SCOTUS & ObamaCare

[Pointedstick]

I think one very big change that has happened in American society that is causing us to have to reevaluate private citizens relationship with their government is the breakdown of community. Your community used to be a source of security, but this no longer exists. People are thus forced to search for security from their government. In other words the role of government has had to expand to fill in the gaps where our private gated and sheltered communites have withdrawn from their social obligations. I was reading John Adams biography a while ago and I was impressed by the part that talked about how both he and his father ( as leaders in the community) were expected to take in and care for other members of the community who had no where to turn for help.

I also see this correlation, but I wonder if the cause was private citizens or if the cause was government; i.e. which came first?  If people know the government is already "taking care of" the poor, it seems to me that they would feel less of an obligation to do so.  Or did people, at some point or over time, just become cold-hearted?  Maybe it's a combination of the two?  Of course, it's not something you can ever prove one way or the other, so we'll never know.

I wonder the same things at times. Used to be that churches provided a great deal of care for the hungry, sick, and poor, but nowadays the government does through welfare. I wonder if the church would be up to the task if all the various welfare schemes went away. Same goes for the elderly; would the children of those with modest savings be willing to take care of them in their old age?

[D1984]

I wonder the same things at times. Used to be that churches provided a great deal of care for the hungry, sick, and poor, but nowadays the government does through welfare. I wonder if the church would be up to the task if all the various welfare schemes went away. Same goes for the elderly; would the children of those with modest savings be willing to take care of them in their old age?

I'm not entirely sure that churches would be able to provide assistance to the needy, sick, and unfortunate regardless of willingness. I'm not up-to-date on the exact numbers but add up all the spending on Medicaid (both for the poor and for the elderly in nursing homes), TANF/welfare, Food Stamps/SNAP, WIC, SSI/SSDI, the Federally paid portion of extended UI benefits, and the portion of Medicare and Social Security benefits that are spent on the poor, disabled, and survivors of Social Security recipients and I'm sure it would be in the hundreds of billions...and that's not even counting the billions more for the "net negative tax liability" (i.e. more is paid out to the tax filer than he/she paid in) of EIC/EITC and the refundable child tax credit. Finally, add the soon-to-be-in-effect (by 2014 if PPACA survives until then) Medicaid subsides up to 133% of FPL and the tens if not hundreds of billions more in premium subsidies for the exchanges and you are probably looking at over half a trillion dollars a year if not more. I don't think all the churches/mosques/synagogues in America could pay that much out every year even if they did nothing else with their money; they would simply run out of funds.

You should also keep in mind that churches would probably discriminate in handing out assistance so someone could end up being denied help just because they were of the "wrong" skin color, "wrong" sexual orientation, of a faith that is a small minority where you live, lived together without being married, or were an atheist/agnostic/freethinker and consider if that would really be a step forward or not.

Finally, I don't think many children of those elderly with little or no savings would themselves have the resources to take care of their parents (and what of those elderly with no offspring or at least none that survived?); the earnings/wealth of one generation are in many cases somewhat correlated with those if the next (i.e. if your parents were poor you are more likely to be poor as well and vice versa if they were affluent). This is not to say that Social Security could not be taken care of a by a free market system; it almost certainly could (being nothing in effect but a giant tontine anyway) but the method would have to be people paying in to private tontine and/or deferred annuity policies for themselves rather than children being expected to take care of their parents and grandparents when the latter got too old to work. Such a system would probably take the better part of a generation or two to implement and something would have to be done to help those currently receiving benefits under the pay-as-you-go system we now have who were thus unable to buy their own policies (because their FICA taxes that could have been used to do so were instead paying for others' Social Security).

[MediumTex]

I wonder the same things at times. Used to be that churches provided a great deal of care for the hungry, sick, and poor, but nowadays the government does through welfare. I wonder if the church would be up to the task if all the various welfare schemes went away. Same goes for the elderly; would the children of those with modest savings be willing to take care of them in their old age?

