WHODATINCA - I am done answering your questions, i dont have time for games or biased symantics... Simply based on the fact that you asked me if I read the law and Congress voted on this law with out having ample time to read.

Nancy Pelosi ~ "You have to pass the law to find out what is in it."

Xan - The 10th Amendment does protect states rights and prevent one State from having to abide by another States laws... The Federal Government sidesteps the 10th by making the law Federal after modeling it after a State in most cases, therefor it actually makes 49 states conform to 1 State's law.. No? Massachusetts in this case.

As far as for the privileged exclusivity of being American... I was always under the assumption that, that such privilege extended to my Representatives having ample time to vet Bills they vote on before voting. Again.. both parties do covert ops in the middle of the night and people keep voting for them.

To the best of my knowledge; no Ive not tried to operate a Nuclear Facility. I would prefer however that a dozen more be opened so we can start being able to cleanly charge electric vehicles that are presently being charged with coal powered electricity.

The exchanges are competition but its a competition where you are forced to make a choice other than "No thank you"... Similar to forcing all Americans to buy a vehicle from an Auto manufacturer that participated in the bailout even if they do not need a vehicle. (Light Bulb) Why don't we force all Americans to do just that and alleviate the public and Government from the costs of Public transportation? You can drive what ever you want as long as it was from a bailout manufacturer and you are driving.... Not necessarily Apples to Oranges if you happen to be a member of a family that has a surgeon and a GP.. They still have to have insurance and are not allowed to opt out of all but emergency room needs.

This whole discussion is based on the legislation of subjective morality, and that is where it comes to an end for me. As you pointed out, these are not laws to save lives but more to make the expense of Health Care less while never addressing the true costs associated with that care. Furthermore, flooding an already burdened Health Care system is not a pathway to better care, and there is zero in the AFA to address quality.

"I am objecting to a tax for merely living with no option out other than death."

I believe that many to most taxes are no-opt out until death.

"Government interference that creates a list of rules so granular that no one person can possibly know them all."

Outside of stop signs, most laws qualify here. Have you read the law, at all? Talk about labyrinthine.

"I am objecting to Government breeding a nation of idiots"
So how come the conservatives want to cut funding for education and other programs like Head Start?

"...that no longer read the fine print on anything..."
Again, the question about education funding...

"I am objecting to the Government attempting to remove the risk aspect of risk/reward and thus lowering the possible reward."

Again, stop signs, Homeland Security and the CDC arguably attempt to remove some risk while lowering the possible reward. Guess it depends on which reward you are looking for.

I wonder how the shutdown is affecting Homeland Security and their contractors. I imagine another terrorist attack while the government is de-funded would enlarge that -22 point deficit (in the polls) the conservatives are experiencing.

You were right, I had it backwards. It exempts the 5% of firms over 50 employees from going on the exchanges. But, guess what, still a negligible change, affecting 300,000 people (less than 0.1% of beneficiaries). Firms who currently offer must still do so. It does not prevent those not covered by the exemption to seek coverage on the exchanges. Even Rand said this was a tempest in a dollhouse teapot.

I was confused with another provision on mandated benefits with ERISA and it's corresponding impact by the ACA. I am certainly not going to argue that this law is complex.

You can avoid the tax by being poor. In fact, you'll get a subsidy to get insurance. The intent is that these people will now stop using the emergency room (the highest cost point of contact) and use the primary care system (the lowest cost point of contact). We can only hope that will transpire.

Isn't it a privilege to be an American? I kinda thought it is an exclusive club, where it means something to be a member. That we behave, treat each other respect and exact that last measure of devotion to the ideals. That we enjoy the benefits of equal protection, fairness and obligation to the society in which we live.

I'm certain that you can't argue that for the 100 million Americans and their families who work hard and play by the rules that the American society exists only to extract from them, not provide any benefit to them. No nation has a population entirely of supreme intellects. Information is not perfect. That life is complicated should not be a shock to anyone, and to expect every citizen to know everything about every idea is unrealistic. The reason why representative governments are formed is to organize and prioritize on a large scale for the benefit of the citizens, not for profiting off them. Protecting the weakest or those who cannot defend themselves is implicit. This is why prohibitions on fraud, theft and murder are the cornerstone of any society. The problem is that as society gets more complicated, the crimes do as well. For many who study it, our healthcare system is a crime, a very sophisticated multilevel marketing crime syndicate. Any governor dedicated to equity would try to fix this.

