
The House Passed the Health Bill - raintrees
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/07/AR2009110701504.html?hpid=topnews
======
Zak
_Individuals would be required to obtain insurance or pay a fine of as much as
2.5 percent of income._

This seems like a horrible violation of property rights, perhaps to the point
of being a violation of the fifth amendment.

~~~
pg
I agree it's a bit big brotherish. For a while after we sold Viaweb I didn't
have health insurance, because I figured I had enough in effect to be my own
insurer. I ended up getting health insurance eventually, because I found the
system won't treat you without it; you can't simply offer to pay doctors with
a credit card, the way you can with dentists. But from a civil liberties point
of view it is a bit alarming to think the government could force you to
purchase something, and jail you if you didn't. I hope they don't enforce that
too diligently, or we could end up with a string of Ruby Ridges.

~~~
davidw
Leaving aside whether people like the government to do things for them or not
(there are many internet libertarians here who obviously do not), is requiring
you to purchase something really that different from just taxing you and
purchasing it for you? For instance, I am not happy about having purchased a
share of a war in Iraq or numerous other things the government spends my money
on.

Also, a point for consideration: you're pretty much required to own car
insurance if you want to drive.

~~~
Zak
If you want to drive, but this would require health insurance simply for being
alive, the alternative to which most of us do not consider an acceptable
option.

It's also noteworthy that in most states, you can demonstrate an ability to
pay for a certain amount of damage in lieu of car insurance.

~~~
swombat
If you don't consider being dead an acceptable option, then health insurance
sounds just right for you!

Seriously, this debate only makes sense in a context where you consider health
insurance to be an "optional extra". It's not. Health insurance is as basic as
roads and garbage collection, fire departments and a police force. Out of the
whole developed world, it's only in America that something as fundamental as
health insurance is considered an optional extra.

~~~
docmach
Health insurance is optional. My parents never had health insurance and were
always able to pay for medical expenses, even with six kids. I also don't have
health insurance and so far I've also had no problems paying for medical care.
I don't know where the idea that health insurance is a necessity comes from,
but it's not based on fact.

~~~
swombat
I know some people who have crossed the road without looking many times, and
they're still ok.

I guess looking before you cross the road is also "optional".

~~~
docmach
It is and there is no tax on people who don't have road crossing insurance.
It's a risk that you can choose to take. If you choose to not have medical
insurance and you can't pay for medical care then you might die, but it should
be up to you choose if the risk is acceptable or not.

~~~
swombat
That's not the argument you previously made. You said "it's fine not to have
health insurance because I didn't have health insurance and I'm still ok".
That's a severe failure of logic. Anecdotal reasoning when looking at
something like health insurance is pretty silly.

Unless you're the kind of person whose plan to get rich is to play the
lottery, you need health insurance. At some point, in your life, it is quite
likely that you will get very sick, or have a serious accident, or have some
sort of mishap that suddenly smacks you with a multi-tens-of-thousands-of-
dollars-or-more medical bill. At that point, if you don't either a) have
health insurance or b) have lots of money, you're basically fucked.

If you pay the insurance all your life and you never actually get to use it,
you should count yourself lucky. Health insurance if the kind of thing you pay
every month and fervently hope that you never actually need. But if you do
need it, having (good, not the american "we'll drop you if you get too
expensive" type) health insurance is quite literally a life-saver.

Finally, if you declare bankruptcy because you can't afford your medical bills
(and huge medical bills can happen to anyone), society is paying for your
treatment anyway, indirectly. Therefore, it is reasonable to mandate that
everyone _must_ have health insurance.

------
tptacek
It's interesting to see people who supported Obama, or even paid attention to
the '08 election at all, acting surprised about the health insurance mandate.
Obama was pummeled over the concept during the race, most notably by Clinton
during the primary. This was a long time coming.

As for the concept of a mandate, it's simply the flip side of guaranteed
issue. Without a mandate, guaranteed issue screws insurers: it creates --- as
a matter of law --- an incentive for people not to get insurance until they
get sick. Adverse selection is the enemy of insurance.

It seems to me that you can't argue about whether an insurance mandate is
confiscatory or overreaching without at the same time arguing about whether
people with preexisting or chronic conditions (or some statistical disposition
to same) should be excluded from the health care system. And yet: all I see
here is arguments about whether politicians should run the health care system.

