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Re: ObamaCare

Postby jj3044 on Wed Feb 05, 2014 11:42 am

BigBallinStalin wrote:
Metsfanmax wrote:My principled response to this is simply that I'd likely find that to be a worthwhile sacrifice if the net healthcare of Americans was substantially improved as a result of the law. Even if it wasn't, I still might find it to be a worthwhile sacrifice if the healthcare of the poorest Americans was very substantially improved. If neither of those things are true, then I wouldn't have a reason to support the law.


How do you compare the improvement of "the poorest" to some reduction in wealth for all the non-poorest categories?

Rawl's criterion about focusing on the poorest seems satisfying, but I've never found that position to be useful--nor considerate--toward the wealth/well-being of all the non-poorest. Let's ignore the veil of ignorance reasoning since it's impractical--beyond the realm of philosophy).

I didn't get the sense he meant wealth, just well-being. Perhaps on the premise that every American should be able to access a basic standard of healthcare, regardless of their wealth?
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Re: ObamaCare

Postby Metsfanmax on Wed Feb 05, 2014 12:32 pm

BigBallinStalin wrote:
Metsfanmax wrote:My principled response to this is simply that I'd likely find that to be a worthwhile sacrifice if the net healthcare of Americans was substantially improved as a result of the law. Even if it wasn't, I still might find it to be a worthwhile sacrifice if the healthcare of the poorest Americans was very substantially improved. If neither of those things are true, then I wouldn't have a reason to support the law.


(1) How do you compare the improvement of "the poorest" to some reduction in wealth for all the non-poorest categories?
Rawl's criterion about focusing on the poorest seems satisfying, but I've never found that position to be useful--nor considerate--toward others.


Yeah, I don't particularly subscribe to Rawlsian ethics. As a utilitarian, I generally believe that such an example of wealth redistribution is a net good thing because it makes the lives of the poor significantly better than it harms the lives of the wealthier. That is, the marginal value of $1,000 is much less to an individual with a $100,000 income than it is to an individual with a $10,000 income.

Also, (2) even if the poorest aren't faring as well as imagined, why not consider that individuals move across categories? By implication, focusing on the poorest category can be less fruitful since more and more subsidies would go to those who remain the longest in the poorest category.


You're making the tautological point that there will always be poor people. But my argument isn't about whether or not they're poor relative to others in the country; the point is whether they're poor in an absolute sense. I would define that as lacking access to basic services and goods that are necessary to maintain a reasonable lifestyle -- such as always having access to a meal, clean water, a warm place to live, etc. If we bring the absolute level of poverty upward, we've done a good thing.
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 1:46 pm

Mets and JJ - do you guys think poor people in the United States do not have access to basic healthcare (which depends upon your definition of "basic"), meals, clean water, and a warm place to live?

For what it's worth, I believe the impoverished in the United States have access to all of those things and so your points confuse me. You seem well-intentioned.

From my perspective, the ACA is not a cure-all for a healthcare problem. People had access to healthcare prior to the passing of the law; rather, the ACA was meant (according to its proponents) to provide health insurance benefits to everyone and control healthcare costs. It was not to grant everyone access to healthcare because everyone already had access to healthcare.

Further, while it is inarguable that the marginal value of $1,000 is less to an individual with $100,000 of income to someone with $10,000 of income, why is that relevant? If the person making $10,000 has access to healthcare, meals, clean water, and a warm place to live, why is it important that they also have $1,000 and not, say, me?
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Re: ObamaCare

Postby Metsfanmax on Wed Feb 05, 2014 1:58 pm

thegreekdog wrote:Mets and JJ - do you guys think poor people in the United States do not have access to basic healthcare (which depends upon your definition of "basic"), meals, clean water, and a warm place to live?


Yes. I don't see how it's arguable that there are many poor people, even in the U.S., that do not have access to some or all of these things on a regular basis. There are homeless people all over the country (and if they have a place to sleep, it's usually provided by the local government), for example.

For what it's worth, I believe the impoverished in the United States have access to all of those things and so your points confuse me. You seem well-intentioned.


I believe that the marginal aid dollar is much better spent on someone living in, say, Africa, but that doesn't mean we don't have these problems here too.

From my perspective, the ACA is not a cure-all for a healthcare problem. People had access to healthcare prior to the passing of the law; rather, the ACA was meant (according to its proponents) to provide health insurance benefits to everyone and control healthcare costs. It was not to grant everyone access to healthcare because everyone already had access to healthcare.


What do you mean everyone "had access to healthcare?" You mean, emergency rooms are legally required to treat patients when they're dying? (Again, a government intervention.)

Further, while it is inarguable that the marginal value of $1,000 is less to an individual with $100,000 of income to someone with $10,000 of income, why is that relevant? If the person making $10,000 has access to healthcare, meals, clean water, and a warm place to live, why is it important that they also have $1,000 and not, say, me?