I'm not entirely sure that churches would be able to provide assistance to the needy, sick, and unfortunate regardless of willingness. I'm not up-to-date on the exact numbers but add up all the spending on Medicaid (both for the poor and for the elderly in nursing homes), TANF/welfare, Food Stamps/SNAP, WIC, SSI/SSDI, the Federally paid portion of extended UI benefits, and the portion of Medicare and Social Security benefits that are spent on the poor, disabled, and survivors of Social Security recipients and I'm sure it would be in the hundreds of billions...and that's not even counting the billions more for the "net negative tax liability" (i.e. more is paid out to the tax filer than he/she paid in) of EIC/EITC and the refundable child tax credit. Finally, add the soon-to-be-in-effect (by 2014 if PPACA survives until then) Medicaid subsides up to 133% of FPL and the tens if not hundreds of billions more in premium subsidies for the exchanges and you are probably looking at over half a trillion dollars a year if not more. I don't think all the churches/mosques/synagogues in America could pay that much out every year even if they did nothing else with their money; they would simply run out of funds.

You should also keep in mind that churches would probably discriminate in handing out assistance so someone could end up being denied help just because they were of the "wrong" skin color, "wrong" sexual orientation, of a faith that is a small minority where you live, lived together without being married, or were an atheist/agnostic/freethinker and consider if that would really be a step forward or not.

Finally, I don't think many children of those elderly with little or no savings would themselves have the resources to take care of their parents (and what of those elderly with no offspring or at least none that survived?); the earnings/wealth of one generation are in many cases somewhat correlated with those if the next (i.e. if your parents were poor you are more likely to be poor as well and vice versa if they were affluent). This is not to say that Social Security could not be taken care of a by a free market system; it almost certainly could (being nothing in effect but a giant tontine anyway) but the method would have to be people paying in to private tontine and/or deferred annuity policies for themselves rather than children being expected to take care of their parents and grandparents when the latter got too old to work. Such a system would probably take the better part of a generation or two to implement and something would have to be done to help those currently receiving benefits under the pay-as-you-go system we now have who were thus unable to buy their own policies (because their FICA taxes that could have been used to do so were instead paying for others' Social Security).

Those are all good thoughts.

The basic problem I have with the welfare state is not its goal, which is commendable, but rather its means of achieving that goal, which is theft.

The question that it seems we should be debating is whether it is okay in some cases to confiscate (i.e., steal) private property if you do something with it that most people agree is good.

I also have to think that there would be more private sector resources available to provide assistance to those in need if the government welfare apparatus was smaller. 

A more basic question that always comes to mind is whether poverty, illness and other social misfortunes are the result of having too little government involvement in those facets of society, or whether there is a certain amount of poverty, illness and misfortune that just comes with having a population of 300 million or so people living within a nation's borders. 

When you look at history it certainly does seem like rising standards of living are more correlated with societies that protect property rights, encourage productivity and have political institutions with somewhat limited powers than it does with societies in which government seeks to solve every possible social problem by redistributing society's wealth according to a bureaucratic plan.

I think that one of the core delusions of many statist politicians is that there will always a pool of surplus production that will be available for government confiscation and use in various world changing endeavors.

I love this 1976 Margaret Thatcher summation of what I'm talking about:

I think [the Labour Party has] made the biggest financial mess that any government's ever made in this country for a very long time, and Socialist governments traditionally do make a financial mess. They always run out of other people's money. It's quite a characteristic of them. They then start to nationalise everything, and people just do not like more and more nationalisation, and they're now trying to control everything by other means. They're progressively reducing the choice available to ordinary people.

[Reub]

That was a classic line by Thatcher!

[D1984]

The basic problem I have with the welfare state is not its goal, which is commendable, but rather its means of achieving that goal, which is theft.

