2013 3.8% Health Care Tax

[Coronita]

All you prospective pigglords, don’t forget about this one…

http://www.schwabe.com/showarticle.aspx?Show=12149

For tax years starting on or after January 1, 2013, the 2010 Health Care Bills impose a new 3.8% “Medicare Tax” on “net investment income” in excess of specified amounts. The tax is generally levied on nonbusiness income from interest, dividends, annuities, royalties, rents, and capital gains. This memo will summarize the new tax (in highly simplified form) and offer some related observations which may illuminate how the tax works.

Note that for individual taxpayers engaged in passive activities, the post-2013 interplay of the income and Medicare Tax mean that current income tax reporting for aggregation of passive activities will likely have lasting (and possibly adverse) significance for the Medicare Tax in later years.

Each person will be taxed – in addition to his/her income tax – on 3.8% of the amount that the following income causes adjusted gross income to exceed $250,000 (for joint filers) or $200,000 (for non-married filers):

1. Nonbusiness interest, dividends, annuities, royalties, and rents;
2. Other gross income of a passive activity or a business trading financial instruments;
3. Net gain on the disposition of nonbusiness property (including net gain indirectly derived from disposition of a partnership interest or S corporation stock); and
4. Investment of any business’s working capital.

Thank you big government, medicare, and baby boomers who are going to suck this country dry..

[SD Realtor]

Obviously you are a wealthy, fox news watching, war mongering, homophobic, tea bagger party, racist. Shut up and get with the program because there were no other alternatives. Damn 1%er…

[briansd1]

[quote=flu]
Each person will be taxed – in addition to his/her income tax – on 3.8% of the amount that the following income causes adjusted gross income to exceed $250,000 (for joint filers) or $200,000 (for non-married filers):
[/quote]

3.8% of the excess, not the total.

Seems reasonable to me.

[sdrealtor]

I would be happy to pay that. Once you get over about 100K you stop paying SS so this doesnt seem like such a big deal to me if it actually helps bring health care to all. Unfortunately in the most wealthy country in the world not everyone can just head off to the their drs’ appointment.

[briansd1]

[quote=sdrealtor]I would be happy to pay that. Once you get over about 100K you stop paying SS so this doesnt seem like such a big deal to me if it actually helps bring health care to all. [/quote]

I’m also thinking along those lines.

[quote=sdrealtor]
Unfortunately in the most wealthy country in the world not everyone can just head off to the their drs’ appointment.[/quote]

The irony here is that flu is the sick one, the leech that is sucking more out of the heath care system than he’s putting in.

The truth is that health care cost, as a proportion of the economy is an effective tax on all of us. The best way to reduce that “tax” is to provide coverage for everyone while capping or reducing health care costs, as a proportion of the economy.

[Coronita]

[quote=briansd1][quote=sdrealtor]I would be happy to pay that. Once you get over about 100K you stop paying SS so this doesnt seem like such a big deal to me if it actually helps bring health care to all. [/quote]

I’m also thinking along those lines.

[quote=sdrealtor]
Unfortunately in the most wealthy country in the world not everyone can just head off to the their drs’ appointment.[/quote]

The irony here is that flu is the sick one, the leech that is sucking more out of the heath care system than he’s putting in.

The truth is that health care cost, as a proportion of the economy is an effective tax on all of us. The best way to reduce that “tax” is to provide coverage for everyone while capping or reducing health care costs, as a proportion of the economy.[/quote]

first off brian. fvck you.

second off, I pay for my health care insurance, both as being a w2 employer who provides my health care, and also by my supplemental insurance policy that I bought and paid for myself, and yes with the high deductibles and the high premiums I pay more for insurance than the insurance companies pays the treatment facilities. But it’s still worthwhile to pay for the insurance because they, as a private entity, negotiated the rates with the hospital and doctors.

But that’s exactly the point. People *should* pay for their insurance. Everyone… So don’t tell be about being a leech. you fvcking hypocritic, who don’t even bother paying internet sales taxes, you tax cheat…

Third, it’s too bad we don’t have a better universal health plan, because maybe there would then be a treatment plan for you… apparently you were born with your ass where your head is suppose to be.