Obviously you've never tried to argue a variance from your municipality if you think the healthcare laws are granular...Or get a drug approved, or operate a nuclear facility.

The exchanges are exactly the definition of competition, and I'm an economist, so I think I can tell competition from uncompetitive situations.

As to the interstate portion, I agree. However, the States have the right to regulate insurance carriers in their states, and the other states do not have to abide by those regulations. The 10th amendment keeps the Federal government from requiring one state to abide by another state's laws. It is the insurer's obligation to abide by the local laws. The exchanges operate like NASDAQ, where any business in any state can list their products. The Feds can only tax and enforce Fed laws, they can't ask the state to do the Fed's work. If you wanted interstate, you'd have to ask for single payer - like Medicare or Medicaid. And I will stipulate that this is a bit oversimplified.

Xan,

1) Its 50 or more employees (period).

1st paragraph Page 1.
http://www.rand.org/content/dam/rand...RAND_RR411.pdf

1st paragraph
ObamaCare Employer Mandate

I can find no reference to 'tweeners', please provide.

2) I am objecting to a tax for merely living with no option out other than death. I am objecting to Government interference that creates a list of rules so granular that no one person can possibly know them all. I am objecting to Government breeding a nation of idiots that no longer read the fine print on anything they execute assuming they have protection. I am objecting to the Government attempting to remove the risk aspect of risk/reward and thus lowering the possible reward.

The exchanges you reference are elective participation, not mandated participation.

There is but only one way to truly drive down costs with minimal effect on product value and that is competition.

Federal healthcare exchanges are ok but interstate competition is taboo?

sorry, my bad. I guess I have to refresh my reading for comprehension skills.

Xan,

Oak is the one with the states rights sentiment -- not me.

WHODATINCA

Oak -

1) the piece of the Employer Mandate that was delayed was only for firms less than 50 employees but more than 15. It is because some of the rules were not hammered out to make the exchanges work. It affects very few firms. That special "class" of firm was created by lobbyists for special treatment, so paradigms needed to be created. It doesn't mean that the 99% of the rest of the mandate is useless or invalid.

2) Are you objecting to this particular Government mandate or any of the literally millions of other municipal, county/parish/state or federal mandates that are used to govern commerce? As it relates to the market for insurance, are you saying that creating and regulating an open access, high disclosure level exchange of financial products is a bad thing? Are you against the NYSE or NASDAQ or the CBOT? Are you suggesting that these exchanges are perfect or that they are not free markets?

3) I guess time will tell.

As for enrollment, one does not have to enroll until december 15. The exhanges only came online October 1. No one expected (based on observed human shopping behaviors) that the rate of enrollment would be constant over the period. Like anything in life, if we can wait, we will. Although I suspect that most will be signed up by the beginning of december to avoid the rush. Still got almost 50 days.

WHODATINCA -

I appreciate the "states rights" sentiment. Allowing local jurisdictions to self govern is a desirable goal. The tough part is that the political borders are mostly artificial. That makes the "equal protection" aspect of the universal law somewhat of a superseding concept. As for your notes on the 10th and second amendments, many laws have been passed and tested in the courts on both, and it is rare that one has been held unconstitutional. Gun laws abound in every state and on a federal level and are constitutional, and states have been hard pressed to define a "power" that is not delineated in the Constitution. Just like world business is now a "global" concept, many foundational US laws not delineated in the constitution are transcending states' borders. The courts have been involved increasingly so that jurisdictions don't codify discriminatory and preferential laws. It will be interesting to see where the Roberts Court goes with this, as they have teetered recently.

BTW, liberals are just as much in favor of gun possession as the wingnuts (I'm assuming that liberal is a slur much like wingnut). It seems like the approach to legislation is a bit different.

Forward Progressives

“Boehner not letting the House vote on the Senate’s resolution is why the government’s shut down, not because the people have rejected anything.”

Boehner responded by saying, “There aren’t enough votes in the House to pass the Senate’s resolution.” The person then asked Boehner to prove it, to which Boehner replied, “No.