The question that it seems we should be debating is whether it is okay in some cases to confiscate (i.e., steal) private property if you do something with it that most people agree is good.

I also have to think that there would be more private sector resources available to provide assistance to those in need if the government welfare apparatus was smaller.

A more basic question that always comes to mind is whether poverty, illness and other social misfortunes are the result of having too little government involvement in those facets of society, or whether there is a certain amount of poverty, illness and misfortune that just comes with having a population of 300 million or so people living within a nation's borders.

When you look at history it certainly does seem like rising standards of living are more correlated with societies that protect property rights, encourage productivity and have political institutions with somewhat limited powers than it does with societies in which government seeks to solve every possible social problem by redistributing society's wealth according to a bureaucratic plan.

I think that one of the core delusions of many statist politicians is that there will always a pool of surplus production that will be available for government confiscation and use in various world changing endeavors.

Of course any society that has upwards of 300 million people will have some poverty, illness and misfortune. The question is what is the best way to handle it.

There would quite probably be more resources theoretically available to help the unfortunate if government didn't take so much in taxes but the question is would those resources actually be used to do so or not. IIRC the wealthier one got (and this was by income bracket...the studies were done by Indiana University and by a nonprofit group called  Independent Sector) two things became apparent: one, the less as a percentage of one's discretionary income one gave to charity, and two, of what one DID give to charities/nonprofits, more of it went to arts and culture, one's own alma mater, supporting political causes and think tanks one agreed with, etc and less went to charities that provided basic human services (helping the sick, poor, homeless, etc).

One also has to consider that even if the rich and super-rich DID up their giving if their taxes went down do we truly want a quasi-welfare state run by the type of people who make up the top 1 and 0.1%? While the current welfare state is not ideal (and needs more of a complete overhaul than a a little tweaking IMO) do we really want people like Soros or the Kochs deciding (quite possibly based on their own political leanings) who should get help and who shouldn't?

I also think it makes no sense to say that even in the (hypothetical) complete absence of a welfare state (i.e. if TANF, food stamps, Medicare, Medicaid, SSI, and the like were all abolished but everything else stayed the same) that the government would not be redistributing wealth, income, and power vis-a-vis what would happen in a truly free market. You'd also have to abolish "welfare for the rich" (just for starters: corporate subsidies, bloated "defense" spending, the Carter doctrine and America's willingness to go to war to protect oil companies' interests, oil supplies, and sea lanes that that oil is shipped over, the prison-industrial complex and the War on Drugs, corporate limited liability and corporate personhood, the protection of titles to absentee land, patents and copyrights, laws that protect wlel-paid professionals from real free-market competition, below-market priced use rights to government-owned mineral rights/oil/gas, grazing land, irrigation, and timber land, non-enforcement or lax enforcement of pollution laws, eminent domain in the Kelo mold, "tort reform" that limits legal consequences for those rich and powerful corporations and persons who harm others, bankruptcy laws that let corporate bankrupts off somewhat easily (and let them dump their pension obligations on the government and by extension the taxpayers and don't even try to claw back things like "recapitalization dividends") but treat ordinary middle-class debtors quite harshly (thanks to the 2005 bankruptcy reform), laws that force businesses to act as garnishment agents on unsecured creditors' behalf, the Fed and its crony-capitalist below-market lending relationships with the TBTF banks, the FDIC, and bailouts in general) or else you wouldn't have a true free market but would instead have market discipline for working Americans but a generous safety net for the rich. To abolish our current "welfare state" without getting rid of or reducing the above would only serve to make the average American worse off in many cases by taking away what the government does to help him/her (even if such help sometimes does have unintended negative consequences) while at the same time leaving intact all the special privileges the wealthy and well-connected receive (and that generally make the poor and middle class worse off) from Uncle Sam and from the states.

[doodle]

The basic problem I have with the welfare state is not its goal, which is commendable, but rather its means of achieving that goal, which is theft.