[bearishgurl]

[quote=flu]… I pay for my health care insurance, both as being a w2 employer who provides my health care, and also by my supplemental insurance policy that I bought and paid for myself, and yes with the high deductibles and the high premiums I pay more for insurance than the insurance companies pays the treatment facilities. But it’s still worthwhile to pay for the insurance because they, as a private entity, negotiated the rates with the hospital and doctors….[/quote]

flu, even though I have a $5K/$8K HDHP and no supplemental policy, I agree that it is still worth it to pay the premiums for the negotiated rates alone.

[no_such_reality]

[quote=sdrealtor]I would be happy to pay that. Once you get over about 100K you stop paying SS so this doesnt seem like such a big deal to me if it actually helps bring health care to all. Unfortunately in the most wealthy country in the world not everyone can just head off to the their drs’ appointment.[/quote]

I mind that. If it’s health care for all, then all should pay.

If all paid, it might be only 1.3%. Or more like 1.9% since those affected pay roughly 48% of income taxes.

Also, I’m really sick of the thousand cuts. It’s only a percent. and a percent. and percent. and percent.

So Obama’s ‘millionaire’s tax’ starts at $250K too. yea, Millionaire…

This tax starts at $250.

Jerry’s tax starts at $250.

with another at $300.

and nother at $500.

We should have universal healthcare. We should have ALL paying for it.

[all]

[quote=no_such_reality]

So Obama’s ‘millionaire’s tax’ starts at $250K too. yea, Millionaire…

This tax starts at $250.

Jerry’s tax starts at $250.

with another at $300.

and nother at $500.

We should have universal healthcare. We should have ALL paying for it.[/quote]

There is no adjustment for inflation built in. In a decade or two everyone will be paying for it (alternatively, politicians will have another thing to bargain about every year since AMT and Medicare payments are not enough)

[Anonymous]

[quote=no_such_reality]We should have universal healthcare. We should have ALL paying for it.[/quote]

That’s a great idea, but mathematically impossible.

In your sentence above we could replace the word “universal healthcare” with anything the government provides (defense, roads, education, …)

BTW, Most of the healthcare legislation (“Obamacare”) is not about government paying for healthcare. This specific tax is only a small part of it. Obamacare an attempt to provide consistent access to healthcare, not a system where the government pays for it. That’s an important distinction.

As far as who pays this tax, we have a progressive tax system for just about everything. Nothing new here.

[Anonymous]

If a genie granted me three wishes, I would likely “waste” one of them on the following:

“Give everyone in the United States the ability to understand the word marginal.”

I do agree that the baby boomers are going to “suck us dry.”

Can the “Greatest Generation” really be so great if their offspring ruins everything?

[enron_by_the_sea]

SCOTUS is probably taking this down in anyway! Let’s talk about it only if this stands after June …

[briansd1]

[quote=enron_by_the_sea]SCOTUS is probably taking this down in anyway! Let’s talk about it only if this stands after June …[/quote]

No, they won’t. They are just playing the losing side before they turn on the them and uphold the law.

There’s a lot of politics at play here. We shall see.

Planned Parenthood v. Casey is when Kennedy changed his mind and uphelp Roe v. Wade.
http://en.wikipedia.org/wiki/Planned_Parenthood_v._Casey

[Coronita]

[quote=pri_dk]If a genie granted me three wishes, I would likely “waste” one of them on the following:

“Give everyone in the United States the ability to understand the word marginal.”

I do agree that the baby boomers are going to “suck us dry.”

Can the “Greatest Generation” really be so great if their offspring ruins everything?[/quote]

If a genie granted me one wish, it would be that everyone understand that paying any additional taxes (even if it is MARGINAL) still sucks since added together it’s a wealth building detractor, and for those that think it’s not a big deal, should be forced to pay it for everyone else. But then again, we are in a nanny state where no one wants to pay more for anything, except we expect everyone else to pay for it.

Off to my doc appointment….

[Anonymous]

[quote=flu][…] paying any additional taxes (even if it is MARGINAL) still sucks since added together it’s a wealth building detractor […][/quote]

Try “building wealth” in a place that has no taxes and see which environment is more favorable.

Of course not all taxes are a good idea, but the idea that “more government is always bad” or “more taxes are always bad” is silly.

The Constitution was written with the purpose of creating a government with the power to tax. Some people were arguing “more government is bad” back then too.

[Coronita]

[quote=pri_dk]
Try “building wealth” in a place that has no taxes and see which environment is more favorable.

