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The vast majority of medical spending is on chronic illness for the elderly. You should have your argument focus on this type of common outcome rather than "suddenly gets sick/hurt".
Sure, but it doesn't really change anything. In fact, most people become elderly so it only stands to reason that most people are going to need insurnace, and the money they pay in when they're young makes up for the money they take out when they're old.
Required purchase of health insurance is NOT Socialism!
Many will still not be able to afford it or obtain sufficient assistance to do so.
True, on its own it isn't. ACA does include subsidies for the poor which is a form of socialism, though limited in scope.
Prices will continue to go up.
Well, they don't have to under a system like this if it is done right (aside from inflation, or rising levels of service). I don't think the ACA was really done right - it was a compromise all-around. The US health system is a nest of problems, and ACA really only hits a few of them. There is no one thing that you can do to fix it.
I have nearly quit bothering to try to support any 'new' things that come out from food places - anything I *like* will end up getting pulled anyway. I'm still bitter over the scrapping of the McDLT. The McDonald's Chicken Strips? Gone. Wendy's breakfast stuff? Liked them - gone. Wendy's super bar? Gone. I suspect the Taco Bell gorditas will go within 6 months of me developing a regular taste for them. It's a shame, because I want to support innovation, but the larger companies don't seem to be able to commit to things long term any more. Yes, the McDLT was... 5 years? That's about the longest I've ever seen any variation from a menu core last.
That's why I hate fuckin' white people, and no longer am going to be forced by politically correct, inbred hick motherfuckers, who can't tell their bible from their asshole, to refrain from saying so publicly. "Oh you can't call me white trash, that's raaacciiiisssmmmm" the losers whine. Send 'em back to England or Italy or Portugal or whatever other shithole they came from.
Different people reformatting the code with their preferred beautifier isn't a particularly useful exercise, though.
What happens if you have no insurance for 20 years, and never get sick. Then you sign up for insurance and pay your bills for 5 years. Then you get sick. What is the fine, and what happens if the person doesn't have the money to pay it at this point?
Do you even understand this question? What happens if I purchase insurance for 2 months and get sick. It doesn't matter, I purchased the insurance just the same as if I purchased it 20 years ago.
The whole point of insurance is that in order for it to work, people need to pay MORE than they consume on average. If people wait until they're sick to sign up, it can't work.
This is INSURANCE. The whole point of insurance is that you don't know when you'll need it, so you pay money now so that in the event you need it you know you'll have it. I "waste" money on fire insurance every month. My house will probably never burn down, and thus I'll probably never get anything back. However, if my house does burn down, then I get a new house for very little money.
And some people do not and will not need it. Why are they forced to pay for it when they do not want to? Why are normal law abiding citizens being told they are no longer free and must do as the government says and purchase something from a third party when they do nothing wrong?
So, your choices are force everybody to buy insurance even if they don't "need" it, or let people die when it turns out that they needed it after all.
In most cases insurance is voluntary, but then you suffer the loss if you don't have it. That's how health care was supposed to work before the ACA. The problem with that is that insurance companies were scumbags and if there was any lapse in coverage they assumed that your sickness started during the lapse and denied coverage. On the other hand, if you get rid of that loophole then everybody else behaves like scumbags and avoids paying for insurance until they start to feel sick.
What happens when some gun nut tea party gets elected and declares that anyone who doesn't own a gun has to pay a $2000 a year penalty?
If people who didn't own guns cost the average citizen money, then I'd be fine with such a law. People without health insurance DO cost others money, unless we as a society choose to let them die.
The only way to allow people to not buy health insurance is if we as a society refuse to provide care for them when they get sick unless they can pay the full bill themselves. If we were all sociopaths that system would work just fine, and people WOULD buy insurance because they would understand the consequences if they didn't.
lol.. so the last 200+ years of this country didn't happen and everything starts right now because you though of something you pretend is the only possible logic?
Yeah, I guess everything being peachy is the reason Obama won the election... The previous system worked reasonably well for anybody with a job with a large employer. The problem is that costs are spiraling out of control and the model just wasn't sustainable, and MANY people had no healthcare at all.