The question that it seems we should be debating is whether it is okay in some cases to confiscate (i.e., steal) private property if you do something with it that most people agree is good.

Underlying your argument is the ideology that private property is a natural right. I think this position is certainly debatable especially when such private property must be purchased using state money tokens and relies on a states legal system to enforce ownership rights.

What if I'm a Native American whose ancestors inhabited a piece of land for the last 5000 years? Do I need to purchase the land of my ancestors back from the very people that stole it from me? Especially since the idea of private property is a totally alien concept to me foisted upon my people by a foreign culture.

What if we take the Warren Mosler approach and just print the money necessary to take care of these people? Then we are not technically stealing anything from anyone?

A more basic question that always comes to mind is whether poverty, illness and other social misfortunes are the result of having too little government involvement in those facets of society, or whether there is a certain amount of poverty, illness and misfortune that just comes with having a population of 300 million or so people living within a nation's borders.  

True, but that doesn't negate the fact that a civilized society still needs to confront these issues.

[MediumTex]

The basic problem I have with the welfare state is not its goal, which is commendable, but rather its means of achieving that goal, which is theft.

The question that it seems we should be debating is whether it is okay in some cases to confiscate (i.e., steal) private property if you do something with it that most people agree is good.

Underlying your argument is the ideology that private property is a natural right. I think this position is certainly debatable especially when such private property must be purchased using state money tokens and relies on a states legal system to enforce ownership rights.

What if I'm a Native American whose ancestors inhabited a piece of land for the last 5000 years? Do I need to purchase the land of my ancestors back from the very people that stole it from me? Especially since the idea of private property is a totally alien concept to me foisted upon my people by a foreign culture.

The kind of property I am referring to is the property created by human labor, creativity and ingenuity.

I am talking about the stuff that often never gets created in the first place if there aren't protections of property rights in place.  In many social and political arrangements there is simply no incentive to take the risks involved in creating new wealth in the first place, and the larger societies suffer as a consequence.

If I am a member of the Native American tribe you posit and I create a better bow and arrow and the chief's thugs immediately take it from me, I'm probably not going to be too excited about making another one, even though if I did life for the whole tribe might get easier.  That's the kind of property rights situation I am talking about.

[doodle]

The kind of property I am referring to is the property created by human labor, creativity and ingenuity.

I am talking about the stuff that often never gets created in the first place if there aren't protections of property rights in place.  In many social and political arrangements there is simply no incentive to take the risks involved in creating new wealth in the first place, and the larger societies suffer as a consequence.

If I am a member of the Native American tribe you posit and I create a better bow and arrow and the chief's thugs immediately take it from me, I'm probably not going to be too excited about making another one, even though if I did life for the whole tribe might get easier.  That's the kind of property rights situation I am talking about.

MT, I don't see any evidence that the Affordable Care Act is going to abolish protections on the property you refer to...so I'm not sure where this line of argument is heading. I think it is a far stretch to refer to any taxation at all as theft since it is one of the central reasons why the paper fiat money we use has value in the first place. Without this paper fiat money and the economic activity that it facilitates we wouldn't be living in this incredibly complex world that we now inhabit...and we probably wouldn't be debating how to make health care affordable. Besides, according to MMT taxation is merely a form of inflation control, not theft. And it is also difficult to imagine a government needing to "steal" back the very money that only it has the ability to create.

The central problem with the "libertarian" philosophy in my mind is that it attempts to create a structure for the organization of a society that is completely unnatural and doesn't exist anywhere in the universe. It attempts to impose an artificial structure of atomic individualism on the true reality of nature which is symbiotism.

The basic problem I have with the welfare state is not its goal, which is commendable, but rather its means of achieving that goal, which is theft.

