Supreme Court Rules Affordable Healthcare Act Constitutional

CNBC: Obama's Insurance Rule is Upheld by Supreme Court
Long story short, SCOTUS ruled that President Obama's Affordable Care Act is constitutional in a 5-4 ruling with Justice Roberts joining the four liberal justices.

 

There goes any chance of good healthcare. More money will come in, but the quality of care will drop all around because hospitals will lack economic incentives and/or funds necessary to stay high-end.

The only conclusion is that they are taxing people for continued existence.

 

No it is not the only conclusion, it is a conclusion, and by no means the conclusion most associate with free access to healthcare, i've heard America has one of the worst healthcare industries in the world, according to time to see patients, efficiency in work, accuracy of diagnosis and treatment. This will not make the service any worse I can guess, may even improve in some areas.

It's not like the private sector will vanish away, there will still be people who would rather seek private healthcare professionals, it just means greater access for people who can not afford it. Provate sector is just gonna have to market themselves a bit differently.

Countries won't fall apart over this and you won't have the excuse of not affording the doctors anymore.

 

I didn't want to look at it that way, but after you said it, I am looking at it like that. A tax to stay alive. Ain't that sad.

Good thing I'm moving to China, I guess.

 

It will make it worse simply because the economic incentives to seek excellence will be absent.

I am not suggesting that it will make the private sector less privately owned, but it will take away all healthcare providers' major incentives to do well.

If I understand correctly, this will lower the price of health care but increase the number of people buying it, creating constant income for healthcare providers and lowering the value of independent procedures. Because each individual procedure does little to increase income, the quality of individual procedures will go down.

Another sector will instead give care better than standard but charge a large amount for it because they have few active competitors and will get fewer customers than the cheaper, lower quality providers. To be more specific, only the elite will be able to afford good private care. Not a lot will change there other than the standard quality going down even more, which allows them to aim lower as well. The lower the standard is, the less effort you have to put in to beat it.

 

Ha ha ha

Okay I'll just provide a counterexample to hypothesis. Here's the World Health Organization's ranking of health systems. The first twenty countries on that list all provide public healthcare. Some of those countries in the Top 20 also have the highest life expectancy in the world as well. Now notice where the US is on that list. 37th place. Now if all of these countries have "lost the economic incentives to seek excellence" then explain how their health care systems are still better than the US's health care system which has only lost that incentive relatively recently.

Because obviously people who suffer from illnesses but unfortunately can't afford to pay for the treatment should be left to die.

 

There could be various reasons, but the incentives to excellence are gone when payment is ensured regardless of individual failures.

Something like a more rigorous selection process for licensing doctors might counteract the problem? You can counteract this problem by introducing even more legislation to qualify it. Is there something like that in place in those countries?

There is no "should" or "should not" for death outside of human causes. That is not up to others to decide. People die of natural causes apart from the interference of others. Someone who lives alone in the wild and does not interact with others at all may still fall ill or simply die of old age. An individual's dispute with nature, as one might call it, is that individual's dispute with nature. There is no observable reason to feel obligated to interfere in such a dispute. Forcefully dragging someone else into your own disputes is not something I, or many, look kindly on.

When you come to a point where someone is forced to interact in disputes against their will, or to fund one side of a dispute against their will, there is an ethical problem.

When you force someone to pay for continuing their own existence, you are taxing them for existing, and also enforcing the idea that they should rely on others for their health.

That also creates ethical problems.

I am not suggesting that anyone should die anymore than I am saying that illnesses should exist. I am instead suggesting that forcing others to get involved in disputes against their wills is unethical.

Though to be perfectly fair, all that I said originally was that it was a tax on existence, which was a neutral point with no positive or negative connotation.

 

Could you please clarify what you mean when you say "the incentives to excellence are gone when payment is ensured regardless of individual failures" by giving an example. I think I understand what you mean but it'd be best for you to clarify then for me to assume and probably be wrong.

As for your question as to whether there is a more rigorous selection process, I don't know if there is one. The process for getting a license for most physicians in the US actually takes between 3 to 6 months due to the extensive background checks, educational, training, and historical primary source verification which are required so it isn't exactly soft.

