A Controversial Hobby

HobbyLobbyby Tia Will

I believe in the value of the Constitution of the United States of America. I believe in the value of the Bill of Rights and specifically in our First Amendment .

“Congress shall make no law respecting an establishment of religion… “

While the recent Supreme Court decision in Burell vs Hobby Lobby may not abridge the technical wording of this amendment, it certainly contradicts its spirit.

Quoting from the majority decision;

“The Religious Freedom Restoration Act of 1993 (RFRA) prohibits the “Government [from] substantially burden[ing] a person’s exercise of religion even if the burden results from a rule of general applicability” unless the Government “demonstrates that application of the burden to the person—(1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest.”

Quoting from the majority opinion by Justice Alito: “The owners of the businesses have religious objections to abortion, and according to their religious beliefs the four contraceptive methods at issue are abortifacients.”

People are certainly entitled to their own religious beliefs. However, they are not entitled to their own facts. Of the two IUDs cited as abortifacients, only one, the Paraguard could by any stretch of the imagination be considered an abortifacient since it can be used as emergency contraception. This is also true for the preparation known as Plan B. The other IUD, the Mirena has no known abortifacient action and so is not approved for emergency contraception. So what the Supreme Court has actually decided is that that the religious objection to abortion of the owners can be extrapolated to their erroneous beliefs about the mechanisms of action and therefore should take precedence over the demonstrated biological facts. Would the Supreme Court have taken the same stance if the employer were a company founded by Jehovah’s Witnesses and the procedure that they were refusing to insure was a blood transfusion, as suggested by Justice Ginsburg in her dissent. The majority states this would not necessarily apply. But why not ? What would make one genuinely held religious belief superior to another? This seems to me to be skating extremely close to interpreting law so as to respect the establishment of a certain type of religion, namely the Christian faith. Would the court have upheld the genuinely held beliefs of other religious groups, such as Muslims who legitimately practice Sharia law as part of their religious doctrine?

Justice Alito continues: “Nor do we hold, as the dissent implies, that such corporations have free rein to take steps that impose “disadvantages . . . on others” or that require “the general public [to] pick up the tab.”

This statement is clearly contradicted by the portion of the decision that states the HHS has the less restrictive option of providing direct coverage for women who are unable to obtain contraception through their employer’s health plan. If the government is providing the coverage, who other than the general public through their tax dollars does Justice Alito believe is “picking up the tab?”

And if neither their employer nor the general public are to “pick up the tab”, then most certainly these women are disadvantaged both by comparison to other women and to their male counterparts working at the same company, having the same insurance, but without the same religious restrictions imposed on their personal medical options by their employer.

Justice Ginsburg continued: “Approving some religious claims while deeming others unworthy of accommodation could be ‘perceived as favoring one religion over another,’ the very risk the [Constitution’s] Establishment Clause was designed to preclude.”

In my opinion Justice Ginsburg has this exactly right. I also believe that the five Justices in the majority in this case were unable to see past their own religious and ideological biases. I agree with Justice Alito’s suggestion that had this case been about blood transfusion, or pork containing products that it would have been decided in favor of the HHS. I believe that this would have occurred because the majority justices would not have connected so fundamentally with the religious beliefs being expressed. While each of the justices is entitled to their own religious beliefs, these should not be allowed to color their views of the issues before them thus leading to a de facto respect for a very specific religious establishment, namely a specific belief of the Christian faith.

I believe our First Amendment clearly forbids the making of laws respecting an establishment of religion. Since this is clear, should it then not follow that the Supreme Court should not interpret existing law so as to respect an establishment of religion? It would seem clear to me that this is the effect of the current majority decision and that this decision should itself be considered unconstitutional. My appreciation to Judge Ginsburg for her clear and well reasoned opposition to this majority decision.

About The Author

Related posts

752 thoughts on “A Controversial Hobby”

  1. SODA

    ….and my appreciation to you Tia for the article. I do agree with all you and what you quote from Justice Ginsburg…..only point is that to my knowledge issues of blood transfusions and pork, etc have never come before the Court? Easy for the majority to say what might happen if it hasn’t.
    I remember being involved in a case early in my career of a Jehovah’s Witness with a bleeding ulcer. The controversy and angst on both sides. Then years later I read Anne Fadiman’s “When the Spirit Catches you then You Fall” which had a profound affect on me and brought multicultural issues front and center in a powerful way.
    You didn’t mention the fact (I think true?) that the company’s insurance does cover vasectomies and erectile dysfunction meds? Is that true?
    Thanks Tia!

    1. Tia Will

      Hi Soda,

      My understanding is that their insurance does cover medications for erectile dysfunction. I do not know about their policy regarding vasectomy.

  2. SODA Post author

    ….and my appreciation to you Tia for the article. I do agree with all you and what you quote from Justice Ginsburg…..only point is that to my knowledge issues of blood transfusions and pork, etc have never come before the Court? Easy for the majority to say what might happen if it hasn’t.
    I remember being involved in a case early in my career of a Jehovah’s Witness with a bleeding ulcer. The controversy and angst on both sides. Then years later I read Anne Fadiman’s “When the Spirit Catches you then You Fall” which had a profound affect on me and brought multicultural issues front and center in a powerful way.
    You didn’t mention the fact (I think true?) that the company’s insurance does cover vasectomies and erectile dysfunction meds? Is that true?
    Thanks Tia!

    1. Tia Will Post author

      Hi Soda,

      My understanding is that their insurance does cover medications for erectile dysfunction. I do not know about their policy regarding vasectomy.

  3. Barack Palin

    Hobby Lobby covers something like 16 of the 20 birth control options. This is just antoher hyped up non controversy for the War on Women Democrats to try and stir up their base.

    1. Davis Progressive

      for a non-controvery, it sure seems to have struck a nerve. and no, i don’t believe you can randomly drum up controversies to stire up the base – if you could, everyone would stir their base every election cycle and that simply doesn’t happen.

    2. TrueBlueDevil

      Yup. But this is how the Progressives gin up votes.

      I mean, do you think they’ll have a serious discussion of how Hillary Clinton defended the brutal rapist of a 12-year-old girl, and later cackled about it? Do you think they’ll discuss the Motion she filed in court that is filled with blatant lies, used to get her rapist-client free with a few months served in prison? Sure, Hillary was young, it was Arkansas, and there weren’t rape shield laws then … but doesn’t this tell us a whole lot more about power-hungry Mrs. Clinton?

    3. Tia Will

      BP

      Actually, this is not “trumped up”. Holly Hobby’s policy excludes from coverage both of the IUDs. The Paraguard IUD is the only non hormonal means of contraception that comes even close to the < 1% effectiveness and so is the only statistically effective alternative for many women with serious medical conditions who cannot use a hormonal contraceptive.

    4. TrueBlueDevil

      Meanwhile, Obama pays women in the White House less than the men; raises in the WH were larger for the men than the women; and he plays golf predominantly with white Jewish men.

      Hypocrisy?

  4. Barack Palin Post author

    Hobby Lobby covers something like 16 of the 20 birth control options. This is just antoher hyped up non controversy for the War on Women Democrats to try and stir up their base.

    1. Davis Progressive Post author

      for a non-controvery, it sure seems to have struck a nerve. and no, i don’t believe you can randomly drum up controversies to stire up the base – if you could, everyone would stir their base every election cycle and that simply doesn’t happen.

    2. TrueBlueDevil Post author

      Yup. But this is how the Progressives gin up votes.

      I mean, do you think they’ll have a serious discussion of how Hillary Clinton defended the brutal rapist of a 12-year-old girl, and later cackled about it? Do you think they’ll discuss the Motion she filed in court that is filled with blatant lies, used to get her rapist-client free with a few months served in prison? Sure, Hillary was young, it was Arkansas, and there weren’t rape shield laws then … but doesn’t this tell us a whole lot more about power-hungry Mrs. Clinton?

    3. Tia Will Post author

      BP

      Actually, this is not “trumped up”. Holly Hobby’s policy excludes from coverage both of the IUDs. The Paraguard IUD is the only non hormonal means of contraception that comes even close to the < 1% effectiveness and so is the only statistically effective alternative for many women with serious medical conditions who cannot use a hormonal contraceptive.

    4. TrueBlueDevil Post author

      Meanwhile, Obama pays women in the White House less than the men; raises in the WH were larger for the men than the women; and he plays golf predominantly with white Jewish men.

      Hypocrisy?

  5. Frankly

    “We should be afraid of this court, that five guys [are] determining what contraceptives are legal or not.

    That court decision was a frightening one that five men should get down to the specifics of whether a woman should use a diaphragm and she should pay for it herself or her boss. It’s not her boss’s business.”

    This from a liberal-loved California Democrat politician that was just recently 2 steps away from the job of President.

    So male supreme court justices cannot help but be sexist in their decisions. From Megyn Kelly: When Roe v. Wade was decided it was all men in the majority. Does Miss Pelosi think those justices were ill-equipped to fairly decide that case?”

    Nancy Pelosi is a sexist, lying, hypocrite, partisan, ignorant fool that somehow gets re-elected by the people of this once great state.

    Maybe SCOTUS just needed to vote on the case so we could read it and see what was inside.

    1. Davis Progressive

      “So male supreme court justices cannot help but be sexist in their decisions. ”

      i do think ideology rather than gender was the biggest factor. it so happens that the five male justices were also the politically most conservative on the court.

      1. Davis Progressive

        with that said, from a political stand point, they couldn’t have picked a worse time to stir up women voters. look at the voting difference from 2008 to 2010 to 2012 among women and how that impacted electoral outcomes.

        1. Frankly

          “stir up women voters?”

          Right DP, because those women are just so emotional and cannot think well enough for themselves to understand the facts and the truth. Let’s keep playing that play.

          Do those on the left every get how denigrating and demeaning their constant gender, race and sexual class-ism arguments are?

          Those little black and brown people, and those little poor people, and those little women and those little gays… they need constant defense from those big, bad conservative (white?) males. That is your party message over and over and over again.

          It seems you are excusing Nancy Pelosi on this as just being political. That is similar to what we are hearing from the left about all of Obama’s lies and misdeeds. So the end justifies the means? No wonder we are at the highest levels of partisanship ever.

          Let’s keep ginning up the war… class war, race war, gender war… you name it victim’s group wars. I wonder if women really like being put into a victim category? The ones I know don’t. But then maybe there are more Janeane Garofalo types than we know about.

          1. Davis Progressive

            “Right DP, because those women are just so emotional and cannot think well enough for themselves to understand the facts and the truth.”

            i’m wondering if you didn’t misunderstand my point. women were angered by the outcome, women have been angry at the rhetoric on sexual assaults and other issues as well for some time. from a conservative stand point, this didn’t seem like an opportune time to anger a large constituency.

            women are just so emotional? no more than the white males who go ballistic every time the gun issue comes up.

          2. Dorte Jensen

            Hi Davis Progressive, I am a woman and am not angered by the outcome. In fact, I think it was the proper decision, based on the Constitution.

            This whole Obamacare thing is a mess–telling employers that they have to provide insurance and that they have to cover certain products or procedures as part of that insurance. Why not let the free market take over? If people don’t like the insurance policy that one company has, they can work elsewhere. Why isn’t that OK anymore?

          3. Don Shor

            Why not let the free market take over?

            Because the “free market” was excluding millions of us from health coverage.

          4. Davis Progressive

            as don said, we tried the free market and it wasn’t working. i saw an article yesterday that the number of uninsured california’s has been cut in half in a less than a year.

          5. South of Davis

            Dorte wrote:

            > I am a woman and am not angered by the outcome.
            > In fact, I think it was the proper decision, based on
            > the Constitution.

            I get why the press (both left and right) is all excited about this (a classic “wedge issue” that not only distracts the masses but aids in fundraising (donate to the blue team to protect women, and donate to the red team to protect the unborn).

            I’m all for “freedom of religion” (and “freedom from religion”), but I don’t get why there is a big fuss about a company insurance policy paying for plan B (that is probably easier for most people to buy for $50 at Wal-Mart or Walgreens than take an hour to fill out a bunch of forms and hope you get your “insurance” to cover it).

            Why is it OK to pay for condoms that a gay employee could “sin” with here in America or a straight employee could take to “sin” with on an underage sex trip to Thailand (pissing off most devout Christians “and” Progressive Atheists)?

            If it is OK to stop paying for emergency contraception since someone “might” use it to have “what some call” an abortion it seems like it should be OK to stop paying all “non-believers” since they “might” take $50 of their pay and buy plan B for a niece who “might” use it after she is not sure what happened after she blacked out at the fraternity party…

          6. Barack Palin

            “8 – 10 million previously uninsured are now covered nationwide.”

            That’s flat out totally untrue.

          7. Don Shor

            Great link, since it proves what I said. I said ““8 – 10 million previously uninsured are now covered nationwide.”
            You said it was “flat out totally untrue.”
            You then posted a link that says:

            Research from RAND Corp. shows 9.3 million more people had insurance in March 2014 than did in September 2013, and a recent Gallup poll puts the uninsured rate at its lowest level since 2008. The percentage of adults who don’t have insurance has dropped from 20.5 percent to 15.8 percent in the last year.
            But it’s unclear how much of the drop can be credited to Obamacare and how much to other factors, such as changes to Medicaid enrollment. RAND’s study and another from the Urban Institute Health Policy Center both found fewer than half of the newly-insured gained coverage through the Obamacare exchanges.

            So, the number of uninsured has dropped substantially because people are buying health insurance through the exchanges, and because of the expansion of Medicaid. Those were the main provisions of the Affordable Care Act.
            My statement was true.

          8. Davis Progressive

            “The Daily Signal is supported by the resources and intellectual firepower of The Heritage Foundation”

            can you find one not written by a publication that is backed by a right-wing think-tank?

          9. Dorte Jensen

            Hi Don,

            I was one of the millions that was excluded, and I haven’t signed up for Obamacare, so I am still excluded. Let me tell you how my thinking on this issue has evolved.

            Before Obamacare, I looked at the problem theoretically. The available data I had (and I was less discerning then) was that other countries with national health care had in general lower medical costs and greater population health, or some such thing. From this I decided that a national health care system in this country would benefit me and all citizens. (I did not vote for President Obama, however.)

            When Obamacare was passed with its special deals (such as exempting or subsidizing Congress and Congressional aides, whichever one it is), I realized what a mess we were going to be in. The President’s oft-repeated pledge, “If you like your health plan you can keep it, period,” is an example of a lie proffered to keep a politician and political party (the Democrats were only those who voted for it, as I remember) in power.

            Now that Obamacare is up and (sort of) running, I don’t want to apply for it because I don’t want to be part of a big governmental system, especially one tied to/associated with others (like the IRS and the VA, respectively) in the midst of scandal.

            However, as they say on the late-night commercials, “But wait; there’s more!”

            When I expressed the above concerns to an assistant in John Garamendi’s office, she replied, “Don’t worry. That will be fixed when we get single-payer.” As it turns out, there is a provision in Obamacare (on one of however many thousands of pages) which states that a state can opt out if it comes up with a system which is as good.

            On July 22, a group will be meeting in Winters to discuss the single-payer option. For information about that meeting, click on the following link:

            http://www.davisenterprise.com/local-news/meeting-examines-single-payer-health-care-system/

            I have spoken with the representatives of that group, who answered my questions and welcomed my participation. Whether or not single-payer would be better than Obamacare is beside the point. It should not have been hidden in Obamacare to begin with.

            What I’m trying to say is that the United States may be a special case. Perhaps national health care works in other countries but would not work here. My immediate goal would be to get prices of medical care down–through the free market–so that people could better afford to pay for what they want.

            Many factors complicate this. In the free market, we have insurance companies whose red tape makes the price of services go up, and we have lawyers whose threats of massive lawsuits make doctors want to perform every test (which makes patients think that they need them, which makes insurance rates go up, which also makes insurers want to drop clients costing them money). Government programs also complicate the picture, since Medicare and Medicaid compensate doctors less, so doctors have to charge uninsured people–like myself–more.

            In other words, our health care system before Obamacare was a hybrid of the free market and the government, but after Obamacare it is much closer to the latter. Now that I see the problems there, I would like to reverse direction and move towards the free market again with the goal of correcting conditions which prompted the change to begin with.

            Simply put, I don’t have an answer, but I don’t think that Obamacare is it.

            Finally, to lead this comment back to the article in question, I don’t think that Obamacare mandates, when they infringe on religious liberty, are “it” either, and that’s what the Supreme Court ruled. Forgive me if my phrasing here (use of “it”) is a little vague, but this post is long, and I don’t have the time/energy to expound. If anyone is interested, let me know, and I’ll give it a crack later.

          10. Don Shor

            I’ll keep my reply simple. Before the ACA, I couldn’t get health insurance. Now I can. It’s a reasonable cost, and it covers what I need. The only reason I can get it now, and couldn’t before, is the ACA.
            I don’t support single-payer, and certainly don’t expect to see it implemented in the United States in my lifetime.

          11. Don Shor

            Now that Obamacare is up and (sort of) running, I don’t want to apply for it because I don’t want to be part of a big governmental system,

            The health insurance I purchased through the California health exchange is with a private insurer. The doctors that I go to are in a private health care group. There is no aspect of my coverage that is part of a “big governmental system,” except that the state of California set up and runs the health exchange I used. It was very easy to navigate. I suggest you check it out.

          12. David Greenwald

            We have Kaiser through Covered California. Not Government in the least. In fact, ACA has allowed us to go from a government plan to Kaiser. The level of treatment is far superior.

          13. Dorte Jensen

            Hi South of Davis,

            Thanks for your response. The full text of the Hobby Lobby decision is here:

            http://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf

            I have not read much of it, but I doubt that it is about “sin”, “emergency contraception”, or “abortion”. I believe it is about birth control, specifically the kind which the majority decribes as that which “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus” (p. 2 in above link).

            Discussion of this issue is difficult in part because people are unfamiliar with the meaning of terms. For reference, consider these definitions from the American Heritage Dictionary:

            –contraception: prevention of conception, as by use of a device, drug, or chemical agent
            –conception: formation of a viable zygote by the union of the male sperm and the female ovum; fertilization
            –abortion: induced termination of pregnancy and expulsion of an embryo or fetus before it is viable
            –pregnant: carrying developing offspring within the body
            –embryo: an organism in its early stages of development, esp. before it has reached a distinctively recognizable form

            Based on these definitions, the type of birth control Hobby Lobby objected to was not a contraceptive (since it did not prevent fertilization) and not an abortifacient (since that concerns an embryo, which I understand is what a fertilized egg is called after implantation). What this type of birth control is called I don’t know. Perhaps Tia does.

            The fuzziness may come in part in the definition of pregnancy, which concerns “developing offspring”. Since the fertilized egg is developing but won’t develop further if it does not implant, I guess this is an example of someone being “somewhat pregnant” (which is something people laugh about and say can never occur).

            The bottom line is that Hobby Lobby did not want to pay for any form of birth control which would (or might) prevent this implantation, since they believe that a fertilized egg is on the way to becoming a human being. Preventing implantation would arrest that course, so it would destroy the earliest form of human life, which is the fertilized egg.

            I hope this helps!

          14. South of Davis

            wdf1 wrote:

            > Republicans Who Signed Up For Obamacare This Year Are Pretty Happy

            Like most changes the people who come out ahead are “pretty happy”. I have a Republican friend with failed kidneys (he goes to dialysis) and as a self employed software engineer with a big giant “pre-existing condition” he is VERY happy with Obamacare (despite the fact that he hates Obama). I have another healthy (vegan health nut) friend who is a proud Democrat (and left of Tia) but since his HSA with a $10K deductible is not allowed under Obamacare he is not happy that he is paying more, but he still (really) has the HOPE sticker on his Prius…

    2. Barack Palin

      Pelosi recently had to recant all her lies she had said about the Hobby Lobby decision.

      You also have the fool Harry Reid saying it was 5 white men who made the decision. It’s hard to believe that thse two fools actually have high position in running this country.

        1. Davis Progressive

          i just reading this morning an article in the wash post about elizabeth warren becoming the champion of progressive democrats. i read your comments and bp’s and don’t think you really understand the political landscape.

          1. TrueBlueDevil

            He’s enriched one of his sons, a lawyer who is now representing energy companies, as well as spending campaign monies on his granddaughter’s new jewelry line.

    3. Tia Will

      BP

      “it’s a lie that five old white men made the decision.”

      I am not understanding your comment. Who do you think made the majority decision ?

        1. Tia Will

          BP

          Well now that depends on who is counted as “white” doesn’t it ? My ex -husband
          was darker than most Hispanics I have met in skin tone, and yet considered himself
          “white”. This is basically why forms allow self identification of racial make up.
          Skin tone doesn’t tell the whole story.

          And, besides, what exactly does Harry Reids ability to accurately discern racial composition have to do with this Supreme Court case. It was the decision of the
          5 majority justices that I was commenting on , not Harry Reid’s opinion about which I care not at all.

          1. Barack Palin

            Earth to Tia, Clarence Thomas is black. There’s no defending Harry Reid’s stupid comment.

          2. Barack Palin

            I’m sure this is where Tia will probably come back and tell me that Clarence Thomas is white because in the liberal world up is down and black is white.

          3. TrueBlueDevil

            Barack Palin: no, Justice Thomas is clearly white because he enjoys driving his RV across our country.

            Side note: Justice Thomas lived for a while, I believe, with womenfolk in his family, and was a bit coddled. He then went to live with his super-independent grandfather who was determined that no man own or control anything that impacted his existence. His first words to a young Clarence? “Vacations over, son.” I love that!

          4. D.D.

            It’s who we identify with, also. It was difficult when I worked for W.I.C. because many do not want to self identify at all, & want to put R for refused when asked the race and ethnicity questions.

  6. Frankly Post author

    “We should be afraid of this court, that five guys [are] determining what contraceptives are legal or not.

    That court decision was a frightening one that five men should get down to the specifics of whether a woman should use a diaphragm and she should pay for it herself or her boss. It’s not her boss’s business.”

    This from a liberal-loved California Democrat politician that was just recently 2 steps away from the job of President.

    So male supreme court justices cannot help but be sexist in their decisions. From Megyn Kelly: When Roe v. Wade was decided it was all men in the majority. Does Miss Pelosi think those justices were ill-equipped to fairly decide that case?”

    Nancy Pelosi is a sexist, lying, hypocrite, partisan, ignorant fool that somehow gets re-elected by the people of this once great state.

    Maybe SCOTUS just needed to vote on the case so we could read it and see what was inside.

    1. Davis Progressive Post author

      “So male supreme court justices cannot help but be sexist in their decisions. ”

      i do think ideology rather than gender was the biggest factor. it so happens that the five male justices were also the politically most conservative on the court.

      1. Davis Progressive Post author

        with that said, from a political stand point, they couldn’t have picked a worse time to stir up women voters. look at the voting difference from 2008 to 2010 to 2012 among women and how that impacted electoral outcomes.

        1. Frankly Post author

          “stir up women voters?”

          Right DP, because those women are just so emotional and cannot think well enough for themselves to understand the facts and the truth. Let’s keep playing that play.

          Do those on the left every get how denigrating and demeaning their constant gender, race and sexual class-ism arguments are?

          Those little black and brown people, and those little poor people, and those little women and those little gays… they need constant defense from those big, bad conservative (white?) males. That is your party message over and over and over again.

          It seems you are excusing Nancy Pelosi on this as just being political. That is similar to what we are hearing from the left about all of Obama’s lies and misdeeds. So the end justifies the means? No wonder we are at the highest levels of partisanship ever.

          Let’s keep ginning up the war… class war, race war, gender war… you name it victim’s group wars. I wonder if women really like being put into a victim category? The ones I know don’t. But then maybe there are more Janeane Garofalo types than we know about.

          1. Davis Progressive Post author

            “Right DP, because those women are just so emotional and cannot think well enough for themselves to understand the facts and the truth.”

            i’m wondering if you didn’t misunderstand my point. women were angered by the outcome, women have been angry at the rhetoric on sexual assaults and other issues as well for some time. from a conservative stand point, this didn’t seem like an opportune time to anger a large constituency.

            women are just so emotional? no more than the white males who go ballistic every time the gun issue comes up.

          2. Dorte Jensen Post author

            Hi Davis Progressive, I am a woman and am not angered by the outcome. In fact, I think it was the proper decision, based on the Constitution.

            This whole Obamacare thing is a mess–telling employers that they have to provide insurance and that they have to cover certain products or procedures as part of that insurance. Why not let the free market take over? If people don’t like the insurance policy that one company has, they can work elsewhere. Why isn’t that OK anymore?

          3. Don Shor Post author

            Why not let the free market take over?

            Because the “free market” was excluding millions of us from health coverage.

          4. Davis Progressive Post author

            as don said, we tried the free market and it wasn’t working. i saw an article yesterday that the number of uninsured california’s has been cut in half in a less than a year.

          5. South of Davis Post author

            Dorte wrote:

            > I am a woman and am not angered by the outcome.
            > In fact, I think it was the proper decision, based on
            > the Constitution.

            I get why the press (both left and right) is all excited about this (a classic “wedge issue” that not only distracts the masses but aids in fundraising (donate to the blue team to protect women, and donate to the red team to protect the unborn).

            I’m all for “freedom of religion” (and “freedom from religion”), but I don’t get why there is a big fuss about a company insurance policy paying for plan B (that is probably easier for most people to buy for $50 at Wal-Mart or Walgreens than take an hour to fill out a bunch of forms and hope you get your “insurance” to cover it).

            Why is it OK to pay for condoms that a gay employee could “sin” with here in America or a straight employee could take to “sin” with on an underage sex trip to Thailand (pissing off most devout Christians “and” Progressive Atheists)?

            If it is OK to stop paying for emergency contraception since someone “might” use it to have “what some call” an abortion it seems like it should be OK to stop paying all “non-believers” since they “might” take $50 of their pay and buy plan B for a niece who “might” use it after she is not sure what happened after she blacked out at the fraternity party…

          6. Barack Palin Post author

            “8 – 10 million previously uninsured are now covered nationwide.”

            That’s flat out totally untrue.

          7. Don Shor Post author

            Great link, since it proves what I said. I said ““8 – 10 million previously uninsured are now covered nationwide.”
            You said it was “flat out totally untrue.”
            You then posted a link that says:

            Research from RAND Corp. shows 9.3 million more people had insurance in March 2014 than did in September 2013, and a recent Gallup poll puts the uninsured rate at its lowest level since 2008. The percentage of adults who don’t have insurance has dropped from 20.5 percent to 15.8 percent in the last year.
            But it’s unclear how much of the drop can be credited to Obamacare and how much to other factors, such as changes to Medicaid enrollment. RAND’s study and another from the Urban Institute Health Policy Center both found fewer than half of the newly-insured gained coverage through the Obamacare exchanges.

            So, the number of uninsured has dropped substantially because people are buying health insurance through the exchanges, and because of the expansion of Medicaid. Those were the main provisions of the Affordable Care Act.
            My statement was true.

          8. Davis Progressive Post author

            “The Daily Signal is supported by the resources and intellectual firepower of The Heritage Foundation”

            can you find one not written by a publication that is backed by a right-wing think-tank?

          9. Dorte Jensen Post author

            Hi Don,

            I was one of the millions that was excluded, and I haven’t signed up for Obamacare, so I am still excluded. Let me tell you how my thinking on this issue has evolved.

            Before Obamacare, I looked at the problem theoretically. The available data I had (and I was less discerning then) was that other countries with national health care had in general lower medical costs and greater population health, or some such thing. From this I decided that a national health care system in this country would benefit me and all citizens. (I did not vote for President Obama, however.)

            When Obamacare was passed with its special deals (such as exempting or subsidizing Congress and Congressional aides, whichever one it is), I realized what a mess we were going to be in. The President’s oft-repeated pledge, “If you like your health plan you can keep it, period,” is an example of a lie proffered to keep a politician and political party (the Democrats were only those who voted for it, as I remember) in power.

            Now that Obamacare is up and (sort of) running, I don’t want to apply for it because I don’t want to be part of a big governmental system, especially one tied to/associated with others (like the IRS and the VA, respectively) in the midst of scandal.

            However, as they say on the late-night commercials, “But wait; there’s more!”

            When I expressed the above concerns to an assistant in John Garamendi’s office, she replied, “Don’t worry. That will be fixed when we get single-payer.” As it turns out, there is a provision in Obamacare (on one of however many thousands of pages) which states that a state can opt out if it comes up with a system which is as good.

            On July 22, a group will be meeting in Winters to discuss the single-payer option. For information about that meeting, click on the following link:

            http://www.davisenterprise.com/local-news/meeting-examines-single-payer-health-care-system/

            I have spoken with the representatives of that group, who answered my questions and welcomed my participation. Whether or not single-payer would be better than Obamacare is beside the point. It should not have been hidden in Obamacare to begin with.

            What I’m trying to say is that the United States may be a special case. Perhaps national health care works in other countries but would not work here. My immediate goal would be to get prices of medical care down–through the free market–so that people could better afford to pay for what they want.

            Many factors complicate this. In the free market, we have insurance companies whose red tape makes the price of services go up, and we have lawyers whose threats of massive lawsuits make doctors want to perform every test (which makes patients think that they need them, which makes insurance rates go up, which also makes insurers want to drop clients costing them money). Government programs also complicate the picture, since Medicare and Medicaid compensate doctors less, so doctors have to charge uninsured people–like myself–more.

            In other words, our health care system before Obamacare was a hybrid of the free market and the government, but after Obamacare it is much closer to the latter. Now that I see the problems there, I would like to reverse direction and move towards the free market again with the goal of correcting conditions which prompted the change to begin with.

            Simply put, I don’t have an answer, but I don’t think that Obamacare is it.

            Finally, to lead this comment back to the article in question, I don’t think that Obamacare mandates, when they infringe on religious liberty, are “it” either, and that’s what the Supreme Court ruled. Forgive me if my phrasing here (use of “it”) is a little vague, but this post is long, and I don’t have the time/energy to expound. If anyone is interested, let me know, and I’ll give it a crack later.

          10. Don Shor Post author

            I’ll keep my reply simple. Before the ACA, I couldn’t get health insurance. Now I can. It’s a reasonable cost, and it covers what I need. The only reason I can get it now, and couldn’t before, is the ACA.
            I don’t support single-payer, and certainly don’t expect to see it implemented in the United States in my lifetime.

          11. Don Shor Post author

            Now that Obamacare is up and (sort of) running, I don’t want to apply for it because I don’t want to be part of a big governmental system,

            The health insurance I purchased through the California health exchange is with a private insurer. The doctors that I go to are in a private health care group. There is no aspect of my coverage that is part of a “big governmental system,” except that the state of California set up and runs the health exchange I used. It was very easy to navigate. I suggest you check it out.

          12. David Greenwald

            We have Kaiser through Covered California. Not Government in the least. In fact, ACA has allowed us to go from a government plan to Kaiser. The level of treatment is far superior.

          13. Dorte Jensen Post author

            Hi South of Davis,

            Thanks for your response. The full text of the Hobby Lobby decision is here:

            http://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf

            I have not read much of it, but I doubt that it is about “sin”, “emergency contraception”, or “abortion”. I believe it is about birth control, specifically the kind which the majority decribes as that which “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus” (p. 2 in above link).

            Discussion of this issue is difficult in part because people are unfamiliar with the meaning of terms. For reference, consider these definitions from the American Heritage Dictionary:

            –contraception: prevention of conception, as by use of a device, drug, or chemical agent
            –conception: formation of a viable zygote by the union of the male sperm and the female ovum; fertilization
            –abortion: induced termination of pregnancy and expulsion of an embryo or fetus before it is viable
            –pregnant: carrying developing offspring within the body
            –embryo: an organism in its early stages of development, esp. before it has reached a distinctively recognizable form

            Based on these definitions, the type of birth control Hobby Lobby objected to was not a contraceptive (since it did not prevent fertilization) and not an abortifacient (since that concerns an embryo, which I understand is what a fertilized egg is called after implantation). What this type of birth control is called I don’t know. Perhaps Tia does.

            The fuzziness may come in part in the definition of pregnancy, which concerns “developing offspring”. Since the fertilized egg is developing but won’t develop further if it does not implant, I guess this is an example of someone being “somewhat pregnant” (which is something people laugh about and say can never occur).

            The bottom line is that Hobby Lobby did not want to pay for any form of birth control which would (or might) prevent this implantation, since they believe that a fertilized egg is on the way to becoming a human being. Preventing implantation would arrest that course, so it would destroy the earliest form of human life, which is the fertilized egg.

            I hope this helps!

          14. South of Davis Post author

            wdf1 wrote:

            > Republicans Who Signed Up For Obamacare This Year Are Pretty Happy

            Like most changes the people who come out ahead are “pretty happy”. I have a Republican friend with failed kidneys (he goes to dialysis) and as a self employed software engineer with a big giant “pre-existing condition” he is VERY happy with Obamacare (despite the fact that he hates Obama). I have another healthy (vegan health nut) friend who is a proud Democrat (and left of Tia) but since his HSA with a $10K deductible is not allowed under Obamacare he is not happy that he is paying more, but he still (really) has the HOPE sticker on his Prius…

        2. TrueBlueDevil Post author

          The Dems have to run on gender and other victim issues, as they can’t turn around our economy, VA, border, Benghazi, or IRS.

    2. Barack Palin Post author

      Pelosi recently had to recant all her lies she had said about the Hobby Lobby decision.

      You also have the fool Harry Reid saying it was 5 white men who made the decision. It’s hard to believe that thse two fools actually have high position in running this country.

        1. Davis Progressive Post author

          i just reading this morning an article in the wash post about elizabeth warren becoming the champion of progressive democrats. i read your comments and bp’s and don’t think you really understand the political landscape.

        1. Barack Palin Post author

          It’s not that Harry Reid played the race card 9which he did) , it’s that it’s a lie that five old white men made the decision.

          1. TrueBlueDevil Post author

            He’s enriched one of his sons, a lawyer who is now representing energy companies, as well as spending campaign monies on his granddaughter’s new jewelry line.

    3. Tia Will Post author

      BP

      “it’s a lie that five old white men made the decision.”

      I am not understanding your comment. Who do you think made the majority decision ?

        1. Tia Will Post author

          BP

          Well now that depends on who is counted as “white” doesn’t it ? My ex -husband
          was darker than most Hispanics I have met in skin tone, and yet considered himself
          “white”. This is basically why forms allow self identification of racial make up.
          Skin tone doesn’t tell the whole story.

          And, besides, what exactly does Harry Reids ability to accurately discern racial composition have to do with this Supreme Court case. It was the decision of the
          5 majority justices that I was commenting on , not Harry Reid’s opinion about which I care not at all.

          1. Barack Palin Post author

            Earth to Tia, Clarence Thomas is black. There’s no defending Harry Reid’s stupid comment.

          2. Barack Palin Post author

            I’m sure this is where Tia will probably come back and tell me that Clarence Thomas is white because in the liberal world up is down and black is white.

          3. TrueBlueDevil Post author

            Barack Palin: no, Justice Thomas is clearly white because he enjoys driving his RV across our country.

            Side note: Justice Thomas lived for a while, I believe, with womenfolk in his family, and was a bit coddled. He then went to live with his super-independent grandfather who was determined that no man own or control anything that impacted his existence. His first words to a young Clarence? “Vacations over, son.” I love that!

          4. D.D. Post author

            It’s who we identify with, also. It was difficult when I worked for W.I.C. because many do not want to self identify at all, & want to put R for refused when asked the race and ethnicity questions.

  7. Ryan Kelly

    Women are not served well by political conservatives. It is about control and domination of women. Women, thank goodness, are becoming wiser and more independent in how they vote.

    1. Frankly

      Ryan you drink the Kool Aide well. I think you might actually own a lot of stock in the company that makes it.

      Women are not served well by Democrats. Just like they are not served well by NOW. They are exploited by both for political power. And the left media exploits the gender conflict for money.

      Survey after survey has confirmed that conservative women are much happier than are those that those on the left. Why do you think that is?

      1. D.D.

        I question the validity of these surveys & also wonder how a person’s feelings can be quantified in a survey. Do they ask the woman to sign her name to the survey? How large was the survey? Where was the survey taken?

    2. Frankly

      Sorry about the Kool aid comment. But please don’t just mouth partisan talking points without any thought behind it.

      The issue of abortion and woman’s rights is a convoluted ginned up topic stuck in a political war but that deserves greater social dialogue. There are valid moral arguments on both sides. Democrats that exploit it as a political conflict should be ashamed.

      1. Davis Progressive

        it’s funny. above you said, “because those women are just so emotional and cannot think well enough for themselves” but you’re comment, “The issue of abortion and woman’s rights is a convoluted ginned up topic.” seems like you believe that yourself.

          1. Davis Progressive

            sarcasm relies on non-verbal indicators and therefore doesn’t translate well to the written format.

            that said, i think the republicans have to re-think their strategy, white males are no longer a majority of voters in this country.

      2. TrueBlueDevil

        But they won’t give it up, because they have no idea how to run an economy … which is to get out of the way of the Free Market wherever possible.

      3. Tia Will

        Frankly

        “Democrats that exploit it as a political conflict should be ashamed.”
        But Republicans who exploit it as a optical conflict should not be ?”

        Please correct me if I am misunderstanding you.

  8. Ryan Kelly Post author

    Women are not served well by political conservatives. It is about control and domination of women. Women, thank goodness, are becoming wiser and more independent in how they vote.

