Hee! Hee! Hee!

^^^^ The second word there is supposed to be, "maybe."

to

edure

They've already done it to some extent. Once I was able to negotiate with doctors, and pay between 1/3rd and 1/2 for whatever, in cash. And they were glad to do it, to get paid on the spot, with no paperwork or chance of rejection. Minimal overhead.

Now most doctors can't do that. Why? Medicare requires that anyone they deal with give them their "best price," and not give anyone else a better deal.

Do I think Obama-Pelosi will ever place an outright ban outside care? No, probably not. But such care contravenes their vision, and they have plenty of sly tools to restrict it with.

-- Cheers, James Arthur

me in

Yep.

buying

f

That's in part because, by regulation, private people aren't allowed to form their own groups.

That's another thing that shouldn't be. People _should_ be allowed to band together, to pool risk, and buy insurance accordingly. Pelosicare doesn't permit it.

-- Cheers, James Arthur

Even worse, I misheard... nothing before _50_ :-( ...Jim Thompson

--
| James E.Thompson, CTO                            |    mens     |
| Analog Innovations, Inc.                         |     et      |
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| Voice:(480)460-2350  Fax: Available upon request |  Brass Rat  |
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 Think things are bad now?  Wait until Obama "takes care" of you.

Hi Joel, It will be like the present. Sure, you can walk into a doctor's office or hospital, and agree to pay cash, just don't have a heart attach when you see the bill! You see, at present, all medicare and insurance reimbursements are calculated as a DISCOUNT to the cash price. BY LAW, you can not reduce this cash price without reducing all your disbursements across the board. Oh, and the discount is something on the order of 50-60% (and sometimes MORE!)

So, if you are really rich, and don't care about the price, you can go without health insurance. If you are poor, and won't pay anyway, you can go without health insurance. if you are a working stiff, you can't afford to go wtihout health insurance!

Charlie

Thanks for the explanation, Charlie.

I thought our own Jonathan Kirwan was claiming he could still finagle really good "cash" deals on healthcare... are you out there, Jonathan?

The local hospital (southern Oregon) provides a 10% discount (on your estimated costs of a procedure) if you pay before the procedure actually happens rather than afterwards. My brother also received some similar discount for paying on schedule; he's in Mississippi.

---Joel

You can do that in some places, but the providers have to be very careful. Note, that they are offering a discount for pre-payment, not for cash, as such. Now, I am not saying that some doctors won't make deals. They just need to be very carefull (or not accept insurance, anyway!) to not be found out. My brother in law, the doctor, says the penalty is usually they just prorate ALL your disbursement by the amount you discounted the cash payee...

Charlie

ally

That could be quite a hit. I was quoted $800-odd bucks for an MRI some 13(?) years ago. I asked about the cash price.

"Oh, you're not going to use insurance?"

$300, cash, done.

(Got it the same day, BTW)

-- Cheers, James Arthur

The "limit" was the income tax[1] - paying people more money simply increased their tax burden, so employers offered "benefits."

Thanks, Rich [1] Essentially, the worst thing that the felons in Washington DC have inflicted on the American People, so far.

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rationed

Sure, they are special considerations for unions; they're one of the special interests this crap was created to please.

But, you can't get a bunch of your neighbors together and form your own group; that's not allowed. Nor can you collect a bunch of your friends, and so forth.

Those are artificial restrictions. To what good?

-- Cheers, James Arthur

ow is

e OK

That's a very good question.

Basically, it arises from FDR's New Deal, and his misconstruction of the General Welfare clause to exactly seize the very broad powers the Founders feared.

(Social Security, BTW, was challenged & upheld by the Supreme Court (1937, Helvering v. Davis) on the finding that it was specifically _not_ an illegal requirement for citizens to purchase any form of insurance, but was a tax paid into general revenues that were not earmarked in any way.

That is, there was never any setting aside of people's money to provide for their future. It was never a pooling of risk--i.e., insurance--but was from its inception a program of taxes collected and immediately paid out. That's likely why Pelosi-care's presented in the same way--to skirt challenges.)

I'm pulling a few references so I can post more particularly on FDR, with citations....

-- Cheers, James Arthur

I'm reminded of something I once heard George Lucas say of Star Wars, that the old stories have to be re-told to each generation, to teach them, keep them alive, and to pass them on.

This same argument over the general welfare clause has arisen several times in our history, and each time was beaten back by telling and re- telling the Founders' stories; each time until FDR.

Medicare--and Social Security before it--date to the time of FDR's New Deal, a time of strife not much different from today.

Prior to FDR, courts, Congress, and Presidents had uniformly held that the Constitution prevented the federal government from enacting anything like the grand social entitlements of today. There are any number of famous writings to that effect from each time the principle was challenged.

Yet FDR wanted massive powers; he'd passed his New Deal through the Legislative branch, comprising a massive government takeover in the name of economic necessity, just as today.

His justification? The General Welfare clause.

But, program by program, the Supreme Court beat him back. His "stimulus bill", The National Recovery Act of 1933" (an attempt at centralized control of the economy), was laid waste, nullified by the Court. [1]

Furious the Supreme Court had struck down his ambitions time and again as unconstitutional, FDR threatened the Justices personally, that if they didn't bend to his will he'd replace the older members, and add up to six additional hand-picked justices, packing the Court with cronies. [2]

It was a disgusting bill, a tactic you'd expect from Putin, not an American president.

They yielded.

The chastised court ratified Social Security[3].