Finally, I'll just note that the dollar amounts being discussed for the fine
accompanying the mandate are a fraction of what someone would pay for actual
health insurance, and probably lower that one would pay even for low-
deductable coverage. I think lots of people don't realize that, because right
now, the cost of coverage is very stealthily deducted from their income at the
fiat of HR directors and the health insurance reps that instruct them.

~~~
DanielBMarkham
Couldn't you just allow cross-state insurance pools, insurance portability,
require direct payment and encourage the states to have their own pooling
solutions, much like some states currently do with automotive insurance?

I don't think it's an either-or question -- pooling/mandate or not -- at the
national level. Sure, I think lots of folks would like it to be that way, but
it doesn't have to be. It doesn't have to have a centralized answer for it to
have a solution. Co-ops, for instance, have been left on the floor so far.

~~~
tptacek
Cross-state insurance seems like such an obvious proxy for insurance _de_
-regulation that I'm surprised its advocates don't just come out and say it:
"we should work with the minimum possible regulation on insurance companies".

I'm wholly ambivalent about whether states or the federal government should
operate the government-sponsored risk pool.

You already know where this discussion is going to go with me, so think about
whether you want to wade into it. Pick your poison: government by the
Government, or government by the insurance companies. I'm not wild about what
the federal government is coming up with (though not because of the mandate,
which seems sensible), but the major insurance companies are both inept and
actively evil, and the system we have today is rigged to favor them decisively
whether we regulate or not.

~~~
DanielBMarkham
We have a system where the cost of cool things to extend and improve your life
is greater than your ability to pay. The problem here is that somebody is
going to have to say "no".

Right now the evil insurance companies are saying "no" in order to control
costs. Those damn capitalists! Describing a new system as a deal where "you
are guaranteed not to pay any more into it, but there's no limit for how much
you get out of it" as I just heard the speaker describe is completely crazy.

Our national politicians are great at a bunch of things. Cost control isn't
one of them.

Government has a role in defining open markets. Right now the product of
insurance is so confusing and convoluted that there effectively is no market.
Defining what policies are, where policies can be sold, or how long you can
keep them -- that makes a lot of sense. There's a lot of other things that
government can do that make a lot of sense.

Trying to legislate a new solution to a problem of the pool of uninsured? Its
like trying to create a startup to suddenly manage 40 million customers. It's
crazy. Large systems don't work like that. It's completely idiotic.

You can try to slant this as "government" or not, but it's a lot more nuanced
than that. The choice isn't just "minimum possible regulation" -- and nobody
said it was. This is about problem-solving versus ideology. This is about what
types of systems work best for problem-solving.

~~~
tptacek
Give me a break. You're talking to someone with firsthand experience of the
arbitrariness of the health insurance system. "Those damn capitalists!"
refused to insure my wife, despite any actual pre-existing condition, even
with an exemption on the policy. Women of childbearing age are routinely
screwed by the system we have now. That's just one example.

You really think _this_ is your best argument? Sticking up for Blue Cross and
Kaiser?

The government does a fine job providing insurance to many millions of people.
Private insurers do a calamitously bad job, and moreoever are part of a
collusive system to simultaneously jack up the cost of care and fund it with a
private shadow tax on everyone who works for a large company. I'll go with the
devil I can vote out of office every couple years, thanks.

~~~
DanielBMarkham
You had a bad experience. Thanks for sharing.

I had a bad experience with government-ran health care.

You want we should compare belly-buttons? Or talk about the underlying issues?
Because anecdotes are free and plentiful.

Nobody is sticking up for anybody.

The government is currently going broke providing the existing programs. As
much as the plan is supposed to be "save $500 Billion in Medicare" it's a
historically unsupportable standpoint.

So the same guys that are spending more than they make in retirement,
healthcare for seniors and poor people is now going to suddenly become as
efficient as ten thousand possible insurers and insurance co-opts? Would you
take the largest, poorest-ran insurance company and force another 20x into
their customer lists?

If you have anything more than angry hand-waving I'd like to hear it. Perhaps
I'm smoking crack. Been wrong many times before. But you're not making your
case so far.

