Delphi is the standard programming language taught to many German kids in school. I have many friends in Germany (I live in Sweden) and they have horrible stories from those "lessons" :-)
Problem is not all of them are knowledgeable/interested enough to realise that what they're being taught is deprecated and not worth a lot.
It would be cool with in modern web development there were a tool that allowed you to design webpages as easily as you could design UI in VB3. Just saying.
There have been a few attempts. The autogenerated code isn't/wasn't all that great. I periodically use something like Quickbase, which lets you focused on the data collection and processing aspect, rather than where widgets go on the screen (VB3's UI being the first thing you interact with and what everything is tied to leads to some less than ideal maintenance nightmares).
For example, coding a button event handler is just like it is in Visual Studio/Delphi - just double-click on the button in the form designer and you're in the code editor positioned inside of an empty event handler code block.
> what they're being taught is deprecated and not worth a lot.
It's only "not worth a lot" if the only thing they're being taught is the specifics of the language. If they're being taught to program, then that skill is trivially transferrable to other languages.
Sorry, I don't buy that anyone would've written a custom application to DDoS a web site by slowly loading two relatively static pages on the site when there are a billion tools out there that will do the same thing far more effectively (see LOIC for just one popular example).
This almost seems like a false flag to make healthcare.gov into an innocent victim of a DDoS attack when as the original article says there is no evidence of an actual DDoS attack.
I agree with this viewpoint, though I think it's also possible that a lone actor, frustrated with Obamacare, acted out using the only tools he knew in a 1/2 hour.
It wouldn't surprise me if healthcare.gov was very vulnerable to DDOS attacks - we are talking about a 2013 site which is hosted in a single data-center.
The security researcher quoted in the article agree with you:
> Arbor researcher Marc Eisenbarth said there's no evidence
> Healthcare.gov has withstood any significant denial-of-service
> attacks since going live last month. He also said the
> limited request rate, the lack of significant
> distribution, and other features of the tool's underlying
> code made it unlikely that it could play a significant
> role in taking down the site.
Although, I will say that if the tool is grabbing the dependencies of each page (which in total comes to about a megabyte per page load), it might add up over time. Yeah, it's static, and yeah, it's not LOIC (it'd surprise me if LIOC weren't also being used against this site), but the site debs didn't do themselves any favors with the size and number of their static assets.
This comes from a very concerted effort by highly placed folks in the US (Koch Brothers, health care companies). Essentially, they create fear and confusion around the new laws through Fox News and dial-in radio, and American idiots eat it up like it was the Bible truth. The people in this country who are against the health care law, uniformly, know nothing about it and regurgitate Fox News BS when asked why it's a bad law.
Thing is, the law has its issues, but the other side never gets near them, they just make shit up "death panels" and government interference and stuff. I, as an American, am super embarrassed by all this. It doesn't help that the health care companies wrote the fucking law, anyway... now they're fighting against it!
The sad truth is, unless we have a single-payer, socialized medical system, none of these changes will help much. Really, the biggest change the new law enacts is that it forces health care companies to cover people with pre-existing conditions like Diabetes and heart disease. Right now, they can tell you to go away, they won't cover that stuff. IN 2014, I hear they'll be forced to at least offer you a psychotically expensive plan if you have diabetes.... Ah, this country sucks ass.
I respectfully disagree - I think the biggest change the law enacts is the cap on the MLR. Telling insurance companies they have to cover those with pre-existing conditions doesn't make them want to cover those with pre-existing conditions, it just makes them not want to be sued for one more thing. That is no kind of motivation to keep costs down or provide decent service - if Joe Sicko says "screw this, I am going to your competition" they break out the champaigne. With the MLR cap, having one more person means they can take home more money, so long as they're operating near the cap to begin with.
According to webmd, plan rates will only depend on age:
""
Q: Will there be a limit as to how high a premium insurance companies can charge if you have a pre-existing condition?
A: Yes. As of 2014, insurers cannot charge consumers different rates for health insurance because of health status or gender.
You can be charged more for your age, however, with older people paying a higher premium than young people. But that increased charge is capped at no more than three times the standard rate"[1]
Edit: Actually "The law allows for differences of premiums based only on four criteria: age, location, family size, and smoking."[2], which seems like a good way to do racial profiling and increasing premiums on poor people(since they're probably less healthy), as expected in the u.s, but at least pre existing conditions couldn't be a basis for a rate difference.
I wonder thought how legal would be doing data mining with this information (an other free datatbases) , and how much deanonimization could be practically achieved ?
While I totally agree with your proposed change, I don't think that fixes the system as a whole - especially if it were the only change to the pre-ACA state of affairs.
In the US, if your employer pays for your health insurance, they pay for it with pre-tax dollars. If you buy it, you buy with post tax dollars. That's why employers pay for it in lieu of paying you more.
If your employer pays for your car insurance as a benefit, they pay for it with post tax dollars, so they don't do that.
So, employers pay the premium on your health care for the tax advantage. Now consider the how psychology behind not being the one who pays for the premium.
Do you care how much your services cost? No.
Do you care if the premium goes up? No.
Do you shop around for better insurance? No.
Do you care if you loose your job if you're sick? Hell yes.
In effect all normal market pressures are gone. No one who consumes resources cares about their costs because they're are completely disconnected from paying them or some derivative of them.
This is why doctors don't post prices.
While the net effect for people with employer provided health insurance is ever increasing rates, the effect on those people without health insurance is brutal. They are trying to enter a market that has no price pressure.
So essentially the market for health insurance is competitive on what companies can afford rather than individuals? So the proposed change would force insurance companies to be more competitive on a smaller scale and in the long run, cheaper. Interesting.
Health insurance is weird in the US. In World War II we had wage controls which kept wages tight. When the War Labor Board declared that fringe benefits, such as sick leave and health insurance, did not count as wages for the purpose of wage controls, employers responded with significantly increased offers of fringe benefits, especially health care coverage, to attract workers. As a result it became the defacto standard to get your insurance through your employer and your employer picks a company and group plan that spreads the risks over everyone and pays most or all of the premiums with before tax dollars. Employees can usually pick from a few plans (individual or family, maybe two levels of coverage) For example, my employer pays 2/3rds of my premiums and I pay 1/3rd. They would rather give me health insurance than money for my own health insurance because they don't have to pay taxes on the health insurance premiums they pay for me. Nobody gets a choice in what your employer picks as a health insurance. If I wanted my own insurance of my choice I would have to opt out my that extra money my employer kicks into my health insurance (I would lose it, I couldn't apply it to my own plan, and it is a substantial amount of money)
Sorry, I don't mean to take this out on you in particular. And I'm hardly an ACA fanboy myself. But your comment just goes to show that no one has a clue about what the ACA actually does, and it drives me crazy.
The ACA does remove that tax exemption, albeit partially. Every dollar above $10k or so ends up being taxed now. And not a small amount, either: the tax is to the tune of 40%. And since the cost of healthcare will continue to rise faster than inflation for the foreseeable future, more and more employer health plans are going to be hitting that number.
I'd certainly prefer the tax exclusion to disappear entirely, but the ACA is nothing if not an attempt to offer coverage to the poor and people with pre-existing conditions while doing the minimum possible to disrupt the healthcare market. That's why it's a bit of a Frankenstein: no one in their ideal world would have chosen the ACA as their ideal policy. But given the set of institutional actors and the setup of our government, it may well be the best that was possible. That's how the Obama administration thought of it, at least.
IIRC that tax was actually a pretty nasty fight between the Obama administration and labor unions, who get their members relatively good benefits and will be hit disproportionately by it. And you know what? The tax-free cap may well have been significantly lower with Republican input. But they chose to put 100% of their efforts into making a mediocre law fail than trying to turn it into a good or great one.
Employer premium contributions for employees and their opposite-sex spouses and tax dependents are 100% deductible as business expenses under federal and state tax law. This is true regardless of business type-sole proprietorship, partnership, LLC, corporation, etc. These rules also apply to owners of C corporations and LLCs classified as corporations for tax purposes. These business owners are considered to be employees of the business for purposes of the tax treatment of premium contributions.
A 40 percent excise tax will be assessed, beginning in 2018, on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage). Health insurance issuers and sponsors of self-funded group health plans must pay the tax of 40 percent of any dollar amount beyond the caps that is considered "excess" health spending.
So, you cherry picked a bunch of stuff here.
1) Neglected to state it starts 4 years from now...a lot can happen in that time.
2) Neglected to state 10K limit is for individuals, 27K for families.
3) Confused excise tax and tax exemption.
I don't think anything here refutes my point or makes what I said incorrect.
You complained that no one is proposing that we tax employer health plans instead of creating a subsidy that distorts the market and raises prices.
I point out that the ACA did do that. Not enough to yours or my liking, but it did nonetheless.
Your response is to complain that it didn't go far enough. Sure. But the least you can do is recognize that the ACA certainly does do something in the spirit of what you were claiming no one had attempted. That doesn't mean you have to like the law as a whole.
I love how you make baseless accusations directed at the "Koch brothers" based on an article that doesn't even say that there were actual denial of service attacks.
