I won't deny the possibility of what you're saying, I just don't understand how that's possible. Surely the ACA isn't outlawing "premium", "excellent coverage" plans, is it? Is that what you're alleging? That the ACA arbitrarily outlaws good plans? Why would such legislation even be drafted, to accomplish what goal? Furthermore, why wouldn't anyone be able to point out that bit of legalese responsible this and say "See -- This is why the ACA is terrible" in the years since it's been signed into law? It just doesn't add up to me. Surely out of the many millions of people complaining about the ACA, one of them would be identify the piece of the law that requires the cancellation of such "premium" plans, no? Do you understand how someone who hasn't been negatively impacted in the way you describe might be skeptical regarding such claims? I mean, I'll grant that it's possible, but it really just doesn't make sense.

Okay, so there's compliance costs. That's a very real cost in the healthcare industry. Some estimates of what percentage of healthcare costs are the result of compliance burdens are hard to believe. I won't deny that additional regulation in that industry could (and likely would) have significant costs. Even something as simple as the Sunshine Act (2007) has had a significant impact in the industry. I believe compliance (and all other) costs were included in surveys conducted that demonstrate that overall, the ACA has had a positive impact on the cost of healthcare. Looking at the numbers, it is evident that the cost of healthcare has continued to rise since the ACA hit, but the rate at which it is increasing has dropped to 3% (from 5%-7%). These numbers aren't very comprehensive. It would be nice to know not just the average impact, but the median and maybe even the distribution of cost impact. Maybe some small number of people is saving a huge amount and everyone else is getting a slight cost increase (although I don't think that's likely). Maybe some small number of people is getting royally fucked and everyone else is getting a slight cost decrease (also unlikely). These numbers only tell us that on average, the rise in costs has been somewhat stemmed, and that the increased costs of compliance have been more than countered by decreased costs elsewhere.

It's a market. The Mayo Clinic did the math and decided it would be more profitable to raise their prices, limiting the demand for their product, but enjoying fatter margins. Other doctors will lower their prices, increasing demand for their product, but tightening up their margins. While it's nice to think that everyone can be served by the finest medical practitioners, that's not realistic. What will all the other doctors do? How will the best of the best find time to treat everyone? If we're honest with each other, we must admit that healthcare will be rationed no matter which way you slice it. It's just that today, instead of thinking in terms of actual prices, we're forced to think in terms of which doctors accept which insurance plans.

No system is perfect, and it's not hard to find anecdotes to support a position on any side of the argument. Have you not heard of failures here in the US? People getting sick only to have their insurance drop their coverage, and next thing you know they're filing for bankruptcy and their house is gone? Uninsured people who use the emergency room as their primary care provider? I understand that the system of healthcare rationing found in single-payer countries is similarly imperfect. It may be frustrating for someone who is well-off that they have to wait their turn to get services that they deem to be a high priority. However, there are only so many doctors. In this country, the well-off don't need to wait as long, but the poor, well, they don't need to wait at all. They're just fucked. At least those well-off people in single-payer countries have the option to go somewhere where they can pay cash and skip the line. The poor here in America, they're not buying tickets to socialist paradises to get their healthcare. They're just dying.

Indeed, I understand that. It could be argued that our system encourages the formation of this type of society. In a single-payer country, the government is incentivized to improve health, to decrease the cost of healthcare, because that cost is paid from the government's pocket. In our country, insurers have no such incentive (and may even be incentivized to worsen health, as their profits are capped to a percentage of their revenues -- the more healthcare services rendered, the more revenues, the more profits). However, if it's not fair to say that we have worse outcomes (because Americans are fat cows), then it's not fair to say that we have the best healthcare (how can you compare quality of healthcare if there's no fair way of comparing outcomes?).

For some values of best. I don't deny that a lot of the groundbreaking advances in medicine happen right here in the states. But is that what we want out of our healthcare system? R&D? Or do we want health? Because being good at one doesn't necessarily mean being good at the other. I don't begrudge you access to your specialist, but your specialist can't treat everyone. How, as a society, do we want to ration his services? Should we only allow him to treat the wealthiest patients who have the insurance plans willing to pay the most for his services? Only the uber-wealthy who are willing to pay extraordinary amounts out of pocket? Or should we decouple the access to healthcare from access to wealth? It's a legitimate question, with legitimate arguments on all sides.