    1. Frankly Post author

      Ryan you drink the Kool Aide well. I think you might actually own a lot of stock in the company that makes it.

      Women are not served well by Democrats. Just like they are not served well by NOW. They are exploited by both for political power. And the left media exploits the gender conflict for money.

      Survey after survey has confirmed that conservative women are much happier than are those that those on the left. Why do you think that is?

      1. D.D. Post author

        I question the validity of these surveys & also wonder how a person’s feelings can be quantified in a survey. Do they ask the woman to sign her name to the survey? How large was the survey? Where was the survey taken?

    2. Frankly Post author

      Sorry about the Kool aid comment. But please don’t just mouth partisan talking points without any thought behind it.

      The issue of abortion and woman’s rights is a convoluted ginned up topic stuck in a political war but that deserves greater social dialogue. There are valid moral arguments on both sides. Democrats that exploit it as a political conflict should be ashamed.

      1. Davis Progressive Post author

        it’s funny. above you said, “because those women are just so emotional and cannot think well enough for themselves” but you’re comment, “The issue of abortion and woman’s rights is a convoluted ginned up topic.” seems like you believe that yourself.

          1. Davis Progressive Post author

            sarcasm relies on non-verbal indicators and therefore doesn’t translate well to the written format.

            that said, i think the republicans have to re-think their strategy, white males are no longer a majority of voters in this country.

      2. TrueBlueDevil Post author

        But they won’t give it up, because they have no idea how to run an economy … which is to get out of the way of the Free Market wherever possible.

      3. Tia Will Post author

        Frankly

        “Democrats that exploit it as a political conflict should be ashamed.”
        But Republicans who exploit it as a optical conflict should not be ?”

        Please correct me if I am misunderstanding you.

  9. Ryan Kelly

    I don’t believe that independent women who do not subscribe to roles dictated by their religious beliefs want others to make medical choices for them. Maybe conservative women survey better because the population is smaller than that of women on the left which encompasses greater diversity and life experience. Don’t believe for an instant that forcing the religious beliefs on others will result in their happiness. This argument is offensive and typical of the religious right.

    1. Frankly

      http://nypost.com/2013/12/27/conservative-women-hold-secret-to-happiness/

      Women in the United States have long reported greater levels of happiness than men. Their advantage has, however, been shrinking, and for an unhappy reason: falling happiness among women.

      Yes, at the same time that NOW has succeeded in getting women everything that NOW says they want.

      Over the last 40 years, women who describe themselves as “conservative” have been more likely than women to their left to say they are “very happy,” and those who say they are “extremely conservative” have been happier still. Over the same period, conservatives in general have held the same pattern: Righty men, too, have been happier than their more liberal counterparts. So maybe the last two presidential elections should be seen as a victory for the redistribution of happiness as well as income.

      And then this raises the obvious questions: Are people more likely to be unhappy because they are liberal, or does the ideology of liberalism attract more unhappy people?

      And somewhat related to this, if we could somehow change the thinking of some liberals to be more conservative, maybe the world would be a happier place.

      Really, how happy does W seem compared to Obama? Obama only seems happy on the golf course and away from Michele. What about Mr. grumpy Harry Reid? And Nancy Pelosi (Pelosi has a perpetual smile from Botox… but her words are anything but happy most of the time).

      1. D.D.

        In the 70’s I imagined a world where men & women would share housework evenly. I think many members of N.O.W. imagined that would happen in their future.

      2. Tia Will

        Frankly

        ” how happy does W seem compared to Obama? Obama only seems happy on the golf course and away from Michele. What about Mr. grumpy Harry Reid? And Nancy Pelosi (Pelosi has a perpetual smile from Botox… but her words are anything but happy most of the time).

        I am really having a hard time seeing how this has any relevance to the topic of my article.
        Perhaps you can tie the two together ?

    2. D.D.

      Sometimes, not always, conservative women can get out and vote with more ease because they can have someone else watch their children for a while, to wait in line to vote. I wonder how the voting has turned out in areas where people can vote on Saturday. I also wonder what will happen when people can vote olline, using their cell phones.

    3. D.D.

      Maybe a certain percentage of wealthy conservative women don’t have as many accidental pregnancies because their hubbies work extremely long hours to provide a lavish lifestyle, the women can afford their expensive private OB/GYN’s, and they can afford to tell their very well providing hubbies they “have a headache” and practice abstinence during their fertile months. Maybe some of them enjoy pilates, shopping @ Nordy’s, cocktails at the club with their girlfriends, book club wine parties, and other activities as much as they enjoy sex. So maybe they are a little more content, after their dip in the spa, and mani & pedi appointment. Maybe a few of ther hubbies don’t mind because they have a younger, prettier make & model of the same trophy wife and that younger woman is the hubby’s mistress.
      Maybe.
      Maybe not.

      1. tribeUSA

        D.D.–there are plenty of liberal guys who lead such a lifestyle as well, as played out by the Hollywood crowd! The difference is that the conservatives will put the guilty-dog mantle on their face before going to sex-addict rehab; whereas the liberals will first go to counseling to excorcise their guilty feelings (whether fake or real) before going to sex-addict rehab (where they might meet some babes!)

  10. Ryan Kelly Post author

    I don’t believe that independent women who do not subscribe to roles dictated by their religious beliefs want others to make medical choices for them. Maybe conservative women survey better because the population is smaller than that of women on the left which encompasses greater diversity and life experience. Don’t believe for an instant that forcing the religious beliefs on others will result in their happiness. This argument is offensive and typical of the religious right.

    1. Frankly Post author

      http://nypost.com/2013/12/27/conservative-women-hold-secret-to-happiness/

      Women in the United States have long reported greater levels of happiness than men. Their advantage has, however, been shrinking, and for an unhappy reason: falling happiness among women.

      Yes, at the same time that NOW has succeeded in getting women everything that NOW says they want.

      Over the last 40 years, women who describe themselves as “conservative” have been more likely than women to their left to say they are “very happy,” and those who say they are “extremely conservative” have been happier still. Over the same period, conservatives in general have held the same pattern: Righty men, too, have been happier than their more liberal counterparts. So maybe the last two presidential elections should be seen as a victory for the redistribution of happiness as well as income.

      And then this raises the obvious questions: Are people more likely to be unhappy because they are liberal, or does the ideology of liberalism attract more unhappy people?

      And somewhat related to this, if we could somehow change the thinking of some liberals to be more conservative, maybe the world would be a happier place.

      Really, how happy does W seem compared to Obama? Obama only seems happy on the golf course and away from Michele. What about Mr. grumpy Harry Reid? And Nancy Pelosi (Pelosi has a perpetual smile from Botox… but her words are anything but happy most of the time).

      1. D.D. Post author

        In the 70’s I imagined a world where men & women would share housework evenly. I think many members of N.O.W. imagined that would happen in their future.

      2. Tia Will Post author

        Frankly

        ” how happy does W seem compared to Obama? Obama only seems happy on the golf course and away from Michele. What about Mr. grumpy Harry Reid? And Nancy Pelosi (Pelosi has a perpetual smile from Botox… but her words are anything but happy most of the time).

        I am really having a hard time seeing how this has any relevance to the topic of my article.
        Perhaps you can tie the two together ?

    2. D.D. Post author

      Sometimes, not always, conservative women can get out and vote with more ease because they can have someone else watch their children for a while, to wait in line to vote. I wonder how the voting has turned out in areas where people can vote on Saturday. I also wonder what will happen when people can vote olline, using their cell phones.

    3. D.D. Post author

      Maybe a certain percentage of wealthy conservative women don’t have as many accidental pregnancies because their hubbies work extremely long hours to provide a lavish lifestyle, the women can afford their expensive private OB/GYN’s, and they can afford to tell their very well providing hubbies they “have a headache” and practice abstinence during their fertile months. Maybe some of them enjoy pilates, shopping @ Nordy’s, cocktails at the club with their girlfriends, book club wine parties, and other activities as much as they enjoy sex. So maybe they are a little more content, after their dip in the spa, and mani & pedi appointment. Maybe a few of ther hubbies don’t mind because they have a younger, prettier make & model of the same trophy wife and that younger woman is the hubby’s mistress.
      Maybe.
      Maybe not.

      1. tribeUSA Post author

        D.D.–there are plenty of liberal guys who lead such a lifestyle as well, as played out by the Hollywood crowd! The difference is that the conservatives will put the guilty-dog mantle on their face before going to sex-addict rehab; whereas the liberals will first go to counseling to excorcise their guilty feelings (whether fake or real) before going to sex-addict rehab (where they might meet some babes!)

  11. Don Shor

    This ruling is extremely broad in its potential effects and could be a major political liability for Republicans.
    Dozens of other companies are already ready to stop covering contraception. The Supreme Court clarified that the ruling applies to all contraception, not just the supposed “abortifacients.”
    It could extend to any number of other discriminations employers choose to apply based on ‘religious beliefs’.
    As a work-around, it increases the likelihood that taxpayers will end up funding contraception. It isn’t clear to me why that is morally acceptable to these plaintiffs.

    Why is this perceived as especially targeted at women? Well, they are the major consumers of contraception products. Contraceptive health services are basic health care for women. Health insurance that doesn’t cover contraception doesn’t cover the most common health care that women seek.

    Here’s the context of the ‘war on women’ narrative.
    There has been, in the last 3 to 4 years, a major increase in the number of state laws seeking to restrict access to abortion. By one source: 22 states, 70 different restrictions in three years. There are some states where you would have to go hundreds of miles to attain an abortion, even within the legal timeframe established by Roe v Wade.
    The Supreme Court has eliminated the buffer zones around abortion clinics, allowing harassment of women seeking a legal abortion.
    States have tried to restrict access to emergency contraception. Oklahoma’s latest attempt was just blocked by a state judge. I’m guessing the Supreme Court will have to rule on this issue several more times.
    Some states have tried to exclude emergency contraception from their Medicaid coverage.
    Some states allow pharmacists to refuse to dispense them.
    It is an unrelenting pattern of seeking to put up roadblocks to women who are seeking contraception and abortion services.
    And now, refusing to fund them at the place of work, based on nebulous religious beliefs. Some contraceptives, but not others? Hobby Lobby was objecting to copper IUD’s, to Plan B pills, to ella pills, to hormonal IUD’s. None of those are abortion pills. RU-486 is the abortion pill.
    They are objecting to highly effective birth control methods that do not, repeat do NOT, cause abortion. If there is something in their religion that says altering the body’s hormones or changing the lining of the uterus violates their religious principles, I’d be very curious what it is. They’re Assemblies of God, which I guess is biblical literalist. I don’t recall that much about hormones and uteruses in the Bible. More to the point: it’s none of their business. And it has created a fearsome precedent that will be tested over and over again.

    1. Frankly

      “Perceived at targeting at women”

      Because folks like you and Nancy Pelosi are well served politically ginning up this false war on women.

      “Nebulous religious beliefs”

      Yup, just like banning plastic bags.

      1. Don Shor

        I don’t understand your plastic bag reference.
        ‘War on women’ may be inflated rhetoric (gee, how unusual is that? Is there a “war on Christmas?”). But the disproportional impact of these decisions and laws is adverse to women’s health care and their freedom to control their own reproduction. You simply cannot deny that.
        It’s not false.

        1. Frankly

          “War on Christmas” Christmas is a benign non-voting entity. And it is true.

          “War on women” is a political wedge from the left. And it is not true.

      2. Don Shor

        I also don’t understand why conservatives get so unhinged about Nancy Pelosi. What bothers them about her, as compared to strongly ideological politicians elsewhere in the House and Senate, I do not understand. She’s a liberal from the Bay Area. Surprise! There are lots of them. And lots of off-the-wall conservatives from some states. There seems to be a special venom reserved just for Pelosi. It almost seems, I dunno, emotional or something.

        1. Frankly

          Are you kidding. “We need to vote for Obamacare so we can see what is in it.”

          “The Tea Party people are Nazis.”

          “Right wing extremists shot Gabby Gifford.”

          “Five guys on SCOTUS are sexist and wage war on women.”

          All those quotes are reasonable approximations of what she said. And there is tons more.

          What is absurd to me that so many smart people from any political stripe actually support her. She epitomizes what is wrong with Washington.

          1. Don Shor

            She is supported by a small congressional district in San Francisco. She has worked her way up the ladder of seniority to her position in the House, just as John Boehner did. I could find any number of absurd quotations from members of Congress across the political spectrum. I don’t think any of the current congressional leaders — Boehner or Pelosi, Reid or McConnell — are particularly astute or articulate or effective leaders. She no more “epitomizes what is wrong with Washington” than do any of the others. Perhaps if your hostility was more broadly directed to congressional leaders of both parties, I’d find it more reasonable.

        2. D.D.

          Maybe Nancy P. reminds them of a classy older woman who tried to teach them proper manners and who was extremely intelligent & patient. She reminds them of a school teacher who tried to help them by teaching them how to be articulate, to “use their words”…proper debating skills. That’s my guess.
          Maybe a tiny percentage don’t perceive her as having the right “looks” to be in front of the camera, but they are probably embarrassed to admit that.

    2. Tia Will

      Don

      Thank you for your clear and concise summary of the legal attempts to block women’s exercise of their right to choose the best medical preventive services available to them.

      What is being missed is that all health care providers and all pro life individuals want the same thing. We want there to be as few abortions as possible. What the “pro lifers” are over looking is that the single best way to prevent an abortion is to prevent the pregnancy. By limiting or making more difficulty pregnancy prevention, they are actually contributing to the number of abortions. How ironic !

  12. Don Shor Post author

    This ruling is extremely broad in its potential effects and could be a major political liability for Republicans.
    Dozens of other companies are already ready to stop covering contraception. The Supreme Court clarified that the ruling applies to all contraception, not just the supposed “abortifacients.”
    It could extend to any number of other discriminations employers choose to apply based on ‘religious beliefs’.
    As a work-around, it increases the likelihood that taxpayers will end up funding contraception. It isn’t clear to me why that is morally acceptable to these plaintiffs.

    Why is this perceived as especially targeted at women? Well, they are the major consumers of contraception products. Contraceptive health services are basic health care for women. Health insurance that doesn’t cover contraception doesn’t cover the most common health care that women seek.

    Here’s the context of the ‘war on women’ narrative.
    There has been, in the last 3 to 4 years, a major increase in the number of state laws seeking to restrict access to abortion. By one source: 22 states, 70 different restrictions in three years. There are some states where you would have to go hundreds of miles to attain an abortion, even within the legal timeframe established by Roe v Wade.
    The Supreme Court has eliminated the buffer zones around abortion clinics, allowing harassment of women seeking a legal abortion.
    States have tried to restrict access to emergency contraception. Oklahoma’s latest attempt was just blocked by a state judge. I’m guessing the Supreme Court will have to rule on this issue several more times.
    Some states have tried to exclude emergency contraception from their Medicaid coverage.
    Some states allow pharmacists to refuse to dispense them.
    It is an unrelenting pattern of seeking to put up roadblocks to women who are seeking contraception and abortion services.
    And now, refusing to fund them at the place of work, based on nebulous religious beliefs. Some contraceptives, but not others? Hobby Lobby was objecting to copper IUD’s, to Plan B pills, to ella pills, to hormonal IUD’s. None of those are abortion pills. RU-486 is the abortion pill.
    They are objecting to highly effective birth control methods that do not, repeat do NOT, cause abortion. If there is something in their religion that says altering the body’s hormones or changing the lining of the uterus violates their religious principles, I’d be very curious what it is. They’re Assemblies of God, which I guess is biblical literalist. I don’t recall that much about hormones and uteruses in the Bible. More to the point: it’s none of their business. And it has created a fearsome precedent that will be tested over and over again.

    1. Frankly Post author

      “Perceived at targeting at women”

      Because folks like you and Nancy Pelosi are well served politically ginning up this false war on women.

      “Nebulous religious beliefs”

      Yup, just like banning plastic bags.

      1. Don Shor Post author

        I don’t understand your plastic bag reference.
        ‘War on women’ may be inflated rhetoric (gee, how unusual is that? Is there a “war on Christmas?”). But the disproportional impact of these decisions and laws is adverse to women’s health care and their freedom to control their own reproduction. You simply cannot deny that.
        It’s not false.

        1. Frankly Post author

          “War on Christmas” Christmas is a benign non-voting entity. And it is true.

          “War on women” is a political wedge from the left. And it is not true.

      2. Don Shor Post author

        I also don’t understand why conservatives get so unhinged about Nancy Pelosi. What bothers them about her, as compared to strongly ideological politicians elsewhere in the House and Senate, I do not understand. She’s a liberal from the Bay Area. Surprise! There are lots of them. And lots of off-the-wall conservatives from some states. There seems to be a special venom reserved just for Pelosi. It almost seems, I dunno, emotional or something.

        1. Frankly Post author

          Are you kidding. “We need to vote for Obamacare so we can see what is in it.”

          “The Tea Party people are Nazis.”

          “Right wing extremists shot Gabby Gifford.”

          “Five guys on SCOTUS are sexist and wage war on women.”

          All those quotes are reasonable approximations of what she said. And there is tons more.

          What is absurd to me that so many smart people from any political stripe actually support her. She epitomizes what is wrong with Washington.

          1. Don Shor Post author

            She is supported by a small congressional district in San Francisco. She has worked her way up the ladder of seniority to her position in the House, just as John Boehner did. I could find any number of absurd quotations from members of Congress across the political spectrum. I don’t think any of the current congressional leaders — Boehner or Pelosi, Reid or McConnell — are particularly astute or articulate or effective leaders. She no more “epitomizes what is wrong with Washington” than do any of the others. Perhaps if your hostility was more broadly directed to congressional leaders of both parties, I’d find it more reasonable.

        2. D.D. Post author

          Maybe Nancy P. reminds them of a classy older woman who tried to teach them proper manners and who was extremely intelligent & patient. She reminds them of a school teacher who tried to help them by teaching them how to be articulate, to “use their words”…proper debating skills. That’s my guess.
          Maybe a tiny percentage don’t perceive her as having the right “looks” to be in front of the camera, but they are probably embarrassed to admit that.

    2. Tia Will Post author

      Don

      Thank you for your clear and concise summary of the legal attempts to block women’s exercise of their right to choose the best medical preventive services available to them.

      What is being missed is that all health care providers and all pro life individuals want the same thing. We want there to be as few abortions as possible. What the “pro lifers” are over looking is that the single best way to prevent an abortion is to prevent the pregnancy. By limiting or making more difficulty pregnancy prevention, they are actually contributing to the number of abortions. How ironic !

  13. Eric Gelber

    At the risk of being referred to as “ignorant” or a “fool” by certain individuals who eschew civil discourse in favor of name-calling, the Supreme Court’s Hobby Lobby decision is one that should be a cause of concern for anyone who values individual rights, including privacy rights and religious freedom. Despite protestations from the Court majority, the decision recognizes the right of corporations (and those who run them) to impose their religious beliefs on their employees. Corporations can determine to provide medical benefits only to the extent that those benefits are used in a manner consistent with ownership’s religious beliefs—thereby intruding into what should be the private and personal healthcare choices of its employees. The decision opens the door to other impositions of “corporate” religious beliefs on individuals—e.g., religious opposition to all means of birth control, to transfusions, to any medical intervention. I, for one, am very concerned with this step down the road to theocracy.

    1. Frankly

      “the decision recognizes the right of corporations (and those who run them) to impose their religious beliefs on their employees.”

      Nice way to frame the argument incorrectly.

      Working for a corporation is not a right. Any employee can choose to not apply or quit and work somewhere else. A corporation is a separate taxed entity, but they are simply businesses started by and owned by individuals. And individuals have principles and beliefs that they have a right to hold. As long as there is no material harm done, we should celebrate and support the freedom to have and hold individual principles and beliefs, and the rights of free association.

      And your use of the term “religion” in this context is quite disturbing and demonstrates some bias. What about a company owned by Godless liberals that demand that no employee can bring any plastic bags to work? I have a guess that you would fully support that erosion of rights.

      “Step down the road to theocracy” LOL. Sure… we are heading toward a church-state if you consider liberalism a religion. I actually do think it fills a spiritual need for many atheists, and so maybe we should look it as a religion and stop the march toward a theocracy of liberalism.

      1. Don Shor

        What the Supreme Court has said, in effect, is that corporations can enact policies against one sub-set of their workers based on scientifically illiterate or inaccurate beliefs (they have a right to be ignorant) simply because they can claim a religious basis to those beliefs.
        They can do this regardless of the burden that it may impose on their workers, because evidently (said Alito) the government can provide the necessary services or products. For some reason, he seemed to believe that this was a limited ruling, in spite of how obviously broad its application could be.
        And they have extended the principle that a corporation has these human rights, even though a corporation can’t hold a specific set of beliefs if there is more than a single owner. Do you and your spouse or business partner agree on all theological principles and practices? The right of an individual to act on their beliefs is valid. But a corporation should have no such right. Unfortunately, the rights granted to corporations keep getting expanded by this Court.

      2. Tia Will

        Frankly

        ” As long as there is no material harm done”

        But there is great chance of material harm in limiting a woman’s right to choose her form of contraception, or to make it effectively unavailable to her.

        Let me give you a real life example from my clinic.
        I have a young woman ( under 35) who has been diagnosed with breast cancer. She is in need of highly statistically effective contraception while she completes her chemotherapy.
        If she goes into remission, she would be a candidate for pregnancy in the future.
        The only highly statistically effective and non hormonal means of contraception available to her is the Paraguard IUD, which because some people’s religion, not scientific fact determines this to be an abortifacient, it would not be covered by her insurance.

        I am very disturbed that the Supreme Court has decided that the religion of employers is of more relevance to the covered form of birth control than the religion of the woman herself.
        My patient and I had a long conversation about the mechanism of action of the Paraguard IUD which is primarily to induce what is termed a hostile cervical mucous through which sperm cannot penetrate, far from inducing an abortion it prevent sperm and egg from getting together. She was very clear that this was acceptable to her and we agreed as doctor and patient that this was by far her best option.

        How do you see preventing her from easily accessing this potentially life saving means of birth control as “no material harm” ?

        1. TrueBlueDevil

          Tia, there seem to be several missing points here.

          1. Condoms. Condoms have worked for centuries. I believe the failure rate of condoms also includes those that decide to forgo them once in a while, or buy cheap versions. Let’s also just say that if the user “checks the method” before the conclusion, that also helps. (No tears, hasn’t broken.)

          2. Making public healthy policy based on an “outlying” case seems like a bad move. To make police based on the .1 % of those insured doesn’t seem wise.

          3. She can’t pay for this method herself?

          4. Since you have repeatedly stated that you (and other doctors) and significantly overpaid, can’t you eliminate your profit with this patient? That would help her defray costs.

          1. Don Shor

            Condoms have worked for centuries.

            Thanks, that gave me a good laugh this morning. I hope you’re not relying on them, though. Tia can address this in more detail.

          2. Tia Will

            TBD

            I am happy to address your points.
            1) First with regard to condoms, they are a good means of prevention of sexually transmissible diseases. As contraceptives they are of low statistical efficacy. Of 100 couples between the ages of 18 and 35 ( woman’s age)
            using condoms as their only means of contraception ( consistently and as recommended) 20 will have conceived within one year. That is 1/5.
            What I tell my patient’s is that if that is an acceptable odds for them, that is fine. If they want more statistical efficacy, they need to choose another means.
            2) When you add up all the woman for whom a pregnancy would be medially dangerous including those with cancer, those with diabetes, hypertension, bleeding disorders, severe asthma, clotting abnormalities,
            seizure disorders, morbid obesity….we are no longer just talking about
            “outliers”. One other thing that I neglected to mention in my article is that the Mirena IUD is frequently used for non contraceptive health purposes such as control of excessively heavy menstrual bleeding leading to anemia, disabling menstrual cramps ( think time lost from work),
            and some forms of overgrowth conditions of the lining of the uterus.
            So in effect, this erroneous religious view of what the Mirena IUD does and does not do could prevent women from obtaining it regardless of whether they are even sexually active. I find this kind of employer control over women’s medical decisions deeply disturbing.
            3) The cost of the IUD itself is typically around $800.00. I am quite sure that is beyond the means of many woman who would be working for a store like Hobby Lobby.
            4) No, unless one is working in fee for service medicine, which I am not, I get no profit from placing or not placing a patient’s IUD. Since I work for Kaiser, I am salaried. Since under Kaiser policy, an IUD is considered preventative, the vast majority of women will pay nothing but their copay which for my services is typically between 0 -$25.00. So the answer is no,
            I honestly don’t see how I can affect the woman’s nominal payment of
            $25.00 for 5 years worth of prevention and / or treatment.

  14. Eric Gelber Post author

    At the risk of being referred to as “ignorant” or a “fool” by certain individuals who eschew civil discourse in favor of name-calling, the Supreme Court’s Hobby Lobby decision is one that should be a cause of concern for anyone who values individual rights, including privacy rights and religious freedom. Despite protestations from the Court majority, the decision recognizes the right of corporations (and those who run them) to impose their religious beliefs on their employees. Corporations can determine to provide medical benefits only to the extent that those benefits are used in a manner consistent with ownership’s religious beliefs—thereby intruding into what should be the private and personal healthcare choices of its employees. The decision opens the door to other impositions of “corporate” religious beliefs on individuals—e.g., religious opposition to all means of birth control, to transfusions, to any medical intervention. I, for one, am very concerned with this step down the road to theocracy.

    1. Frankly Post author

      “the decision recognizes the right of corporations (and those who run them) to impose their religious beliefs on their employees.”

      Nice way to frame the argument incorrectly.

      Working for a corporation is not a right. Any employee can choose to not apply or quit and work somewhere else. A corporation is a separate taxed entity, but they are simply businesses started by and owned by individuals. And individuals have principles and beliefs that they have a right to hold. As long as there is no material harm done, we should celebrate and support the freedom to have and hold individual principles and beliefs, and the rights of free association.

      And your use of the term “religion” in this context is quite disturbing and demonstrates some bias. What about a company owned by Godless liberals that demand that no employee can bring any plastic bags to work? I have a guess that you would fully support that erosion of rights.

      “Step down the road to theocracy” LOL. Sure… we are heading toward a church-state if you consider liberalism a religion. I actually do think it fills a spiritual need for many atheists, and so maybe we should look it as a religion and stop the march toward a theocracy of liberalism.

      1. Don Shor Post author

        What the Supreme Court has said, in effect, is that corporations can enact policies against one sub-set of their workers based on scientifically illiterate or inaccurate beliefs (they have a right to be ignorant) simply because they can claim a religious basis to those beliefs.
        They can do this regardless of the burden that it may impose on their workers, because evidently (said Alito) the government can provide the necessary services or products. For some reason, he seemed to believe that this was a limited ruling, in spite of how obviously broad its application could be.
        And they have extended the principle that a corporation has these human rights, even though a corporation can’t hold a specific set of beliefs if there is more than a single owner. Do you and your spouse or business partner agree on all theological principles and practices? The right of an individual to act on their beliefs is valid. But a corporation should have no such right. Unfortunately, the rights granted to corporations keep getting expanded by this Court.

      2. Tia Will Post author

        Frankly

        ” As long as there is no material harm done”

        But there is great chance of material harm in limiting a woman’s right to choose her form of contraception, or to make it effectively unavailable to her.

        Let me give you a real life example from my clinic.
        I have a young woman ( under 35) who has been diagnosed with breast cancer. She is in need of highly statistically effective contraception while she completes her chemotherapy.
        If she goes into remission, she would be a candidate for pregnancy in the future.
        The only highly statistically effective and non hormonal means of contraception available to her is the Paraguard IUD, which because some people’s religion, not scientific fact determines this to be an abortifacient, it would not be covered by her insurance.

        I am very disturbed that the Supreme Court has decided that the religion of employers is of more relevance to the covered form of birth control than the religion of the woman herself.
        My patient and I had a long conversation about the mechanism of action of the Paraguard IUD which is primarily to induce what is termed a hostile cervical mucous through which sperm cannot penetrate, far from inducing an abortion it prevent sperm and egg from getting together. She was very clear that this was acceptable to her and we agreed as doctor and patient that this was by far her best option.

        How do you see preventing her from easily accessing this potentially life saving means of birth control as “no material harm” ?

        1. TrueBlueDevil Post author

          Tia, there seem to be several missing points here.

          1. Condoms. Condoms have worked for centuries. I believe the failure rate of condoms also includes those that decide to forgo them once in a while, or buy cheap versions. Let’s also just say that if the user “checks the method” before the conclusion, that also helps. (No tears, hasn’t broken.)

          2. Making public healthy policy based on an “outlying” case seems like a bad move. To make police based on the .1 % of those insured doesn’t seem wise.

          3. She can’t pay for this method herself?

          4. Since you have repeatedly stated that you (and other doctors) and significantly overpaid, can’t you eliminate your profit with this patient? That would help her defray costs.

          1. Don Shor Post author

            Condoms have worked for centuries.

            Thanks, that gave me a good laugh this morning. I hope you’re not relying on them, though. Tia can address this in more detail.

          2. Tia Will Post author

            TBD

            I am happy to address your points.
            1) First with regard to condoms, they are a good means of prevention of sexually transmissible diseases. As contraceptives they are of low statistical efficacy. Of 100 couples between the ages of 18 and 35 ( woman’s age)
            using condoms as their only means of contraception ( consistently and as recommended) 20 will have conceived within one year. That is 1/5.
            What I tell my patient’s is that if that is an acceptable odds for them, that is fine. If they want more statistical efficacy, they need to choose another means.
            2) When you add up all the woman for whom a pregnancy would be medially dangerous including those with cancer, those with diabetes, hypertension, bleeding disorders, severe asthma, clotting abnormalities,
            seizure disorders, morbid obesity….we are no longer just talking about
            “outliers”. One other thing that I neglected to mention in my article is that the Mirena IUD is frequently used for non contraceptive health purposes such as control of excessively heavy menstrual bleeding leading to anemia, disabling menstrual cramps ( think time lost from work),
            and some forms of overgrowth conditions of the lining of the uterus.
            So in effect, this erroneous religious view of what the Mirena IUD does and does not do could prevent women from obtaining it regardless of whether they are even sexually active. I find this kind of employer control over women’s medical decisions deeply disturbing.
            3) The cost of the IUD itself is typically around $800.00. I am quite sure that is beyond the means of many woman who would be working for a store like Hobby Lobby.
            4) No, unless one is working in fee for service medicine, which I am not, I get no profit from placing or not placing a patient’s IUD. Since I work for Kaiser, I am salaried. Since under Kaiser policy, an IUD is considered preventative, the vast majority of women will pay nothing but their copay which for my services is typically between 0 -$25.00. So the answer is no,
            I honestly don’t see how I can affect the woman’s nominal payment of
            $25.00 for 5 years worth of prevention and / or treatment.

  15. DavisBurns

    While I do not like the Supreme Courts’s decision in any way, I would prefer that we have the option of a single payer health system and leave business owners, corporations, insurance agents ( and the profits they make off us) out of the equation entirely. The cobbled together health coverage we have now is an inefficient mess. It’s a stupid way to provide health insurance.

    1. TrueBlueDevil

      That’s Obama’s plan, this is just the first step of dismantling the best medical system in the world. Google any comparison of our American medical system to the United Kingdom, and you’ll see how much better we perform… or should I say performed.

      We’ll now get more of what the VA is experiencing… months long waits to see a doctor, or being purposefully dropped off waiting lists.

        1. TrueBlueDevil

          Nothing in life is perfect, we could have had market-based solutions that would have helped far better, and then expanded Medicaid (as has already happened), instead of adding the monstrosity that is the ACA,

          BTW, prices will continue to rise. I believe that insurance companies were given coverage and help by the federal government the first few years, but as that fades away, prices will continue to rise, and individuals will continue to lose coverage.

          Don’t think the ACA travesty is over or stagnant.

          1. Don Shor

            we could have had market-based solutions that would have helped far better

            Not a single proposal from the ‘other’ side would have expanded coverage as thoroughly as the ACA did.

            the monstrosity that is the ACA,

            The ACA is working. The dire predictions have fallen away, one by one.

          2. TrueBlueDevil

            Don: it doesn’t seem like you read the news much. Have you heard about the VA?

            How will the ACA be better than the VA?

            The only individuals I know who like the ACA are those who had a limited income, weren’t working, and / or had a pre-exisiting condition.

            Our President lied about the ACA repeatedly, and that is one of many reasons why his approval ratings are in the toilet, and Hillary Clinton is running away from him.

          3. Don Shor

            The ACA is working. How is there any comparison with the VA? Through the ACA, via the state exchange, I have private insurance and see private doctors. Anyone who compares the ACA (private) and the VA (public) either doesn’t understand them, or is being intentionally dishonest.
            The VA does happen to have a high patient satisfaction index. The scandals we are reading about are very serious. But they don’t, fortunately, affect the vast majority of VA patients.

        2. Frankly

          Get it TrueBlue?

          Flood the country with 50 million poor and uneducated people.

          Destroy business and job growth by “save the environment” and hyper entitlement policies.

          Then claim that our healthcare system outcomes are below average based on the stats.

          See how these people work? It is the playbook of collectivists everywhere throughout history. Divide and conquer. Explode the population of moochers to justify the looter existence. Think about all the money earned by producers… all those hard working and risk taking people that eventually win a profit.

          Those who can do, those that can’t stew.

          And the stewies have done well to develop their backdoor strategy to getting a bigger piece of the shrinking pie. Just like for the histories of many Mid Eastern countries, they learned that looting others is much easier than producing themselves.

          And if we turn healthcare over to government, the stewies win one of their biggest prizes ever. Think about all those public sector employees… the new millionaires.

          Just like Governor Brown and RDA… let others build something up until the stewies can harvest it to consume. It is a scorched earth strategy… consume, consume, consume… don’t stop until it is all gone. They try to do it quick enough so they get the maximum benefits before they die. To hell with the kids, they are on their own to deal with that empty husk.

          If you remove the flood of poor and uneducated illegal immigrants only, the US healthcare statistical outcomes match and exceed those with socialized healthcare.

          And that still does not explain why so many people from these countries with socialized healthcare flock to the US for their specialized procedures.

          1. Don Shor

            This is a spectacular reply. One of your best. You managed to get Ayn Rand, Jerry Brown, health care, immigrants, the Mid East, public sector employees, and the RDA — all in one comment! You just forgot Benghazi and the IRS, and Obama.

          2. TrueBlueDevil

            Frankly, you make interesting points. I heard a commentator put it another way: we have 10% of the population that is in the cart, who can’t work for various substantive, real, reasons, and 90% who pull the cart. And we accept that. We are a just society, and we want to help the 10% who can’t do for themselves.

            But the Left wants to expand those in the cart being pulled to 15%, 20%, 30% … and many think we’ve reached a breaking point. The numbers don’t add up. This is why I still think they use the laughable “12 million illegal immigrant” number, because if they used a real number like 30 or 40 million, plus another 10-20-30 million family members brought over for “family reunification”, the political tide might stop.

            Yes, wdf1 mentioned education. California was once number one in education, now we’re number 48 or 49? Libs only blame Prop 13, not the millions of non-native illegal immigrant children we now try to educate.

            I spoke recently with a teacher from Wilmington, and I asked her if there are any African American students in her elementary school. She replied: “There is one black student … and I think maybe 1 white student, but I’m not sure… yes, we are an ‘underperforming’ school.”

        3. South of Davis

          DP wrote:

          > how do you have the best medical system where huge numbers
          > of people do not have access to it?

          The same way we can have the best higher education system in the world where huge numbers of people do not have access to it (just because every kid that sneaks across the border can’t get in to a viniculture and enology department at UCD does not mean it is not the “best”). If EVERYONE has access to something it will not be the “best” for long (think of a restaurant, sports team or private school that had to let EVERYONE in, how long would it be the “best”)?

      1. Eric Gelber

        TBD: Ask the 10s of millions who now have healthcare coverage because of Obamacare if they think it is dismantling the best medical system in the world. Ask those who get medical care through the VA if they are happy with the quality of care they receive. I don’t think the answers will fit your premise.

        1. TrueBlueDevil

          How do you think the people feel who lost coverage because of Obamacare?

          How do you think people feel (when Obama lied) who lost their doctor?

          How do you think people feel who had their coverage costs skyrocket?

          A big chunk of the people who now have health coverage simply have Medicaid, which already existed!

          Talk to people who are covered through the VA? Have you read the news the past 2 months or 6 years?

          1. Don Shor

            How do you think people felt who could not get coverage before Obamacare?
            How do you think people felt who had our coverage costs skyrocket, or had insurance cancelled, or had procedures denied, or had specific health issues excluded?
            Why do you think Medicaid has ‘simply’ been expanded to millions of people who didn’t have it before? Why do you think that isn’t happening in some states?

          2. Frankly

            There were only TWO problems with our healthcare system that could have been easily remedied with a bipartisan plan.

            1. Pre-existing conditions. Change health insurer regulations, like for auto insurance, were rate tier limits exist based on certain actuarial critera. Index the rate tiers for people with per-existing conditions for the number of months that they have been without insurance after a 12 month window of sing up. Provide exceptions for people out of work that can prove inability to pay for health insurance.

            2. Reduce healthcare costs with tort reform, intra and extra-state competition, regulatory simplification. Encourage HSA high deductible plans, and require healthcare providers to clearly publish the cost of all procedures.

            But instead the left manufactured a crisis and leveraged it to take over private industry on a march to pure collectivism where the looters can better pad their pockets.

