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the_ignored
SFN Addict

2557 Posts

Posted - 01/31/2011 :  14:05:14  Show Profile Send the_ignored a Private Message  Reply with Quote
In a ruling by Federal Judge Roger Vinson it seems so.

The full text of the decision from Federal Judge Roger Vinson is not available yet, but according to reporters who've seen the decision, he's ruled the entire Patient Protection and Affordable Care Act unconstitutional. The ruling favors of the 26 state attorney generals challenging the law. The judge ruled the individual mandate that requires all Americans to purchase health insurance invalid and, according to the decision, "because the individual mandate is unconstitutional and not severable, the entire Act must be declared void."


Any idea what that means for you guys in the States?

Naturally, certain people are overjoyed:

Of course, now that the Republicans have judicial cover to kill Obamacare once and for all, they'll probably offer the Democrats a compromise in order to revive most of it.
.

I've asked before: Why even bother trying to compromise?


>From: enuffenuff@fastmail.fm
(excerpt follows):
> I'm looking to teach these two bastards a lesson they'll never forget.
> Personal visit by mates of mine. No violence, just a wee little chat.
>
> **** has also committed more crimes than you can count with his
> incitement of hatred against a religion. That law came in about 2007
> much to ****'s ignorance. That is fact and his writing will become well
> know as well as him becoming a publicly known icon of hatred.
>
> Good luck with that fuckwit. And Reynold, fucking run, and don't stop.
> Disappear would be best as it was you who dared to attack me on my
> illness knowing nothing of the cause. You disgust me and you are top of
> the list boy. Again, no violence. Just regular reminders of who's there
> and visits to see you are behaving. Nothing scary in reality. But I'd
> still disappear if I was you.

What brought that on? this. Original posting here.

Another example of this guy's lunacy here.

alienist
Skeptic Friend

USA
210 Posts

Posted - 01/31/2011 :  20:00:57   [Permalink]  Show Profile Send alienist a Private Message  Reply with Quote
Talk about an activist judge! There ar thousands of pages of the health care law of which the mandate that individual have to get insurance is just a part.
Being in medicine, I see a lot of what is wrong with US medicine. it is discouraging. So many of our politicians bury their heads in the sand. I guess as long as they have their federal health insurance...
there was an article recently (I forget where) explaining how the "founding fathers" would be supportive of the health care reform law.

The only normal people are the ones you don't know very well! - Joe Ancis
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alienist
Skeptic Friend

USA
210 Posts

Posted - 01/31/2011 :  20:17:40   [Permalink]  Show Profile Send alienist a Private Message  Reply with Quote
I found the article on the founding fathers and "socialized medicine."
It is on Forbes magazine website
by Rich Ungar
http://blogs.forbes.com/rickungar/2011/01/17/congress-passes-socialized-medicine-and-mandates-health-insurance-in-1798/

To add insult to injury (or injury to insult), tea party nut, Michelle Bachman, is trying to decrease funding to the VA health system. Someone needs to send her to Afghanistan or even just boot camp.

The only normal people are the ones you don't know very well! - Joe Ancis
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Robb
SFN Regular

USA
1223 Posts

Posted - 01/31/2011 :  22:07:42   [Permalink]  Show Profile Send Robb a Private Message  Reply with Quote
Originally posted by alienist

I found the article on the founding fathers and "socialized medicine."
It is on Forbes magazine website
by Rich Ungar
http://blogs.forbes.com/rickungar/2011/01/17/congress-passes-socialized-medicine-and-mandates-health-insurance-in-1798/

To add insult to injury (or injury to insult), tea party nut, Michelle Bachman, is trying to decrease funding to the VA health system. Someone needs to send her to Afghanistan or even just boot camp.
But they still had a choice. They were not required to pay just because they existed. If they did not want to pay they could have quit. With the healthcare bill you have to pay just becasue you exist.

If the federal government can order its citizens to buy health care, why can't it mandate you to buy a gym membership, eat no more than a certain amount of calories or abort that down sybdrome baby you are going to have because these will lessen the burden on the healthcare system.

If the health care bill is constitutional then why can't the government mandate anything it wants?