Well, I don't agree with you on the basic premise that everyone in the US has these necessities. But even if I did, I'd still argue that people are morally obligated to share that wealth from a utilitarian standpoint. I'm just much less likely to call for government coercion to enforce that if those necessities are being met.
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Re: ObamaCare

Postby Phatscotty on Wed Feb 05, 2014 2:43 pm

jj3044 wrote:
BigBallinStalin wrote:
Metsfanmax wrote:My principled response to this is simply that I'd likely find that to be a worthwhile sacrifice if the net healthcare of Americans was substantially improved as a result of the law. Even if it wasn't, I still might find it to be a worthwhile sacrifice if the healthcare of the poorest Americans was very substantially improved. If neither of those things are true, then I wouldn't have a reason to support the law.


How do you compare the improvement of "the poorest" to some reduction in wealth for all the non-poorest categories?

Rawl's criterion about focusing on the poorest seems satisfying, but I've never found that position to be useful--nor considerate--toward the wealth/well-being of all the non-poorest. Let's ignore the veil of ignorance reasoning since it's impractical--beyond the realm of philosophy).

I didn't get the sense he meant wealth, just well-being. Perhaps on the premise that every American should be able to access a basic standard of healthcare, regardless of their wealth?


It used to be called the emergency room. Now, people who do not have insurance are instructed by emergency room personnel to first call an insurance company. According to the one person I know who works in the ER.
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 2:50 pm

We're going to have to agree to disagree on the relative state of affairs of the American poor. I've had this argument with Player before and while you're much more articulate, the determination of what constitutes a basic need continues to change over time and is apparently dependent upon the country in which the poor lives. As a side note, while we have a lot of government intervention and assistance for the poor and have had since at least the 1960s, most remain poor (the homeless are a prime example - no one has to be homeless in the United States). I would argue that necessitates a basic change in our culture's thinking about how to care for the poor (or, in my opinion, who actually constitutes the poor), but that's for another thread I think.

Unless I'm mistaken, the poor received healthcare from government intervention in the form of Medicare/Medicaid as well as emergency rooms being required to treat patients. Additionally, at least in my region, charitable hospitals treat everyone, regardless of ability to pay and there are many charitable hospitals. That being said, there is no doubt that access to healthcare for the poor has been provided by the government in some material way. Which begs the question, again, why the ACA (if it's not going to reduce the overall cost of healthcare)?

I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.
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Re: ObamaCare

Postby Metsfanmax on Wed Feb 05, 2014 2:54 pm

Phatscotty wrote:It used to be called the emergency room. Now, people who do not have insurance are instructed by emergency room personnel to first call an insurance company. According to the one person I know who works in the ER.


Legally mandated access to ER treatment is not what any reasonable person should call access to basic healthcare. Aside from a woman being in labor, the only types of treatment ER personnel are required to give are in response to serious, imminent danger to a person's health. So if you're having a heart attack, you have to be treated, but the ER isn't required to give you any tests or preventive medicine to stop a future heart attack. And so this is why it's just a bad economic argument. If we're choosing between giving people free ER treatment for heart attacks and giving them free cholesterol medication, which do you think is cheaper?
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Re: ObamaCare

Postby jj3044 on Wed Feb 05, 2014 3:05 pm

thegreekdog wrote:Mets and JJ - do you guys think poor people in the United States do not have access to basic healthcare (which depends upon your definition of "basic"), meals, clean water, and a warm place to live?

For what it's worth, I believe the impoverished in the United States have access to all of those things and so your points confuse me. You seem well-intentioned.

From my perspective, the ACA is not a cure-all for a healthcare problem. People had access to healthcare prior to the passing of the law; rather, the ACA was meant (according to its proponents) to provide health insurance benefits to everyone and control healthcare costs. It was not to grant everyone access to healthcare because everyone already had access to healthcare.

Further, while it is inarguable that the marginal value of $1,000 is less to an individual with $100,000 of income to someone with $10,000 of income, why is that relevant? If the person making $10,000 has access to healthcare, meals, clean water, and a warm place to live, why is it important that they also have $1,000 and not, say, me?

Most poor people who did not have insurance through an employer did not have access to basic healthcare. If you are poor and without insurance, you couldn't afford preventive care, and medicines for chronic conditions like diabetes or high blood pressure, that with proper treatment can be controlled for a low cost and good outcomes. Instead, poor individuals without insurance did not access preventive services, did not control conditions that were easily treatable, and only accessed the system through the E.R., which is insanely expensive. So, someone goes in for a heart attack or stroke instead which 1) is much more expensive to treat than preventive medications, 2) lowers the individual's quality of life and perpetuates more diseases and downward spiral of health, and 3) makes the individual less able to contribute to society (cant be a productive worker), meaning that they are then even MORE reliant on the government.

