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Nv1ncible
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#1
11-20-2013
Default Affordable Care Act: Why am I required to buy Health Insurance?

Ok, this is a topic that's been on my mind a lot lately, and despite having a relatively good idea of who will respond to this and what they will say, I want to (try to) be open minded.

Why should I be required to carry health insurance, less be penalized (taxed)?
muRda
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#2
11-20-2013
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I remember that "explain it to me like an 11yo" or w/e subreddit that had a pretty good layout of everything (I think including reasoning from Congressional hearings or w/e).
Nv1ncible
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#3
11-20-2013
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Ok, I'll see if I can find it.

Edit: Maybe this? http://www.reddit.com/r/explainlikei...d_what_did_it/

So, hypothetically, the logic used to justify this legislation could be extended to almost any good or service if it were deemed "required" by the legislative majority?

Last edited by Nv1ncible; 11-20-2013 at 03:56 PM.
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#4
11-20-2013
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why don't we have single payer?

cause our country is fucked and run by greedy people who might hate us
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#5
11-20-2013
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You're required to have insurance because instead of having a completely unified system we have to force people into... having choice because freedom.

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#6
11-20-2013
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I don't want to hijack the thread but since it's a similar topic I've been wondering something. Children get cut from their parents plan at 25yo but parents are able to pay for their children's car insurance for as long as they wish... why can't parents choose to cover their adult children on their health insurance for as long as they wish as well?
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#7
11-20-2013
Default

Quote:
Originally Posted by Nv1ncible View Post
Ok, this is a topic that's been on my mind a lot lately, and despite having a relatively good idea of who will respond to this and what they will say, I want to (try to) be open minded.

Why should I be required to carry health insurance, less be penalized (taxed)?
Because you need to do your part to take care of the less fortunate (those who are less wealthy and/or those who have worse health). If a person doesn't want insurance, it is usually because that person thinks they are relatively healthy. But the people that are healthy are just the people we need to join the health care system because they can help drive down premiums, thus making health care more accessible for those burdened by bad health. Without healthy people buying insurance that they don't use that often, premiums will be too high.

In addition, you never know when an emergency may occur. Therefore you should always be protected by insurance because there is always some risk of you becoming injured or ill.
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#8
11-21-2013
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A fair and measured account of those in support's argument^

Health care is a requirement for life just like food and shelter, so as far as I'm concerned it's something that "must" be purchased anyway. Sure you can weasel your way around facing that reality based on a few outliers, but by and large, just as I'm comfortable saying people need 3 squares a day and a roof over their heads, I'm comfortable saying people need health care. You don't get taxed for not acquiring food, but you do die (which is probably a worse outcome), and if your issue is with a tax on some abstract, vague ethical level, feel free to be dismissive and link up some Youtube anti tax guys saying lots of words about it, but that doesn't change the fact that taxation is a real phenomenon that isn't going anywhere. So try to stick to stuff that is actually happening or has a high likelihood of happening, instead of jumping to:

Quote:
So, hypothetically, the logic used to justify this legislation could be extended to almost any good or service if it were deemed "required" by the legislative majority?
The world generally doesn't operate in abstract hypothetical reductio ad absurdum.

Mike touches on my own misgivings with the act, and Crest nails it. The spin around the act is that it's anti-freedom or whatever to force people to buy something, and that may be so, but I'd argue that if you want to go down that line of thought you'll end up at single-payer eventually. Really what's going on is that people are required to buy from private companies who now, in the ideal scenario, will have to actually compete with each other on a national level. The idea is that it will get more affordable in time, after the market catches up (and provided we go further to ensure insurers stop straight up lying to their current customers about their options--"Oh we went ahead and enrolled you in this more expensive plan but it's the cheapest you'll get" lol get fucked). What is actually going on is people are still terrified of the prospects of a real single payer system, so we got this shitty compromise instead and insurance companies still get to fuck us.
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Last edited by davobrosia; 11-21-2013 at 08:59 AM.
Nv1ncible
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#9
11-21-2013
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I have no problem saying that health care is a necessity either, but we are talking about health insurance. I guess the first thing I would want to understand is WHY is healthcare itself so costly? What about that marketplace makes it noncompetitive? I think the answer to that has to have some relation to US govenment policy, because I have heard and read about people leaving the country to have operations done to save money. So why is the global market more competitive than the US health care market?

I think if health care costs come down, it would make sense that health insurance costs would as well, at least to some extent.