You seem to have misunderstood what I said. I never said that we should feel obligated to interfere. If a person doesn't want help, then I will not give it to them. I will feel sorry for them but one life's and one's body is one's own and they shall do with it whatever they want. But isn't it just as unethical to leave a person to die even if they don't want to and help can be provided but unfortunately the price tag is far too high for them to pay and thus help is declined.

People are already being forced to pay for continuing their own existence. Medicine has a price tag and it isn't cheap. This bill just makes continuing their existence much more affordable for everybody. And I personally don't see how people relying on others for their own health is a bad thing. A human being as an individual is imperfect and cannot always do everything by themselves, especially in regards to physical medicine. You cannot diagnose yourself with a myocardial infraction and administer appropriate treatment, can you?

 

I mean that when someone has medical insurance or a healthcare plan, a doctor is ensured payment regardless of the quality of individual procedures whereas when an individual must pay directly, the doctor will lose income for low quality work. The economic incentive to just prescribe some drug or another and put as little effort in as possible is raised when you have an insurance company paying the bills. It is even worse when everyone is forced to have such a company.

I was actually thinking of something like a rigorous review process by which a doctor's work is assessed and their license revoked if they do not meet a certain standard. Meeting a license requirement before actually facing market factors does not change the effects those market factors will have on your work.

On the contrary, you misread what I said. I am arguing that a doctor should not be obligated to interfere with nature's attack on a person.

By that token, what if my price tag is simply "not for sale" but I am able to perform the procedure? That is the argument I pose: that I should not be forced to work for any price that I do not agree to myself. To someone who refuses to help, even the highest price is cheaper than not helping at all.

I do not find it unethical to leave someone to settle their own disputes.

That is incorrect, at least in the healthcare aspect. They are being forced to pay to have others aid them in continuing their own existence. They are not being forced to pay to continue their own existences without active aid. This ruling will force people to pay for existing on their own steam.

This bill will tax people who either do not want healthcare or do not need it, as well as those who neither want it nor need it. Those who go through life without the direct aid of others are being taxed simply because they are alive.

 

That isn't necessarily true, from a purely economic stand point that would be a truth, but in the pratical use of economics in real life tha tis not always the case, sice it doesn't account for numerous factors, the main one being the humanity factor, as viewing people as more then numbers.
Here in the UK we have access to free healthcare, and still have access to private healthcare obviously. The public sector has healthcare professionals that are both good and bad, as well as the private sector has good and bad.

My father had two knee operations in the last 3 years, both in the public sector, which was good because we could'nt afford to have it done provately. He is now able to work like he has before thanks to the free healthcare provided and his operations have both been succesful.

On the other hand, my uncle who was suffering from a similar knee problem around 20 years ago, went to see a private healthcare professional at the time and paid for his own knee operation. As a result, he has been effectively wheel chair bound for the last 20 years with no recovery possible, because the private practitioners at the time made a mistake during the surgery.

It didn't matter whether they were private or public, it depended on the doctor who was conducting the surgery, the hospital they went to, the after care they were given. Most public healthcare professionals have huge wages to compensate for their expertise, the best in general are as much in the public sector as they are in the private.

There incentive is to help and heal, to earn their wages, to not get fired. Whether it is fear, compassion or success that drives them, healthcare professionals will still provide you with sufficient care

 

Dear god, I almost lost this post by accidentally closing the tab. Thank god for auto-save. I was on the verge of tears. ; _ ;

You say that the economic incentive to do just the bare minimum will rise since their pay is guaranteed. Okay that is a legitimate worry. But let's look at other healthcare system. France, for example, spends 11.7 per cent of GDP, or $4,000 per capita, according to 2009 World Health Organization figures. The US spends 16.2 per cent of its GDP on health care, or $7,400 per capita. Yet France was ranked higher than the US by the World Health Organization in quality, efficiency, acceptability, and equity and its healthcare is considered the best in the world. And over 75% of the healthcare is of the public sector. This article on the French healthcare system even states that there is no significant difference between the public and private sector in France. Even the countries from 2nd to 36th place spend less the US and some of them even spend less than France yet they are still considered better than the US.