I'm not familiar with the rhetoric you refer to (but if that statement was meant literally, I disagree with it wholeheartedly). Regarding Gov. Patrick's statement, it may not be acceptable to you, but we need to have an honest discussion about this. For you, such an approach is a death sentence. But what if you were poor and uninsured and he was arguing that one way to control costs would be to do as you suggest, block people that don't have insurance. Why would that death sentence be any better? Fundamentally, the problem is that healthcare is not in abundant supply. It's not free. Due to this scarcity, it needs to be rationed in some manner. Some people will be handed death sentences. It will suck. However, to pretend that leaving things as they are somehow gets around this problem is absurd. We're already rationing healthcare, on the basis of insurance coverage and financial means. Many people just don't understand this because "I've got mine" is a powerful sentiment.

Indeed, if they keep it up, they'll soon have caught up to the Walmart probe out in the Kuiper Belt, the Apple spacecraft out exploring the Oort cloud, and the Exxon-Mobil "lander" navigating the depths of the seas on Titan.

You say "for a government run operation" as though those weren't the most impressive operations to date.

Alright, Barf.

The irony that actual adults are expected to not proudly wear vile condescending attitudes and otherwise act like jackasses?

I mean, that sounds rather vague. It's unlikely that your policy contained a clause saying that it would be discontinued if any legislation titled "Affordable Care Act" was passed. It's similarly unlikely that the ACA specifically singled out plan #X provided by insurer $Y as no longer legal. So it's become clear that "they said so" is your only basis for knowing that the passage of the ACA was the cause of the cancellation. But you don't know why, specifically, that was the case. For someone that's so infuriated by the impact of the ACA, you don't seem very motivated to get more information on the subject. Either way, let's at least acknowledge that it is possible your plan was discontinued because it was predatory and/or ineffectual, in which case your ire may not be entirely justified.

Lower costs as compared against what? Are you comparing costs from one year to the previous year? Why do you feel that to be a fair comparison? Do you honestly believe that in the absence of the ACA, your costs would have remained the same year over year? Especially when you consider that healthcare costs have been rising by double-digit rates for years? That's a disingenuous comparison to make. The reason the ACA was passed was to reign in the costs of healthcare, which are (by anyone's measure) spiraling out of control. If you believe that the ACA is failing in this goal because absolute costs are not decreasing, then you had some very lofty expectations, but you're entitled to your opinion. However, if you feel the ACA is having a negative impact on costs (compared to how things would have looked had we done nothing), then you're flat out incorrect, as this isn't a matter of opinion. All studies of the issue have shown that, in general, healthcare is cheaper today with the ACA than it would have been today without the ACA. That means, necessarily, that the ACA is, in general, saving us money. I wouldn't doubt that some are being helped more than others, and that some might actually be being harmed. But in general, overall, the ACA is lowering costs compared to how costs would otherwise be without the ACA. Comparing against the previous year is disingenuous because it assumes that without the ACA, costs would not have risen, which is a baseless (and frankly, ridiculous) assumption.

I understand that a great many people "don't want single payer". Usually the debate turns to one rooted in political ideology, sadly. Nonetheless, regardless of how you feel about single-payer, if it were to be implemented in America, it would very much be the federal government's job to force it on us. That's how single-payer works.

I think you have that backwards. It's Americans that are going abroad to seek medical treatment now.

I'm not aware of the VA constantly being in trouble. I don't believe federal programs like Medicare underpay doctors, since doctors in this country are paid significantly more than elsewhere in the world and enjoy income greatly in excess of the median (and even average) American income. Your only justification for your claim that single-payer would destroy health care in our country is "that's what federal bureaucracy does", and that's not a very convincing argument.

I honestly have no idea what you're talking about here, and perhaps providing some context would make you sound like less of a raving lunatic. I've indeed had to wait to see a doctor, as I needed to schedule an appointment, and my doctors also accept other patients, so their availability is limited. Is this one of these secret wait lists that you speak of?

So it's because we make uniquely poorer decisions in this country than in single-payer countries. But single-payer doesn't fix this problem, it encourages it. So then why is this less of a problem in single-payer countries?

Ah, so comparisons to other countries are unfair. It's unreasonable to point out how much better single-payer systems are elsewhere because we're special. How convenient.