~~~
tptacek
My bad experience refutes your claim about what the insurance companies are
doing. They aren't simply minimizing costs by saying no to unreasonable
treatments. Way to move the goalposts there, friend.

We should stop discussing this. You'll never convince me of anything. I know
what your politics are. I'll never convince you of anything. You know where I
stand. Fortunately for me (I believe), my side's winning.

~~~
DanielBMarkham
No it doesn't. Geesh. We can compare stories until the cows come home. The
only thing it'll show is that people have unique experiences with both
government-ran and insurance-ran healthcare.

Insurance companies are rational actors. If they are acting in ways that are
socially unacceptable then define the market such that they are unable to do
that. It's called governance. Not control, but governance.

Come now, you know more than to take your experience and extrapolate it to an
entire society, right? And even if you did, why the need for demonization?
Just assume things need tweaking and find where the adjustments need to be
made. If my doctor got drunk and paralyzed my grand-dad I'd look for cross-
checks to prevent drunken doctors from operating, not demand that all of
medical care would need overhauling.

To answer my question -- nope, not more than hand-waving. You are indeed
correct: I know exactly how this goes. You'll keep up the snide and personal
barbs in an effort to draw me out to say something stupid. Either you'll win
or not, but in either case you're not interested in what I'm saying, only in
the inevitable rebuttal that you'll make.

C'est finis.

~~~
tptacek
You're right, Daniel. I wasn't particularly interested in what you had to say.
I don't think you can say you weren't warned.

Threads like this (and, be honest, most of the other threads on this article)
are why we should keep topics like this the hell off Hacker News.

~~~
DanielBMarkham
I'm just going to keep assuming people want to have a conversation, tptacek.
Next time if you're only replying -- because why exactly? -- as a game or
something you can save us a lot of time and effort by pointing that out,
instead of thinking I'm going to remember your nick or style.

What you see in politics and religion I see in every discussion that goes on
at HN. People have preconceived ideas, and act mostly on emotion. The question
is whether or not they (and me) can move past all that posturing.

So nope, I don't see much at all special about this subject. To me it's the
same as "what should I do with my life?" or "C++ or LISP: What should I try
first?" or "What types of footwear do you use when you hack?" "Does Country
and Western music go with VB programming?" "Has Microsoft stopped being the
most evil company on earth yet?" or any one of the 1000 other issues and
questions that require people of differing worldviews the chance to converse.
(not debate) I enjoy having a conversation, asking questions, and learning
stuff. Quite frankly some of the other topics, as emotional as they can be to
some, bore me to tears any more.

------
gojomo
The most sensible package of market- and technology-friendly health reforms
I've seen proposed:

[http://www.willwilkinson.net/flybottle/2006/03/19/health-
car...](http://www.willwilkinson.net/flybottle/2006/03/19/health-care-
fantasia/)

In particular, it doesn't call things 'insurance' that are not insurance, and
faces the reality that some people are going to be charity cases, and that
society will (one way or another) ration the care that goes to charity cases.

The house bill hides difficult choices in mandates that turn 'insurance' into
something else entirely -- a compulsory social service, run by 'companies'
that have essentially become federal agencies collecting taxes. Nationalizing
the industry outright would be more honest.

------
protomyth
I just cannot understand how we can keep looking at medicaid, medicare, and
social security projections and think that this will save us money. I find the
rhetoric and fiscal foolishness of this bill to be beyond the pale.

Also, how is this the top priority. Perhaps some of the congressmen need to
check the unemployment rate and economic numbers.

~~~
elblanco
It's pretty simple math. The U.S. pays 2x the (nationally) for health care for
comparable (and usually a more poorly ranked) level of care.

The U.S. ranks relatively poorly -- near the bottom of the industrialized
countries -- on almost every measure of performance. The only exception are
measures where simply paying unlimited amounts of money into your care will
get you something.