I should also add that a physician doesn't get a full license to practice medicine unsupervised until he has completed 1 or 2 years of his residency so he has faced "market factors" when he gets to practice it unsupervised. In most countries, physicians are also expected to stay up to date on the current happenings of medicine and are often reviewed by a board to see if they are still capable of performing their jobs.

The obligation to help a fellow human being would in itself be a positive ethical thing. Helping others solve their dilemmas is not unethical. On the contrary, it is a positive ethical factor because it serves to establish something quite like the fraternal bond between fellow human beings, which is the basis of positive ethical behaviour by its definition of fairness, equality, helping others, etc.

As for the second part of your argument, I'm a little confused. If somebody who can perform the procedure doesn't want to then they don't have to. Let's just hope that they don't expect their paycheck anytime soon or, if they're working for a hospital, expect to still have their job.

As I said earlier, I don't see what's wrong with having others aid you. One of our biological imperatives is to form groups. A human being as an individual is imperfect and we cannot always do everything by themselves, especially in regards to physical medicine. You have been diagnosed with lung cancer. Now tell me how you're going to treat yourself by yourself. Good luck.

Yes, the bill is forcing everyone, although not everybody technically since you can be exempt from the bill for religious beliefs or financial hardship, to buy health insurance, and the government has the right to levy a small tax on those who don't(Only an estimated 1 percent of the population will face the tax though – a tax that maxes out at 1 percent). But by doing this, it becomes cheaper for everyone since the cost is split.

 

While that is possible, I would prefer a market where the incentives are for progress and stability even in the time of a crash instead of "free" aid, which relies on revenue being ample. See my response to GS below.

In a market where free healthcare is provided at a tax and the standard of living and rate of employment is high, the private doctors will make far less because they have fewer customers regardless of their prices. A medical institution with limited funds will give worse results on a whole. The only exceptions to this factor might be the doctors payed by the elite.

You really ought to be careful about that. I noticed that KHV's buffer system is buggy.

I should address a central point I neglected earlier.

A system of free healthcare and welfare systems in general only work when other sectors of the economy are also doing well. If employment rates are high, then nearly any welfare system will be beneficial. My worries are based more in the long-term. If an economic crash comes and such a system is in place, the quality of care will go down significantly, and its purpose as a tax becomes more obvious. In a society where the average standard of living is high, the the welfare systems will also function well, but if the standard of living goes down, the absence of those economic incentives will become much more pronounced.

I disagree because that obligation creates a contradiction. It is unethical to force someone to interact with others. It is ethical to help, but it is unethical to force someone to help. I do not see it as unethical to avoid interacting with someone because my definition of ethical treatment is "respecting the consent of others regarding their body and property". I did not use "wishes" because that would be ridiculous. If it is unethical not to, say, feed someone who is starving, then it follows that it is unethical not to sleep with someone who is aroused and inviting.

My argument is that an individual should be free to interact with other individuals on consensual terms without third party involvement. A law like this will hurt the finances of doctors who want to work in the private sector and choose their patients carefully.

It is incorrect to say I am free to trade with people when you make the people I would be trading with pay others regardless. I will use this metaphor again: you cannot say that I am free to leave by any door when you lock them all.

I'm not, I'm going to die. I don't think it's worth the effort to treat it. What now?

However, this law also greatly affects the market for those who do not get the health insurance. It will be much harder to find a doctor who will take care of you if they are not guaranteed payment by an insurance company. Insurance will become the primary mode of payment, and nothing else will be trusted by most hospitals. Especially with the unemployment rate so high.

This bill will force people to buy insurance both directly and indirectly. If they do not want healthcare, they must pay simply because it is the law. If they do want healthcare, they will have to buy insurance to get it. Forcing someone to buy a product is unethical. Forcing those they trade with to use it as a standard is also unethical; doubly so because it effectively forces the one to buy as well. In this scenario, both are happening.

Both ethical and economic factors should make it clear that this is a bad idea. However great it may sound for some people to get free healthcare, a system like that is unsustainable and will hurt many others for every person it helps, and even just the idea that it helps people beyond keeping them alive at the time is debatable; it does not facilitate progress in any way.

 

Yeah, I've resorted to just writing everything up in LibreOffice first then copypasting to KHV. Much safer this way.