We have the most expensive doctors and facilities in the world. We may also have the best doctors and facilities in the world, but you're not using them. You can't afford them. Neither can I. We can only afford those doctors and facilities that our health insurance grants us. These doctors and facilities are not the best in the world, but they're still dramatically more expensive than comparable doctors and facilities elsewhere in the developed world. There's this widely spread misconception that America is some shining example of the pinnacle of healthcare. It's not, but people like you are dead-set on propagating this myth and perpetuating the scam that it enables.

Mod parent up. Fucking brilliant.

I'm pretty sure nobody's talking about restrictions on campaign financing that are so draconian that they'd prevent the purchase of a book. That might be a bit of a strawman argument. Regarding the food on the table and roof over head, I support the notion that the political process shouldn't be the basis of anyone's livelihood. Candidates that are actually supported by actual people will find supporters that voluntarily support them. I'd imagine that candidates that are supported primarily by non-natural "persons" would inherently have a harder time finding such voluntary support, and I feel that would be a good thing. Limited funding would level the playing field between candidates, allowing those with relatively little funding (by today's standards) to have comparable exposure to those who are flush with cash. Unable to leverage financial advantage to win elections, politicians might instead have to win votes by supporting popular policies instead. I would welcome such a change.

Is this an actual problem? Or, more importantly, is this an actual problem that is solved by enabling unlimited money-as-speech? Which candidates were railroaded by the media during the last presidential election? Was it Romney or Obama? Or was it Johnson, Stein, Goode, and Anderson? Did this unlimited money-as-speech approach help Johnson, Stein, Goode, and Anderson overcome this media bias? Or did it help Romney and Obama dominate the conversation, further silencing everyone else? I think the problem of media favoritism that you describe is only exacerbated by the influence of money, as the candidates favored by the media are all too often the same ones favored by those with deep pockets.

No, this argument is just "I, personally, don't like excess money in politics". It's a statement of personal belief, an opinion, and not an argument that excess money in politics is bad. Perhaps I should have separated this statement of personal belief from the rest of my argument so that it wouldn't be mistaken for something it's not.

I disagree vehemently. There's absolutely no reason to believe that any message promoted by a candidate increases the availability of perfect knowledge of the available products. Have you never heard of the idea of a conflict of interest? If you trust politicians to the extent that you actually believe giving them more money increases the amount of truth they broadcast, we have a fundamentally different view of human nature. Can you say with a straight face that a publicly financed campaign of publishing verified information about all the candidates (from one common fund) would provide less perfect knowledge of the available products than the system of fearmongering, mudslinging, and blatant propaganda funded by corporations, special interests groups, and plutocrats that we have today? Do you really believe that minimizing conflicts of interest will lead to a more corrupt system?

That does not correspond to my understanding of MAYDAY PAC at all. Lessig seeks to return to how things were prior to 2010. I don't remember the 2010 decision lifting us out of some despotic hell. I don't remember a vastly more informed electorate arriving at the polls after 2010. I don't understand how any effort to overturn or limit the decision reached in Citizens United could possibly result in any of these apocalyptic scenarios that are feared, since it's not like we'd be treading new ground.

Personally, the spending of vast sums of money on campaigns makes me uneasy. I don't like the idea of elections being bought. That's my personal stance regardless of whether or not money is the primary determining factor in who is elected. I'd like to clarify my earlier point, as the way I originally stated it is easily countered, as you just demonstrated. It's not that money wins elections, it's more that money buys votes. Some campaigns are more efficient and can buy votes at a lower cost, some campaigns are in safe districts where one party has an inherent advantage. To say that the side with more money wins is an oversimplification. All other things being equal, the side with more money wins. That being said, all other things are seldom equal. In any case, I still thing the influence of money in politics, however large or small, is clearly nonzero. Any nonzero influence of money on politics, I believe, corrupts the nature of democracy.

Would it, though? As far as I understand the restrictions being proposed, it would only impact those groups of individuals' spending. It would have no impact on non-spending speech. If you're right and money isn't as big an issue as I'm making it sound, then this restriction on spending similarly isn't that big an issue, no?

I wasn't able to keep my plan either. But, now that you mention it, my employer forced a change of plans on me the year before the ACA was passed too. And indeed, there's been other times where I've been unable to keep my plan, entirely unrelated to the passage of any healthcare legislation (as far as I know). How do you know the ACA was the proximate cause for your old plan's cancellation? Furthermore, which aspect of your old plan caused it to be outlawed under the new law?

