From a doctor's perspective, is it better to repeal or keep healthcare reform

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[Updated at 10:15 a.m. ET] The Supreme Court has upheld the entire health care law by a vote of 5 to 4, Supreme Court Producer Bill Mears said. That includes the medicare provision.
 
Haha, lol @ CNN. scotusblog is the only place for this story.
 
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Lots and lots of tears will be spilled by conservatives today.
 
Justice Roberts' opinion upholds the entire PPACA. Only exception is that the federal government can offer new funds for Medicaid expansion but can't penalize states who don't participate by taking away existing Medicaid funds.
 
thanks to cnn i was pissed at the supreme court for about 2 minutes, apparently john roberts was the deciding vote..
 
Plain English summary from SCOTUSblog:

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.
 
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Anyone care to explain how these doomsday scenarios are going to come about? It's a pretty ineffective bill and won't have much of an effect at all.
 
Anyone care to explain how these doomsday scenarios are going to come about? It's a pretty ineffective bill and won't have much of an effect at all.

I've been reading blogs/journals/articles about this all day, and I've read dozens of posts by small business owners now despairing of being able to hire new employees.
 
Yes, many business cannot afford to hire more employees and expand business due to the requirement of providing health care. Small businesses will likely lay off or cease hiring. A man I know whose business produces $6-7 million per year told me that he is cutting back to as few employees as possible. He is in the manufacturing industry, so he is considering using machinery instead as well. He told me that before this bill with all of the business taxes in place his business only kept 25% of what it made. With the new bill, he will surely survive, but he said it makes more financial sense to cut employment as much as he hates firing people.
 
Anyone else kind of impressed by Roberts strategy? Ignoring the content of the ruling, the Supreme Court could ill afford deciding this case 5-4 on partisan lines or risk further tarnishing its reputation.

I knew what would happen if it looked like a 5-4 decision for the President's bill - Roberts would join to make it 6-3 instead.

I had no idea what would happen if it went 5-4 against the President's bill. it seems like that is what was going to happen, and Roberts also switched his vote so that although it would be a 5-4 decision, it was not a partisan one.

Maybe he really just decided on the merits of the law, but if his goal was salvaging the reputation of the Supreme Court as an apolitical body, he made the right move.
 
It's good that he focused on the constitutionality of a statute, rather than politics. Roberts left the fate of law with political branches and voters, where it belongs. He's a predictable conservative.


Anyone else kind of impressed by Roberts strategy? Ignoring the content of the ruling, the Supreme Court could ill afford deciding this case 5-4 on partisan lines or risk further tarnishing its reputation.

I knew what would happen if it looked like a 5-4 decision for the President's bill - Roberts would join to make it 6-3 instead.

I had no idea what would happen if it went 5-4 against the President's bill. it seems like that is what was going to happen, and Roberts also switched his vote so that although it would be a 5-4 decision, it was not a partisan one.

Maybe he really just decided on the merits of the law, but if his goal was salvaging the reputation of the Supreme Court as an apolitical body, he made the right move.
 
It's good that he focused on the constitutionality of a statute, rather than politics. Roberts left the fate of law with political branches and voters, where it belongs. He's a predictable conservative.

It's clear he jumped through hoops and performed grotesque distortions to make his "constitutional" argument.

And when it's all said and done, it's not like politics was avoided - see the repugnant bashing by liberals of Scalia and Thomas.

Incidentally, why is it that when a black or a woman is a "conservative" it arouses such ire and hate? Just wondering...

Oh, and did you notice that the fact that Kagan, Sotomayor, Breyer, and Ginsburg were shoe-ins was never deemed political? No, no way. :barf: at the hypocrisy.
 
Clarence Thomas really is a disgrace and he knows it.

He's the classic example of someone who only got his position through affirmative action and therefore hates it because it reminds him of his own inadequacies.

Seriously, he's barely a justice, he just leans back in his chair, doesn't ask questions, and doesn't write opinions.