[/quote]

funny you should mention that… but never mind.

[an]

[quote=pri_dk]Try “building wealth” in a place that has no taxes and see which environment is more favorable.

Of course not all taxes are a good idea, but the idea that “more government is always bad” or “more taxes are always bad” is silly.

The Constitution was written with the purpose of creating a government with the power to tax. Some people were arguing “more government is bad” back then too.[/quote]
Isn’t that a little bit of a hyperbole? No one, AFAIK, is advocating no taxes. The counter of your first sentence would be, try “building wealth” in a place that has 100% taxes and see which environment is more favorable. I’m sure you’re not advocating that either, but it’s just as useless of an argument.

Also, AFAIK, no one is saying “more government is always bad” or “more taxes are always bad”. Yes, it’s silly as you say. But then, to flip that around, it’s just just as silly saying “less taxes are always bad” and “less government is always bad”.

[poorgradstudent]

I for one feel quite sorry for those people whose gross exceeds 200k and will be slightly affected by this.

Oh, no, wait, I don’t.

[briansd1]

[quote=poorgradstudent]I for one feel quite sorry for those people whose gross exceeds 200k and will be slightly affected by this.

Oh, no, wait, I don’t.[/quote]

Gross exceeds $200k AND have passive income.

Gosh, Pelosi and Feinstein who are multi-millionaires themselves voted for the law.

[briansd1]

flu, please don’t take it personally.

It’s common parlance to describe the very nature of insurance.

With health insurance, you have the leeches (those with chronic diseases, cancer, families with kids who use maternity services, etc…) and the golden geese, like me, who never go to the doctor’s.

In fact, I have a little pink rash on my face that won’t go away. I don’t want to go see the doctor who will just tell me to use a hydrocortisone cream. Anyway, hope it’s not the beginning stage of chronic exzema that will forever mar my good looks. 😉

[bearishgurl]

[quote=briansd1]…In fact, I have a little pink rash on my face that won’t go away. I don’t want to go see the doctor who will just tell me to use a hydrocortisone cream. Anyway, hope it’s not the beginning stage of chronic exzema that will forever mar my good looks. ;)[/quote]

Try Benadryl cream …

[Coronita]

[quote=bearishgurl][quote=briansd1]…In fact, I have a little pink rash on my face that won’t go away. I don’t want to go see the doctor who will just tell me to use a hydrocortisone cream. Anyway, hope it’s not the beginning stage of chronic exzema that will forever mar my good looks. ;)[/quote]

Try Benadryl cream …[/quote]

It doesn’t work on STD’s… Oh wait, for Brian… it can’t be that. Never mind.

[bearishgurl]

[quote=briansd1]…With health insurance, you have the leeches (those with chronic diseases, cancer, families with kids who use maternity services, etc…) and the golden geese, like me, who never go to the doctor’s.[/quote]

Remember brian, that those with multiple kids who are STILL using maternity services are NOT the same as unlucky individuals with inherited predispositions to cancer and other persons being treated for cancer through no fault of their own.

That’s the REAL purpose of medical coverage, IMHO. It shouldn’t be in place for people to pay $10 visit to see drs multiple times per week or month for hangnails and the common cold or to subsidize the pregnancy and birth of one’s 8th child (although I don’t see a better alternative) :={

[ocrenter]

[quote=briansd1]flu, please don’t take it personally.

It’s common parlance to describe the very nature of insurance.

With health insurance, you have the leeches (those with chronic diseases, cancer, families with kids who use maternity services, etc…) and the golden geese, like me, who never go to the doctor’s.

In fact, I have a little pink rash on my face that won’t go away. I don’t want to go see the doctor who will just tell me to use a hydrocortisone cream. Anyway, hope it’s not the beginning stage of chronic exzema that will forever mar my good looks. ;)[/quote]

brian, your original post was quite offensive. I think flu’s response was quite justified.

that said, I think the tax is not that unreasonable. I wouldn’t mind paying it. but would also like to see the likes of Romney pay my tax rate on his capital gains earnings.

[scaredyclassic]

Goddamnit am I going to have to pay this on my lottery winnings? What a headache, and how unfair!

I wish I’d never bought these tix.

[scaredyclassic]

I do recall thinking my insurance was a screaming good deal when wevwere having kids. What a bargain! Almost like taking candy from a gynecologist.