So have mine. My health care costs have been dramatically rising since long before the ACA took effect. From what I've seen, data suggests that overall costs did rise, but they rose at a considerably lower rate than they had been rising previously. Obviously, it's not likely that this trend holds true for every individual, and it's possible that your costs did indeed rise more than they would have otherwise. Overall, though, the numbers suggest that on average, the growth of healthcare costs has been decreased. Not exactly a resounding success story, but an improvement nonetheless.

Liked plans were supposed to continue (with the understanding that the ACA wouldn't impose a requirement for insurers to continue all existing plans, so your plan's continuation would still be subject to the whims of your insurer). Costs were supposed to go down compared against continuing the way things were. I don't think anyone ever claimed that absolute costs would actually decrease, merely that the ACA would help reign in the rapidly rising cost by slowing the rate of growth.

That's... actually... See, I don't understand why people say this. USA is the only developed country in the world with this type of healthcare system. Every country that outranks us on the Human Development Index has a single payer system.

Yes, and we have some of the highest costs and worst outcomes in the developed world. People that think the US healthcare system is some shining star are simply ignorant of the world beyond these borders.

That seems like a silly claim. Why would the signature on checks impact healthcare beyond the accounting department? If my doctor bills Washington instead of me or my insurance company, why does the quality of care I receive need to change? Any answers I've heard to these types of questions inevitably end up sounding like a whole of assumptions about how a single payer system needs to be run.

Those waiting lists aren't very secret if you're posting on slashdot about them, but I digress. I invite you to learn about how single payer healthcare systems work in other developed countries. Crack open Wikipedia and read some of the cited references. Maybe you'll find some useful ammunition for your crusade against the implementation of such a system here. Or maybe you'll find that it's really not as scary as "secret waiting lists", that it's a lot cheaper, and that it helps people live longer, happier lives.

Man, there's conservative, and then there's you. The way I see it, the healthcare system in this country is so broken (based solely on absolutely extreme expense and relatively poor outcomes) that I'm okay with trying anything to fix it. There's no need to be careful when everything is already so far gone. You're worrying about some worst-case scenario as though you don't realize we're already living in it.

I didn't vote for Obama (the second time around). I have mixed feelings about the ACA (I was hoping for a single-payer system, and I fear that this compromise approach may leave us even worse off than we were before).

But, come on, man. As far as I'm aware, the only people whose plans were discontinued were the predatory and/or ineffectual ones explicitly outlawed because they were predatory and/or ineffectual. If you honestly believe that Obama's "if you like it, you can keep it" pledge ought to have applied to shitty plans that no reasonable person would be expected to "like", then I would argue that you're not a reasonable person.

Cue the idiots complaining that Obama lied because passage of the Fair Networking Act (Obamanet) has caused their ISP to stop offering 4800 baud dialup plans.

I see these "debates" (and I use that term loosely) on Slashdot rather frequently. I just want to say thank you, on behalf of myself and anyone else like me that simply doesn't have it in them to deal with these people. You have the patience of a saint.

They supported a number of Republican candidates. One of their two winning campaigns was for a Republican. In other words, they helped elect as many Republicans as Democrats.

Of course, it's rather disheartening to hear people always trying to put a political spin on these sorts of things. I don't vote for Democrats (or Republicans) and I still support MAYDAY PAC and WOLF PAC.

What fucking shithole do you live in where there were only two candidates to choose from?

At least vote for a write-in, you lazy bastard! I voted for non-Republicrats when presented with the option, and write-ins otherwise. It took me a few minutes after work. It didn't change the election, but it bought me the right to complain, not only about the establishment politicians that got re-elected, but also the indolent assholes like yourself! :)

In my experience, that's way off.

Most people - about 80% by some estimates - are fucking idiots. They claim loyalty to either the Democrat or Republican party, yet remain largely ignorant of the fact that both parties take the same position on an overwhelming majority of issues, and that neither party's platform is especially aligned with their personal interests. They vote according to their team, even though their team doesn't share their beliefs. Relatively inconsequential issues (gay rights, abortion rights), issues which are unlikely to have any direct personal impact on an overwhelming majority of individuals (a majority of the population is not gay and will not have any abortions), are cited as reasons for supporting one party over another.

And you say it's Lessig that's blind to his own bias. If only the average voter were as "blind".