Health insurance doesn't make any cents. You don't need it, right?

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Dr McSteamy

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insurance costs $15000 per year for a family of 4, for a medium deductible plan.

no wonder people are dropping health insurance.... cuz you really don't need it.

for that kind of money, even the uninsured comorbid fat fark with diabeetus and dyslipidemia can see the doctor at least 100 times a year.


let's do the math.

assuming you're 40 years old with a family. you pay $800 per month for a high deductible plan
your kids are healthy. everyone gets the flu once a year.

total insurance- ~$10000 a year.

actual cost of doctor's visit and meds = $100 x4 = $400 with no insurance.
with insurance = $40 copay x 4. meds = $10 copay x 4. total = $200 with insurance.

you're paying $10000 for $400 of care.

total cost with insurance = 10000 + 200 = 10200.
total cost uninsured = 400-500.


let's say you need a CT scan. Without insurance, +$1000 out of pocket after personally haggling with the hospital.

Even if you had your $10k insurance plan, you'd still pay $800 extra out of pocket because you haven't reached your annual deductible.

total cost with insurance = 10k + 800 = 10800.
total cost uninsured = 1000.


so i say everyone should drop their insurance, pay out of pocket, and don't text & drive. :)

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I'm a hypochondriac, so it's worth it.
 
Well before this new POS legislation I would have said, drop your comprehensive coverage and keep catastrophic. That way you are covered if you get into a serious accident/ get cancer/ etc.
 
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Once the healthcare legislation kicks in does it make sense for anyone who is fairly healthy to get insurance? Wouldnt it make more financial sense to simply pay a fine since this is cheaper than insurance. If you get really sick, or have an accident which requires expensive care, buy insurance then (can't be refused, and cant be denied for preexisting condition).
 
insurance costs $15000 per year for a family of 4, for a medium deductible plan.

no wonder people are dropping health insurance.... cuz you really don't need it.

for that kind of money, even the uninsured comorbid fat fark with diabeetus and dyslipidemia can see the doctor at least 100 times a year.


let's do the math.

assuming you're 40 years old with a family. you pay $800 per month for a high deductible plan
your kids are healthy. everyone gets the flu once a year.

total insurance- ~$10000 a year.

actual cost of doctor's visit and meds = $100 x4 = $400 with no insurance.
with insurance = $40 copay x 4. meds = $10 copay x 4. total = $200 with insurance.

you're paying $10000 for $400 of care.

total cost with insurance = 10000 + 200 = 10200.
total cost uninsured = 400-500.


let's say you need a CT scan. Without insurance, +$1000 out of pocket after personally haggling with the hospital.

Even if you had your $10k insurance plan, you'd still pay $800 extra out of pocket because you haven't reached your annual deductible.

total cost with insurance = 10k + 800 = 10800.
total cost uninsured = 1000.


so i say everyone should drop their insurance, pay out of pocket, and don't text & drive. :)

One serious illness or accident will easily cost 10k. Heck, a visit to the emergency room for a simple fracture can easily cost 1-2k.
 
Plus, some of the medicines are really, really, expensive. Try getting a couple of CT scans and a couple visits to a doctor and having the hospital bill you their cash rates? $700 for a 10 minute consultation with an oncologist? Yup. That's what they would have charged my dad out of pocket...the insurance paid a tenth of that, or less.

If I could get the same rates insurance companies, or medicare pay, I would seriously think about dropping insurance and keeping catastrophic.
 
Once the healthcare legislation kicks in does it make sense for anyone who is fairly healthy to get insurance? Wouldnt it make more financial sense to simply pay a fine since this is cheaper than insurance. If you get really sick, or have an accident which requires expensive care, buy insurance then (can't be refused, and cant be denied for preexisting condition).
We have a winner!
 
Once the healthcare legislation kicks in does it make sense for anyone who is fairly healthy to get insurance? Wouldnt it make more financial sense to simply pay a fine since this is cheaper than insurance. If you get really sick, or have an accident which requires expensive care, buy insurance then (can't be refused, and cant be denied for preexisting condition).