[scaredyclassic]

I better start looking for an estate planning lawyer to organize my vast lottery wealth

[Coronita]

[quote=walterwhite]I better start looking for an estate planning lawyer to organize my vast lottery wealth[/quote]

I wouldn’t want to win the lotto really. I don’t think there’s a price I would want to put on the media circus afterwards.

[sdrealtor]

brian, yes it was quite offensive and flu’s response quite justified. There is a difference between explaining the nature of insurance and using insulting language. Leeches choose to latch onto something and suck the life out of it. I dont think anyone collecting insurance benefits would choose illness and benefits over good health and unused benefits. There in lies the difference.

[Coronita]

[quote=briansd1]flu, please don’t take it personally.

It’s common parlance to describe the very nature of insurance.

With health insurance, you have the leeches (those with chronic diseases, cancer, families with kids who use maternity services, etc…) and the golden geese, like me, who never go to the doctor’s.

In fact, I have a little pink rash on my face that won’t go away. I don’t want to go see the doctor who will just tell me to use a hydrocortisone cream. Anyway, hope it’s not the beginning stage of chronic exzema that will forever mar my good looks. ;)[/quote]

There is a difference between what insurance does and who pays for it… What part if “I pay for my insurance, complete with terms/limits/etc” did your pea brain not understand?

And please explain to me how it is possible that we can possibly cover the Medicare deficit? Because the problem is the system is broke. You have baby boomers retiring in droves, you have generation X, Y, Z, etc not making up the difference because, and short of a flood legalized immigration in which a lot more people pay into the system, ain’t going to work.

How about increasing the cost of people using these benefits, IE folks that are using it? You want to socialize medicine. Fine. Great. Perfect… Then socialize it… Get the insurance companies out of the way. This hybrid system of an insurance middleman doesn’t work.

[briansd1]

[quote=flu]
And please explain to me how it is possible that we can possibly cover the Medicare deficit? Because the problem is the system is broke. You have baby boomers retiring in droves, you have generation X, Y, Z, etc not making up the difference because, and short of a flood legalized immigration in which a lot more people pay into the system, ain’t going to work.
[/quote]

Rationing and eligibility testing based on income.

BTW, rationing is not bad. If people want extra services, they can pay out of pocket or obtain additional insurance.

PS: A lot of opposition to Obama Care is not cost, but rationing or the perception of it.

[quote=flu]
How about increasing the cost of people using these benefits, IE folks that are using it?
[/quote]

Good idea. Definitely.

[quote=flu]
You want to socialize medicine. Fine. Great. Perfect… Then socialize it… Get the insurance companies out of the way. This hybrid system of an insurance middleman doesn’t work.[/quote]

Step by step to a single payer system. It works. Data from around the world show that, with a single payer system, we can have better health at lower cost, as a proportion of the economy.

[blake]

Here’s a leech:

…
What happened next is starkly summarized in a 1995 letter sent to Premera Blue Cross by a woman in Eastern Washington.

A few months before she gave birth that year, the woman bought an individual policy from Premera. As soon as the insurer paid her hospital expenses, the woman canceled the policy, telling Premera “we will do business with you again when we are pregnant.”

True to her word, in 1996, she bought insurance, Premera said, once again canceling after the insurer paid for the delivery of her next child.

Altogether, she paid in $1,807 in premiums. Premera paid out $7,024.68 in medical bills.

You don’t have to be a business genius to recognize the problem with those numbers when multiplied by thousands of customers.

Claims went up. Premiums rose. Pretty soon only sick people thought insurance was worth the cost. Premiums rose even more.
…

Why Washington state’s health reform faltered after loss of mandates

[ocrenter]

[quote=blake]Here’s a leech:

…
What happened next is starkly summarized in a 1995 letter sent to Premera Blue Cross by a woman in Eastern Washington.

A few months before she gave birth that year, the woman bought an individual policy from Premera. As soon as the insurer paid her hospital expenses, the woman canceled the policy, telling Premera “we will do business with you again when we are pregnant.”

True to her word, in 1996, she bought insurance, Premera said, once again canceling after the insurer paid for the delivery of her next child.

Altogether, she paid in $1,807 in premiums. Premera paid out $7,024.68 in medical bills.