Later, FDR stacked the Court anyhow. By 1941, eight of the nine justices were FDR appointees. But, by 1939, the Congress was moving aggressively to rescind the New Deal. It hadn't worked.

But since then we've moved from a nation of mostly autonomous independent states, to a nation where states have to beg Washington to get their own (tax) monies back, giving Washington ever more control over the entire republic.

FDR began work on the National Health Program, but WWII intervened. Still, after decades of bitter debate, on the ground laid for such programs by Social Security, Medicare itself was signed into law by Johnson in 1965.

Constitutionally, Washington can't demand that the States do very much, so a work-around was found: incentive payments. You can do whatever you want, but we won't give you your own money back unless you do what we want. Hence the mechanism of Pelsoi-care's tort "reform" poison-pill, HR 3962 Sec. 2531.

The Wikipedia article on FDR's presidency [4] reveals many parallels to today, lends some perspective to how massive Mr. Obama's expenditures are by comparison, and how similar programs were tried in situations arguably less dire, to no effect.

For example, after the First Stim^H^H^H^H New Deal of 1933-34 came the Second New Deal in 1935-36. Today, one year in, Mr. Obama and the Congress are starting to speak of a 2nd stimulus bill.[5] The New Deal drove national debt as a % of GDP in 1937 to 40%. Today it's

85%.

And so the story goes.

=93Those who do not learn from history are doomed to repeat it.=94 -- George Santayana

"Those who do learn from history are doomed to repeat it too." --James Arthur

[1] [2] The Judiciary Reorganization Bill of 1937 [3] [4] [5]

-- Cheers, James Arthur

ow is

Neither is constitutional.

No, I hate that.

First, payroll taxes recreate a moral hazard--they hide the costs of services from the people who have to pay for them. That's a critical reason prices are what they are today.

2nd, payroll-based plans only cover people with jobs. 3rd, more annoying paperwork for employers. 4th, the payroll-payer is inherently going to make plan choices for you, limiting your own ability to select what you want.

So for the vast bulk of the public, I'd much rather they just get paid more, and be able to spend that money toward health care--or anything else they choose--as they see fit.

I'm not sure what to do about the indigent. We already have a program for that though, so that hardly justifies turning the other 95% of the populations' worlds upside down.

-- Cheers, James Arthur

Hi Jame,

You have a strong argument there, butI think that ship has already sailed: There's no way the supreme court would accept a challenge to medicare on the grounds that it's unconstitutional. I suppose the best that could be done is what Jim Yanik advocates -- amend the constitution to reflect "reality:" If people want to interpret the "provide for the general welfare" clause as "entitlements are fine," get an amendment passed and be done with it.

I am surprised that few businesses make a point of advertising to their employees what the cost of their health care and additional benefits are. In my own company, I certainly would -- every time you have an annual review or whatever, not only go over what your raise will be, also relate what the current costs of your fringe benefits are... particularly since their cost has been increasing much faster than raises have been!

---Joel

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fringe

When and where was this? Compare early history of Ford Motors.

=46ringe benefits were provided because the company could get more of the better people by using benefits because they were not taxed.

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Wage freezes during WWII. Unions objected, so benefits were exempted. Another FDR legacy.

-- Cheers, James Arthur

ow is

There's another difference--we can't afford the Medicare we already provide, but it's a lot easier to swallow that inefficiency for those comparatively few people. Just as the nation can afford to provide fuel for a few hotshots flying fighter jets, but there's no way we could afford to give that to everyone.

Spreading Medicare nationwide will just make it that much more expensive.

:

the

Really? I suppose not, once properly loaded with wise latinas.

If

The reality is that only one-in-four Americans pays any federal tax at all now, while more than half the population already receives a monthly government check; the argument then would simply be over how much.

Socialism inexorably leads to a tragedy of the commons.

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Don't you get it? Socialized health care *is* your raise. FDR's legacy of restrictions and centralized control has been driving up costs.

FDR's open-loop, non-market, politically-allocated dictate-from-on- high philosophy directs the half of our health care dollars spent by government, and permeates the private half of the system through a maze of bizarre anti-competitive regulations and incentives from Washington.

And you've been paying for it.

Presently, the promoters of that defective thinking figure it isn't that their theory's bad, it's just that we need more of it.

My brother pointed out that Kaiser Permanente may not survive the putsch.

Too bad.

-- James Arthur

.

Besides preventing needless amputations and providing preventive care (which it now turns out we're not going to get), the supposed reason for health care "reform" is that the masses can't afford insurance. You don't think people will jump to save 20% on something that's allegedly killing them?

As the government extracts a huge amount of money out of the economy to spend more on health care, it'll displace existing providers two ways:

a) by providing cheaper, subsidized services, and b) by snatching their health care money away from consumers before they can spend it elsewhere.

Impoverished, consumers won't have many options left.

One way to look at HR3962 as a whole is that it's designed to collapse into one giant government option.

-- Cheers, James Arthur

h is

on,

I think the $406B is understated by a country mile. That assumes stupid stuff like after 10 years only 2% of the population will use the government option, and that they'll cut the very reimbursements they're in fact simultaneously raising ~$250B (in a separate bill, not counted in their quote), etc.

It's a giant sloppy load of fertilizer.

But this is why they have a decent chance of succeeding--make something complicated enough that people can't understand it, and they'll generally just take your word on it. You know, like a sub- prime loan.

-- Cheers, James Arthur