          3. Don Shor

            #1 won’t work for a number of reasons, and #2 is just tinkering around the margins. Tort reform is fine, HSA’s are fine, but they don’t achieve providing health insurance to the uninsured.
            It was a crisis, Frankly, for those of us who couldn’t get health insurance. You really, really don’t get that.

          4. Frankly

            The VA scandal and the quality of care are perfect examples of what government-run single-payer health care will provide. Thanks Eric!

          5. Davis Progressive

            which doesn’t address the biggest problem – uninsured people. manufactured a crisis?

          6. Frankly

            A nationwide audit by the Department of Veteran Affairs found that 57,000 veterans have been waiting more than 90 days for an appointment and that an additional 64,000 requested medical care but never made it onto VA waiting lists.

            Eric, I just noticed that you might not get to this part of that article you linked.

            The quality of care makes little difference if you cannot get an appointment.

          7. Eric Gelber

            “The VA scandal and the quality of care are perfect examples of what government-run single-payer health care will provide” …

            Yes. When the GOP-controlled Senate repeatedly blocks funding requests, including $21 billion this February. At least you now acknowledge that government healthcare is of high quality. Thanks, Frankly!

          8. Eric Gelber

            By Republican-controlled, I mean through the use of fillibusters and other obstructionist measures, not majority membership.

          9. TrueBlueDevil

            Frankly, you make good suggestions, but I have a few more.

            3. Allow for health savings accounts (HSA).

            4. Allow individuals to transfer their monies from their HSA to family members or friends. This would help in times of large medical procedures.

            5. Published pricing. This has always been a big one for me. How can we be educated consumers if we don’t know what something costs? I had a basic health test conducted, I called and told the billing specialist “Here is my plan, here is the test I’ll have at your office, what will it cost?” Her reply: “I don’t know.”

            If I knew the price, and there was competition, I could go in at 5AM for the test, or Saturday, or go to Fairfield on a Saturday to save $400 … all of these options weren’t available to me as they don’t tell me what the costs are! Do they do this on purpose?

            But even given these and many other options, we know that the number one way to reduce costs is the so-called death panels. Many of the seniors I know over 75, 80, have multiple health issues at play. They have survived cancer, strokes, diabetes, quadruple bipass, you name it … 4 senior men I know all have survived prostate cancer … it seems like we do an amazing job with many of these formerly fatal diseases. These are where the big dollars are, and where they will try to trim … as they also provide free health care to individuals from other countries.

          10. Tia Will

            TBD

            “How do you think the people feel who lost coverage because of Obamacare?

            How do you think people feel (when Obama lied) who lost their doctor?”

            I can only answer for those who after losing their coverage chose Kaiser in the exchange, but this is not an insignificant number. Some are sad about leaving a trusted doctor. This usually resolves once they realize that I also can be a trusted doctor. When people who did not have Kaiser previously join, the typical ( although of course not universal reaction) is
            “Wow, you mean that I can get all of that done here today !”
            I can see a specialist in Sacramento or Vacaville tomorrow ? You will personally e-mail me or phone me with my lab results if they are not normal ? Or even more surprising to many who need a minor procedure….you mean that you can do that for me today ? I won’t have to come back later and pay another copay ? The typical patient that I meet who was uninformed about the Kaiser system is usually delighted because of our commitment to providing as much as possible that the patient needs on the same day as their first appointment. For the vast majority of patients, the advantages of an integrated plan far outweigh their initial disappointment and insecurity about changing providers and plans.

    2. Topcat

      DavisBurns wrote: “The cobbled together health coverage we have now is an inefficient mess. It’s a stupid way to provide health insurance.”

      Yes. We have a cobbled together mess of a system with lots of waste and inefficiency. I’ve seen figures that about 1/3 of the healthcare expenditure goes to administrative, insurance costs and pure waste. Lots of time and money is wasted by insurance companies and bureaucratic nonsense.

      I don’t know what the answer is, but I do know that the system we have now is a mess.

          1. Barack Palin

            the estimate after all that already had healthcare that signed up, all that signed up and haven’t actually paid, all that don’t qualify because they reported false income or personal stats, etc. actually comes out to 2 to 3 million now covered that weren’t covered before. How much did it cist to cover these 2 to 3 million?

        1. Topcat

          Don wrote: “The system we had before excluded tens of millions of people from health coverage. The ACA is working.”

          Yes, it is providing a chance for previously uninsured to get coverage. What I am concerned about is the waste and inefficiency of the overall healthcare system. As I stated before, I have seen figures that 1/3 of healthcare expenditure does not go to providing healthcare, but rather to insurance companies, bureaucracy, administration, and waste.

          The Hobby Lobby debate is an example of the wastefulness in our system. I just don’t see why someone’s employer should have anything to do with the person’s healthcare.

          1. Don Shor

            I just don’t see why someone’s employer should have anything to do with the person’s healthcare.

            My understanding is that is something of a post-war relic. But it’s the system we’ve got. I’ve read analyses, by people who seem to know about this topic, that the employer mandate is probably the least important part of the process of getting more people insured. The individual mandate, Medicaid expansion, and the subsidies are much more crucial. But the employer mandate provides funding that wouldn’t be there otherwise. So if there’s going to be a reform that removes that, and makes health insurance truly individual, portable, and economical, there would have to be a mix of taxes and incentives to provide that lost revenue.

          2. Tia Will

            Dorte

            “This whole Obamacare thing is a mess”

            This is clearly a matter of perspective and I do not share yours.
            What I am seeing as a provider is a large number of woman coming in for care who were not able to obtain it before. In my area this includes women who are severely anemic from menstrual abnormalities, women who have breast cancer, women who have untreated diabetes, women who are in need of statistically effective contraception.
            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.
            I have posted frequently on how I believe that one of the first two provisions of Obamacare enabling those not yet 26 to remain on their parents insurance. My daughter at age 23 was diagnosed with anorexia requiring several prolong hospitalizations and outpatient intensive therapy which would potentially have bankrupted me and still left her with a 1/5 chance of dying without adequate care when I became unable to pay.
            Does anyone really believe that this is acceptable.

          3. Don Shor

            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.

            This succinctly explains why the suggestions Frankly has made about how to deal with pre-existing conditions would be ineffective and, in some ways, punitive. Many people have been without insurance for long intervals due to decisions made by insurance companies, not of their own volition. The only practical answer to the problem of pre-existing conditions is the method of the ACA: make it illegal to deny coverage, and deal with the cost by broadening the risk pool to include everybody.

          4. Frankly

            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.

            This succinctly explains why the suggestions Frankly has made about how to deal with pre-existing conditions would be ineffective and, in some ways, punitive. Many people have been without insurance for long intervals due to decisions made by insurance companies, not of their own volition. The only practical answer to the problem of pre-existing conditions is the method of the ACA: make it illegal to deny coverage, and deal with the cost by broadening the risk pool to include everybody.

            Read what I wrote again.

            So Obama give time and keeps extending time for people to sign up, yet for some reason this won’t work for uninsured women? Sounds sexist to me.

            You cannot simply say preexisting conditions are covered at the same rate. That will not work since many people will just wait until they are diagnosed and then get insurance. The best way to deal with it is to give people a deadline to sign up. And if Obama is still in power he can extend that date by executive order several times. But after the deadline, anyone acquiring insurance with preexisting conditions would pay a higher rate based on the number of months they had been without insurance. That premium on their premiums would be an incentive to get insurance as early as they could afford it. And also we should provide exceptions to this premium if the insured can prove inability to pay for insurance.

            You know this would work Don. Don’t be so stubborn in love of Obamacare to reject all other valid ideas.

          5. Frankly

            And here is the other ironic thing.

            The reason that so many people are still out of work has a lot to do with the Obama administration putting healthcare reform toward the left dream of single payer over economic policy to grow the economy and create more jobs so more people could get or afford healthcare insurance.

          6. Dorte Jensen

            Hi Tia,

            I say that Obamacare is a mess for (at least) the following reasons. The way it was:

            –passed (arm twisting, kickbacks, strict party-line vote)
            –implemented (website failures, insecure data, unverified subsidies)
            –upheld by a 5-4 Supreme Court vote (public intimidation by President of Supreme Court justices, a “penalty”–Obama’s term–became a “tax”–the majority’s term)
            –changed 37 times (I believe) by the President, whose job is to execute the laws, not make them
            –assigned to the IRS for enforcement, a government agency knee-deep in scandal
            –billed as a final solution but allows states to replace it, probably by single-payer

            Yes, none of these objections deal with the reality that you see, that some people now have insurance. They may be helped, but I fear that many more people will be hurt.

            For example, the following may occur:

            –Health care costs in general may rise
            –Employers may opt out when the employer mandate kicks in (more uninsured pushed into Obamacare, but will healthy young people enroll in sufficient numbers to finance older, sicker ones?)

            In other words, you are looking at a small piece of the present. (Granted, your experience is first-hand.) I am looking at the past and anticipating the future. (Granted, my experience is second-hand.) We will see who ends up being right. At some point, reality is no longer a question of perspective, or at least I hope not.

          7. TrueBlueDevil

            Dorte, you forgot that Congress, their staffers, and the President exempted themselves from the law!!!

          8. Dorte Jensen

            Hi TrueBlueDevil,

            I mentioned Congress and their staffers in my post of July 15, 3:05 p.m. (which starts “Hi Don” and is located about 1/5 down the entire comment page as measured by the orange cursor on the right-hand bar).

            I did omit listing the President. Thanks for the correction!

        2. DavisBurns

          Don, I agree that what we have now is better than what we had before however we still don’t cover everyone so it’s still a problem. Medicare works (been on for 8 months). The paper work could be better and sign up was a learning experience but the single payer crowd believed we just needed to expand Medicare over time until everyone was covered.

          1. Topcat

            DavisBurns wrote: “Medicare works (been on for 8 months). The paper work could be better and sign up was a learning experience but the single payer crowd believed we just needed to expand Medicare over time until everyone was covered.”

            Yes, that would have been a better solution than what we ended up with. What we have now is a patchwork system with tremendous inefficiency where a lot of our dollars go to insurance companies, administration and waste. I’ve seen estimates that about 1/3 of our health care dollars go for these things rather than actually providing healthcare. Imagine how much more healthcare we could provide for the same cost if we could just eliminate some of the inefficiency from the system.

    3. Tia Will

      DavisBurns

      As a thirty year practitioner, I could not agree more with your views on a single party payer system delivered through a Kaiser like model as Frankly once suggested ( well the Kaiser part anyway).

  16. DavisBurns Post author

    While I do not like the Supreme Courts’s decision in any way, I would prefer that we have the option of a single payer health system and leave business owners, corporations, insurance agents ( and the profits they make off us) out of the equation entirely. The cobbled together health coverage we have now is an inefficient mess. It’s a stupid way to provide health insurance.

    1. TrueBlueDevil Post author

      That’s Obama’s plan, this is just the first step of dismantling the best medical system in the world. Google any comparison of our American medical system to the United Kingdom, and you’ll see how much better we perform… or should I say performed.

      We’ll now get more of what the VA is experiencing… months long waits to see a doctor, or being purposefully dropped off waiting lists.

        1. TrueBlueDevil Post author

          Nothing in life is perfect, we could have had market-based solutions that would have helped far better, and then expanded Medicaid (as has already happened), instead of adding the monstrosity that is the ACA,

          BTW, prices will continue to rise. I believe that insurance companies were given coverage and help by the federal government the first few years, but as that fades away, prices will continue to rise, and individuals will continue to lose coverage.

          Don’t think the ACA travesty is over or stagnant.

          1. Don Shor Post author

            we could have had market-based solutions that would have helped far better

            Not a single proposal from the ‘other’ side would have expanded coverage as thoroughly as the ACA did.

            the monstrosity that is the ACA,

            The ACA is working. The dire predictions have fallen away, one by one.

          2. TrueBlueDevil Post author

            Don: it doesn’t seem like you read the news much. Have you heard about the VA?

            How will the ACA be better than the VA?

            The only individuals I know who like the ACA are those who had a limited income, weren’t working, and / or had a pre-exisiting condition.

            Our President lied about the ACA repeatedly, and that is one of many reasons why his approval ratings are in the toilet, and Hillary Clinton is running away from him.

          3. Don Shor Post author

            The ACA is working. How is there any comparison with the VA? Through the ACA, via the state exchange, I have private insurance and see private doctors. Anyone who compares the ACA (private) and the VA (public) either doesn’t understand them, or is being intentionally dishonest.
            The VA does happen to have a high patient satisfaction index. The scandals we are reading about are very serious. But they don’t, fortunately, affect the vast majority of VA patients.

        2. Frankly Post author

          Get it TrueBlue?

          Flood the country with 50 million poor and uneducated people.

          Destroy business and job growth by “save the environment” and hyper entitlement policies.

          Then claim that our healthcare system outcomes are below average based on the stats.

          See how these people work? It is the playbook of collectivists everywhere throughout history. Divide and conquer. Explode the population of moochers to justify the looter existence. Think about all the money earned by producers… all those hard working and risk taking people that eventually win a profit.

          Those who can do, those that can’t stew.

          And the stewies have done well to develop their backdoor strategy to getting a bigger piece of the shrinking pie. Just like for the histories of many Mid Eastern countries, they learned that looting others is much easier than producing themselves.

          And if we turn healthcare over to government, the stewies win one of their biggest prizes ever. Think about all those public sector employees… the new millionaires.

          Just like Governor Brown and RDA… let others build something up until the stewies can harvest it to consume. It is a scorched earth strategy… consume, consume, consume… don’t stop until it is all gone. They try to do it quick enough so they get the maximum benefits before they die. To hell with the kids, they are on their own to deal with that empty husk.

          If you remove the flood of poor and uneducated illegal immigrants only, the US healthcare statistical outcomes match and exceed those with socialized healthcare.

          And that still does not explain why so many people from these countries with socialized healthcare flock to the US for their specialized procedures.

          1. Don Shor Post author

            This is a spectacular reply. One of your best. You managed to get Ayn Rand, Jerry Brown, health care, immigrants, the Mid East, public sector employees, and the RDA — all in one comment! You just forgot Benghazi and the IRS, and Obama.

          2. Frankly Post author

            You two must really be Penn and Teller.

            But thanks for the complement. 😉

          3. TrueBlueDevil Post author

            Frankly, you make interesting points. I heard a commentator put it another way: we have 10% of the population that is in the cart, who can’t work for various substantive, real, reasons, and 90% who pull the cart. And we accept that. We are a just society, and we want to help the 10% who can’t do for themselves.

            But the Left wants to expand those in the cart being pulled to 15%, 20%, 30% … and many think we’ve reached a breaking point. The numbers don’t add up. This is why I still think they use the laughable “12 million illegal immigrant” number, because if they used a real number like 30 or 40 million, plus another 10-20-30 million family members brought over for “family reunification”, the political tide might stop.

            Yes, wdf1 mentioned education. California was once number one in education, now we’re number 48 or 49? Libs only blame Prop 13, not the millions of non-native illegal immigrant children we now try to educate.

            I spoke recently with a teacher from Wilmington, and I asked her if there are any African American students in her elementary school. She replied: “There is one black student … and I think maybe 1 white student, but I’m not sure… yes, we are an ‘underperforming’ school.”

        3. South of Davis Post author

          DP wrote:

          > how do you have the best medical system where huge numbers
          > of people do not have access to it?

          The same way we can have the best higher education system in the world where huge numbers of people do not have access to it (just because every kid that sneaks across the border can’t get in to a viniculture and enology department at UCD does not mean it is not the “best”). If EVERYONE has access to something it will not be the “best” for long (think of a restaurant, sports team or private school that had to let EVERYONE in, how long would it be the “best”)?

      1. Eric Gelber Post author

        TBD: Ask the 10s of millions who now have healthcare coverage because of Obamacare if they think it is dismantling the best medical system in the world. Ask those who get medical care through the VA if they are happy with the quality of care they receive. I don’t think the answers will fit your premise.

        1. TrueBlueDevil Post author

          How do you think the people feel who lost coverage because of Obamacare?

          How do you think people feel (when Obama lied) who lost their doctor?

          How do you think people feel who had their coverage costs skyrocket?

          A big chunk of the people who now have health coverage simply have Medicaid, which already existed!

          Talk to people who are covered through the VA? Have you read the news the past 2 months or 6 years?

          1. Don Shor Post author

            How do you think people felt who could not get coverage before Obamacare?
            How do you think people felt who had our coverage costs skyrocket, or had insurance cancelled, or had procedures denied, or had specific health issues excluded?
            Why do you think Medicaid has ‘simply’ been expanded to millions of people who didn’t have it before? Why do you think that isn’t happening in some states?

          2. Frankly Post author

            There were only TWO problems with our healthcare system that could have been easily remedied with a bipartisan plan.

            1. Pre-existing conditions. Change health insurer regulations, like for auto insurance, were rate tier limits exist based on certain actuarial critera. Index the rate tiers for people with per-existing conditions for the number of months that they have been without insurance after a 12 month window of sing up. Provide exceptions for people out of work that can prove inability to pay for health insurance.

            2. Reduce healthcare costs with tort reform, intra and extra-state competition, regulatory simplification. Encourage HSA high deductible plans, and require healthcare providers to clearly publish the cost of all procedures.

            But instead the left manufactured a crisis and leveraged it to take over private industry on a march to pure collectivism where the looters can better pad their pockets.

          3. Don Shor Post author

            #1 won’t work for a number of reasons, and #2 is just tinkering around the margins. Tort reform is fine, HSA’s are fine, but they don’t achieve providing health insurance to the uninsured.
            It was a crisis, Frankly, for those of us who couldn’t get health insurance. You really, really don’t get that.

          4. Frankly Post author

            The VA scandal and the quality of care are perfect examples of what government-run single-payer health care will provide. Thanks Eric!

          5. Davis Progressive Post author

            which doesn’t address the biggest problem – uninsured people. manufactured a crisis?

          6. Frankly Post author

            A nationwide audit by the Department of Veteran Affairs found that 57,000 veterans have been waiting more than 90 days for an appointment and that an additional 64,000 requested medical care but never made it onto VA waiting lists.

            Eric, I just noticed that you might not get to this part of that article you linked.

            The quality of care makes little difference if you cannot get an appointment.

          7. Eric Gelber Post author

            “The VA scandal and the quality of care are perfect examples of what government-run single-payer health care will provide” …

            Yes. When the GOP-controlled Senate repeatedly blocks funding requests, including $21 billion this February. At least you now acknowledge that government healthcare is of high quality. Thanks, Frankly!

          8. Eric Gelber Post author

            By Republican-controlled, I mean through the use of fillibusters and other obstructionist measures, not majority membership.

          9. TrueBlueDevil Post author

            Frankly, you make good suggestions, but I have a few more.

            3. Allow for health savings accounts (HSA).

            4. Allow individuals to transfer their monies from their HSA to family members or friends. This would help in times of large medical procedures.

            5. Published pricing. This has always been a big one for me. How can we be educated consumers if we don’t know what something costs? I had a basic health test conducted, I called and told the billing specialist “Here is my plan, here is the test I’ll have at your office, what will it cost?” Her reply: “I don’t know.”

            If I knew the price, and there was competition, I could go in at 5AM for the test, or Saturday, or go to Fairfield on a Saturday to save $400 … all of these options weren’t available to me as they don’t tell me what the costs are! Do they do this on purpose?

            But even given these and many other options, we know that the number one way to reduce costs is the so-called death panels. Many of the seniors I know over 75, 80, have multiple health issues at play. They have survived cancer, strokes, diabetes, quadruple bipass, you name it … 4 senior men I know all have survived prostate cancer … it seems like we do an amazing job with many of these formerly fatal diseases. These are where the big dollars are, and where they will try to trim … as they also provide free health care to individuals from other countries.

          10. Tia Will Post author

            TBD

            “How do you think the people feel who lost coverage because of Obamacare?

            How do you think people feel (when Obama lied) who lost their doctor?”

            I can only answer for those who after losing their coverage chose Kaiser in the exchange, but this is not an insignificant number. Some are sad about leaving a trusted doctor. This usually resolves once they realize that I also can be a trusted doctor. When people who did not have Kaiser previously join, the typical ( although of course not universal reaction) is
            “Wow, you mean that I can get all of that done here today !”
            I can see a specialist in Sacramento or Vacaville tomorrow ? You will personally e-mail me or phone me with my lab results if they are not normal ? Or even more surprising to many who need a minor procedure….you mean that you can do that for me today ? I won’t have to come back later and pay another copay ? The typical patient that I meet who was uninformed about the Kaiser system is usually delighted because of our commitment to providing as much as possible that the patient needs on the same day as their first appointment. For the vast majority of patients, the advantages of an integrated plan far outweigh their initial disappointment and insecurity about changing providers and plans.

    2. Topcat Post author

      DavisBurns wrote: “The cobbled together health coverage we have now is an inefficient mess. It’s a stupid way to provide health insurance.”

      Yes. We have a cobbled together mess of a system with lots of waste and inefficiency. I’ve seen figures that about 1/3 of the healthcare expenditure goes to administrative, insurance costs and pure waste. Lots of time and money is wasted by insurance companies and bureaucratic nonsense.

      I don’t know what the answer is, but I do know that the system we have now is a mess.

          1. Barack Palin Post author

            the estimate after all that already had healthcare that signed up, all that signed up and haven’t actually paid, all that don’t qualify because they reported false income or personal stats, etc. actually comes out to 2 to 3 million now covered that weren’t covered before. How much did it cist to cover these 2 to 3 million?

        1. Topcat Post author

          Don wrote: “The system we had before excluded tens of millions of people from health coverage. The ACA is working.”

          Yes, it is providing a chance for previously uninsured to get coverage. What I am concerned about is the waste and inefficiency of the overall healthcare system. As I stated before, I have seen figures that 1/3 of healthcare expenditure does not go to providing healthcare, but rather to insurance companies, bureaucracy, administration, and waste.

          The Hobby Lobby debate is an example of the wastefulness in our system. I just don’t see why someone’s employer should have anything to do with the person’s healthcare.

          1. Don Shor Post author

            I just don’t see why someone’s employer should have anything to do with the person’s healthcare.

            My understanding is that is something of a post-war relic. But it’s the system we’ve got. I’ve read analyses, by people who seem to know about this topic, that the employer mandate is probably the least important part of the process of getting more people insured. The individual mandate, Medicaid expansion, and the subsidies are much more crucial. But the employer mandate provides funding that wouldn’t be there otherwise. So if there’s going to be a reform that removes that, and makes health insurance truly individual, portable, and economical, there would have to be a mix of taxes and incentives to provide that lost revenue.

          2. Tia Will Post author

            Dorte

            “This whole Obamacare thing is a mess”

            This is clearly a matter of perspective and I do not share yours.
            What I am seeing as a provider is a large number of woman coming in for care who were not able to obtain it before. In my area this includes women who are severely anemic from menstrual abnormalities, women who have breast cancer, women who have untreated diabetes, women who are in need of statistically effective contraception.
            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.
            I have posted frequently on how I believe that one of the first two provisions of Obamacare enabling those not yet 26 to remain on their parents insurance. My daughter at age 23 was diagnosed with anorexia requiring several prolong hospitalizations and outpatient intensive therapy which would potentially have bankrupted me and still left her with a 1/5 chance of dying without adequate care when I became unable to pay.
            Does anyone really believe that this is acceptable.

          3. Don Shor Post author

            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.

            This succinctly explains why the suggestions Frankly has made about how to deal with pre-existing conditions would be ineffective and, in some ways, punitive. Many people have been without insurance for long intervals due to decisions made by insurance companies, not of their own volition. The only practical answer to the problem of pre-existing conditions is the method of the ACA: make it illegal to deny coverage, and deal with the cost by broadening the risk pool to include everybody.

          4. Frankly Post author

            Many of these women previously had insurance which they lost their jobs and / or had their hours cut. They were then unable to get health insurance because of their pre existing conditions.

            This succinctly explains why the suggestions Frankly has made about how to deal with pre-existing conditions would be ineffective and, in some ways, punitive. Many people have been without insurance for long intervals due to decisions made by insurance companies, not of their own volition. The only practical answer to the problem of pre-existing conditions is the method of the ACA: make it illegal to deny coverage, and deal with the cost by broadening the risk pool to include everybody.

            Read what I wrote again.

            So Obama give time and keeps extending time for people to sign up, yet for some reason this won’t work for uninsured women? Sounds sexist to me.

            You cannot simply say preexisting conditions are covered at the same rate. That will not work since many people will just wait until they are diagnosed and then get insurance. The best way to deal with it is to give people a deadline to sign up. And if Obama is still in power he can extend that date by executive order several times. But after the deadline, anyone acquiring insurance with preexisting conditions would pay a higher rate based on the number of months they had been without insurance. That premium on their premiums would be an incentive to get insurance as early as they could afford it. And also we should provide exceptions to this premium if the insured can prove inability to pay for insurance.

            You know this would work Don. Don’t be so stubborn in love of Obamacare to reject all other valid ideas.

          5. Frankly Post author

            And here is the other ironic thing.

            The reason that so many people are still out of work has a lot to do with the Obama administration putting healthcare reform toward the left dream of single payer over economic policy to grow the economy and create more jobs so more people could get or afford healthcare insurance.

          6. Dorte Jensen Post author

            Hi Tia,

            I say that Obamacare is a mess for (at least) the following reasons. The way it was:

            –passed (arm twisting, kickbacks, strict party-line vote)
            –implemented (website failures, insecure data, unverified subsidies)
            –upheld by a 5-4 Supreme Court vote (public intimidation by President of Supreme Court justices, a “penalty”–Obama’s term–became a “tax”–the majority’s term)
            –changed 37 times (I believe) by the President, whose job is to execute the laws, not make them
            –assigned to the IRS for enforcement, a government agency knee-deep in scandal
            –billed as a final solution but allows states to replace it, probably by single-payer

            Yes, none of these objections deal with the reality that you see, that some people now have insurance. They may be helped, but I fear that many more people will be hurt.

            For example, the following may occur:

            –Health care costs in general may rise
            –Employers may opt out when the employer mandate kicks in (more uninsured pushed into Obamacare, but will healthy young people enroll in sufficient numbers to finance older, sicker ones?)

            In other words, you are looking at a small piece of the present. (Granted, your experience is first-hand.) I am looking at the past and anticipating the future. (Granted, my experience is second-hand.) We will see who ends up being right. At some point, reality is no longer a question of perspective, or at least I hope not.

          7. TrueBlueDevil Post author

            Dorte, you forgot that Congress, their staffers, and the President exempted themselves from the law!!!

          8. Dorte Jensen Post author

            Hi TrueBlueDevil,

            I mentioned Congress and their staffers in my post of July 15, 3:05 p.m. (which starts “Hi Don” and is located about 1/5 down the entire comment page as measured by the orange cursor on the right-hand bar).

            I did omit listing the President. Thanks for the correction!

        2. DavisBurns Post author

          Don, I agree that what we have now is better than what we had before however we still don’t cover everyone so it’s still a problem. Medicare works (been on for 8 months). The paper work could be better and sign up was a learning experience but the single payer crowd believed we just needed to expand Medicare over time until everyone was covered.

          1. Topcat Post author

            DavisBurns wrote: “Medicare works (been on for 8 months). The paper work could be better and sign up was a learning experience but the single payer crowd believed we just needed to expand Medicare over time until everyone was covered.”

            Yes, that would have been a better solution than what we ended up with. What we have now is a patchwork system with tremendous inefficiency where a lot of our dollars go to insurance companies, administration and waste. I’ve seen estimates that about 1/3 of our health care dollars go for these things rather than actually providing healthcare. Imagine how much more healthcare we could provide for the same cost if we could just eliminate some of the inefficiency from the system.

    3. Tia Will Post author

      DavisBurns

      As a thirty year practitioner, I could not agree more with your views on a single party payer system delivered through a Kaiser like model as Frankly once suggested ( well the Kaiser part anyway).

  17. Ryan Kelly

    Frankly,
    Your article about happy conservative women is from the American Enterprise Institute for Public Policy Research (AEI) is a private, conservative think tank. http://en.wikipedia.org/wiki/American_Enterprise_Institute
    The report says that happiness is the result of 4 factors: Faith, Family, Friends and Work. Funny how political affiliation was never mentioned. It is complete bullshit to say that conservative women have a lock of these four factors and I suspect that non-conservative women are just as happy where these factors are strong.

    How about this report: http://www.motherjones.com/politics/2014/07/biology-ideology-john-hibbing-negativity-bias , – “conservatism is positively associated with heightened epistemic concerns for order, structure, closure, certainty, consistency, simplicity, and familiarity, as well as existential concerns such as perceptions of danger, sensitivity to threat, and death anxiety.”

    I think a reliance on simple religious codes or belief to explain everything, a desire for consistency and familiarity with regards to family, friends and work would lead to a sense of happiness. That is until someone wants to give healthcare access to everyone and changing the rules, or immigrant children come into town needing temporary housing while their families are located. Then the danger, threat, death anxiety alarms go off.

    1. Frankly

      Here is a very good article on this “conservatives are happier” truths. I hope it does not make you less happy.

      http://www.nytimes.com/2012/07/08/opinion/sunday/conservatives-are-happier-and-extremists-are-happiest-of-all.html?_r=0

      I love this point:

      So conservatives are ignorant, and ignorance is bliss, right? Not so fast, according to a study from the University of Florida psychologists Barry Schlenker and John Chambers and the University of Toronto psychologist Bonnie Le in the Journal of Research in Personality. These scholars note that liberals define fairness and an improved society in terms of greater economic equality. Liberals then condemn the happiness of conservatives, because conservatives are relatively untroubled by a problem that, it turns out, their political counterparts defined

      And this point:

      There is one other noteworthy political happiness gap that has gotten less scholarly attention than conservatives versus liberals: moderates versus extremists.

      Political moderates must be happier than extremists, it always seemed to me. After all, extremists actually advertise their misery with strident bumper stickers that say things like, “If you’re not outraged, you’re not paying attention!”

      But it turns out that’s wrong. People at the extremes are happier than political moderates. Correcting for income, education, age, race, family situation and religion, the happiest Americans are those who say they are either “extremely conservative” (48 percent very happy) or “extremely liberal” (35 percent). Everyone else is less happy, with the nadir at dead-center “moderate” (26 percent).

      What explains this odd pattern? One possibility is that extremists have the whole world figured out, and sorted into good guys and bad guys. They have the security of knowing what’s wrong, and whom to fight. They are the happy warriors.

      Which probably explains why I am so happy all the time when I am not pissed at all the unhappy people gumming up the works with so much absurdity. And related to this, I don’t think the apathetic can really be happy. So fire away!

      1. wdf1

        What Makes Us Happy, Revisited; A new look at the famous Harvard study of what makes people thrive

        In June 2009, The Atlantic published a cover story on the Grant Study, one of the longest-running longitudinal studies of human development. The project, which began in 1938, has followed 268 Harvard undergraduate men for 75 years, measuring an astonishing range of psychological, anthropological, and physical traits—from personality type to IQ to drinking habits to family relationships to “hanging length of his scrotum”—in an effort to determine what factors contribute most strongly to human flourishing.

        Recently, George Vaillant, who directed the study for more than three decades, published Triumphs of Experience, a summation of the insights the study has yielded.

        ….

        Political ideology had no bearing on life satisfaction—but the most-conservative men ceased sexual relations at an average age of 68, while the most-liberal men had active sex lives into their 80s. “I have consulted urologists about this,” Vaillant writes. “They have no idea why it might be so.”

        source

        1. Frankly

          Why do liberals make everything about sex? And why are they obsessed with older people having sex?

          Frankly, I will more happy if I can just walk or drive myself to church and maybe play a little golf.

          1. wdf1

            Frankly: Why do liberals make everything about sex? And why are they obsessed with older people having sex?

            I’m amused at how obsessed you are with pigeonholing everyone here on the political spectrum. And nearly every other poster here seems to be at least a little less politically conservative than you, and hence, liberal.

            If I’m going to make a step and self-identify as a liberal, then I might like to consider what all the possible consequences are. And if self-identifying as a liberal means an active sex life into my 80’s, I might like to take that into consideration.

            For instance, in my octogenarian years, I might like to have some juicy stories to tell the priest during confession, and maybe also have a very credible excuse to not play golf if I don’t feel like it that day…. 😉

      2. tribeUSA

        Frankly–I’m not an ordinary low-key moderate, but a fanatical moderate! It seems to me we need more moderates to get fanatical, to balance out the fanatical extremes, and perhaps act as moderators. I too am convinced my viewpoint is the best one, and am happy in expressing my moderation with fanatical enthusiasm and emphasis!!

  18. Ryan Kelly Post author

    Frankly,
    Your article about happy conservative women is from the American Enterprise Institute for Public Policy Research (AEI) is a private, conservative think tank. http://en.wikipedia.org/wiki/American_Enterprise_Institute
    The report says that happiness is the result of 4 factors: Faith, Family, Friends and Work. Funny how political affiliation was never mentioned. It is complete bullshit to say that conservative women have a lock of these four factors and I suspect that non-conservative women are just as happy where these factors are strong.

    How about this report: http://www.motherjones.com/politics/2014/07/biology-ideology-john-hibbing-negativity-bias , – “conservatism is positively associated with heightened epistemic concerns for order, structure, closure, certainty, consistency, simplicity, and familiarity, as well as existential concerns such as perceptions of danger, sensitivity to threat, and death anxiety.”

    I think a reliance on simple religious codes or belief to explain everything, a desire for consistency and familiarity with regards to family, friends and work would lead to a sense of happiness. That is until someone wants to give healthcare access to everyone and changing the rules, or immigrant children come into town needing temporary housing while their families are located. Then the danger, threat, death anxiety alarms go off.

    1. Frankly Post author

      Here is a very good article on this “conservatives are happier” truths. I hope it does not make you less happy.

      http://www.nytimes.com/2012/07/08/opinion/sunday/conservatives-are-happier-and-extremists-are-happiest-of-all.html?_r=0

      I love this point:

      So conservatives are ignorant, and ignorance is bliss, right? Not so fast, according to a study from the University of Florida psychologists Barry Schlenker and John Chambers and the University of Toronto psychologist Bonnie Le in the Journal of Research in Personality. These scholars note that liberals define fairness and an improved society in terms of greater economic equality. Liberals then condemn the happiness of conservatives, because conservatives are relatively untroubled by a problem that, it turns out, their political counterparts defined

      And this point:

      There is one other noteworthy political happiness gap that has gotten less scholarly attention than conservatives versus liberals: moderates versus extremists.

      Political moderates must be happier than extremists, it always seemed to me. After all, extremists actually advertise their misery with strident bumper stickers that say things like, “If you’re not outraged, you’re not paying attention!”

      But it turns out that’s wrong. People at the extremes are happier than political moderates. Correcting for income, education, age, race, family situation and religion, the happiest Americans are those who say they are either “extremely conservative” (48 percent very happy) or “extremely liberal” (35 percent). Everyone else is less happy, with the nadir at dead-center “moderate” (26 percent).

      What explains this odd pattern? One possibility is that extremists have the whole world figured out, and sorted into good guys and bad guys. They have the security of knowing what’s wrong, and whom to fight. They are the happy warriors.

      Which probably explains why I am so happy all the time when I am not pissed at all the unhappy people gumming up the works with so much absurdity. And related to this, I don’t think the apathetic can really be happy. So fire away!

      1. wdf1 Post author

        What Makes Us Happy, Revisited; A new look at the famous Harvard study of what makes people thrive

        In June 2009, The Atlantic published a cover story on the Grant Study, one of the longest-running longitudinal studies of human development. The project, which began in 1938, has followed 268 Harvard undergraduate men for 75 years, measuring an astonishing range of psychological, anthropological, and physical traits—from personality type to IQ to drinking habits to family relationships to “hanging length of his scrotum”—in an effort to determine what factors contribute most strongly to human flourishing.

        Recently, George Vaillant, who directed the study for more than three decades, published Triumphs of Experience, a summation of the insights the study has yielded.

        ….

        Political ideology had no bearing on life satisfaction—but the most-conservative men ceased sexual relations at an average age of 68, while the most-liberal men had active sex lives into their 80s. “I have consulted urologists about this,” Vaillant writes. “They have no idea why it might be so.”

        source

        1. Frankly Post author

          Why do liberals make everything about sex? And why are they obsessed with older people having sex?

          Frankly, I will more happy if I can just walk or drive myself to church and maybe play a little golf.

          1. wdf1 Post author

            Frankly: Why do liberals make everything about sex? And why are they obsessed with older people having sex?

            I’m amused at how obsessed you are with pigeonholing everyone here on the political spectrum. And nearly every other poster here seems to be at least a little less politically conservative than you, and hence, liberal.

            If I’m going to make a step and self-identify as a liberal, then I might like to consider what all the possible consequences are. And if self-identifying as a liberal means an active sex life into my 80’s, I might like to take that into consideration.

            For instance, in my octogenarian years, I might like to have some juicy stories to tell the priest during confession, and maybe also have a very credible excuse to not play golf if I don’t feel like it that day…. 😉

      2. tribeUSA Post author

        Frankly–I’m not an ordinary low-key moderate, but a fanatical moderate! It seems to me we need more moderates to get fanatical, to balance out the fanatical extremes, and perhaps act as moderators. I too am convinced my viewpoint is the best one, and am happy in expressing my moderation with fanatical enthusiasm and emphasis!!