They would call 911 with chest pains, the call center would be set up to do an automatic insurance/credit check, and the guy on the phone would tell them that if they'd like an ambulance they need to get somebody else to provide a credit card number if the credit check isn't good. That isn't the society most voters want to live in.
And that happens every day in the previous 200+ years of our country's existence? Am I right or are you making things up in order to justify your worldview?
200 years ago if you dialed 911 you wouldn't get an answer, because you didn't have a phone. We hardly have 200 years of experience with modern medicine. Go take a look at the average inner city hospital and tell me that the previous status quo made any kind of financial sense.
And such issues don't cost that much money to treat or are incredibly rare, which is why regular insurance plans don't cost that little. What was your plan if you got diabetes or kidney failure? Is that when you sign up for the $110/month plan and stick everybody else with the bills since you didn't pay the $80/month they paid for the previous 20 years when you weren't sick?
How is signing up for a more expensive plan sticking everyone else with the bill? There is your logic flaw, if I purchase insurance, they do actuary studies and quote my prices based on my factors. It has nothing to do with you paying my expenses. Insurance is not some bank you put money into in order to get billions out later when you need medical care and that billions will disappear if someone else gets sick. I think someone has fooled you or something.
The problem is that normally you can't change insurance plans AFTER a problem happens and have them pay at the higher level of service. Most insurance applies to point-in-time events like fires, accidents, etc. You can say that on one day you had a house, and on the next you had a pile of ashes.
With something like diabetes you just get gradually sicker. In the first year your costs are barely higher at all. So, you can get a cheap plan today, and switch after you get sick. If you did that with fire insurance they wouldn't pay a dime towards your pile of ashes. With health insurance the company is forced to pay for pre-existing conditions under the ACA. Previously they wouldn't have, and as I already said that model is perfectly valid but subject to abuse.
You have a very nice local hospital. Most would have given you a steep discount and charged you only $50. However, no insurance company would pay the $95 - there is a good chance they might not even pay the $22 (though as I said you got a decent deal). Usually the hospital cash discounts are actually more expensive than what the insurance company pays, because the insurance company can basically shut the hospital down if they don't like the rate. I don't have a bill that just covers A1C, but a bill I recently paid included a $71 (list price) A1C test in a set of tests that cost $286 total, and the cost to me and the insurance was $47. That is pretty typical - insurance companies only pay 20% of the list price for most things. When the hospital cuts 60% off the bill for a cash customer they love to go on about the deal they got, even though they paid twice what most people pay.
Most hospitals will not offer this much of a discount to cash customers. Also, looking at our bills it looks like I paid a lower percentage of my cost with insurance than you did with your cash discount. The figures are close enough that it is hard to compare, but most people pay substantially more when paying cash. True, they don't pay list, but most people can't negotiate the deals insurance companies get.
I pay more than your health insurance bills every year for fire insurance on my house (a rather modest one at that). I spend $0 on repairs caused by fire. Sounds like I'm getting ripped off! Except, if my house burns down when I'm age 55 I won't be homeless for the rest of my life, or dependent on my fellow taxpayers for welfare or charity.
Most likely you are paying that because you had to barrow money to purchase the house. Either way it doesn't matter because for what ever reason it is what you chose to do with your money. I didn't demand you purchase fire insurance, I didn't demand you buy the house. What makes you think you can demand I spend my money a certain way when I cost you nothing, have no loans with or without conditions from you nor do I really care about you in any way? Why are you so greedy that you think if I don't have insurance there might be a chance I might not be able to cover my own treatment and you might have to pay slightly more for coverage so I must without ever indicating I couldn't provide for myself, spend my money the way you want me to? That's pretty selfish of you isn't it?
I'll be the first to agree that normally insurance is voluntary, and that is really where it makes the most sense. I can choose to get fire insurance or not. Of course, if I don't get it nobody will buy me a new house when it burns down.
Society for whatever reason has decided that you have a right to medical treatment if you get sick. Heck, it is illegal to kill yourself.
So, if society is not willing to let people die, then it has to have a way to pay for people not to die. That means somebody has to pay the bills. An insurance mandate is just a way to force those with the means to help pay. Other countries don't require anybody to "purchase" insurance as it is all tax-funded, but you still don't get a choice to participate.