It's a real embarrassment that he was picked to replace Thurgood Marshall.

(This isn't just conservative bashing on my part - I have immense respect for Scalia despite disagreeing with him about almost everything. He's a genius, albeit an evil one.)

No matter where they fall on the political spectrum, justices should at least be competent.
 
Ok jonathan.... tell us how you REALLY feel.... Don't hold back now :laugh:
 
Incidentally, why is it that when a black or a woman is a "conservative" it arouses such ire and hate? Just wondering...

I don't dislike Thomas because he's conservative. I dislike him because he was, at best, marginally qualified to be appointed to the Supreme Court, and he has done absolutely nothing to disturb that impression ever since.
 
Yes, many business cannot afford to hire more employees and expand business due to the requirement of providing health care. Small businesses will likely lay off or cease hiring. A man I know whose business produces $6-7 million per year told me that he is cutting back to as few employees as possible. He is in the manufacturing industry, so he is considering using machinery instead as well. He told me that before this bill with all of the business taxes in place his business only kept 25% of what it made. With the new bill, he will surely survive, but he said it makes more financial sense to cut employment as much as he hates firing people.

It's a mixed bag for small businesses. If I hire a tech right now I am under no obligation to provide health insurance (fewer than 50 employee rule), but I could get a tax credit for 35% of the premiums if I chose to provide it. I can see wage adjustments ameliorating the effects for business >50 employees.

It would be very nice for everyone, including entrepreneurs, to put an end to job-lock.
 
I agree. It's just a little ironic how Roberts was the swing vote, and that all 3 women Justices stood together in the 5-4 majority.



It's clear he jumped through hoops and performed grotesque distortions to make his "constitutional" argument.

And when it's all said and done, it's not like politics was avoided - see the repugnant bashing by liberals of Scalia and Thomas.

Incidentally, why is it that when a black or a woman is a "conservative" it arouses such ire and hate? Just wondering...

Oh, and did you notice that the fact that Kagan, Sotomayor, Breyer, and Ginsburg were shoe-ins was never deemed political? No, no way. :barf: at the hypocrisy.
 
I agree. It's just a little ironic how Roberts was the swing vote, and that all 3 women Justices stood together in the 5-4 majority.

It's not ironic at all. As chief justice, his primary objective aside from upholding the law as he sees it is maintaining the dignity of the court.

Repeated 5-4 partisan decisions diminish the court.

Had he allowed another one to go forward that reversed the major "accomplishment" of the Obama presidency, the Supreme Court would have been dismissed as another political body and Denocrats would have been gunning for it.

With his opinion, he simultaneously set a precedent limiting federal power and maintained the court's independence.

He's not a dummy.
 
It's not ironic at all. As chief justice, his primary objective aside from upholding the law as he sees it is maintaining the dignity of the court.

Repeated 5-4 partisan decisions diminish the court.

Had he allowed another one to go forward that reversed the major "accomplishment" of the Obama presidency, the Supreme Court would have been dismissed as another political body and Denocrats would have been gunning for it.

With his opinion, he simultaneously set a precedent limiting federal power and maintained the court's independence.

He's not a dummy.

I agree with this. Much of his decision should make conservatives happy, especially with the precedent he just set for the commerce clause. The only thing he did was to uphold the taxation interpretation of the health care bill.
 
I agree with this. Much of his decision should make conservatives happy, especially with the precedent he just set for the commerce clause. The only thing he did was to uphold the taxation interpretation of the health care bill.

Yeah, if he hadn't upheld the bill, the court would have been seen as just another partisan institution and Obama and the Democrats would have started looking into ways to undermine it (much like FDR).

Instead, he confirmed the courts independence ("Hey, a conservative defied other conservatives!"), forced the President to support the decision (and therefore the court), and won conservatives a significant victory against expansion of federal power.

If conservatives actually were rational these days, they'd be applauding the decision.

