House passes "repeal and replace"

[Whack-a-Mole]

@Chronos

The ACA is not analogous to a hypothetical bill compelling people to pay tuition at Trump University. The analogous bill would instead compel people to pay for tuition at the university of their choice. While I don’t think that this would be a wise move, I see no fundamental objection to government being able to issue that compulsion.

Actually we all are forced to pay for K-12 education already…like it or not.

That said going to university is a choice and one people are free to choose to do or not as they see fit. Forcing everyone to pay would therefore go too far.

The thing about healthcare is we all need it. Some more than others but the person who makes it from cradle to an old age grave without needing to see a doctor once is few and far between. Nor do people generally shop around for the best deal with healthcare (which you could do for a university). If you are sick or injured you go to the nearest hospital.

So, our choice is to check the ability to pay at the hospital doors and if you can’t pay let you bleed out on the sidewalk (or better, take your plague back into public) or let them in and treat them. If we do the latter and the person cannot pay then the rest of us pick up the tab.

Put another way, everyone has ALWAYS been paying for other people’s healthcare all along. It was just hidden in higher insurance prices and hospital costs.

To have the government formalize this into a system where we all share the costs up front is just moving numbers around on paper and certainly a legitimate government interest.

[Whack-a-Mole]

@DSYoungEsq

Please note that a) I never said any such thing, and b) nor did HMS Irruncible. I recommend going back and reading the interchange of commentary.

You put forward the following:

If the justification for the ACA is simply, “They did it, because they had the power, and that’s all the justification they need,” then Bricker can justifiably reply that today’s passage of the ACHA was justified by the fact that “they had the power, and that’s all the justification they need.” Principles of government be damned, in other words; just do what you want when you have the power. That’s not a good idea. Do you think it is a good idea?

I was answering what you put forward. I made no claim that you held those views personally.

[wolfpup]

@Bone

Because I have a choice if I want to drive. The only choice to avoid being forced to purchase health insurance is to pay or die. Do you see the difference?

Yes I do. The difference is that you may be able to choose not to drive, thus being able to avoid the mandate wherein it serves a vital public interest to ensure that every driver is insured. You cannot in any practical sense choose not to be alive, and thus cannot reasonably avoid the mandate wherein it serves a vital public interest to ensure that every resident has access to health care. Indeed the average person is far more likely to need health care at various points in their life than they are to need auto liability coverage, with odds approaching 100%. I myself have never in my life needed to use my liability coverage, but needless to say we all normally have health care needs, and sometimes they can be very very costly indeed. I have always been a strong supporter of our single-payer system, but as I get older it becomes more than just theoretical, and my gratitude for it is boundless.

@Okrahoma

Why can’t liberals just try their solutions in some more liberal states first? Like Vermont trying to institute a single payer health care reform (and failing miserably).

Do you realize that your second sentence answers the question in your first sentence? Why do you think Vermont failed, while every single Canadian province managed to enact single-payer health care nearly half a century ago with no problem at all, and with very significant savings in total health care costs?

I briefly addressed these points in #112, but let me quote the relevant part again with added emphasis:
… Medicare has been a federal program for a great many years, thoroughly opposed by Republicans at the beginning for much the same reasons that they’re opposing Obamacare now – too socialist, gives too many people health care who should damn well either pay for it themselves or have the good grace to die. But now Medicare is well entrenched and highly valued and it’s not going anywhere. That ship – federal management of health care – sailed a long time ago.

I actually agree with you that a UHC program should ultimately be state-administered, but because of Medicare and many other factors there is a federal role in cost-sharing and establishing standards. The federal government has to be viewed as a collaborative partner in these state initiatives, otherwise “let the states handle it” is just a cop-out synonymous with “I don’t want it” and ensures it will never happen, just like the states that have struggled in vain trying to propose or introduce single-payer.

[marshmallow]

@Leaper

I mean, you may not care, but do you at least acknowledge that running a national government that way might wind up with people being guillotined in the town square?

This is America, the sans-culottes march shoulder to shoulder in defense of the nobility.

@Bricker

Fifty years ago, the nation managed to navigate itself without adopting the policy that the federal government owed free health care to citizens. Forty years ago, thirty, twenty – still we chugged along.

The nation could chug along if a small comet impacted northern Virginia.

[kaylasdad99]

@DrCube

Paying less and altering regulations does not mean the government isn’t involved. Any more than changing the rules of the road to allow drivers to turn right on a red light means that the government has “gotten out of the traffic business”. The government is just as much involved as it was before, you just like these particular rules better.

You appear to be making a qualitative assertion, here: that government involvement still exists. Bricker’s assertion is quantitative: that this legislation, if enacted into law, results in LESS government involvement than under the ACA.

[Bricker]

@Miller

So, about that job…

When can you start?

[The_Tooth]

My objection to Obamacare has always been one of basic philosophy: I don’t agree that providing everyone with health care is a proper role of government.

Therefore, I think that it’s wise when we move away from that model, and unwise when we move towards it.

If Bricker dies tomorrow, he will not think about this policy at all, because he’ll have ceased to exist. Will that affect the wisdom or lack thereof of providing health care? Perhaps someone who’s not Bricker can explain how the wisdom of a policy depends on how Bricker feels about it rather than, say, the consequences of enacting the policy.

[kaylasdad99]

@Bricker

No, it’s a fundamental argument about what government’s role is. The idea seems to be that we inch along, with every generation accepting the idea that government must provide more stuff for them, plus all the entitlements of a previous generation.

I don’t revel in people getting sick or declaring bankruptcy. But I don’t agree that the right role of government is to say to the other folks, the ones that are not sick or destitute, “Hey, we’re all a family here; chip in and cover Uncle Billy.”