I thought I read that they were trying to prevent people from jumping into the insurance whenever they get sick to protect the insurance companies. Maybe I'm wrong?
 
Once the healthcare legislation kicks in does it make sense for anyone who is fairly healthy to get insurance? Wouldnt it make more financial sense to simply pay a fine since this is cheaper than insurance. If you get really sick, or have an accident which requires expensive care, buy insurance then (can't be refused, and cant be denied for preexisting condition).

In theory it seems this would work. If everyone starting thinking like this though then there would most likely be changes no?

As for insurance, why is it paying for everything. Why not transfer more of the direct costs/personal responsibility to the patient/consumer? Do this minimizing health care insurance premiums so it's not such a burden for even poorer families to buy it.
 
Once the healthcare legislation kicks in does it make sense for anyone who is fairly healthy to get insurance? Wouldnt it make more financial sense to simply pay a fine since this is cheaper than insurance. If you get really sick, or have an accident which requires expensive care, buy insurance then (can't be refused, and cant be denied for preexisting condition).

Yup. That was why the insurance industry wanted a higher fine for not buying insurance. My feeling is that they'll keep neutering the fine while keeping the regulations of the insurance industry the same - leading to a situation where the insurance companies might collapse or come close to it, and the government can step in with medicare expansion or a public option. Or at least that's what the liberals in congress (and people like me) are hoping happens :).
 
Yup. That was why the insurance industry wanted a higher fine for not buying insurance. My feeling is that they'll keep neutering the fine while keeping the regulations of the insurance industry the same - leading to a situation where the insurance companies might collapse or come close to it, and the government can step in with medicare expansion or a public option. Or at least that's what the liberals in congress (and people like me) are hoping happens :).

you still have never answered the question I have asked you three times at least why doctors should trust the government with monopoly reimbursement power when they already rediculously abuse their power to set reimbursement levels on any medical specialties that can not effectively refuse Medicare/Caid patients? I bet you will not this time as well.
 
you still have never answered the question I have asked you three times at least why doctors should trust the government with monopoly reimbursement power when they already rediculously abuse their power to set reimbursement levels on any medical specialties that can not effectively refuse Medicare/Caid patients? I bet you will not this time as well.

It works in other countries. If we had single payer, it would work here as well. Obviously, physicians won't go bankrupt or the system wouldn't be sustainable.
 
It works in other countries. If we had single payer, it would work here as well. Obviously, physicians won't go bankrupt or the system wouldn't be sustainable.

It does not "work" in other countries any more than our system "works" here. Worldwide all western nations are experiencing financial difficulties with their healthcare system and the changing demographics. Taxation levels are high enough here (for those who actually pay taxes), and are even worse elsewhere. Better yet, most countries do not bear the burden of funding a self reliant defense, choosing, rather, to rely upon NATO and Uncle Sam to have their back if need be.

Oh -- one thing I forgot -- other countries are governed by a different set of documents and rules. A single payer system, constructed upon our current MC model, would face significant constitutional challenges based upon the 5th amendment. They would either have to go back to a usual and customary payment mechanism or possibly even amend the Constitution.
 
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It does not "work" in other countries any more than our system "works" here. Worldwide all western nations are experiencing financial difficulties with their healthcare system and the changing demographics. Taxation levels are high enough here (for those who actually pay taxes), and are even worse elsewhere. Better yet, most countries do not bear the burden of funding a self reliant defense, choosing, rather, to rely upon NATO and Uncle Sam to have their back if need be.

Oh -- one thing I forgot -- other countries are governed by a different set of documents and rules. A single payer system, constructed upon our current MC model, would face significant constitutional challenges based upon the 5th amendment. They would either have to go back to a usual and customary payment mechanism or possibly even amend the Constitution.