As a somewhat atypical liberal, I'd have rather seen it overturned, and am very worried by the Roberts' opinion's implications.
 
It's not ironic at all. As chief justice, his primary objective aside from upholding the law as he sees it is maintaining the dignity of the court.

Repeated 5-4 partisan decisions diminish the court.

Had he allowed another one to go forward that reversed the major "accomplishment" of the Obama presidency, the Supreme Court would have been dismissed as another political body and Denocrats would have been gunning for it.

With his opinion, he simultaneously set a precedent limiting federal power and maintained the court's independence.

He's not a dummy.

Really? Is that in his job description? To get favorable Letters-to-the-Editor in the New York Times?

Edit: Obama already has targeted the Court. Did you see him lie about them in his State of the Union address? Absolutely disgraceful. Talk about unqualified.
 
Really? Is that in his job description? To get favorable Letters-to-the-Editor in the New York Times?

Edit: Obama already has targeted the Court. Did you see him lie about them in his State of the Union address? Absolutely disgraceful. Talk about unqualified.

Stop being silly (re: the State of the Union).

Yes, of course it's in his job description (if he wants to be remembered as a great Chief Justice and for the Supreme Court to remain a powerful institution in American politics).

If he wants to be a partisan hack with no influence on the future of the nation then you might be right.

Most of the power of the court comes from opinion and precedent, so yes, it is actually very fragile and susceptible to change. The subtleties of this decision and its implications are clearly lost on you.

You probably also opposed the ACA without having a real reason why.
 
Really? Is that in his job description? To get favorable Letters-to-the-Editor in the New York Times?

Edit: Obama already has targeted the Court. Did you see him lie about them in his State of the Union address? Absolutely disgraceful. Talk about unqualified.

Your partisan vitriol has become ridiculous. If you're talking about the way he addressed the Citizens United case, you need to understand that the ruling totally changed the way elections are run and was misleading at best. It's impossible to stop a candidate from coordinating with a super pac, even if they cannot legally corroborate directly. And yes, the chief justice always leaves a legacy based on the rulings his court has made. Look at how cases like Roe v. Wade, Brown v. Board of Ed. or Marbury v. Madison changed history. As justices serve for life, most of them are well aware of how their votes can affect people's daily lives. Chief Justice John Roberts understands the importance of his decisions in setting and following precedent, for the continued legitimacy of the Supreme Court.
 
Every time I read your interpretation of this amendment all I can think is "six degrees to Kevin Bacon".....

Can you fond even a single instance where anyone in congress has proposed such an over extended interpretation of that amendment?

P.s. the amendment does not guarantee protection by police. It guarantees protection FROM police.

That's how congress and the courts interpret the amendment. The courts have been abundantly clear in ruling that the right to bear arms for defensive purposes is legally mandatory as a substitute for police protection because no right to police protection exists, but a right to defense does exist. It's a right by deduction. See Castle Rock v. Gonzalez and DC v. Heller.

Healthcare is the same thing. It's protection from illness. If you have a right to pursue healthcare for attempt to defend yourself from illness, but the government infringes somewhat on the right for the sake of practicality, you're entitled to compensation for said infringement. It's just like receiving compensation for eminent domain.

Now that we've achieved partial victory, the real question is: How do we lower costs for the patient without bankrupting ourselves?
 
:laugh: you do realize that the upheld mandate does not support your idea of a right to healthcare, right? You truly just see whatever you want to see in the documents....

and lets keep with your 2nd amendment argument for a minute. "Right to pursue healthcare"... fine. Nobody is against that. But the right to pursue does not equal "right to have provided". Even when we talk about the right to keep and bear arms, the arms are not provided. The citizen still has the obligation to purchase for themselves whatever arms they wish to own. That is why your interpretation of these amendments and the extension to healthcare is so inappropriate. If we draw a direct parallel as you have been attempting to, the people are still required to pay for healthcare. I am not even taking a position of "right or wrong" with respect to whether or not healthcare is a right in these posts..... I am just saying your logical leap from the amendments is wrong. This has been a round-about battle with you, though.....