One might wonder, in the absence of a moral arbiter of an ecclesiastical character (because the Constitution forbids the imposition of one): WHOSE ROLE IS IT?

[Some_Call_Me.Tim]

@QuickSilver

You should stop paying and filing taxes, on principal.

Indeed! You should not pay taxes on the principal of your investments, but only on the income that principal provides in interest, dividends, etc.

It’s a matter of principle.

[Doubticus]

@Bricker

Why is the rest of the country required to pay for you and your beloved?

Why is the rest of the country required to pay for the military, public roads, or the justice system?

[Whack-a-Mole]

@Okrahoma

Why can’t liberals just try their solutions in some more liberal states first? Like Vermont trying to institute a single payer health care reform (and failing miserably).

You say this like universal healthcare is some crazy new thing. It’s not.

Among OECD countries the US is the only one without universal healthcare (actually I think Mexico does not have it either…not sure). By and large they get comparable or better health outcomes than we do in the US too so there is no lack of quality broadly speaking.

Here’s a list of them:

AUSTRALIA
AUSTRIA
BELGIUM
CANADA
CHILE
CZECH REPUBLIC
DENMARK
ESTONIA
FINLAND
FRANCE
GERMANY
GREECE
HUNGARY
ICELAND
IRELAND
ISRAEL
ITALY
JAPAN
KOREA
LATVIA
LUXEMBOURG
MEXICO
NETHERLANDS
NEW ZEALAND
NORWAY
POLAND
PORTUGAL
SLOVAK REPUBLIC
SLOVENIA
SPAIN
SWEDEN
SWITZERLAND
TURKEY
UNITED KINGDOM
UNITED STATES

[Whack-a-Mole]

@Doubticus

Why is the rest of the country required to pay for the military, public roads, or the justice system?

Add in K-12 education too (I chose not to have kids so why should I pay for yours?).

[sub]For the record I am fine paying for K-12 education and would be fine if it was K-16.[/sub]

[kaylasdad99]

@Bricker

No, it’s a fundamental argument about what government’s role is. The idea seems to be that we inch along, with every generation accepting the idea that government must provide more stuff for them, plus all the entitlements of a previous generation.

I don’t revel in people getting sick or declaring bankruptcy. But I don’t agree that the right role of government is to say to the other folks, the ones that are not sick or destitute, “Hey, we’re all a family here; chip in and cover Uncle Billy.”

@DrCube

But that wasn’t your argument. You said “people did just fine without it”. But you were wrong. Some people did. Others did terribly. That particular argument had nothing to do with the government or its role at all. Just “I did fine, and I don’t really care about anyone else”. And that’s a terrible argument. Just saying.

“Government’s role”: That argument might have legs.

“I personally was oblivious to the pain and suffering going on around me for the past 50 years, so the status quo was hunky dory in my opinion”: Eh, not so much.

Sorry, I missed where he said “people did just fine without it.” Could you provide a quote, please? What I saw was an assertion that the Union did not break asunder when we didn’t have [expanded access to health insurance]. But I could be mistaken.

[Bricker]

@Doubticus

Why is the rest of the country required to pay for the military, public roads, or the justice system?

Because there is wide-spread agreement that funding these is a proper role of government.

[Bricker]

@kaylasdad99

Sorry, I missed where he said “people did just fine without it.” Could you provide a quote, please? What I saw was an assertion that the Union did not break asunder when we didn’t have [expanded access to health insurance]. But I could be mistaken.

I truly appreciate this – thank you.

This is a commitment to an argument on merits. Bravo.

[HMS_Irruncible]

@Bricker

Sure. I don’t disagree in the slightest.

But this thread was opened after one of the two houses of Congress ALSO passed a law,

I know it must be exciting to imagine all those people with pre-existing conditions dying in penury because they can’t afford their medical expenses, but they didn’t pass a law. They passed a bill. A cynical, cowardly bill designed merely to placate rabid extremists in the 2018 elections and let the wrath of the electorate devolve to the Senate. If this cheers you at all, then you’re as hoodwinked as the rest of the Trump voters.

which I assume you’ll agree will be equally constitutional if passed by the Senate and signed by the President. So that argument is a wash, in a sense.

As is your argument about “the proper role of government.” The proper role of government is nothing but the express political will of the electorate, and we’re not done talking yet.

[Stranger_On_A_Train]

@Bricker

Because there is wide-spread agreement that funding these is a proper role of government.

i.e. I need and like the military, public roads, the justice system, et cetera, which benefit me, therefore it is good that government provides them. I don’t need government guaranteed or subsidized health care, therefore it would be bad for the government to provide it.

As I pointed out above, Bricker is completely consistent on this. You aren’t going to find some kind of logical loophole in his reasoning. He’s just purely selfishly against this concept even if it would be a fiscal benefit to the nation as a whole because he doesn’t personally want it.

Stranger

[Whack-a-Mole]

@Bricker

Because there is wide-spread agreement that funding these is a proper role of government.

Why isn’t universal healthcare on the list?

I am hoping for more than “widespread agreement” being the metric.

[Slash1972]

@Bricker

Because there is wide-spread agreement that funding these is a proper role of government.

Could you post the form in which this wide-spread agreement manifests itself?

I can understand “military” and “justice system” but what agreement mechanism applies to “public roads”?

(Disclaimer, my health insurance is already provided by taxpayers so this vote doesn’t affect me or my family)

[Okrahoma]

@Whack-a-Mole

You say this like universal healthcare is some crazy new thing. It’s not.

Among OECD countries the US is the only one without universal healthcare (actually I think Mexico does not have it either…not sure). By and large they get comparable or better health outcomes than we do in the US too so there is no lack of quality broadly speaking.

Here’s a list of them:

So - why can’t it be implemented on state level? In some state where people genuinely and votingly want it very much? Instead of forcing it on people in states that don’t?