  19. Dave Hart

    First observations: Why is it that people who post on this blog under their actual names tend to use fact-based and issue-oriented language while those posting under pseudonyms include more emotional language and rely more on their beliefs as opposed to science. So, I’d like to offer one more issue-oriented, fact-based observation aimed at establishing that the Supreme Court decision in the Hobby Lobby case was just plain wrong.

    No pregnancy is terminated by these contraceptives. The Supreme Court majority does not understand the facts or science of human reproduction even in the context of their religious views. Here are some relevant facts regarding the human reproductive systems, especially as it pertains to women who are the only people who can get pregnant and therefore the only people whose healthcare needs are subject to the restrictions by the Supreme Court in this case:

    Why scientific facts prove the US Supreme Court decision on Hobby Lobby is wrong:
    1. Sperm and egg come in close proximity: not pregnant.
    2. Sperm fertilizes egg => ovum in fallopian tube: not pregnant until implantation in uterus.
    3. It takes the ovum about 72 hours to get from the fallopian tube to the uterus: not pregnant.
    3. Fertilized egg implants itself in uterine wall: pregnant.
    4. The I.U.D. and Morning-After pill prevent step (3) above,

    1. tribeUSA

      Mr. Hart–I post under a psuedonym for several reasons
      (1) Many of my viewpoints are non-pc; and I am still in the employment market
      (2) I was a key witness to a serious crime that got a gang-banger jailed (pertinent when I post about crime-related issues)
      (3) My psuedonym is a gestalt that pertains to an underlying philosophy on many issues presented in the Vanguard Forum.

      I too respect and support science based arguments; but don’t mind emotional expressions (can help in figuring out where people are coming from); also remember only a small part of life and the universe is understood (or perhaps can ever be understood) by the scientific method; consciousness itself is a complete mystery to science.

    2. Frankly

      Mr. Hart – I have to say that this was a very unhappy post.

      But I really appreciate the science and largely agree with you on it.

      Too bad that science does not dictate policy else we would still be getting our groceries in plastic bags.

  20. Dave Hart Post author

    First observations: Why is it that people who post on this blog under their actual names tend to use fact-based and issue-oriented language while those posting under pseudonyms include more emotional language and rely more on their beliefs as opposed to science. So, I’d like to offer one more issue-oriented, fact-based observation aimed at establishing that the Supreme Court decision in the Hobby Lobby case was just plain wrong.

    No pregnancy is terminated by these contraceptives. The Supreme Court majority does not understand the facts or science of human reproduction even in the context of their religious views. Here are some relevant facts regarding the human reproductive systems, especially as it pertains to women who are the only people who can get pregnant and therefore the only people whose healthcare needs are subject to the restrictions by the Supreme Court in this case:

    Why scientific facts prove the US Supreme Court decision on Hobby Lobby is wrong:
    1. Sperm and egg come in close proximity: not pregnant.
    2. Sperm fertilizes egg => ovum in fallopian tube: not pregnant until implantation in uterus.
    3. It takes the ovum about 72 hours to get from the fallopian tube to the uterus: not pregnant.
    3. Fertilized egg implants itself in uterine wall: pregnant.
    4. The I.U.D. and Morning-After pill prevent step (3) above,

    1. tribeUSA Post author

      Mr. Hart–I post under a psuedonym for several reasons
      (1) Many of my viewpoints are non-pc; and I am still in the employment market
      (2) I was a key witness to a serious crime that got a gang-banger jailed (pertinent when I post about crime-related issues)
      (3) My psuedonym is a gestalt that pertains to an underlying philosophy on many issues presented in the Vanguard Forum.

      I too respect and support science based arguments; but don’t mind emotional expressions (can help in figuring out where people are coming from); also remember only a small part of life and the universe is understood (or perhaps can ever be understood) by the scientific method; consciousness itself is a complete mystery to science.

    2. Frankly Post author

      Mr. Hart – I have to say that this was a very unhappy post.

      But I really appreciate the science and largely agree with you on it.

      Too bad that science does not dictate policy else we would still be getting our groceries in plastic bags.

  21. tribeUSA

    Mr. Hart–many religions (including the Catholic Church, I think) regard stage 2 (sperm fertilizes egg) the moment of conception, as the stage at which there should be no further interference to step 3 (you have listed two step 3s; the technical definition of pregnancy) and beyond. Perhaps many of the church spokespeople use the phrase ‘pregnancy termination’ in a technically incorrect manner; when they should really use the phrase ‘termination of the fertilized egg’; however the shorter phrase is used as a convenience to denote all stages from stage 2 thru birth; and is a phrase that is more familiar to the general public.

  22. tribeUSA Post author

    Mr. Hart–many religions (including the Catholic Church, I think) regard stage 2 (sperm fertilizes egg) the moment of conception, as the stage at which there should be no further interference to step 3 (you have listed two step 3s; the technical definition of pregnancy) and beyond. Perhaps many of the church spokespeople use the phrase ‘pregnancy termination’ in a technically incorrect manner; when they should really use the phrase ‘termination of the fertilized egg’; however the shorter phrase is used as a convenience to denote all stages from stage 2 thru birth; and is a phrase that is more familiar to the general public.

  23. Frankly

    Why is it that people who post on this blog under their actual names tend to use fact-based and issue-oriented language while those posting under pseudonyms include more emotional language and rely more on their beliefs as opposed to science.

    You want to back that statement up with any science, or are you just relying on your beliefs?

  24. Frankly Post author

    Why is it that people who post on this blog under their actual names tend to use fact-based and issue-oriented language while those posting under pseudonyms include more emotional language and rely more on their beliefs as opposed to science.

    You want to back that statement up with any science, or are you just relying on your beliefs?

  25. Dave Hart

    Frankly, I generalized, hence the word “most”. Re-using cloth bags for 10-15 years as we’ve been doing is less resource intensive and resource efficient than single use bags. But on the issue, the Supreme Court is wrong because they allow the religious belief of Hobby Lobby to allow that birth control pills are okay to include in insurance coverage which prevent sperm from fertilizing an egg while there is strong evidence that is how the IUD works. In nature, fertilized eggs don’t always implant in the uterus. They are flushed out of the uterus and murdered by Mother Nature herself. So they decided in a totally arbitrary way. The most galling of all, however, is that this only affects women. I don’t give a damn about women who agree with the idea of human life beginning at conception because they don’t have to do anything to live the way they want to live. This only affects women who want and NEED to have control over their lives. The decision is wrong on so many levels. It is an affront to the intelligence and humanity of people who want to take NORMAL advantage of simple and safe birth control but who are told somebody else’s crazy superstitious beliefs have more weight than your rational need for health care.

    As Isaac Asimov said, “There is a cult of ignorance in the United States and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge.” That’s what pisses me off.

    1. Frankly

      I agree. Ignorance pisses me off too… but mostly stubborn ignorance. And there is a lot of that these days. People taking a position and digging in their heels and not really listening to others or really caring so much about the truth or fact rather than winning an argument.

      I am pro-abortion… but only to an extent. And you pretty much hit on my scientific understanding of conception and gestation and where I currently draw the line at life of not life.

      But there is too much pushing at the extremes from both sides. Anti-abortion activists and NOW demand that even late-term and partial birth abortions be kept legal and accessible. Some pro-life religious extremists demand that even condoms be banned from easy access.

      Where the left and the pro-life argument loses me though is the Constitutional right for freedom of religion and freedom of association. I don’t have to agree with the opinions of a group to demand that they have a right to believe and express what they believe if. I bristle at the left constantly telling everyone else what they can or cannot believe in, and who the must associate with.

      My litmus test is always material harm. If nobody is materially harmed by the beliefs and practice freedom of association, then there should be be any acceptance of any attempt to force some change through government or judicial tactics.

      I use plastic bags as a reference because the science was clearly not in support of the claims of material harm, yet that has been forced upon us anyway.

      And for Hobby Lobby, I don’t see enough material harm to any female employee to justify forcing them to violate their own beliefs… however stupid they may seem. And in the case where a woman employee just cannot tolerate the policy, she has the freedom to leave and go work somewhere else. There are a lot of things about a company policy that an employee might not like.

      1. Dave Hart

        Let’s say, for a moment, that I believe cancer cells are God’s expression of Her desire to test a person’s faith and should in no way be interfered with. To make it a little more real, let’s say I only care about prostate cancer. I shouldn’t have to pay for PSA tests or any treatment in my medical plan. Affects just men. Whose beliefs are violated and how reasonable is it to insist that you, Frankly (I assume you are male) are free to go work for someone else and pay for your own life-saving treatment. Why can’t we as a society just say “All medical decisions are between you and your doctor and all health insurance should cover all and any medical condition?” What’s wrong with that simple idea and what is wrong with people that makes them feel like their beliefs should come between you and your doctor?

      2. Tia Will

        Frankly

        “I don’t see enough material harm to any female employee to justify forcing them to violate their own beliefs”

        I would like to provide you with two different examples of real material harm.

        1) The actual case of my patient with breast cancer who needs chemotherapy and also needs statistically effective contraception. Her only statistically effective option is the non hormone containing IUD. I cannot imagine how you could not see this as material harm. And, if you are going to maintain that she can just leave and go get a job elsewhere, as a businessman, please tell me honestly how likely she is to be able to find a new job while on chemotherapy even if she is capable of working ?

        2) Second case, also real. A woman has such heavy periods that she is constantly anemic ( missing work, unable to fully function ) so that there is no possibility that this does not represent material harm. She is not sexually active so there is no possibility that their religious beliefs could be abridged. We have tried other options and are down to a trial of the Mirena IUD. Now should her
        Hobby Lobby cover her IUD ? Should she have to sign a form swearing that she will not engage in sexual activity ? What if her partner has had a vasectomy ? Can Hobby Lobby still deny coverage ? Where does her employers meddling in her health care decisions end ?

    2. Dorte Jensen

      Hi Dave,

      I disagree with your statement, “This only affects women who want and NEED to have control over their lives.” I believe that all of our lives are connected at some level. Therefore, it affects these women first, and then it affects other people, including those who own Hobby Lobby. If you think that my view is unscientific, consider the interface between Buddhism and quantum physics.

  26. Dave Hart Post author

    Frankly, I generalized, hence the word “most”. Re-using cloth bags for 10-15 years as we’ve been doing is less resource intensive and resource efficient than single use bags. But on the issue, the Supreme Court is wrong because they allow the religious belief of Hobby Lobby to allow that birth control pills are okay to include in insurance coverage which prevent sperm from fertilizing an egg while there is strong evidence that is how the IUD works. In nature, fertilized eggs don’t always implant in the uterus. They are flushed out of the uterus and murdered by Mother Nature herself. So they decided in a totally arbitrary way. The most galling of all, however, is that this only affects women. I don’t give a damn about women who agree with the idea of human life beginning at conception because they don’t have to do anything to live the way they want to live. This only affects women who want and NEED to have control over their lives. The decision is wrong on so many levels. It is an affront to the intelligence and humanity of people who want to take NORMAL advantage of simple and safe birth control but who are told somebody else’s crazy superstitious beliefs have more weight than your rational need for health care.

    As Isaac Asimov said, “There is a cult of ignorance in the United States and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge.” That’s what pisses me off.

    1. Frankly Post author

      I agree. Ignorance pisses me off too… but mostly stubborn ignorance. And there is a lot of that these days. People taking a position and digging in their heels and not really listening to others or really caring so much about the truth or fact rather than winning an argument.

      I am pro-abortion… but only to an extent. And you pretty much hit on my scientific understanding of conception and gestation and where I currently draw the line at life of not life.

      But there is too much pushing at the extremes from both sides. Anti-abortion activists and NOW demand that even late-term and partial birth abortions be kept legal and accessible. Some pro-life religious extremists demand that even condoms be banned from easy access.

      Where the left and the pro-life argument loses me though is the Constitutional right for freedom of religion and freedom of association. I don’t have to agree with the opinions of a group to demand that they have a right to believe and express what they believe if. I bristle at the left constantly telling everyone else what they can or cannot believe in, and who the must associate with.

      My litmus test is always material harm. If nobody is materially harmed by the beliefs and practice freedom of association, then there should be be any acceptance of any attempt to force some change through government or judicial tactics.

      I use plastic bags as a reference because the science was clearly not in support of the claims of material harm, yet that has been forced upon us anyway.

      And for Hobby Lobby, I don’t see enough material harm to any female employee to justify forcing them to violate their own beliefs… however stupid they may seem. And in the case where a woman employee just cannot tolerate the policy, she has the freedom to leave and go work somewhere else. There are a lot of things about a company policy that an employee might not like.

      1. Dave Hart Post author

        Let’s say, for a moment, that I believe cancer cells are God’s expression of Her desire to test a person’s faith and should in no way be interfered with. To make it a little more real, let’s say I only care about prostate cancer. I shouldn’t have to pay for PSA tests or any treatment in my medical plan. Affects just men. Whose beliefs are violated and how reasonable is it to insist that you, Frankly (I assume you are male) are free to go work for someone else and pay for your own life-saving treatment. Why can’t we as a society just say “All medical decisions are between you and your doctor and all health insurance should cover all and any medical condition?” What’s wrong with that simple idea and what is wrong with people that makes them feel like their beliefs should come between you and your doctor?

      2. Tia Will Post author

        Frankly

        “I don’t see enough material harm to any female employee to justify forcing them to violate their own beliefs”

        I would like to provide you with two different examples of real material harm.

        1) The actual case of my patient with breast cancer who needs chemotherapy and also needs statistically effective contraception. Her only statistically effective option is the non hormone containing IUD. I cannot imagine how you could not see this as material harm. And, if you are going to maintain that she can just leave and go get a job elsewhere, as a businessman, please tell me honestly how likely she is to be able to find a new job while on chemotherapy even if she is capable of working ?

        2) Second case, also real. A woman has such heavy periods that she is constantly anemic ( missing work, unable to fully function ) so that there is no possibility that this does not represent material harm. She is not sexually active so there is no possibility that their religious beliefs could be abridged. We have tried other options and are down to a trial of the Mirena IUD. Now should her
        Hobby Lobby cover her IUD ? Should she have to sign a form swearing that she will not engage in sexual activity ? What if her partner has had a vasectomy ? Can Hobby Lobby still deny coverage ? Where does her employers meddling in her health care decisions end ?

    2. Dorte Jensen Post author

      Hi Dave,

      I disagree with your statement, “This only affects women who want and NEED to have control over their lives.” I believe that all of our lives are connected at some level. Therefore, it affects these women first, and then it affects other people, including those who own Hobby Lobby. If you think that my view is unscientific, consider the interface between Buddhism and quantum physics.

  27. Tia Will

    Dave Hart

    Thanks for the Asimov quote.

    A major frustration for those of us who work in science based fields, whether research or applied as in medicine, is the level of ignorance of basic functioning of the world demonstrated by those we encounter at work, but also by those who make and interpret our laws.

    Tod Akins is my favorite recent example with his belief that women who are “legitimately raped” rarely get pregnant because their bodies have means to “shut that whole thing down”. The thought that people so ignorant of reproductive functioning could be involved in making any law having to do with reproduction in any way is
    deeply disturbing to those of us who see the very real “material harm” done to women and families by not allowing women to freely choose the best means of pregnancy prevention available to them.

    1. TrueBlueDevil

      I agree with your condemnation of ignorance; does this extend to so-called leaders of women? There is a direct comparison here.

      As a young lawyer in Arkansas, Hillary Clinton defended a brutal child rapist. She now claims she was required to do such, but the record from the time was that she “did it for a friend” (taking the case). There were no rape shield or victim protection laws at that time.

      Hillary filed a Motion claiming that this 12-year-old girl had a history of cozying up to men, wasn’t stable, had a history of making up such stories, and had come from a “troubled” situation. These aren’t exact quotes, but the essence holds true. There was no evidence or substance for these blatant lies. You can Google it. This was a brutal rape of a 12-year-old child. Hillary – on audio tape – even notes that she knew the rapist was guilty, but he passed a polygraph test!

      The rapist got a vastly reduced plea deal with limited jail time. The victim has gone on to have a very hard life. She has only commented on this case once before, but came out a second time when she was informed of what happened “behind the scenes”, and when she was informed that the young Mrs. Clinton was laughing about the case. She said that this case and crime devastated her life.

      So Tia, who is worse, Tod Akin or Hillary Clinton?

    2. Dorte Jensen

      Hi Tia,

      Thanks for discussing this issue in terms of “pregnancy prevention” rather than “contraception”, since the matter in question is the fertilized egg. In case you didn’t notice, I included several relevant definitions in my post of July 15, 4:42 p.m. (which starts “Hi South of Davis” and is located about 1/5 down the entire comment page, as measured by the orange cursor in the right-hand bar).

      Also, I hope you got to see my response to you (July 15, 11:33 p.m.) regarding why I call Obamacare a mess. (This post is located about 1/5 from the bottom of the entire page, as measured again by the orange cursor.)

  28. Tia Will Post author

    Dave Hart

    Thanks for the Asimov quote.

    A major frustration for those of us who work in science based fields, whether research or applied as in medicine, is the level of ignorance of basic functioning of the world demonstrated by those we encounter at work, but also by those who make and interpret our laws.

    Tod Akins is my favorite recent example with his belief that women who are “legitimately raped” rarely get pregnant because their bodies have means to “shut that whole thing down”. The thought that people so ignorant of reproductive functioning could be involved in making any law having to do with reproduction in any way is
    deeply disturbing to those of us who see the very real “material harm” done to women and families by not allowing women to freely choose the best means of pregnancy prevention available to them.

    1. TrueBlueDevil Post author

      I agree with your condemnation of ignorance; does this extend to so-called leaders of women? There is a direct comparison here.

      As a young lawyer in Arkansas, Hillary Clinton defended a brutal child rapist. She now claims she was required to do such, but the record from the time was that she “did it for a friend” (taking the case). There were no rape shield or victim protection laws at that time.

      Hillary filed a Motion claiming that this 12-year-old girl had a history of cozying up to men, wasn’t stable, had a history of making up such stories, and had come from a “troubled” situation. These aren’t exact quotes, but the essence holds true. There was no evidence or substance for these blatant lies. You can Google it. This was a brutal rape of a 12-year-old child. Hillary – on audio tape – even notes that she knew the rapist was guilty, but he passed a polygraph test!

      The rapist got a vastly reduced plea deal with limited jail time. The victim has gone on to have a very hard life. She has only commented on this case once before, but came out a second time when she was informed of what happened “behind the scenes”, and when she was informed that the young Mrs. Clinton was laughing about the case. She said that this case and crime devastated her life.

      So Tia, who is worse, Tod Akin or Hillary Clinton?

    2. Dorte Jensen Post author

      Hi Tia,

      Thanks for discussing this issue in terms of “pregnancy prevention” rather than “contraception”, since the matter in question is the fertilized egg. In case you didn’t notice, I included several relevant definitions in my post of July 15, 4:42 p.m. (which starts “Hi South of Davis” and is located about 1/5 down the entire comment page, as measured by the orange cursor in the right-hand bar).

      Also, I hope you got to see my response to you (July 15, 11:33 p.m.) regarding why I call Obamacare a mess. (This post is located about 1/5 from the bottom of the entire page, as measured again by the orange cursor.)

  29. Tia Will

    Dorte

    “Yes, none of these objections deal with the reality that you see, that some people now have insurance. They may be helped, but I fear that many more people will be hurt.”

    You are using the word “may” to describe things that are already reality ( people that I have already seen being helped) and to describe things that you fear may happen ( things that are speculative).

    It is a fact that women who receive screening for cervical cancer rarely develop this form of cancer since we catch it and treat it when it is in a a precancerous form. I am typically screening 3-4 patients daily in my clinic who had not been screened within the past 3-5 years and are now able to get it because they signed up through Covered California. I know, because I ask my new patient’s what brought them to Kaiser.

    It is a fact, not a “may” that I have seen women with treatable breast cancer who were not able to be treated before they were signed up. It is fact that I have helped women who could not get treatment for anemia and other readily treatable problems because they were not insured.

    It is a fact that my daughter received life saving treatment which I would not have been able to afford for a prolonged period because of the provision of Obamacare that allowed her to be continued under my insurance policy until age 26.

    These are facts, not speculation or my vision of what “may” happen.

    I do not consider the ACA perfect. I wanted a single party payer system administered through systems like Kaiser.
    I would happily do away with fee for service medicine altogether. It is fee for service medicine that makes it virtually impossible to determine what a procedure costs as one poster noted. It is true that “they” namely the insurance companies, hospitals , manufacturers of medical equipment and pharmaceuticals do not want you to know what each item actually costs. If the costs were transparent, people would not be driving up the cost of medicine by demanding completely unnecessary tests which I dissuade patients from doing on a regular basis. If I can determine the cause of a problem with a simple exam or office procedure, why would I order an MRI or CT ?
    In fee for service medicine the answer is obvious. Its the money, although that is not what you will be told.

    1. Dorte Jensen

      Hi Tia,

      I use the word “may” in terms of the overall population of the presently insured who were previously uninsured. Yes, some of these people are helped now, such as those who have diseases which are caught or treated. However, if they never had a disease (such as cancer) and are screened now and still don’t have it, then knowing that may help psychologically, but it is not a help in the real sense, since they don’t have the disease to begin with.

      In other words, I’m glad that some people are being helped, but I think that they and pretty much everyone else could have been helped by another approach. That would have been a net gain (in mathematical terms, a gain for the uninsured plus a gain for the country as a whole), rather than a net wash (some winners and some losers, the latter of which include people who had cancer, had their insurance cancelled due to Obamacare, and could not buy another policy at a comparable price) or a net loss (the whole medical and economic system comes crashing down or basically grinds to a halt). Of course, some of these events concern the future, but some of them have already occurred.

      By the way, I commented to Don earlier on (in a very long post) that I was uninsured before Obamacare and am uninsured now. So at least I follow through with what I believe (at least in this case!). The IRS hasn’t come after me yet–I guess the individual mandate has been extended–so after that I will pay the fine as long as that is affordable, I suppose. I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick. To echo sentiments you often express, how is this situation acceptable?

      1. Don Shor

        You should get insurance. If you become sick with a chronic condition, you will become a major burden on the system unless you are very wealthy.

          1. Don Shor

            And I think that the Affordable Care Act has provided people like you and me with the option of obtaining insurance — which is a personal responsibility — more affordably and more readily than before. It is based on private insurers providing coverage via private health care providers. But if don’t want to use the exchange, you can still buy insurance directly from companies like Anthem or Kaiser.
            The major burden to the system was, among other things, uninsured people getting sick and using health care services, and being unable to pay for them.

          2. Dorte Jensen

            Hi Don,

            It took me a while to answer because I was thinking about what to say. Three points:

            First, I don’t like health insurance in general, since companies drop customers when they start filing too many claims. That is when customers are sick and need insurance, and that is when they are dropped.

            Second, I don’t like Obamacare, which is a means of getting insurance and a means of wealth distribution, since taxpayers subsidize the premiums of people with lower incomes. I have written on other posts why I think that it harms/will harm people and the country as a whole, so I won’t repeat myself here.

            Finally, I don’t think that I have a responsibility to participate in something I find destructive. I do have a responsibility to pay medical bills which I incur, and I explained to Tia in my post of July 20, 2:53 a.m. that I would do so.

          3. Don Shor

            The ACA prohibits companies from dropping people from coverage when they get sick.

            If you don’t wish to have taxpayers subsidize the premiums of people with lower incomes, how do you propose they get their medical care paid for if they cannot afford it? Do you think poor people have a right to health care?

            You and your family would quickly be bankrupted by any medical issue of any duration or complexity. Moreover, you would be paying a much higher cost for services, because insured patients pay rates that are negotiated down by the insurers. You wouldn’t have that benefit.
            You are taking a huge gamble by opting not to get insurance coverage.

          4. Dorte Jensen

            Hi Don,

            Oops. When I said, “a means of wealth distribution,” I meant wealth re-distribution.

          5. Dorte Jensen

            Hi Don,

            Some comments in response to yours:

            –You write, “The ACA prohibits companies from dropping people from coverage when they get sick.” I am glad of this, since doing so after a person has paid into the system is basically fraud.

            That said, I do wonder how these companies will stay in business, since they probably agreed to Obamacare thinking that they would get a lot of young/healthy people (so-called “invincibles”)who would make few claims for a long time. Data regarding the final percentage of this group (after the open-enrollment period closed) can be found here:

            http://dailysignal.com/2014/05/02/details-missing-obamacare-headcount-final-report/

            Here’s a quote from that article:

            “[O]fficials promoted the 2.2 million young adult (ages 18 to 34) that made up 28 percent of the participant pool. Officials originally projected that, to be successful, Obamacare’s state and federal exchanges would need nearly 40 percent of new enrollees to be relatively healthy young adults — and thus spread out health care costs.”

            As a result of this shortfall perhaps, a few months ago insurance companies wanted to raise premiums, and the President amended the ACA to provide taxpayer funds to prevent this increase (what critics have called a “bailout” of the insurance companies).

            http://www.latimes.com/nation/la-na-insurance-bailout-20140521-story.html#page=1

            (The fact that the President has changed the ACA–as I remember–37 times is a Constitutional problem, one that the Speaker of the House is addressing in his planned suit against the President for the delay of the employer mandate.)

            As a result of this latest change, the people who have insurance without subsidies (who have as taxpayers the burden of paying for the subsidies of others) have the additional burden of paying insurance companies not to increase premiums. Obamacare just keeps getting more and more complicated, but a certain group keeps getting left holding the bag.

            –You write, “If you don’t wish to have taxpayers subsidize the premiums of people with lower incomes, how do you propose they get their medical care paid for if they cannot afford it?” I thought that this was going to be taken care of by the invincibles (the funding source in the version of the ACA that was originally passed). If I am mistaken, please let me know.

            –You ask, “Do you think poor people have a right to health care?” I don’t know if anyone has that right. Based on the Declaration of Independence (which is in the same spirit as the Constitution), we have the right to life, liberty, and the pursuit of happiness (which are human rights based on natural law). Here is a definition of human rights:

            http://www.businessdictionary.com/definition/human-rights.html

            The justification that the Supreme Court provided for Obamacare had nothing to do with human rights; it addressed the question of the individual mandate and responded that Congress has the power to tax (why logically it can tax people because they do not buy something now–health insurance–but will buy a related thing later–health care services–I do not know).

            Since the Supreme Court has not weighed in on whether citizens have the right to health care, I hesitate to do so, since I’d say right off the bat that my thinking is less disciplined than theirs. If you really wish me to give it a crack, I could. (I think that I might start with the fact that human rights cannot be taken away, but health care is something that must be added.)

            By the way, the Bill of Rights does not contain anything that would make me think that there should be universal health care. Perhaps that is because at that time doctors had little to offer in that regard. I mean, if you were sick you would probably die.

            Here’s the Bill of Rights:

            http://www.ratical.org/co-globalize/BillOfRights.html

            –You write, “You and your family would quickly be bankrupted by any medical issue of any duration or complexity. Moreover, you would be paying a much higher cost for services, because insured patients pay rates that are negotiated down by the insurers. You wouldn’t have that benefit.” You are right. That’s why it’s important to get the cost of health care down. Government is known for its inefficiency, so that’s why I would look more to a free-market system.

            –You conclude, “You are taking a huge gamble by opting not to get insurance coverage.” You are right. I wish I did not have to do so. However, I don’t want to take advantage of a system which takes advantage of my fellow citizens.

            A partial solution would be for all of us (including myself) to be more charitable to one another. We tend to look to taxes and organizations to do this, but we ought to look at ourselves.

            Before Obamacare, we could have helped pay for the medical bills of the less fortunate (a sibling, a neighbor) as individuals or as groups (fundraisers). In doing so, we would have had the incentive to find true solutions, since the money would have been coming directly and voluntarily out of our own pockets.

            Now that Obamacare has passed, however, this approach may be harder to try, since many people seem to accept that the government is the best solution and that Obamacare is the best approach. I do not think that either of these is true, and I think that Obamacare is on life support, as shown by the many changes the President has made to it. If it ends up failing (or if another party gets control of the White House and Congress) it could be replaced with something better or changed so that it becomes better.

            That is my hope. At that time I will join.

          6. Don Shor

            from the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMhpr1405667

            As expected, enrollment among 18-to-34-year-olds surged as the March 31 deadline approached, climbing from 27% of total enrollment in February to 31% in the month of March. It is widely agreed that there is no single desired rate of young-adult participation. What really matters is whether the observed rate turns out to be consistent with the projections of insurance companies for any period — that is, whether the 31% participation is about what the companies expected for 2014. If young-adult participation fell short of expectations, this could prompt rate increases in 2015. However, even if participation in the pools skews to an older age than companies predicted, an analysis by the Kaiser Family Foundation showed that 2015 premiums might increase by only 1 to 2% to offset higher-than-expected costs…
            —–
            THE RECORD TO DATE
            Taking all existing coverage expansions together, we estimate that 20 million Americans have gained coverage as of May 1 under the ACA.
            We do not know yet exactly how many of these people were previously uninsured, but it seems certain that many were. Recent national surveys seem to confirm this presumption. The CBO projects that the law will decrease the number of uninsured people by 12 million this year and by 26 million by 2017. Early polling data from Gallup, RAND, and the Urban Institute indicate that the number of uninsured people may have already declined by 5 million to 9 million and that the proportion of U.S. adults lacking insurance has fallen from 18% in the third quarter of 2013 to 13.4% in May 2014.

          7. TrueBlueDevil

            Dorte, I enjoy reading your posts and reasoning, thank you.

            You example of charity starting at home (essentially) is a perfect one.

            What if we all had medical savings accounts that started at birth? We could accumulate hundreds of thousands of dollars in this account, and then use it when we are in our twilight years. We could also transfer duns to a family or church member in need. Imagine a church group having 100 members each transferring $1,000 into a fellow member’s medical account!

            This system would also give incentive to saving the medical account monies for future, larger needs – say, a pregnancy or major operation.

          8. Dorte Jensen

            Hi Don,

            Thanks for the article about the final enrollment numbers. I read it and found it to be informative but overly rosy. How else to account for recent polls, the first of which was taken April 23-27 and the second of which was taken June 1-3:

            http://www.washingtonpost.com/blogs/post-politics/wp/2014/05/05/poll-obamacare-hits-new-low/

            http://www.foxnews.com/politics/2014/06/10/fox-news-poll-voters-regret-obamacare-say-country-is-worse-off-under-new-law/

            In both polls disapproval of Obamacare was at a new high of 55 percent.

            More to the point of your post, however, the enrollment rate of the so-called invincibles must not have been high enough, since President Obama decided in late May of this year to change the ACA to give insurance companies tax money to keep their rates low:

            http://www.latimes.com/nation/la-na-insurance-bailout-20140521-story.html#page=1

            The article states, “Although more than 8 million people signed up for health coverage under the law, exceeding expectations, insurance companies in several states have been eyeing significant rate increases for next year amid concerns that their new customers are older and sicker than anticipated.”

            Who knows whether Aetna (a major health insurance company) got any of this new tax money. As announced June 11, 2014, its rates will rise for the next year by less than 20%, which I think is a significant increase:

            http://www.reuters.com/article/2014/06/11/aetna-insurance-idUSL2N0OS1CF20140611

            In other words, you seem to think that the ACA is working. I think that we need to stay tuned.

          9. Don Shor

            Once in the 1990’s I had an 18% increase followed by a 20% increase the next year.
            Did you know that polls have routinely shown that the public supports nearly every component of the ACA when asked about them individually? See Kaiser, for example: http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-march-2014/ The one exception is the individual mandate, which isn’t popular. Unfortunately, without the individual mandate the whole thing collapses. What we will really see affect rates is when the penalties for failing to get insurance kick in. Right now it’s a nominal penalty. Next year it goes up significantly, though it’s still less than the cost of insurance for most young people. The question is whether a $600+ fine (tax, per the Supreme Court) will be sufficient to persuade reluctant young adults to buy insurance.

          10. Dorte Jensen

            Hi TrueBlueDevil,

            I’m glad that you and others are reading my posts. You gave me my first compliment, so thanks!

            I researched Medical Savings Accounts, information about which can be found on the following link:

            https://en.wikipedia.org/wiki/Medical_savings_account_(United_States)

            I guess that the program would have to be modified to incorporate your features (establishment from birth and transfer of funds). However, these accounts would provide a nice incentive for saving and giving. (As I have mentioned before, incentives are much better than disincentives in modifying behavior.)

            Thanks for the input. All of us need to share ideas about how to improve health care. The national conversation was started by Obamacare, but it need not be the last word.

          11. Dorte Jensen

            Hi Don,

            Thanks for the link to the Kaiser Health Tracking Poll. It was less recent than the ones I offered but much more comprehensive. I also found it to be more factual than the article in the New England Journal of Medicine which you brought to my attention. For example, in the latter the authors write:

            “In advocating for the ACA before its passage, President Barack Obama promised that anyone who liked their insurance would be able to keep it under the new law. In hindsight, his assurances should have been more nuanced.”

            Really? I don’t think that lying (he already knew what was in the law) for political purposes (up until the 2012 election) was a matter of nuance. If he had explained the true state of affairs (that millions of people would get letters in the mail come January 2013 that their insurance policies were cancelled), he most likely would have lost votes, which most likely would have cost him re-election. The balance of power in the Senate might have shifted as well.

            I guess these authors don’t understand the meaning of fraud, which in the American Heritage Dictionary is “a deliberate deception for unfair or unlawful gain”. However, what the President did was political, so I guess that can be excused. I mean, things are such these days that the old adage should now be “All’s fair in love, war, and politics.”

            However, the fact that two doctors writing in the New England Journal of Medicine pay so little attention to the meaning of words–the definition in said dictionary of “nuance” is “a subtle or slight degree of difference, as in meaning or feeling”–makes me want to gag. Not gag so much that I need to go to the doctor, however. Remember, I don’t have insurance.

            I’d call these two doctors on their mistake, but that would cost me cell phone minutes, and they probably wouldn’t appreciate the correction. In other words, I’m finding that life is frustrating when you insist on the truth or a reasonable facsimile thereof.

            Anyway, I wanted to draw your attention to one statement in the Kaiser Health Tracking poll, which was factual/fair enough not to raise my blood pressure. The article writes:

            “[F]our in ten of the uninsured are still unaware of the law’s subsidies to help lower-income Americans purchase coverage.”

            There are two big rulings about those subsidies today. See link:

            http://money.cnn.com/2014/07/22/news/economy/obamacare-subsidies/

            In one, the judges ruled that subsidies for customers on the federal exchange are unlawful. In another, the judges ruled the opposite. Since there are opposing rulings, the issue will need to be heard by the Supreme Court.

            More details about the first ruling are here:

            http://www.businessweek.com/articles/2014-07-22/obamacare-ruling-by-the-numbers-4-dot-7-million-could-lose-subsidies

            Anyway, I thought you’d like to know!

            By the way, Don, you keep mentioning that if Obamacare is repealed you will lose your insurance. Americans are a very forgiving sort (that includes Republicans) and don’t want to take away things that are already given. In fact, there is broad support for some parts of Obamacare (like that regarding pre-existing conditions and children up to the age of 26 on parents’ insurance plans). Therefore, I think that it is unlikely that the whole thing will be trashed. Here is a poll from yesterday:

            http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/health_care_law

            The article begins: “Voters still expect Republicans to repeal Obamacare if they take control of Congress in November, but they’re slightly more sympathetic now to a piece-by-piece approach to changing the law rather than a total overhaul.”

            By the way, I don’t know how Republicans can repeal it, since the President wouldn’t sign it, but never mind. The main point is that you probably won’t lose your insurance, whatever happens. To put it more precisely (as I seem to insist with others) you will still be able to get insurance, but you may not have the policy that you have now.

          12. Dorte Jensen

            Hi Don,

            Thanks for the link to the article from the Robert Wood Johnson Foundation about 2015 insurance rates. The article was interesting and very detailed. The predictions may need to be changed in light of today’s rulings on subsidies for the federal exchange. I mean, business abhors uncertainty.

          13. Don Shor

            Today’s rulings will go to the full court of appeals, which is majority Democratic. Then the Supreme Court can decide if they want to review it, or just let it stand. Interesting to see court rulings following so closely along partisan lines.
            From your previous comment:

            you keep mentioning that if Obamacare is repealed you will lose your insurance. Americans are a very forgiving sort (that includes Republicans) and don’t want to take away things that are already given.

            I have zero confidence in that. The Tea Party controls the nominating process in the Republican Party. Tea Party folks are dead set against replacing the ACA, and only want to repeal it.

          14. Dorte Jensen

            Hi Don,

            Thanks for the correction. I just hope the plaintiffs win in the end. I mean, they are going up against the full force of the executive branch, the head of which has made I don’t know how many changes to that law. One count I heard was 37; today I heard 81. However many it is, that’s a lot of changes from someone who is supposed to administer the laws, not make them.

            As for your certainty about the Tea Party, Ill look into that.

          15. Don Shor

            I just hope the plaintiffs win in the end.

            Why? If implemented, it would lead to huge premium increases for millions of people in several states. Not California, fortunately. Probably there would be a work-around by the administration, working with those states that don’t want their citizens adversely affected, to designate the federal exchange as a ‘state’ exchange.
            But it’s clear that there are some state governors and legislators who will, for ideological reasons, choose to harm the health care of their citizens in their continued goal of blocking the ACA. They’re already doing so as they refuse the Medicare expansion. So it seems very likely that governors like Brownback of Kansas and Perry of Texas would refuse to allow any change, even if it meant thousands of their own citizens losing coverage or having to pay considerably more for it.
            It is very clear that Republicans would act to destroy the ACA under any circumstances, that they consider the status quo ante preferable to the ACA. Just ask Frankly. This lawsuit is simply part of that ongoing strategy.