You don’t have to be a business genius to recognize the problem with those numbers when multiplied by thousands of customers.

Claims went up. Premiums rose. Pretty soon only sick people thought insurance was worth the cost. Premiums rose even more.
…

Why Washington state’s health reform faltered after loss of mandates[/quote]

Not surprising at all. People are intrinsically selfish. They will always look out for number one first. If left up to the individual, we would all not have car insurance and simply call All State or Farmers to sign up after a collision.

A San Diego city retiree once bragged to me that when she goes to the doctor, she always demands branded medications. When I simply suggested why not try equivalent generics and maybe save fellow taxpayers some money, she said she earned the rights to use branded medications working for the city. A LA Unified retiree had the same sentiment in a different convo. again, as long as I benefit, screw the rest of y’all.

[briansd1]

[quote=ocrenter]
Not surprising at all. People are intrinsically selfish. They will always look out for number one first. If left up to the individual, we would all not have car insurance and simply call All State or Farmers to sign up after a collision.
[/quote]

Funny, Antonin Scalia remarked that young people are not stupid. They’ll sign up for insurance when they need it.

[quote=ocrenter]
A San Diego city retiree once bragged to me that when she goes to the doctor, she always demands branded medications. When I simply suggested why not try equivalent generics and maybe save fellow taxpayers some money, she said she earned the rights to use branded medications working for the city. A LA Unified retiree had the same sentiment in a different convo. again, as long as I benefit, screw the rest of y’all.[/quote]

The funny thing is that people think that more medication is better. Advertising is so pernicious that it convinces people they need expensive medication to feel better. And people do feel like they got something when they get $10/pill “free.”

The truth is that, health wise, you’re better off to change your lifestyle to do without medication.

I don’t feel sorry for those who’s lifestyles induce sickness. They will have it coming to them sooner or later.

But I still feel that the humane thing to do is to have universal baseline health coverage for everyone. In the long run, that will reduce costs for society.

[bearishgurl]

[quote=briansd1]…The funny thing is that people think that more medication is better. Advertising is so pernicious that it convinces people they need expensive medication to feel better. And people do feel like they got something when they get $10/pill “free.”

The truth is that, health wise, you’re better off to change your lifestyle to do without medication.

I don’t feel sorry for those who’s lifestyles induce sickness. They will have it coming to them sooner or later.

But I still feel that the humane thing to do is to have universal baseline health coverage for everyone. In the long run, that will reduce costs for society.[/quote]

brian, this is actually a very good post!

[CardiffBaseball]

Wifey just had a double mastectomy with stage 2 breast cancer.

I hadn’t thought that she was just a leech thanks. Soon Chemo starts up I’ll be sure at that time to let her know she’s a total leech. If only she’d maintained Brian’s lifestyle, she’d be cancer free. Not that every one of her aunt’s had the surgery and her sister died of Ovarian cancer at 42, family history alone makes her an automatic leech in the new progressive thinking world.

Viva la Revolucion!!!

[bearishgurl]

[quote=CardiffBaseball]Wifey just had a double mastectomy with stage 2 breast cancer.

I hadn’t thought that she was just a leech thanks. Soon Chemo starts up I’ll be sure at that time to let her know she’s a total leech. If only she’d maintained Brian’s lifestyle, she’d be cancer free. Not that every one of her aunt’s had the surgery and her sister died of Ovarian cancer at 42, family history alone makes her an automatic leech in the new progressive thinking world.

Viva la Revolucion!!![/quote]

I’m sorry to hear this, CardiffBaseball. We can’t choose our parents. I myself am close to being the sole survivor of a family of six. We have to deal with the cards we’re dealt in life. Sometimes it doesn’t matter if we have made the effort to keep fit throughout life and didn’t smoke and become addicted to alcohol and/or other substances.

I wish for your spouse full recovery from her treatments and a full remission!

[briansd1]

Actually the reason I used the word leech is that, in the ACA suit, the plaintiffs are arguing that one reason we shouldn’t have the individual mandate or personal responsibility is because we should not force young healthy golden geese (their word) to pay for the leeches (my terminology). I’m just carrying on with the animal metaphor.

I wonder if we could challenge Mello Roos because it’s not really a tax. It’s an assessment to pay private bondholders and services. If I’m not using the services and the facilities I should not be forced to pay that assessment.