Then you poke fun at "American idiots", and then admit in your last sentence that you don't really even know how the law works yourself.
Bonus points for picking the two conditions, heart disease and diabetes, that mostly result from poor choices instead of random innocent victims.
Your whole post is like a parody of pseudo-intellectual liberalism.
Uhm.... Diabetes can be a life-long disease. Way to discount people for being irresponsible. Clearly people who eat too many sweets don't deserve health care in your eyes.
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”
― C.S. Lewis
Yes, classic American culture tends to take rights violations very seriously, to the point that it may baffle those used to living under tyranny. Yes, many of us have a problem with the government commandeering the healthcare of 100% of the population just to "help" 3% of the population. Would have been cheaper, and far less disruptive, to just buy that 3% health insurance outright.
That's a great quote, but poorly applied in this case. The financial crisis we will face in the absence of effective reform is of concern to more than just the "moral busybodies".
Obamacare has problems, but being targeted to just 3% of the population is not none of them. Are you completely free from anything that an insurance company might call a pre-existing condition? Do you plan to never be unemployed? Of so then congratulations, you might not personally benefit from healthcare reform of this type. Most Americans are not in that boat. Certainly more than 3%.
Or it would've been cheaper to enact price caps on healthcare services and eliminate for-profit insurance companies, to replace them with single payer.
I, a self employed entrepreneur, was rejected for healthcare. Maybe now I'll be able to get it as soon as they fix their website. So they got that much right.
In the meanwhile, I am perfectly healthy and will look both ways before crossing streets.
To be fair, the way Obamacare is implemented is crazy.
They should have just gone with full-on socialized health care like the rest of the civilized world... Would have been better for every party involved (except perhaps the insurance companies).
A plurality of the population doesn't want full-on socialized health care. Those insisting on making it happen anyway concocted this crazy implementation as a means of squeezing something thru in that direction, quite possibly in hopes that the fallout would make "single payer" the only viable option.
Yes, we're not "like the rest of the civilized world": this country was founded on valuing individual rights above the whims of the majority.
So you'd rather your government spend money on the NSA, TSA, wars on terrorism and drugs and a thousand other programs that inhibit your freedom than to ensure that the poorest, most vulnerable members of society have access to free health care?
ETA: just because I'm opposed to one program doesn't mean I favor others. I'm just as opposed to "NSA, TSA, wars on terrorism and drugs and a thousand other programs" as I am to Obamacare. I'm not sure how you conclude that by opposing wasteful oppression in one area somehow means I'd be more tolerant of wasteful oppression in other areas.
If you're opposed to wasteful spending by NSA, TSA, wars on terrorism and drugs and a thousand other programs and Obamacare, where do you propose spending all those trillions?
I can't speak for the parent here but for me I would rather them not spend so wastefully so that I don't have to give them 30% of every dollar I earn. So how about spending some of those trillions to give us all some of our taxes back.
Did you read my comment? Because I didn't say anything even close to that. Not at all. I simply wish they would not spend so wastefully and that the money they do spend is more effective. I didn't say we should pay no taxes. I think we should pay less taxes and have that money used more efficiently.
We don't have those trillions. The government is borrowing near 50% of what it spends, with no idea/plan/expectation of paying it back. If any money is saved by such cuts, give the money back to the citizens who earned it and let them decide where their money should go.
> Yes, we're not "like the rest of the civilized world": this country was founded on valuing individual rights above the whims of the majority.
This is why we fail so badly as a country.
Your right to previously underpay for health insurance had ended. Externalized costs are now being internalized. That's how insurance works; to spread risk across everyone. Now, if you're unhappy with that, I suggest either leaving the country or simply not paying for insurance and paying the IRS-imposed fine. You can then self-insure and absorb any of your healthcare costs yourself.
I agree 100%, but let me see if I can explain their view (which I disagree with) in a way that will make sense, or at least seem less crazy.
If you're an open-source participant, you may have experienced the power of what I've heard called adhocracy or do-ocracy. In it, we're all equal individuals; power is used situationally, in a bottom-up fashion, by those who are currently accomplishing something for the common good. In those contexts, top-down exercise of power feels very interfering.
The US's history includes a strong dose of that, plus a strong sense of individual liberty. Our country was born in rebellion to some far-away people who wanted to boss us around. Almost everybody here is descended from somebody who said, "Fuck this country; I'm outta here," and moved to America. One of our central civic documents, the Bill of Rights, basically lists all the things the federal government can't do. A giant chunk of our national mythos is bound up in westward expansion, where in a thinly populated frontier, the cowboy-hero did what he wanted and bowed to no man. Never mind that the era was short and the story more complicated; it's the idea that lives on.
Most of us who live in cities have long ago accepted the need for modest civic organization and collective action. We live too close to one another to be able to pretend that every man is an island. But even here, we tend to jealously guard our independence. Much more so in the suburbs and in rural America, where interdependence is harder to see.
Given all that, a demand that you buy health insurance can easily seem like (or be made to seem like) a crazy imposition from a far-off bureaucracy. Most other tax in the US is based on income, assets, or expenditures; if you aren't making/owning/spending anything, you don't have to pay. To some this feels like being dragged into participation in a society that they never particularly wanted to be part of.
All of that is intensified by several factors. A big one is the Republican party's strong shift rightward [1]. There is also a large segment on the right that has decided that the black guy with the funny name is not an American [2], making anything he does seem more like an imposition. Plus, there's a long tradition [3] of painting this as "us" (that is, white people) paying for "them" (black and brown people), even though the federal government actually shifts a lot of money from liberal states to conservative ones [4]. There are also strong streaks of anti-intellectualism and fundamentalist religion that play into this.
All that said, I agree it's kinda crazy when you take the bigger picture into account. America's health care system is a mess, costing way more than anybody else's, and leaving millions with little or no service. Something has to be done. This solution was actually a conservative one [5], and it's not like the American right has proposed anything better. It's not the solution I would have picked on my own, but given current American politics, I think it was the most achievable option.
Ok. That's more than you every wanted to know about America. Thanks for making it this far.
If you are discussing this topic, you might consider referring to the legislation as the "Affordable Health Care Act", which I believe is the title on the actual legislation. Calling it "Obamacare" triggers an overly emotional response from people on both side of this issue.
Ask people if they want universal affordable health care, and most people will discuss the issue. Ask people if they want Obamacare, and you instantly raise all sorts of issues that have nothing to do with health care.
Edit:
I agree with many of the responses here as well. The actual name, which I believe has ten titled parts [0], is a bit of marketing copy as well. But at least it's marketing copy that relates to the substance of the act.
Calling it Obamacare makes it personal, and this is about much more than Obama taking care of all of us.
I'd love to see a neutral name for the legislation itself. I am starting to call it "the current health care legislation".
...what does that have to do with anything? It's the actual name of the act. Making up a new name for something to signal your disapproval is the fastest way I can think of to indicate you aren't capable of discussion.
It's the "Patient Protection and Affordable Care Act", or ACA (oddly never PPACA in real usage that I've seen, though I see wikipedia lists that acronym).
I can't refer to the legislation by its name because I consider its name disingenuous. A rose by any other name may smell as sweet, but calling dung a rose doesn't make it smell any better. Words mean things; "affordable" the act isn't. The legislation itself raises all sorts of issues that have nothing to do with health care.
ETA: "Obamacare" is used because it's a catchy name which is both quite descriptive (Obama pushed this healthcare law thru, so he owns it) and is not inherently insulting (like "Bushoppression" or "Obamasux" mentioned elsewhere in this thread). Use of this popular nickname causes a frenzy because of its subject, not its inherent phrasing - it is not an ad-hominem attack.
So when it comes up for renewal, you go around saying "I hope they don't renew treason this year." That use of language must make communication somewhat difficult.
Its not "the Patriot Act". Its "the USA PATRIOT Act". And USA PATRIOT is not just a ridiculous emotional appeal embedded into a name, its also an acronym for "Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism".
As an anecdote, we signed up my inlaws for $2/month after subsidies. Until now they couldn't afford the $900/month so they didn't have insurance. I'd say that's pretty affordable, almost free.
It isn't free. Someone else is paying your parent's bill, either through their own premiums (which some say have tripled, though they have no prior conditions) or through taxes. Don't judge the price till the bill takes full effect; you may not be smiling.
Think of it this way. Let's say the two of us were talking. And your real name was John Smith (making this up, I have no idea and not relevant). I had a choice between referring to you as "idiot" or "John." The latter is factually correct, neutral and lacks emotional triggers.
Using your logic, you shouldn't call Social Security Social Security you should call it FDR Forced Set Asides. Because you know, nobody likes being forced by the government to set aside their hard earned cash by some politician, and one who's personally and solely responsible for that happening. And which has absolutely no upside to it at all, of course. But wait, that wouldn't be true. So people don't do that. They call it Social Security. Because that is it's name, and is less loaded, and more politically neutral.
Um, I don't consider "Obamacare" emotional, I consider it neutral. I just think it's a catchy nickname for legislation. It is neither negative or positive.