It is basically socialism. You can love it or hate it, but either way it only works if you're forced to participate. Welcome aboard, comrade!
Snip a bunch of debate about a point you claim you didn't make
Who said anything about charging only people who collect from insurance?
You did. You said that people shouldn't be penalized if they didn't get insurance. Instead they should only be penalized when they sign up after they're sick. If you aren't claiming that, then fine, but that was about half of your previous post...
85% of the population had coverage before the ACA became law, we were only talking about needing to get around 45 million people covered or 15% of the population who either couldn't afford health insurance or didn't want it. What in this world makes you think that those 85% or 270 some million people would all the sudden cancel their insurance when they didn't cancel it before the law mandated it?
I never claimed they would. People who stay insured pay no penalties. Those who do not pay a penalty immediately, but one that is way too small. Thus, the ACA is fairly likely to fail unless it is adjusted.
My original statement was a simple one. Either you have to deny coverage for pre-existing conditions (which is how things worked before the ACA), or you have to force people to buy insurance. That's just a matter of how insurance works. You're making it into some kind of overall debate about the ACA.
Show me any insurance program anywhere which allows people to submit claims for pre-existing conditions without a mandate to buy insurance. You certainly won't find one anywhere in the last 200 years of history of the US that you keep going on about.
Hopefully 11 billion worth of North koreas long suffering citizens not starving.
Well , ideally. More like 11 billion worth of NK's absurd army spending more on armaments. Alas.
A tax on living.
Guess that makes large numbers of the homeless etc into tax evaders too now.
What do you think socialized healthcare is? Socialism only works if you don't let people opt-out.
Granted, the homeless folks aren't really the problem, since for the most part they're the recipients in any socialized benefit. The issue is the person who makes plenty of money and doesn't feel they need to pay taxes (which mostly benefit others).
If it was a fine the Supreme Court would have struck down the law. But they recognized Congress' authority to impose taxes, so the law stands.
Semantics. But, whatever. s/fine/tax and my argument stands. You can't force insurance companies to treat pre-existing conditions unless you make people pay for insurance when they're healthy (or have somebody else pay for it for them).
If you want to understand how insurance works, first look at what the insurance pays for. Then figure out the total annual US cost of paying for that thing. Then divide that by the total population of the country, and add a few percent. That is the cost per-person of insurance if everybody buys it (whether they think they need it or not).
On the other hand, if you only want people who need it to pay for it, then instead of dividing it by the total population, divide it by the number of people who think they need insurance, and since you're dividing by a smaller number you get a bigger insurance premium.
In the case of health insurance, if only people who get sick want to pay for insurance then the cost will be something like 20x higher, and then the sick people won't want insurance since it costs more than their care.
Insurance is normally just voluntary socialism. The problem with healthcare is that we don't like making people die without treatment when they get really sick, so we don't want to make it voluntary. Insurance only works as a voluntary program if you actually let people who don't buy in suffer the full consequences of their decision. As soon as you create a "safety net" you've basically created an insurance program where all the taxpayers are paying for insurance for everybody, and that only works if you tax them enough to pay for it. However, Obamacare expects private insurance companies to actually pay the bills (aside from subsidies applied to premiums). So, you can't have a "safety net" in that case.
And before you go all authoritarianism on me, you can't have it both ways. Either you have to allow insurance companies to deny pre-existing conditions, or you have to force people to buy insurance. If you don't do either then people wait until they're sick to buy insurance, and then insurance companies go out of business. Socialist healthcare systems like in Europe do the second one by basically buying insurance for everybody through tax receipts (I didn't say that the insured had to directly pay the premium).
Such shallow thinking. How about forcing a penalty after needing treatment without insurance or the ability to pay it?
What happens if you have no insurance for 20 years, and never get sick. Then you sign up for insurance and pay your bills for 5 years. Then you get sick. What is the fine, and what happens if the person doesn't have the money to pay it at this point?
Why wait 20 years to charge them for 20 years of premiums?