Also,

He also issued an injunction that I bet President Obama will not follow. http://www.marklevinshow.com/goout.asp?u=http://citadelcc.vo.llnwd.net/o29/network/Levin/MP3/ShowAudio/Florida-Healthcare-Summary-Judgment.pdf page 75

(5) Injunction
The last issue to be resolved is the plaintiffs’ request for injunctive relief
enjoining implementation of the Act, which can be disposed of very quickly.
Injunctive relief is an “extraordinary” [Weinberger v. Romero-Barcelo, 456
U.S. 305, 312, 102 S. Ct. 1798, 72 L. Ed. 2d 91 (1982)], and “drastic” remedy
[Aaron v. S.E.C., 446 U.S. 680, 703, 100 S. Ct. 1945, 64 L. Ed. 2d 611 (1980)
(Burger, J., concurring)]. It is even more so when the party to be enjoined is the
federal government, for there is a long-standing presumption “that officials of the
Executive Branch will adhere to the law as declared by the court. As a result, the
declaratory judgment is the functional equivalent of an injunction.” See Comm. on
Judiciary of U.S. House of Representatives v. Miers, 542 F.3d 909, 911 (D.C. Cir.
2008); accord Sanchez-Espinoza v. Reagan, 770 F.2d 202, 208 n.8 (D.C. Cir.
1985) (“declaratory judgment is, in a context such as this where federal officers
are defendants, the practical equivalent of specific relief such as an injunction . . .
since it must be presumed that federal officers will adhere to the law as declared
by the court”) (Scalia, J.) (emphasis added).
There is no reason to conclude that this presumption should not apply here.
Thus, the award of declaratory relief is adequate and separate injunctive relief is
not necessary.


Edited to add:

‘If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house, - Senator Obama 2008.

Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master. - George Washington
Edited by - Robb on 01/31/2011 22:15:01
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Dave W.
Info Junkie

USA
26001 Posts

Posted - 01/31/2011 :  23:18:52   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Robb

If the federal government can order its citizens to buy health care...
It's been doing so for years, in the form of taxes which pay for Medicare, Medicaid, the VA, etc..
...why can't it mandate you to buy a gym membership, eat no more than a certain amount of calories or abort that down sybdrome baby you are going to have because these will lessen the burden on the healthcare system.
If it can order you to pay taxes, why can't it order you do any of the things you mention? Get enough votes in Congress for it, and the FBI could be tasked with enforcing monthly bestiality.
If the health care bill is constitutional then why can't the government mandate anything it wants?
I'd be asking that question about the USA PATRIOT Act, which directly and indisputably contravenes some our civil rights, but which was inexplicably re-authorized by a Democratic Congress.
‘If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house, - Senator Obama 2008.
You definitely won't see an argument from me against the idea that mandated health insurance is a dumb idea, since I think that health insurance itself is a dumb idea, and that health care should be provided by the government, like it is more cheaply and more effectively by many European countries (and Canada, and Japan, etc.).

The 2008 Obama quote says that he knew it was a dumb idea long ago, so the real question is why did he offer it up at all? The answer would be that he knew that better health-care programs wouldn't gather any votes from conservative Democrats, but the political environment demanded that he do something. The whole legislative climate is utterly toxic, since our elected officials are much more concerned with getting re-elected than with doing what's right. Lose the backing of the health-insurance and pharmaceutical lobbies (which nationalizing health care would do), and your political career will be dead. You'd have to find 218 Representatives, 60 Senators and one President who'd be willing to commit political suicide before a bill mandating socialized medicine would pass.

But still, it needs to happen. And the sooner, the better. Things are just insane when a US hospital feels free to bill an insurance company 900% more for a simple anesthetic than the UK government pays for it.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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Kil
Evil Skeptic

USA
13462 Posts

Posted - 02/01/2011 :  00:03:10   [Permalink]  Show Profile  Visit Kil's Homepage  Send Kil an AOL message  Send Kil a Yahoo! Message Send Kil a Private Message  Reply with Quote
Even the public option would have been better, and would not have required 100 percent compliance because it would have pressured privet insurance companies to be competitive against a non profit. But noooo. So what's left? Compele those who are less likely to get sick and less likely to buy health insurance to buy health insurance to offset the cost from those who cause insurance companies to actually have to pay out. End cherry picking. That's the only way left to bring down health care costs in a country that absolutely refuses to do the sane thing, single payer, or the runner up, a public option.