It doesn't matter what you consider it, it matters what others consider it and it most certainly is emotional to most. That the affordable care act polls higher than Obamacare should make that clear to you.
Of course it's relevant. I (and every other person I know personally) have been calling it by it's shorthand Obamacare when discussing it and I would like to know if we have been using this "emotional" word to portray the bill positively or negatively.
The real name isn't really neutral either. You have to consider at least a little bit that having the word "affordable" in the name is naturally going to bias people toward it. I doubt the Subsidized Care Act would poll very favorably.
You said: That the affordable care act polls higher than Obamacare should make that clear to you.
So I meant during the polling... one name already had bias baked into it by using the word affordable rather than the word subsidized. Not many people are keen on subsidies when you call them subsidies. But if you just say something is now more affordable and don't tell people it is more affordable because it is subsidized, you have baked in a bias from the start. So naturally that bias is going to be reflected in more favorable polling results.
> (Obama pushed this healthcare law thru, so he owns it)
Facts:
Congressional majority voted in favor of it, then Obama signed it, turning it into the law of the land. All those individuals were voted into their jobs by the American people, by a majority of voters.
The Supreme Court then upheld it.
The same President who, as you said, pushed for it, and signed it into law, and who was the candidate of the very party which also comprised the overwhelming majority of the Congressional votes which turned it into law, was then chosen by a majority of voters to be re-elected as President for a second term.
Now, that law is starting to finally go fully into effect.
This is how government works. All the key players above were either elected directly (or put into place indirectly by the former) by a majority of American voters. Your side (I assume), lost. It happens. This is a democracy.
Think about what you're asking for by implication.
Constraint-free purchase of health insurance would mean that I could sell you health insurance that would 'insure' that you could only be doctored by me, on my yoga mat, with a chainsaw. Someone less principled than me would have the same idea --- or one like it --- and sell a billion innocent souls a false comfort and a dangerous service. So someone would. Like someone has already sold those same people fake food that's killing them.
Do you like alive citizens, or dead ones? The utopia you seek may be for the machines and the undertakers. And the undertakertrons.
give me a fucking break. people (including lots of loyal democrats) are getting their plans cancelled because their plans don't cover things they'll never need. Are you 60 years old, childless and single? Does your existing plan cover pediatric dental? No? PLAN CANCELLED.
My brother is a healthy, single, childless young college student who has a cheap, catastrophic plan to insure (aka share risk) for a major accident or major ailment (cancer, etc). He won't get to keep it after Dec 31st. Instead he'll have to pay a dramatically larger sum to offset risks that he doesn't have.
But now your brother won't be dropped when he does fall ill or get cancer. That was a common tactic among insurers. You didn't dot an I correctly on one of your forms? Dropped. And now that you're dropped, good luck finding another insurer with your "pre-existing condition".
Unless your brother is immortal, he will eventually fall ill or suffer an accident. Such is the nature of life. Some people live long & healthy lives, others get cancer at 25. You simply cannot know the future. Shared risk, in the greater scheme of things, is preferable to the alternatives.
That is the thing I can't stand about most liberals, they always think they know what's better for you than you do. Take your nanny state regulations and bother someone without their own brain.
"they always think they know what's better for you than you do. Take your nanny state regulations and bother someone without their own brain."
Do you think people should be able to own and have their own nuclear weapons? How about biological weapons? What about murder? Should that be legal?
If you said no, then you do agree there needs to be some "nanny state regulations". We only differ on where the line should be drawn.
When people "grow up", they realize that the general populace isn't too bright. The world is filled with nutjobs, idiots and crazies. People who are downright evil. People who are sociopaths. Letting the "free market" sort them out is a fairy tale for the young and children.
I don't mean to sound condescending or harsh, it's just that I was once a libertarian myself (in my early to mid twenties.) I came to realize what a horrible ideology it was and when you see people making the same mistake you made, you can't help but try to help that person out.
"Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience."
- CS Lewis
The ideology of individual liberty and the free market have turned the United States into the most powerful and prosperous nation the world has ever seen. The ideology of "government knows best" has produced the concentration camps of Nazi Germany, the gulags of Soviet Russia, the wholesale slaughter of tens of millions in Mao Zedong's Red China and the pinnacle of oppression: North Korea.
The term "Obamacare" has no semantic relation to your critiques whatsoever, so it's not more accurate at all.
If you really want to be both more accurate and more true to your critiques, try something like "ExpensiveCare" or "ConstrainedSupplyCare" or "BubbleDemandCare" or something like that. I could even see critics attempting something like "UnfairCare", referencing the fact that young healthy people with incomes are now paying for old/unhealthy/indigent people's healthcare in addition to their own.
But "Obamacare" is silly, non-descriptive, purely partisan, and universally detracts from any conversation about it.
But the name is a joke. I take offense to it labeling "health care" as being "affordable." It does nothing to change the cost of health care. It still costs the same. But for a lot of people, someone else will be paying for it.
I'm not so sure about the affordable part. Maybe all I see is people posting letters about their rates going up though. What is the argument against that from people who still support this legislation? Is it denied that prices have gone up in general or accepted and justified because of increased benefits on the plans?
If all you see are reports about people's rates going up, then you are in a filter bubble - just like everyone else who consumes a majority of their news through personalized online sources. There are people in neighboring filter bubbles whose ACA-related stories are almost entirely about people saving money because of the new exchanges.
Please post links with people saving money. I have yet to see one that was genuine. I have seen actual evidence of people getting coverage that could not before.
A search on google for the term "how obamacare has helped people" provides over 24 million results. Here are couple reports you can read at your leisure:
> Maybe all I see is people posting letters about their rates going up though. What is the argument against that from people who still support this legislation?
That what you see is not representative, because along with those I see plenty of people that could not get private insurance at any price (e.g., for whom the cost was infinite) due to preexisting conditions that can get health insurance because of the ACA.
> Is it denied that prices have gone up in general
For like benefits, costs have gone down since the ACA was introduced, in part because of parts of the ACA that went into effect earlier, like the limit on profits which required refunding excess premiums (because health insurance, even prior to the ACA, was not an ideal competitive market but an oligopolistic one in which rents were being extracted, and this was a limit on the rents that could be extracted.)
With the minimum benefit levels effective for non-grandfathered plans some low-cost, low-benefit plans are going away. This, on its own, would increase the minimum price of private insurance after this stage of implementation of the ACA above what it was prior to this stage of the implementation. In addition, changes to rules on what factors can be used in price setting have shifted costs so that, compared to what they would be without those rule changes, prices for plans for young, currently healthy individuals have gone up, while prices for everyone else have (again, considering only the effect of that rules change) gone down.
Expanding the size of risk pools as the mandate does should slightly reduce overall prices, but that may be a lagging effect since it can't be factored in fully without a clear picture of the magnitude and how many people will opt out in favor of paying the penalties for non-insurance.
Additionally, subsidies have been made available to people at the low end of the scale to which the individual mandate applies; this doesn't help with total costs (ignoring the effect that coverage vs. non-coverage has on total healthcare costs, which is significant in the long term, but not necessarily the short term) but does help with affordability.
Even moreso, except in states that opted out of it, Medicaid expansion means a lot of people are getting coverage with no out-of-pocket cost that could not afford any coverage before.
But, yes, the people that could afford insurance and who paid the least for the coverage they were getting because of youth and current health are often going to be paying more.
> Maybe all I see is people posting letters about their rates going up though.
a data point:
I also see a lot of people talking about God and Jesus and how they have a personal relationship with them, etc, etc. Personally I've never seen them. I have a guess as to the status of things in those situations.
Also I see a lot of "people" saying how Justin Bieber is, "like, so cute. OMG. he's so hawt! and a genius! omg. like, amazing. omg. omg". So clearly, this must be factually true, correct?
>So clearly, this must be factually true, correct?
I didn't say that. You shouldn't try to put words in someone else's mouth. I was mainly looking for some credible, unbiased facts. A lot of the positive anecdotes seem to be ignoring price reductions due to tax credits or something but I am not sure. Huffington Post's story has a family of 5 getting insurance for $100-something, while I see people saying their family went from like $600 to $1,000+.
The name actually does affect people's opinion on the subject. I don't fully trust this source yet [0], but I do trust that the name affects people's opinions.
Quoting from the Wikipedia article [1] on the same:
President Obama endorsed the nickname, saying, "I have no problem with people saying Obama cares. I do care."[2] Because of the number of "Obamacare" search engine queries, the Department of Health and Human Services purchased Google advertisements, triggered by the term, to direct people to the official HHS site.[3] In March 2012, the Obama reelection campaign embraced the term "Obamacare", urging Obama's supporters to post Twitter messages that begin, "I like #Obamacare because...".[4]
I agree with many of the responses here as well. The actual name, which I believe has tent titled parts [0], is a bit of marketing copy as well. But at least it's marketing copy that relates to the substance of the act.
Calling it Obamacare makes it personal, and this is about much more than Obama taking care of all of us.
I'd love to see a neutral name for the legislation itself. I am starting to call it "the current health care legislation".
