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Archive for Wednesday, March 31, 2010

Health care freedom’ amendment will get one last debate in Topeka when senators return later this month

March 31, 2010

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— A Republican state senator is seeking to force a debate next month on an amendment to the Kansas Constitution meant to nullify federal health reform.

The proposed "Health Care Freedom" amendment would prohibit the state from requiring anyone to buy health insurance. The federal law requires most Americans to have coverage starting in 2014.

Shortly before the Kansas Senate adjourned Tuesday, Sen. Mary Pilcher-Cook of Shawnee made a motion to pull the measure out of committee for debate. Senate rules require the motion to wait until the next session day for action, which will be April 28.

Pilcher-Cook needs 24 votes to force the vote and 27 to get the amendment on the ballot.

The House has already voted, falling short of the 84 votes needed.

Comments

SettingTheRecordStraight 4 years, 9 months ago

I can't believe we've gotten to a point where we need a constitutional amendment to protect our citizens from insurance mandates.

just_another_bozo_on_this_bus 4 years, 9 months ago

I agree, STRS. Mandating that we purchase insurance from private insurance companies remains as bad an idea now as when the Republicans first proposed it.

SettingTheRecordStraight 4 years, 9 months ago

You should know by now, bozo, that I defend ideas, not political parties. Therefore, it's easy for me to remain vigilant to my claim that the government has no right to force the masses into purchasing any product or service as a condition of U.S. citizenship.

Destroying a civil liberty (the freedom to buy or not buy insurance) as part of a larger goal of creating a social utopia (government insurance for all) is still indefensible.

average 4 years, 9 months ago

You don't lose your citizenship if you don't buy insurance. You pay an additional tax. That's it. No jail time. No prosecution. A tax.

I get a tax credit if I go out and buy some high-efficiency Pella windows this year. I pay more taxes (i.e., don't get the credit) if I don't. Is the government forcing me to buy windows?

TaintYourWagon 4 years, 9 months ago

There are basically two ways to achieve universal coverage. One way is to adopt a single-payer system, like Canada and the UK have, where the government provides health insurance to everyone using tax revenue in lieu of premiums. But because of the bedwetting and hysteria that such a plan would cause among the many Americans conditioned to fear and despise anything that can even remotely be labeled as "socialism", we can't have such a system.

The other way to achieve universal coverage is to maintain private health insurance companies but require them to insure everyone, regardless of age or health status. This strategy leaves the fundamentals of our current system intact, but can only be achieved if everyone is mandated to purchase insurance. This is easy enough to understand. Consider what would happen if, in the absence of a mandate, insurance companies were required to insure everyone. The number of sick people in the insured pool would increase, and insurance companies would spend more money on payments to caregivers. Rates would then rise, driving young, healthy individuals to drop coverage, leaving the insurance companies with an older, sicker pool of insureds, leading to another increase in premiums, etc... This is what is known in the insurance industry as a "death spiral". The only way to avoid it is to mandate that everyone, including the young and healthy, have health insurance.

Those are essentially the only two ways to get universal coverage. You either embrace Canadian-style socialized medicine (which really is the best option), or you stick with private insurance companies but require everyone to be in the pool. Of course, if you don't support universal coverage, and instead think it's just peachy to deny sick people access to health care, then this entire discussion is moot.

just_another_bozo_on_this_bus 4 years, 9 months ago

"Of course, if you don't support universal coverage, and instead think it's just peachy to deny sick people access to health care, then this entire discussion is moot."

That describes a lot of people on this forum-- although to them denying coverage isn't merely "peachy," but rather a moral imperative.

woodscolt 4 years, 9 months ago

Sen. Mary Pilcher-Cook of Shawnee , try sitting in a corner and holding your breath till you get your way. Taintyourwagon's explanation says it all.

The mandate for everyone to buy insurance, originally proposed by the republicans when they were "socialists" i guess, was a result of all the bedwetting over what should have been done. The real solution was for the insurance companies to be regulated, the bed wetters ruined that- the second was to have a "government option, and the bedwetters ruined that and now we are stuck with third place. The bedwetters are holding out for 4th place. Buying health insurance was never the real problem. The real problem was getting health insurance after you paid for it. That would require forcing the insurance companies to provide services they were paid to provide but refused to. Government regulations were the only way to do this since insurance companies wouldn't police themselves.