Paints a pretty bleak picture, but this was the reality before the ACA with so many poorer Americans not being able to afford insurance on their own. I'm not saying the ACA is great (it has plenty of flaws that still need more reform), but it does do a few good things, that should hopefully turn out to be really good things in the future.
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Re: ObamaCare

Postby Metsfanmax on Wed Feb 05, 2014 3:09 pm

thegreekdog wrote:We're going to have to agree to disagree on the relative state of affairs of the American poor. I've had this argument with Player before and while you're much more articulate, the determination of what constitutes a basic need continues to change over time and is apparently dependent upon the country in which the poor lives.


The only thing to "agree to disagree" on would be on what constitutes a basic need. Once we agree on a definition, then it's just a matter of collecting the relevant facts about the poorest Americans. So, for example, if you don't think that someone who is homeless is not having their basic needs being met, then yes, we'll have to agree to disagree.

As a side note, while we have a lot of government intervention and assistance for the poor and have had since at least the 1960s, most remain poor (the homeless are a prime example - no one has to be homeless in the United States). I would argue that necessitates a basic change in our culture's thinking about how to care for the poor (or, in my opinion, who actually constitutes the poor), but that's for another thread I think.


That's literally the same tautological point that BBS made. You can't "end poverty." You can only raise the absolute level of poverty to a higher standard. So the relevant question is, has the real wealth of the poor increased since the 1960s? (I think it has, if for no other reason than the increasing real wealth of the entire country during that time period.)

Now, when it comes to something like homelessness, we similarly should be asking, has the percentage of the population that is homeless decreased since LBJ was in office? I don't have good data to answer that question. The fact that "there are still homeless people" is not inherently a condemnation of government assistance for the poor.

On the other hand, there are surely many more effective methods of helping the homeless than we do now. Like, say, giving them homes.

Unless I'm mistaken, the poor received healthcare from government intervention in the form of Medicare/Medicaid as well as emergency rooms being required to treat patients.


See above for response on emergency rooms. And in terms of Medicaid, I don't know much about it, but what I have read suggests that it is successful and that a better implementation than the ACA would have just been to extend Medicaid universally.

Additionally, at least in my region, charitable hospitals treat everyone, regardless of ability to pay and there are many charitable hospitals. That being said, there is no doubt that access to healthcare for the poor has been provided by the government in some material way.


A good fraction of charitable healthcare is really just funded by the government.

Which begs the question, again, why the ACA (if it's not going to reduce the overall cost of healthcare)?


http://begthequestion.info

I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.


Even if you don't agree with the utilitarian argument, there are plenty of practical reasons to justify this. For example, "your wealth" wasn't created by you uniquely. You have only achieved that absolute level of wealth because of the framework society provided for you to do so, so sharing some of it back to society is only fair.
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Re: ObamaCare

Postby WILLIAMS5232 on Wed Feb 05, 2014 5:46 pm

thegreekdog wrote:I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.


this is basically how i see it.

for one thing, i think it's a big pile of crap for one person to say "hey you, you make enough money to give some to this guy that doesn't make as much as you. give it to him or i will garnish your wages tenfold"

each person has a degree of belief whether or not a person actually needs the money or is just being a sponge. i tend to believe that there are way more sponges in our society than there are genuinely needy people. especially when i drive through welfare neighborhoods and see overpriced vehicles tricked out with thousands of dollars of aftermarket accessories. or for instance when i see the items in a grocery basket paid for by ebt cards. i can't help not to get infuriated by this because i live within my means and have to watch our govt support this behavior. when i was in school (85-97) school lunch went from .85 cents to $1.25. that comes out to an average of $180 per school year per child. it astonishes me that a person would have children and yet be unable to come up with $180 dollars per year to feed them at school. that's like .50 cent per day is all they have to make in a year. i'm not sure what the costs are for school lunch today. but how many people smoke that have kids on free lunch? or drink beer.... or play lotto..... or go to the movies.........etc.

i don't know. i just think the more money given will be more money expected. i mean this is a historic fact. welfare is out of control.
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Re: ObamaCare

Postby Metsfanmax on Wed Feb 05, 2014 6:15 pm

WILLIAMS5232 wrote:each person has a degree of belief whether or not a person actually needs the money or is just being a sponge.