What about the theft perpetrated against the American people daily by a profit hungry health insurance industry that parasitically leeches money and contributes little to no value to the overall health of society? What about a system where hospitals charge 100 dollars for a 2 dollar roll of gauze? Or pharmaceutical reps and doctors that push drugs on patients that they don't really need so that they can rake in more cash? Is this not theft as well? If our market driven health care system is such a fantastic example of what the private sector can do, why does it cost four times as much or more to get care here than in many other industrialized countries while providing health outcomes that are simply on par with the rest of the world?

[hoost]

What if we take the Warren Mosler approach and just print the money necessary to take care of these people? Then we are not technically stealing anything from anyone?

Why don't we just print enough money for everyone to take care of themselves?  We could make everyone rich.

[hoost]

I think it is a far stretch to refer to any taxation at all as theft since it is one of the central reasons why the paper fiat money we use has value in the first place. Without this paper fiat money and the economic activity that it facilitates we wouldn't be living in this incredibly complex world that we now inhabit...and we probably wouldn't be debating how to make health care affordable. Besides, according to MMT taxation is merely a form of inflation control, not theft. And it is also difficult to imagine a government needing to "steal" back the very money that only it has the ability to create.

So what type of taxation would not be theft?  If the income tax is not theft, then we're all slaves who are owned by the people who belong to this organization called "government".  In states that have a property tax, you don't really own real property.  Because if you stop paying your property tax to the "government", they will evict you and confiscate "your" property; it's more of a long term leasing arrangement.

The philosophical question is do you own yourself or does the government own you?  If you posit that you own yourself you can't logically argue that taxation is not theft.  True, you may have people that are willing and happy to pay taxes; but, what happens if you're not willing and happy to pay taxes?

I would actually make a modification to the idea of taxation as theft.  I think that taxation is more akin to robbery, whereasa inflation is theft.  A robber walks in, points a gun at you, and demands your money.  A thief sneaks around and takes your money (purchasing power) while you're not looking.

Also, what would happen if we didn't have this paper money printed by the government?  Do you truly think that if the government got itself out of the business of printing money that there would be no medium of exchange?  I don't think we'd be having this discussion if the government couldn't print money, because they would be able to afford to pay for everyone's healthcare through direct taxation.

What about the theft perpetrated against the American people daily by a profit hungry health insurance industry that parasitically leeches money and contributes little to no value to the overall health of society? What about a system where hospitals charge 100 dollars for a 2 dollar roll of gauze? Or pharmaceutical reps and doctors that push drugs on patients that they don't really need so that they can rake in more cash? Is this not theft as well? If our market driven health care system is such a fantastic example of what the private sector can do, why does it cost four times as much or more to get care here than in many other industrialized countries while providing health outcomes that are simply on par with the rest of the world?

We do not really have a market driven health care system; it may be more free than anywhere else in the world, but it is filled with government interventions and is nowhere near a "free" market.

[Pointedstick]

What about the theft perpetrated against the American people daily by a profit hungry health insurance industry that parasitically leeches money and contributes little to no value to the overall health of society? What about a system where hospitals charge 100 dollars for a 2 dollar roll of gauze? Or pharmaceutical reps and doctors that push drugs on patients that they don't really need so that they can rake in more cash? Is this not theft as well? If our market driven health care system is such a fantastic example of what the private sector can do, why does it cost four times as much or more to get care here than in many other industrialized countries while providing health outcomes that are simply on par with the rest of the world?

Our health care system probably the worst example of a healthy private sector industry you can find. Just because the whole thing's not a nationalized single payer system, doesn't make it some kind of beacon of the free market. I highly recommend reading this site, written by a doctor who attempts to discover the true costs of medical services and is stymied at every step of the way. A market in which prices are systematically obscured and nearly all srvice is paid for by a third party doesn't sounds much like a healthy market to me.

http://truecostofhealthcare.org/introduction

I'm a pretty hardcore libertarian, but I'll acknowledge that there's a LOT of low-hanging fruit if the government really wanted to make this market work better, such as abolishing pharmaceutical patents, ending the tax advantages of employer-sponsored health insurance, doing away with the AMA's medical monopoly that suppresses the supply of doctors, requiring care providers to 1) know and 2) disclose the costs of their services, and eliminating regulations that requires insurance companies to pay for non-insurable transactions (such as all medical care that's planned in advance, which is by definition not insurable), and bringing sanity to Medicare reimbursements.