Are you referring to this part of the 5th Amendment : "nor shall private property be taken for public use, without just compensation"? I don't see how that is applicable here, so if you would please elaborate.

While I don't entirely agree with what I am about to spew, maybe physician wages/fees, or what we expect to be paid, is actually too high? This is addressing RabbMD who keeps purporting that the government payer abuses their power to low ball these specialties that effectively must accept medicare, but maybe, just maybe, Anesthesia doesn't deserve to make more than FP/IM (Gas residency is essentially just as long, and there are some arguments, especially from the mid-levels, that a majority of the work of an Anesthesiologist can be done by a mid-level). We might need to have an entire reworking of our medical system, clearly defining what levels are responsible for what work (ie: Should all primary care be NP/PA and if it is beyond their scope then refer out? Should all anesthesia be administered by CRNA and surgeons take more responsibility for those actions [my vote is no for that as a future surgeon]? Should radiology be all outsourced to india? Should payment be based on outcome alone, a combination of volume and outcome (paid x per case/visit/etc + bonus for outcomes such as A1C met, HTN guidelines, Surgical Site infection rate/readmit rate), a flat salary based on patients registered with them/combo with outcome?) The bottom line is, appropriate payment is not necessarily what someone thinks they should get paid, and is not necessarily what the monopoly that decides payment pays them. Another thing that needs to definately be addressed is streamlining/simplifying the billing system (which wouldn't be an issue with salary based practice and would lead to doctors taking a more minimalistic approach and not doing enough vs the current fee for service model which pushes doctors to do more even when it is not necessary... which is why having outcome measures would encourage doctors to do what is warrented, or cheat the system).
 
Are you referring to this part of the 5th Amendment : "nor shall private property be taken for public use, without just compensation"? I don't see how that is applicable here, so if you would please elaborate.

While I don't entirely agree with what I am about to spew, maybe physician wages/fees, or what we expect to be paid, is actually too high? This is addressing RabbMD who keeps purporting that the government payer abuses their power to low ball these specialties that effectively must accept medicare, but maybe, just maybe, Anesthesia doesn't deserve to make more than FP/IM (Gas residency is essentially just as long, and there are some arguments, especially from the mid-levels, that a majority of the work of an Anesthesiologist can be done by a mid-level). We might need to have an entire reworking of our medical system, clearly defining what levels are responsible for what work (ie: Should all primary care be NP/PA and if it is beyond their scope then refer out? Should all anesthesia be administered by CRNA and surgeons take more responsibility for those actions [my vote is no for that as a future surgeon]? Should radiology be all outsourced to india? Should payment be based on outcome alone, a combination of volume and outcome (paid x per case/visit/etc + bonus for outcomes such as A1C met, HTN guidelines, Surgical Site infection rate/readmit rate), a flat salary based on patients registered with them/combo with outcome?) The bottom line is, appropriate payment is not necessarily what someone thinks they should get paid, and is not necessarily what the monopoly that decides payment pays them. Another thing that needs to definately be addressed is streamlining/simplifying the billing system (which wouldn't be an issue with salary based practice and would lead to doctors taking a more minimalistic approach and not doing enough vs the current fee for service model which pushes doctors to do more even when it is not necessary... which is why having outcome measures would encourage doctors to do what is warrented, or cheat the system).

Yes, that is the portion. Our services -- and the earned knowledge that is required to provide said services -- are our property. The only way for one to be able to determine a "fair market value" is for a market to exist. We really don't have that now in medicine -- we have some socialized chimera.

As for the remaining portion of your post: how can you say that with a straight face? A market leads to a division of labor; these divisions are not "equal" and rightly so. From a causal realist perspective the price differential is bound to occur, and for good cause.

Beyond that, it is inappropriate to view everything through an "aggregate" prism; in medicine services are rendered on an individual basis. The final transaction price of any given service should always be considered relative to the price of other services. Said simpler -- pricing for a CABG should be determined solely by the negotiation between the purchaser and the provider, and this price should be different that that of an annual physical.