[sdrealtor]

Good thoughts and prayers your way CB. My Mom is a 2 time winner beating it in 1991 and again 2010. They have come a long way in helping women win that battle.

[ocrenter]

Brian, you need to stop defending yourself for the very unfortunate use of the term leech. It was wrong, insensitive, and frankly very hurtful to any one that’s ever been sick, or has love ones with a major illness.

Plus it is just not true.

If you look at flu, he is in the category known in medicine as a true underutilizer. (Asian men in general do not seek care needlessly, they as a group have the least somatic complaints.) yet all underutilizers (including you, Brian) have a potential to get sick and become a utilizer. And that’s why we have insurance.

The argument FOR the mandate is simple.

If we as a country and as a society have laws and expectations that anyone sick or dying (utilizer) will not be turned away. And all underutilizers may potentially become a utilizer at any given moment of time. Then ALL (regardless of utilizing status) should be mandated to have insurance because we ALL may potentially utilize the health care system.

If we don’t want the mandate, then we as a country and society need to move away from the laws and expectations that all sick and dying should be treated.

The best example here is China. It is the ultimate in the capitalist model. health care is available purely by cash. You do not have enough cash, you WILL be turned away even while you are clinching your chest or if you are bleeding nonstop. And if you only have partial cash, expect the care to be partial as well. (like the woman who didn’t have enough to give to her obgyn, and her vagina was sutured closed until she came up with the money).

We absolutely can’t have it both ways, that leads to bankruptcy, as we are clearly well on our way.

[Anonymous]

There is nothing selfish about filing a legitimate insurance claim.

That’s the whole point of insurance.

[briansd1]

Of course, ocrenter, you’re very right and reasonable.

Sometimes I like to push the envelope of the absurd.

Good piece in WaPo on the point you made about insurance:

An essential element of the Republican strategy these days is that, whenever confronted with an obvious failure of the free market, the correct response is always to try to turn the tables and blame it on misguided government policy. So it was this week when the solicitor general and several justices tried to make the obvious point that one reason so many Americans lack health insurance is that the market is inherently unlike any other in that we don’t deny medical care to sick people who can’t pay for it. It is from this anomaly that springs the “individual mandate,” a requirement that all citizens buy health insurance, to prevent them from becoming free-riders on a system paid for by others.

Rather than wrestling with this obvious anomaly, however, Scalia and Alito simply gave it the old Republican razzmatazz, blaming the government for creating the problem in the first place by obligating hospitals to treat the sick even if they are uninsured and cannot pay for the care. It was the kind of sophomoric logic you’d expect from high school debaters — or a Republican presidential candidate at a tea party rally — not from members of the highest court in the richest country on Earth.

Michael Carvin, the lawyer representing the NFIB, was clever enough to see that this was not going to be a winning constitutional argument. The proper constitutional solution to that dilemma, he explained, was not to shut the emergency room door on the uninsured, but simply require them to buy insurance when they show up seeking emergency care.

Ah, I get it! An insurance market in which nobody has to sign up for coverage until they’re ready to make a claim. Why didn’t Aetna and Kaiser think of that? And if it works for health insurance, why not extend it to fire, auto and flood insurance as well? Scalia and Alito, of course, wasted no time in taking up this brilliant idea.

http://www.washingtonpost.com/business/economy/steven-pearlstein-eat-your-broccoli-justice-scalia/2012/03/30/gIQAyGkynS_story.html

[ocrenter]

[quote=briansd1]Of course, ocrenter, you’re very right and reasonable.

Sometimes I like to push the envelope of the absurd.

Good piece in WaPo on the point you made about insurance:

An essential element of the Republican strategy these days is that, whenever confronted with an obvious failure of the free market, the correct response is always to try to turn the tables and blame it on misguided government policy. So it was this week when the solicitor general and several justices tried to make the obvious point that one reason so many Americans lack health insurance is that the market is inherently unlike any other in that we don’t deny medical care to sick people who can’t pay for it. It is from this anomaly that springs the “individual mandate,” a requirement that all citizens buy health insurance, to prevent them from becoming free-riders on a system paid for by others.

Rather than wrestling with this obvious anomaly, however, Scalia and Alito simply gave it the old Republican razzmatazz, blaming the government for creating the problem in the first place by obligating hospitals to treat the sick even if they are uninsured and cannot pay for the care. It was the kind of sophomoric logic you’d expect from high school debaters — or a Republican presidential candidate at a tea party rally — not from members of the highest court in the richest country on Earth.