          16. Dorte Jensen

            Hi Don,

            I think that you may be constructing a false dilemma: either allow no changes to the ACA by President Obama or let the uninsured/poor die. I think that there is a middle ground, which is either to let Congress rework the law when problems come up (which is what should have happened all along) or to repeal and replace. I know that you do not believe that replacement would ever happen, so I’ll try to contact some Tea Party people, since you think they are the ones deciding that.

            By the way, if my description of how to change the law is incorrect (return it to Congress; have them modify it), please let me know.

      2. Tia Will

        Dorte

        “Of course, some of these events concern the future, but some of them have already occurred.”

        Which of these events do your already think have happened ?

        1. Dorte Jensen

          Hi Tia,

          I found some references to help answer your question about events to which I referred.

          Most of the events are in the “net wash” category. You have written about many women who are benefiting from the Obamacare, but here are stories about people who have been harmed by it.

          –Michigan woman battling leukemia called “liar” by Senator Harry Reid:
          http://www.mediaite.com/online/cancer-patient-who-lost-insurance-due-to-obamacare-demands-apology-from-harry-reid/

          –Tom Coburn, Senator, will pay for his oncologist out-of-pocket:
          http://www.politico.com/story/2014/01/obamacare-tom-coburn-cancer-doctor-102724.html

          –San Diego woman losing oncologist mid-treatment for stage 4 cancer; new plans cost 40-50% more:
          http://www.theblaze.com/stories/2013/11/04/woman-with-cancer-loses-world-class-insurance-plan-because-of-obamacare/

          –Virginia woman with kidney cancer loses employer insurance; new plans more costly:
          http://hotair.com/archives/2013/11/25/video-cancer-patient-loses-insurance-coverage-thanks-to-obamacare/

          –Michigan woman battling cancer loses policy; other plans more expensive:
          http://www.cnbc.com/id/101170381

          As for the “net loss” category, it contains indicators that things are bad (but improving/possibly getting worse/getting worse) or very bad, getting worse.

          Bad but improving:

          –U3 unemployment rate higher under Obama than Bush:
          http://portalseven.com/employment/unemployment_rate.jsp

          –U6 unemployment rate much higher under Obama than Bush:
          http://portalseven.com/employment/unemployment_rate_u6.jsp

          –Applications for unemployment benefits same as pre-recession levels:
          http://www.foxbusiness.com/markets/2014/07/10/applications-for-us-unemployment-aid-likely-were-unchanged-last-week-as-layoffs/

          Bad, possibly getting worse:

          –Gross Domestic Product Shrinks in Q1 of this year:
          http://www.bloomberg.com/news/2014-05-29/u-s-economy-shrank-early-this-year-for-first-time-since-2011.html

          Bad, getting worse:

          –Consumer prices increased due to regulations?
          http://www.foxnews.com/politics/2014/05/27/report-increased-regs-under-obama-have-hiked-consumer-prices-by-11k/

          Very bad, getting worse:

          The national debt:
          http://www.justfacts.com/nationaldebt.asp

          The “net loss” category also contains the employer mandate, which has been postponed until 2015, after 2014 elections:
          http://www.bloomberg.com/news/2013-07-02/health-law-employer-mandate-said-to-be-delayed-to-2015.html
          –Why postponed if a good or neutral thing?
          –According to Wikipedia, “Most Americans with private health insurance receive it through an employer-sponsored program.”
          https://en.wikipedia.org/wiki/Health_insurance_in_the_United_States
          –Will most employers drop employee coverage? Yes, says Obamacare architect:
          http://www.newsmax.com/Newsfront/Emanuel-employers-drop-health/2014/03/21/id/560906/
          –Will new plans have higher prices?

          That’s it for now! Let me know what you think.

          1. Tia Will

            Dorte

            I read your examples, and I have some questions which are just that since we cannot obtain more information from the individuals involved.
            First, I would want to know if, for each of these individuals, the plan that they chose was the only one available ? I would also want to know in the case of Tom Coburn, if his new plan did not cover his particular oncologist who he just prefers to continue to see, or if it did not offer any oncologist.
            If there were a specialist of equal competency, I would not see this as in any way different from what we had previously since every year I saw new patients if their employer decided to provide Kaiser coverage and terminate their old plan and vice versa. Unlike what many people believe, most workers were already limited by their employers choice of health plan, not their personal choice of doctor.
            This is one of the reasons that I would prefer single party payer which would stay with the individual for life regardless of employment. That way the decision about which doctor to see would always lie with the patient instead of with their insurer.

            Also, what we do not know about these individuals who are sharing their stories is whether or not they live in states that full implemented the ACA and developed or allowed the Federal Government to develop robust exchanges. Like any system, if individuals act to thwart if, it will not work as effectively as if everyone accepts the changes as does their best to make the new system work.

            Finally, unlike with my patient’s who I know are telling the truth because I can usually track their previous care, or lack thereof, on the system known as “Care Everywhere” that allows me to electronically get the health care records from previous providers, not to show any disrespect as they may all be telling the truth, however, without the ability to verify, it could also be true that some are not being entirely truthful and may have ideologic reasons for relating these stories. We simply do not have the means to verify.

            I am not an economist, so I cannot respond meaningfully to the overall economic effects. However, I can speak to a couple of issues.
            I am completely in favor of the abolition of the private medical insurance industry. This industry for the 30 + years in which I have seen the direct results has behaved consistently in a completely immoral fashion acting not in the best interest of patient but only with concern for the monetary bottom line of the company. Examples:
            1) Dropping people from coverage once a serious diagnosis was made on such trumped up excuses as the patient forgetting to put down teenage acne, or child hood exercise induced asthma as previous diagnosis on their initial forms.
            2) Not approving obviously needed care such as hysterectomies until a number of unnecessary tests such as ultrasounds had been done prior.
            3) Delaying patient care which could easily be accomplished in one visit so that a planned procedure could be
            “pre approved”. For anyone thinking that the government was going to run “death panels” you obviously do not understand that this was the defacto role of the insurance company employees who would not approve payment for care, sometimes until too late, thus saving themselves the expense.
            4) Denying insurance for “pre existing conditions”.
            For those of you , such as Frankly who believe that all of these issues could be dealt with “in better ways”, my question is, why weren’t they ? It was primarily the Republicans who blocked Hilary Clinton’s attempt at health care reform instead of attempting to work with her. There was plenty of opportunity for the years of the Bush administrations to take on these well known problems…..but they were not addressed. Mitt Romney was the initiator of the closest domestic policy to the ACA and yet because this was a proposal of Obama, the Republicans refused to attempt to work with this proposal in favor of constantly trying to block and repeal it.

            So after years of ignoring and /or stonewalling the problem, Republicans and some Democrats are angry.
            I believe that it is the American people who should be angry. Angry that in our very materially well off country we had decided that up until now we were going to ration care and that our form of rationing was going to be called
            “ability to pay”.

          2. Dorte Jensen

            Hi Tia,

            Thanks for the response. Some thoughts:

            Like me, you have thought critically about these accounts of people losing their plans. However, we differ in our conclusions.

            –In my opinion, any difficulty is unacceptable, since these people (like all Americans) were promised, “If you like your health plan, you can keep it, period.” You seem to think that lying for political purposes is OK if the outcome is good. In other words, the ends justify the means. I disagree. We are all adults, so we can make choices if we get sufficient information.

            –You question whether the people sharing their experiences are doing so for political reasons. I agree that they might be, but I give them credit for sticking their necks out, given the political climate. With increased government intrusion (NSA collection of data, wiretaps on journalists) and harassment (IRS targeting of conservative groups), it’s easier to go along with the powers that be than to express an opposing point of view.

            –In line with that perhaps, you blame the situation these people may be in on state governors rather than on the President. You write, “Like any system, if individuals act to thwart if, it will not work as effectively as if everyone accepts the changes as does their best to make the new system work.” Since the governors were fully authorized by the ACA to set up their own exchanges, they are not thwarting the law, however well the exchanges end up working.

            (By the way, the state v. federal exchange question is important, since there is a lawsuit right now about subsidies to each. See the following link:

            http://www.forbes.com/sites/gracemarieturner/2014/07/10/awaiting-key-obamacare-court-decision/

            This link concerns the fact that the ACA authorized subsidies specifically for the state exchanges, but they were also given on the federal exchange. The lawsuit contends that since subsidies for the latter were not mentioned in the ACA that they are unlawful, but if the plaintiffs prevail I guess that would not matter immediately, since the President could amend the law again (I think he’s done so 37 times) to specifically allow federal subsidies. If that happened or if the plaintiffs lost to begin with, they could appeal to the Supreme Court. If the Supremes agreed to hear the case, this would be another challenge to the ACA.)

            In this post you also discuss the insurance companies. I am not a fan of them either. In this we agree. However, how to move from a basically failed system to a better one is another matter. The ACA tried to do it, and as you know I have many problems with its means and ends. Hillary Clinton wanted to do it, and people at the time had problems with that.

            By the way, why do you think that Hillary Clinton would have been the one to lead the effort? She was not elected, did not have a background in medicine or economics, and was a lawyer. President Obama differs in these variables only on the first, so I guess that is how he got the ACA through, in addition to mounting national frustrations over health care.

            As for your comments about George W. Bush and Mitt Romney, I have a different take from yours:

            –I think that President Bush might have been overly consumed with foreign affairs (the war on terror), which prevented him from dealing with health care. Also, in general the Democrats are seen as the party of government, and the Republicans are seen as the party of the free market. Therefore, President Bush’s political orientation might have made him less inclined to impose a governmental solution on the problem.

            –As to whether Mitt Romney’s health care plan was the same as Obamacare, the following article provides a very good analysis:

            http://www.cato.org/policy-report/januaryfebruary-2008/lessons-fall-romneycare

            Like Obamacare, Romneycare was enacted to cover all citizens and reduce cost. However, unlike the former we know how the latter turned out. In 2012, six years after it had been passed, Romneycare had achieved neither of these goals. That is one reason–a big reason–that Romney did not want to talk about national health care, and it is an example of why conservatives did not vote for him, which cost him in a close election.

            Rather than dredging up old news, however, the important point is to learn from it. As the author of the previous article (written in 2012) concludes, “The answer to controlling health care costs and increasing access to care lies with giving consumers more control over their health care spending while increasing competition in the health care marketplace — not in mandates, subsidies, and regulation. That is the lesson we should be drawing from the failure of RomneyCare.”

            That’s all! Thanks for corresponding with me. It takes a lot of time for both of us, but I think it is worth it.

      3. Topcat

        Dorte wrote: “I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick.”

        What would you suggest replacing it with and how would such a replacement be realistically paid for?

        1. Dorte Jensen

          Hi Topcat,

          Here is a new plan from Bobby Jindal, Governor of Louisiana. It is not a replacement but a modification. Perhaps that would be good enough (I haven’t studied the plan, so I don’t know):

          http://www.businessweek.com/articles/2014-04-10/bobby-jindal-has-smart-ideas-to-improve-obamacare

          Two aspects of this plan are as follows (quotes are from above article):

          1) “[L]et nurse practitioners and other medical professionals practice to the full extent of their abilities.” (This would lower costs.)
          2) Change the tax code so that health benefits from employers are no longer tax exempt. (This exemption leads to over-consumption of services, leading to a higher price of health care.) “Obamacare will tax high-cost plans starting in 2018; Jindal wants to scrap the exclusion altogether, replacing it with a tax deduction for all health insurance.” In other words, Obama approaches this problem with a disincentive, and Jindal approaches it with an incentive. As I have written in comments to a Vanguard article a few weeks ago, people learn better with reward (reinforcement) rather than with punishment, as shown by operant conditioning, the science of behavior modification.

          As for how it is realistically paid for, I don’t know, but if prices are lower then they are more easily paid for. In any case, more plans will be coming down the pike, the article says, since Republican presidential hopefuls want to have something concrete to offer voters.

          As for whether Obamacare is realistically paid for, that’s another can of worms, which I have discussed in my posts today to Tia (on this article) at 12:24 p.m. and 12:40 p.m.

          1. Tia Will

            Dorte

            ““[L]et nurse practitioners and other medical professionals practice to the full extent of their abilities.” (This would lower costs.)”

            Mr. Jindal may not be aware since he is in a state where there is no Kaiser, but within our system this is already the case.
            We employee Nurse Practitioners, Certified Nurse Midwives, Physicians Assistants, PharmDs manage many chronic stable conditions for patients in consultation with their physicians thus preventing the need for added expense. We use RNs, LVNs and medical assistants and engage in a constant process of training and retraining so that each job category is working to the top of their level of competency.

            I am not informed enough to comment on Mr. Jindal’s second point.

          2. TrueBlueDevil

            Dr. Dean Edell has marveled at how quickly and efficiently the pharmacists at Costco do their vaccinations, and has wondered aloud why the government or a regular doctor’s office can’t do the same thing.

  30. Tia Will Post author

    Dorte

    “Yes, none of these objections deal with the reality that you see, that some people now have insurance. They may be helped, but I fear that many more people will be hurt.”

    You are using the word “may” to describe things that are already reality ( people that I have already seen being helped) and to describe things that you fear may happen ( things that are speculative).

    It is a fact that women who receive screening for cervical cancer rarely develop this form of cancer since we catch it and treat it when it is in a a precancerous form. I am typically screening 3-4 patients daily in my clinic who had not been screened within the past 3-5 years and are now able to get it because they signed up through Covered California. I know, because I ask my new patient’s what brought them to Kaiser.

    It is a fact, not a “may” that I have seen women with treatable breast cancer who were not able to be treated before they were signed up. It is fact that I have helped women who could not get treatment for anemia and other readily treatable problems because they were not insured.

    It is a fact that my daughter received life saving treatment which I would not have been able to afford for a prolonged period because of the provision of Obamacare that allowed her to be continued under my insurance policy until age 26.

    These are facts, not speculation or my vision of what “may” happen.

    I do not consider the ACA perfect. I wanted a single party payer system administered through systems like Kaiser.
    I would happily do away with fee for service medicine altogether. It is fee for service medicine that makes it virtually impossible to determine what a procedure costs as one poster noted. It is true that “they” namely the insurance companies, hospitals , manufacturers of medical equipment and pharmaceuticals do not want you to know what each item actually costs. If the costs were transparent, people would not be driving up the cost of medicine by demanding completely unnecessary tests which I dissuade patients from doing on a regular basis. If I can determine the cause of a problem with a simple exam or office procedure, why would I order an MRI or CT ?
    In fee for service medicine the answer is obvious. Its the money, although that is not what you will be told.

    1. Dorte Jensen Post author

      Hi Tia,

      I use the word “may” in terms of the overall population of the presently insured who were previously uninsured. Yes, some of these people are helped now, such as those who have diseases which are caught or treated. However, if they never had a disease (such as cancer) and are screened now and still don’t have it, then knowing that may help psychologically, but it is not a help in the real sense, since they don’t have the disease to begin with.

      In other words, I’m glad that some people are being helped, but I think that they and pretty much everyone else could have been helped by another approach. That would have been a net gain (in mathematical terms, a gain for the uninsured plus a gain for the country as a whole), rather than a net wash (some winners and some losers, the latter of which include people who had cancer, had their insurance cancelled due to Obamacare, and could not buy another policy at a comparable price) or a net loss (the whole medical and economic system comes crashing down or basically grinds to a halt). Of course, some of these events concern the future, but some of them have already occurred.

      By the way, I commented to Don earlier on (in a very long post) that I was uninsured before Obamacare and am uninsured now. So at least I follow through with what I believe (at least in this case!). The IRS hasn’t come after me yet–I guess the individual mandate has been extended–so after that I will pay the fine as long as that is affordable, I suppose. I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick. To echo sentiments you often express, how is this situation acceptable?

      1. Don Shor Post author

        You should get insurance. If you become sick with a chronic condition, you will become a major burden on the system unless you are very wealthy.

          1. Don Shor Post author

            And I think that the Affordable Care Act has provided people like you and me with the option of obtaining insurance — which is a personal responsibility — more affordably and more readily than before. It is based on private insurers providing coverage via private health care providers. But if don’t want to use the exchange, you can still buy insurance directly from companies like Anthem or Kaiser.
            The major burden to the system was, among other things, uninsured people getting sick and using health care services, and being unable to pay for them.

          2. Dorte Jensen Post author

            Hi Don,

            It took me a while to answer because I was thinking about what to say. Three points:

            First, I don’t like health insurance in general, since companies drop customers when they start filing too many claims. That is when customers are sick and need insurance, and that is when they are dropped.

            Second, I don’t like Obamacare, which is a means of getting insurance and a means of wealth distribution, since taxpayers subsidize the premiums of people with lower incomes. I have written on other posts why I think that it harms/will harm people and the country as a whole, so I won’t repeat myself here.

            Finally, I don’t think that I have a responsibility to participate in something I find destructive. I do have a responsibility to pay medical bills which I incur, and I explained to Tia in my post of July 20, 2:53 a.m. that I would do so.

          3. Don Shor Post author

            The ACA prohibits companies from dropping people from coverage when they get sick.

            If you don’t wish to have taxpayers subsidize the premiums of people with lower incomes, how do you propose they get their medical care paid for if they cannot afford it? Do you think poor people have a right to health care?

            You and your family would quickly be bankrupted by any medical issue of any duration or complexity. Moreover, you would be paying a much higher cost for services, because insured patients pay rates that are negotiated down by the insurers. You wouldn’t have that benefit.
            You are taking a huge gamble by opting not to get insurance coverage.

          4. Dorte Jensen Post author

            Hi Don,

            Oops. When I said, “a means of wealth distribution,” I meant wealth re-distribution.

          5. Dorte Jensen Post author

            Hi Don,

            Some comments in response to yours:

            –You write, “The ACA prohibits companies from dropping people from coverage when they get sick.” I am glad of this, since doing so after a person has paid into the system is basically fraud.

            That said, I do wonder how these companies will stay in business, since they probably agreed to Obamacare thinking that they would get a lot of young/healthy people (so-called “invincibles”)who would make few claims for a long time. Data regarding the final percentage of this group (after the open-enrollment period closed) can be found here:

            http://dailysignal.com/2014/05/02/details-missing-obamacare-headcount-final-report/

            Here’s a quote from that article:

            “[O]fficials promoted the 2.2 million young adult (ages 18 to 34) that made up 28 percent of the participant pool. Officials originally projected that, to be successful, Obamacare’s state and federal exchanges would need nearly 40 percent of new enrollees to be relatively healthy young adults — and thus spread out health care costs.”

            As a result of this shortfall perhaps, a few months ago insurance companies wanted to raise premiums, and the President amended the ACA to provide taxpayer funds to prevent this increase (what critics have called a “bailout” of the insurance companies).

            http://www.latimes.com/nation/la-na-insurance-bailout-20140521-story.html#page=1

            (The fact that the President has changed the ACA–as I remember–37 times is a Constitutional problem, one that the Speaker of the House is addressing in his planned suit against the President for the delay of the employer mandate.)

            As a result of this latest change, the people who have insurance without subsidies (who have as taxpayers the burden of paying for the subsidies of others) have the additional burden of paying insurance companies not to increase premiums. Obamacare just keeps getting more and more complicated, but a certain group keeps getting left holding the bag.

            –You write, “If you don’t wish to have taxpayers subsidize the premiums of people with lower incomes, how do you propose they get their medical care paid for if they cannot afford it?” I thought that this was going to be taken care of by the invincibles (the funding source in the version of the ACA that was originally passed). If I am mistaken, please let me know.

            –You ask, “Do you think poor people have a right to health care?” I don’t know if anyone has that right. Based on the Declaration of Independence (which is in the same spirit as the Constitution), we have the right to life, liberty, and the pursuit of happiness (which are human rights based on natural law). Here is a definition of human rights:

            http://www.businessdictionary.com/definition/human-rights.html

            The justification that the Supreme Court provided for Obamacare had nothing to do with human rights; it addressed the question of the individual mandate and responded that Congress has the power to tax (why logically it can tax people because they do not buy something now–health insurance–but will buy a related thing later–health care services–I do not know).

            Since the Supreme Court has not weighed in on whether citizens have the right to health care, I hesitate to do so, since I’d say right off the bat that my thinking is less disciplined than theirs. If you really wish me to give it a crack, I could. (I think that I might start with the fact that human rights cannot be taken away, but health care is something that must be added.)

            By the way, the Bill of Rights does not contain anything that would make me think that there should be universal health care. Perhaps that is because at that time doctors had little to offer in that regard. I mean, if you were sick you would probably die.

            Here’s the Bill of Rights:

            http://www.ratical.org/co-globalize/BillOfRights.html

            –You write, “You and your family would quickly be bankrupted by any medical issue of any duration or complexity. Moreover, you would be paying a much higher cost for services, because insured patients pay rates that are negotiated down by the insurers. You wouldn’t have that benefit.” You are right. That’s why it’s important to get the cost of health care down. Government is known for its inefficiency, so that’s why I would look more to a free-market system.

            –You conclude, “You are taking a huge gamble by opting not to get insurance coverage.” You are right. I wish I did not have to do so. However, I don’t want to take advantage of a system which takes advantage of my fellow citizens.

            A partial solution would be for all of us (including myself) to be more charitable to one another. We tend to look to taxes and organizations to do this, but we ought to look at ourselves.

            Before Obamacare, we could have helped pay for the medical bills of the less fortunate (a sibling, a neighbor) as individuals or as groups (fundraisers). In doing so, we would have had the incentive to find true solutions, since the money would have been coming directly and voluntarily out of our own pockets.

            Now that Obamacare has passed, however, this approach may be harder to try, since many people seem to accept that the government is the best solution and that Obamacare is the best approach. I do not think that either of these is true, and I think that Obamacare is on life support, as shown by the many changes the President has made to it. If it ends up failing (or if another party gets control of the White House and Congress) it could be replaced with something better or changed so that it becomes better.

            That is my hope. At that time I will join.

          6. Don Shor Post author

            from the New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMhpr1405667

            As expected, enrollment among 18-to-34-year-olds surged as the March 31 deadline approached, climbing from 27% of total enrollment in February to 31% in the month of March. It is widely agreed that there is no single desired rate of young-adult participation. What really matters is whether the observed rate turns out to be consistent with the projections of insurance companies for any period — that is, whether the 31% participation is about what the companies expected for 2014. If young-adult participation fell short of expectations, this could prompt rate increases in 2015. However, even if participation in the pools skews to an older age than companies predicted, an analysis by the Kaiser Family Foundation showed that 2015 premiums might increase by only 1 to 2% to offset higher-than-expected costs…
            —–
            THE RECORD TO DATE
            Taking all existing coverage expansions together, we estimate that 20 million Americans have gained coverage as of May 1 under the ACA.
            We do not know yet exactly how many of these people were previously uninsured, but it seems certain that many were. Recent national surveys seem to confirm this presumption. The CBO projects that the law will decrease the number of uninsured people by 12 million this year and by 26 million by 2017. Early polling data from Gallup, RAND, and the Urban Institute indicate that the number of uninsured people may have already declined by 5 million to 9 million and that the proportion of U.S. adults lacking insurance has fallen from 18% in the third quarter of 2013 to 13.4% in May 2014.

          7. TrueBlueDevil Post author

            Dorte, I enjoy reading your posts and reasoning, thank you.

            You example of charity starting at home (essentially) is a perfect one.

            What if we all had medical savings accounts that started at birth? We could accumulate hundreds of thousands of dollars in this account, and then use it when we are in our twilight years. We could also transfer duns to a family or church member in need. Imagine a church group having 100 members each transferring $1,000 into a fellow member’s medical account!

            This system would also give incentive to saving the medical account monies for future, larger needs – say, a pregnancy or major operation.

          8. Dorte Jensen Post author

            Hi Don,

            Thanks for the article about the final enrollment numbers. I read it and found it to be informative but overly rosy. How else to account for recent polls, the first of which was taken April 23-27 and the second of which was taken June 1-3:

            http://www.washingtonpost.com/blogs/post-politics/wp/2014/05/05/poll-obamacare-hits-new-low/

            http://www.foxnews.com/politics/2014/06/10/fox-news-poll-voters-regret-obamacare-say-country-is-worse-off-under-new-law/

            In both polls disapproval of Obamacare was at a new high of 55 percent.

            More to the point of your post, however, the enrollment rate of the so-called invincibles must not have been high enough, since President Obama decided in late May of this year to change the ACA to give insurance companies tax money to keep their rates low:

            http://www.latimes.com/nation/la-na-insurance-bailout-20140521-story.html#page=1

            The article states, “Although more than 8 million people signed up for health coverage under the law, exceeding expectations, insurance companies in several states have been eyeing significant rate increases for next year amid concerns that their new customers are older and sicker than anticipated.”

            Who knows whether Aetna (a major health insurance company) got any of this new tax money. As announced June 11, 2014, its rates will rise for the next year by less than 20%, which I think is a significant increase:

            http://www.reuters.com/article/2014/06/11/aetna-insurance-idUSL2N0OS1CF20140611

            In other words, you seem to think that the ACA is working. I think that we need to stay tuned.

          9. Don Shor Post author

            Once in the 1990’s I had an 18% increase followed by a 20% increase the next year.
            Did you know that polls have routinely shown that the public supports nearly every component of the ACA when asked about them individually? See Kaiser, for example: http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-march-2014/ The one exception is the individual mandate, which isn’t popular. Unfortunately, without the individual mandate the whole thing collapses. What we will really see affect rates is when the penalties for failing to get insurance kick in. Right now it’s a nominal penalty. Next year it goes up significantly, though it’s still less than the cost of insurance for most young people. The question is whether a $600+ fine (tax, per the Supreme Court) will be sufficient to persuade reluctant young adults to buy insurance.

          10. Dorte Jensen Post author

            Hi TrueBlueDevil,

            I’m glad that you and others are reading my posts. You gave me my first compliment, so thanks!

            I researched Medical Savings Accounts, information about which can be found on the following link:

            https://en.wikipedia.org/wiki/Medical_savings_account_(United_States)

            I guess that the program would have to be modified to incorporate your features (establishment from birth and transfer of funds). However, these accounts would provide a nice incentive for saving and giving. (As I have mentioned before, incentives are much better than disincentives in modifying behavior.)

            Thanks for the input. All of us need to share ideas about how to improve health care. The national conversation was started by Obamacare, but it need not be the last word.

          11. Dorte Jensen Post author

            Hi Don,

            Thanks for the link to the Kaiser Health Tracking Poll. It was less recent than the ones I offered but much more comprehensive. I also found it to be more factual than the article in the New England Journal of Medicine which you brought to my attention. For example, in the latter the authors write:

            “In advocating for the ACA before its passage, President Barack Obama promised that anyone who liked their insurance would be able to keep it under the new law. In hindsight, his assurances should have been more nuanced.”

            Really? I don’t think that lying (he already knew what was in the law) for political purposes (up until the 2012 election) was a matter of nuance. If he had explained the true state of affairs (that millions of people would get letters in the mail come January 2013 that their insurance policies were cancelled), he most likely would have lost votes, which most likely would have cost him re-election. The balance of power in the Senate might have shifted as well.

            I guess these authors don’t understand the meaning of fraud, which in the American Heritage Dictionary is “a deliberate deception for unfair or unlawful gain”. However, what the President did was political, so I guess that can be excused. I mean, things are such these days that the old adage should now be “All’s fair in love, war, and politics.”

            However, the fact that two doctors writing in the New England Journal of Medicine pay so little attention to the meaning of words–the definition in said dictionary of “nuance” is “a subtle or slight degree of difference, as in meaning or feeling”–makes me want to gag. Not gag so much that I need to go to the doctor, however. Remember, I don’t have insurance.

            I’d call these two doctors on their mistake, but that would cost me cell phone minutes, and they probably wouldn’t appreciate the correction. In other words, I’m finding that life is frustrating when you insist on the truth or a reasonable facsimile thereof.

            Anyway, I wanted to draw your attention to one statement in the Kaiser Health Tracking poll, which was factual/fair enough not to raise my blood pressure. The article writes:

            “[F]our in ten of the uninsured are still unaware of the law’s subsidies to help lower-income Americans purchase coverage.”

            There are two big rulings about those subsidies today. See link:

            http://money.cnn.com/2014/07/22/news/economy/obamacare-subsidies/

            In one, the judges ruled that subsidies for customers on the federal exchange are unlawful. In another, the judges ruled the opposite. Since there are opposing rulings, the issue will need to be heard by the Supreme Court.

            More details about the first ruling are here:

            http://www.businessweek.com/articles/2014-07-22/obamacare-ruling-by-the-numbers-4-dot-7-million-could-lose-subsidies

            Anyway, I thought you’d like to know!

            By the way, Don, you keep mentioning that if Obamacare is repealed you will lose your insurance. Americans are a very forgiving sort (that includes Republicans) and don’t want to take away things that are already given. In fact, there is broad support for some parts of Obamacare (like that regarding pre-existing conditions and children up to the age of 26 on parents’ insurance plans). Therefore, I think that it is unlikely that the whole thing will be trashed. Here is a poll from yesterday:

            http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/health_care_law

            The article begins: “Voters still expect Republicans to repeal Obamacare if they take control of Congress in November, but they’re slightly more sympathetic now to a piece-by-piece approach to changing the law rather than a total overhaul.”

            By the way, I don’t know how Republicans can repeal it, since the President wouldn’t sign it, but never mind. The main point is that you probably won’t lose your insurance, whatever happens. To put it more precisely (as I seem to insist with others) you will still be able to get insurance, but you may not have the policy that you have now.

          12. Dorte Jensen Post author

            Hi Don,

            Thanks for the link to the article from the Robert Wood Johnson Foundation about 2015 insurance rates. The article was interesting and very detailed. The predictions may need to be changed in light of today’s rulings on subsidies for the federal exchange. I mean, business abhors uncertainty.

          13. Don Shor Post author

            Today’s rulings will go to the full court of appeals, which is majority Democratic. Then the Supreme Court can decide if they want to review it, or just let it stand. Interesting to see court rulings following so closely along partisan lines.
            From your previous comment:

            you keep mentioning that if Obamacare is repealed you will lose your insurance. Americans are a very forgiving sort (that includes Republicans) and don’t want to take away things that are already given.

            I have zero confidence in that. The Tea Party controls the nominating process in the Republican Party. Tea Party folks are dead set against replacing the ACA, and only want to repeal it.

          14. Dorte Jensen Post author

            Hi Don,

            Thanks for the correction. I just hope the plaintiffs win in the end. I mean, they are going up against the full force of the executive branch, the head of which has made I don’t know how many changes to that law. One count I heard was 37; today I heard 81. However many it is, that’s a lot of changes from someone who is supposed to administer the laws, not make them.

            As for your certainty about the Tea Party, Ill look into that.

          15. Don Shor Post author

            I just hope the plaintiffs win in the end.

            Why? If implemented, it would lead to huge premium increases for millions of people in several states. Not California, fortunately. Probably there would be a work-around by the administration, working with those states that don’t want their citizens adversely affected, to designate the federal exchange as a ‘state’ exchange.
            But it’s clear that there are some state governors and legislators who will, for ideological reasons, choose to harm the health care of their citizens in their continued goal of blocking the ACA. They’re already doing so as they refuse the Medicare expansion. So it seems very likely that governors like Brownback of Kansas and Perry of Texas would refuse to allow any change, even if it meant thousands of their own citizens losing coverage or having to pay considerably more for it.
            It is very clear that Republicans would act to destroy the ACA under any circumstances, that they consider the status quo ante preferable to the ACA. Just ask Frankly. This lawsuit is simply part of that ongoing strategy.

          16. Dorte Jensen Post author

            Hi Don,

            I think that you may be constructing a false dilemma: either allow no changes to the ACA by President Obama or let the uninsured/poor die. I think that there is a middle ground, which is either to let Congress rework the law when problems come up (which is what should have happened all along) or to repeal and replace. I know that you do not believe that replacement would ever happen, so I’ll try to contact some Tea Party people, since you think they are the ones deciding that.

            By the way, if my description of how to change the law is incorrect (return it to Congress; have them modify it), please let me know.

      2. Tia Will Post author

        Dorte

        “Of course, some of these events concern the future, but some of them have already occurred.”

        Which of these events do your already think have happened ?

        1. Dorte Jensen Post author

          Hi Tia,

          I found some references to help answer your question about events to which I referred.

          Most of the events are in the “net wash” category. You have written about many women who are benefiting from the Obamacare, but here are stories about people who have been harmed by it.

          –Michigan woman battling leukemia called “liar” by Senator Harry Reid:
          http://www.mediaite.com/online/cancer-patient-who-lost-insurance-due-to-obamacare-demands-apology-from-harry-reid/

          –Tom Coburn, Senator, will pay for his oncologist out-of-pocket:
          http://www.politico.com/story/2014/01/obamacare-tom-coburn-cancer-doctor-102724.html

          –San Diego woman losing oncologist mid-treatment for stage 4 cancer; new plans cost 40-50% more:
          http://www.theblaze.com/stories/2013/11/04/woman-with-cancer-loses-world-class-insurance-plan-because-of-obamacare/

          –Virginia woman with kidney cancer loses employer insurance; new plans more costly:
          http://hotair.com/archives/2013/11/25/video-cancer-patient-loses-insurance-coverage-thanks-to-obamacare/

          –Michigan woman battling cancer loses policy; other plans more expensive:
          http://www.cnbc.com/id/101170381

          As for the “net loss” category, it contains indicators that things are bad (but improving/possibly getting worse/getting worse) or very bad, getting worse.

          Bad but improving:

          –U3 unemployment rate higher under Obama than Bush:
          http://portalseven.com/employment/unemployment_rate.jsp

          –U6 unemployment rate much higher under Obama than Bush:
          http://portalseven.com/employment/unemployment_rate_u6.jsp

          –Applications for unemployment benefits same as pre-recession levels:
          http://www.foxbusiness.com/markets/2014/07/10/applications-for-us-unemployment-aid-likely-were-unchanged-last-week-as-layoffs/

          Bad, possibly getting worse:

          –Gross Domestic Product Shrinks in Q1 of this year:
          http://www.bloomberg.com/news/2014-05-29/u-s-economy-shrank-early-this-year-for-first-time-since-2011.html

          Bad, getting worse:

          –Consumer prices increased due to regulations?
          http://www.foxnews.com/politics/2014/05/27/report-increased-regs-under-obama-have-hiked-consumer-prices-by-11k/

          Very bad, getting worse:

          The national debt:
          http://www.justfacts.com/nationaldebt.asp

          The “net loss” category also contains the employer mandate, which has been postponed until 2015, after 2014 elections:
          http://www.bloomberg.com/news/2013-07-02/health-law-employer-mandate-said-to-be-delayed-to-2015.html
          –Why postponed if a good or neutral thing?
          –According to Wikipedia, “Most Americans with private health insurance receive it through an employer-sponsored program.”
          https://en.wikipedia.org/wiki/Health_insurance_in_the_United_States
          –Will most employers drop employee coverage? Yes, says Obamacare architect:
          http://www.newsmax.com/Newsfront/Emanuel-employers-drop-health/2014/03/21/id/560906/
          –Will new plans have higher prices?

          That’s it for now! Let me know what you think.

          1. Tia Will Post author

            Dorte

            I read your examples, and I have some questions which are just that since we cannot obtain more information from the individuals involved.
            First, I would want to know if, for each of these individuals, the plan that they chose was the only one available ? I would also want to know in the case of Tom Coburn, if his new plan did not cover his particular oncologist who he just prefers to continue to see, or if it did not offer any oncologist.
            If there were a specialist of equal competency, I would not see this as in any way different from what we had previously since every year I saw new patients if their employer decided to provide Kaiser coverage and terminate their old plan and vice versa. Unlike what many people believe, most workers were already limited by their employers choice of health plan, not their personal choice of doctor.
            This is one of the reasons that I would prefer single party payer which would stay with the individual for life regardless of employment. That way the decision about which doctor to see would always lie with the patient instead of with their insurer.

            Also, what we do not know about these individuals who are sharing their stories is whether or not they live in states that full implemented the ACA and developed or allowed the Federal Government to develop robust exchanges. Like any system, if individuals act to thwart if, it will not work as effectively as if everyone accepts the changes as does their best to make the new system work.

            Finally, unlike with my patient’s who I know are telling the truth because I can usually track their previous care, or lack thereof, on the system known as “Care Everywhere” that allows me to electronically get the health care records from previous providers, not to show any disrespect as they may all be telling the truth, however, without the ability to verify, it could also be true that some are not being entirely truthful and may have ideologic reasons for relating these stories. We simply do not have the means to verify.