To answer your question more directly -- it is impossible to say whether one is over or under compensated for any given service as we have no market mechanism to determine fair pricing levels. Our current system employs a logical positivism mechanism to determine the "appropriate" pricing level for any given service. They incorporate aggregate input cost data and spit out some RVU factor. They then perform some fiscal masturbatory manipulation and spit out the "price" for a service. If we were to have some form of a market, it is likely that some prices would rise, some would fall, and some would remain similar... the difficulty (or impossibility according to some) lies in the determination of which services would encounter which fate.

Central economic planning -- which is what this is -- always fails eventually for it cannot provide for an appropriate pricing mechanism.
 
Are you referring to this part of the 5th Amendment : "nor shall private property be taken for public use, without just compensation"? I don't see how that is applicable here, so if you would please elaborate.

While I don't entirely agree with what I am about to spew, maybe physician wages/fees, or what we expect to be paid, is actually too high? This is addressing RabbMD who keeps purporting that the government payer abuses their power to low ball these specialties that effectively must accept medicare, but maybe, just maybe, Anesthesia doesn't deserve to make more than FP/IM (Gas residency is essentially just as long, and there are some arguments, especially from the mid-levels, that a majority of the work of an Anesthesiologist can be done by a mid-level). We might need to have an entire reworking of our medical system, clearly defining what levels are responsible for what work (ie: Should all primary care be NP/PA and if it is beyond their scope then refer out? Should all anesthesia be administered by CRNA and surgeons take more responsibility for those actions [my vote is no for that as a future surgeon]? Should radiology be all outsourced to india? Should payment be based on outcome alone, a combination of volume and outcome (paid x per case/visit/etc + bonus for outcomes such as A1C met, HTN guidelines, Surgical Site infection rate/readmit rate), a flat salary based on patients registered with them/combo with outcome?) The bottom line is, appropriate payment is not necessarily what someone thinks they should get paid, and is not necessarily what the monopoly that decides payment pays them. Another thing that needs to definately be addressed is streamlining/simplifying the billing system (which wouldn't be an issue with salary based practice and would lead to doctors taking a more minimalistic approach and not doing enough vs the current fee for service model which pushes doctors to do more even when it is not necessary... which is why having outcome measures would encourage doctors to do what is warrented, or cheat the system).

As a future surgeon, or any kind of doctor really, I just don't see why you would want to trust the government to determine what your paycheck will be. Try to step outside the liberal dogma and what AMSA feeds you, and think about what a single payer system actually means. It means bureaucrats in Washington, or the legislature, or a panel of physicians, or any combination of the three, will determine what your fair reimbursement is. What do these entities have in common? No interest or motive whatsoever to make sure that you are paid fairly for your work and the time and money you have invested in your education. Their only interest is in decreasing out-of-pocket expense for the masses to make themselves or their employers more electable.

There are examples in our own system of how well a free market pricing system works. You only have to look at services which aren't covered by insurance to see the market in action. Laser eye corrective surgery and cosmetic plastic surgeries are two phenomenal examples. These fields have shown tremendous growth in technology, improved safety of procedures, improved outcomes, and all the while, prices have consistently decreased over the past few decades (unlike the rest of medicine).
 
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It does not "work" in other countries any more than our system "works" here. Worldwide all western nations are experiencing financial difficulties with their healthcare system and the changing demographics.

They spend half as much and still manage great outcomes....

Their difficulty is in deciding whether to go from 8% of GDP to 10%. We're trying to figure out how not to get to 1/5 of GDP.

A single payer system, constructed upon our current MC model, would face significant constitutional challenges based upon the 5th amendment. They would either have to go back to a usual and customary payment mechanism or possibly even amend the Constitution.

Do you believe medicare is unconstitutional? If not, why not?
 
They spend half as much and still manage great outcomes....

Their difficulty is in deciding whether to go from 8% of GDP to 10%. We're trying to figure out how not to get to 1/5 of GDP.