The Republicans COULD have declared that:
1. Until all abortions cease in the US they are going to de-fund the government, or
2. Until the rich pay no taxes at all, or
3. Until all the SEC's policing of Wall Street ceases or
4. Until we crown Donald F**king Trump as King -- no money for running the government.

You see? THE REASON IS 100% IRRELEVANT.

Funding the government IS NOT A MATTER FOR DEBATE. And, my assertion of that fact comes not from the news media -- but from the Constitution that you say you hold so dear, Oak. Our Constitution says that we will have a government. Period, end of the argument.

Oak, your argument on this subject is specious.

As i am new to this web site, I have sat back and followed the chat since I have joined and i must say that it is refreshing to read the comments from so many obviouse knowlegable fans who follow the team as intensly as myself,.
I believe that coach Payton has proven that the pass to our RB's out of the backfield or lined up outside is an ext. of our running game, it has been very effective as we seen last week with the screen pass to thomas for a TD. Although I would love to see more of a pounding rushing attack I havent been impressed so far this season, I hope we all agree on that,
It's kinda depressing that Ingram hasnt been more effective considering what we gave to get him in the draft, I have heard rumors that there is talk of dealing him at the conclusion of this season, has anybody heard the same talk? or is it just talk up here in north La.
I do believe the rushing game has more to do with the offensive line than our running backs because it seems that we do not have success with running the ball no matter who the RB is. Besides Drew is taking more hits this year than he has in the previous years,
Ofcourse this is just one Saint fans opinion...

WHODATINCA

The term "efficiently" was used "intentionally" and has no bearing on the term successfully. The Government is not a profit generating entity and it survives on other peoples money (Taxes). Again, they are the most inefficient body in this country. They are also not held to the same standard as every other business unit in this country, they are not required to generate a Balance Sheet, they do not have to conform to GAAP. They cant even set a budget.

Correct, all of those benefits were shut down to maximize impact. Death benefits were shut down for spouses who desperately need those to survive and feed their children. Welfare has not been touched. You should be questioning the Government for its intentional decision to target impact for maximum panic and place blame on Republicans.

What you are failing to understand is that I am neither Republican nor Democrat. I am a Constitutionalist and believe that neither party should posses the power to shut down this Nation. The power of Governing should be delegated to the states, so that there is never a total shut down of Federal benefits. One huge reason I prefer this is due to the fact that the people can only retroactively take action through voting to do anything about Federal taxation and laws. If the only taxes we paid were at the State level then the Federal Government would have to actually justify beforehand taxation to the states to get money.

The Constitution delegates power to 3 branches, not two parties.

I do not argue that Republicans are to blame for our present situation, I argue that they are not SOLELY to blame and there is equal blame to go around in both branches of Government the entire Congress is to blame as well as the President. We do not vote them into office to break things, we elect them to fix things.


If Liberals want me to resign to the fact that The SC has proclaimed the AFA a tax, then they need to leave the Constitution (and I am picking my battle here, there are arguments for all of the Amendments including the 10th that covers States Rights)and the Second Amendment alone.

Xan,

1. Republicans didn't postpone nor want a delay in the Employer mandate.. That was Obama.
Delaying Parts of Obamacare: 'Blatantly Illegal' or Routine Adjustment? - Simon Lazarus - The Atlantic

2. This is not Free Market scenario - This is a Governmental mandated scenario.

3. To your last statement. Great question, and one that both sides need to answer for as they both have elected to not mediate to compromise and keep the Government running.

"If" a Republican president took action that postponed the execution of a mandate/law for big Corp. with out also giving the same option to the public they would be tried in the media as giving big Corporations favoritism.

CBO numbers state that 7M people have to sign up for Obamacare for it to be in the black and not suffer financial collapse. The Obama Administration has claimed over and over that they did not have the true enrollment numbers.. I suppose some people believed that?

The true numbers: 1st day it was open for enrollment 6,200 people signed up. After the first week, that number is 51,000. Open enrollment is 6 months and if that number holds true that's less than 20% (1.32M people) of the requirement, if it some how doubled in the next 6 months you are still less than 40%. They need roughly 39,000 people a day to enroll and they are no where near that number.