Michael Carvin, the lawyer representing the NFIB, was clever enough to see that this was not going to be a winning constitutional argument. The proper constitutional solution to that dilemma, he explained, was not to shut the emergency room door on the uninsured, but simply require them to buy insurance when they show up seeking emergency care.

Ah, I get it! An insurance market in which nobody has to sign up for coverage until they’re ready to make a claim. Why didn’t Aetna and Kaiser think of that? And if it works for health insurance, why not extend it to fire, auto and flood insurance as well? Scalia and Alito, of course, wasted no time in taking up this brilliant idea.

http://www.washingtonpost.com/business/economy/steven-pearlstein-eat-your-broccoli-justice-scalia/2012/03/30/gIQAyGkynS_story.html

[/quote]

Personally, I would say this: if the individual mandate is thrown out, it is the federal governments responsibility to challenge all of the laws local and state that guarantee the right to be treated regardless of ability to pay and allow this country to let people die on the streets.

I really am ok with that and the government should make it clear that would be their strategy moving forward.

Btw, the individual mandate has always been a Republican idea, period.

[scaredyclassic]

I’m not sure there are local laws requiring hospitals to treat emergency cases. Maybe there are.

Doctors have independent ethical duties.

Certainly seems like a fertile ground for lawsuits when hospitals let corpses start to pile up at the emergency room door while the doctors are inside busily doing nose jobs.

[ocrenter]

[quote=walterwhite]I’m not sure there are local laws requiring hospitals to treat emergency cases. Maybe there are.

Doctors have independent ethical duties.

Certainly seems like a fertile ground for lawsuits when hospitals let corpses start to pile up at the emergency room door while the doctors are inside busily doing nose jobs.[/quote]

Certainly. Although one can argue the constitution does not guarantee health care. And if the individual mandate is thrown out, then the government can’t force doctors to save lives instead of working on nose jobs.

Recently a lower court just used the “corporation are people” argument in the tobacco companies’ favor. Ruling that it is against the tobacco companies’ freedom of speech to force them to place labels that warn people of cancer risks.

That carried forward, then hospitals are people too, and the government can not force someone to save someone’s life when that person has no ability to pay.

[briansd1]

[quote=ocrenter]
Btw, the individual mandate has always been a Republican idea, period.[/quote]

Yes, it was the answer to Clinton’s health reform.

Skeptics of government should clearly prefer the individual mandate to single-payer. In fact, the individual mandate was developed by conservative economist Mark Pauly as an alternative to single-payer. “We did it because we were concerned about the specter of single-payer insurance, which isn’t market-oriented, and we didn’t think was a good idea,” Pauly told me last year. In the 1990s, the individual mandate was also the Republican counterproposal to President Bill Clinton’s health-care bill, and in 2005, it was the centerpiece of Massachusetts Gov. Mitt Romney’s health-care reforms.
http://www.washingtonpost.com/business/economy/individual-mandate-is-ryan-tax-credit-by-other-name/2012/03/31/gIQA0uB1nS_story.html

[briansd1]

We already let people die slowly; we just don’t let they drop dead in front of us.

Plenty of people have chronic problems that go untreated. Then when things become very grave, they shop up a the hospital emergency. And after they get patched up, they’re sent away with no follow up or ongoing treatment. Eventually they show up at the emergency again.

[livinincali]

The EMTALA is the law responsible for forcing hospitals to treat people regardless of their ability to pay. It was passed by congress in 1986.

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

Before EMTALA their were charity hospitals that were funded by donations and volunteers that would treat people that had no ability to pay. The treatment was likely of lower quality and you couldn’t guarantee that there was one close enough that you wouldn’t die in transport, but you theoretically had access to affordable treatment.

The bottom line for in nearly every country whether it’s single payer, cash only, or what we have there’s no way to afford the best available treatment option for everybody. Ration care which is what happens in Single Payer countries or best care goes to the highest bidder China, Mexico, etc.

Insurance should cover the freak cancer case (40 and otherwise healthy) or the broken leg in a accident. Truly one off events that don’t happen all that often and for many people never happen. Insurance can’t cover the cost of just getting old. We all need to save for that.

[Author]

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