            I am not an economist, so I cannot respond meaningfully to the overall economic effects. However, I can speak to a couple of issues.
            I am completely in favor of the abolition of the private medical insurance industry. This industry for the 30 + years in which I have seen the direct results has behaved consistently in a completely immoral fashion acting not in the best interest of patient but only with concern for the monetary bottom line of the company. Examples:
            1) Dropping people from coverage once a serious diagnosis was made on such trumped up excuses as the patient forgetting to put down teenage acne, or child hood exercise induced asthma as previous diagnosis on their initial forms.
            2) Not approving obviously needed care such as hysterectomies until a number of unnecessary tests such as ultrasounds had been done prior.
            3) Delaying patient care which could easily be accomplished in one visit so that a planned procedure could be
            “pre approved”. For anyone thinking that the government was going to run “death panels” you obviously do not understand that this was the defacto role of the insurance company employees who would not approve payment for care, sometimes until too late, thus saving themselves the expense.
            4) Denying insurance for “pre existing conditions”.
            For those of you , such as Frankly who believe that all of these issues could be dealt with “in better ways”, my question is, why weren’t they ? It was primarily the Republicans who blocked Hilary Clinton’s attempt at health care reform instead of attempting to work with her. There was plenty of opportunity for the years of the Bush administrations to take on these well known problems…..but they were not addressed. Mitt Romney was the initiator of the closest domestic policy to the ACA and yet because this was a proposal of Obama, the Republicans refused to attempt to work with this proposal in favor of constantly trying to block and repeal it.

            So after years of ignoring and /or stonewalling the problem, Republicans and some Democrats are angry.
            I believe that it is the American people who should be angry. Angry that in our very materially well off country we had decided that up until now we were going to ration care and that our form of rationing was going to be called
            “ability to pay”.

          2. Dorte Jensen Post author

            Hi Tia,

            Thanks for the response. Some thoughts:

            Like me, you have thought critically about these accounts of people losing their plans. However, we differ in our conclusions.

            –In my opinion, any difficulty is unacceptable, since these people (like all Americans) were promised, “If you like your health plan, you can keep it, period.” You seem to think that lying for political purposes is OK if the outcome is good. In other words, the ends justify the means. I disagree. We are all adults, so we can make choices if we get sufficient information.

            –You question whether the people sharing their experiences are doing so for political reasons. I agree that they might be, but I give them credit for sticking their necks out, given the political climate. With increased government intrusion (NSA collection of data, wiretaps on journalists) and harassment (IRS targeting of conservative groups), it’s easier to go along with the powers that be than to express an opposing point of view.

            –In line with that perhaps, you blame the situation these people may be in on state governors rather than on the President. You write, “Like any system, if individuals act to thwart if, it will not work as effectively as if everyone accepts the changes as does their best to make the new system work.” Since the governors were fully authorized by the ACA to set up their own exchanges, they are not thwarting the law, however well the exchanges end up working.

            (By the way, the state v. federal exchange question is important, since there is a lawsuit right now about subsidies to each. See the following link:

            http://www.forbes.com/sites/gracemarieturner/2014/07/10/awaiting-key-obamacare-court-decision/

            This link concerns the fact that the ACA authorized subsidies specifically for the state exchanges, but they were also given on the federal exchange. The lawsuit contends that since subsidies for the latter were not mentioned in the ACA that they are unlawful, but if the plaintiffs prevail I guess that would not matter immediately, since the President could amend the law again (I think he’s done so 37 times) to specifically allow federal subsidies. If that happened or if the plaintiffs lost to begin with, they could appeal to the Supreme Court. If the Supremes agreed to hear the case, this would be another challenge to the ACA.)

            In this post you also discuss the insurance companies. I am not a fan of them either. In this we agree. However, how to move from a basically failed system to a better one is another matter. The ACA tried to do it, and as you know I have many problems with its means and ends. Hillary Clinton wanted to do it, and people at the time had problems with that.

            By the way, why do you think that Hillary Clinton would have been the one to lead the effort? She was not elected, did not have a background in medicine or economics, and was a lawyer. President Obama differs in these variables only on the first, so I guess that is how he got the ACA through, in addition to mounting national frustrations over health care.

            As for your comments about George W. Bush and Mitt Romney, I have a different take from yours:

            –I think that President Bush might have been overly consumed with foreign affairs (the war on terror), which prevented him from dealing with health care. Also, in general the Democrats are seen as the party of government, and the Republicans are seen as the party of the free market. Therefore, President Bush’s political orientation might have made him less inclined to impose a governmental solution on the problem.

            –As to whether Mitt Romney’s health care plan was the same as Obamacare, the following article provides a very good analysis:

            http://www.cato.org/policy-report/januaryfebruary-2008/lessons-fall-romneycare

            Like Obamacare, Romneycare was enacted to cover all citizens and reduce cost. However, unlike the former we know how the latter turned out. In 2012, six years after it had been passed, Romneycare had achieved neither of these goals. That is one reason–a big reason–that Romney did not want to talk about national health care, and it is an example of why conservatives did not vote for him, which cost him in a close election.

            Rather than dredging up old news, however, the important point is to learn from it. As the author of the previous article (written in 2012) concludes, “The answer to controlling health care costs and increasing access to care lies with giving consumers more control over their health care spending while increasing competition in the health care marketplace — not in mandates, subsidies, and regulation. That is the lesson we should be drawing from the failure of RomneyCare.”

            That’s all! Thanks for corresponding with me. It takes a lot of time for both of us, but I think it is worth it.

      3. Topcat Post author

        Dorte wrote: “I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick.”

        What would you suggest replacing it with and how would such a replacement be realistically paid for?

        1. Dorte Jensen Post author

          Hi Topcat,

          Here is a new plan from Bobby Jindal, Governor of Louisiana. It is not a replacement but a modification. Perhaps that would be good enough (I haven’t studied the plan, so I don’t know):

          http://www.businessweek.com/articles/2014-04-10/bobby-jindal-has-smart-ideas-to-improve-obamacare

          Two aspects of this plan are as follows (quotes are from above article):

          1) “[L]et nurse practitioners and other medical professionals practice to the full extent of their abilities.” (This would lower costs.)
          2) Change the tax code so that health benefits from employers are no longer tax exempt. (This exemption leads to over-consumption of services, leading to a higher price of health care.) “Obamacare will tax high-cost plans starting in 2018; Jindal wants to scrap the exclusion altogether, replacing it with a tax deduction for all health insurance.” In other words, Obama approaches this problem with a disincentive, and Jindal approaches it with an incentive. As I have written in comments to a Vanguard article a few weeks ago, people learn better with reward (reinforcement) rather than with punishment, as shown by operant conditioning, the science of behavior modification.

          As for how it is realistically paid for, I don’t know, but if prices are lower then they are more easily paid for. In any case, more plans will be coming down the pike, the article says, since Republican presidential hopefuls want to have something concrete to offer voters.

          As for whether Obamacare is realistically paid for, that’s another can of worms, which I have discussed in my posts today to Tia (on this article) at 12:24 p.m. and 12:40 p.m.

          1. Tia Will Post author

            Dorte

            ““[L]et nurse practitioners and other medical professionals practice to the full extent of their abilities.” (This would lower costs.)”

            Mr. Jindal may not be aware since he is in a state where there is no Kaiser, but within our system this is already the case.
            We employee Nurse Practitioners, Certified Nurse Midwives, Physicians Assistants, PharmDs manage many chronic stable conditions for patients in consultation with their physicians thus preventing the need for added expense. We use RNs, LVNs and medical assistants and engage in a constant process of training and retraining so that each job category is working to the top of their level of competency.

            I am not informed enough to comment on Mr. Jindal’s second point.

          2. TrueBlueDevil Post author

            Dr. Dean Edell has marveled at how quickly and efficiently the pharmacists at Costco do their vaccinations, and has wondered aloud why the government or a regular doctor’s office can’t do the same thing.

  31. Tia Will

    Dorte

    I think it is far too soon to judge whether or not Obamacare is a positive or a burden to the system. I am wondering what actual evidence rather than fears is causing you to believe that it is overall a burden.

    1. Dorte Jensen

      Hi Tia,

      As I wrote in my post below, I think that a large portion of the proverbial ____ will hit the fan when the employer mandate kicks in (2015). That is after the 2014 elections. Some of that ____ hit the fan when the individual mandate kicked in (2013), which was after the 2012 elections. (You know, the President repeatedly said, “If you like your health plan, you can keep it, period,” even when he knew it was not true.)

      Do you notice a pattern here? What do you think the outcome will be?

      1. Tia Will

        Dorte

        I do not choose to judge a program by the way in which it has been promoted by a politician.
        If I were that naive, I would believe that our intervention in Iraq was a stunning success because President Bush appeared in front of a banner saying Mission Accomplished.

        The key for me is to assess the program itself. Is it being successful in providing a net benefit ? Is it achieving its stated goals ?

        So far, the view from my own life and from my office is “yes”.

        I am not as focused as you seem to be on what may go wrong. If things are not working, then it will be time to make adjustments. This president was elected, not once but twice because the majority of voters favored his positions over those of his opponent. My understanding of how our Democratic system is supposed to work is that those who are elected give it their best shot and should be supported to succeed to the extent possible.
        That has not been the case with this president with the opposition stating that it was their chief goal to bring about his defeat even before he was sworn in. To me, this shows not only profound disrespect for the man himself, for the office of the Presidency, but also for the majority of voters who elected him.

        1. Dorte Jensen

          Hi Tia,

          You claim that the President made this statement to promote his program. However, he repeated it many times knowing that it was false.

          I know this from these articles:

          http://www.usatoday.com/story/news/politics/2013/11/11/fact-check-keeping-your-health-plan/3500187/

          http://thehill.com/policy/healthcare/216223-cbo-millions-of-americans-could-lose-their-employer-coverage

          By repeating it so many times (before the ACA was passed, after it was passed, and up to the 2012 elections) he encouraged voters to believe a falsehood before they knew the truth (and saw it in the form of cancellation letters in their mailboxes).

          In other words, there is a difference between “promotion” and “fraud”. The President’s statement is the latter not the former.

          You also write, “If things are not working, then it will be time to make adjustments.” Once entitlement programs are in place, they are very hard to remove. Do you know of one that has been cancelled?

          You write, “This president was elected, not once but twice because the majority of voters favored his positions over those of his opponent.” Do you think that he would have been re-elected if voters knew that their policies might be cancelled?

          You write, “My understanding of how our Democratic system is supposed to work is that those who are elected give it their best shot and should be supported to succeed to the extent possible.” The First Amendment guarantees us the right to free speech, which means that we can criticize someone with whom we disagree.

          Consider your objections:

          –“That has not been the case with this president with the opposition stating that it was their chief goal to bring about his defeat even before he was sworn in.” The President had associations with people who had non-mainstream beliefs (such as the Reverend Jeremiah Wright) and actions (such as William Ayers), so some people believed that the President might share these people’s convictions. Whether the President does or doesn’t, the First Amendment allows us to comment on him and to work in a lawful manner to block his goals, if that is what we would like to do. In fact, our tri-partite system of government was established so that there could be checks and balances, so that no branch could become too strong. This is how our democracy is supposed to work.

          –“To me, this shows not only profound disrespect for the man himself, for the office of the Presidency, but also for the majority of voters who elected him.” To me, the highest respect for someone is to treat that person like an adult and express to him/her one’s point of view. That is sticking one’s neck out, showing one’s true colors, and facilitating an honest discussion of issues.

          That is what I do with you and with other Vanguard readers.

          1. Tia Will

            Dorte

            “Obamacare’s state and federal exchanges would need nearly 40 percent of new enrollees to be relatively healthy young adults — and thus spread out health care costs.”

            I know I am really out of sync with my comments but I just received new information. Our enrollment of new members in the “relatively healthy young adult” demographic was within 5 percentage points of this target. Sorry that I am unable to provide the exact number.

            Again, I am going to stress that there is a lot of speculation and fear about what may be going to happen. I like to keep in mind that when the word
            “may” is used, one might just as well include the phrase “or may not”. We simply do not know how this is going to play out. Perhaps because I have had my career in medicine, I am trained to wait for the evidence before drawing a conclusion. That is the approach that I am taking to this bill.

            We also seem to see another objection that you have made to the bill very differently. You have frequently made reference to the number of changes that Obama has made as though that were a negative. I see change when a better option is presented as a positive. Then in another paragraph, you mention that you want the bill to be modified. I am having difficulty seeing how you can both want change, but then criticize change when the need for it is perceived by President Obama. Could it be that you are so biased against the president that you will not see anything that he does as a step in the right direction ?

          2. Tia Will

            Dorte

            “the highest respect for someone is to treat that person like an adult and express to him/her one’s point of view.”

            On this point, we are in agreement. I see a difference in expressing one’s point of view so as to effect favorable change, and name calling, threats,
            belittlement, and derision none of which I have ever found particularly helpful in trying to effect positive changes when working within a collaborative framework. However, these seem to be the principle MO of many who have constantly worked against the proposals of this administration.

          3. Tia Will

            Dorte

            “Do you know of one that has been cancelled?”

            Yes, I do. President Clinton fundamentally changed the nature of welfare which had been in place for many years.

            Also your choice of words is illustrative of how differently we see the world. You chose to use the word “entitlement program”. Having been a beneficiary of Social Security after my father’s death when I was nine, I tend to see these programs as “freedom programs”. In my case, freedom from hunger.

            It is interesting to me that in this country, we tend to view the word freedom as only having one aspect…. freedom to do something. I have a more balanced view of that word freedom. I see it also applying to freedom from ( freedom from hunger, from homelessness, from preventable and treatable illness). If we want the strongest society possible, it is my view that we should fully respect both aspects of the word “freedom” that we use so casually.

          4. Dorte Jensen

            Hi Tia,

            Per the Constitution, the role of the Congress is to make the laws, and the role of the President is to execute them. When a law is changed as many times as the ACA has been, that makes me think that it is being made. When that is being done by the President, that is a violation of the Constitution.

            Also, we have a government of laws, not men, but this law (the ACA) is being changed by this man (President Obama). If you think this is OK because you like both of them, see how you feel when both are different (new man/new law).

            For more information, see the following column by Jonathan Turley, a Constitutional law professor:

            http://jonathanturley.org/2014/05/21/a-question-of-power-the-imperial-presidency/

            You also write, “I am trained to wait for the evidence before drawing a conclusion.” As a doctor, you look for evidence of things present (such as the fact that the patient is breathing, which is good) and things absent (not breathing=bad). I know you’ve said that you don’t have much of a background in economics, and my knowledge is only basic, but consider the following about the U.S. economic recovery:

            –It is the weakest in the world since 1970:

            http://www.aei-ideas.org/2012/07/u-s-recovery-weakest-of-any-in-the-world-since-1970/

            –It is the weakest in U.S. history since WWII:

            http://www.huffingtonpost.com/2012/08/15/us-economic-recovery-weak_n_1783065.html

            Unfortunately, these articles are somewhat outdated (I couldn’t find any which were more recent), but the question remains: Why would this recovery be so bad? What might have changed to make it so?

            –The ACA was enacted, which changed the national health care system, which is 1/6 of the economy. Therefore, the economy changed as well.

            –The many changes to this law lead to a climate of uncertainty, which leads to less economic investment, which leads to lower economic growth. As the last article points out: “And the deeply divided U.S. political system has delivered growth-chilling uncertainty.”

            In other words, our economy is limping along probably because of the ACA. Why does the economy matter? All of its indices–such as jobs, unemployment, inflation–affect us on a daily basis because they involve money, and money is what we use as a means of exchange.

            Of course, I don’t understand all of economics, but neither does anyone else, not even the pros. Economists are learning more all the time, and they continue to disagree. The point that I am making is this:

            –The U.S. economy was weak to begin with (the recession ended in June 2009, according to the following link):

            http://usgovinfo.about.com/od/moneymatters/a/When-Did-The-Great-Recession-End.htm

            –The ACA was passed only six months later, which I believe was far too early for the recovering economy to adjust to.

            You are a doctor, so think about the following scenario (in which I have arbitrarily assigned genders as masculine, since fewer words equal less confusion):

            A patient is very ill, with several organs not functioning well. One of these is his heart, so his doctor gives him a heart transplant. He survives the operation but is still in poor health.

            That is the situation of the U.S. economy. A massive change to it (the ACA) has been made, and the economy is still not doing well. You see the positive results for individual people. I look at the overall picture and am concerned, both on a Constitutional level (where the abstract becomes real over time) and on a concrete level (the overall economy as it is functioning now).

            You conclude by asking, “Could it be that you are so biased against the president that you will not see anything that he does as a step in the right direction?” I admit that I do not like the President personally (from what I have seen of him) or politically (from what he has done especially in regards to the ACA). However, I will give him credit for doing what Republicans would not do (for philosophical or other reasons), which was to try to improve long-standing problems in national healthcare. That said, I fault him on his:

            –manner of doing it (many revisions, which are most likely un-Constitutional)

            –timing of it (during a nascent economic recovery)

            I don’t know what will happen to this country, but I know that things will turn out better if people engage in honest and civil debate about the issues, the ACA being a crucial one. In another post, you write that you have not seen much of this so far. I am not responsible for the actions of others. I can only do my best and encourage others to do the same.

          5. Matt Williams

            When a law is changed as many times as the ACA has been, that makes me think that it is being made. When that is being done by the President, that is a violation of the Constitution.

            Dorte, is the law being changed or are the regulations that pertain to the law being adjusted? The IRS changes the tax code on a very regular basis, but that falls into the category of “regulatory change.” Why do you see the ACA changes as different from IRS changes?

      2. TrueBlueDevil

        Dorte, don’t these significant lies hit you the wrong way?

        When our nation passed Social Security and Medicare, it was done in the light of day, with bi-partisan support. This monstrosity was passed with midnight votes, backdoor deals, significant lies and deceptions.

        This thing has been a foul-smelling turkey since Day 1, and a chief reason why the Tea Party and nation revolved in the election which followed.

  32. Tia Will Post author

    Dorte

    I think it is far too soon to judge whether or not Obamacare is a positive or a burden to the system. I am wondering what actual evidence rather than fears is causing you to believe that it is overall a burden.

    1. Dorte Jensen Post author

      Hi Tia,

      As I wrote in my post below, I think that a large portion of the proverbial ____ will hit the fan when the employer mandate kicks in (2015). That is after the 2014 elections. Some of that ____ hit the fan when the individual mandate kicked in (2013), which was after the 2012 elections. (You know, the President repeatedly said, “If you like your health plan, you can keep it, period,” even when he knew it was not true.)

      Do you notice a pattern here? What do you think the outcome will be?

      1. Tia Will Post author

        Dorte

        I do not choose to judge a program by the way in which it has been promoted by a politician.
        If I were that naive, I would believe that our intervention in Iraq was a stunning success because President Bush appeared in front of a banner saying Mission Accomplished.

        The key for me is to assess the program itself. Is it being successful in providing a net benefit ? Is it achieving its stated goals ?

        So far, the view from my own life and from my office is “yes”.

        I am not as focused as you seem to be on what may go wrong. If things are not working, then it will be time to make adjustments. This president was elected, not once but twice because the majority of voters favored his positions over those of his opponent. My understanding of how our Democratic system is supposed to work is that those who are elected give it their best shot and should be supported to succeed to the extent possible.
        That has not been the case with this president with the opposition stating that it was their chief goal to bring about his defeat even before he was sworn in. To me, this shows not only profound disrespect for the man himself, for the office of the Presidency, but also for the majority of voters who elected him.

        1. Dorte Jensen Post author

          Hi Tia,

          You claim that the President made this statement to promote his program. However, he repeated it many times knowing that it was false.

          I know this from these articles:

          http://www.usatoday.com/story/news/politics/2013/11/11/fact-check-keeping-your-health-plan/3500187/

          http://thehill.com/policy/healthcare/216223-cbo-millions-of-americans-could-lose-their-employer-coverage

          By repeating it so many times (before the ACA was passed, after it was passed, and up to the 2012 elections) he encouraged voters to believe a falsehood before they knew the truth (and saw it in the form of cancellation letters in their mailboxes).

          In other words, there is a difference between “promotion” and “fraud”. The President’s statement is the latter not the former.

          You also write, “If things are not working, then it will be time to make adjustments.” Once entitlement programs are in place, they are very hard to remove. Do you know of one that has been cancelled?

          You write, “This president was elected, not once but twice because the majority of voters favored his positions over those of his opponent.” Do you think that he would have been re-elected if voters knew that their policies might be cancelled?

          You write, “My understanding of how our Democratic system is supposed to work is that those who are elected give it their best shot and should be supported to succeed to the extent possible.” The First Amendment guarantees us the right to free speech, which means that we can criticize someone with whom we disagree.

          Consider your objections:

          –“That has not been the case with this president with the opposition stating that it was their chief goal to bring about his defeat even before he was sworn in.” The President had associations with people who had non-mainstream beliefs (such as the Reverend Jeremiah Wright) and actions (such as William Ayers), so some people believed that the President might share these people’s convictions. Whether the President does or doesn’t, the First Amendment allows us to comment on him and to work in a lawful manner to block his goals, if that is what we would like to do. In fact, our tri-partite system of government was established so that there could be checks and balances, so that no branch could become too strong. This is how our democracy is supposed to work.

          –“To me, this shows not only profound disrespect for the man himself, for the office of the Presidency, but also for the majority of voters who elected him.” To me, the highest respect for someone is to treat that person like an adult and express to him/her one’s point of view. That is sticking one’s neck out, showing one’s true colors, and facilitating an honest discussion of issues.

          That is what I do with you and with other Vanguard readers.

          1. Tia Will Post author

            Dorte

            “Obamacare’s state and federal exchanges would need nearly 40 percent of new enrollees to be relatively healthy young adults — and thus spread out health care costs.”

            I know I am really out of sync with my comments but I just received new information. Our enrollment of new members in the “relatively healthy young adult” demographic was within 5 percentage points of this target. Sorry that I am unable to provide the exact number.

            Again, I am going to stress that there is a lot of speculation and fear about what may be going to happen. I like to keep in mind that when the word
            “may” is used, one might just as well include the phrase “or may not”. We simply do not know how this is going to play out. Perhaps because I have had my career in medicine, I am trained to wait for the evidence before drawing a conclusion. That is the approach that I am taking to this bill.

            We also seem to see another objection that you have made to the bill very differently. You have frequently made reference to the number of changes that Obama has made as though that were a negative. I see change when a better option is presented as a positive. Then in another paragraph, you mention that you want the bill to be modified. I am having difficulty seeing how you can both want change, but then criticize change when the need for it is perceived by President Obama. Could it be that you are so biased against the president that you will not see anything that he does as a step in the right direction ?

          2. Tia Will Post author

            Dorte

            “the highest respect for someone is to treat that person like an adult and express to him/her one’s point of view.”

            On this point, we are in agreement. I see a difference in expressing one’s point of view so as to effect favorable change, and name calling, threats,
            belittlement, and derision none of which I have ever found particularly helpful in trying to effect positive changes when working within a collaborative framework. However, these seem to be the principle MO of many who have constantly worked against the proposals of this administration.

          3. Tia Will Post author

            Dorte

            “Do you know of one that has been cancelled?”

            Yes, I do. President Clinton fundamentally changed the nature of welfare which had been in place for many years.

            Also your choice of words is illustrative of how differently we see the world. You chose to use the word “entitlement program”. Having been a beneficiary of Social Security after my father’s death when I was nine, I tend to see these programs as “freedom programs”. In my case, freedom from hunger.

            It is interesting to me that in this country, we tend to view the word freedom as only having one aspect…. freedom to do something. I have a more balanced view of that word freedom. I see it also applying to freedom from ( freedom from hunger, from homelessness, from preventable and treatable illness). If we want the strongest society possible, it is my view that we should fully respect both aspects of the word “freedom” that we use so casually.

          4. Dorte Jensen Post author

            Hi Tia,

            Per the Constitution, the role of the Congress is to make the laws, and the role of the President is to execute them. When a law is changed as many times as the ACA has been, that makes me think that it is being made. When that is being done by the President, that is a violation of the Constitution.

            Also, we have a government of laws, not men, but this law (the ACA) is being changed by this man (President Obama). If you think this is OK because you like both of them, see how you feel when both are different (new man/new law).

            For more information, see the following column by Jonathan Turley, a Constitutional law professor:

            http://jonathanturley.org/2014/05/21/a-question-of-power-the-imperial-presidency/

            You also write, “I am trained to wait for the evidence before drawing a conclusion.” As a doctor, you look for evidence of things present (such as the fact that the patient is breathing, which is good) and things absent (not breathing=bad). I know you’ve said that you don’t have much of a background in economics, and my knowledge is only basic, but consider the following about the U.S. economic recovery:

            –It is the weakest in the world since 1970:

            http://www.aei-ideas.org/2012/07/u-s-recovery-weakest-of-any-in-the-world-since-1970/

            –It is the weakest in U.S. history since WWII:

            http://www.huffingtonpost.com/2012/08/15/us-economic-recovery-weak_n_1783065.html

            Unfortunately, these articles are somewhat outdated (I couldn’t find any which were more recent), but the question remains: Why would this recovery be so bad? What might have changed to make it so?

            –The ACA was enacted, which changed the national health care system, which is 1/6 of the economy. Therefore, the economy changed as well.

            –The many changes to this law lead to a climate of uncertainty, which leads to less economic investment, which leads to lower economic growth. As the last article points out: “And the deeply divided U.S. political system has delivered growth-chilling uncertainty.”

            In other words, our economy is limping along probably because of the ACA. Why does the economy matter? All of its indices–such as jobs, unemployment, inflation–affect us on a daily basis because they involve money, and money is what we use as a means of exchange.

            Of course, I don’t understand all of economics, but neither does anyone else, not even the pros. Economists are learning more all the time, and they continue to disagree. The point that I am making is this:

            –The U.S. economy was weak to begin with (the recession ended in June 2009, according to the following link):

            http://usgovinfo.about.com/od/moneymatters/a/When-Did-The-Great-Recession-End.htm

            –The ACA was passed only six months later, which I believe was far too early for the recovering economy to adjust to.

            You are a doctor, so think about the following scenario (in which I have arbitrarily assigned genders as masculine, since fewer words equal less confusion):

            A patient is very ill, with several organs not functioning well. One of these is his heart, so his doctor gives him a heart transplant. He survives the operation but is still in poor health.

            That is the situation of the U.S. economy. A massive change to it (the ACA) has been made, and the economy is still not doing well. You see the positive results for individual people. I look at the overall picture and am concerned, both on a Constitutional level (where the abstract becomes real over time) and on a concrete level (the overall economy as it is functioning now).

            You conclude by asking, “Could it be that you are so biased against the president that you will not see anything that he does as a step in the right direction?” I admit that I do not like the President personally (from what I have seen of him) or politically (from what he has done especially in regards to the ACA). However, I will give him credit for doing what Republicans would not do (for philosophical or other reasons), which was to try to improve long-standing problems in national healthcare. That said, I fault him on his:

            –manner of doing it (many revisions, which are most likely un-Constitutional)

            –timing of it (during a nascent economic recovery)

            I don’t know what will happen to this country, but I know that things will turn out better if people engage in honest and civil debate about the issues, the ACA being a crucial one. In another post, you write that you have not seen much of this so far. I am not responsible for the actions of others. I can only do my best and encourage others to do the same.

          5. Matt Williams

            When a law is changed as many times as the ACA has been, that makes me think that it is being made. When that is being done by the President, that is a violation of the Constitution.

            Dorte, is the law being changed or are the regulations that pertain to the law being adjusted? The IRS changes the tax code on a very regular basis, but that falls into the category of “regulatory change.” Why do you see the ACA changes as different from IRS changes?

      2. TrueBlueDevil Post author

        Dorte, don’t these significant lies hit you the wrong way?

        When our nation passed Social Security and Medicare, it was done in the light of day, with bi-partisan support. This monstrosity was passed with midnight votes, backdoor deals, significant lies and deceptions.

        This thing has been a foul-smelling turkey since Day 1, and a chief reason why the Tea Party and nation revolved in the election which followed.

  33. Tia Will

    Dorte

    “However, if they never had a disease (such as cancer) and are screened now and still don’t have it, then knowing that may help psychologically, but it is not a help in the real sense, since they don’t have the disease to begin with.”

    With your post as my only indication, I think that you and I may have a fundamentally different view of the value of screening tests and preventive health care.
    With screening tests for a given disease, there is a benefit not only to the individual, but also to the population as a whole. Many people who have not gone in to medicine perceive health care as a strictly private matter. Those of us who are in the business are keenly aware that there is a societal effect of the individual choices that we all make with regard to health care.

    If we take cervical cancer screening as an example, when abnormal cells that have a high probability of progressing to cancer are found early, we are able to save the life of the individual woman. By preventing the more expensive to treat invasive cancer we also improve the health of the overall community since she will not be passing on HPV which can infect her partner(s) and their future partner(s) and because the money that would have been spent on cancer treatment is now available for research or management of other diseases. This effect is true for all sexually transmissible diseases. It is our policy ,for example ,to screen all sexually active women under the age of 24 for gonorrhea and chlamydia every year, both for her own protection and for the protection of other members of her age cohort.

    Another benefit of preventive care can be seen with immunization. When an individual has insurance, they are more likely to take advantage of services such as immunization. This also has a community wide benefit as is seen in the current epidemic of pertussis. Staying up to date on pertussis immunization is quite literally life saving for infants under one year of age. While it is true that you would probably never know that you had saved a life, the reality is that this effect is real.

    1. Dorte Jensen

      Hi Tia,

      You write, “With your post as my only indication, I think that you and I may have a fundamentally different view of the value of screening tests and preventive health care.”

      I don’t have a fundamentally different view of the value of these things, but I may have a different view of their cost. Before we get to the cost aspect, however, I’ll discuss the frequency of screenings, which relates to their cost.

      In your next post, you describe recommended frequency of screenings for women, including those for breast cancer. You write that women should have a “mammography every one to two years starting around age 40 ( again for the average risk woman).” Suppose a patient and her provider are part of a state-funded program to cover mammography, and both of them need to choose how often to receive/provide one. Which would each choose? The patient is in a low-income group (not paying state income tax), so she will not pay anything, even indirectly, for the service. Therefore, she would probably choose to do it every year to be more safe. The doctor in question is in a higher-income group (presumably, so he/she would be paying state income tax for it indirectly), but the cost to him/her is small, so he/she would probably recommend to the patient to do it every year.

      The point is that people tend to use things more when they perceive them to be free.

      However, those who are taxed to provide the service are those who are paying the bill. You have said that you personally don’t mind paying more taxes to fund things you believe in, but taxes by nature are not a choice (since they are enforced). So all tax-payers end up paying for these screenings, whether they support them (like you do) or not.

      So the question of free screenings come down not only to the problem of overuse but to the problem of income redistribution. To put it bluntly, why would a working couple trying to feed/clothe/send their own children to college want to pay extra so that someone else can have extra mammograms?

      In other words, paying for preventive screening for poor people is a balancing act: Patients/doctors should not overuse funds, or sooner or later taxpayers will elect legislators who will not approve those programs.

      As another example, consider the sign-ups for Obamacare on the federal marketplace. Nine out of every ten people who have signed up qualify for subsidies, and those subsidies reduce premium prices by 76%. The cost to taxpayers is $11 billion.

      http://hotair.com/archives/2014/06/18/report-obama-admin-congratulates-itself-on-cutting-subsidy-eligible-enrollees-premiums-by-an-average-of-76-percent/

      Do taxpayers want to fund this? They have no choice, since Obamacare is the law of the land. However, when the employer mandate kicks in (2015) and many employees probably lose their employer-provided insurance (I provided two relevant links in my above post of July 19, 12:35 a.m.), they will be forced onto the exchanges. Will they get a subsidy? Probably not. Will their premiums be higher. Probably so. You see, they (as taxpayers) are subsidizing Obamacare now, but soon there will be nobody to subsidize them.

      Do you think that this scenario sounds good?

      1. Don Shor

        In any risk pool, those who aren’t currently using health care are ‘subsidizing’ those who are. The ACA expanded the risk pool to include all Americans, including the poor and those with pre-existing conditions. The more who sign up, the broader the risk pool and the less the burden on the others who are paying. All of us, as we age, use more health care. The majority of your expense comes in the last years of your life.
        The grand bargain of the Affordable Care Act was that it handed the insurance companies an enormously larger risk pool over which to spread the cost of insuring more Americans. It will only work, cost-wise, if there is an individual mandate. The employer mandate is less crucial, but provides some important financing. So if we all want to get rid of the employer mandate, and have everyone responsible for his or her own insurance, some of the cost would probably have to be recouped–probably in the form of a tax on employers. I think that is politically unlikely.

        Employer-based health coverage is the reality for most in America. The problems with that are becoming obvious, such as these religious exemptions. But since there isn’t likely to be any modification of the ACA, at least not within the next 2 – 3 years, then we will simply have to work with this patchwork of coverage that includes holes being created by court decisions such as Hobby Lobby.

        1. Dorte Jensen

          Hi Don,

          As I alluded to in my post of July 21, 12:09 a.m., the fact that subsidies are paid for by taxpayers means that the new risk pool is not a closed system.

          In a closed system, participants would pay once (for premiums without subsidies) or in effect less than once (for premiums with subsidies). In the new insurance system (as a result of Obamacare), the former group’s taxes pay for the latter group’s subsidies, so the former group ends up paying in effect more than once. This is one of the main reasons why Obamacare is unfair, since it is not only an insurance system but a means of wealth redistribution.

          1. Don Shor

            Why is wealth redistribution unfair if it serves a social good? We do that for all kinds of things.
            Why does it matter if the system is open or closed?
            Why does it matter if the lower-income subsidies are paid for by the overall system, or by taxes, or by some combination of the two?
            People who can’t afford health care, fully or partially, are either going to go without it (and get sick and die), or use the system and be unable to pay for it. Or they will be on a partially or fully subsidized health system. The money has to come from somewhere for that. The funds for the ACA came from expanding the pool (individual mandate), various fees, various taxes. It’s a combination of revenues.

            Conservatives, over the last 5 – 6 years, have moved to a position of opposition to universal health coverage. As recently as 2007, conservatives and Republicans advocated for universal coverage and the individual mandate. Even Jim DeMint is on record for those things. Then there was a gradual shift to opposition to any expansion of the federal role in health insurance, complete opposition to raising taxes and fees, and governors refused to consider expansion of health services to their poorest citizens. So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care. Do you hold that position? If you do, we have a fundamental difference of values.
            If Obamacare is repealed, I will lose my health care. It’s that simple.

          2. TrueBlueDevil

            Wouldn’t you call it unfair to take 60% of someone else’s income? Why do we have a right to their money? Some people call that theft, Dr. Walter Williams being one of them.

            The funds for the ACA didn’t come from expanding the pool; they are being put on our nation’s credit card, something Obama has become a master at.

            As time goes on, no matter how grating she was, Sarah Palin was right – we will have Death Panels. I’m currently friends with several older Americans over 75 and 80, and the majority of them have battled at least 2 major illnesses; some have battled 4 or 5. There are enormous costs there, and rationing is the only way under the ACA to even come close to paying the tab.

          3. Don Shor

            Sarah Palin was right – we will have Death Panels.

            So you complain about lies on one comment, and then repeat the most egregious, outlandish, ridiculous lie on another comment.

          4. TrueBlueDevil

            We will have rationing of services, which will lead to deaths; Palin simply gave it a memorable name that stuck with the public.

          5. Don Shor

            We will not have any more “rationing of services” than we had done by insurance companies. In fact, we’ll have less.

        2. TrueBlueDevil

          You wrote: “The grand bargain of the Affordable Care Act was that it handed the insurance companies an enormously larger risk pool over which to spread the cost of insuring more Americans.”

          The sign-up rate for youngsters for Obamacare hasn’t happened, so the system has added older, sicker people, but not the numbers of young healthy people needed. So rates will rise, possibly skyrocket, in the next go around.

          You wrote: “. But since there isn’t likely to be any modification of the ACA, at least not within the next 2 – 3 years,…”

          There have been over 40 changes to the ACA; Obama has made at least 24 unilaterally, which I thought was illegal under our Constitution.

          http://www.galen.org/newsletters/changes-to-obamacare-so-far/

          1. Don Shor

            As noted on a previous reply, the signup rate for young people has been sufficient because it has met the expectations of the insurers as they established their rates.

          2. Don Shor

            There have been over 40 changes to the ACA; Obama has made at least 24 unilaterally, which I thought was illegal under our Constitution.

            Most of the President’s actions were delays and exemptions. Congress blocked some minor portions. The major change was the Supreme Court’s ill-advised decision allowing the states to opt out of the Medicare expansion. That’s going to require some kind of fix to get poor people covered.
            As to what’s illegal, I assume that will be resolved in court at some point. Are you a constitutional scholar? Do Obama’s executive actions have some unique aspect that previous presidents’ didn’t?

      2. Tia Will

        Don

        “So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care. Do you hold that position? If you do, we have a fundamental difference of values.”

        I really do believe that this is the critical difference and that it is one of values. Either one sees health care as a human right or one sees it as a societal good as one poster put it earlier.
        This to me is the difference between necessity and “nice to have”. For me health care should be considered as much a right of citizens as is protection by our military. To be safe, it is necessary to have protection, not only against foreign enemies, but also from the internal and social enemies or hunger, homelessness, illness. It the goal is a strong society, it cannot be built by people who are weak or ill. We as humans have the obligation to care for others.
        And yes, we can afford it as a nation. It would mean re prioritizing. It would not mean the destruction of the middle class ( actually I suspect that without the fear of losing ones home or savings or job to illness ) the middle class might be significantly better off as medical costs have often been the straw that broke the proverbial back of the middle class family just making it before illness struck. It would not mean the descent into some kind of mythical
        “socialist hell” as some on the right have claimed.

        1. Frankly

          So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care.

          Define “basic” and then I will tell you if you are correct or not.

          And one more point to make. Do all people have a right to basic food and basic shelter? Because without those they would die. And if you believe so, then why don’t you advocate for the government to take over all food production and all housing?