Obama and Liberals have slammed Republicans repeatedly for "not wanting 30 million Americans to have healthcare". The way i see it, its 25 million +/- Americans that do not want healthcare.

As for taxation and subsidies, this area is more complicated due to the policy need to distribute the burden of tax as fairly and equitably as possible. The challenge of any tax system is to not encourage adverse behaviors or discourage positive behaviors. The reason we tax virtually everything is so that one can't escape paying into society. No activity should get special treatment. Some activities are not taxed directly, like charities that promote a social good (like cancer research, or the ASPCA) but the salaries paid to the employees do get taxed.

Our government uses the tax system to alter behaviors. One major criticism of this is that the tax may not achieve its objective (see tobacco tax) or cause inadvertent transfers of wealth (see carried interest rule). Until a tax is implemented and behaviors adjust, one cannot accurately predict whether tax policy will be successful. However, if a type of tax consistently produces similar effects, one can predict the outcome probabilties. New taxes are the hardest to characterize. Debate rages on a transaction tax for trading shares on NYSE and NASDAQ. Arguments for are that traders can manipulate share prices with small fast trades, and that a tax makes this unfair strategy come with a penalty. Arguments against include that most trades are simply portfolio adjustments, not manipulations, and that those trades bear too much burden.

The taxes raised under the plan are mostly on the product sellers, like drug companies and device manufacturers, and some system suppliers. The theory is that these companies benefit most from reimbursement in these plans, so they should subsidize the least able to pay. The estimates are that the revenues from these sources plus the receipts from those insured should provide adequate coverage from the costs of adding the newly covered. Now, you can argue that these costs are already being borne by the system because those poor are getting healthcare for free. But if you agree that individuals who have been purchasing healthcare plans are already bearing too much of the burden of subsidizing the poor, this leaves only corporate profits as a source to make up lowering premiums for those who have been forced to subsidize for so long.

As it relates to other forms of subsidies in healthcare, Medicare is a classic example. One of the largest, most successful and most popular government run programs in history, Medicare relies on taxing all wage earners while none of them can draw benefits until (and if) they reach the age of eligibility. Young healthy wage earners pay for the care of the elderly. This single payer system is similar to programs in Europe and Asia. There are some differences in its administration and coverage, but when politics are removed from its management, it is a highly efficient (2% administrative costs vs. 15-20% for private plans) program. CMS sets prices and some outcome benchmarks, making it a very "regulated" program. It is ironic to see those demanding government get out of their healthcare but to leave their Medicare alone.

A difficult transition that is being forced through the tax/subsidy/reimbursement program is the one from an "emergency care" model to a "preventive care - outcomes" model. This is the trickiest because a transition of this nature is best achieved through a single payer paradigm. However, in an attempt to keep the historical insurer based model, taxing profits and altering some reimbursement schemes are the only ways to change behaviors (I'd include regulations, but standard of care tends to change faster than legislation is capable of keeping up with that change, so policy makers are reluctant to codify medical practice into law).

Emergency care is the best model for suppliers of care because the demand curve is inelastic, which means that people will pay whatever is being charged because they have no negotiating leverage. Moving the model to a preventive care paradigm means that providers essentially get paid for patients NOT touching the system. This gives the patient more flexibility and causes the system to allocate resources more efficiently. Rather than dedicate resources to the worst cases and denying primary care that would obviate the emergency, the policy intent is to encourage a more proactive care system, lowering the risks of adverse medical emergencies and improving quality of life.

This will be complicated. It certainly can't be achieved without an iterative process of test-adjust-test. To say that the initial implementation isn't optimal so it should be abandoned is like advocating firing Drew Brees before week 1 because he already didn't win that season's Super Bowl.

I cannot say whether this program will work or not. However, the way it is structured is the only way to preserve a free market, insurance based system in which almost half the population participates in the market as a free/public good.

The baffling fact is that those who object to this plan haven't offered any comprehensive alternative that preserves a free market insurance based system. There is a lot not to like. There's a lot to like. Same as any other massive overhaul of a broken system.

The reason why Republicans want to delay implementation for a year is because insurance programs only work if the pool is big enough to cover the costs. Delay would stop the pool from getting bigger, leaving only sick and those with insurance having to raise their premiums to cover those sick. Because many of the programs in the ACA are wildly popular so much so that they will survive any repeal, delay would crush traditional insurers, disrupting the system and creating massive chaos. I'm not sure that this has been factored into the strategies for holding Government hostage to repeal.