You see, this makes sense in theory but it seems that the opposite has happened in practice. As I mentioned earlier, France and various European countries are considered to have the best healthcare yet the unemployment rates of some of those countries are higher than the US's. The US has an unemployment rate of 8.3 while France and the European Union have an unemployment rate of 10.2 and 10.3 respectively. If those countries are able to make their healthcare system run well despite having a higher unemployment rate than the US then the US should be more than capable of doing the same. Especially when you consider the fact that the US has a much higher population than all of those countries and thus would have a larger labor force and thus more money going into the welfare system.

By the way, there are some parts of PPACA that are actually trying to improve the economy. The bill has already put these into effect so far. It allows the Food and Drug Administration to approve more generic drugs, making for more competition in the market to drive down prices. It increases the rebates on drugs people get through Medicare so drugs cost less. It establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. The Congressional Budget Office even estimates that the health care law in its entirety would reduce the Federal budget deficit over the next decade.

And to address a point that you made earlier about physicians losing the economic incentive to do their best and being able to do just the bare minimum. Apparently after 2015, the act will make a physician's pay be determined by the quality of their care, not how many people they treat.

I'm personally a fan of ethical hedonism/utilitarianism so I personally define ethical treatment as “the course of action which brings the most happiness, pleasure, well-being or good to the most people. To maximize the good and minimize the bad is the most desirable course of action”. So I concede that forcing a physician into interacting with others is unethical since it would increase his “suffering” in a sense but I also find it unethical to leave a person to handle a “dispute” that they are incapable of winning despite one being able to help them because one has chosen the path that leads to more suffering for that person without a justifiable reason to do so.

Also I'd like to add that the last sentence of that first paragraph confused me for so much time. And it was because you used "not to" instead of "to not" which really really fucked up with the flow of the sentence and made it sound weird in my head. As for your argument, while the first would be considered unethical since it leads to the suffering of one person, I would only consider it to be unethical if a person is perfectly capable of feeding and helping that person and then decides not to without a reason to justify it. The second one isn't unethical though because you aren't making that person experience suffering. And honestly if they feel suffering from not having sex then they need help anyway.

Could you please go into more depth about how it would hurt the physicians who want to work in the private sector?

You die. Simple as that. But not everybody is you. If there were a way to treat their condition, more often than not, a person would choose to receive treatment.

You do realize that the ability to pay out of your pocket won't disappear just because health insurance has become more affordable, right? In my country, Brazil, we have both public and private healthcare systems and both seem to work fine together. One time I had to take an x-ray for my orthodontist but when I went to get the results, I was told that there was apparently some complication with my health insurance provider and that I would have to get into contact with them before I could get the x-ray. But the problem was that I needed those x-rays now. So I just asked if I could pay out of my pocket and there were like “Sure”. No problem with that whatsoever. I would assume that the same would apply in the US. In the end, as long as things are getting paid, I don't see how the problem you stated would arise. Has the money suddenly lost its value?

The tax for not wanting health insurance is a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, a fee of 1% from what I've read which is relatively small when it comes to taxes to my knowledge, unless of course you're not buying insurance because you just can't afford it and there will be help in the form of rebates or subsidies to help those people. I would assume that if a person doesn't want health insurance, then they would have the money to pay for healthcare when they actually needed it.

You have provided no evidence that shows that people will need health insurance to receive healthcare. That is purely speculative and quite the opposite happens across the world. If you can find actual evidence of that happening then please provide it. Even then it'd probably more of an exception than the rule.

 

Those numbers sound very low to me. Oh, but you are using entire countries. I am imagining a slum setting, in which a welfare program will only perpetuate the problem and decrease the quality for everyone. In essence, the poorest communities will have the worst quality of healthcare, and breaking market factors like this will only worsen the problem.

The issue is that the customer is not the one judging the quality of their doctors. They make that step on paper, but the fact that they are payed by a middle man, and that the middle man gets payed by force, remains regardless of what they are payed based on. You might as well have said that the doctors will state the creed again to the committee that taxed me, and will be payed according to how well they have it memorized.