If we can move cost down from 20% of GDP (or whatever the figure is), to a
level that everybody else enjoys, like 10% of GDP, we'll have realized a very
large savings at a national level. Even if the cost of the program grows north
of all estimates.

~~~
lionhearted
> The U.S. pays 2x the (nationally) for health care for comparable (and
> usually a more poorly ranked) level of care.

The United States also has only 5% of the world's population (304M/6,700M),
but produces a heck of a lot more than 5% of the world's medical innovation.
Over the next 20 years, one side effect of this sort of bill might be to slow
that innovation down.

> The U.S. ranks relatively poorly -- near the bottom of the industrialized
> countries -- on almost every measure of performance.

With an incredibly unhealthy lifestyle, it's pretty incredible how long
American longevity is. A fine on obesity would probably do more to increase
American health than a fine on being uninsured, but that's unlikely to happen.

~~~
rmanocha
> Over the next 20 years, one side effect of this sort of bill might be to
> slow that innovation down.

There was an article in The Economist recently (unable to find the link - read
a hard copy) which dispelled this myth. Research was done in some European
countries (including the UK) which showed that introducing the NHS has not
slowed down innovation. They also suggested some incentive plans to make sure
innovation did not take a hit.

In either case, I think it's a long stretch to say that this bill, among other
things, will lead to a reduced drug innovation. The money in the Drug business
in the US and around the world will ensure that does not happen.

~~~
elblanco
I pretty sure it's possible to find examplars in other industrialized
countries with modern healthcare systems where their lifestyles are unhealthy.

I can't speak for the UK (but I believe I've seen a study that claims obesity
rates in the UK are in fact higher than in the US), but Germans aren't exactly
the pinnacle of healthy living, majority smoke, drink and eat outrageously bad
(thought incredible delicious) food. Koreans likewise engage in lots of
walking about, but the air quality in the major cities is very poor, they have
remarkably sedentary lifestyles until college, and then as "salarymen", they
probably compete drink for drink with the Russians and Korean food is full of
high protein and high fat food sources -- ever sit down and eat 2 kg of Sam
Gyeop Sal (Pork Belly) at a sitting? My friends in Japan report a similar
lifestyle in Japan.

What's remarkable is that Americans, who generally like to stake claim at
being the best in everything, tolerate a system that ranks them down with 2nd
and 3rd world countries fighting for what, 40th place between Colombia and
Brunei?

------
physcab
What the bill provides:

>>Required coverage for preventative care

>>Starting next year, private insurers could no longer deny anyone coverage
based on preexisting conditions, place lifetime limits on coverage or abandon
people when they become ill

>>Insurers would be required to disclose and justify proposed premium
increases to regulators, and could not remove adult children younger than 27
from their parents' family policies.

>>the House package would immediately offer discounts on prescription drugs
and reduce a gap in Medicare prescription drug coverage, closing it entirely
by 2019.

>>Uninsured people who cannot get coverage could join temporary high-risk
insurance pools, and unemployed workers would be permitted to keep their COBRA
benefits until the public plan and insurance exchanges started in 2013.

>>Tax-free benefits for domestic partners just like health benefits provided
to the family of an employee married to a person of the opposite sex.

>>Provide grants to states for home visitation programs in which nurses and
social workers counsel pregnant women and new mothers in low-income families.

>>Nutrition labeling requirements for snack food sold in vending machines and
many restaurants.

------
natrius
This seems like it will be a rare political discussion on HN that won't be
flagged, so I'd like to take the opportunity to copy/paste a comment I made on
reddit a while back about how the public option is a bad idea, and see if
intelligent discussion follows this time around.

A government run plan will be able to easily attract customers because it gets
free advertising, making it more attractive than even private, non-profit
insurers. Once the government plan has enough customers, it will be able to
demand lower prices while still getting the same quality of care for its
customers. If doctors refuse to accept it, they'll be turning down a huge
chunk of potential customers. The government's even lower prices will draw
more customers, thereby intensifying the effect until we get to the point
where the government dominates the insurance industry and can set whatever
price it wants.

In a functioning market with several players, prices stabilize at a level that
customers are willing to pay for the goods or services in question. Healthcare
costs have been rising so much because we've always valued healthcare greatly,
and lower costs of food and other necessities leave more money for us to spend
on it. As a result, advances in medicine come fairly quickly. If the
government uses its power as the dominant insurer to drive down prices,
advances in medicine will come more slowly because less money will be
available. Most of the arguments I've seen for the public option seem to
assume that cost reductions will come solely from eliminating non-medical
expenses, like advertising. If you think that's the case, can you explain how
that will happen? When the government tells doctors what its willing to pay
for certain services, are they going to pay no less than private insurers are
paying? That's not what happens today with Medicare, and that's not what a
private insurer would do if it became the dominant insurer. This isn't about
hating government; it's about how markets don't function properly when few
players rule them. A public option will almost guarantee that outcome.

The public option is undoubtedly the best way to lower the cost of healthcare.
However, I don't think that should be our goal. Our goal should be to maximize
the quality of care for everyone, not minimize the price. We should ensure
that everyone can afford healthcare by subsidizing it for those who can't, but
trying to create dominant government insurer so we can provide healthcare for
everyone isn't necessary. Let's get rid of silly things like preexisting
conditions and the antitrust exemption, then pay what it costs to ensure
everyone is insured and maintain the progress in healthcare technology that we
enjoy today.