There is plenty of precedence for compelling Americans to pay for things whether they like it or not. But really, Robb. The conservatives were not cool with any other way and they aren't cool with this. In other words, the Right is not cool with the idea that healthcare access for all Americans is a human right. And because of that, the blue dogs and the whole of the Republican party disgusts me. I am so sick of the idea that personal freedom will be damaged if all Americans have equal access to medical care. I'm tired of the cowboy mentality that makes what should be a human right a privilege for those who never get sick, or for those who can afford to pay outrageous premiums to have access.

Dave is right. A single payer system is the right way to go. But to attack even this flawed way to bring down healthcare costs is despicable. Protect someone else's freedoms because I want access to healthcare, and I don't really care if that means some healthy people will be forced to buy insurance. How selfish is too selfish, Robb? Given what the conservatives really want, it will not be long, if they get their way, before we are stepping over dead bodies on the street. (We already are...)

And yeah, Europe and Canada's healthcare systems may not be perfect, but to my thinking they are far more civilized than what we have here.

And then there is the hypocrisy of the right, considering that what you guys call "Obamacare" was a Republican idea. Almost the whole plan was suggested by Republicans as an answer to the Clinton healthcare plan. At the time, both plans were considered unacceptable. But it was conservatives who came up with the idea that all Americans should be compelled to buy health insurance. Now they scream "unconstitutional" and "socialism" because it works for them politically. What a bunch of lying heartless hypocritical bastards the conservatives are...


Uncertainty may make you uncomfortable. Certainty makes you ridiculous.

Why not question something for a change?

Genetic Literacy Project
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Ebone4rock
SFN Regular

USA
894 Posts

Posted - 02/01/2011 :  05:29:29   [Permalink]  Show Profile Send Ebone4rock a Private Message  Reply with Quote
I dunno what should be done. I'm no economist or anything but it seems to me that it is the health insurance companies themselves that are the cause of over-inflated health care costs. I remember when I was a kid we had health insurance but that was only used for major things like when my Grandad got cancer. The rest of the time when we went to the doctor my Granny wrote them a check when we were doen....PAID IN FULL!
The major thing that makes me think this way is that a couple of years ago my wife and I had to go a number of months without insurance. During that time my wife had to go in for a CT scan. We got a $2500 bill for the CT scan. We made payment arrangements and paid it off. This year my wife had to go in for another CT scan, this time with insurance. We got our insurance statement and found that the price of the CT scan was still $2500 but it was discounted for the insurance company. They paid only $600!
So why cant the middle man (insurance companies) get the fuck out of it? Here's what I want. I want the hospitals to charge a reasonable amount so that we can afford just pay as we go, right to the hospital itself. We can have health insurance that covers major medical expenses but all I want is to be able to afford to pay as we go. Most years we pay considerably more in health insurance premiums that we actually use.
I am fully aware that this is merely anecdotal evidence but it sure makes sense to me.

Haole with heart, thats all I'll ever be. I'm not a part of the North Shore society. Stuck on the shoulder, that's where you'll find me. Digging for scraps with the kooks in line. -Offspring
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Kil
Evil Skeptic

USA
13462 Posts

Posted - 02/01/2011 :  11:13:52   [Permalink]  Show Profile  Visit Kil's Homepage  Send Kil an AOL message  Send Kil a Yahoo! Message Send Kil a Private Message  Reply with Quote
Originally posted by Ebone4rock

I dunno what should be done. I'm no economist or anything but it seems to me that it is the health insurance companies themselves that are the cause of over-inflated health care costs. I remember when I was a kid we had health insurance but that was only used for major things like when my Grandad got cancer. The rest of the time when we went to the doctor my Granny wrote them a check when we were doen....PAID IN FULL!
The major thing that makes me think this way is that a couple of years ago my wife and I had to go a number of months without insurance. During that time my wife had to go in for a CT scan. We got a $2500 bill for the CT scan. We made payment arrangements and paid it off. This year my wife had to go in for another CT scan, this time with insurance. We got our insurance statement and found that the price of the CT scan was still $2500 but it was discounted for the insurance company. They paid only $600!
So why cant the middle man (insurance companies) get the fuck out of it? Here's what I want. I want the hospitals to charge a reasonable amount so that we can afford just pay as we go, right to the hospital itself. We can have health insurance that covers major medical expenses but all I want is to be able to afford to pay as we go. Most years we pay considerably more in health insurance premiums that we actually use.
I am fully aware that this is merely anecdotal evidence but it sure makes sense to me.