[MachineGhost]

Our health care system probably the worst example of a healthy private sector industry you can find. Just because the whole thing's not a nationalized single payer system, doesn't make it some kind of beacon of the free market. I highly recommend reading this site, written by a doctor who attempts to discover the true costs of medical services and is stymied at every step of the way. A market in which prices are systematically obscured and nearly all srvice is paid for by a third party doesn't sounds much like a healthy market to me.

http://truecostofhealthcare.org/introduction

What a great little site!  Everyone, be sure and read the Conclusion page.  I liked this part:

Few of my patients under 65 have that many chronic medical problems. Most of them have three or less. Even so, I have a patient with only high blood pressure and high cholesterol and because he has to buy his own insurance and is considered high risk by the insurance companies, his premiums for just his own coverage are $900 a month. In the 9 years that hes been my patient, he has not run up enough medical bills to ever even meet his $2,000 deductible. He even buys his medications at Costco so the insurance isn't even involved with that. He's 64 now so, next year he will be eligible for Medicare and, for roughly one third the price, Medicare will cover 80% of his medical expenses for the rest of his life. The private insurance plan that cost nearly $100,000 over the last decade will be done covering his medical conditions. And they'll have paid hardly anything for his medical care. Again, where is all this money going?

Every time I crunch the numbers for health insurance, it is just not cost effective or makes any economic sense.

[doodle]

Again, where is all this money going?

Right into the big fat pockets of the insurance company execs.

[Pointedstick]

doodle, that's exactly why PPACA as a law is so perplexing to me. We all know that health insurance is a big racket, and that it makes no financial sense for it to be paying for most of the things it currently pays for... and so now along comes this law that forces everyone to buy it and forces the insurance companies themselves to pay for even more non-insurable things. It makes no sense! In the process of further entrenching a nonsensical system, it amounts to a giant subsidy to America's most hated industry. It just dumbfounds me that anyone likes this law, especially liberals who I would expect to loathe it based on its rampant corporatism. The thing is a huge giveaway to the most unpopular corporations in America fer cryin' out loud!

[Tortoise]

I'm a pretty hardcore libertarian, but I'll acknowledge that there's a LOT of low-hanging fruit if the government really wanted to make this market work better, such as abolishing pharmaceutical patents, ending the tax advantages of employer-sponsored health insurance, doing away with the AMA's medical monopoly that suppresses the supply of doctors, requiring care providers to 1) know and 2) disclose the costs of their services, and eliminating regulations that requires insurance companies to pay for non-insurable transactions (such as all medical care that's planned in advance, which is by definition not insurable), and bringing sanity to Medicare reimbursements.

Don't forget legal system reform. Defensive medicine raises the cost of medical care significantly.

In the process of further entrenching a nonsensical system, it amounts to a giant subsidy to America's most hated industry. It just dumbfounds me that anyone likes this law, especially liberals who I would expect to loathe it based on its rampant corporatism. The thing is a huge giveaway to the most unpopular corporations in America fer cryin' out loud!

Perhaps the idea is to damage the health care system in incremental steps so that eventually, the American populace will not only accept fully nationalized health care, but will actually demand it?

That's a slightly conspiratorial interpretation, though, and as Hanlon's Razor states, "Never attribute to malice that which is adequately explained by stupidity." It may simply be that ever-tighter partnership between government and large corporations--i.e., corporatocracy--is the unique type of mixed economy that is the inevitable result of the devolution of American culture in recent decades. We see a similar government-corporate partnership not only in health care, but also in finance, agriculture, and other entrenched industries where government force protects corporate cartels that would not be able to persist in a free market.