  34. Tia Will Post author

    Dorte

    “However, if they never had a disease (such as cancer) and are screened now and still don’t have it, then knowing that may help psychologically, but it is not a help in the real sense, since they don’t have the disease to begin with.”

    With your post as my only indication, I think that you and I may have a fundamentally different view of the value of screening tests and preventive health care.
    With screening tests for a given disease, there is a benefit not only to the individual, but also to the population as a whole. Many people who have not gone in to medicine perceive health care as a strictly private matter. Those of us who are in the business are keenly aware that there is a societal effect of the individual choices that we all make with regard to health care.

    If we take cervical cancer screening as an example, when abnormal cells that have a high probability of progressing to cancer are found early, we are able to save the life of the individual woman. By preventing the more expensive to treat invasive cancer we also improve the health of the overall community since she will not be passing on HPV which can infect her partner(s) and their future partner(s) and because the money that would have been spent on cancer treatment is now available for research or management of other diseases. This effect is true for all sexually transmissible diseases. It is our policy ,for example ,to screen all sexually active women under the age of 24 for gonorrhea and chlamydia every year, both for her own protection and for the protection of other members of her age cohort.

    Another benefit of preventive care can be seen with immunization. When an individual has insurance, they are more likely to take advantage of services such as immunization. This also has a community wide benefit as is seen in the current epidemic of pertussis. Staying up to date on pertussis immunization is quite literally life saving for infants under one year of age. While it is true that you would probably never know that you had saved a life, the reality is that this effect is real.

    1. Dorte Jensen Post author

      Hi Tia,

      You write, “With your post as my only indication, I think that you and I may have a fundamentally different view of the value of screening tests and preventive health care.”

      I don’t have a fundamentally different view of the value of these things, but I may have a different view of their cost. Before we get to the cost aspect, however, I’ll discuss the frequency of screenings, which relates to their cost.

      In your next post, you describe recommended frequency of screenings for women, including those for breast cancer. You write that women should have a “mammography every one to two years starting around age 40 ( again for the average risk woman).” Suppose a patient and her provider are part of a state-funded program to cover mammography, and both of them need to choose how often to receive/provide one. Which would each choose? The patient is in a low-income group (not paying state income tax), so she will not pay anything, even indirectly, for the service. Therefore, she would probably choose to do it every year to be more safe. The doctor in question is in a higher-income group (presumably, so he/she would be paying state income tax for it indirectly), but the cost to him/her is small, so he/she would probably recommend to the patient to do it every year.

      The point is that people tend to use things more when they perceive them to be free.

      However, those who are taxed to provide the service are those who are paying the bill. You have said that you personally don’t mind paying more taxes to fund things you believe in, but taxes by nature are not a choice (since they are enforced). So all tax-payers end up paying for these screenings, whether they support them (like you do) or not.

      So the question of free screenings come down not only to the problem of overuse but to the problem of income redistribution. To put it bluntly, why would a working couple trying to feed/clothe/send their own children to college want to pay extra so that someone else can have extra mammograms?

      In other words, paying for preventive screening for poor people is a balancing act: Patients/doctors should not overuse funds, or sooner or later taxpayers will elect legislators who will not approve those programs.

      As another example, consider the sign-ups for Obamacare on the federal marketplace. Nine out of every ten people who have signed up qualify for subsidies, and those subsidies reduce premium prices by 76%. The cost to taxpayers is $11 billion.

      http://hotair.com/archives/2014/06/18/report-obama-admin-congratulates-itself-on-cutting-subsidy-eligible-enrollees-premiums-by-an-average-of-76-percent/

      Do taxpayers want to fund this? They have no choice, since Obamacare is the law of the land. However, when the employer mandate kicks in (2015) and many employees probably lose their employer-provided insurance (I provided two relevant links in my above post of July 19, 12:35 a.m.), they will be forced onto the exchanges. Will they get a subsidy? Probably not. Will their premiums be higher. Probably so. You see, they (as taxpayers) are subsidizing Obamacare now, but soon there will be nobody to subsidize them.

      Do you think that this scenario sounds good?

      1. Don Shor Post author

        In any risk pool, those who aren’t currently using health care are ‘subsidizing’ those who are. The ACA expanded the risk pool to include all Americans, including the poor and those with pre-existing conditions. The more who sign up, the broader the risk pool and the less the burden on the others who are paying. All of us, as we age, use more health care. The majority of your expense comes in the last years of your life.
        The grand bargain of the Affordable Care Act was that it handed the insurance companies an enormously larger risk pool over which to spread the cost of insuring more Americans. It will only work, cost-wise, if there is an individual mandate. The employer mandate is less crucial, but provides some important financing. So if we all want to get rid of the employer mandate, and have everyone responsible for his or her own insurance, some of the cost would probably have to be recouped–probably in the form of a tax on employers. I think that is politically unlikely.

        Employer-based health coverage is the reality for most in America. The problems with that are becoming obvious, such as these religious exemptions. But since there isn’t likely to be any modification of the ACA, at least not within the next 2 – 3 years, then we will simply have to work with this patchwork of coverage that includes holes being created by court decisions such as Hobby Lobby.

        1. Dorte Jensen Post author

          Hi Don,

          As I alluded to in my post of July 21, 12:09 a.m., the fact that subsidies are paid for by taxpayers means that the new risk pool is not a closed system.

          In a closed system, participants would pay once (for premiums without subsidies) or in effect less than once (for premiums with subsidies). In the new insurance system (as a result of Obamacare), the former group’s taxes pay for the latter group’s subsidies, so the former group ends up paying in effect more than once. This is one of the main reasons why Obamacare is unfair, since it is not only an insurance system but a means of wealth redistribution.

          1. Don Shor Post author

            Why is wealth redistribution unfair if it serves a social good? We do that for all kinds of things.
            Why does it matter if the system is open or closed?
            Why does it matter if the lower-income subsidies are paid for by the overall system, or by taxes, or by some combination of the two?
            People who can’t afford health care, fully or partially, are either going to go without it (and get sick and die), or use the system and be unable to pay for it. Or they will be on a partially or fully subsidized health system. The money has to come from somewhere for that. The funds for the ACA came from expanding the pool (individual mandate), various fees, various taxes. It’s a combination of revenues.

            Conservatives, over the last 5 – 6 years, have moved to a position of opposition to universal health coverage. As recently as 2007, conservatives and Republicans advocated for universal coverage and the individual mandate. Even Jim DeMint is on record for those things. Then there was a gradual shift to opposition to any expansion of the federal role in health insurance, complete opposition to raising taxes and fees, and governors refused to consider expansion of health services to their poorest citizens. So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care. Do you hold that position? If you do, we have a fundamental difference of values.
            If Obamacare is repealed, I will lose my health care. It’s that simple.

          2. TrueBlueDevil Post author

            Wouldn’t you call it unfair to take 60% of someone else’s income? Why do we have a right to their money? Some people call that theft, Dr. Walter Williams being one of them.

            The funds for the ACA didn’t come from expanding the pool; they are being put on our nation’s credit card, something Obama has become a master at.

            As time goes on, no matter how grating she was, Sarah Palin was right – we will have Death Panels. I’m currently friends with several older Americans over 75 and 80, and the majority of them have battled at least 2 major illnesses; some have battled 4 or 5. There are enormous costs there, and rationing is the only way under the ACA to even come close to paying the tab.

          3. Don Shor Post author

            Sarah Palin was right – we will have Death Panels.

            So you complain about lies on one comment, and then repeat the most egregious, outlandish, ridiculous lie on another comment.

          4. TrueBlueDevil Post author

            We will have rationing of services, which will lead to deaths; Palin simply gave it a memorable name that stuck with the public.

          5. Don Shor Post author

            We will not have any more “rationing of services” than we had done by insurance companies. In fact, we’ll have less.

        2. TrueBlueDevil Post author

          You wrote: “The grand bargain of the Affordable Care Act was that it handed the insurance companies an enormously larger risk pool over which to spread the cost of insuring more Americans.”

          The sign-up rate for youngsters for Obamacare hasn’t happened, so the system has added older, sicker people, but not the numbers of young healthy people needed. So rates will rise, possibly skyrocket, in the next go around.

          You wrote: “. But since there isn’t likely to be any modification of the ACA, at least not within the next 2 – 3 years,…”

          There have been over 40 changes to the ACA; Obama has made at least 24 unilaterally, which I thought was illegal under our Constitution.

          http://www.galen.org/newsletters/changes-to-obamacare-so-far/

          1. Don Shor Post author

            As noted on a previous reply, the signup rate for young people has been sufficient because it has met the expectations of the insurers as they established their rates.

          2. Don Shor Post author

            There have been over 40 changes to the ACA; Obama has made at least 24 unilaterally, which I thought was illegal under our Constitution.

            Most of the President’s actions were delays and exemptions. Congress blocked some minor portions. The major change was the Supreme Court’s ill-advised decision allowing the states to opt out of the Medicare expansion. That’s going to require some kind of fix to get poor people covered.
            As to what’s illegal, I assume that will be resolved in court at some point. Are you a constitutional scholar? Do Obama’s executive actions have some unique aspect that previous presidents’ didn’t?

      2. Tia Will Post author

        Don

        “So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care. Do you hold that position? If you do, we have a fundamental difference of values.”

        I really do believe that this is the critical difference and that it is one of values. Either one sees health care as a human right or one sees it as a societal good as one poster put it earlier.
        This to me is the difference between necessity and “nice to have”. For me health care should be considered as much a right of citizens as is protection by our military. To be safe, it is necessary to have protection, not only against foreign enemies, but also from the internal and social enemies or hunger, homelessness, illness. It the goal is a strong society, it cannot be built by people who are weak or ill. We as humans have the obligation to care for others.
        And yes, we can afford it as a nation. It would mean re prioritizing. It would not mean the destruction of the middle class ( actually I suspect that without the fear of losing ones home or savings or job to illness ) the middle class might be significantly better off as medical costs have often been the straw that broke the proverbial back of the middle class family just making it before illness struck. It would not mean the descent into some kind of mythical
        “socialist hell” as some on the right have claimed.

        1. Frankly Post author

          So basically, conservatives and Republicans have abandoned the principle that all Americans have a right to basic health care.

          Define “basic” and then I will tell you if you are correct or not.

          And one more point to make. Do all people have a right to basic food and basic shelter? Because without those they would die. And if you believe so, then why don’t you advocate for the government to take over all food production and all housing?

  35. Tia Will

    Dorte

    “I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick.”

    Wishing that one does not get sick is fine. However, I would strongly recommend being proactive rather than reactive with regard to one’s health. A truly proactive and sometimes life saving approach is to get regular health care evaluations which for women include cervical cancer screening every three years ( for the average risk woman), mammography every one to two years starting around age 40 ( again for the average risk woman), colon cancer screening after age 50, Cholesterol, blood sugar and thyroid testing every two to three years after age 40-50 depending on additional risk factors and staying current on one’s immunizations. Of course, all of this can be done without any insurance at all by paying up front for your tests. Most people I know do not choose this course of action if they are not insured. I consider this reactive because there are many conditions that do not have any associated symptoms until the disease has caused significant damage to vital organs such as the liver, kidneys or heart after which point it can be very difficult and expensive to manage.

    1. Dorte Jensen

      Hi Tia,

      You write, “Most people I know do not choose this course of action if they are not insured.”

      I guess I am in the minority of those people you know. You might have guessed that based on my posts on other issues.

      1. Tia Will

        Hi Dorte

        Since you are deliberately choosing not to carry insurance, I have some questions for you.
        What if you are in a life threatening car accident tomorrow and you are now disabled and cannot work. Lets further say that this is a “no fault accident ” and so there is no one to sue. What do you feel is the right course of action and why ?
        Do you feel that you should be provided only with ER care and stabilized even if you need far more extensive care ? Who should pay for the ER services ? If you believe that you should receive hospital services and or skilled nursing or rehabilitative services until such time as you are able to resume work, who do you believe should pay for this care ?
        What if you are permanently disabled and can no longer work at all ? Do you believe that you should be helped….and if not by the government, then by whom ?

        1. Dorte Jensen

          Hi Tia,

          Since you responded to me on this thread (if that is what it is called) I thought you might say that you were glad that I’m not going to die from one of those preventable diseases. I guess not.

          Thanks for the post, though. I’d like to answer it in full, but I’d rather not tell everyone in the world about personal details of my life. Suffice it to say that I am not employed but help my mother manage her household.

          If I were catastrophically hurt, I would pay the bill myself first, and then my mom would want to kick in for the rest. Perhaps my Dad would kick in some. I would use the minimum amount of services, so that probably would not include rehabilitative care. The goal would not be to be patched up enough to resume work–I’m not employed now!–but to be able to crawl around my house if need be. I believe that if I could crawl I could learn to walk, since I did that once before, some 50 years ago.

          If this catastrophic event happened after my parents were dead (you can guess their ages, based on mine), I would want even less services. I might even decide I wanted to be allowed to die. You see, my only dependents are my cats, and I could probably get someone to take care of them.

          In other words, I don’t have the life you think I have. I don’t have the life I thought I would have. I have the life I have, and it’s good enough. In fact, it’s great because it’s the one I have.

          Of course, if the accident actually happened I might change my mind. I can’t predict how I would feel when actually faced with those circumstances. However, I have the sense now that “my” life is basically over. I still live (here I am typing), but there is less of “me”–wants, desires, goals–and since there is less of “me” there is more room in my experience for things which are “not-me”. Of course, this me/not-me distinction is ridiculous, since when there is less of me, there is less of not-me as well. There is more of everything around.

          In other words, I feel more connected to everything and everyone since I don’t separate myself out so much or since there is less to separate out to begin with.

          A logical extension of this is that it would not be terrible to die as long as doing so hurt nobody. When I’m here, I’ll do my best to do what I think I am here to do–no, what I am almost certain I am here to do–and then “I” will be gone. In fact, “I” am almost already gone. And that’s good. In fact, it’s great.

          And lest you tell me, in doctor mode, that I am depressed, I’ll tell you that that’s not very possible, since there is not much “I” there. If you tell me that you know better than I do, I’ll tell you that’s not likely, since now I know things for myself.

          I’m glad I’ve reached this place. All my life I hoped I would. I didn’t anticipate how I would get here or how I would be when I got here, but the important thing is that I am here.

          So thanks for asking about this possible catastrophic event. It gave me the opportunity to tell you a little about my life.

          1. Tia Will

            Dorte

            “In other words, I don’t have the life you think I have. ”

            Prior to this post, I knew absolutely nothing about your life and therefore had no thoughts whatsoever about what it might be like.

            It would seem that at least some of your thoughts are based on the willingness to accept that death is a normal part of life and therefore you do not place expensive medical care as high on your list of “must haves” as some people do. We share this view point. I do not mind the thought of dying, which we will indeed all do at some point. However, I certainly do mind the thought of extensive surgeries, intractable pain and disability
            which are other potential outcomes.
            And it is important not to forget that some people value life over all else, often for religious reasons and would do anything to keep themselves or a loved one alive. For people without insurance, this can be a virtual impossibility.
            Someone pays for all care. Whether it is the person themselves, their relatives, their insurance company, or the entire society either through insurance premiums or through our taxes. So unless an individual has signed paper work that says in case of accident or being “found down”
            do not resuscitate and carries this message with them everywhere, they are acknowledging whether they admit it or not, that they are willing to accept governmental help to pay for their care. Only the truly wealthy,
            the fully insured ( and not with the “skinny” plans of the pre Obamacare
            days which often did not cover anything worth covering, but that people were” happy with ” because they didn’t understand the fine print)
            or those willing to accept being left at the side of the road to die are not going to be using “other people’s money” to pay for their health care.
            Most people are not aware of this because we do not see the bills for the
            “health care” of others.

            I appreciate that you are willing to share so much of your story since it is the individual stories and perspectives that provide the richness to our dialogues here.

          2. Frankly

            In other words, I don’t have the life you think I have. I don’t have the life I thought I would have. I have the life I have, and it’s good enough. In fact, it’s great because it’s the one I have

            I love this line. Perfect. You are happy and satisfied with life because you have it.

            I wish more people would adopt this thinking.

            Unfortunately the lyrics to one of my favorite songs too often ring true…

            I turn on the tube and what do I see
            A whole lotta people cryin’ “Don’t blame me”
            They point their crooked little fingers ar everybody else
            Spend all their time feelin’ sorry for themselves
            Victim of this, victim of that
            Your momma’s too thin; your daddy’s too fat

            Get over it
            Get over it
            All this whinin’ and cryin’ and pitchin’ a fit
            Get over it, get over it

            You say you haven’t been the same since you had your little crash
            But you might feel better if I gave you some cash
            The more I think about it, Old Billy was right
            Let’s kill all the lawyers, kill ’em tonight
            You don’t want to work, you want to live like a king
            But the big, bad world doesn’t owe you a thing

            Get over it
            Get over it
            If you don’t want to play, then you might as well split
            Get over it, Get over it

            It’s like going to confession every time I hear you speak
            You’re makin’ the most of your losin’ streak
            Some call it sick, but I call it weak

            You drag it around like a ball and chain
            You wallow in the guilt; you wallow in the pain
            You wave it like a flag, you wear it like a crown
            Got your mind in the gutter, bringin’ everybody down
            Complain about the present and blame it on the past
            I’d like to find your inner child and kick its little ass

            Get over it
            Get over it
            All this bitchin’ and moanin’ and pitchin’ a fit
            Get over it, get over it

            Get over it
            Get over it
            It’s gotta stop sometime, so why don’t you quit
            Get over it, get over it

  36. Tia Will Post author

    Dorte

    “I wish that Obamacare could be repealed and replaced, and I wish as before that I don’t get sick.”

    Wishing that one does not get sick is fine. However, I would strongly recommend being proactive rather than reactive with regard to one’s health. A truly proactive and sometimes life saving approach is to get regular health care evaluations which for women include cervical cancer screening every three years ( for the average risk woman), mammography every one to two years starting around age 40 ( again for the average risk woman), colon cancer screening after age 50, Cholesterol, blood sugar and thyroid testing every two to three years after age 40-50 depending on additional risk factors and staying current on one’s immunizations. Of course, all of this can be done without any insurance at all by paying up front for your tests. Most people I know do not choose this course of action if they are not insured. I consider this reactive because there are many conditions that do not have any associated symptoms until the disease has caused significant damage to vital organs such as the liver, kidneys or heart after which point it can be very difficult and expensive to manage.

    1. Dorte Jensen Post author

      Hi Tia,

      You write, “Most people I know do not choose this course of action if they are not insured.”

      I guess I am in the minority of those people you know. You might have guessed that based on my posts on other issues.

      1. Tia Will Post author

        Hi Dorte

        Since you are deliberately choosing not to carry insurance, I have some questions for you.
        What if you are in a life threatening car accident tomorrow and you are now disabled and cannot work. Lets further say that this is a “no fault accident ” and so there is no one to sue. What do you feel is the right course of action and why ?
        Do you feel that you should be provided only with ER care and stabilized even if you need far more extensive care ? Who should pay for the ER services ? If you believe that you should receive hospital services and or skilled nursing or rehabilitative services until such time as you are able to resume work, who do you believe should pay for this care ?
        What if you are permanently disabled and can no longer work at all ? Do you believe that you should be helped….and if not by the government, then by whom ?

        1. Dorte Jensen Post author

          Hi Tia,

          Since you responded to me on this thread (if that is what it is called) I thought you might say that you were glad that I’m not going to die from one of those preventable diseases. I guess not.

          Thanks for the post, though. I’d like to answer it in full, but I’d rather not tell everyone in the world about personal details of my life. Suffice it to say that I am not employed but help my mother manage her household.

          If I were catastrophically hurt, I would pay the bill myself first, and then my mom would want to kick in for the rest. Perhaps my Dad would kick in some. I would use the minimum amount of services, so that probably would not include rehabilitative care. The goal would not be to be patched up enough to resume work–I’m not employed now!–but to be able to crawl around my house if need be. I believe that if I could crawl I could learn to walk, since I did that once before, some 50 years ago.

          If this catastrophic event happened after my parents were dead (you can guess their ages, based on mine), I would want even less services. I might even decide I wanted to be allowed to die. You see, my only dependents are my cats, and I could probably get someone to take care of them.

          In other words, I don’t have the life you think I have. I don’t have the life I thought I would have. I have the life I have, and it’s good enough. In fact, it’s great because it’s the one I have.

          Of course, if the accident actually happened I might change my mind. I can’t predict how I would feel when actually faced with those circumstances. However, I have the sense now that “my” life is basically over. I still live (here I am typing), but there is less of “me”–wants, desires, goals–and since there is less of “me” there is more room in my experience for things which are “not-me”. Of course, this me/not-me distinction is ridiculous, since when there is less of me, there is less of not-me as well. There is more of everything around.

          In other words, I feel more connected to everything and everyone since I don’t separate myself out so much or since there is less to separate out to begin with.

          A logical extension of this is that it would not be terrible to die as long as doing so hurt nobody. When I’m here, I’ll do my best to do what I think I am here to do–no, what I am almost certain I am here to do–and then “I” will be gone. In fact, “I” am almost already gone. And that’s good. In fact, it’s great.

          And lest you tell me, in doctor mode, that I am depressed, I’ll tell you that that’s not very possible, since there is not much “I” there. If you tell me that you know better than I do, I’ll tell you that’s not likely, since now I know things for myself.

          I’m glad I’ve reached this place. All my life I hoped I would. I didn’t anticipate how I would get here or how I would be when I got here, but the important thing is that I am here.

          So thanks for asking about this possible catastrophic event. It gave me the opportunity to tell you a little about my life.

          1. Tia Will Post author

            Dorte

            “In other words, I don’t have the life you think I have. ”

            Prior to this post, I knew absolutely nothing about your life and therefore had no thoughts whatsoever about what it might be like.

            It would seem that at least some of your thoughts are based on the willingness to accept that death is a normal part of life and therefore you do not place expensive medical care as high on your list of “must haves” as some people do. We share this view point. I do not mind the thought of dying, which we will indeed all do at some point. However, I certainly do mind the thought of extensive surgeries, intractable pain and disability
            which are other potential outcomes.
            And it is important not to forget that some people value life over all else, often for religious reasons and would do anything to keep themselves or a loved one alive. For people without insurance, this can be a virtual impossibility.
            Someone pays for all care. Whether it is the person themselves, their relatives, their insurance company, or the entire society either through insurance premiums or through our taxes. So unless an individual has signed paper work that says in case of accident or being “found down”
            do not resuscitate and carries this message with them everywhere, they are acknowledging whether they admit it or not, that they are willing to accept governmental help to pay for their care. Only the truly wealthy,
            the fully insured ( and not with the “skinny” plans of the pre Obamacare
            days which often did not cover anything worth covering, but that people were” happy with ” because they didn’t understand the fine print)
            or those willing to accept being left at the side of the road to die are not going to be using “other people’s money” to pay for their health care.
            Most people are not aware of this because we do not see the bills for the
            “health care” of others.

            I appreciate that you are willing to share so much of your story since it is the individual stories and perspectives that provide the richness to our dialogues here.

          2. Frankly Post author

            In other words, I don’t have the life you think I have. I don’t have the life I thought I would have. I have the life I have, and it’s good enough. In fact, it’s great because it’s the one I have

            I love this line. Perfect. You are happy and satisfied with life because you have it.

            I wish more people would adopt this thinking.

            Unfortunately the lyrics to one of my favorite songs too often ring true…

            I turn on the tube and what do I see
            A whole lotta people cryin’ “Don’t blame me”
            They point their crooked little fingers ar everybody else
            Spend all their time feelin’ sorry for themselves
            Victim of this, victim of that
            Your momma’s too thin; your daddy’s too fat

            Get over it
            Get over it
            All this whinin’ and cryin’ and pitchin’ a fit
            Get over it, get over it

            You say you haven’t been the same since you had your little crash
            But you might feel better if I gave you some cash
            The more I think about it, Old Billy was right
            Let’s kill all the lawyers, kill ’em tonight
            You don’t want to work, you want to live like a king
            But the big, bad world doesn’t owe you a thing

            Get over it
            Get over it
            If you don’t want to play, then you might as well split
            Get over it, Get over it

            It’s like going to confession every time I hear you speak
            You’re makin’ the most of your losin’ streak
            Some call it sick, but I call it weak

            You drag it around like a ball and chain
            You wallow in the guilt; you wallow in the pain
            You wave it like a flag, you wear it like a crown
            Got your mind in the gutter, bringin’ everybody down
            Complain about the present and blame it on the past
            I’d like to find your inner child and kick its little ass

            Get over it
            Get over it
            All this bitchin’ and moanin’ and pitchin’ a fit
            Get over it, get over it

            Get over it
            Get over it
            It’s gotta stop sometime, so why don’t you quit
            Get over it, get over it

          3. Dorte Jensen Post author

            Hi Frankly,

            I’m glad you liked my comment. Your song made me laugh.

  37. Frankly

    Note that the company is not preventing any employee from using any type of contraceptive available. They are only wanting to not pay for some that are not supported by their beliefs.

    That is the essence of the lie that this is a war on women. Just because I don’t want to pay for something for you, does not mean I am against you.

    Now, if I was legislating to take away influence, choice or resources that you enjoy, then yes, call it a war.

    That is why I see liberals as being at war with humanity.

      1. Tia Will

        TBD

        “For the record, Hobby Lobby covers 16 types of contraception free of charge, including 2 types of oral contraceptive.

        Your statement is true but ignores two critical points that I have made several times.
        1)For women who cannot use hormonal contraception, there is only one highly statistically form of contraception and it is not covered by Hobby Lobby. This is the Paraguard IUD which is not an abortifacient even though Hobby Lobby claims that their religious beliefs are that it is. Many women who cannot use hormonal contraception cannot use it precisely because they have a medical condition ( uncontrolled HTN, heart, blood clotting problem, cancer) that would also make pregnancy very dangerous. So the Supreme Court has essentially said that the sentiments of the employers take precedence over not only the sentiments of the employee but could potentially cost her life if she conceived. Significant “material harm” in my book.
        2) They also will not cover the Mirena IUD which is frequently used for control of excessive bleeding not successfully managed by other means even if not being used for contraception. Does anyone believe that this is justifiable lets say for the celibate woman ?

        I simply do not believe that the religious beliefs of any group should determine the health care of another group. I am not sure that all of you who support this decision would do so if another religious tradition were involved.

        Certain groups of Hmong believe that a an open surgery will cause a person to lose their soul. So if there are Hmong owners of a large for profit business and a woman is employed by them, should the insurance they provide not cover a medically indicated Cesarean ?
        If not, why not ?

        Of the examples that Justice Ginsburg made, no payment for your transfusion if you happen to be employed by a large company owned by Jehovah’s Witnesses ? These would be the logical extensions of the principle that the majority opinion.

        1. TrueBlueDevil

          Then why can’t these infrequent, unusual cases (patients) pay for contraceptive method 19 or 20?

          I see no reason why a religious group should pay for a medical procedure they consider murder.

          1. Tia Will

            TBD

            OK, so now explain to me why they should not have to cover it for celibate or lesbian women who are using it for other medical indications.

            And explain to me why my tax money goes to make weapons of war which I consider murder ( defined as the killing of innocent life) which we all know occurs during war ( including plenty of fetuses still within their mother by the way). Where is the outcry over those deaths?

            And explain to me why my tax dollars are used to fund the death penalty which I also consider murder.

        2. Don Shor

          I am not sure that all of you who support this decision would do so if another religious tradition were involved.

          There have been Christian Scientists in my family who, in two cases, chose to die of cancer without treatment, pain medication, or any intervention. It was, to put it mildly, hard on their families. More to the point, their beliefs would not permit medical treatment of any kind. In our family, and my in-laws’, they did not extend those practices to their children, but that has often occurred. Some Christian Scientists might believe that their beliefs extend to those who work for them, or to their families. So the precedent is set by the Supreme Court: a Christian Scientist employer can refuse to cover any medical insurance?
          My son works for a large company that was recently purchased by the largest company in that industry. The new owners are LDS. My son put in several weeks of unpaid training to get the certification needed for his job. Fortunately, the new owners have not shown any inclination to change the benefits. But now, thanks to the Supreme Court, they could?
          According to a 2009 report, more than 50% of private employment in the US is with “closely-held corporations.” Extrapolated to today’s work force, that is over 60 million employees. All now potentially subject to the religious beliefs of their employers.

          1. Don Shor

            Article 1, Section 2 had some real problems, even when amended by the 14th.
            The 18th amendment was a real buzz kill.
            How about you? Do you think the Constitution was perfect as written?

          2. Don Shor

            Basically, we’re asking you. Conservatives are very fond of the slippery-slope arguments when it comes to things like gun control. So let’s take that slippery-slope concept and apply it to the religious freedom argument that the SCOTUS has just upheld. You believe that any employer of any religion has the right to impose any religious belief on his or her employees? If not, where do you draw the line? Which religions? Which beliefs? Catholic business owners like Eden Foods already intend to stop paying for insurance that covers contraception. Any contraception. So we’ve given you examples: Jehovahs Witnesses, Christian Scientist. Do you draw a line anywhere?

  38. Frankly Post author

    Note that the company is not preventing any employee from using any type of contraceptive available. They are only wanting to not pay for some that are not supported by their beliefs.

    That is the essence of the lie that this is a war on women. Just because I don’t want to pay for something for you, does not mean I am against you.

    Now, if I was legislating to take away influence, choice or resources that you enjoy, then yes, call it a war.

    That is why I see liberals as being at war with humanity.

      1. Tia Will Post author

        TBD

        “For the record, Hobby Lobby covers 16 types of contraception free of charge, including 2 types of oral contraceptive.

        Your statement is true but ignores two critical points that I have made several times.
        1)For women who cannot use hormonal contraception, there is only one highly statistically form of contraception and it is not covered by Hobby Lobby. This is the Paraguard IUD which is not an abortifacient even though Hobby Lobby claims that their religious beliefs are that it is. Many women who cannot use hormonal contraception cannot use it precisely because they have a medical condition ( uncontrolled HTN, heart, blood clotting problem, cancer) that would also make pregnancy very dangerous. So the Supreme Court has essentially said that the sentiments of the employers take precedence over not only the sentiments of the employee but could potentially cost her life if she conceived. Significant “material harm” in my book.
        2) They also will not cover the Mirena IUD which is frequently used for control of excessive bleeding not successfully managed by other means even if not being used for contraception. Does anyone believe that this is justifiable lets say for the celibate woman ?

        I simply do not believe that the religious beliefs of any group should determine the health care of another group. I am not sure that all of you who support this decision would do so if another religious tradition were involved.

        Certain groups of Hmong believe that a an open surgery will cause a person to lose their soul. So if there are Hmong owners of a large for profit business and a woman is employed by them, should the insurance they provide not cover a medically indicated Cesarean ?
        If not, why not ?

        Of the examples that Justice Ginsburg made, no payment for your transfusion if you happen to be employed by a large company owned by Jehovah’s Witnesses ? These would be the logical extensions of the principle that the majority opinion.

        1. TrueBlueDevil Post author

          Then why can’t these infrequent, unusual cases (patients) pay for contraceptive method 19 or 20?

          I see no reason why a religious group should pay for a medical procedure they consider murder.

          1. Tia Will Post author

            TBD

            OK, so now explain to me why they should not have to cover it for celibate or lesbian women who are using it for other medical indications.

            And explain to me why my tax money goes to make weapons of war which I consider murder ( defined as the killing of innocent life) which we all know occurs during war ( including plenty of fetuses still within their mother by the way). Where is the outcry over those deaths?

            And explain to me why my tax dollars are used to fund the death penalty which I also consider murder.

        2. Don Shor Post author

          I am not sure that all of you who support this decision would do so if another religious tradition were involved.

          There have been Christian Scientists in my family who, in two cases, chose to die of cancer without treatment, pain medication, or any intervention. It was, to put it mildly, hard on their families. More to the point, their beliefs would not permit medical treatment of any kind. In our family, and my in-laws’, they did not extend those practices to their children, but that has often occurred. Some Christian Scientists might believe that their beliefs extend to those who work for them, or to their families. So the precedent is set by the Supreme Court: a Christian Scientist employer can refuse to cover any medical insurance?
          My son works for a large company that was recently purchased by the largest company in that industry. The new owners are LDS. My son put in several weeks of unpaid training to get the certification needed for his job. Fortunately, the new owners have not shown any inclination to change the benefits. But now, thanks to the Supreme Court, they could?
          According to a 2009 report, more than 50% of private employment in the US is with “closely-held corporations.” Extrapolated to today’s work force, that is over 60 million employees. All now potentially subject to the religious beliefs of their employers.

          1. Don Shor Post author

            Article 1, Section 2 had some real problems, even when amended by the 14th.
            The 18th amendment was a real buzz kill.
            How about you? Do you think the Constitution was perfect as written?

          2. Don Shor Post author

            Basically, we’re asking you. Conservatives are very fond of the slippery-slope arguments when it comes to things like gun control. So let’s take that slippery-slope concept and apply it to the religious freedom argument that the SCOTUS has just upheld. You believe that any employer of any religion has the right to impose any religious belief on his or her employees? If not, where do you draw the line? Which religions? Which beliefs? Catholic business owners like Eden Foods already intend to stop paying for insurance that covers contraception. Any contraception. So we’ve given you examples: Jehovahs Witnesses, Christian Scientist. Do you draw a line anywhere?

  39. Tia Will

    Frankly

    Do you believe that Obamacare should be repealed or its provision for those not previously covered revoked ?
    If so, then you would most definitely be legislating to take away resources that might daughter and I “enjoyed”.
    Especially if you consider continuing to live “enjoyment”.

  40. Tia Will Post author

    Frankly

    Do you believe that Obamacare should be repealed or its provision for those not previously covered revoked ?
    If so, then you would most definitely be legislating to take away resources that might daughter and I “enjoyed”.
    Especially if you consider continuing to live “enjoyment”.

  41. Tia Will

    TBD

    “You example of charity starting at home (essentially) is a perfect one.”

    Charity starting at home is of course a good point. However, I do not believe that it should also end at home.
    Or with one’s church. Or within one’s own community. I believe that charity should exist where it is needed and that it is most powerful when it is all inclusive and not dependent on belonging to any one “tribe”, or race, or religion, or state or country.

  42. Tia Will Post author

    TBD

    “You example of charity starting at home (essentially) is a perfect one.”

    Charity starting at home is of course a good point. However, I do not believe that it should also end at home.
    Or with one’s church. Or within one’s own community. I believe that charity should exist where it is needed and that it is most powerful when it is all inclusive and not dependent on belonging to any one “tribe”, or race, or religion, or state or country.

  43. Tia Will

    TBD

    “We will have rationing of services, which will lead to deaths; Palin simply gave it a memorable name that stuck with the public.”

    We already had rationing of services. We called it fee for service. No ability to pay, no service.

    1. DavisBurns

      There is another kind of rationing. The delay and difficulty of getting services can serve the same purpose as having no insurance.

      Three weeks ago our daughter had an ongoing problem with pain in her lower back. We’ve been trying to find a new GP since her doctor left but we kept being told the various doctors weren’t accepting new partnership patients. This kid has six specialist but needs a GP as well so I read the blurbs for the docs who are accepting new patients and call to make an appointment. The “service” that makes appointments hears about HCM, ICD, heart attacks, anoxia, hypothermic therapy, Intensive care, etc and insists on a reason for the appointment. Well, she needs meds refilled and she has this backache that just won’t resolve. So we get to the appointment without a back ache but with a migraine headache. Can’t take imetrex, it could kill her, but something for nausea would be good. The doctor wants to know who we are–parents who take her to appointment and act as memory aides. She then says she demands complete honesty from her patients and since there is no acute backache, we lied to her and this just won’t work out. Goodbye. Now the manager is trying to find a doctor who is willing to take her on as a patient–I guess she will be more trouble than partnership pays for. The joys of poverty insurance coverage. All plans are not created equally.

  44. Tia Will Post author

    TBD

    “We will have rationing of services, which will lead to deaths; Palin simply gave it a memorable name that stuck with the public.”

    We already had rationing of services. We called it fee for service. No ability to pay, no service.

    1. DavisBurns Post author

      There is another kind of rationing. The delay and difficulty of getting services can serve the same purpose as having no insurance.

      Three weeks ago our daughter had an ongoing problem with pain in her lower back. We’ve been trying to find a new GP since her doctor left but we kept being told the various doctors weren’t accepting new partnership patients. This kid has six specialist but needs a GP as well so I read the blurbs for the docs who are accepting new patients and call to make an appointment. The “service” that makes appointments hears about HCM, ICD, heart attacks, anoxia, hypothermic therapy, Intensive care, etc and insists on a reason for the appointment. Well, she needs meds refilled and she has this backache that just won’t resolve. So we get to the appointment without a back ache but with a migraine headache. Can’t take imetrex, it could kill her, but something for nausea would be good. The doctor wants to know who we are–parents who take her to appointment and act as memory aides. She then says she demands complete honesty from her patients and since there is no acute backache, we lied to her and this just won’t work out. Goodbye. Now the manager is trying to find a doctor who is willing to take her on as a patient–I guess she will be more trouble than partnership pays for. The joys of poverty insurance coverage. All plans are not created equally.

  45. Tia Will

    There are a few ideas being expressed about how people utilize health care services and how they are paid for that I would like to address as a primary care provider.