A very big problem is that health care providers accept hugely discounted payments from insurance companies, but if I get sick, I'm billed the full amount. I suppose it's because even if I paid the discounted rate, many people still wouldn't pay the bill because they can't afford to. So the health providers make it up by charging full price. Being insured means a guaranteed payment from the insurance company.

What I don't understand is why there aren't any non profit insurers out their. They could cut the same deals with healthcare providers but not be beholden to share holders for huge profits. But then, maybe the incentive isn't there. But I know people who work for non profits and they get nice salaries and still provide a valuable service at a lower cost than the for profit alternatives. Maybe the startup costs are too high. I dunno. That's what the public option was supposed to be. And it would have had the feds help with startup even though it would not have been federally operated.

But yeah. I have seen the bills from my hospitalizations and they were huge. The insurance companies paid a small percentage of what was billed. Had I no insurance, bankruptcy would have been the only way out for me. (That could happen to me because I am currently not insured and uninsurable unless I pay a huge amount every month.) And if I were to get cancer, I suppose I would be just left to die. (Interestingly, liars like Bachmann talked about death panels. You know what a death panel is? It's our current system!

I know Dave likes to place most of the blame on the blue dogs. But I like to spread it around more. I mean, really, if there were only a few hearts beating among the Republicans, we wouldn't have required the blue dog vote. What happened to the party that had at least two presidents try to reform healthcare? The Republicans now are not the Republicans of old. They continue to purge their party of moderate Republicans. Just look at how John McCain has sold out every principal he ever had and is now just a conservative brown nose.

The moderates of today were the conservatives of yesterday. It's a sad thing to watch. The John Birch society was once considered too far right and a fringe group. Now their thinking is almost mainstream Republican. Sensible guys (on some issues) like Robb don't even realize how far right his party has become. (Perhaps he lacks the historical perspective that I have. I dunno...) If Robb ran, his party would not support him. Hell, even Nixon tried to push through healthcare reform.

The lunatics have taken over the asylum...


Uncertainty may make you uncomfortable. Certainty makes you ridiculous.

Why not question something for a change?

Genetic Literacy Project
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alienist
Skeptic Friend

USA
210 Posts

Posted - 02/01/2011 :  12:06:03   [Permalink]  Show Profile Send alienist a Private Message  Reply with Quote
There are so many problems with the US healthcare system, I don't know where to start.
Individual insurance mandate: Because not every one has insurance, that means hospitals charge more to make up for people who cannot pay. Ideally, if everyone had insurance, this will decrease the cost for everyone. I think a lot of people want health insurance but just can't afford it. But if you can afford it, it is just stupid to not have health insurance. Of course, making everyone have health insurance will not solve all the problems

Insurance regulation: for example, the law ensures that insurances don't spend more than 20% of income on administrative costs. Medicare has only a 3% administrative cost. Unfortunately, insurance companies will try to get around a lot of regulation. There are some non-profit insurance companies in the US, but the US is the only country that has for profit insurance companies

Single payer system may not work for the US. Part of the reason but other countries have come up with different systems. I think Germany requires their people to buy health insurance but they have a choice of which insurance co. There is enough competition that people can get what they want. In the US, you have to choose what your employer offers.

The most important thing for the US to do is to take the profit motive out of medicine. But this may be impossible because nobody wants to give up any money at all

I could go on and on, but I have to get back to work. Health care reform law is less than perfect, but doing nothing will bankrupt the country more quickly.

The only normal people are the ones you don't know very well! - Joe Ancis
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Ebone4rock
SFN Regular

USA
894 Posts

Posted - 02/01/2011 :  12:10:45   [Permalink]  Show Profile Send Ebone4rock a Private Message  Reply with Quote
So here's my solution.

Eliminate the current insurance companies.

Restructure the insurance industry so that insurance is mainly for high cost procedures rather than for every little thing a person goes to the doctor for.