Jimo 4 years, 9 months ago

You're not required to buy insurance, you don't loose your citizenship, and this amendment is null. All that is required is that you stop mooching off me and the other taxpayers, you medical welfare cheats.

Jimo 4 years, 9 months ago

BTW - don't you people feel like morons???

Here's one more example of your betters manipulating you like puppets, in this case to follow some initiative that they know from day one is irrelevant, unconstitutional, and will go nowhere. And laughing at your gullibility all the way!!!

love2fish_ks 4 years, 9 months ago

This is about freedom and liberty, and the proper role of government in promoting those things that support liberty......time to stand up and demand government to back out of our lives.

SettingTheRecordStraight 4 years, 9 months ago

taint and bozo imply that some seek to actually denying health insurance to certain individuals. To suggest such is nothing more than a willful mischaracterization of others' points of view.

The heart of this matter remains: liberty, freedom, the proper role of government, lower taxes and fewer governmental mandates.

DKB79 4 years, 9 months ago

Heath care freedom? I wish I had health care freedom now--instead, I'm stuck with whatever my employer dishes out because I can't get insurance elsewhere--and my insurance sucks. I know I'm lucky to even have insurance in the first place--but I definitely have no freedom of choice in the matter under our current system. I'm glad we have a president in office who is actually doing something about providing health care instead of watching people get consistently denied it.

tomatogrower 4 years, 9 months ago

Ah yes, freedom to not carry insurance, so if you get sick you can just go to the hospital, which is forced to treat you, then they can raise rates for the rest of us who are smart enough to have insurance. I say they can change the law, so that if a person can show a special account of say $500, 000.00 dollars (cost of a transplant, in case they need it) that can only be used for medical reasons, then they don't have to buy insurance. Otherwise, get some insurance.

TaintYourWagon 4 years, 9 months ago

"taint and bozo imply that some seek to actually denying health insurance to certain individuals. To suggest such is nothing more than a willful mischaracterization of others' points of view.

The heart of this matter remains: liberty, freedom, the proper role of government, lower taxes and fewer governmental mandates."

I fail to see any mischaracterization. If you oppose universal coverage, then you support, tacitly or otherwise, a system in which people are denied access to health care. And the real "heart of the matter" is that, prior to the passage of the Affordable Care Act, the health care system in the United States was inhumane and unjust, locking out the sick and the poor, and bankrupting millions. I don't think you'll find many people lamenting the loss of their freedom to be denied health insurance because they have diabetes, or longing for the liberty to have their coverage rescinded when they get sick because they had acne a few years back.

And without getting into an entire discussion about the "proper role of government", I will say that heath care reform is something that even the most conservative should support. The bedrock of conservative free-market values is equality of opportunity, the idea that everyone, regardless of the peculiarities of their life, has the same potential to be successful, provided that they work hard and embrace the entrepreneurial spirit. But what if you're born with diabetes? What if you have asthma or a history of lymphoma? Well, prior to the passage of the ACA, it meant that you could pretty much give up any hope of starting your own business because you'd either be totally uninsurable on the individual market or your premiums would likely be unaffordable. Where's the equality of opportunity in that? It's hard to think of something more crushing to entrepreneurship than a health care status quo that chains people to their employer if they harbor any desire to have health insurance. The enacted reform is fundamentally conservative, and one can say it threatens liberty only if one holds a largely brutish, Hobbesian concept of the term.

Bob_Keeshan 4 years, 9 months ago

STRS, are you willing to support the elimination of mandatory health care? Do you believe it is wrong for society to compel medical institutions to provide care regardless of ability to pay?

Because, you see, that is current law. Nobody seems to be talking about that, about how in this nation we already have mandated universal health care.

And liberty_one, your post is laughable. There was no health care utopia in the ear "prior to government intervention." What a fairy tale.

TaintYourWagon 4 years, 9 months ago

"Prior to government intervention in health care when we used to have a free market (not even close anymore), it was affordable so that almost everyone could pay for it themselves."