    1) The idea that if something is “free” people will use more of it.
    This does not prove to be the case with preventive medicine and screening. It is the lower socioeconomic groups
    that tend to screen less frequently, even when the service is “free to them”. I see this in our outreach to try to
    get people to come in for screening. This may be because of mistaken ideas about the nature of the disease
    being screened for, it may be because of fears about the test itself, or it may be because it is just more difficult
    for them to get to the facility. There are lots of factors besides just cost.
    2) Why should a working family have to pay for screening for others when they are trying to support their own
    kids ?
    A few thoughts on this.
    1. Because this is the system we have built politically and economically. I have asked myself repeatedly, why
    when I was trying to raise my kids was I paying to make weapons to go blow up people in Iraq, a war which
    I did not support. We have decided as a society that we will pay for the projects that our elected officials
    decide are critical to the well being of our country. Now those on the right may feel that paying for “someone
    else’s medical care is not “critical”. I feel it is much more critical than blowing up someone else in their home.
    But then, maybe that’s just me.
    2. Because, if it is their infant that doesn’t die of pertussis because someone else got their free immunization
    made possible by the “redistribution of wealth” ( aka resources) then it will be well worth it for them. They
    just won’t ever know that this is what saved their child’s life.
    3. If the example that was given previously of the struggling family paying for someone else’s screening were
    an accurate depiction of our entire economic system my idea of providing basic health for all might not be
    feasible. But it is not. In addition to the working poor, we also have individuals who make, and take home,
    far, far more than they could ever reasonably spend. And in some cases they do it at the expense of their
    underpaid workers. So here we have a case, not of redistribution of money, but of redistribution of wealth
    if you factor in the time spent earning the money, from the working poor to the rich. We just don’t happen
    to call it that. But since, time is the same for everyone, that is actually what is occurring.
    The fact is that if you look across our entire society, we have more than enough “wealth” to pay for health
    care. We just prefer clinging to the idea that if something is labelled “free market” it has to be good and
    if something even slightly whiffs of “socialism” it must be bad without ever considering the nuances.
    Their are clearly pros and cons to any complex system. Until Obamacare, we had decided as a society to
    cling tooth and nail to the dysfunctions of our own system, either minimizing or pretending its problems.

    Now we have a new system that at least attempts to address those problems. Is it any surprise that this attempt to address the problems will introduce new problems of its own ? Why would that be any more surprising than the fact that President Bush’s efforts to free the world of Saadam Hussein produced its own set of problems ?
    Every initiative carries with it pros and cons.

    As Don has pointed out, the ACA is advantageous to him as it was to me. Others will dislike what they see as take aways. Does anyone find this surprising. It is far, far to early to judge whether this will overall be a positive or a negative. But in the entire time that the United States has been in existence we have tried the “fee for service” and “free market” approach with results that were statistically far from the best in the world for all except the
    very wealthy who themselves or through their insurers could afford the cutting edge treatments. In my view it was long past time to try something else. This would not have been my first choice…but at least it was an attempt rather than blind acceptance of a failed means of health care delivery.

  46. Tia Will Post author

    There are a few ideas being expressed about how people utilize health care services and how they are paid for that I would like to address as a primary care provider.

    1) The idea that if something is “free” people will use more of it.
    This does not prove to be the case with preventive medicine and screening. It is the lower socioeconomic groups
    that tend to screen less frequently, even when the service is “free to them”. I see this in our outreach to try to
    get people to come in for screening. This may be because of mistaken ideas about the nature of the disease
    being screened for, it may be because of fears about the test itself, or it may be because it is just more difficult
    for them to get to the facility. There are lots of factors besides just cost.
    2) Why should a working family have to pay for screening for others when they are trying to support their own
    kids ?
    A few thoughts on this.
    1. Because this is the system we have built politically and economically. I have asked myself repeatedly, why
    when I was trying to raise my kids was I paying to make weapons to go blow up people in Iraq, a war which
    I did not support. We have decided as a society that we will pay for the projects that our elected officials
    decide are critical to the well being of our country. Now those on the right may feel that paying for “someone
    else’s medical care is not “critical”. I feel it is much more critical than blowing up someone else in their home.
    But then, maybe that’s just me.
    2. Because, if it is their infant that doesn’t die of pertussis because someone else got their free immunization
    made possible by the “redistribution of wealth” ( aka resources) then it will be well worth it for them. They
    just won’t ever know that this is what saved their child’s life.
    3. If the example that was given previously of the struggling family paying for someone else’s screening were
    an accurate depiction of our entire economic system my idea of providing basic health for all might not be
    feasible. But it is not. In addition to the working poor, we also have individuals who make, and take home,
    far, far more than they could ever reasonably spend. And in some cases they do it at the expense of their
    underpaid workers. So here we have a case, not of redistribution of money, but of redistribution of wealth
    if you factor in the time spent earning the money, from the working poor to the rich. We just don’t happen
    to call it that. But since, time is the same for everyone, that is actually what is occurring.
    The fact is that if you look across our entire society, we have more than enough “wealth” to pay for health
    care. We just prefer clinging to the idea that if something is labelled “free market” it has to be good and
    if something even slightly whiffs of “socialism” it must be bad without ever considering the nuances.
    Their are clearly pros and cons to any complex system. Until Obamacare, we had decided as a society to
    cling tooth and nail to the dysfunctions of our own system, either minimizing or pretending its problems.

    Now we have a new system that at least attempts to address those problems. Is it any surprise that this attempt to address the problems will introduce new problems of its own ? Why would that be any more surprising than the fact that President Bush’s efforts to free the world of Saadam Hussein produced its own set of problems ?
    Every initiative carries with it pros and cons.

    As Don has pointed out, the ACA is advantageous to him as it was to me. Others will dislike what they see as take aways. Does anyone find this surprising. It is far, far to early to judge whether this will overall be a positive or a negative. But in the entire time that the United States has been in existence we have tried the “fee for service” and “free market” approach with results that were statistically far from the best in the world for all except the
    very wealthy who themselves or through their insurers could afford the cutting edge treatments. In my view it was long past time to try something else. This would not have been my first choice…but at least it was an attempt rather than blind acceptance of a failed means of health care delivery.

  47. Tia Will

    Dorte

    “I don’t think that I have a responsibility to participate in something I find destructive.”

    Let’s apply that more broadly. Just three examples.

    1. I find wars destructive….so I shouldn’t have to pay taxes that go towards weapons production.
    2. I find long prison terms for non violent crimes such as drug dealing destructive to families so I shouldn’t have
    to pay taxes to support our prison system.
    3. I find four attempts to get a conviction for “gang related” activity destructive….so I shouldn’t have to pay
    taxes to support our local judicial system.

    This is not how we have structured our society. We have a system in which we follow the laws that our elected leaders enact. We do this whether we like them or not. To not follow the laws is fundamentally not just a rejection of that particular law, but a rejection of our system. Unfortunately, none of us get to just pick and choose which laws we are going to adhere to. That is called anarchy and I doubt you will find many people even on the political extremes who believe that is a good option.

    1. Dorte Jensen

      Hi Tia,

      I think that you are misinterpreting my words. I am under the law and will follow it, which means that I will pay the tax. If that is good enough for the IRS, it should be good enough for you.

    2. TrueBlueDevil

      Tia, per number “2” – my understanding is that most criminals in jail for drug crimes are dealers of drugs. I don’t consider them “non violent”. These deals are also often plead down – so there are multiple charges, and they take a plea deal on one of the lesser charges to make things look as tame as possible. Same thing happened recently with the priest who had three or four felony charges logged against him with a minor, he took a plea deal on one of the lesser felonies, and won’t have to register as a sex offender.

      Given that drugs have ravaged our nation, I’m surprised that you take a less serious view towards drug dealers. Again, my understanding is that most drug dealers aren’t in jail for dealing two joints, they are in there for larger quantities of drugs, typically harder drugs like heroine and crack. (Crack prison times were passed that are longer than cocaine due to the huge amounts of violence that surrounded the drug.)

      When we look at how drugs are peddled to young people, and when we see that a large percentage of the so called homeless have a serious drug or alcohol problem, I’d think you’d want to stem the flow of such deleterious items. Same goes for an open border, where many of our drugs come from… and a larger quantity here means a lower price point, which means more and younger users.

      We’ll see what happens with the next congressional election.

      1. DavisBurns

        The war on drugs has ravaged our nation more than the drugs themselves. As for the plea bargain, even if you are innocent, once charged you will be advised to plead guilty to a lesser charge with a lower sentence than you’d get if you went to trial and lost on the original charge. We think it is guilty until proven innocent but the plea system and the case load (thank you, war on drugs) means the system is designed to plead down and so the time.

        The war on drugs hasn’t been kind to Mexico either. It was ill conceived and a waste of lives and money.

      2. Tia Will

        TBD

        “I’m surprised that you take a less serious view towards drug dealers.”

        I don’t know what I have written that would make you think that I “take a less serious view towards drug dealers”.
        I take addiction very seriously. However, I do not believe that our “war on drugs” has been anymore successful than prohibition was. I do not believe that low level drug dealers or
        “mules” should be locked up for years for non violent albeit illegal actions. Some of these people will have been exposed to far more violence in our prisons than they would ever have committed out in the society.

        I think that it will be very interesting to see how the progressive decriminalization of marijuana plays out across the various states. Then we will have some current idea how decriminalization of an arbitrarily criminalized substance plays out. I suspect that what we will find will be an overall gain for our society. But that is purely speculation on my part at this time.

  48. Tia Will Post author

    Dorte

    “I don’t think that I have a responsibility to participate in something I find destructive.”

    Let’s apply that more broadly. Just three examples.

    1. I find wars destructive….so I shouldn’t have to pay taxes that go towards weapons production.
    2. I find long prison terms for non violent crimes such as drug dealing destructive to families so I shouldn’t have
    to pay taxes to support our prison system.
    3. I find four attempts to get a conviction for “gang related” activity destructive….so I shouldn’t have to pay
    taxes to support our local judicial system.

    This is not how we have structured our society. We have a system in which we follow the laws that our elected leaders enact. We do this whether we like them or not. To not follow the laws is fundamentally not just a rejection of that particular law, but a rejection of our system. Unfortunately, none of us get to just pick and choose which laws we are going to adhere to. That is called anarchy and I doubt you will find many people even on the political extremes who believe that is a good option.

    1. Dorte Jensen Post author

      Hi Tia,

      I think that you are misinterpreting my words. I am under the law and will follow it, which means that I will pay the tax. If that is good enough for the IRS, it should be good enough for you.

    2. TrueBlueDevil Post author

      Tia, per number “2” – my understanding is that most criminals in jail for drug crimes are dealers of drugs. I don’t consider them “non violent”. These deals are also often plead down – so there are multiple charges, and they take a plea deal on one of the lesser charges to make things look as tame as possible. Same thing happened recently with the priest who had three or four felony charges logged against him with a minor, he took a plea deal on one of the lesser felonies, and won’t have to register as a sex offender.

      Given that drugs have ravaged our nation, I’m surprised that you take a less serious view towards drug dealers. Again, my understanding is that most drug dealers aren’t in jail for dealing two joints, they are in there for larger quantities of drugs, typically harder drugs like heroine and crack. (Crack prison times were passed that are longer than cocaine due to the huge amounts of violence that surrounded the drug.)

      When we look at how drugs are peddled to young people, and when we see that a large percentage of the so called homeless have a serious drug or alcohol problem, I’d think you’d want to stem the flow of such deleterious items. Same goes for an open border, where many of our drugs come from… and a larger quantity here means a lower price point, which means more and younger users.

      We’ll see what happens with the next congressional election.

      1. DavisBurns Post author

        The war on drugs has ravaged our nation more than the drugs themselves. As for the plea bargain, even if you are innocent, once charged you will be advised to plead guilty to a lesser charge with a lower sentence than you’d get if you went to trial and lost on the original charge. We think it is guilty until proven innocent but the plea system and the case load (thank you, war on drugs) means the system is designed to plead down and so the time.

        The war on drugs hasn’t been kind to Mexico either. It was ill conceived and a waste of lives and money.

      2. Tia Will Post author

        TBD

        “I’m surprised that you take a less serious view towards drug dealers.”

        I don’t know what I have written that would make you think that I “take a less serious view towards drug dealers”.
        I take addiction very seriously. However, I do not believe that our “war on drugs” has been anymore successful than prohibition was. I do not believe that low level drug dealers or
        “mules” should be locked up for years for non violent albeit illegal actions. Some of these people will have been exposed to far more violence in our prisons than they would ever have committed out in the society.

        I think that it will be very interesting to see how the progressive decriminalization of marijuana plays out across the various states. Then we will have some current idea how decriminalization of an arbitrarily criminalized substance plays out. I suspect that what we will find will be an overall gain for our society. But that is purely speculation on my part at this time.

    1. Barack Palin

      My posts were about Tia Will saying that we can’t just choose what laws we can obey or ignore. I just showed a couple of examples of laws that aren’t obeyed which Tia would consider anarchy. Sometimes Don I think you let your political leanings come in to play when you decide which posts to delete. All I ask for is fairness to all posters regardless of which side of the political aisle they are on.

      1. Don Shor

        If you have concerns about moderation practices on the Vanguard, you can contact me at donshor@gmail.com. If you don’t want to discuss it with me, you can contact David. You frequently post off-topic criticisms of the president. I will remove them. I am really not concerned whether you think what I do is fair. If you disagree, I have explained what you can do about it. What you cannot do about it is discuss it here.

          1. Matt Williams

            BP, a simple solution to this problem would be to have a daily “National” article in which comments about Obama would be on topic.

            We realize that you want to keep your identity anonymous, and we think there is a solution that can accomodate your desire on both fronts. Are you interested in pursuing such a solution? If you are then post a reply here and we will create an anonymous dialogue space where we can discuss how you can submit the daily (or periodic) articles.

          2. Dorte Jensen

            Hi Matt,

            You are as resourceful here as you were on the water issue. That’s a compliment.

          3. Barack Palin

            Matt, as one of the editorial board members of the Vanguard I have to say that you’ve been reasonable and fair. This article is about Hobby Lobby and the Supreme Court’s decision about their right to ban certain birth control options. Now go read the 236 comments and see how many posts have swayed off that topic. My post was in reply to Tia Will’s post saying that “none of us get to just pick and choose which laws we are going to adhere to” to which I pointed out a couple of laws that Obama chooses not to follow. It was totally in the flow of the conversation but yet it gets erased when so many other off topic posts are allowed to remain. Like I said, all I ask for is a level playing field for all. Yes, I would love to post an occasional article on some ripe topics that I know the Vanguard would never touch.

          4. Matt Williams

            BP, I am not going to get in the middle of Don’s moderation. The point you make has some resonance for me, but you need to temper that with the understanding that Don and I no longer speak to one another due to irreconcilable differences of opinion about Mace 391.

            Regarding your final sentence, the Vanguard has a very liberal publishing policy, and as long as the ripe topic you choose to write on is practical, we will publish it.

          1. Barack Palin

            So we can’t bring Obama’s name into an article about OBAMAcare but it’s okay to infuse Sarah Palin’s name as was used in earlier posts?

          2. Dorte Jensen

            Hi Barack Palin,

            I think that it would be great if you wrote some articles. Your posts are pretty condensed, as I remember, so a 1,000-word article (or however long they are) would allow readers to immerse themselves more in your thought process. Then they would be more able to ask intelligent questions and learn from your point of view.

    1. Barack Palin Post author

      My posts were about Tia Will saying that we can’t just choose what laws we can obey or ignore. I just showed a couple of examples of laws that aren’t obeyed which Tia would consider anarchy. Sometimes Don I think you let your political leanings come in to play when you decide which posts to delete. All I ask for is fairness to all posters regardless of which side of the political aisle they are on.

      1. Don Shor Post author

        If you have concerns about moderation practices on the Vanguard, you can contact me at donshor@gmail.com. If you don’t want to discuss it with me, you can contact David. You frequently post off-topic criticisms of the president. I will remove them. I am really not concerned whether you think what I do is fair. If you disagree, I have explained what you can do about it. What you cannot do about it is discuss it here.

          1. Matt Williams

            BP, a simple solution to this problem would be to have a daily “National” article in which comments about Obama would be on topic.

            We realize that you want to keep your identity anonymous, and we think there is a solution that can accomodate your desire on both fronts. Are you interested in pursuing such a solution? If you are then post a reply here and we will create an anonymous dialogue space where we can discuss how you can submit the daily (or periodic) articles.

          2. Dorte Jensen Post author

            Hi Matt,

            You are as resourceful here as you were on the water issue. That’s a compliment.

          3. Barack Palin Post author

            Matt, as one of the editorial board members of the Vanguard I have to say that you’ve been reasonable and fair. This article is about Hobby Lobby and the Supreme Court’s decision about their right to ban certain birth control options. Now go read the 236 comments and see how many posts have swayed off that topic. My post was in reply to Tia Will’s post saying that “none of us get to just pick and choose which laws we are going to adhere to” to which I pointed out a couple of laws that Obama chooses not to follow. It was totally in the flow of the conversation but yet it gets erased when so many other off topic posts are allowed to remain. Like I said, all I ask for is a level playing field for all. Yes, I would love to post an occasional article on some ripe topics that I know the Vanguard would never touch.

          4. Matt Williams

            BP, I am not going to get in the middle of Don’s moderation. The point you make has some resonance for me, but you need to temper that with the understanding that Don and I no longer speak to one another due to irreconcilable differences of opinion about Mace 391.

            Regarding your final sentence, the Vanguard has a very liberal publishing policy, and as long as the ripe topic you choose to write on is practical, we will publish it.

        1. DavisBurns Post author

          Don, thank you. I don’t want this blog to be an echo chamber. I appreciate different perspectives but the O-badman rants get old.

          1. Barack Palin Post author

            So we can’t bring Obama’s name into an article about OBAMAcare but it’s okay to infuse Sarah Palin’s name as was used in earlier posts?

          2. Dorte Jensen Post author

            Hi Barack Palin,

            I think that it would be great if you wrote some articles. Your posts are pretty condensed, as I remember, so a 1,000-word article (or however long they are) would allow readers to immerse themselves more in your thought process. Then they would be more able to ask intelligent questions and learn from your point of view.

  49. Topcat

    Don Wrote: “According to a 2009 report, more than 50% of private employment in the US is with “closely-held corporations.” Extrapolated to today’s work force, that is over 60 million employees. All now potentially subject to the religious beliefs of their employers.”

    It makes no sense that employers should be responsible for providing health care. As you know, it is a historical accident that the US implemented this crazy system. It’s too bad that our political leaders will not address such a basic issue that is causing so many problems. This whole “Hobby Lobby” issue would not even exist if worker’s healthcare was not dependent upon their employers.

  50. Topcat Post author

    Don Wrote: “According to a 2009 report, more than 50% of private employment in the US is with “closely-held corporations.” Extrapolated to today’s work force, that is over 60 million employees. All now potentially subject to the religious beliefs of their employers.”

    It makes no sense that employers should be responsible for providing health care. As you know, it is a historical accident that the US implemented this crazy system. It’s too bad that our political leaders will not address such a basic issue that is causing so many problems. This whole “Hobby Lobby” issue would not even exist if worker’s healthcare was not dependent upon their employers.

  51. TrueBlueDevil

    Big ruling today which could effect the ACA, federal subsidies found to be illegal. It may go to a higher court which is dominated by Democrats, who most likely will vote along party lines.

    Dorte, Congressman Dr. Tom Coburn had a plan that he offered years ago: there is an Executive Summary, and then a larger plan. Obama didn’t consider it’s many relevant suggestions.

    Now, after Obamacare, he is also part of a group that has offered to repeal and replace the ACA with a better plan. It is called called the Patient Choice, Affordability, Responsibility, and Empowerment Act, or the Patient CARE Act (PCA). Here is an 8=page Summary.

    http://www.hatch.senate.gov/public/_cache/files/bf0c9823-29c7-4078-b8af-aa9a12213eca/The%20Patient%20CARE%20Act%20-%20LEGISLATIVE%20PROPOSAL.pdf

    Here also is an article covering the PCA plan.

    http://healthaffairs.org/blog/2014/02/12/a-senate-gop-health-reform-proposal-the-burr-coburn-hatch-plan/

    In a sad note, Obama’s lie about being able to keep your doctor’s has come home to roost with Dr. Cobuen, who is now suffering from cancer. “Republican Sen. Tom Coburn revealed Tuesday that his ObamaCare insurance plan does not cover his cancer specialist, forcing him to pay out of pocket — in the latest reminder of complications with the health law as President Obama prepares to address the nation.”

    http://www.foxnews.com/politics/2014/01/28/coburn-says-obamacare-cost-him-coverage-for-cancer-doctor/

    1. DavisBurns

      I thought the senate excluded themselves from ADA and kept their gold plated health coverage. You can’t have it both ways. And as far as coverage changing, I had blue cross insurance for decades and I swear every year there was something else they didn’t cover. They paid for my son to get speech therapy, two years later they no longer covered the same service for my daughter. They paid for othodics for a long time, then they stopped. Every year they new policy came and summarized all the changes which included co-pays. So why all the whining about coverage changing? That is the nature of free market medicine. If it gets used too much, don’t cover it any more. KEEP YOUR PROFITS AT ALL COSTS Well all costs to the consumer. Really private health insurance is a game rigged for the insurers. Put everyone in the same pool, give them the same coverage and the cost per person foes down dramatically. And cut out all the paper work. Give everybody one card that covers everything like they so in France. Put all the billing departments out of work and save money.

    2. Tia Will

      Topcat

      I have long wanted the separation of health care from employment for a number or reasons.
      1. Your point about interference in the health care decisions of the individual is an obvious reason
      2. This system traps people in jobs that they may not be a good fit for because they cannot afford to lose
      coverage.
      This is not good for the individual, the company, or our society as a whole.
      3. This system also keeps people in unhealthy social situations. I have had women who cannot leave failed
      relationships because they need the health care insurance that hinges on their husbands employment. Now, I
      am all in favor of strong families, but not families that are forced to stay together for their health care.
      4. People who are not employed outside the home, or are self employed need insurance just as much as those
      who are employed outside the home, so what is the moral justification for favoring one group over another ?

      1. Topcat

        Tia,

        You make excellent arguments for separating health care from employment.

        In addition, I could point out that employers with less than 50 employees are not required to provide healthcare. A lot of people fall in this category. Also, some employers have limited hours worked so that an employee is “part time”. Once again, the employer doesn’t have to provide healthcare.

        With all of these issues I am amazed that there seems to be no political movement towards separating healthcare and employment.

    3. Dorte Jensen

      Hi TrueBlueDevil,

      Thanks so much for the references. I read all of them. Coburn’s plan seems to be very good. What do you think that people can do to support it? Also, people who now have Obamacare (especially those who were previously uninsured) might be fearful of it (since it involves repeal and replacement),and they might think that the latter would never happen. What can people do to convince them otherwise?

  52. TrueBlueDevil Post author

    Big ruling today which could effect the ACA, federal subsidies found to be illegal. It may go to a higher court which is dominated by Democrats, who most likely will vote along party lines.

    Dorte, Congressman Dr. Tom Coburn had a plan that he offered years ago: there is an Executive Summary, and then a larger plan. Obama didn’t consider it’s many relevant suggestions.

    Now, after Obamacare, he is also part of a group that has offered to repeal and replace the ACA with a better plan. It is called called the Patient Choice, Affordability, Responsibility, and Empowerment Act, or the Patient CARE Act (PCA). Here is an 8=page Summary.

    http://www.hatch.senate.gov/public/_cache/files/bf0c9823-29c7-4078-b8af-aa9a12213eca/The%20Patient%20CARE%20Act%20-%20LEGISLATIVE%20PROPOSAL.pdf

    Here also is an article covering the PCA plan.

    http://healthaffairs.org/blog/2014/02/12/a-senate-gop-health-reform-proposal-the-burr-coburn-hatch-plan/

    In a sad note, Obama’s lie about being able to keep your doctor’s has come home to roost with Dr. Cobuen, who is now suffering from cancer. “Republican Sen. Tom Coburn revealed Tuesday that his ObamaCare insurance plan does not cover his cancer specialist, forcing him to pay out of pocket — in the latest reminder of complications with the health law as President Obama prepares to address the nation.”

    http://www.foxnews.com/politics/2014/01/28/coburn-says-obamacare-cost-him-coverage-for-cancer-doctor/

    1. DavisBurns Post author

      I thought the senate excluded themselves from ADA and kept their gold plated health coverage. You can’t have it both ways. And as far as coverage changing, I had blue cross insurance for decades and I swear every year there was something else they didn’t cover. They paid for my son to get speech therapy, two years later they no longer covered the same service for my daughter. They paid for othodics for a long time, then they stopped. Every year they new policy came and summarized all the changes which included co-pays. So why all the whining about coverage changing? That is the nature of free market medicine. If it gets used too much, don’t cover it any more. KEEP YOUR PROFITS AT ALL COSTS Well all costs to the consumer. Really private health insurance is a game rigged for the insurers. Put everyone in the same pool, give them the same coverage and the cost per person foes down dramatically. And cut out all the paper work. Give everybody one card that covers everything like they so in France. Put all the billing departments out of work and save money.

    2. Tia Will Post author

      Topcat

      I have long wanted the separation of health care from employment for a number or reasons.
      1. Your point about interference in the health care decisions of the individual is an obvious reason
      2. This system traps people in jobs that they may not be a good fit for because they cannot afford to lose
      coverage.
      This is not good for the individual, the company, or our society as a whole.
      3. This system also keeps people in unhealthy social situations. I have had women who cannot leave failed
      relationships because they need the health care insurance that hinges on their husbands employment. Now, I
      am all in favor of strong families, but not families that are forced to stay together for their health care.
      4. People who are not employed outside the home, or are self employed need insurance just as much as those
      who are employed outside the home, so what is the moral justification for favoring one group over another ?

      1. Topcat Post author

        Tia,

        You make excellent arguments for separating health care from employment.

        In addition, I could point out that employers with less than 50 employees are not required to provide healthcare. A lot of people fall in this category. Also, some employers have limited hours worked so that an employee is “part time”. Once again, the employer doesn’t have to provide healthcare.

        With all of these issues I am amazed that there seems to be no political movement towards separating healthcare and employment.

    3. Dorte Jensen Post author

      Hi TrueBlueDevil,

      Thanks so much for the references. I read all of them. Coburn’s plan seems to be very good. What do you think that people can do to support it? Also, people who now have Obamacare (especially those who were previously uninsured) might be fearful of it (since it involves repeal and replacement),and they might think that the latter would never happen. What can people do to convince them otherwise?

  53. Frankly

    Don Shor: You believe that any employer of any religion has the right to impose any religious belief on his or her employees? If not, where do you draw the line?

    Draw the line at material harm.

    Not emotional harm (because that IS a slippery slope), but harm that can be quantified as something of value lost or taken away.

    There is no material harm in the Hobby Lobby decisions because:

    1. Employees that do not support owner’s decisions and practices can quit and work somewhere else. A job with any private company is not an entitlement. Free choice is not impacted because there are alternatives. The employees are not slaves.

    2. There are plenty of alterative birth control options available. And for those few that are not, employees can spend their own money to get them. That would be their choice… their free choice.

    In fact, even if a company decides it will not pay for any contraceptive, the employees continue to have freedom of choice. They are not materially harmed.

    Now, if the courts forced the Hobby Lobby owners to abandon their beliefs in support of the types of birth control they opposed, then the owners would be materially harmed in the loss of freedom to chose to uphold their beliefs… again… beliefs that would not cause material harm to the employees because they are still free to choose. If the practice of those beliefs cause material harm to others (as would many aspects of Sharia Law), then it would require a balanced decision, and I would agree that a company should not be allowed to materially harm its employees with policies based on religious beliefs or other beliefs for that matter. But again, employees can quit and work for another company, so that material harm argument becomes very difficult to prove.

    I think one fundamental difference in perspectives for this debate is that some people seem to think of companies as not being entitled to protection of rights, and employees being hyper-entitled to any and all protections up to and including things that only cause even hurt feelings.

    And others see companies as being privately owned by people who’s rights are equal to the rights of employees.

    1. Don Shor

      harm that can be quantified as something of value lost or taken away.

      Obviously contraception has value. And as Tia Will has pointed out, the specific contraceptions that they object to (out of clear ignorance) are often prescribed for non-contraceptive purposes. Does Hobby Lobby now get to see a doctor’s note as to why something is medically needed?

      An obvious issue is that the employer is trying to meddle in one specific aspect of their employees’ personal lives. They are interfering in the doctor-patient relationship. Even the courts can’t do that, if I recall.
      Because of this ruling, I am coming to the conclusion that employers who don’t want to pay for specific aspects of health care should simply pay the fine (tax per the Supreme Court) and send their employees to the exchanges. They are violating the privacy of their employees, and doing so in a gender-specific manner.

      Dozens of other companies are now intending to meddle in the private lives of their employees. It is ludicrous to set this precedent that could potentially affect millions of employees, and then fall back on the argument that ‘they can just quit and work for another company. We are talking about a huge percentage of the work force here. Did you ever, when you applied for a job, think to inquire about the religious beliefs of the owners, and ask how that might affect your benefits?
      Ruth Bader Ginsburg has this exactly right. And if it snowballs, I’m afraid it sets the stage for a move toward single-payer. That would make some people happy, I guess.

      1. Frankly

        They are not meddling. The employee can do anything they want to do. They can go get any kind of contraceptive that they want to get or that the doctor prescribe to them. The company is not preventing that. Your argument is disingenuous. You are projecting harm that is not there.

        What if the employee wants gastric bypass or the doctor prescribe it but the company refuses to cover it? Are you going to claim material harm for that too?

        Get real.

        1. Don Shor

          What if the employee wants gastric bypass or the doctor prescribe it but the company refuses to cover it? Are you going to claim material harm for that too?

          Yes, of course. If the doctor thinks that is necessary, that is between the patient and the doctor. Health plans cover health care. This level of micromanagement by the employer is ridiculous.

          1. Don Shor

            Here’s the main point. They’re not paying for the gastric bypass. They’re not paying for the specific form of contraception. They’re paying for the insurance coverage. They shouldn’t even know the details of what an employee goes to a doctor for. They shouldn’t even know what the insurance plan is being billed for. They can offer a range of plans, with a range of coverage, to all of their employees equally. The minimum coverage is now regulated by the government. What the employee actually uses it for? None of their business. It is a clear violation of the employee’s privacy that they are even trying to make these distinctions.
            They aren’t paying for medicine. They aren’t paying for treatment. They are paying for insurance.

          2. Tia Will

            Frankly

            “What if the employee wants gastric bypass or the doctor prescribe it but the company refuses to cover it? Are you going to claim material harm for that too?”

            Of course it should be covered. The statistical efficacy of gastric bypass is significantly higher than any of behavioral and medical means of weight loss.
            So why exactly would we not want the most effect therapy to be covered.
            I am completely missing your point here. Could you explain ?

          3. Just Me

            I am simply afraid of the following…

            Someone covered under your medical goes through some mental issues… Employer is Scientologist.. Guess what, they dont believe in pysch drugs.. NO antidepressants for you or your loved one..

            Need a blood transfusion.. Your Jehovas Witness employer says no!

            Medical needs should not involve anyone but yourself and your doctor!!!

          4. Matt Williams

            The medical needs absolutely should not involve anyone but the patient and their doctor. However, the financial responsibility for the delivery of care to address those medical needs is an entirely different matter. An employer has every right to decide that his/her financial needs absolutely should not involve anyone but the employer and their chosen insurance carrier. Similarly, an employee has every right to decide that his/her compensation needs should include a certain level of coverage, and then include the meeting of those compensation needs in their employment negotiations.

            With that said, if the employer is a Scientologist opposed to the provision of psych drugs and an employee believes that their compensation package should include the value of psych drug coverage, then all the employee has to do is calculate the value of the psych drug coverage and accept an increase in salary in lieu of the coverage that the employer is morally opposed to providing. Same thing for blood transfusion coverage if the employer is a Jehovah’s Witness. If the employee wants to work for the company, then accepting the responsibility for getting enough higher salary/pay to be able to cover the antidepressant/blood costs is a very small price to pay.

          5. Frankly

            They aren’t paying for medicine. They aren’t paying for treatment. They are paying for insurance.

            You are not making a good point with your hairsplitting.

            When is the last time you purchased a company policy?

            There are a lot of procedures that are covered or not covered based on cost. You can ask to have procedures added or deleted and there will be a cost differentiation.

            In this case there are adequate alternatives.

            Gastric bypass is generally not covered as a default. It is expensive and there are alternatives called diet and exercise. Just like there are alternatives to the few types of contraception and or abortion tools that the company does not want to pay for.

            So, it gets back to this point that you are disingenuous in your arguments because there are copious moral equivalency arguments that cannot be won unless your position is that every employer should pay for every procedure that any employee might demand.

          6. Don Shor

            You are not making a good point with your hairsplitting.

            If they don’t pay for it, then it is likely that in many instances the taxpayers will pay for it. So they object morally to paying for it indirectly through insurance. Should they be required to pay taxes to cover procedures that they object to on moral grounds?
            An employer who objects to very specific medical procedures on religious grounds should not offer health insurance. They should just pay the fine, which is actually a tax according to the SCOTUS, and their employees can buy their own health insurance through the exchanges. There is, as you would like to say, an alternative for the employer.

          7. Dorte Jensen

            Hi Just Me,

            You write, “Medical needs should not involve anyone but yourself and your doctor!!!” I agree. However, the question is what things are needed and who will pay for them.

            Consider the treatments you cite: blood transfusions and antidepressants. You claim that both are needed, but that is not always true.

            –In the case of blood transfusions, a patient planning a surgery could schedule blood donations for him/herself, which I think Jehovah’s Witnesses are OK with, i.e., will pay for.

            –In the case of antidepressants, the patient could use behavioral treatments which might be more effective and which Scientologists would probably pay for.

            Assuming, however, that both blood transfusions and antidepressants are needed, let’s consider whether the four types of birth control which Hobby Lobby objected to are needed as well.

            –As Tia pointed out, in some cases these birth control methods (or some of them) are the best choice to prevent pregnancy. However pregnancy is predicated on sexual activity (in this case), so is sexual activity needed? It might be wanted by either or both partners, but is it needed?

            Assuming so (as we did for blood transfusions and antidepressants), let’s consider what the treatments in question involve.

            –In the case of blood transfusions and antidepressants, they are done to benefit the individual in question.

            –In the case of the types of birth control that Hobby Lobby objected to, they are done to benefit the individual in question at the expense (or the believed expense) of the fertilized egg. (I add the wiggle room because Tia said that an IUD, which was one of the methods objected to by Hobby Lobby, actually prevents fertilization, not implantation.)

            In any case, interference with implantation was what Hobby Lobby objected to, since they do not want to pay for an insurance plan which covers birth control methods which harm what otherwise would or could become a human being.

            Therefore, your analogy does not hold because the treatments you cite (blood transfusions, antidepressants) do not target something which could become a human being. In fact, no other treatments (other than therapeutic abortions) do so. In this way, the Hobby Lobby decision is not a slippery slope.

      2. Topcat

        Don Wrote: “Dozens of other companies are now intending to meddle in the private lives of their employees.”

        This illustrates the ridiculousness of having health care tied to employment. This whole “Hobby Lobby” discussion would not be an issue if we did not have this ludicrous system of providing health care.

        1. TrueBlueDevil

          This “ludicrous” system has provided the majority of innovation in the world. New techniques, new drugs, new procedures to save lives.

          1. Topcat

            TBD The “Ludicrous” was merely referring to the system of having employers being responsible for providing healthcare.

      3. DavisBurns

        Employers cannot ask their potential employees about their religious beliefs. Can prospective employees ask the interviewer what the owners religious beliefs are? Would the interviewer even know? Given how corporations buy up other corporations, would employees know know who owned them? (Yeah, sounds like slavery, whose our master now?). What if you worked for a place 20 years and you worked your way up the ladder but now Hobby Lobby bought the company…so just quit and get another job. Let’s opt for universal health care.

      4. Tia Will

        Don

        I would certainly be happier ; )

        I am having a very hard time reconciling how anyone who believes that the government should be as little involved in our personal decision making as possible, believes that it is somehow all right for our employers to have any say, whether direct or indirect, in what medical options an individual should or should not have. I do not believe that health care should ever depend upon employment. But since it currently does, there should be strict firewalls between the employer and the insurance, and between the insurance company and the decision making between the employee patient and their doctor.

        1. Dorte Jensen

          Hi Tia,

          You write, “I am having a very hard time reconciling how anyone who believes that the government should be as little involved in our personal decision making as possible, believes that it is somehow all right for our employers to have any say, whether direct or indirect, in what medical options an individual should or should not have.”

          If anyone provides anything, that person/entity has a say over it. If you don’t like what an employer says, you could get a new job. If you don’t like what the government says, you could get a new country. Which is easier/more fair?

          Our system of government is set up so that the latter should not have to occur (e.g., three equal branches–executive, legislative, judicial– providing checks and balances; states rights; freedom of speech and of the press). However, recent national events are posing a Constitutional crisis.

          Jonathan Turley is a Constitutional scholar who has spoken out about this. His column today concerns the opposing rulings yesterday regarding subsidies to the federal exchange, which were not mentioned in the ACA as originally passed.

          http://jonathanturley.org/2014/07/23/a-tale-of-two-circuits-obamacare-is-either-on-life-support-or-in-robust-health/

          His column starts out like this:

          “Call it the “