That's why democracy is wonderful. I feel free to discuss what I feel people are morally obliged to do because ultimately my vote counts the same as anyone who disagrees with me.
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Re: ObamaCare

Postby jj3044 on Wed Feb 05, 2014 6:20 pm

WILLIAMS5232 wrote:
thegreekdog wrote:I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.


this is basically how i see it.

for one thing, i think it's a big pile of crap for one person to say "hey you, you make enough money to give some to this guy that doesn't make as much as you. give it to him or i will garnish your wages tenfold"

each person has a degree of belief whether or not a person actually needs the money or is just being a sponge. i tend to believe that there are way more sponges in our society than there are genuinely needy people. especially when i drive through welfare neighborhoods and see overpriced vehicles tricked out with thousands of dollars of aftermarket accessories. or for instance when i see the items in a grocery basket paid for by ebt cards. i can't help not to get infuriated by this because i live within my means and have to watch our govt support this behavior. when i was in school (85-97) school lunch went from .85 cents to $1.25. that comes out to an average of $180 per school year per child. it astonishes me that a person would have children and yet be unable to come up with $180 dollars per year to feed them at school. that's like .50 cent per day is all they have to make in a year. i'm not sure what the costs are for school lunch today. but how many people smoke that have kids on free lunch? or drink beer.... or play lotto..... or go to the movies.........etc.

i don't know. i just think the more money given will be more money expected. i mean this is a historic fact. welfare is out of control.

Generally speaking, I completely agree with your points, with a few exceptions.

One of the exceptions relevant to this thread is individuals that are disabled, either mentally or physically. Part of the point I made above was the downward spiral an individual's health can take if they don't have access to proper healthcare resulting in them not being physically able to be a productive member of society anymore. And with healthcare being so expensive, before the ACA, it was virtually impossible for someone in a low wage job to afford healthcare if their employer didn't offer it, even if they lived within their means.

THe point of all this is that the health of Americans should be first and foremost, and productivity (and hopefully prosperity) will follow.

...We have a long ways to go though!
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Re: ObamaCare

Postby WILLIAMS5232 on Wed Feb 05, 2014 6:32 pm

Metsfanmax wrote:
WILLIAMS5232 wrote:each person has a degree of belief whether or not a person actually needs the money or is just being a sponge.


That's why democracy is wonderful. I feel free to discuss what I feel people are morally obliged to do because ultimately my vote counts the same as anyone who disagrees with me.


ditto

jj3044 wrote:THe point of all this is that the health of Americans should be first and foremost, and productivity (and hopefully prosperity) will follow.

i'm not against this a bit. it pains me to see how much that could be done that isnt. and how much is wasted on efforts disguised as progress. i'd hate to know the billions or trillions spent so far that could have just went directly towards actual healthcare.
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Re: ObamaCare

Postby Phatscotty on Wed Feb 05, 2014 7:05 pm

WILLIAMS5232 wrote:
Metsfanmax wrote:
WILLIAMS5232 wrote:each person has a degree of belief whether or not a person actually needs the money or is just being a sponge.


That's why democracy is wonderful. I feel free to discuss what I feel people are morally obliged to do because ultimately my vote counts the same as anyone who disagrees with me.


ditto

jj3044 wrote:THe point of all this is that the health of Americans should be first and foremost, and productivity (and hopefully prosperity) will follow.

i'm not against this a bit. it pains me to see how much that could be done that isnt. and how much is wasted on efforts disguised as progress. i'd hate to know the billions or trillions spent so far that could have just went directly towards actual healthcare.


oh, it's in the trillions...
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 7:53 pm

jj3044 wrote:
thegreekdog wrote:Mets and JJ - do you guys think poor people in the United States do not have access to basic healthcare (which depends upon your definition of "basic"), meals, clean water, and a warm place to live?

For what it's worth, I believe the impoverished in the United States have access to all of those things and so your points confuse me. You seem well-intentioned.

From my perspective, the ACA is not a cure-all for a healthcare problem. People had access to healthcare prior to the passing of the law; rather, the ACA was meant (according to its proponents) to provide health insurance benefits to everyone and control healthcare costs. It was not to grant everyone access to healthcare because everyone already had access to healthcare.

Further, while it is inarguable that the marginal value of $1,000 is less to an individual with $100,000 of income to someone with $10,000 of income, why is that relevant? If the person making $10,000 has access to healthcare, meals, clean water, and a warm place to live, why is it important that they also have $1,000 and not, say, me?

Most poor people who did not have insurance through an employer did not have access to basic healthcare. If you are poor and without insurance, you couldn't afford preventive care, and medicines for chronic conditions like diabetes or high blood pressure, that with proper treatment can be controlled for a low cost and good outcomes. Instead, poor individuals without insurance did not access preventive services, did not control conditions that were easily treatable, and only accessed the system through the E.R., which is insanely expensive. So, someone goes in for a heart attack or stroke instead which 1) is much more expensive to treat than preventive medications, 2) lowers the individual's quality of life and perpetuates more diseases and downward spiral of health, and 3) makes the individual less able to contribute to society (cant be a productive worker), meaning that they are then even MORE reliant on the government.

Paints a pretty bleak picture, but this was the reality before the ACA with so many poorer Americans not being able to afford insurance on their own. I'm not saying the ACA is great (it has plenty of flaws that still need more reform), but it does do a few good things, that should hopefully turn out to be really good things in the future.