I disagree. The name 'obamacare' began as an attack on the legislation, but the other side has taken over the term as in 'Obama cares', so in some circles it's derogatory, in some it's posiive, but I think both sides accept and are relatively happy with the term--for better or worse.
Denying people access to healthcare.gov is like blocking an ambulance trying to take someone to the hospital, you'd have to be a pretty low criminal to do it.
If you don't want healthcare then don't buy it and pay the fine (or refuse to pay the fine) just don't block others.
That's the problem: people DO want healthcare, but the legislation blocks them from buying the form of healthcare they want. Seriously ill people with perfectly good health insurance are getting their plans cancelled for want of irrelevant requirements; yes, many of us DO consider those causing such cancellations "pretty low criminals", hence the consternation unto DDOS.
The legislation does lots of things, including making it possible for people like me with pre-existing conditions to actually get insurance. Plans are cancelled because free market corporations decide to cancel them -- the law could have forced all those companies to continue policies while bringing them up to standards, but if it did, you'd be complaining about that.
The law indeed forced those companies to bring policies up to highly disputable standards, which for all practical purposes amounts to canceling them and requiring enrollment in much more expensive plans - that is indeed what I'm complaining about.
I think you're missing the hypothetical above. I read it as "the law could have required insurers to bring policies up to snuff without increasing premiums". That presumably would have kept people from getting cancellation notices (and would have been a huge controverstifuck).
In any case, I think you're wrong. I think it's nice that there's a minimum standard for what 'insurance' should actually do. I think mandating certain minimal care coverage is critical in preventing people from being fleeced by super cheap plans that don't cover crap.
I think you're missing the practical reality. Insurers cannot bring policies "up to snuff" without increasing premiums. The changes are significant enough (both benefits and costs) that they are for all practical purposes new & different plans, the old plans are cancelled and new ones must be chosen. That "minimum standard for what insurance should actually do" is now legislated to a very high, and very expensive, level; we're not talking minimum reasonable, we're talking compelling luxury plans.
The minimums hardly make these plans "Luxury Plans".
The (very good) reason to have minimum coverage requirements is to push people from burdening the acute care system (ERs).
This is necessary in order to keep overall health costs in check. We cannot, as a society, continue to have people rely on ERs for their only care.
Some of the lavish coverage that is now required[1]:
* Blood Pressure Screening
* Blood Sugar (Diabetes) Screening
* Cholesterol Screening
All of these things are precursors to chronic (expensive) conditions. It is much cheaper to manage these things before you develop heart disease or diabetes. Mandating coverage for these things is simply the smarter allocation of resources than treating the end-stage disease.
It is critical they force churn of healthy young people so they can jack up the prices. that is what the whole Act is predicated on. the more young, health people with cheap plans tha exist, the more the act fails. those plans were not priced to subsize the aca's higher risk pool. that is why the "keep your existing plan" lie is/was so pernicious. the entire thing was a subterfuge, as behind the scence the gov't was <planning> the system to <intentionally churn> people off existing plans. the evidence is quite strong on this...sorry.
Still not seeing the plan side by side, or seeing the other options/plans that were offered in place. The article only mentions a couple dollar amounts.
As ck2 says, everything that's been tossed around (that I've seen) so far has been anecdotal, sensationalized, or flat out bogus. Will there be some hiccups? Of course. But they are the exception, not the rule.
>which could also not explain why the plan did not meet the Affordable Care Act's requirements.
News at 10, health insurance companies are participating in shady business deals. I have absolutely no proof but they probably did some huge accounting for Obamacare and cancelled plans that they deemed less profitable rather than making some minor change in favor of those they thought they would make more money on using Obamacare as an excuse.
In some cases, its not about the specific coverage, but about cost. Completely anecdotal, but a friend of mine that owns a small business had his current coverage canceled on him, and that the cost to cover his family (wife, 2 young kids) in the new system was going be about $700/month more. Sure, you can probably identify additional value that he would be receiving. In his case, the new, more expensive plan was the cheapest he could get (subject to unknown constraints that he obviously chose through the search process). In the end, he just wanted his old plan back, and was being offered something he didn't want for a lot more money.
As someone who doesn't live in the States, can anyone explain the opposition to Obamacare other than the recent technical problems (which seem to happen anytime governments go near a computer)?
On the left, people are upset it didn't go further and provide universal coverage via a single-payer system. On the right, people are upset that they are being mandated to buy insurance from a private company. There's irony in there somewhere. When voters are polled on the individual components of the plan, it is very popular. When polled on the plan as a whole, it is unpopular.
Summary: my health care insurance is a matter between me, my doctor, and my chosen insurer - which is none of the government's business. Disrupting my insurance because of issues not relevant to my treatment is intolerable.
Both should be limited to the truly needy, rather than becoming de facto norms for _everyone_ in broad categories.
I have no qualms about using a program I was compelled to paid into, while considering I shouldn't have been compelled to pay into it and that I'm a prime example of what's wrong with the system. And yes, I've said "no" to comparable "here, take even more taxpayer money" programs.
Ok that's an understandable position. Let's continue that logic and apply it everywhere else in life:
The relationship between your neighbors and you is a matter solely between them and you. The government should not interfere. So, if for example your neighbor were to choose to rob your house, or murder a loved one, clearly, the government should not get involved.
When you're driving, that's a matter between you, your car, and perhaps the road. And your relationship with other drivers or pedestrians is solely up to you and them. You should all be able to do whatever you want and/or work out any disputes between each other as they come up. Laws would be pesky and just be government interference.
And by the way, as to your point about disrupting your insurance for reasons not relevant to your treatment. That's a big whoosh that misses the point of the ACA. The whole core point of the ACA was in reaction to private insurance companies which would deny or drop people who were seriously sick. Thus, effectively denying treatment, or forcing them to rely on rush-to-emergency-room treatment, rather than cheaper and less stressful preventative care, or experience catastrophic costs, which then either bankrupt them and/or get passed on to all other taxpayers and customers, against those others parties wishes, anyway. Making sure more people get more and better treatment, more consistently, is the whole point of the ACA. It's not perfect, nobody claims that. But it has a heck of a lot of objectively good elements which are pro-health.
Some industries do develop systemic defects, and it is appropriate for government to apply regulations to correct those. There is a vast difference between coming up with a regulation amounting to "you cannot drop coverage just because a case proves costly" or "you must accept pre-existing conditions for coverage-transferring customers by accepting them at exactly the same plan/cost as a current customer facing the same treatment costs", vs. taking over the entire industry and compelling a multitude of costly irrelevancies and disruptive non-sequiturs.
And you're missing a heck of a lot of objectively bad elements which are anti-health. The point of a discussion is to address both sides of the issue, not just loudly ignore the opposition's objections.
You know how when the US invaded Iraq and you said "Wow, the American government is evil". And then when the US did a terrible job of handling the Hurricane Katrina disaster you said "Wow, the American government is incompetent". And then when the US bailed out well-connected wall street banks in the financial crisis you said "Wow, the American government is corrupt".
It turns out, some Americans don't want that same evil, incompetent, corrupt government controlling their healthcare.
Well, they claim its because of the individual mandate (you must have health insurance). This idea has been the sole thing the Democrats and Republicans have disagreed on since the late 80s. The Democrats didn't want it, the Republicans didn't want health care reform without it. Now Obama really wanted to pass health care reform, so him and the Democratic strategists sat down and decided to adopt the idea of an individual mandate. This pissed off the Republicans since it meant they had nothing to complain about without looking like a dick, so they decided to abandon the idea. OE they are just racist dicks. I know few of the more vocal advocates for an individual mandate were asked why they are Noe against it and they basically said Obama shouldn't have supported it and left it at that.
The health care system was structured poorly before any of this got started. Basically, how health insurance worked in the US is that about 90% of people get health insurance through their employer. This happened for two reasons: during the wage freezes around World War II, companies started offering fringe benefits to get around it, and there is a standard tax deduction for companies to offer health insurance. Individuals cannot claim this deduction.
For the remaining 10%, about half of them buy insurance on the open market, which is really cheap and easy for people that are young and healthy, expensive for older people, and pretty much impossible if you have an existing condition.
The remaining 5% go uninsured either by choice or because they can't afford insurance at all. That doesn't mean they can't get health care, that just means they use free clinics and pay cash at places like urgent care centers.
The ACA made changes to the insurance market. Among the changes were new minimum requirements for what companies could sell as "health insurance". For example, even if you are a single 25-year-old male, you now have to pay for maternity coverage, mental health coverage, childhood mental health care, and other things that you're very unlikely to need. Further, health insurance is no longer allowed to have a cap on coverage, and companies are not allowed to charge old, sick people more than a small multiple of what they charge young and healthy people.
Mind you, a key campaign promise while passing the bill was that "if you like your health insurance you can keep it".
After the bill was passed in rules were promulgated, it turns out that if health insurance companies make any change at all in a plan (even changing the deductible by five dollars), then they are no longer able to offer the old plan and have to switch to a plan that qualifies.