And when I asked you for even a single instance in the courts, I was referring to your insistence that the rulings relate to healthcare. the courts have not been "abundantly clear" on that. All things considered - you are pretty much just making it up :thumbup:
 
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Your partisan vitriol has become ridiculous. If you're talking about the way he addressed the Citizens United case, you need to understand that the ruling totally changed the way elections are run and was misleading at best. It's impossible to stop a candidate from coordinating with a super pac, even if they cannot legally corroborate directly. And yes, the chief justice always leaves a legacy based on the rulings his court has made. Look at how cases like Roe v. Wade, Brown v. Board of Ed. or Marbury v. Madison changed history. As justices serve for life, most of them are well aware of how their votes can affect people's daily lives. Chief Justice John Roberts understands the importance of his decisions in setting and following precedent, for the continued legitimacy of the Supreme Court.

Obama: Citizens United "open[ed] the floodgates for special interests - including foreign corporations - to spend without limit in our elections. Well I don't think American elections should be bankrolled by America's most powerful interests, or worse, by foreign entities."

This is false. The Court held 2 U.S.C. Section 441a, which prohibits all corporate spending, unconstitutional. Foreign nationals,including foreign corporations, are prohibited from donating to elections under 2 U.S.C.Section 441e. They are also prohibited from contributing to a political party's committee, and from making expenditures from electioneering communication.

I'll offer you a choice: either he is a liar, or incompetent.
 
Obama: Citizens United "open[ed] the floodgates for special interests - including foreign corporations - to spend without limit in our elections. Well I don't think American elections should be bankrolled by America's most powerful interests, or worse, by foreign entities."

This is false. The Court held 2 U.S.C. Section 441a, which prohibits all corporate spending, unconstitutional. Foreign nationals,including foreign corporations, are prohibited from donating to elections under 2 U.S.C.Section 441e. They are also prohibited from contributing to a political party's committee, and from making expenditures from electioneering communication.

I'll offer you a choice: either he is a liar, or incompetent.

The current understanding of the ruling is that it is so loose, foreign nationals can easily donate to non-profit organizations that have no need to disclose their donor lists, but can in turn donate to a campaign.

Colbert exploited this when he set up his SuperPAC, think he called it his Super Secret PAC (I believe the entity involved is a 501.4(c))

It doesn't matter if you officially forbid foreign nationals from donating if there's no mechanism to make sure they don't.
 
This is false. The Court held 2 U.S.C. Section 441a, which prohibits all corporate spending, unconstitutional. Foreign nationals,including foreign corporations, are prohibited from donating to elections under 2 U.S.C.Section 441e. They are also prohibited from contributing to a political party's committee, and from making expenditures from electioneering communication.

The loophole is domestically organized companies that are owned or controlled by foreign interests. Those are not prohibited by 411e form spending money to influence US elections. In this instance Obama's statement is perfectly reasonable.

Dave89 said:
I'll offer you a choice: either he is a liar, or incompetent.

He is displaying neither quality here. You, on the other hand, are turning into Old Faithful.
 
The current understanding of the ruling is that it is so loose, foreign nationals can easily donate to non-profit organizations that have no need to disclose their donor lists, but can in turn donate to a campaign.

Colbert exploited this when he set up his SuperPAC, think he called it his Super Secret PAC (I believe the entity involved is a 501.4(c))

It doesn't matter if you officially forbid foreign nationals from donating if there's no mechanism to make sure they don't.

The loophole is domestically organized companies that are owned or controlled by foreign interests. Those are not prohibited by 411e form spending money to influence US elections. In this instance Obama's statement is perfectly reasonable.



He is displaying neither quality here. You, on the other hand, are turning into Old Faithful.