Arguing % of GDP expended on anything is fraught with problems. Actually, now that I think of it, both assumptions implied are bogus. How well they fare depends largely upon what endpoint is being observed... GDP is a BS number as pointed out before, but beyond that, to argue how much any given population should pay for any given service speaks to an underlying belief that there exists some "ideal" expenditure level. This simply is not true.

Now we can argue that we waste way too much money on futile or otherwise needless care. We could acknowledge that our population is less healthy due to societal -- not medical -- factors which lead to more intensive consumption per capita. We can even argue that we pay more for certain services and goods compared to what they do in other countries.... but what we cannot argue, with sound economic or philosophical underpinnings, that there exists an "appropriate" aggregate spending level.

Do you believe medicare is unconstitutional? If not, why not?

I am not a legal scholar, but my bet would be that, if you were to ask actual constitutional scholars, you would get differing opinions. I am not aware of the courts actually taking up the challenges of the MC program in its entirety. From a philosophical standpoint I am not a fan of Medicare for a host of reasons. I really, really dislike its financing structure. I also do not like how it has led to the development of a centralized reimbursement determining mechanism.

Still, to answer your question, I believe that challenging MC on constitutionality concerns would be measurably more difficult than the challenge of today's bill. The courts have (unfortunately) taken a decidedly Hamiltonian view of federal authority and constitutional interpretation over the past 100 years or more; as such, any constitutional challenge of MC would be tenuous at best. Here's why: MC is funded by an actual tax, levied impartially, and collected by the treasury. It has an opt out provision -- therefore the provider has the option of non-participation (albeit a false option for some specialties).
 
Well before this new POS legislation I would have said, drop your comprehensive coverage and keep catastrophic. That way you are covered if you get into a serious accident/ get cancer/ etc.

Just curious, what do you all think should happen to someone who opts out of insurance (assuming they could afford it) and then is hit by a car? As it is, the ambulance crew will take you to the ED where due to EMTALA they will have to treat you. If you need surgery you'll get it. Follow up care will suck for you, but you'll be cared for emergently.

Who should pay that bill? Hospitals eat a lot of these bills because only Bill Gates could afford a catestrophic event. Is it right to expect to be taken care of in such an event, yet refuse to buy insurance? It wasn't too long ago that fire departments were all private and you put a medalion in your window. If there was a fire, and you had the medalion, then you got taken care of. Should we have ambulance drivers make the same distinction?

I certainly don't trust the government much, but was hoping that the individual mandate would protect the private market. In Switzerland, most of their insurance is private and makes a profit, but it covers everyone, and there are tons of plans to choose from. But take away the mandate, and people are likely to just buy once they are sick. Then they WILL lose tons of money, and WILL go out of buisiness, and we'll be stuck with single payer. Strangely the people most against single payer are also against the mandate. Why?
 
Just curious, what do you all think should happen to someone who opts out of insurance (assuming they could afford it) and then is hit by a car? As it is, the ambulance crew will take you to the ED where due to EMTALA they will have to treat you. If you need surgery you'll get it. Follow up care will suck for you, but you'll be cared for emergently.

I think the OP was arguing that it makes sense to get a catastrophic policy (say a 10K deductible) and essentially self insure routine health care and minor acute care. This make financial sense, especially with a medical savings account.

Under the new system, the incentives will be all screwed up. If insurance companies are tagged with "must-issue" laws and their rates are regulated, why on earth would I buy insurance prior to needing it? I'll just take my $800/year penalty and pocket the $5K the insurance would cost. This really is equivalent to being permitted to buy home-owner's insurance once the fire has started.

The result of all this is quite predictable if you ask me. Only those with chronic medical problems with carry insurance. Employers, knowing employees can now easily get insurance, will stop paying for insurance and just eat the $2000 penalty rather than pay $10,000 for the policy. There will no longer be balancing of risk pools and insurance companies will decrease policies to the minimum allowed by law, because they really don't want to attract sick customers. I really doubt in the long run they will be able to stay in business. Then we'll be "rescued" by the government.