We went over this on MSN, hopefully you got most of it there. Suffering is defined by the victim of suffering. Simply put, to suffer is to not get what one wants. That is why masochists are not said to suffer if they hurt themselves, and are said to suffer if they are hungry; because it relates to what they want. Someone who starves themselves, to lose weight perhaps, is also not said to be suffering. It applies to any "need".

Because there is no objective way to define suffering, the sexual desire and the desire to eat are equal.

My argument is that the only objective way to make an ethical decision is to leave individual happiness up to each person and avoid violating their consent. That is the only way to minimize harm while maximizing happiness consistently.

I did so in my response to Peace-and-War. To be more direct, it will harm everyone who does not want to contribute to settling a dispute with nature, not just doctors. Being forced to pay for someone else's procedure is functionally the same as being forced to do the procedure yourself. If the government decides that you have the funds, you are forced to pay for the procedures of others. This is the same as the government finding someone able to perform a procedure and forcing them to do it personally. Everyone who is able to take care of others is forced to take care of everyone else, not just a doctor.

The private sector that avoids government welfare programs while revenue is high will lack funds, and a medical facility that lacks funds will be hurting in the market. When people are forced to pay for one program, any other program becomes superfluous. Hence why most people do not hire body guards, and why that business is not very big—individuals must pay for the police regardless. In fact, even a private market doctor or a body guard would be forced to buy insurance or pay for the police themselves (I assume, no reason for an exception)—thereby hurting their own business. You have the same problem with any service citizens are forced to purchase.

Not quite! I will live for an indeterminate time before dying, and if I live well enough in that time, I will be taxed. You are arguing that I should suffer because others would want treatment.

It will disappear if healthcare is made the standard, because both wages and prices reflect the standard.

In order for healthcare to become more affordable, the actual price of the procedures will have to go down, or the insurers will have to take the hit out of their own pockets. You can't just lower prices out of nowhere without actually lowering the amount payed to the doctors, and if you are going to do that, then just let people pay those lower prices directly. Otherwise, the prices will be lowered artificially if at all.

Exactly why do they need a tax in order to get rid of what you are proposing?

If I am being forced to pay for the service of getting rid of it, then how am I not being forced to pay for healthcare via that tax?

I am speaking of a world in which people are turned away if they cannot pay, of course. If you happen to be somewhere where you are refused care without guaranteed payment, it should go without saying that a healthcare organization would make you more acceptable as a customer because payment would be guaranteed. The only exceptions to that idea would be cash or otherwise obvious ability to pay.

If you are not turned away without payment, then market factors have become absent because you will get care period. If you take the voluntary association part out of business, it becomes worthless to assess it as a business, because it is no longer one.

 

One thing I noticed while reading through your post is that you seem to mistake healthcare with health insurance. They are not the same. This act affects health insurance much more than it affects healthcare. The point is to give all Americans a new set of consumer protection rules that prevented insurance companies from denying coverage for pre-existing conditions and imposing lifetime caps on coverage and as a result of this, health insurance becomes more accessible and as a result of that, more people will be able to afford healthcare.

The way I understand it, it should work somewhat like this. For example, Dr. Smith is a surgeon and will have to report his average operative time for a cholecystectomy and his post-operative wound infection rate. If he falls below a certain percentile nationally, his reimbursement will be negatively affected. If he is in say, the top 10% nationally, he will receive a small bonus

Seems like a good idea on the surface but the problem I see with it is what if a patient doesn't listen to his doctor and makes their condition worse. Technically the doctor's pay will go down because of this since on paper, the patient is doing worse. Although I guess the doctor could tell their patient that if they don't stop smoking or something that affects their health badly then they'll just drop them since they obviously don't care about their health in the first place.

Things might be up for change though in the future though.

In the end, it all depends on context. In the situations given to me earlier, the desire to eat outweighs sexual desire simply because you can live without sex but you can't live without eating. As I also told you in that MSN convo, people can reach a compromise. One side doesn't have to win and the other has to lose. Both can reach a conclusion that increases the happiness, either short-term or long-term, of both parties.

Your proposition would lead to tragedy of the commons in my opinion since long-term interest isn't taken into account. In the end, this isn't about individual happiness though but instead the happiness of the many. If an action minimizes harms just as much as it maximizes the happiness, then I consider it to be ethical which I consider this act to be because it does just that.