~~~
WesleyJohnson
I'm genuinely interested in the debate on Health Care Reform, but I will be
the first to admit I have neither the political chops or core knowledge of the
bill to really back up that interest with a solid argument. So instead, I'll
try some questions.

1) I've read somewhere that there are some states, Alabama I believe was one,
where there is basically a single dominant health insurance provider. As your
post suggests, when few players rule, the market doesn't function properly.
How is this scenario any different than what you proposed will happen under
the HCR bill? If it does indeed exist already in the private sector, how do we
go about putting end to these monopolies (I know that's the wrong word here,
but it's the best I could come up with), without government regulation?

2) My brother works at a very small game studio based out of Florida. The
company has maybe 20 people, at best, and because of this it has been
impossible for the company to procure any decent rates on insurance for their
employees because they do not have the leverage that a larger company would
have. Why should he have to pay amounts in excess of several hundred percent
more for insurance than he would have to pay at a larger company, for the same
coverage? How can that be fixed without regulation?

3) You mention that without the high costs of private health care, there will
not be enough funding to assist with advances in medicine. You suggest that
cures and treatments will come at a slower pace as more people switch to the
public option or as more and more private insurers fold up shop because they
can't compete at the new, lower costs of health insurance. And yet, on the
opposite hand, I continually run into, what I consider to be intelligent
conversations, that would suggest that advances in medicine are actually held
back by these large organizations. That it is more lucrative to treat diseases
than it is to cure them. Is your stance that these discussions are merely
brought on by conspiracy theorists and have little to no merit, or do you
believe that there is some validity to them?

I realize the position I hold is probably apparent, but I really am interested
in hearing your (or anyone else's) opinions on these items.

~~~
natrius
To clarify, my position is far from the Republican party line on the issue. I
agree with most of the new regulations in the bill that I'm aware of, but I
would vastly prefer a bill without a public option.

1) The scenario you described isn't as damaging because it's just a single
state. If doctors are underpaid by the dominant insurer in Alabama, they can
move elsewhere. Even if they don't, losing money from just Alabama isn't going
to set progress that much. Losing money from the whole nation will.

2) They shouldn't, and regulation is necessary to fix that.

3) I don't think insurers and pharmaceutical companies _hold back_ cures for
diseases, but they definitely do _push forward_ treatments that will lead to
long-term revenue. This is why non-profit research funding is an important
part of the system.