As I said in the beginning of this post, this will be a wild ride because disinformation and rhetoric will ultimately be stripped away and we will have to deal with the reality of the situation.

Is it truly worth obliterating the US economy and harming US families for this?

>The US Government has never exhibited the ability to
> efficiently execute a project

Really? So, WWII didn't impress you? The moon landing? Nor, the Hoover Dam? The interstate highway system? Taking out bin Laden?

I guess it depends on your definition of efficiency, but our government IS capable of executing a project -- at least it was until a few days ago.

Here are actual and projected of the impacts the government shutdown:

Thousands of workers are laid off at defense contractors

Federal government cannot pay bills and our credit rating is lowered again -- resulting in a huge increase in our debt due to cost to borrow money

VA stops paying pensions and other benefits

Federal Courts shutdown

19,000 children left out of Head Start programs

How the ripple effects of the government shutdown might spread, day by day - U.S. News

And, Oak, I'm sorry but, a law does not have more weight, significance, relevance or authority than any other law by virtue of the length of it's existence. In the current moment, all laws have same enforcement imperative.

Of course, a law ( or portion thereof ) can gain more gravity by being challenged in the courts and then reaffirmed by the setting of judicial precedent -- but the setting of precedent is only tangentially time-related.

Oak, I just don't know where to begin. I'll try, but just realize I'm not defending, just explaining.

The "mandate" portion of the ACA requires everyone to participate in the current insurance based model who is eligible. (Those not are covered by Medicare and Medicaid). One does not have to purchase insurance, but opting out will trigger a penalty of 95% of a "bronze" level plan, making purchasing a plan almost a no-brainer. A plan can be purchased similar to the way one shops for airfares on Orbitz. For the first time ever, Insurance companies must delineate each plan's specifics and characterize the premium costs to the insured. In this way, consumers have better information about the coverage that they are buying and the company through whom they will purchase plans. The Federal government put a set of minimum coverage requirements on all plans, but beyond those minimums, consumers can add features and pay extra for them.

From an "economics of insurance" analysis, this is the optimal arrangement. The more participants in the pool, the lower the participant's cost for participating in the pool as risk is spread out over a larger population. Even the "old" model insurance works exactly the same way but insurers had to advertise to attract healthy participants for a larger pool. The mandate simply substitutes out some of the need to advertise for those same healthy individuals.

The mandate also eliminates the "free rider" issue that plagues all public goods. Being purposely simple for the purposes of this discussion, hospitals and doctors and clinics are essentially open to the public. In some instances hospitals are required by law to provide care even if the patient cannot pay. Patients know this and are therefore have no incentive to purchase insurance knowing that they can successfully access the system. This is fundamentally unfair to those who pay for insurance because the costs of these "free riders" are passed on to those who pay. Prior to Oct. 1, the number of free riders was increasing far faster than new purchasers of insurance. This reality of cost shifting had to be addressed because the rich were/are forced to pay for care for the poor. By disconnecting the mandate, one would effectively destroy the insurance model, because only rich+poor health people would buy "insurance." Proponents of "personal accountability" and "anti-government takeover of healthcare" recognize that this is the only way to make the system fair and equitable.

The core difference between the "old" model and the "Obamacare" model is the transparency. Insurers are required to spell out specifics of coverage under Obamacare in a way that the average consumer can understand while stating a price that can be compared to other companies' plans. Kinda like looking at labels and prices when shopping at the supermarket. Aside from the requirements of the minimums, there are few new requriements that impact the insurer, other than they are limited to spending no less than 85% of policy revenues on delivery of care, no discriminating for pre-existing conditions, and that children up to 26 can buy into parents' existing plans.

The "exchange" feature of the ACA is about as free market as one can get in a healthcare system based on insurance, as the government does not set the price nor does it deliver the care. You have to remember that the insurance model is an extreme rarity in the world healthcare markets, as most nations with any meaningful healthcare infrastructure are single payer. The Massachusetts exchange paradigm was shared with all the states that chose to make their own exchange, and the Federal Government modified that model to account for those states who chose not to create an exchange. Having been implemented for over 10 years, the Mass model was fairly debugged.