Get the hospitals to charge reasonable prices directly to the patients.

Patient goes to the doctor and writes them a motherfucking check for reasonably priced health care. This eliminates the need for all of the nosensical middle people in the insurance industry.

Insurance company people go out and get real jobs doing real things rather than doing all of the unnecessary paper shuffling that they currently do.

Government charges a tax that funds a health care program for the people who need it.

Problem solved.


Haole with heart, thats all I'll ever be. I'm not a part of the North Shore society. Stuck on the shoulder, that's where you'll find me. Digging for scraps with the kooks in line. -Offspring
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alienist
Skeptic Friend

USA
210 Posts

Posted - 02/01/2011 :  13:35:38   [Permalink]  Show Profile Send alienist a Private Message  Reply with Quote

this may be the wrong forum for the following but it is amusing

Diagnostic Criteria for PIISD – Private Insurance Induced Stress Disorder By Carol A. Paris, MD | October 28, 2010
Dr Paris is a member of the Maryland Chapter of Physicians for a National Health Program and a board certified adult psychiatrist in private practice in Leonardtown, Maryland.

----------------------------------------------------------------------


The essential feature of private insurance induced stress disorder (PIISD) is the development of characteristic symptoms following exposure to an insurance-induced traumatic stressor involving direct personal experience of an event or witnessing an event that threatens another person. Traumatic events include, but are not limited to, recission of health insurance after developing a costly illness, denial of health insurance due to a pre-existing condition such as being female and fertile or delay of needed treatment or medication due to requirements for pre-authorization. In the case of physicians, traumatic events include witnessing the deterioration of patients due to financial ruin resulting from uncovered costs of care. Similar to some forms of PTSD, this disorder is prone to be severe because the stressor is of human/corporate design. Note: this diagnosis is not currently reimbursed by health insurance carriers.

Diagnostic criteria for PIISD include a history of exposure to a traumatic insurance-induced event meeting the following criteria and symptoms:

Criterion A: The person has been exposed to a traumatic insurance-induced event in which both of the following have been present:

• The person has experienced a health insurance traumatic event, due either to lack of access to health insurance, or due to failure of their health insurance to meet their health care needs. (NOTE: in the case of physicians/providers, the trauma is based on the inability to provide needed care to one’s patients, or doing so at one’s personal expense, ie, free care and/or oppressive paperwork burdens).
• The person’s traumatic response involved intense fear, helplessness, anger, and confusion and was caused by financial considerations that seriously complicate their (or their patient’s) medical treatment and recovery.


Criterion B: The traumatic event is persistently reexperienced in one (or more) of the following ways:

• Feelings of anger, frustration, and shame at the thought of one’s inability to access (or provide) needed care.
• Feelings of alienation from and abandonment by one’s countrymen and elected officials, precipitated by exposure to any form of corporate-controlled news media coverage of the health care crisis.
• Feelings of inadequacy, as an individual, as a family member, or as a physician/provider, due to the repeated inability to obtain needed care for oneself, one’s family member, or one’s patient.
• Avoidance of seeking, or providing, needed care due to fear of serious financial strain or even bankruptcy.
• Fear of an acute confusional state or other cognitive disorder following attempts to understand one’s EOBs (explanation of benefits).

Criterion C: Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, as indicated by three or more of the following:

• Efforts to avoid thoughts, feelings or conversations about anything related to health insurance or healthcare.
• Efforts to avoid interactions with physicians, hospitals or health care centers that arouse recollection of the trauma. In the case of physicians, efforts to avoid patients who are experiencing health insurance trauma.
• Markedly diminished interest or participation in significant activities.
• Feelings of detachment or estrangement from others.
• Restricted range of affect (eg, unable to experience feelings of wellbeing)
• Sense of foreshortened future (eg, does not expect to have a career, marriage, children, or a normal life span). In the case of physicians, does not expect to remain in practice, anticipates early retirement or disability due to consequences of health insurance trauma.