~~~
elblanco
You talk about moving between states like it's changing a pair of pants.
That's a pretty big deal for most people. A monopoly in an area the size of
Alabama is like a monopoly in an area the size of Bosnia.

~~~
natrius
It's more than just moving. Fewer doctors will choose to practice in the
state. I'm not saying that things are fine since they can just move; I'm
saying that thing's _aren't_ fine so some of them _will_ move.

------
DanielBMarkham
I'm going to step out on a limb and predict that if this passes both houses
and is signed, the Supreme Court will strike it down.

You just can't have a law that requires people to buy something. There's
nothing in the Constitution that can be remotely construed to allow the
government forcing people to purchase things.

Now at the state level it's a different matter entirely. Congress could have
easily come up with some kind of reward-punishment system that required states
to find some solution. And then you'd have 50 states each trying different
ideas. They could harvest the best from each other. But it does not appear (to
me) that the goal here is iterative, incremental solutions to a pressing
problem. It appears that the goal is Big Design Up Front, Top-Down control,
and over-engineering every possibility.<sarcasm>An obvious recipe for
success</sarcasm>

In the last decade, and with this bill especially, I think we've finally
reached the end-game of the American federalist experiment. It's become
obvious that we can't meet our current obligations, and it's also become
obvious that politicians get elected making promises for even more
obligations, not fixing the ones we currently have. So the goal isn't to "fix
the system" The goal is to gin up new and various ways to keep making more
promises while blaming all problems on the other party. The party's over, but
it might be another 20 years before the cops show up, so let's have fun while
we can!

------
sachinag
The best thing about my new gig at oneforty is that I'm in Massachusetts and I
can get health insurance via the Massachusetts exchange. I seriously,
seriously believe that if health insurance doesn't pass that startups who
aren't looking to raise money locate in Massachusetts for this reason alone
(and there are a ton of other good things about the community here).

------
Mz
My issue with this is that it presumes "healthcare" and "medical care" are the
same thing. Study after study after study indicates that diet and lifestyle
are major factors in health outcomes and greatly influence your odds of
suffering the deadliest conditions. But getting a prescription for a pill is a
lot easier than making dietary and lifestyle changes, so a great many people
will go that route and then complain about the high cost of medicine when they
wouldn't need medication and frequent doctor's visits if they just took care
of themselves. If you really want to bring down medical costs, people will
have to start taking better care of themselves. Restructuring how we pay for
it won't do a heckuva lot towards lowering costs if people continue to pursue
self-destructive lifestyles. To the degree that it adds regulation and
bureaucracy, the odds are good it will increase costs.

------
protomyth
Why can I buy car insurance across state lines, but not health insurance? The
funny part is that the "public option" crosses state lines, but current
insurance companies can't.

~~~
ars
You can't. Your car insurer needs to be licensed in your home state.

And especially Massachusetts where car insurance is completely run by the
government, and few regular insurance companies operate there. (Every plan by
all companies costs exactly the same amount - AAA has a 5% discount for
members, so the other companies are allowed to offer a discount too if you ask
for it.)

~~~
protomyth
You are correct in the "McCarran Ferguson Act" leaves health, auto, homeowners
to the state regulators, but it sure seems to be easier to buy my car
insurance from a national company then any attempt at health.

Good to know about Massachusetts, I had never heard of a state pulling that.

------
raintrees
Now if we can only reform medical insurance...

~~~
old-gregg
Medical insurance? What a barbaric concept.

I paid $30K in taxes last year. I don't quite understand why would I even
_have to think_ about terms like "insurance" and "money" when/if I get sick.
I'm not an American, although I've been living here for 11 years, yet the
thought of PAYING for medical care still feels shameful and medieval.

If there isn't enough money in the budget to pay doctors then start cutting:
on "defense", on bureaucrats, I don't care. Medical care must be absolutely
the highest priority federal expense: not a single government employee should
be paid until the last US citizen who needs medical attention gets help.

~~~
ryanwaggoner
This kind of over-the-top rhetoric is great for rallying the masses, but it
breaks down under the lightest of logical scrutiny. Here are three of my
favorite issues with your position:

1\. Why is medical care the highest priority? What about food? Shelter? Safety
from rape, murder, and other forms of violence? What about electricity, water,
and other infrastructure? While most people don't get very sick, pretty much
everyone needs the things above. Why should medical care be the highest
priority federal expense?

2\. You think it's barbaric to think about paying for medical care, but guess
what: you do pay for it. Everyone does. Your "right" to healthcare is not
free; someone has to pay for it. And because you think you're entitled to that
free of charge, someone else out there is having money taken from them _under
the threat of force_ so that you don't have to worry about healthcare. The
right to private property far outweighs the right to healthcare, according to
the US Constitution, but your system reverses this relationship.

3\. The decoupling of supply and demand in the type of system we're about to
pass is likely to result in dramatically higher costs and lower quality care
over the long run, not to mention the fact that we have no way of paying for
it. Granted, our current system is screwed up, but this is far from a fix.
This is just moving further in a bad direction.

EDIT: Added a third item :)

~~~
olefoo
There is a viewpoint, and it is strongest in Europe, that human rights extend
to the basics of civilized human existence; that food, shelter and medical
care are basic necessities that a society must provide for it's citizens if it
is to be considered civilized. The purest expression of this can be found in
the Universal Declaration of Human Rights
<http://www.un.org/en/documents/udhr/> (see section 25) but it is also
enshrined in national constitutions the world over.