This rule is resulting in millions of people having their health insurance canceled, and they are being forced to go on to the (nonworking) exchanges to buy health insurance that in most cases is much more expensive (if you're relatively healthy and young). New insurance results in you having to pick all new doctors, most likely, also.
So the main opposition comes from conservatives who oppose it on the grounds that government is interfering in the healthcare market, healthy people who are now being forced to pay sometimes more than twice as much, and young people who now get to subsidize the insurance of old people.
An additional philosophical objection comes from the individual mandate, which technically was upheld by the Supreme Court but many conservatives think that the Chief Justice had to contort himself into a pretzel to do it. Essentially, the ruling said that the government doesn't have the power to force you to buy something but they do have the ability, under the taxing power to tax you for not buying something. This was not written into the law, and the Supreme Court had to, in effect, change a clause in the law to make this work.
There is a populist opposition to the law because there are many large companies and labor unions (and Congress itself, including the president) that have been exempted from the law... And there are rumors that the president is going to further exempt certain well-connected labor unions from the tax on high-cost health plans.
There are legal objections to the law because the president decided to postpone a tax on employers that was written into the law. Many legal conservatives don't believe that the president has the power to rewrite portions of a law after it's been passed by Congress.
There are religious objections the law because it requires private companies run by very religious people to offer abortion and contraception coverage in the health insurance they offer their employees.
And finally, because the Democrats and the President decided to pass this law without any Republican votes (And using a questionable tactic called reconciliation that en...
>There is a populist opposition to the law because there are many large companies and labor unions (and Congress itself, including the president) that have been exempted from the law... And there are rumors that the president is going to further exempt certain well-connected labor unions from the tax on high-cost health plans.
How are they except? I am legitimately curious.
>There are religious objections the law because it requires private companies run by very religious people to offer abortion and contraception coverage in the health insurance they offer their employees.
It doesn't require health care plans to provide abortion services. States are allowed to offer plans that have abortion services, if there isn't a state law prohibiting it. However the "abortion" portion of the premium is collected separately, put in a separate account and is only allowed to be used for abortion services. Abortion coverage is completely "opt-in."
(i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED.—The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(i) collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment for each of the following:
(I) an amount equal to the portion of the premium to be paid directly by the enrollee for coverage under the plan of services other than services described in paragraph (1)(B)(i) (after reduction for credits and cost-sharing reductions described in subparagraph (A)); and
(II) an amount equal to the actuarial value of the coverage of services described in paragraph (1)(B)(i), and
(ii) shall deposit all such separate payments into separate allocation accounts as provided in subparagraph (C). In the case of an enrollee whose premium for coverage under the plan is paid through employee payroll deposit, the separate payments required under this subparagraph shall each be paid by a separate deposit.
(C) SEGREGATION OF FUNDS.—
(i) IN GENERAL.—The issuer of a plan to which subparagraph (A) applies shall establish allocation accounts described in clause (ii) for enrollees receiving amounts described in subparagraph (A).
(ii) ALLOCATION ACCOUNTS.—The issuer of a plan to which subparagraph (A) applies shall deposit—
(I) all payments described in subparagraph (B)(i)(I) into a separate account that consists solely of such payments and that is used exclusively to pay for services other than services described in paragraph (1)(B)(i); and
(II) all payments described in subparagraph (B)(i)(II) into a separate account that consists solely of such payments and that is used exclusively to pay for services described in paragraph (1)(B)(i).
Every single State in the Union has restrictions on insurance plans that cover abortion and some outlaw it completely. Full list can be seen here:
As to the abortion issue, it appears that I was slightly incorrect. The objection is mostly to the contraceptive mandate (free contraceptives for women). I still think there is some objection on the abortion issue, but frankly I'm not familiar with it so I can't say whether it's justified or not.
Nothing on the linked page says anything about "Congress is exempt."
Everything I've read on the subject says exactly the opposite, that Congress and their staff are forced to purchase healthcare from the Healthcare Exchanges.
The law’s final language on this, written by Sen. Tom Coburn, says that: “the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are — (I) created under this Act (or an amendment made by this Act); or (II) offered through an Exchange established under this Act.”
I admit that this may be a fuzzy edge case that I'm not completely familiar with, but I think the objection is not that Congress is completely exempt from the act but that the president had the executive branch issue a rule that allowed the government to subsidize congressional health plans, where this is not allowed in any other business.
This is technically separate from the waiver objection.
I know there's an objection here, so if you can find a reference to it I would appreciate the clarification.
While I personally am OK with the Affordable Care Act, and do not doubt for a second that many conservatives and libertarians are reveling in the troubles the federal healthcare exchange website has been facing, I do not for a second believe that it is due to a DDoS from people running this tool. I would be very surprised if this tool even existed before the exchange site was launched. It seems to be someone seeking attention after the fact, and here we are giving it to them.
NY's own health exchange received 10 million visits by evening of the first day. That seems like a lot of traffic for 20 million residents. As of Oct 28, only 37k people have enrolled in insurance. If the numbers are all true, the traffic seems fishy to me.
> I do not for a second believe that it is due to a DDoS from people running this tool.
Have you seen some of the discussions about the ACA? There are people out there who seem to genuinely believe that it will destroy America. I would expect a DDoS to be in the realm of things someone in that position would do.
Just, please, don't blame it on the Tea Party. We need them badly - at least until they finish fracturing the Republican Party. As for the Democrats - all in good time, my friends, all in good time.
I predicted things like this were being used. My rough logic is that when you see directly observible evidence of an entity (Republicans and/or Tea Party in Congress, or whatever you wish to label them) engaging in a DoS attack against the American people out in the open -- in the form of the repeated attempts to shutdown the Federal government and risk defaults, etc -- it's even easier to believe the same kinds of people will be arranging for DoS under the covers, through more shady means.
Not that I'm saying these DoS attacks are effective, or even a significant factor. I don't have enough data to know. But I have no doubt they were at least attempted.
We are talking about a government entity trying to tie together purposefully archaic data feeds from insurance companies, waterfall methodology, a myriad of different consulting companies, and changing requirements right up until the last month. ...and you are looking for a conspiracy?
You have made the mistake of assuming mutual exclusion when I for one did not. I am a software engineer and I do this professionally. I am fully aware of the kinds of technical issues, and procedurally issues, which can fully or at least even partially account for its woes. That was not my point. My point was pretty clear and I was very very careful with my exact wording, if you'd care to take a second look at my original comment you've attacked, and probably downvoted, erroneously.
165 comments
[ 4.9 ms ] story [ 263 ms ] threadWhoever wrote this was definitely older. Nobody under 35 knows Delphi ;)
Problem is not all of them are knowledgeable/interested enough to realise that what they're being taught is deprecated and not worth a lot.
http://www.elevatesoft.com/products?category=ewb&type=web
For example, coding a button event handler is just like it is in Visual Studio/Delphi - just double-click on the button in the form designer and you're in the code editor positioned inside of an empty event handler code block.
It's only "not worth a lot" if the only thing they're being taught is the specifics of the language. If they're being taught to program, then that skill is trivially transferrable to other languages.
Sorry, I don't buy that anyone would've written a custom application to DDoS a web site by slowly loading two relatively static pages on the site when there are a billion tools out there that will do the same thing far more effectively (see LOIC for just one popular example).
This almost seems like a false flag to make healthcare.gov into an innocent victim of a DDoS attack when as the original article says there is no evidence of an actual DDoS attack.
It wouldn't surprise me if healthcare.gov was very vulnerable to DDOS attacks - we are talking about a 2013 site which is hosted in a single data-center.
Otherwise you end up with unforeseen events, like a tornado taking out power, or a backhoe incident, or internet outages.
America you so crazy.
Thing is, the law has its issues, but the other side never gets near them, they just make shit up "death panels" and government interference and stuff. I, as an American, am super embarrassed by all this. It doesn't help that the health care companies wrote the fucking law, anyway... now they're fighting against it!
The sad truth is, unless we have a single-payer, socialized medical system, none of these changes will help much. Really, the biggest change the new law enacts is that it forces health care companies to cover people with pre-existing conditions like Diabetes and heart disease. Right now, they can tell you to go away, they won't cover that stuff. IN 2014, I hear they'll be forced to at least offer you a psychotically expensive plan if you have diabetes.... Ah, this country sucks ass.
"" Q: Will there be a limit as to how high a premium insurance companies can charge if you have a pre-existing condition?
A: Yes. As of 2014, insurers cannot charge consumers different rates for health insurance because of health status or gender.
You can be charged more for your age, however, with older people paying a higher premium than young people. But that increased charge is capped at no more than three times the standard rate"[1]
Edit: Actually "The law allows for differences of premiums based only on four criteria: age, location, family size, and smoking."[2], which seems like a good way to do racial profiling and increasing premiums on poor people(since they're probably less healthy), as expected in the u.s, but at least pre existing conditions couldn't be a basis for a rate difference.
I wonder thought how legal would be doing data mining with this information (an other free datatbases) , and how much deanonimization could be practically achieved ?
[1]http://www.webmd.com/health-insurance/health-reform-insuranc...
