're not allowed to do now.

You could brand that on your forehead but if you are unconscious they are obligated to save your life. DNR (Do Not Resuscitate) orders have to be given to ANYONE that could be called to make decisions, this typically means, spouses, parents, children and filed with every single hospital, clinic, ambulance or EMT service you could be serviced by before they would even consider obeying them.

The immense liability of allowing someone to die absolutely guarantees that unless there is someone there with notarized copy of the DNR AND a family relationship that would grant power of attorney that the order will be ignored. Until you deal with this and an elderly or terminal patient you don't realize how hard it is to get medical personal to honor this request. (I understand why, if the document was fake the medical personal would still be liable).

Oh, I'm sorry, I thought that whole thing about the POTUS now being able to imprison or kill US citizens without due process, not to mention the TLA fiascos, GPS tracking, warrant-less searches and data/voice snooping, and everything else that nearly everybody on Slashdot has howled about for a decade under both GWB and Obama (including me) when they were announced actually happened!

Whew! Thanks!

I feel much better now that I know that was all hysteria.

Mass hysteria too, apparently. Good thing everybody will have insurance for the therapy they'll need.

Strat

But thank God your right to be overly dramatic has been upheld.

Maybe. But apparently you can be taxed for exercising it.

Heh. Nice!

Of course, someone who has no truly deeply-held beliefs in individual freedom, the rule of law, or the principles upon which the nation *was* based, will find those that do have such beliefs "overly dramatic" when they protest their trampling. So it has always been with those who think like he does.

Timid men prefer the calm of despotism to the tempestuous sea of liberty." - Thomas Jefferson

Strat

Of course, someone who has no truly deeply-held beliefs in individual freedom, the rule of law, or the principles upon which the nation *was* based, will find those that do have such beliefs "overly dramatic" when they protest their trampling. So it has always been with those who think like he does.

Timid men prefer the calm of despotism to the tempestuous sea of liberty." - Thomas Jefferson

Son, if all it takes to "trample" the "principles upon which the nation was based" is a law that requires people to have medical insurance, then those were some weak-ass "principles" to begin with.

Now, if you can get up off the fainting couch and stop clutching your pearls for a minute, you might realize that the exact same hysterical sisters were claiming that Social Security was also going to "trample the principles upon which the nation *was* based". And still, the greatest decades of this Nation's history followed that law, too. We ended up as a stronger nation, with more enduring principles because we decided that we were going to make sure that people didn't have to eat cat food when they got old.

Maybe take a minute and realize I'm trying to talk you down off the ledge here. The "principles" that hold this country together were never "The Constitution" or some Burkean fantasy of the Right. The principles that have always held this country together are the ones that say, "We're all in this together" and "Let's get this done" and "Things work better when people aren't selfish assholes".

Until that sinks in, stay in your bunker. I'll knock twice when the zombie health care apocalypse is over and you can come out again and go back to getting your health care from the emergency room. It's really not healthy to live your life in such fear and dread, you know.

Yes, they have a few doozies:

"I got a letter the other day from a woman. She said, 'I don't want government-run health care. I don't want socialized medicine. And don't touch my Medicare." (some anonymous woman ot th ePresident) Arthur Laffer

"If you like the post office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid and health care done by the government.

Simply brilliant! The biggest problem with Medicare is that weird "Donut hole". Courtesy of?

That comes from catering to people who can hold two or more conflicting viewpoints at the same time.

Further, there was a lot of activity on Twitter today from the rabid right from people who were declaring they were going to move to Canada. See how that works? Hate "Amercia" because they have some sort of universal healthcare? the fix is to move to Canada, which has a single payer healthcare system. Makes no sense until you realize it is part of the dissonance.

You answered your own question: USA *has* world-class healthcare for the most affluent people, those who have top-notch insurance or can afford to pay.

But on the *average* US healthcare is both more expensive, and poorer than that of all other similarly wealthy democratic countries I can think of. This makes a lot of sense: benefits of healthcare is diminishing-return, i.e. you get more additional health by spending $1000 more on someone who has no or very limited access to healthcare than you get by spending the same $1000 on someone who already have very good healthcare.

USA does the latter. The very good are turned into EXCELLENT. That's fine and good for those people who belong to that segment.

Meanwhile most other wealthy democracies are much better at turning poor into good. And this gives more benefits for less money. You do more for public health by going poor to good than by going very_good to excellent, it's also cheaper.

The main reason USA doesn't have socialized healthcare long ago, is that essentially all of the people with power and influence in USA belong to the "very good" category. For *them* it makes perfect sense to prefer very good to excellent instead of poor to good.