The most sensible solution would be to just have the government buy insurance for anybody who does not do so, and then tax them for it. That is what happens if you don't mow your lawn - the local government will just mow it for you and send you a bill, and put a lein on your house if you don't pay it.
However, for whatever reason the government choosing your insurance policy turned people off, so instead we have a tax that people without insurance have to pay. The problem is that the tax is way too low, so for those who are young and healthy it just makes sense to pay the tax.
You do not need to force insurance purchased or allow preexisting condition exclusions. You can simply penalize the people who do not have coverage when they need it and also do not have the ability to pay for their treatment. You can also mandate as part of that penalty that they maintain coverage for a certain period of time.
If the penalty is less than the total of all the unpaid premiums, then there is no incentive to buy insurance, and the insurer loses money on the patient (since the premiums are calculated as the amount of money needed to cover losses on average, plus a profit).
What you propose is like a retirement plan where you tell people to save up for retirement, and then if they fail to do so and have no money you fine them, except they have no money so you can't fine them, and you still have to pay for their retirement. If you want people to invest in the future you have to give them incentive to do it when they can actually do it (whether investment is for retirement, or future health problems, or whatever).
The thing is, the people who say they don't want/need insurance are more than happy to sign up for it once they get an expensive medical condition, so what they usually really want is to have the benefits of insurance without actually paying for it.
What people want is to not pay for something until they need it. They don't want to buy new tires for their car until their old ones need replaced, They do not want to buy another gallon of milk until the other is almost empty. Can you blame them for not wanting to be forced into buying something they do not need at the moment?
This is INSURANCE. The whole point of insurance is that you don't know when you'll need it, so you pay money now so that in the event you need it you know you'll have it. I "waste" money on fire insurance every month. My house will probably never burn down, and thus I'll probably never get anything back. However, if my house does burn down, then I get a new house for very little money.
The only way to allow people to not buy health insurance is if we as a society refuse to provide care for them when they get sick unless they can pay the full bill themselves. If we were all sociopaths that system would work just fine, and people WOULD buy insurance because they would understand the consequences if they didn't. They would call 911 with chest pains, the call center would be set up to do an automatic insurance/credit check, and the guy on the phone would tell them that if they'd like an ambulance they need to get somebody else to provide a credit card number if the credit check isn't good. That isn't the society most voters want to live in.
The thing is, the insurance available to those people who do not want it, is more or less the same as not having insurance for all practical purposes. I had a Health Savings Account and a catastrophic plan. The catastrophic insurance cost me $5 a week or $20 a month and covered any major medical like a broken bone, cancer, heart attach and so on.
And such issues don't cost that much money to treat or are incredibly rare, which is why regular insurance plans don't cost that little. What was your plan if you got diabetes or kidney failure? Is that when you sign up for the $110/month plan and stick everybody else with the bills since you didn't pay the $80/month they paid for the previous 20 years when you weren't sick?
Everything else was out of pocket which you will find that medical bills are dramatically cheaper when you are paying cash or cash equivalent at the time of service. That's where the HSA came in handy, the $95 Hemoglobin A1c with fasting glucose levels out the door cost me $22 total when paying cash at the local hospital.
You have a very nice local hospital. Most would have given you a steep discount and charged you only $50. However, no insurance company would pay the $95 - there is a good chance they might not even pay the $22 (though as I said you got a decent deal). Usually the hospital cash discounts are actually more expensive than what the insurance company pays, because the insurance company can basically shut the hospital down if they don't like the rate. I don't have a bill that just covers A1C, but a bill I recently paid included a $71 (list price) A1C test in a set of tests that cost $286 total, and the cost to me and the insurance was $47. That is pretty typical - insurance companies only pay 20% of the list price for most things. When the hospital cuts 60% off the bill for a cash customer they love to go on about the deal they got, even though they paid twice what most people pay.
Outside of getting that checked for a physical, I don't spend much more than $1.5-2k a year in medical with many years being less that $1000. Now I have to purchase insurance that costs $110 a month and carries a $3000 deductible.
You're missing the point of insurance. You're not paying for your current medical condition. You're paying for when you do (or don't) get diabetes, or kidney disease, or cancer.