Technically if you're paying for health insurance, then you're not being forced to pay for someone's else procedure since you knew what you were getting into before you signed the contract and began paying for it and the point of health insurance is to pool as much money as possible so when people do get sick or injured, they'll be covered and not have to pay an outrageous price. And you aren't being forced to get health insurance and thus pay for other people's “disputes with natureâ€. The only consequence of not getting a health insurance is a tax and I'll talk more about that below.

As for another program becoming superfluous just because another program of a similar field is getting paid through taxes, that is wrong. Let's use your example of the public security and private security. The purpose of public security(police officers) is to protect the public while the purpose of private security is to usually protect a private establishment or private contractor. While there is some overlap in their duties, they do fulfill different objectives and according to Wikipedia, the private security industry(security officers, bodyguards, airport security, etc.) is rapidly growing and is actually a $100 billion dollar a year industry. Not too bad in my opinion. It shouldn't matter that everybody has to pay for the public sector since the public sector is suppose to help the public while the private sector would be there to offer whatever the public sector doesn't provide or doesn't provide enough of. Both are capable of working together without making the other superfluous and I believe that a balance between the two is key.

Actually, no, you won't. I'll explain below. And I never said that you should suffer. Please don't put words in my mouth. You decided that on your own. There was the option of having medical insurance or paying for the procedure out of your own pocket and being treated but you refused so the only reason you're suffering is because of yourself.

First of all from what I've observed the only way healthcare can be made more affordable is if there are more doctors and if the tools of trades that they use become cheaper to use which would require mass production of those tools so that if they broke, they could easily be replaced. If people just stopped paying doctors and waited for them to lower their prices then you're stuck between a rock and a hard place. You either don't lower your prices and get less profit. Or you do lower your prices but be unable to pay the bills that comes with all those big expensive machines and thus go into debt which will make you have to hike up your prices or go into bankruptcy. Both lead to the same end. Pick your poison.

This is why medical insurance becomes the middle man. From what I've read of your post, you do not know how medical insurance works, do you? It's okay to admit it, Mak. Feigning intelligence doesn't really support your argument.

As I told you yesterday, insurance is all about risk management. Unless you have a genetic condition or purposely damage your body with drugs such tobacco or alcohol, you don't know when you'll get sick, how sick you'll get, and in the case of most of the 90%, you won't know how much you'll end up paying the hospital to get better. This is where insurance comes in. An insurance company basically says “Pay this relatively small amount of money every month and if you get sick, I've got your back or if you just want to visit the doctor for a check-up, I'll cover most of the bill while you only pay a small part.†Now the money that you give your insurance company monthly, 20% of that becomes their. In the end, they need to make a profit. This is a business after all. But the other 80%, that goes into a pool. This is a pool of all the money the insurance gets from its customers and if it has a lot of customers, there will be a lot of money. That money is used to cover everybody that has contributed to it. And the pool just keeps on getting bigger and bigger because people are putting more money into it.

Now let's say you have a medical bill of $5000. The insurance company can cover you because $5000 is really small in comparison to $5,000,000 that it has in that pool. Let it be known though that insurance companies make a loooooot more that. And it's statistically improbable for the pool to be used up all at once since it's balanced out by the people who don't get sick and aren't always using the money in it. So they aren't artificially lowering prices, just covering a huge part of the cost for you so you can pay a smaller price.

Let it be known that this is a gross explanation at best and that there are more complicated things that happen. I'm just trying to get across the simple theory of it all.

From what I was able to gather, it's because you're putting yourself in risk by not having health insurance. If you had health insurance then the insurer can cover you if you got sick or injured. But what if you didn't get health insurance and were taken to the ER of a public hospital after suffering a major injury? And let's say you didn't have money to pay the medical bill. Well who pays for you? The taxpayers. Which is why the government collects the tax. To promote the general welfare.

Now what would happen if you didn't want to pay the tax anyway? Nothing. The bill states that failure to pay the tax would not result in either criminal penalties or tax liens. Nobody would come after you if you didn't pay the tax. Congress simply plans to rely primarily on the fact that most Americans understand and accept that they have to pay their taxes. Don't assume that I'm assuming this either. That's the actual plan. The only consequence for failing to pay the tax is that your income tax refund would be reduced by a bit. And if you didn't have a tax refund that year, there are no consequences at all!