Criterion D: Persistent symptoms of increased arousal, as indicated by two or more of the following:

• Difficulty falling or staying asleep, due to intrusive thoughts about the health insurance trauma.
• Irritability or outbursts of anger. In the case of physicians, this often results in sanctions, possible loss of hospital privileges, and being labeled a “disruptive physician.” In the case of patients, it often results in suspiciousness directed at one’s physician, often being labeled a “difficult patient.”
• Difficulty concentrating, resulting in functional impairment and further jeopardizing career, health, and sense of wellbeing.
• Hypervigilance, (eg, won’t let children play on playground equipment for fear of minor injury resulting in possible retraumatizing need to interact with one’s health insurance company).

Criterion E: The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.


The only normal people are the ones you don't know very well! - Joe Ancis
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Robb
SFN Regular

USA
1223 Posts

Posted - 02/01/2011 :  14:09:16   [Permalink]  Show Profile Send Robb a Private Message  Reply with Quote
Originally posted by Kil

That's the only way left to bring down health care costs…
Do you really think there is only one way to bring down health care costs?

Originally posted by Kil
There is plenty of precedence for compelling Americans to pay for things whether they like it or not. But really, Robb. The conservatives were not cool with any other way and they aren't cool with this. In other words, the Right is not cool with the idea that healthcare access for all Americans is a human right.
Where you get the fact that health care is a human right? I think all people should have access to health care but if we want it to be a right then maybe we need to amend the constitution. What other right forces the government to spend trillions of dollars.

Also saying the conservatives want no other way is a lie. They have proposed many alternatives but the democrat congress would not allow them to be discussed.

Originally posted by Kil
And because of that, the blue dogs and the whole of the Republican party disgusts me. I am so sick of the idea that personal freedom will be damaged if all Americans have equal access to medical care. I'm tired of the cowboy mentality that makes what should be a human right a privilege for those who never get sick, or for those who can afford to pay outrageous premiums to have access.
So there are only people paying outrageous premiums for healthcare? There are millions of Americans paying reasonable premiums for healthcare. Why do you think that this health care bill will bring down costs? It has only increased costs so far.

Originally posted by Kil
Given what the conservatives really want, it will not be long, if they get their way, before we are stepping over dead bodies on the street. (We already are...)
Whatever. You can do what most liberals do and demonize conservatives. Yes, we conservatives want all children, women, old people cancer patients etc to die. The faster the better I say. I am tired of the vicious lies you liberals say about conservatives. Can’t you understand that conservatives more or less want the same things liberals want; they just don’t think government strong-arm tactics are the moral way. Why do conservative people give more to charity than liberals do (a lot more). You have no idea how much I or most conservatives give to others. I have given a large percent of my income to others, many with health care bills they cannot pay, through my church or directly to the needy people themselves. Most of the conservative people I know have given so much, that like myself have really no retirement savings or much savings at all. And guess what, I am not special. I am just one of millions, sacrificing to help people with healthcare bills and other needs. If someday I need help with healthcare bills then I hope others will do the same for me and I would rather get help from individuals than from the government. If you want to lie and call us callus murderers then that’s on your conscience, but that won’t stop me from helping others when I can. Conservatives want health care reform and want all people to have coverage, but we disagree on how it should be done.
Originally posted by Kil
And then there is the hypocrisy of the right, considering that what you guys call "Obamacare" was a Republican idea. Almost the whole plan was suggested by Republicans as an answer to the Clinton healthcare plan. At the time, both plans were considered unacceptable. But it was conservatives who came up with the idea that all Americans should be compelled to buy health insurance. Now they scream "unconstitutional" and "socialism" because it works for them politically. What a bunch of lying heartless hypocritical bastards the conservatives are...
Just like the liberals are as well. This argument does not fly but you keep trying. If the republicans were once for child abuse and now they are not then would they be hypocritical bastards?

Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master. - George Washington
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Robb
SFN Regular

USA
1223 Posts

Posted - 02/01/2011 :  14:11:52   [Permalink]  Show Profile Send Robb a Private Message  Reply with Quote
Originally posted by alienist


this may be the wrong forum for the following but it is amusing

Diagnostic Criteria for PIISD – Private Insurance Induced Stress Disorder By Carol A. Paris, MD | October 28, 2010
Dr Paris is a member of the Maryland Chapter of Physicians for a National Health Program and a board certified adult psychiatrist in private practice in Leonardtown, Maryland.