But to go back to the ACA, and what seems to be your justification for a tax in this scenario. 3 squares and a roof over your head are certainly necessities, but in neither case are you actually taxed by the government for lack of possession. The ACA has set a new precedent in that it is unlike all other taxes, where the tax is a result of having actually purchased or owned something, or made particular actions (ex. married). In this case, the tax is distributed for the absence of action/ownership. That seems really dangerous to me, and completely unfair. It's certainly not freedom.
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#10
11-21-2013
Default

Quote:
Originally Posted by Nv1ncible View Post
I have no problem saying that health care is a necessity either, but we are talking about health insurance. I guess the first thing I would want to understand is WHY is healthcare itself so costly? What about that marketplace makes it noncompetitive? I think the answer to that has to have some relation to US govenment policy, because I have heard and read about people leaving the country to have operations done to save money. So why is the global market more competitive than the US health care market?
As it stands, health care in the US requires some form of health insurance due to inflated costs. Like I said, I don't think making people buy insurance is the answer, but I don't think having insurance at all is the answer either. It's noncompetitive because of insurers and because of a simultaneous lack of regulation where it is needed and regulation where it is not needed. ACA hopes to correct that by e.g. providing a national marketplace for insurance and adding regulations for what insurers are allowed to do to their customers.

Quote:
I think if health care costs come down, it would make sense that health insurance costs would as well, at least to some extent.
Health care is expensive because health insurance is expensive because health care is expensive ad nauseam. All roads lead to single payer, as far as I'm concerned.

Quote:
But to go back to the ACA, and what seems to be your justification for a tax in this scenario. 3 squares and a roof over your head are certainly necessities, but in neither case are you actually taxed by the government for lack of possession. The ACA has set a new precedent in that it is unlike all other taxes, where the tax is a result of having actually purchased or owned something, or made particular actions (ex. married). In this case, the tax is distributed for the absence of action/ownership. That seems really dangerous to me, and completely unfair. It's certainly not freedom.
If you want to get abstract and general, then don't half-ass it: like I said, whatever the negative outcome is for not obtaining the necessity, it's still a bad thing, whether it comes from the government or nature or other people. So this line of argument seems really juvenile and contrarian. What you seem to be arguing with is the spin on the tax, not the cost itself. If they'd just rolled this into FICA or something, it wouldn't even be an issue--most people pay that without necessarily using Medicare, so how is that fundamentally different?

You can call it a dangerous precedent, unfair, not freedom, but those are all vague, abstract ideological terms that I don't really care about at all.

Because many people here seem to lack a real-world global perspective and like to abstract away into la-la land, have an anecdote. My dad, a US citizen, spent a week and a half in the hospital in Germany trying to determine whether he'd had a stroke or Bell's palsy or what, and we never saw a bill. Health insurance is compulsory there, and while I lived there, nobody seemed to mind it. People can--you guessed it--pay a tax to opt out of participating in the standard funds and buy their own private insurance instead. They outperform our outcomes while spending less than half per capita what we spend and much less of their GDP.


Quote:
Originally Posted by BuK View Post
I don't know too much about the specifics because I'm still under my mom's health insurance, but say, in the future, I don't have insurance and get taxed X amount of dollars. Where does that go? Is it just part of the government's bank account, or does it go to help those less fortunate and unable to get their own health care? If it's the latter, then the whole "if you don't get health insurance, then we'll just give it to someone else," thing is kind of shitty. I like the idea of helping people in the way of lowering premiums and costs, but taxing healthy individuals with almost no need for insurance for the less healthy seems kind of odd to me.
The idea is that insurance as a concept relies on people who aren't using it still having it. Health insurance doesn't work if healthy individuals don't carry it.

It's really easy for people in good health to talk a big game about nanny states and freedom and liberty when catastrophe hasn't struck and their private insurer hasn't dropped them. If your real problem is with the concept of taxation used for anything but the barest form of government instead of e.g. social services and infrastructure, fine, but using less radical issues as a tool to segue into it every time is really disingenuous, and all the words and posturings translate to most people as just not wanting to participate in society because spoiled petulant brat. Surely you have to be aware that that's what people immediately think as soon as you start in with it, unless you just shut up and deal with it IRL, which is what most people do even in the face of such atrocious attacks on our freedom and liberty as having to buy insurance.

Quote:
Originally Posted by muRda View Post
The battle against the ACA is far from over. The first case was about the ability of Congress via the IRS to exact the tax; there will be another suit about the ability of the IRS to collect it, i.e. once someone pays the penalty, he/she will sue the government. I remember one of my professors telling me that it would be under Due Process and Equal Protection grounds (I think).

There was a lot of troublesome language for me in the case, and many people just saw it as Roberts saving face with Obama.


Except, buying and working are both affirmative acts. The taxpayer does something in each instance. The taxpayer purchases gas or works for a company under US regulation. Nv1's point isn't so ridiculous as it's a point raised by Scalia in his dissent (i.e. the broccoli mandate).


Citing a oft-quoted line from one of Ben's letters as a means for saying the Constitution was worded as to allow such a tax to happen.


Again, Roberts cites affirmative acts in buying a home or going to college. In both instances, people are given tax breaks; people don't have penalties exacted against them for not buying a home or not going to college.



I think this will be the major contention against the ACA pursuant to DP and EP.
^the right way to have this conversation (sticking to real things that are really happening and have really happened, and almost entirely avoiding ideological handwaves).
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