I pay more than your health insurance bills every year for fire insurance on my house (a rather modest one at that). I spend $0 on repairs caused by fire. Sounds like I'm getting ripped off! Except, if my house burns down when I'm age 55 I won't be homeless for the rest of my life, or dependent on my fellow taxpayers for welfare or charity.
But yes, we can have preexisting condition coverage and not mandatory insurance if we treated it just like we treat every other crime and not penalize someone until they actually do something wrong.
Not buying insurance IS the thing they actually did wrong. An involuntary action can't be right or wrong - it just "is." So, getting sick can't be the thing that somebody does wrong. The time to pay for illness is BEFORE you're sick, not after.
Plus, lots of people may go through live for 70 years and never get sick, and then get hit by a truck and die on the scene. The way insurance works is that they pay for it all their life and never get a dime. Then some other poor kid gets leukemia at the age of 6 and the insurance company pays $20k/yr on medical bills for the next 40 years. It all works out, since the insurance costs are based on statistics. However, it doesn't work out when people only want insurance when they "need" it.
Would it make sense for me to not pay for fire insurance for 20 years, then have a fire, and have society come along and spend $150k building me a new home, and then try to fine me for it? What happens if I don't have $150k, or even the total of 20 years worth of premiums? Plus, the insurance company is out more than 20 years worth of premiums - they're out the premiums from all the other people who didn't pay and whose houses didn't burn down (but which they apparently have to repair anyway).
Insurance premiums are based on most people paying and never collecting for most types of insurance. If you only charge people who do collect, then you'll have to charge them a LOT more.
I suspect that a big part of the problem is that the fine for not having insurance is too low. That discourages healthy young people from signing up, since they can always sign up later with little penalty (pre-existing conditions must be covered).
And before you go all authoritarianism on me, you can't have it both ways. Either you have to allow insurance companies to deny pre-existing conditions, or you have to force people to buy insurance. If you don't do either then people wait until they're sick to buy insurance, and then insurance companies go out of business. Socialist healthcare systems like in Europe do the second one by basically buying insurance for everybody through tax receipts (I didn't say that the insured had to directly pay the premium).
So, either you get people complaining about having to pay for insurance they don't want/need, or you get people being ripped off by insurance companies who claim that they must have first contracted their diabetes 6 years ago when they were unemployed and uninsured for two months and it just went undetected all the remaining time so they refuse to pay for it. The thing is, the people who say they don't want/need insurance are more than happy to sign up for it once they get an expensive medical condition, so what they usually really want is to have the benefits of insurance without actually paying for it.
Because often, what you can't see is as important as what you can. Imagination is important. Composition is important, and emotion is important.
Right, the thing is though theres more going on to depth of field than just "This part of the image in focus, and that part out of focus". I mean its definately a useful effect because it pretty much defines what part of the photo your supposed to be looking at, but good shallow DOF really is quite an amazing effect down well and terrible when done bad.
On my 50mm lens (I recomend a 50mm to ANYONE whos playing with SLRs. Its a cheap lens, handles great in low light and very easy to take attractive photos with) the depth of field also interacts with light so you see these great specks of light all through the background and other esoteric effects that really enhance the effect. If I just put the background out of focus with a blur, it'd be just.... well blury.
Finally its not a linear blur either. Some parts are more in focus than others and this adds to the effect because its how your eye does it too.
The test photo in the article just makes it look like someones put a lasso tool on the model, inverted it, then just done some sort of blur on the background. Its just not the same as the DOF on a real wide apearature camera.
I think you're wrong. Both sides go in for regulation, regardless of their rhetoric. (Cicero originally formalized rhetoric as a way of lying in a convincing manner, and taught it in a school for Roman politicians.)
They do tend to regulate different things, but neither side ever seems to undo the other sides regulations, no matter how adversely they may affect the citizenry. After all, they need something to vilify their opponents about.
FWIW, Guiness is the only beer I currently consider worthwhile. But the Guiness I see says on the label that it is brewed in the US, and so would be affected by this ruling.
As someone else said, it is best at room temperature. Cold it's merely acceptable. Most stout I find unpalatable.
But think how much fun doing the comparisons could be!
What is worth doing is worth the trouble of asking somebody to do.