----------------------------------------------------------------------


The essential feature of private insurance induced stress disorder (PIISD) is the development of characteristic symptoms following exposure to an insurance-induced traumatic stressor involving direct personal experience of an event or witnessing an event that threatens another person. Traumatic events include, but are not limited to, recission of health insurance after developing a costly illness, denial of health insurance due to a pre-existing condition such as being female and fertile or delay of needed treatment or medication due to requirements for pre-authorization. In the case of physicians, traumatic events include witnessing the deterioration of patients due to financial ruin resulting from uncovered costs of care. Similar to some forms of PTSD, this disorder is prone to be severe because the stressor is of human/corporate design. Note: this diagnosis is not currently reimbursed by health insurance carriers.

Diagnostic criteria for PIISD include a history of exposure to a traumatic insurance-induced event meeting the following criteria and symptoms:

Criterion A: The person has been exposed to a traumatic insurance-induced event in which both of the following have been present:

• The person has experienced a health insurance traumatic event, due either to lack of access to health insurance, or due to failure of their health insurance to meet their health care needs. (NOTE: in the case of physicians/providers, the trauma is based on the inability to provide needed care to one’s patients, or doing so at one’s personal expense, ie, free care and/or oppressive paperwork burdens).
• The person’s traumatic response involved intense fear, helplessness, anger, and confusion and was caused by financial considerations that seriously complicate their (or their patient’s) medical treatment and recovery.


Criterion B: The traumatic event is persistently reexperienced in one (or more) of the following ways:

• Feelings of anger, frustration, and shame at the thought of one’s inability to access (or provide) needed care.
• Feelings of alienation from and abandonment by one’s countrymen and elected officials, precipitated by exposure to any form of corporate-controlled news media coverage of the health care crisis.
• Feelings of inadequacy, as an individual, as a family member, or as a physician/provider, due to the repeated inability to obtain needed care for oneself, one’s family member, or one’s patient.
• Avoidance of seeking, or providing, needed care due to fear of serious financial strain or even bankruptcy.
• Fear of an acute confusional state or other cognitive disorder following attempts to understand one’s EOBs (explanation of benefits).

Criterion C: Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, as indicated by three or more of the following:

• Efforts to avoid thoughts, feelings or conversations about anything related to health insurance or healthcare.
• Efforts to avoid interactions with physicians, hospitals or health care centers that arouse recollection of the trauma. In the case of physicians, efforts to avoid patients who are experiencing health insurance trauma.
• Markedly diminished interest or participation in significant activities.
• Feelings of detachment or estrangement from others.
• Restricted range of affect (eg, unable to experience feelings of wellbeing)
• Sense of foreshortened future (eg, does not expect to have a career, marriage, children, or a normal life span). In the case of physicians, does not expect to remain in practice, anticipates early retirement or disability due to consequences of health insurance trauma.

Criterion D: Persistent symptoms of increased arousal, as indicated by two or more of the following:

• Difficulty falling or staying asleep, due to intrusive thoughts about the health insurance trauma.
• Irritability or outbursts of anger. In the case of physicians, this often results in sanctions, possible loss of hospital privileges, and being labeled a “disruptive physician.” In the case of patients, it often results in suspiciousness directed at one’s physician, often being labeled a “difficult patient.”
• Difficulty concentrating, resulting in functional impairment and further jeopardizing career, health, and sense of wellbeing.
• Hypervigilance, (eg, won’t let children play on playground equipment for fear of minor injury resulting in possible retraumatizing need to interact with one’s health insurance company).

Criterion E: The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.


Please, this could be said about anything in life that causes stress like trying to pay bills each month. Life has worries, period.

Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master. - George Washington
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Kil
Evil Skeptic

USA
13462 Posts

Posted - 02/01/2011 :  15:49:48   [Permalink]  Show Profile  Visit Kil's Homepage  Send Kil an AOL message  Send Kil a Yahoo! Message Send Kil a Private Message  Reply with Quote
Robb:
Also saying the conservatives want no other way is a lie. They have proposed many alternatives but the democrat congress would not allow them to be discussed.

Name any plan by the Republicans (other than tort reform, because it's on the table and it doesn't amount to much) that would get most of the 50 million who are without access to health insurance insured or give them access to affordable healthcare. Name them please.
Robb:
Where you get the fact that health care is a human right?