Ed
 
I think the OP was arguing that it makes sense to get a catastrophic policy (say a 10K deductible) and essentially self insure routine health care and minor acute care. This make financial sense, especially with a medical savings account.

Under the new system, the incentives will be all screwed up. If insurance companies are tagged with "must-issue" laws and their rates are regulated, why on earth would I buy insurance prior to needing it? I'll just take my $800/year penalty and pocket the $5K the insurance would cost. This really is equivalent to being permitted to buy home-owner's insurance once the fire has started.

The result of all this is quite predictable if you ask me. Only those with chronic medical problems with carry insurance. Employers, knowing employees can now easily get insurance, will stop paying for insurance and just eat the $2000 penalty rather than pay $10,000 for the policy. There will no longer be balancing of risk pools and insurance companies will decrease policies to the minimum allowed by law, because they really don't want to attract sick customers. I really doubt in the long run they will be able to stay in business. Then we'll be "rescued" by the government.

Ed

I largerly agree with you. It just seems silly that so many states are lining up to challenge the individual mandate. Aside from the fact that they are quite unlikely to get anywhere with it, I feel there are better and more important parts of that bill which will cause problems.
 
I largerly agree with you. It just seems silly that so many states are lining up to challenge the individual mandate. Aside from the fact that they are quite unlikely to get anywhere with it, I feel there are better and more important parts of that bill which will cause problems.

By what reasoning do you find it "silly" or "quite unlikely to get anywhere with it"? Many legal scholars -- some of whom were loathe to admit it -- acknowledge that the individual mandate is blatantly unconstitutional -- even if you apply a Hamiltonian interpretation. Their argument has merit. Beyond that, the implicit financing of the bill requires not only a direct redistribution in the form of taxes on the wealthy, but a more insidious redistribution involving all the productive in form of the mandate and the pass through costs of health insurer, device manufacturer, and pharmaceutical fees and taxes. It has been acknowledged from the very beginning that this redistribution (in the form of the mandate) is absolutely necessary for the "reform" to function. At its foundation is a thinly veiled lie... that happens to be unconstitutional as well.
 
By what reasoning do you find it "silly" or "quite unlikely to get anywhere with it"? Many legal scholars -- some of whom were loathe to admit it -- acknowledge that the individual mandate is blatantly unconstitutional -- even if you apply a Hamiltonian interpretation. Their argument has merit. Beyond that, the implicit financing of the bill requires not only a direct redistribution in the form of taxes on the wealthy, but a more insidious redistribution involving all the productive in form of the mandate and the pass through costs of health insurer, device manufacturer, and pharmaceutical fees and taxes. It has been acknowledged from the very beginning that this redistribution (in the form of the mandate) is absolutely necessary for the "reform" to function. At its foundation is a thinly veiled lie... that happens to be unconstitutional as well.

I find it 'silly' because of the question I ask above: who should pay the bill in the event of something catestrophic? You're okay with opting out of the system then sticking the hospital with the bill? Seems like if you want to opt out (which is honestly fine with me) then you shouldn't expect to be scraped off the street when you get hit by a bus and have someone else foot the bill.

As to its constitutionality, most of the legal opinions I've read have said it's extremely unlikely to be successfully challeneged, but who knows. Either way, if you get rid of it, you're just making the private insurance companies more likely to fail, which will move us towards single payer. Supposedly something conservative don't want.

But maybe I'm missing something.
 
I find it 'silly' because of the question I ask above: who should pay the bill in the event of something catestrophic? You're okay with opting out of the system then sticking the hospital with the bill? Seems like if you want to opt out (which is honestly fine with me) then you shouldn't expect to be scraped off the street when you get hit by a bus and have someone else foot the bill.