Okay, two quick things: (1) Medicaid; (2) ACA expands Medicaid. Perhaps I do not understand Medicaid, but it seems that poor individuals without insurance had a government provided health insurance. This, of course, does not include state-provided health insurance type plans.

I understand that there is a certain segment of the population that did not take advantage of Medicaid or could not take advantage of Medicaid and could not afford health insurance (e.g. illegal immigrants). It remains to be seen whether such people are able to take advantage of the ACA (most of what I read says no).
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 8:10 pm

Why do you have to break my posts up? Jerk.

Metsfanmax wrote:
thegreekdog wrote:We're going to have to agree to disagree on the relative state of affairs of the American poor. I've had this argument with Player before and while you're much more articulate, the determination of what constitutes a basic need continues to change over time and is apparently dependent upon the country in which the poor lives.


The only thing to "agree to disagree" on would be on what constitutes a basic need. Once we agree on a definition, then it's just a matter of collecting the relevant facts about the poorest Americans. So, for example, if you don't think that someone who is homeless is not having their basic needs being met, then yes, we'll have to agree to disagree.


I skimmed the wiki on homelessness. There appear to be various definitions, only one of which I would personally classify as homeless. I have no problem providing a shelter for someone who is homeless. But there are plenty of options, both privately provided and publicly provided, for the homeless. So, in my non-expert opinion, I'd say the needs of the homeless are being met.

http://en.wikipedia.org/wiki/Homelessne ... ted_States

Metsfanmax wrote:
As a side note, while we have a lot of government intervention and assistance for the poor and have had since at least the 1960s, most remain poor (the homeless are a prime example - no one has to be homeless in the United States). I would argue that necessitates a basic change in our culture's thinking about how to care for the poor (or, in my opinion, who actually constitutes the poor), but that's for another thread I think.


That's literally the same tautological point that BBS made. You can't "end poverty." You can only raise the absolute level of poverty to a higher standard. So the relevant question is, has the real wealth of the poor increased since the 1960s? (I think it has, if for no other reason than the increasing real wealth of the entire country during that time period.)

Now, when it comes to something like homelessness, we similarly should be asking, has the percentage of the population that is homeless decreased since LBJ was in office? I don't have good data to answer that question. The fact that "there are still homeless people" is not inherently a condemnation of government assistance for the poor.

On the other hand, there are surely many more effective methods of helping the homeless than we do now. Like, say, giving them homes.


We do not need to focus on homelessness; we need only focus on poverty. The amount of people receiving government benefits (in the context of things like food stamps, not in the context of things like corporate tax credits for companies that don't need them) has increased since the time of LBJ. If we were to have a government program, my preference would be for the goal of the government program to get people off of the government program. That is ostensibly what these types of programs are meant to do, but they haven't done it on the whole (perhaps in individual cases they have).

Metsfanmax wrote:[
Additionally, at least in my region, charitable hospitals treat everyone, regardless of ability to pay and there are many charitable hospitals. That being said, there is no doubt that access to healthcare for the poor has been provided by the government in some material way.


A good fraction of charitable healthcare is really just funded by the government.


Really? How is that?

Metsfanmax wrote:
Which begs the question, again, why the ACA (if it's not going to reduce the overall cost of healthcare)?


http://begthequestion.info


Okay. I'll rephrase. "Why the ACA, if it's not going to reduce the overall cost of healthcare?"

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I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.


Even if you don't agree with the utilitarian argument, there are plenty of practical reasons to justify this. For example, "your wealth" wasn't created by you uniquely. You have only achieved that absolute level of wealth because of the framework society provided for you to do so, so sharing some of it back to society is only fair.


I do share with society, I just don't feel an obligation to do so. I don't feel personally responsible to provide financial assistance to any individual or group of individuals simply becuase they exist.

Tomorrow I'll pull data on what it means to be a poor person in the United States, but we've seen it around here enough. Are poor people in worse straits than me? Yes. Does that mean they are lacking basic needs? Most of them are not and thus not only do I not feel a moral obligation to assist those people, I find it disgusting that they continue to feel the need to ask for assistance (or that my representatives in government feel that I should continue to increase my assistance) simply because they don't have what I have. Not everyone should be able to own a home or own a car or get a private college education or retirement simply because other people can or do. It should be a goal to strive for, but it should not be considered a basic need.
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 8:12 pm

Metsfanmax wrote:
WILLIAMS5232 wrote:each person has a degree of belief whether or not a person actually needs the money or is just being a sponge.


That's why democracy is wonderful. I feel free to discuss what I feel people are morally obliged to do because ultimately my vote counts the same as anyone who disagrees with me.


While your vote may count the same, you lack the wherewithal to compete with others in terms of having your point of view heard (notwithstanding our prior discussions).
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Re: ObamaCare

Postby jj3044 on Wed Feb 05, 2014 9:31 pm

TGD, illegal immigrants aren't the only ones who couldn't afford insurance before, LOL...