I think it is a human right because almost everyone gets sick. Just like food and shelter, it should be a right, not a privilege. And as I understand it, the plan would actually reduce spending.
Robb:
There are millions of Americans paying reasonable premiums for healthcare. Why do you think that this health care bill will bring down costs? It has only increased costs so far.

The self employed and their families are in deep trouble. I can't afford what is available to me. Dig this. $1500 a month with a $3000 deductible after which it pays 80%. And that's one of the best rates available to me. What about us Robb? We are the 50 million...

And this plan has just given small business a tax break in order to offer healthcare to their workers. Yes, I know some people are paying a reasonable rate, but those plans are out of reach for millions of us. Why? Why should that be??? I'm uninsurable unless I go to work for a company that offers health insurance. It's a simple as that.

As for the increased costs, that should be looked into by congress. Because the insurers are turning in record profits. As long as we don't control what they do, we have the fox guarding the hen house. The plan doesn't kick in fully until 1214. They are trying to make as much as they can in the meantime. NO, let me say it again, NO healthcare provider should be profit driven. That's a big part of the problem.
Robb:
Can’t you understand that conservatives more or less want the same things liberals want; they just don’t think government strong-arm tactics are the moral way.

But they are in bed with the insurance industry. So they don't want what you call "strong arm tactics" to mess with their money machine. Dave was correct about that too.

Robb:
Why do conservative people give more to charity than liberals do (a lot more).

Source.

And what you do is not relevant to this discussion. Charity will not solve the healthcare crisis in this country.
Robb:
If you want to lie and call us callus murderers then that’s on your conscience...

I'm calling your party callus murderers. I think individuals like you are being led around by the lies of your leaders. No, they don't want to die of cancer. But they have health insurance...
Robb:
If the republicans were once for child abuse and now they are not then would they be hypocritical bastards?

So it wasn't socialism or unconstitutional when they proposed it? Or it was and they knew it? Or did it just suddenly dawn on them that it's a bad idea that's both socialistic and unconstitutional?

You know what the difference really is Robb? It's that at that time they were facing a possibility of a single payer system, so they came up with a plan that would keep their benefactors in business. That's it. It's all politics Robb. It's not as though they saw the light or the error of their ways. That's just silly.

Too bad Obama and congress didn't go after a single payer system. That's what liberals really want, you know. Perhaps if they had, we wouldn't have wound up with the Republican plan that the Republicans are now calling socialist and unconstitutional. Maybe if they had, the Republicans would have offered up Republicare. And it would have looked just like Obamacare...

Uncertainty may make you uncomfortable. Certainty makes you ridiculous.

Why not question something for a change?

Genetic Literacy Project
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H. Humbert
SFN Die Hard

USA
4574 Posts

Posted - 02/01/2011 :  16:20:36   [Permalink]  Show Profile Send H. Humbert a Private Message  Reply with Quote
Originally posted by Robb
Where you get the fact that health care is a human right? I think all people should have access to health care but if we want it to be a right then maybe we need to amend the constitution.
The Constitution already guarantees "life, liberty, and the pursuit happiness" as inalienable rights. A strong argument could be made that having no access to health care violates the right to life.

What other right forces the government to spend trillions of dollars.
Uh, off the top of my head, the right to due process (it would be so much cheaper if the government could do away with the cumbersome court system and simple throw people in jail without a trial).


"A man is his own easiest dupe, for what he wishes to be true he generally believes to be true." --Demosthenes

"The first principle is that you must not fool yourself - and you are the easiest person to fool." --Richard P. Feynman

"Face facts with dignity." --found inside a fortune cookie
Edited by - H. Humbert on 02/01/2011 16:20:57
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Robb
SFN Regular

USA
1223 Posts

Posted - 02/01/2011 :  16:33:19   [Permalink]  Show Profile Send Robb a Private Message  Reply with Quote
Originally posted by H. Humbert

The Constitution already guarantees "life, liberty, and the pursuit happiness" as inalienable rights. A strong argument could be made that having no access to health care violates the right to life.


Show me where. Maybe you have a case where it says to promote the general welfare. But then the constitution enumerates our rights and I don't see health care. I am not against ammending the constitution if that's what people want but the Obama administration cannot makeup rights and then say because we have these rights we need to pay for them.

Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master. - George Washington
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