I'll get to other points later. Problem is that criticisms are usually short but explanations are usually long, especially with healthcare. I guess up next is taxes and subsidies. Which is unfortunately more involved.

Xan,

So now as a country we accept the Microsoft model of get something to market regardless of how broke it is and we will fix it later? Obamacare is the equivalent of Windows ME.

Put your heart strings aside because I know you are smarter than that, or you are just in the mood for a debate; either way I'm your Huckleberry.

The huge difference between the Microsoft model and the Obamacare model is quite easy to differentiate. Even though the Microsoft model put a product on the shelves that is not 100% ready for market, they do go through a beta process to work out the majority of the bugs. Obama care had no such test, actually it was voted on with nearly zero vetting, then pushed to market with no beta runs. Obama throws out the Microsoft model and fans drink it up by the gallon and start using it. The rule for beta/pilot testing is that you NEVER test on the active system.

My opinion of Obamacare is not fabricated based on the opinions of news organizations. The US Government has never exhibited the ability to efficiently execute a project, the inefficiency of our Government is tax money waste at a time when we are at our credit limit and they have no business being in the business of anything.

Look at post Enron GAAP it grew from a pamphlet to a document the size of 10 bibles stacked.. small font and extra thin paper. That effort created more loopholes than it closed and now with in the next 3 years we will be moving to the European model, one smaller than the original.

More importantly, I have a choice when it comes to my operating system, Obamacare offers no choice of financial separation. The program will be heavily subsidized and that involves my taxes going to it.

The touch of Government in any business is the equivalent of a cc of Brown Recluse venom, once it makes contact the decay process begins immediately in regards to risk assessment and liability based decisions. See Subprime Mortgage Crisis. One the Government realizes they did wrong, then the market still has to correct. Market correction due to Government stupidity is very costly to this nation and its people.

WHODATINCA - So the stand that a law that is 3 years old should be accepted because it is law but one that is 222 years old needs to be changed?

What the republicans are saying is as reliable a litmus test on reality as what the Democrats are saying.

The reality is that BOTH party's refuse to budge and that makes it a 50/50 blame hostage situation on the parties. If you are going to insist that law is law then you are resigned to standing ground that Democrats should just accept the Second Amendment.

I am resigned to not allowing partisan news organizations and inept politicians dictate my perception of reality.

All new ventures go through startup issues. Nothing works perfectly out of the box, especially something as complicated as healthcare. The shakedown that Mass did will help other states implement their programs (California premiums are already lower than some of the more optimistic projections and account creation is faring well. Because people have until Dec 15 to sign up and their plans don't activate until Jan 1, it will be tough to say how well this will work until people start showing up in the providing chain.)

However, because the bulk of the implementation of the law covers disclosure by health insurers on these "Orbitz.com" comparison shopping sites, scale is not a factor that will determine its success. That's because large scale interactive shopping sites have been implemented in good working order for over 15 years.

What will be complicated is getting providers to reorient their business model from a "payment for throughput" scheme to a "pay for performance" scheme. It means that hospitals and doctors and clinics will have to stay completely up to date on the best practices and be very aggressive in managing their patients. Otherwise they will be disadvantaged economically. If your model is simply "see 40 patients a day - earn $250K per year" then you will hate Obamacare because you will no longer be paid simply for laying eyes on a patient. You will get penalized if that patient isn't managed to the best practices.

What I find interesting is that when this program ramps up, demand for nurses, technicians, and other healthcare professionals will skyrocket because all those people who now have insurance will flood into the system. That will be horrible for the economy because wages will be paid out to millions instead of dividends to thousands. And wages carry a much higher tax rate than do dividends (15-34% progressive + 10% FICA/Medicare vs 15% flat) Its a dastardly wealth transfer scheme that hits the bullseye of class warfare. I don't know why this doesn't get more attention from people that hate Obama.

Making wholesale healthcare change in the state of Massachusetts is no where the scale of this nation...

Xan, you know better than that argument, what is it you say about presenting an argument with that many holes and what you would be told?

Lets see California pull it off independently then we can talk. Illegals weigh heavily on this... And you know that.