And as much as I absolutely agree with you that welfare needs reform, that is a discussion for another thread. We are talking about ensuring everyone has access to basic healthcare and the best way to do that. Personally I don't equate this to food stamps...
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Re: ObamaCare

Postby WILLIAMS5232 on Wed Feb 05, 2014 10:17 pm

jj3044 wrote:TGD, illegal immigrants aren't the only ones who couldn't afford insurance before, LOL...

And as much as I absolutely agree with you that welfare needs reform, that is a discussion for another thread. We are talking about ensuring everyone has access to basic healthcare and the best way to do that. Personally I don't equate this to food stamps...


i consider insuring that everyone has access to healthcare a form of welfare. which means i can't help but bundle it all together. so where i try to go with it all is if you can shift some of the wasted welfare dollars over to healthcare, then healthcare is more accessible. and if you can stop some of the wasted money spent on healthcare, then welfare is more accessible. it's kind of a win-win for the democratic argument. i mean as far as saying that everyone has basic healthcare and can afford to eat and have rooves over their head.

where i get aggravated is when it's argued that "well, our country needs healthcare and welfare, so even though we are spending at maximum levels already, let's just keep shoveling more money at it because there are still hungry people in the US. and also there are sitll people that need healthcare. and i saw some guys over there the other day without a roof over their head." without saying.... "wait a minute...... we keep putting more money into these programs and people aren't getting to a point where they are able to feed themselves, or put rooves over their heads, or go to the doctor. instead of continuing to fund these useless programs, lets instead try another non-enabling route that may put some pressure on these citizens that may force them to support themselves a bit more."

although i'm not at all involved in the govt process other than my tax-dollars funding this monstrosity, i can think of several ways to inhibit welfare recipients from collecting without starving those that have no other options. but instead of labeling that as productive or efficient, there are those that would call me inhumane or uncaring. which i think is ignorant or close minded.
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Re: ObamaCare

Postby thegreekdog on Wed Feb 05, 2014 10:18 pm

jj3044 wrote:TGD, illegal immigrants aren't the only ones who couldn't afford insurance before, LOL...

And as much as I absolutely agree with you that welfare needs reform, that is a discussion for another thread. We are talking about ensuring everyone has access to basic healthcare and the best way to do that. Personally I don't equate this to food stamps...


Oh, I know that illegal immigrants aren't the only ones who couldn't (and by the way, still can't) afford insurance, but that's not the relevant question. The relevant question is whether people other than illegal immigrants received healthcare. And the answer is yes through Medicaid and associated state programs and charity and etc. Therefore, we're not really talking about whether everyone has access to basic healthcare. I guess that's what you want to talk about, but the law is about health insurance, not healthcare.

What we are talking about is whether everyone has access to health insurance (not healthcare) and we're talking about whether the government granting said access (among many, many, many attendant other things) will make healthcare more efficient and/or effective.

In other words, this law doesn't give more people access to healthcare; it gives more people access to private health insurance with the intent of making health insurance and healthcare affordable and making healthcare costs decrease overall. It has so far failed in giving more people access to private health insurance (although I blame implementation for that, not the law itself), although health insurance has become more affordable for some people. We have to wait and see whether healthcare becomes more affordable or whether healthcare costs decrease overall.
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Re: ObamaCare

Postby BigBallinStalin on Wed Feb 05, 2014 11:40 pm

Metsfanmax wrote:
BigBallinStalin wrote:
Metsfanmax wrote:My principled response to this is simply that I'd likely find that to be a worthwhile sacrifice if the net healthcare of Americans was substantially improved as a result of the law. Even if it wasn't, I still might find it to be a worthwhile sacrifice if the healthcare of the poorest Americans was very substantially improved. If neither of those things are true, then I wouldn't have a reason to support the law.


(1) How do you compare the improvement of "the poorest" to some reduction in wealth for all the non-poorest categories?
Rawl's criterion about focusing on the poorest seems satisfying, but I've never found that position to be useful--nor considerate--toward others.


Yeah, I don't particularly subscribe to Rawlsian ethics. As a utilitarian, I generally believe that such an example of wealth redistribution is a net good thing because it makes the lives of the poor significantly better than it harms the lives of the wealthier. That is, the marginal value of $1,000 is much less to an individual with a $100,000 income than it is to an individual with a $10,000 income.


Let's define poorest as having less than $10k per year in income.

All people who make >$10k per year will incur a cost from that redistribution--e.g. being demoted to part-time, being fired, being taxed more, etc. How does your approach compare their loss to those who make <= $10k per year?

That marginal utility argument won't work though. Try stating your assumptions on how interpersonal comparisons of value--as measured by dollars--is valid.

Metsfanmax wrote:
Also, (2) even if the poorest aren't faring as well as imagined, why not consider that individuals move across categories? By implication, focusing on the poorest category can be less fruitful since more and more subsidies would go to those who remain the longest in the poorest category.