How did Citizens United reverse 100 years of precedent, as the President claimed?
 
there are many doctors supporting obamacare and just as many opposing it. The ama, for example, supported at least a big part of the bill.

it's weird to hear people going into medicine that think not all people should have health care. in the end, it costs everyone if an uninsured person has to wait 10 years to get treated because his illness has gotten so bad that one of the local hospital has to treat him/her.

Universal health care would hopefully prevent many people's diseases from progressing and costing society more in the end. At least this is an argument that i keep hearing in favor of obamacare.

We have to be honest and say that us healthcare sucks in regard to infant mortality . Not sure how all of this can be solved, but a black/white perspective won't help anyone. Unfortunately this is exactly what the us is famous for - a polarizing country where most people either are like "wtf" or "omg iluv".


+1
 
If government says It's going to cost one dollar it is actually going to cost two dollars plus benefits and retirement plans for those who are well connected.

I hate the guy but he speaks the truth.

Let me get this straight . . . … We're going to be "gifted" with a health care Plan we are forced to purchase and fined if we don't, Which purportedly covers at least ten million more people, without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn't understand it, passed by a Congress that didn't read it but exempted themselves from it, and signed by a President who smokes, with funding administered by a treasury chief who didn't pay his taxes, for which we'll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese, and financed by a country that's broke!!!!! What the hell could possibly go wrong?
 
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If government says It's going to cost one dollar it is actually going to cost two dollars plus benefits and retirement plans for those who are well connected. For those who support the plan I have one question,

How many doctors will the plan add vs. how many thousands of IRS agents will be hired?

Liberals' faith in the CBO's fiscal forecasts for the ACA is really quite astonishing and inspiring.

In 1965, the House Ways and Means Committee estimated that Medicare Part A would cost approximately $9 billion by 1990. Actual Part A spending in 1990 was $67 billion. Even after inflation and other factors, reality was 165% higher than the estimate.

In 1967, the House Ways and Means Committee predicted that the new Medicare program, launched in 1966, would cost about $12 billion in 1990. Actual Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

"Medicaid DSH program. In 1987, Congress estimated that Medicaid's disproportionate share hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect loopholes in the legislation..." (Emphasis added by me)

"Medicare home care benefit. When Congress debated changes to Medicare's home care benefit in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than twice that amount, $10 billion."

http://blog.heritage.org/2009/08/04/health-care-reform-cost-estimates-what-is-the-track-record/

And on and on and on and...

By the standard of the proverbial definition of insanity (trying failed approaches over and over again expecting different results), big-government advocates are off-the-wall certifiable lunatics.

EDIT: Hope and Change!
 
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Which parts of the ACA are expected to cost money? Most of it is a Medicare cut, followed by some funds to set up (private) insurance exchanges.

If it actually tried to do anything, I'd agree it could get expensive, but the utter lack of any real effort on the part of the bill means it should stay within it's budget fairly easily.
 
It's a mixed bag for small businesses. If I hire a tech right now I am under no obligation to provide health insurance (fewer than 50 employee rule), but I could get a tax credit for 35% of the premiums if I chose to provide it. I can see wage adjustments ameliorating the effects for business >50 employees.

It would be very nice for everyone, including entrepreneurs, to put an end to job-lock.

I agree that pay cuts will occur for staff.
 
Your partisan vitriol has become ridiculous. If you're talking about the way he addressed the Citizens United case, you need to understand that the ruling totally changed the way elections are run and was misleading at best. It's impossible to stop a candidate from coordinating with a super pac, even if they cannot legally corroborate directly. And yes, the chief justice always leaves a legacy based on the rulings his court has made. Look at how cases like Roe v. Wade, Brown v. Board of Ed. or Marbury v. Madison changed history. As justices serve for life, most of them are well aware of how their votes can affect people's daily lives. Chief Justice John Roberts understands the importance of his decisions in setting and following precedent, for the continued legitimacy of the Supreme Court.