First, I think you're harkening back to a day long before modern medical science, when bleedings were cutting edge care. More importantly though, it's largely settled in economics that health care is not a commodity for which free-market principles apply. This has been standard thought since Stanford economist Kenneth Arrow published his seminal paper, "Uncertainty and the Welfare Economics of Medical Care", in 1963. There is reason why there hasn't been a single example of a fully free-market health care system in the industrialized world. And lastly, just how much cheaper do you think things would get if we just did away with Medicare and, presumably, all health insurance altogether? Think of what is involved in, say, surgery and chemotherapy to treat breast cancer. Think of how many people, all with expensive educations to pay for, are involved in that process, from initial diagnosis through completion of treatment. Think of all the technology that must be used and maintained (MRIs are expensive for a reason) to identify the tumor. Unless doctors, nurses, and technicians are going to take serious pay cuts, the entire process is never going to be something that anyone can pay for, outside of the filthy rich. Are people just supposed to go bankrupt if they get breast cancer? Are they supposed to sweat it out and hope that someone is charitable enough to pay for their treatment? Is that what you're proposing? That people's lives should hinge upon whether or not someone else is feeling particularly generous that month? Sounds like a harsh world to me.

"Case in point: if I can't be denied for having a pre-existing condition, what's the point of carrying health insurance at all? If I get sick I'll sign up then. "

This is why there is a mandate in the current law.

Mary Sucha 4 years, 9 months ago

We have universal health care in the US once you reach that magical age of 65. Why not for those of us under 65?

Also, for those of you that do not believe in government provided health care, please stand up for your principles and be sure not to enroll in Medicare when you turn 65, and if you are already on Medicare, please disenroll -

"If you wish to disenroll from Medicare Part B, you will need to submit form CMS-1763 to the Social Security Administration. The form is used to voluntarily terminate entitlement to Supplementary Medical Insurance (Part B) and Premium hospital Insurance "

average 4 years, 9 months ago

@Liberty_One:

It will be enforced, ultimately, by spot-check IRS auditing. The passed bill functionally exempts anyone making too little to be required to file ($9k single/$18k married), and in fact a lot of people with incomes higher than that. Mind you, they probably should file to get any withholding refunded. Beyond that, it's on the fear-of-audit system.

I know that seems infinitely gameable. And it is. But, that's how most of the tax code works. I never sent in a marriage certificate when I got married (abroad, mind you, so they wouldn't have records any other way). They don't ask for certification when you check the 'blind' box. They don't ask for receipts to be filed to claim the energy tax credits. I didn't have to send in a copy of the deed to claim the homebuyer's credit, though apparently that's tightened up since them. It's all based on spot-check and severe penalties for false statements.

average 4 years, 9 months ago

@Liberty_One:

"Only a person who is close-minded and intentionally blind to the perils of government could possibly look at such facts and conclude that more government intervention is the solution."

A person with a passport could look around the world and conclude that 50 or so first-world medical systems, all of which have more government intervention, are all far cheaper than ours. You may be right (even less government would make it cheaper, we're just in the worst case on the curve), but it would certainly be a reasonable observational deduction that we don't have enough government intervention.

rbwaa 4 years, 9 months ago

@Liberty_One "Not really. Dr. Ron Paul mentions that when he was first practicing medicine he wasn't paid much but that's what it was at the time."

so, why isn't he still practicing medicine and accepting much less now? also, the free market where "everyone could pay for it themselves" could operate on the barter system where a doctor would accept a chicken, or a dozen eggs, or any other material good in exchange for medical care - modern society couldn't operate on that basis even if it wasn't so expensive to obtain a medical license. *and, "I doubt though there's anything much I could say to convince you otherwise" the same can be said to you.

TaintYourWagon 4 years, 9 months ago

"Yes, think of the expensive logging equipment, all the lumberjacks, all the factory workers etc. involved in making a pencil. How they sell them for less than $20,000 each is beyond me. You assume it's supposed to cost a lot of money."

Are you really comparing the mass production of commodities like pencils to the health care? If you can't see the difference in producing billions of pencils and treating a single cancer patient, then I guess I don't know what to say.