[2]http://ahip.org/Issues/January-1-2014-Provisions.aspx [1]http://www.webmd.com/health-insurance/health-reform-insuranc...
I believe we could fix health care costs by removing just one law.
Stop making health insurance a tax deductible employee benefit.
Think critically about the effect that small change would have and you'll see why our system is broken.
If your employer pays for your car insurance as a benefit, they pay for it with post tax dollars, so they don't do that.
So, employers pay the premium on your health care for the tax advantage. Now consider the how psychology behind not being the one who pays for the premium.
Do you care how much your services cost? No.
Do you care if the premium goes up? No.
Do you shop around for better insurance? No.
Do you care if you loose your job if you're sick? Hell yes.
In effect all normal market pressures are gone. No one who consumes resources cares about their costs because they're are completely disconnected from paying them or some derivative of them.
This is why doctors don't post prices.
While the net effect for people with employer provided health insurance is ever increasing rates, the effect on those people without health insurance is brutal. They are trying to enter a market that has no price pressure.
The ACA does remove that tax exemption, albeit partially. Every dollar above $10k or so ends up being taxed now. And not a small amount, either: the tax is to the tune of 40%. And since the cost of healthcare will continue to rise faster than inflation for the foreseeable future, more and more employer health plans are going to be hitting that number.
I'd certainly prefer the tax exclusion to disappear entirely, but the ACA is nothing if not an attempt to offer coverage to the poor and people with pre-existing conditions while doing the minimum possible to disrupt the healthcare market. That's why it's a bit of a Frankenstein: no one in their ideal world would have chosen the ACA as their ideal policy. But given the set of institutional actors and the setup of our government, it may well be the best that was possible. That's how the Obama administration thought of it, at least.
IIRC that tax was actually a pretty nasty fight between the Obama administration and labor unions, who get their members relatively good benefits and will be hit disproportionately by it. And you know what? The tax-free cap may well have been significantly lower with Republican input. But they chose to put 100% of their efforts into making a mediocre law fail than trying to turn it into a good or great one.
Apologies for the angry rant.
Employer premium contributions for employees and their opposite-sex spouses and tax dependents are 100% deductible as business expenses under federal and state tax law. This is true regardless of business type-sole proprietorship, partnership, LLC, corporation, etc. These rules also apply to owners of C corporations and LLCs classified as corporations for tax purposes. These business owners are considered to be employees of the business for purposes of the tax treatment of premium contributions.
http://healthcoverageguide.org/reference-guide/laws-and-righ...
http://www.healthaffairs.org/healthpolicybriefs/brief.php?br...
A 40 percent excise tax will be assessed, beginning in 2018, on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage). Health insurance issuers and sponsors of self-funded group health plans must pay the tax of 40 percent of any dollar amount beyond the caps that is considered "excess" health spending.
So, you cherry picked a bunch of stuff here.
1) Neglected to state it starts 4 years from now...a lot can happen in that time.
2) Neglected to state 10K limit is for individuals, 27K for families.
3) Confused excise tax and tax exemption.
I don't think anything here refutes my point or makes what I said incorrect.
I point out that the ACA did do that. Not enough to yours or my liking, but it did nonetheless.
Your response is to complain that it didn't go far enough. Sure. But the least you can do is recognize that the ACA certainly does do something in the spirit of what you were claiming no one had attempted. That doesn't mean you have to like the law as a whole.
Then you poke fun at "American idiots", and then admit in your last sentence that you don't really even know how the law works yourself.
Bonus points for picking the two conditions, heart disease and diabetes, that mostly result from poor choices instead of random innocent victims.
Your whole post is like a parody of pseudo-intellectual liberalism.
That part is still very much open for debate.
― C.S. Lewis
Yes, classic American culture tends to take rights violations very seriously, to the point that it may baffle those used to living under tyranny. Yes, many of us have a problem with the government commandeering the healthcare of 100% of the population just to "help" 3% of the population. Would have been cheaper, and far less disruptive, to just buy that 3% health insurance outright.
Obamacare has problems, but being targeted to just 3% of the population is not none of them. Are you completely free from anything that an insurance company might call a pre-existing condition? Do you plan to never be unemployed? Of so then congratulations, you might not personally benefit from healthcare reform of this type. Most Americans are not in that boat. Certainly more than 3%.
[citation needed]
In the meanwhile, I am perfectly healthy and will look both ways before crossing streets.
They should have just gone with full-on socialized health care like the rest of the civilized world... Would have been better for every party involved (except perhaps the insurance companies).
I've always thought of ObamaCare as the first step in the right direction. Hopefully many more steps follow shortly.
Yes, we're not "like the rest of the civilized world": this country was founded on valuing individual rights above the whims of the majority.
ETA: just because I'm opposed to one program doesn't mean I favor others. I'm just as opposed to "NSA, TSA, wars on terrorism and drugs and a thousand other programs" as I am to Obamacare. I'm not sure how you conclude that by opposing wasteful oppression in one area somehow means I'd be more tolerant of wasteful oppression in other areas.
If you're opposed to wasteful spending by NSA, TSA, wars on terrorism and drugs and a thousand other programs and Obamacare, where do you propose spending all those trillions?
I feel obliged to point out that America is already severely behind the rest of the developed world in those things.
This is why we fail so badly as a country.
Your right to previously underpay for health insurance had ended. Externalized costs are now being internalized. That's how insurance works; to spread risk across everyone. Now, if you're unhappy with that, I suggest either leaving the country or simply not paying for insurance and paying the IRS-imposed fine. You can then self-insure and absorb any of your healthcare costs yourself.
If you're an open-source participant, you may have experienced the power of what I've heard called adhocracy or do-ocracy. In it, we're all equal individuals; power is used situationally, in a bottom-up fashion, by those who are currently accomplishing something for the common good. In those contexts, top-down exercise of power feels very interfering.
The US's history includes a strong dose of that, plus a strong sense of individual liberty. Our country was born in rebellion to some far-away people who wanted to boss us around. Almost everybody here is descended from somebody who said, "Fuck this country; I'm outta here," and moved to America. One of our central civic documents, the Bill of Rights, basically lists all the things the federal government can't do. A giant chunk of our national mythos is bound up in westward expansion, where in a thinly populated frontier, the cowboy-hero did what he wanted and bowed to no man. Never mind that the era was short and the story more complicated; it's the idea that lives on.
Most of us who live in cities have long ago accepted the need for modest civic organization and collective action. We live too close to one another to be able to pretend that every man is an island. But even here, we tend to jealously guard our independence. Much more so in the suburbs and in rural America, where interdependence is harder to see.
Given all that, a demand that you buy health insurance can easily seem like (or be made to seem like) a crazy imposition from a far-off bureaucracy. Most other tax in the US is based on income, assets, or expenditures; if you aren't making/owning/spending anything, you don't have to pay. To some this feels like being dragged into participation in a society that they never particularly wanted to be part of.
All of that is intensified by several factors. A big one is the Republican party's strong shift rightward [1]. There is also a large segment on the right that has decided that the black guy with the funny name is not an American [2], making anything he does seem more like an imposition. Plus, there's a long tradition [3] of painting this as "us" (that is, white people) paying for "them" (black and brown people), even though the federal government actually shifts a lot of money from liberal states to conservative ones [4]. There are also strong streaks of anti-intellectualism and fundamentalist religion that play into this.
All that said, I agree it's kinda crazy when you take the bigger picture into account. America's health care system is a mess, costing way more than anybody else's, and leaving millions with little or no service. Something has to be done. This solution was actually a conservative one [5], and it's not like the American right has proposed anything better. It's not the solution I would have picked on my own, but given current American politics, I think it was the most achievable option.
Ok. That's more than you every wanted to know about America. Thanks for making it this far.
[1] http://voteview.com/images/polar_house_means.png [2] e.g., http://www.ocregister.com/totalbuzz/obama-469434-http-href.h... [3] http://en.wikipedia.org/wiki/Southern_strategy [4] http://www.economist.com/blogs/dailychart/2011/08/americas-f... [5] beauzero ↗ I haven't seen much "genuine" or "try" out of either party lately.
Ask people if they want universal affordable health care, and most people will discuss the issue. Ask people if they want Obamacare, and you instantly raise all sorts of issues that have nothing to do with health care.
Edit:
I agree with many of the responses here as well. The actual name, which I believe has ten titled parts [0], is a bit of marketing copy as well. But at least it's marketing copy that relates to the substance of the act.
Calling it Obamacare makes it personal, and this is about much more than Obama taking care of all of us.
I'd love to see a neutral name for the legislation itself. I am starting to call it "the current health care legislation".
[0] - http://www.hhs.gov/healthcare/rights/law/
A more apt analogy would be Bushtactics.
ETA: "Obamacare" is used because it's a catchy name which is both quite descriptive (Obama pushed this healthcare law thru, so he owns it) and is not inherently insulting (like "Bushoppression" or "Obamasux" mentioned elsewhere in this thread). Use of this popular nickname causes a frenzy because of its subject, not its inherent phrasing - it is not an ad-hominem attack.