No, I agree with the above. The problem that you bring up, however, relates to another ill conceived regulation -- EMTALA. I am no fan of EMTALA, and, again, do not see how EMTALA is not a violation of the intent of the 5th amendment. A more basic problem with government is the natural tendency towards poor regulation chasing poor regulation; an unfunded mandate is a poor regulation -- which we all know EMTALA to be.

As to its constitutionality, most of the legal opinions I've read have said it's extremely unlikely to be successfully challeneged, but who knows. Either way, if you get rid of it, you're just making the private insurance companies more likely to fail, which will move us towards single payer. Supposedly something conservative don't want.

But maybe I'm missing something.

I don't think you're missing anything, but it will make for a very interesting (and perilous) precedent if it is allowed to stand. There are so many legitimate angles of challenge that it will be a travesty of justice if it is not overturned.

As for the insurance companies -- the way that the bill is currently written they will be fine. The two things that would have severely impeded the insurance companies' viability were redacted from the House version of the bill (the consumer protection agency and the rate regulating commission); as such, the insurers are free to raise their premiums as they deem necessary to fund this redistribution. While I have no doubt that this group of sinister ********ers in Congress and the White House have full intention of introducing these measures as separate bills -- oh, say in October / November, coinciding with the open enrollment for many companies... and an important mid-term election -- as of today premiums are set to skyrocket and insurance companies are insulated.
 
They spend half as much and still manage great outcomes....

Their difficulty is in deciding whether to go from 8% of GDP to 10%. We're trying to figure out how not to get to 1/5 of GDP.

Mange great outcomes? You mean like lower cancer survival rates?

5year survival rate for American Men is 66%, for European men it is only 47%. Only one european country (Sweden) has a 5 year survival 60% rate.

5 year survival rate for women and men is better in the USA than Europe (including the best performing Euro country, Sweden) and Canada. Also in the USA, we are more likely to detect cancers earlier. I don't know about you, but if that was my loved one, I would rather them treated here in the USA. Access to treatment and medications in much better here. If you don't believe me, read this article.

http://www.ncpa.org/pub/ba596
 
Mange great outcomes? You mean like lower cancer survival rates?

5year survival rate for American Men is 66%, for European men it is only 47%. Only one european country (Sweden) has a 5 year survival 60% rate.

5 year survival rate for women and men is better in the USA than Europe (including the best performing Euro country, Sweden) and Canada. Also in the USA, we are more likely to detect cancers earlier. I don't know about you, but if that was my loved one, I would rather them treated here in the USA. Access to treatment and medications in much better here. If you don't believe me, read this article.

http://www.ncpa.org/pub/ba596

Please stick to birth mortality and life expectancy. Not politically correct to imply that our care is anything other than crap in the US.
 
By what reasoning do you find it "silly" or "quite unlikely to get anywhere with it"? Many legal scholars -- some of whom were loathe to admit it -- acknowledge that the individual mandate is blatantly unconstitutional -- even if you apply a Hamiltonian interpretation. Their argument has merit. Beyond that, the implicit financing of the bill requires not only a direct redistribution in the form of taxes on the wealthy, but a more insidious redistribution involving all the productive in form of the mandate and the pass through costs of health insurer, device manufacturer, and pharmaceutical fees and taxes. It has been acknowledged from the very beginning that this redistribution (in the form of the mandate) is absolutely necessary for the "reform" to function. At its foundation is a thinly veiled lie... that happens to be unconstitutional as well.

Most of the state AG's who have filed lawsuits have no legal statute in their suits, no historical cases, and are largely symbolic. It is also only in states with Republican AG's. States like Georgia whose Republican governer is trying to force the democratic AG to file a suit because he wants to file the suit, even though the AG reviewed the law and believes it is all constitutional... just like charges of Mandates in Mass have been dismissed as legit. I don't know the exact details about it, an interview I saw with the georgia AG described it much better, but basically interstate commerce laws, which is what supported SS when they originally tried to challege that, will also be shown that even Scolia, the most conservative on the supreme court, will deem the law constitutional.
 
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