You Know, just because we hate a law and hate government overreach, does not mean that we are partisan. I believe you are replying to a libertarian. I would also like to note how the supreme court has become quite activist-like (They were always activist, they are just more open now) in the last century. I would also like to note the unintended consequences of Brown V Boe and Roe V Wade are pretty big. The former trumping states rights and establishing the path to making blacks a protected minority, The latter trumping states rights.
Let's hope 2 things in the future
1. the court upholding succession as constitutional
2. The states having the b***s to nullify the ruling. Yes, States do have the right to nullify even the supreme court. I believe that is covered with the 1798 Kentucky and Virginia Resolutions.
 
Liberals' faith in the CBO's fiscal forecasts for the ACA is really quite astonishing and inspiring.

In 1965, the House Ways and Means Committee estimated that Medicare Part A would cost approximately $9 billion by 1990. Actual Part A spending in 1990 was $67 billion. Even after inflation and other factors, reality was 165% higher than the estimate.

In 1967, the House Ways and Means Committee predicted that the new Medicare program, launched in 1966, would cost about $12 billion in 1990. Actual Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

"Medicaid DSH program. In 1987, Congress estimated that Medicaid’s disproportionate share hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect loopholes in the legislation..." (Emphasis added by me)

"Medicare home care benefit. When Congress debated changes to Medicare’s home care benefit in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than twice that amount, $10 billion."

http://blog.heritage.org/2009/08/04/health-care-reform-cost-estimates-what-is-the-track-record/

And on and on and on and...

By the standard of the proverbial definition of insanity (trying failed approaches over and over again expecting different results), big-government advocates are off-the-wall certifiable lunatics.

EDIT: Hope and Change!

Despite your hard work, no one will listen. It is always better to state moral cases and moral statistics rather than stating charts, graphs and analysis. Don't bother, the vast majority of Pre-Meds and Medical Students are for social justice and health activism. As a fellow libertarian, try to use Mises or Cato. Using Heritage, while they are capable, will just make people ignore you.
 
If government says It's going to cost one dollar it is actually going to cost two dollars plus benefits and retirement plans for those who are well connected.

I hate the guy but he speaks the truth.

Let me get this straight . . . … We’re going to be “gifted” with a health care Plan we are forced to purchase and fined if we don’t, Which purportedly covers at least ten million more people, without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, and signed by a President who smokes, with funding administered by a treasury chief who didn’t pay his taxes, for which we’ll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese, and financed by a country that’s broke!!!!! What the hell could possibly go wrong?

Everything, just wait until the American NHS comes to fruition. Also, SDN will always try to promote the progressive thing. Why do you think they got a Primary Care Doctor talk about the merits of how are so called "free market" healthcare system needs to be replaced with a canadian single payer. When they know that the single payer countries have gone broke too. This is why i only read from Psych.
 
Despite your hard work, no one will listen. It is always better to state moral cases and moral statistics rather than stating charts, graphs and analysis. Don't bother, the vast majority of Pre-Meds and Medical Students are for social justice and health activism. As a fellow libertarian, try to use Mises or Cato. Using Heritage, while they are capable, will just make people ignore you.

Sorry, buddy, I'm not quite Libertarian. I'd say politically conservative (not a Santorum social conservative). But I sympathize with your philosophy, and believe it is applicable in many instances. :) Sort of like Rand Paul.

My link to Heritage was just to reference the data's source. The argument was based on numbers, i.e. liberals' Kryptonite.
 
So I went to my yearly eye exam and asked for the doctor's opinion. First thing he said is that this country is becoming socialist. His taxes are going up, he will be paid less and is going to be forced to deal with people he doesn't want to deal with. His time will be wasted with people who think his time is not important.

I respect his view specially since he is the one that opened his practice and government was never there to help him but was there to tax him and get in his way. When you open your own business government does everything possible to squeeze your neck and prevent you from hiring enough workers.
 
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