At the root of this viewpoint is the understanding that the citizens of a
nation depend upon each other and have a duty to each other.

This is clearly at odds with the modern American viewpoint which declares each
individual to be utterly responsible for his own welfare. As Americans we are
not in this together, we are each struggling separately.

And it is readily apparent that we are willing to sacrifice any principle on
the altar of our individualism. This country (my country) openly condones
torture, the bombing of civilian populations, extrajudicial imprisonment and
the murder of political dissidents; all in the name of Individual Liberty.

It is less surprising that we cannot do what most of Europe regards as the
sane and sanitary solution to ensuring the health of the nation; and more
surprising that we aren't busy legalizing the hunting of the homeless and the
use of the indigent as pet food.

~~~
ryanwaggoner
_This is clearly at odds with the modern American viewpoint which declares
each individual to be utterly responsible for his own welfare. As Americans we
are not in this together, we are each struggling separately._

I understand the point that you're trying to make, but you're misrepresenting
things. American culture is decidedly more individualistic than Europe's, but
its unfair to characterize us as "not in it together", either as a whole or
when referring to the libertarian argument that you're attempting to refute.
There's no honor in being forced to watch out for your neighbor, and in the
long run, it creates problems of moral hazard where you expect that _someone_
should be taking care of whatever problem you have at the moment.

 _This country (my country) openly condones torture, the bombing of civilian
populations, extrajudicial imprisonment and the murder of political
dissidents; all in the name of Individual Liberty._

This is where you really lost me. Those things have not been done in the name
or spirit of individual liberty. Quite the opposite: they represent an
egregious breach of the individual liberties we're entitled to under the
Constitution. Not sure how you managed to twist this issue up to be an example
in your mind of the supposed dangers of individual liberty.

 _...and more surprising that we aren't busy legalizing the hunting of the
homeless and the use of the indigent as pet food._

Thanks for making my point about over-the-top rhetoric. Have you been to
Europe, by the way? I lived there for years, and they've got their own set of
problems, I assure you.

~~~
olefoo
As near as I can tell, the official definition of Rugged American
Individualism requires that it's practitioner be a healthy white male with a
net worth of more than $20,000. You can recognize one of these Rugged
Individuals due to the products they consume, the (large) vehicles they drive.
their devotion to their football team, and their reluctance to pay taxes for
anything other than roads and weaponry.

As such the systematic dismantling of our policies to prevent torture and hold
torturers accountable; our eager rush into aggressive war and our continuing
efforts to thwart prosecution of our own war criminals is perfectly
comprehensible in the defense of the Rugged Individualist Lifestyle.

I am sorry that I did not adequately communicate the biting sarcasm that I
habitually apply to our political discourse, or the barely repressed anger
that I feel in my forced complicity in the crimes of America. In such light I
think that your inability to see the swiftian satire I intended to lighten the
last line of my last post is perfectly comprehensible.

~~~
Klondike
Dude, I'm a public-option-supporting liberal and all that but you've even lost
me. Chill out.

------
jamesbritt
Nicely done on a Saturday night.

Dems must be proud of their work.

------
vaksel
So the Dems gutted the bill(from single payer), just to gain a single
Republican vote?

~~~
spamizbad
The bill didn't start from single payer - it started as offering a public
option, which would co-exist with existing private plans, which would
theoretically be available to all citizens as an _option_.

The United States attempted implementing a single-payer system during the FDR
Administration, which fizzled before it left the white house, and then again
during the LBJ Administration, which was cut down to what we now call
Medicare/Medicaid via the Social Security Act of 1965.

~~~
vaksel
which just goes to show you that dems don't know how to negotiate. You never
start off with a compromise, you start off with something you have no hope of
getting and slowly get down to the compromise position.

------
natmaster
Great, now I have buy into the screwed up healthcare system or become a felony
and goto prison and lose all my rights. What kind of country do I live in now?

