Healthcare (or "I have a right to your time and money!")

[Deacon]

I don't think it's fair to have the government force my neighbor pay for my health care. My health care is MY responsibility, not theirs.

[Bigity]

Oh I agree, I'm just pointing out the flaw in the idea that the government can run a better health care system. Specifically the idea that we get the government involved and presto, everyone has access to all the health care they could never need.

[Deacon]

I wasn't arguing with you. I was posting my position.

[Mav]

Wait, what? Is it hurr time again already?

In the healthcare reform bill, last I saw, was a section on 'living wills' and setting up a DNR or stop life support section that your doctor is supposed to council you on every five years after you reach about 65.

...And that sounds quite reasonable to me. Granted, my own father has instructed me to take him for a long ride and shoot him if he ever developes alzheimers, so maybe it's just the atmosphere I grew up in. I'd also love for a "right to die" bill to finally be passed. And, again, I fail to see how this is not sound advice, whether it's implemented in a public or private sector.

[adciv]

Ok, first, I take part of it back. It's for everyone every 5 years, period. Now, the reason it's 'bad' is because it's tantamount to the government encouraging people to kill themselves. They are requiring that it be given every five years and dictating what must be in it. This does not belong in a healthcare bill, much less the government setting up people to to be coerced into Euthanasia.

[Mav]

Assuming this avoids another Terry Shievwhatever-you-spell-her-name incident, I'm still failing to see the problem. Furthermore, a "Do Not Resuscitate" is far from euthanasia. It's saying "If my body can't function on its own after a period of time and I don't wake up, it's okay to turn the machine off." And if we are interested in reducing the costs of the healthcare industry, then yes, something like this does belong in a healthcare bill.

[adciv]

The problem is that the government is going to be forcing this on people. It is required for people to go through it, regardless of if they want to or not. The doctors that are giving this are not acting to save lives and are being given what amounts to a direct conflict of interest by getting patients to sign the 'end of life' documents. Further, there is this paragraph in the section:

An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or
a hospice program.

Where the doctors are basically saying, "You know, you really don't want to live anymore, just kill yourself now and everyone will be better off." No, something that creates a conflict of interest for a doctor does NOT belong in a healthcare bill.

[Mav]

The question is, is the increased consultations mandatory? It only says "may be". And are there incentives for the doctor to recommend the DNR aside from the patient's best interest?

[adciv]

Trying to find that out, unfortunately, it takes a while to back track and forth in multiple bills. In the mean time, the bloody thing has a nice large tax built into it for a large chunk of the population.

If one does not have a 'qualified benefit plan', one is taxed at 2.5% of their AGI for the year, prorated based on the number of days in the year one does not have a 'qualified benefit plan'. They then go on to list what a 'qualified benefit plan' shall have. Among other things:

No limitations on pre-existing conditions.
No limitations on annual payouts.
A listing of minimum services.
No cost sharing for 'preventative services'.
A limitation on total cost sharing per year ($5k/individual, $10k/family, CPI adjusted by $100 increments).
A list of how the company shall handle claims and appeals.

Joy. I can have health insurance and still be taxed. I doubt many of us have a plan now that falls under all of the requirements they list. This reads like a guaranteed way to increase private insurance premiums and then effectively force everyone to sign up for a government program because they can no longer afford private insurance.

[Mav]

If true, we may have to riot over that one.

[Deacon]

Is that sarcasm?

[adciv]

If true, we may have to riot over that one.

Of the 1017 page HR 3200,

Tax Section:
Pg. 167 "Tax on individuals without acceptable health care coverage.", Line 20

Qualified Benefit Plan Requirement to avoid 2.5% tax:
Pg.171 Line 12 "Acceptable Coverage Requirement"

Qualified Benefit Plan Requirements:
Pg.19, Subtitle B "Standards Guaranteeing Access to Affordable Coverage"
Pg.25, Subtitle C "Standards Guaranteeing Access to Essential Benefits"
Pg.37, Subtitle D "Additional Consumer Protections"

Ok, here's the exact quote for the tax section. It's not a direct 2.5% on AGI, but an equation using it. Still trying to decipher it.

8 Subtitle A—Shared Responsibility
9 PART 1—INDIVIDUAL RESPONSIBILITY
10 SEC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
11 HEALTH CARE COVERAGE.
12 (a) IN GENERAL.—Subchapter A of chapter 1 of the
13 Internal Revenue Code of 1986 is amended by adding at
14 the end the following new part:
15 ‘‘PART VIII—HEALTH CARE RELATED TAXES
‘‘SUBPART A. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE
COVERAGE.
16 ‘‘Subpart A—Tax on Individuals Without Acceptable
17 Health Care Coverage
‘‘Sec. 59B. Tax on individuals without acceptable health care coverage.
18 ‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
19 HEALTH CARE COVERAGE.
20 ‘‘(a) TAX IMPOSED.—In the case of any individual
21 who does not meet the requirements of subsection (d) at
22 any time during the taxable year, there is hereby imposed
23 a tax equal to 2.5 percent of the excess of—
1 ‘‘(1) the taxpayer’s modified adjusted gross in—
2 come for the taxable year, over
3 ‘‘(2) the amount of gross income specified in
4 section 6012(a)(1) with respect to the taxpayer.

[Mav]

(In response to Deacon, "Is that sarcasm?"/ninja'd by Adciv)

No. My entire siding with a government provided healthcare plan hinges entirely on the notion of said plan being optional. Once you add economic coercion to join, it becomes the complete opposite of what I would support.

Hell, if they said up front "Yo, we're going to raise taxes a little bit to pay for this thing, but it pays off in the long run yada yada yada" I probably would have been okay with it. But this way you're forcing people to pay taxes since no private insurer realistically offers the terms required to be a "qualified benefit plan". Alternatively, you're forcing insurers to change their policies - but again, I would have been potentially willing to consider direct legislation requiring said terms, but the whole behind-the-back thing won't do.

[adciv]

Ok, not sure if you saw it or not, but I also added a mirror of the document up there after the initial post.

Related to what you're saying, the States have traditionally had the power to regulate insurance issue inside their jurisdiction. Among other things, this is why Auto Insurance companies have different base policies for each state. There should be no reason why the States can not do what you are proposing instead of the Federal Government. In fact, it may even be that the Federal Government does not have the power under the constitution to do so.

[collegestudent22]

In fact, it may even be that the Federal Government does not have the power under the Constitution to do so.

With respect to the words general welfare, I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

"The Tenth Amendment is the foundation of the Constitution."

From these quotes, it would seem that the Founders intended that the Federal Government would not be able to do so. Instead, the Federal Government has ignored the list of powers it can and cannot have and gone with whatever powers it can cram into the different ideals in the Preamble. Which then begs the question, if that was intended, why would the rest of the document even be written?