[MachineGhost]

On December 16, 2011, the Department of Health and Human Services (HHS) released a Bulletin describing the approach it intends to take in future rulemaking to define the essential health benefits (EHB) under the Affordable Care Act.  This document is intended to provide additional guidance on HHS’s intended approach to defining EHB.

http://cciio.cms.gov/resources/files/Fi ... aq-508.pdf

[WiseOne]

Our health care system probably the worst example of a healthy private sector industry you can find. Just because the whole thing's not a nationalized single payer system, doesn't make it some kind of beacon of the free market. I highly recommend reading this site, written by a doctor who attempts to discover the true costs of medical services and is stymied at every step of the way. A market in which prices are systematically obscured and nearly all srvice is paid for by a third party doesn't sounds much like a healthy market to me.

http://truecostofhealthcare.org/introduction

I'm a pretty hardcore libertarian, but I'll acknowledge that there's a LOT of low-hanging fruit if the government really wanted to make this market work better, such as abolishing pharmaceutical patents, ending the tax advantages of employer-sponsored health insurance, doing away with the AMA's medical monopoly that suppresses the supply of doctors, requiring care providers to 1) know and 2) disclose the costs of their services, and eliminating regulations that requires insurance companies to pay for non-insurable transactions (such as all medical care that's planned in advance, which is by definition not insurable), and bringing sanity to Medicare reimbursements.

PointedStick, thank you for the pointer to this website!  Everyone should read this.  The author has done an impressive amount of research into the absurdities of medical costs.  I'm curious why the results have never been published in the peer-reviewed medical literature though.

Reducing routine costs is something that physicians can do to some extent despite the barriers that make this absurdly difficult, and you'll find most are willing if you discuss finances during office visits.  In my particular field, balancing brand and generic drugs is a huge issue.  Generics have different requirements for pill-to-pill medication availability, so serum levels can vary a lot more.  They each can have different absorption characteristics, so levels can change drastically if you get a refill with a different generic pill in it.  For the condition I treat, this situation has resulted in some serious adverse events, including a number of deaths.  So picking the lowest cost generic may not be right for every situation, but if you are given a brand name prescription you can ask why, and then explain what your added cost is going to be.  Alternatively, you can try to get the same generic each time, which requires some diligence on your part.  I've also played some tricks with prescribing higher strength tablets and having the patient cut pills.

While allowing the free market to do its work would be an almost instant panacea for the costs of common conditions that comprise the majority of health care costs, there will always be a need for some form of insurance for serious, rare conditions, where the profit motive starts to run afoul of ethical principles.  I would add though, that all the major pharmaceutical companies have compassionate-care programs that allows patients to apply for free or reduced cost medications.

BTW...I HATE the word "provider"...it's rather insulting to go through 4 years of college, 4 years of med school, and 3-6 years of 36 hour shifts and 80-100 hour workweeks only to be referred to the same way as an NP with 6 years of post high school training who has never once answered a phone call at 3am.

Finally, I agree about the AMA.  I've refused to join.

[Reub]

That was a great link! Thanks for that.

[MachineGhost]

Health Reform Subsidy Calculator

http://healthreform.kff.org/SubsidyCalculator.aspx

Apparantly, the CBO thinks that a health insurance plan for a single, 40-year old will cost a whopping $450 a month in 2014 for a "silver" level plan.  I don't know what they're smoking -- maybe an inflation crack pipe?  Even so, 86% of that premium would be subsidized if your gross income is minimum wage.  I fully expect people to upgrade their health insurance plans at government expensive so they can squeeze out more net economic benefit vs those getting all kinds of governemnt benefits on below minimum wage income.

But interestingly, castaphobic-only coverage will still be available for young adults and those that are otherwise exempted.  I'd be real interested to know about that fine print!

I don't understand what xx% acturial value means.  Anyone?