I seriously considered responding to this with just “PUBLIC HOSPITAL BLAH BLAH BLAH PUBLIC HOSPITALS BLAH BLAH BLAH!â€

But yeah, with all the public hospitals in the US, being refused healthcare just because you can't pay doesn't happen. Even then this bill is suppose help a good amount of people afford healthcare so the situation you proposed doesn't happen since it'll make private health insurance more accessible and thus put less strain on the government which would help get America out of its recession, no?

 

It is multi-point. If it were simply to give people affordable insurance, then they would force insurance companies to sell to people who wanted it, not force people to buy it who didn't want it.

When in doubt, any action that creates victims and increases profits must be clearly necessary or else it is clearly for profit.

On the contrary, I worry more that the doctor or the hospital he represents write the papers he turns in, and that the results reported will generally be better than the reality.

But living itself is a desire, which is equal to the desire to have sex. What makes living so much more important a desire, that desires related to it are "more important"? Many do not wish to continue living, and many do wish to. Which of these wishes is more important?

My proposition would not lead to tragedy of the commons because all tragedy is individually defined. You continue to assert that tragedy can be determined by a third party. I assert that it cannot. Each individual defines whether or not they are happy with their situation on their own.

The question is, whose happiness does it maximize, and whose does it minimize? Who decides how much of each is worth how much of the other? If we consider the argument of numbers of people, then making one person happy at the expense of another is ethical. There is no way to determine how happy someone is or its comparative value with the suffering of the other, so you must use a binary. One person is happy, one is suffering. + 1 - 1 = 0.

I do not understand your definition of ethical behavior if you believe that causing harm while not changing the number of happy people is ethical.

I am being forced to buy insurance or pay for some service which will facilitate said insurance schemes. I do not even have to read below to know that the only defense you might have is that it is necessary to support something about this health insurance scheme. If I am being forced to pay for health insurance itself or to make it available to others, then I am being forced to pay for the eventual procedures of people that I would not have contributed to otherwise.

You really ought to stop saying it is not force if I will be contributing to it regardless of my wishes.

You always say purpose. You should not use such terms, they are meaningless. You are paying the police for a service. There is no moral, no ethic. You want them to do a job, and you pay them to do it. The only reason why you attribute such idealistic notions as "purpose" and "meaning" to them is because they are government services.

Any service suddenly becomes public if you force "the public" to buy it. Try to bring up one service that wouldn't be called public if it were given to everyone... At a tax.

A balance between the two is impossible because the private sector is not able to arrest the public sector, and the public sector would keep its position during any hardship while a private business could collapse. The only difference between a private service and a public service is that the public service is an enforced monopoly and the private service is based on voluntary payment by individuals.

You have said that whether or not you force your business on people changes the nature of the product you sell to them. A private service does not change in purpose simply by applying to everyone.

Ah, you misunderstood? The tax itself is the source of my suffering, and the tax exists for other people, not for me.

But I am in favor of a field simply not advancing if it cannot sustain itself without such artificial manipulation. Wouldn't it be a lot simpler for the pool in the insurance company to go into mass producing the tools instead of padding the pockets of people who saw a chance to take advantage of economic troubles? Why wouldn't it be a better investment for people to literally invest in the mass production of those medical tools?

There should and to the best of my knowledge will always be a more direct way to solve a problem than through a Ponzi scheme.

I will only believe that if and when I do not pay it and receive no penalties.

If they were to force me to pay it, then my argument is upheld by your answer. I am being forced to contribute to the procedures of others. The argument that I "may" go to the ER makes no sense because if that were the case then they could simply do the same thing but only to people who did visit the ER that year. In the name of "general welfare" or otherwise, I would be contributing to the service for the benefit of others against my will.

Again with public services, I don't like them for obvious reasons. You are in fact being forced to pay for the procedures of others already if public hospitals exist, and the quality of all hospitals is undermined when you must contribute to one hospital chain period. Supposedly we already do this, or public hospitals would not exist.