Frankly, I don't know what your argument is, other than the underpants gnome theory of health care reform:

  1. Eliminate insurance.
  2. ???
  3. Cheap health care for all.

That's it, nothing more than magical thinking and blind faith in the invisible hand. And this despite the fact that free markets in health care don't work because health care is sufficiently different from everyday commodities like pencils. People don't know when or if they will need it, comparison shopping generally isn't easy and sometimes impossible, etc...

Additionally, your position is considerably out of line with other libertarians I've seen make this sort of argument. In those cases, I've never seen it suggested that this approach would reduce the cost of health care to anything anyone would consider affordable. For example, the most in depth statement of this argument I've seen admitted that treatment for serious illness, like cancer, would, even in a free-market with no comprehensive insurance, likely reach the $100K range. The proposal was that individuals would be on the hook for the first $50K, for which they could get loans, with the remainder paid for by some sort of catastrophic insurance. In other words, even the best libertarian arguments I've seen boil down to admitting that, yes, if you get serious ill, you're going to go deep into debt and possibly bankruptcy. I just haven't seen anyone make the argument that such a free-market system would make treatment of serious illness affordable for a single family or individual. Furthermore, some libertarians, like Megan McArdle, have argued that health care and pharmaceuticals should be expensive, because if they were cheap, then less money would be available to fund research and development and, thus, innovation in health care would be stifled.

So, yes, you're not likely to convince me because I don't understand the basis for your position that a laissez-faire free-market approach to health care will lower costs to the point that serious illness doesn't bankrupt people. It's not a position taken by any libertarians I've seen, it runs counter to the evidence we have (the US pays far more for less health care than even systems that are completely administered by government, Medicare pays less for services than private insurers do, private insurers pay less than individuals for the same service, etc...), and it ignores the fact that people don't shop for health care like they shop for pencils, cheese, or cars.

geekyhost 4 years, 9 months ago

Liberty_One - Health care is cheaper and more effective... in countries that socialized it. They even score better on wait times and suffering.

"The study shows that people in the U.S. face longer wait times to see doctors and have more trouble getting care on evenings or weekends than do people in other industrialized countries. At the same time, Americans were more likely to receive advice on disease prevention and self-care than others."

http://www.foxnews.com/story/0,2933,136990,00.html

And to clarify - Canada doesn't have a single system. They have a system run by each province and territory, so there are some good areas and some bad. And yet their system was ranked as being marginally better than the US and still costs less. 82% of residents were satisfied with it.

TaintYourWagon 4 years, 9 months ago

"You apparantly have no problem making one up for me that you can easily blow down though hmm? "

As far as I can tell, your argument is that health care would be easily affordable for everyone if we eliminated comprehensive health insurance and government regulations and went to a strictly free-market system where patients pay doctors directly for the care they receive. This is an argument that libertarians have been making for a while, but if it isn't what you are advocating, then maybe you can explain what your argument is.

"Umm, the US health care and insurance industries are highly regulated and subsidized. I hope this isn't the "evidence" of the laissez-faire free-market approach to health care you are referring to."

No, the US system is not a laissez-faire system, but it certainly does have a free-market element, certainly more so than something like the NHS in the UK. By the rationale that a free-market lowers costs, then one would predict that the system that more closely approximated a free-market would have lower costs. But the NHS, which is entirely administered by the UK government (to the point that doctors are actually government employees), pays substantially less per person than the US does. And the NHS covers everyone. I imagine that you'd counter that your argument holds only for "pure" free-market systems, but if that's the case then I think we're entering "no true Scotsman" territory, as one could find any number of ad hoc reasons to explain away failures of market forces by claiming that the market forces in question weren't sufficiently free.

average 4 years, 9 months ago

It is worth pointing out that Rep. Dr. Paul didn't graduate with hundreds of thousands in debt. Air Force ROTC and served admirably. And while there are still military (and Public Health Service, Indian Health Service, etc) ways to get a medical training on the taxpayer's dime, they're rare and highly competitive slots and make up a much smaller percentage of medical school slots than they did in the 1950s when Dr Paul went through.

Improve access to medical school without crushing debts, and help open up more primary health (and nurse practitioner) slots. That would help availability and reduce costs (note how many more docs Germany and France have per capita than the US does).

Of course, despite how he got his medical degree, I'm pretty sure Dr Paul would decry it as socialism to suggest opening that opportunity to more today.

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