You're making the tautological point that there will always be poor people. But my argument isn't about whether or not they're poor relative to others in the country; the point is whether they're poor in an absolute sense. I would define that as lacking access to basic services and goods that are necessary to maintain a reasonable lifestyle -- such as always having access to a meal, clean water, a warm place to live, etc. If we bring the absolute level of poverty upward, we've done a good thing.


The point about income mobility is that individuals do cross categories, but a focus on categories neglects to factor this is in. By implication, focusing on the poorest category can be less fruitful since more and more subsidies would go to those who remain the longest in the poorest category. Comparisons of poorness have to be made. There's no such thing as "absolute" poverty since it absolutely varies by country, by city, and by person (rich people can be poor in terms of well-being). You'd have to make a comparison of income levels or some unit of measurement in order to define the "absolutely" poor.
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Re: ObamaCare

Postby BigBallinStalin on Wed Feb 05, 2014 11:45 pm

Metsfanmax wrote:
thegreekdog wrote:
I do not believe anyone is under any moral obligation to share the wealth as a general proposition. In fact, I find it repugnant to even think I have a moral obligation to share my wealth with anyone. I should be able to choose who I get to share my wealth with and how it is shared. I should not be morally obligated to provide monetary dispensation to a poor person who has access to food, clothing, shelter, etc. I could do that out of kindness/charity, but I feel no moral obligation to do so.


Even if you don't agree with the utilitarian argument, there are plenty of practical reasons to justify this. For example, "your wealth" wasn't created by you uniquely. You have only achieved that absolute level of wealth because of the framework society provided for you to do so, so sharing some of it back to society is only fair.


Who is 'society', and how do 'they' provide the framework? Short answer: you're appealing to some vague group. No one should buy that argument.

Regarding the "you didn't build that" argument, so what? Legitimate title ownership depends on the contract which delineate the terms. "Your social capital," thus your brain, wasn't created by you uniquely; therefore, we are entitled to some portion of mental control over you. You wouldn't even accept such terms; it's practically slavery. The only way out of this is reductio is to drop your argument and recognize the role of property rights.
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Re: ObamaCare

Postby Metsfanmax on Thu Feb 06, 2014 12:03 am

BigBallinStalin wrote:Let's define poorest as having less than $10k per year in income.

All people who make >$10k per year will incur a cost from that redistribution--e.g. being demoted to part-time, being fired, being taxed more, etc. How does your approach compare their loss to those who make <= $10k per year?


The marginal utility argument. I take it as valid that a dollar is worth more to someone to who has a lower income than someone who has a higher income, and so it is self-evident that utility is increased if the dollar is given to the person with the lower income.

That marginal utility argument won't work though. Try stating your assumptions on how interpersonal comparisons of value--as measured by dollars--is valid.


"X won't work though" is not an argument.

The point about income mobility is that individuals do cross categories, but a focus on categories neglects to factor this is in. By implication, focusing on the poorest category can be less fruitful since more and more subsidies would go to those who remain the longest in the poorest category. Comparisons of poorness have to be made. There's no such thing as "absolute" poverty since it absolutely varies by country, by city, and by person (rich people can be poor in terms of well-being). You'd have to make a comparison of income levels or some unit of measurement in order to define the "absolutely" poor.


You're straw manning me because you're focusing on the individual, and I am not. That is, I'm not discussing ways to make for stronger income mobility (for any individual to be able to climb from relatively poor to relatively wealthy). I'm discussing ways to bring the poorest out of absolute poverty. I don't have to make any income comparisons to do so; that's the whole point of an absolute wealth measurement. The unit of measurement is as I described: whether or not the income is sufficient for sustaining basic human needs.

Who is 'society', and how do 'they' provide the framework? Short answer: you're appealing to some vague group. No one should buy that argument.


I didn't create the idea of geopolitical borders, but I'm fine with using them for this purpose. Broadly speaking, "they" are the people who contributed to building the economic framework in which your wealth was created.

Regarding the "you didn't build that" argument, so what? Legitimate title ownership depends on the contract which delineate the terms. "Your social capital," thus your brain, wasn't created by you uniquely; therefore, we are entitled to some portion of mental control over you. You wouldn't even accept such terms; it's practically slavery. The only way out of this is reductio is to drop your argument and recognize the role of property rights.


"Recognizing property rights" is not a binary where either A) no one owns anything or B) anyone can claim whatever they want to. Any property rights system would have to have some method of adjudication between competing claims, and in this case there is a conflicting claim between the wealth a person has generated, and the mooching of the system's resources that the person engaged in to generate that wealth. As a concrete example, if I have a trucking business and I'm using public roads to transport my goods, then I owe some fee to the society that constructed the roads for that usage. Describing this in terms of property rights is simply re-defining the problem; it doesn't change the nature of the exchange (since the construct of property rights was implicit in the original claim).
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Re: ObamaCare

Postby Phatscotty on Thu Feb 06, 2014 2:54 am

Metsfanmax wrote:
WILLIAMS5232 wrote:each person has a degree of belief whether or not a person actually needs the money or is just being a sponge.