[1] http://en.wikipedia.org/wiki/Backronym
Using your logic, you shouldn't call Social Security Social Security you should call it FDR Forced Set Asides. Because you know, nobody likes being forced by the government to set aside their hard earned cash by some politician, and one who's personally and solely responsible for that happening. And which has absolutely no upside to it at all, of course. But wait, that wouldn't be true. So people don't do that. They call it Social Security. Because that is it's name, and is less loaded, and more politically neutral.
Read some of the opposition to it. For many people it is not a neutral name.
So I meant during the polling... one name already had bias baked into it by using the word affordable rather than the word subsidized. Not many people are keen on subsidies when you call them subsidies. But if you just say something is now more affordable and don't tell people it is more affordable because it is subsidized, you have baked in a bias from the start. So naturally that bias is going to be reflected in more favorable polling results.
Facts:
Congressional majority voted in favor of it, then Obama signed it, turning it into the law of the land. All those individuals were voted into their jobs by the American people, by a majority of voters.
The Supreme Court then upheld it.
The same President who, as you said, pushed for it, and signed it into law, and who was the candidate of the very party which also comprised the overwhelming majority of the Congressional votes which turned it into law, was then chosen by a majority of voters to be re-elected as President for a second term.
Now, that law is starting to finally go fully into effect.
This is how government works. All the key players above were either elected directly (or put into place indirectly by the former) by a majority of American voters. Your side (I assume), lost. It happens. This is a democracy.
Unsurprisingly, the ensuing decrease of supply and increase in demand is making health plans more expensive for a lot of people.
So, "Obamacare" might be more accurate.
Constraint-free purchase of health insurance would mean that I could sell you health insurance that would 'insure' that you could only be doctored by me, on my yoga mat, with a chainsaw. Someone less principled than me would have the same idea --- or one like it --- and sell a billion innocent souls a false comfort and a dangerous service. So someone would. Like someone has already sold those same people fake food that's killing them.
Do you like alive citizens, or dead ones? The utopia you seek may be for the machines and the undertakers. And the undertakertrons.
http://www.propublica.org/article/answered-why-two-obama-loy...
My brother is a healthy, single, childless young college student who has a cheap, catastrophic plan to insure (aka share risk) for a major accident or major ailment (cancer, etc). He won't get to keep it after Dec 31st. Instead he'll have to pay a dramatically larger sum to offset risks that he doesn't have.
Unless your brother is immortal, he will eventually fall ill or suffer an accident. Such is the nature of life. Some people live long & healthy lives, others get cancer at 25. You simply cannot know the future. Shared risk, in the greater scheme of things, is preferable to the alternatives.
Do you think people should be able to own and have their own nuclear weapons? How about biological weapons? What about murder? Should that be legal?
If you said no, then you do agree there needs to be some "nanny state regulations". We only differ on where the line should be drawn.
When people "grow up", they realize that the general populace isn't too bright. The world is filled with nutjobs, idiots and crazies. People who are downright evil. People who are sociopaths. Letting the "free market" sort them out is a fairy tale for the young and children.
I don't mean to sound condescending or harsh, it's just that I was once a libertarian myself (in my early to mid twenties.) I came to realize what a horrible ideology it was and when you see people making the same mistake you made, you can't help but try to help that person out.
I'll let the results speak for themselves.
Childless men who are incapable of getting pregnant _must_ carry pregnancy coverage under Obamacare.
http://www.youtube.com/watch?v=zKsKExy-7B4
If you really want to be both more accurate and more true to your critiques, try something like "ExpensiveCare" or "ConstrainedSupplyCare" or "BubbleDemandCare" or something like that. I could even see critics attempting something like "UnfairCare", referencing the fact that young healthy people with incomes are now paying for old/unhealthy/indigent people's healthcare in addition to their own.
But "Obamacare" is silly, non-descriptive, purely partisan, and universally detracts from any conversation about it.
How does that follow?
I'm not so sure about the affordable part. Maybe all I see is people posting letters about their rates going up though. What is the argument against that from people who still support this legislation? Is it denied that prices have gone up in general or accepted and justified because of increased benefits on the plans?
http://www.rollingstone.com/politics/news/six-stories-of-oba...
http://www.motherjones.com/politics/2013/10/ted-cruz-obamaca...
http://www.huffingtonpost.com/2013/10/05/i-am-obamacare-_n_4...
Because you don't want to, it's as simple as that. If you were actually looking there's plenty of stories to find.
That what you see is not representative, because along with those I see plenty of people that could not get private insurance at any price (e.g., for whom the cost was infinite) due to preexisting conditions that can get health insurance because of the ACA.
> Is it denied that prices have gone up in general
For like benefits, costs have gone down since the ACA was introduced, in part because of parts of the ACA that went into effect earlier, like the limit on profits which required refunding excess premiums (because health insurance, even prior to the ACA, was not an ideal competitive market but an oligopolistic one in which rents were being extracted, and this was a limit on the rents that could be extracted.)
With the minimum benefit levels effective for non-grandfathered plans some low-cost, low-benefit plans are going away. This, on its own, would increase the minimum price of private insurance after this stage of implementation of the ACA above what it was prior to this stage of the implementation. In addition, changes to rules on what factors can be used in price setting have shifted costs so that, compared to what they would be without those rule changes, prices for plans for young, currently healthy individuals have gone up, while prices for everyone else have (again, considering only the effect of that rules change) gone down.
Expanding the size of risk pools as the mandate does should slightly reduce overall prices, but that may be a lagging effect since it can't be factored in fully without a clear picture of the magnitude and how many people will opt out in favor of paying the penalties for non-insurance.
Additionally, subsidies have been made available to people at the low end of the scale to which the individual mandate applies; this doesn't help with total costs (ignoring the effect that coverage vs. non-coverage has on total healthcare costs, which is significant in the long term, but not necessarily the short term) but does help with affordability.
Even moreso, except in states that opted out of it, Medicaid expansion means a lot of people are getting coverage with no out-of-pocket cost that could not afford any coverage before.
But, yes, the people that could afford insurance and who paid the least for the coverage they were getting because of youth and current health are often going to be paying more.
a data point:
I also see a lot of people talking about God and Jesus and how they have a personal relationship with them, etc, etc. Personally I've never seen them. I have a guess as to the status of things in those situations.
Also I see a lot of "people" saying how Justin Bieber is, "like, so cute. OMG. he's so hawt! and a genius! omg. like, amazing. omg. omg". So clearly, this must be factually true, correct?
I didn't say that. You shouldn't try to put words in someone else's mouth. I was mainly looking for some credible, unbiased facts. A lot of the positive anecdotes seem to be ignoring price reductions due to tax credits or something but I am not sure. Huffington Post's story has a family of 5 getting insurance for $100-something, while I see people saying their family went from like $600 to $1,000+.
I didn't say you said that. boggle
My point was to bring up the general phenomenon of:
-- some people are stupid
-- some people are ignorant (and/or draw conclusions from a very limited or ephemeral data set)
-- some people are liars
-- some people are malicious
-- some people spin
-- some "people", on the web, don't exist, or they're sock puppets
-- some people have subjective tastes ("Burgers taste bad." --> Therefore, all burgers taste bad for everybody. What?)
It's a controversial topic on its substance; the name does not change that either way.
[0] - http://www.policymic.com/articles/65625/why-americans-are-ok...
President Obama endorsed the nickname, saying, "I have no problem with people saying Obama cares. I do care."[2] Because of the number of "Obamacare" search engine queries, the Department of Health and Human Services purchased Google advertisements, triggered by the term, to direct people to the official HHS site.[3] In March 2012, the Obama reelection campaign embraced the term "Obamacare", urging Obama's supporters to post Twitter messages that begin, "I like #Obamacare because...".[4]
[1] http://en.wikipedia.org/wiki/Patient_Protection_and_Affordab...
[2] http://www.cbsnews.com/8301-503544_162-20092578-503544.html
[3] http://www.politico.com/blogs/bensmith/1210/HHS_buys_ObamaCa...
[4] http://thehill.com/blogs/blog-briefing-room/news/217893-obam...
Calling it Obamacare makes it personal, and this is about much more than Obama taking care of all of us.
I'd love to see a neutral name for the legislation itself. I am starting to call it "the current health care legislation".
[0] - http://www.hhs.gov/healthcare/rights/law/
Edit: copying this as an edit to my first post, but leaving this here in case anyone replies.
If you don't want healthcare then don't buy it and pay the fine (or refuse to pay the fine) just don't block others.
In any case, I think you're wrong. I think it's nice that there's a minimum standard for what 'insurance' should actually do. I think mandating certain minimal care coverage is critical in preventing people from being fleeced by super cheap plans that don't cover crap.
The (very good) reason to have minimum coverage requirements is to push people from burdening the acute care system (ERs). This is necessary in order to keep overall health costs in check. We cannot, as a society, continue to have people rely on ERs for their only care.
Some of the lavish coverage that is now required[1]: * Blood Pressure Screening * Blood Sugar (Diabetes) Screening * Cholesterol Screening
All of these things are precursors to chronic (expensive) conditions. It is much cheaper to manage these things before you develop heart disease or diabetes. Mandating coverage for these things is simply the smarter allocation of resources than treating the end-stage disease.