That's why democracy is wonderful. I feel free to discuss what I feel people are morally obliged to do because ultimately my vote counts the same as anyone who disagrees with me.


Hopefully New York does not elect a Republican governor any time soon. Democracy may continue to be so wonderful that New York starts a tradition of telling people who don't agree with them they are not welcome in New York.
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Re: ObamaCare

Postby Phatscotty on Thu Feb 06, 2014 2:56 am

Maybe Obama should change the law again, all by himself. The wonders of Democracy!!!!

Four words in the ACA could spell its doom

Someone you probably are not familiar with has filed a suit you probably have not heard about concerning a four-word phrase you should know about. The suit could blow to smithereens something everyone has heard altogether too much about, the Patient Protection and Affordable Care Act (hereafter, ACA).

(Phat)Scotty Pruitt and some kindred spirits might accelerate the ACA’s collapse by blocking another of the Obama administration’s lawless uses of the Internal Revenue Service. Pruitt was elected Oklahoma’s attorney general by promising to defend states’ prerogatives against federal encroachment, and today he and some properly litigious people elsewhere are defending a state prerogative that the ACA explicitly created. If they succeed, the ACA’s disintegration will accelerate.

Because under the ACA, insurance companies cannot refuse coverage because of an individual’s preexisting condition. Because many people might therefore wait to purchase insurance after they become sick, the ACA requires a mandate to compel people to buy insurance. And because many people cannot afford the insurance that satisfies the ACA’s criteria, the ACA mandate makes it necessary to provide subsidies for those people.

The four words that threaten disaster for the ACA say the subsidies shall be available to persons who purchase health insurance in an exchange “established by the state.” But 34 states have chosen not to establish exchanges.

So the IRS, which is charged with enforcing the ACA, has ridden to the rescue of Barack Obama’s pride and joy. Taking time off from writing regulations to restrict the political speech of Obama’s critics, the IRS has said, with its breezy indifference to legality, that subsidies shall also be dispensed to those who purchase insurance through federal exchanges the government has established in those 34 states. Pruitt is challenging the IRS in the U.S. District Court for the Eastern District of Oklahoma, and there are similar challenges in Indiana, Virginia and Washington, D.C.

The IRS says its “interpretation” — it actually is a revision — of the law is “consistent with,” and justified by, the “structure of” the ACA. The IRS means that without its rule, the ACA would be unworkable and that Congress could not have meant to allow this. The ACA’s legislative history, however, demonstrates that Congress clearly — and, one might say, with malice aforethought — wanted subsidies available only through state exchanges.

Some have suggested that the language limiting subsidies to state-run exchanges is a drafting error. Well.

Some of the ACA’s myriad defects do reflect its slapdash enactment, which presaged its chaotic implementation. But the four potentially lethal words were carefully considered and express Congress’s intent.

Congress made subsidies available only through state exchanges as a means of coercing states into setting up exchanges.

In Senate Finance Committee deliberations on the ACA, Chairman Max Baucus (D-Mont.), one of the bill’s primary authors, suggested conditioning tax credits on state compliance because only by doing so could the federal government induce state cooperation with the ACA. Then the law’s insurance requirements could be imposed on states without running afoul of constitutional law precedents that prevent the federal government from commandeering state governments. The pertinent language originated in the committee and was clarified in the Senate. (See “Taxation Without Representation: The Illegal IRS Rule To Expand Tax Credits Under The PPACA,” by Jonathan H. Adler and Michael F. Cannon in Health Matrix: Journal of Law-Medicine.)

Also, passage of the ACA required the vote of every Democratic senator. One, Nebraska’s Ben Nelson, admirably opposed a federal exchange lest this become a steppingstone toward a single-payer system.

If courts, perhaps ultimately including the Supreme Court, disallow the IRS’s “interpretation” of the law, the ACA will not function as intended in 34 states with 65 percent of the nation’s population. If courts allow the IRS’s demarche, they will validate this:

By dispensing subsidies through federal exchanges, the IRS will spend tax revenues without congressional authorization. And by enforcing the employer mandate in states that have only federal exchanges, it will collect taxes — remember, Chief Justice John Roberts saved the ACA by declaring that the penalty enforcing the mandate is really just a tax on the act of not purchasing insurance — without congressional authorization.

If the IRS can do neither, it cannot impose penalties on employers who fail to offer ACA-approved insurance to employees.

If the IRS can do both, Congress can disband because it has become peripheral to American governance.


http://www.washingtonpost.com/opinions/ ... story.html
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