I mean just one example on a website that can be reviewed for accuracy, other than say fox.
http://www.nbcbayarea.com/news/health/SF-Couple-Kaiser-Healt...
As ck2 says, everything that's been tossed around (that I've seen) so far has been anecdotal, sensationalized, or flat out bogus. Will there be some hiccups? Of course. But they are the exception, not the rule.
http://www.propublica.org/documents/item/815691-kaiser2014be...
News at 10, health insurance companies are participating in shady business deals. I have absolutely no proof but they probably did some huge accounting for Obamacare and cancelled plans that they deemed less profitable rather than making some minor change in favor of those they thought they would make more money on using Obamacare as an excuse.
I have no qualms about using a program I was compelled to paid into, while considering I shouldn't have been compelled to pay into it and that I'm a prime example of what's wrong with the system. And yes, I've said "no" to comparable "here, take even more taxpayer money" programs.
The relationship between your neighbors and you is a matter solely between them and you. The government should not interfere. So, if for example your neighbor were to choose to rob your house, or murder a loved one, clearly, the government should not get involved.
When you're driving, that's a matter between you, your car, and perhaps the road. And your relationship with other drivers or pedestrians is solely up to you and them. You should all be able to do whatever you want and/or work out any disputes between each other as they come up. Laws would be pesky and just be government interference.
And by the way, as to your point about disrupting your insurance for reasons not relevant to your treatment. That's a big whoosh that misses the point of the ACA. The whole core point of the ACA was in reaction to private insurance companies which would deny or drop people who were seriously sick. Thus, effectively denying treatment, or forcing them to rely on rush-to-emergency-room treatment, rather than cheaper and less stressful preventative care, or experience catastrophic costs, which then either bankrupt them and/or get passed on to all other taxpayers and customers, against those others parties wishes, anyway. Making sure more people get more and better treatment, more consistently, is the whole point of the ACA. It's not perfect, nobody claims that. But it has a heck of a lot of objectively good elements which are pro-health.
Some industries do develop systemic defects, and it is appropriate for government to apply regulations to correct those. There is a vast difference between coming up with a regulation amounting to "you cannot drop coverage just because a case proves costly" or "you must accept pre-existing conditions for coverage-transferring customers by accepting them at exactly the same plan/cost as a current customer facing the same treatment costs", vs. taking over the entire industry and compelling a multitude of costly irrelevancies and disruptive non-sequiturs.
And you're missing a heck of a lot of objectively bad elements which are anti-health. The point of a discussion is to address both sides of the issue, not just loudly ignore the opposition's objections.
It turns out, some Americans don't want that same evil, incompetent, corrupt government controlling their healthcare.
The health care system was structured poorly before any of this got started. Basically, how health insurance worked in the US is that about 90% of people get health insurance through their employer. This happened for two reasons: during the wage freezes around World War II, companies started offering fringe benefits to get around it, and there is a standard tax deduction for companies to offer health insurance. Individuals cannot claim this deduction.
For the remaining 10%, about half of them buy insurance on the open market, which is really cheap and easy for people that are young and healthy, expensive for older people, and pretty much impossible if you have an existing condition.
The remaining 5% go uninsured either by choice or because they can't afford insurance at all. That doesn't mean they can't get health care, that just means they use free clinics and pay cash at places like urgent care centers.
The ACA made changes to the insurance market. Among the changes were new minimum requirements for what companies could sell as "health insurance". For example, even if you are a single 25-year-old male, you now have to pay for maternity coverage, mental health coverage, childhood mental health care, and other things that you're very unlikely to need. Further, health insurance is no longer allowed to have a cap on coverage, and companies are not allowed to charge old, sick people more than a small multiple of what they charge young and healthy people.
Mind you, a key campaign promise while passing the bill was that "if you like your health insurance you can keep it".
After the bill was passed in rules were promulgated, it turns out that if health insurance companies make any change at all in a plan (even changing the deductible by five dollars), then they are no longer able to offer the old plan and have to switch to a plan that qualifies.
This rule is resulting in millions of people having their health insurance canceled, and they are being forced to go on to the (nonworking) exchanges to buy health insurance that in most cases is much more expensive (if you're relatively healthy and young). New insurance results in you having to pick all new doctors, most likely, also.
So the main opposition comes from conservatives who oppose it on the grounds that government is interfering in the healthcare market, healthy people who are now being forced to pay sometimes more than twice as much, and young people who now get to subsidize the insurance of old people.
An additional philosophical objection comes from the individual mandate, which technically was upheld by the Supreme Court but many conservatives think that the Chief Justice had to contort himself into a pretzel to do it. Essentially, the ruling said that the government doesn't have the power to force you to buy something but they do have the ability, under the taxing power to tax you for not buying something. This was not written into the law, and the Supreme Court had to, in effect, change a clause in the law to make this work.
There is a populist opposition to the law because there are many large companies and labor unions (and Congress itself, including the president) that have been exempted from the law... And there are rumors that the president is going to further exempt certain well-connected labor unions from the tax on high-cost health plans.
There are legal objections to the law because the president decided to postpone a tax on employers that was written into the law. Many legal conservatives don't believe that the president has the power to rewrite portions of a law after it's been passed by Congress.
There are religious objections the law because it requires private companies run by very religious people to offer abortion and contraception coverage in the health insurance they offer their employees.
And finally, because the Democrats and the President decided to pass this law without any Republican votes (And using a questionable tactic called reconciliation that en...
How are they except? I am legitimately curious.
>There are religious objections the law because it requires private companies run by very religious people to offer abortion and contraception coverage in the health insurance they offer their employees.
It doesn't require health care plans to provide abortion services. States are allowed to offer plans that have abortion services, if there isn't a state law prohibiting it. However the "abortion" portion of the premium is collected separately, put in a separate account and is only allowed to be used for abortion services. Abortion coverage is completely "opt-in."
http://www.hhs.gov/asfr/of/finpollibrary/financialpolicies/s...
(1)(B) ABORTION SERVICES.—
(i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED.—The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(i) collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment for each of the following:
(I) an amount equal to the portion of the premium to be paid directly by the enrollee for coverage under the plan of services other than services described in paragraph (1)(B)(i) (after reduction for credits and cost-sharing reductions described in subparagraph (A)); and
(II) an amount equal to the actuarial value of the coverage of services described in paragraph (1)(B)(i), and
(ii) shall deposit all such separate payments into separate allocation accounts as provided in subparagraph (C). In the case of an enrollee whose premium for coverage under the plan is paid through employee payroll deposit, the separate payments required under this subparagraph shall each be paid by a separate deposit.
(C) SEGREGATION OF FUNDS.—
(i) IN GENERAL.—The issuer of a plan to which subparagraph (A) applies shall establish allocation accounts described in clause (ii) for enrollees receiving amounts described in subparagraph (A).
(ii) ALLOCATION ACCOUNTS.—The issuer of a plan to which subparagraph (A) applies shall deposit—
(I) all payments described in subparagraph (B)(i)(I) into a separate account that consists solely of such payments and that is used exclusively to pay for services other than services described in paragraph (1)(B)(i); and
(II) all payments described in subparagraph (B)(i)(II) into a separate account that consists solely of such payments and that is used exclusively to pay for services described in paragraph (1)(B)(i).
Every single State in the Union has restrictions on insurance plans that cover abortion and some outlaw it completely. Full list can be seen here:
https://www.aclu.org/maps/bans-insurance-coverage-abortion
As far as employer provided insurance, they mostly covered abortion before anyway...
The exemptions that I'm referring to are being referred to as "waivers", and you can see a itemized list and description of each type of waiver here: http://heartland.org/policy-documents/six-types-obamacare-wa...
As to the abortion issue, it appears that I was slightly incorrect. The objection is mostly to the contraceptive mandate (free contraceptives for women). I still think there is some objection on the abortion issue, but frankly I'm not familiar with it so I can't say whether it's justified or not.
Everything I've read on the subject says exactly the opposite, that Congress and their staff are forced to purchase healthcare from the Healthcare Exchanges.
This pages says:
http://www.factcheck.org/2013/05/congress-and-an-exemption-f...
The law’s final language on this, written by Sen. Tom Coburn, says that: “the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are — (I) created under this Act (or an amendment made by this Act); or (II) offered through an Exchange established under this Act.”
This is technically separate from the waiver objection.
I know there's an objection here, so if you can find a reference to it I would appreciate the clarification.
I guess Ars just finds it newsworthy, from a social perspective, that someone bothered to create this software.
The site was built poorly and political foes are also trying to ddos it.
Personally I think it would be nice if we had stronger laws and actual enforcement against ddos.
Have you seen some of the discussions about the ACA? There are people out there who seem to genuinely believe that it will destroy America. I would expect a DDoS to be in the realm of things someone in that position would do.
Not that I'm saying these DoS attacks are effective, or even a significant factor. I don't have enough data to know. But I have no doubt they were at least attempted.