Posted by: Timothy Ellis (The Tim)

Tim Ellis is the founder of Seattle Bubble. His background in engineering and computer / internet technology, a fondness of data-based analysis of problems, and an addiction to spreadsheets all influence his perspective on the Seattle-area real estate market.

419 responses to “Health Care Open Thread II”

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  1. Kary L. Krismer

    By David Losh @ 100:

    The lack of doctors also drives up the cost of health care by supply, and demand. That there is your rationing also.

    A little Losh gem there. Part of the reason that we pay so much more is doctors are severely restricted in this country. If we opened it up, price of services would drop.

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  2. Kary L. Krismer

    The President is cancelling part of Obamacare because it’s unworkable. What a shock! The people who drafted the thing didn’t know what they were doing. ;-)

    http://firstread.msnbc.msn.com/_news/2011/10/14/8325174-obama-administration-halts-part-of-health-care-law

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  3. pfft

    individual mandate is very popular.

    Individual Mandate Repeal Initiative Fail
    http://blog.hcfama.org/2011/11/23/individual-mandate-repeal-initiative-fail/

    it’s like people want health insurance or something.

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  4. Scotsman

    Why the U.S. will be unable to contain costs and health care will fail in the near future:

    http://www.oftwominds.com/photos10/CDC08.jpg

    http://www.oftwominds.com/photos07/global-BMI.gif

    The result of the above:

    http://www.oftwominds.com/photos2011/healthcare-costs-US.jpg

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  5. Kary L. Krismer

    RE: pfft @ 3 – The individual mandate is initially very attractive. I even liked the idea at first because it dealt with the free-rider problem.

    The problem is, even if it’s a good idea, that doesn’t mean it’s constitutional. And in saying that please note that it might be constitutional for say MA to impose it on its citizens, but not the US on its citizens. That, btw, is really the claim that Romney should be making so that he doesn’t appear to be as big of a flip-flopper as what he really is.

    The second problem is that it’s not really a good idea, because it will lead to the inflation that I’m concerned about. That problem outweighs the free-rider problem, IMHO.

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  6. Kary L. Krismer

    RE: Scotsman @ 4 – I would question the first graph, putting WA ahead of AZ.

    But I would agree, weight is a problem.

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  7. pfft

    By Kary L. Krismer @ 105:

    RE: pfft @ 3

    The second problem is that it’s not really a good idea, because it will lead to the inflation that I’m concerned about.

    you don’t cite any facts though.

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  8. Kary L. Krismer

    By pfft @ 7:

    By Kary L. Krismer @ 105:
    RE: pfft @ 3

    The second problem is that it’s not really a good idea, because it will lead to the inflation that I’m concerned about.

    you don’t cite any facts though.

    First, you’ve just forgotten. Second, You just need to understand basic economics. When people don’t care what they pay for things, prices skyrocket.

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  9. Kary L. Krismer

    RE: pfft @ 107 – As to the “you’ve forgotten” comment, look at posts 18 and 56 in this thread.

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  10. pfft

    By Kary L. Krismer @ 108:

    By pfft @ 7:
    By Kary L. Krismer @ 105:
    RE: pfft @ 3

    The second problem is that it’s not really a good idea, because it will lead to the inflation that I’m concerned about.

    you don’t cite any facts though.

    First, you’ve just forgotten. Second, You just need to understand basic economics. When people don’t care what they pay for things, prices skyrocket.

    why does europe cover everyone at half the per-capita cost?

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  11. pfft

    By Kary L. Krismer @ 9:

    RE: pfft @ 107 – As to the “you’ve forgotten” comment, look at posts 18 and 56 in this thread.

    so what? the start-up costs were more than expected. big deal in the context of saving lives.

    healthcare companies are just doing what they always have done and what got us into this mess- raise prices.

    insurance costs for medicare are growing at less of rate than the private insurance industry. it’s easy to see why. medicare doesn’t have the massive overhead administrative costs.

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  12. Kary L. Krismer

    By pfft @ 110:

    why does europe cover everyone at half the per-capita cost?

    You really do need to have your memory checked. We’ve discussed this several times.

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  13. Kary L. Krismer

    By pfft @ 11:

    so what? the start-up costs were more than expected. big deal in the context of saving lives.

    healthcare companies are just doing what they always have done and what got us into this mess- raise prices.

    insurance costs for medicare are growing at less of rate than the private insurance industry. it’s easy to see why. medicare doesn’t have the massive overhead administrative costs.

    It’s not start up costs. They went from having the highest health care costs in the country to having even higher health care costs. Just what standard economic theory would predict.

    And yes, the health care companies (providers) will want to raise prices. More insurance will make that easy for them, because more consumers no longer care what the services cost.

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  14. pfft

    By Kary L. Krismer @ 113:

    By pfft @ 11:
    so what? the start-up costs were more than expected. big deal in the context of saving lives.

    healthcare companies are just doing what they always have done and what got us into this mess- raise prices.

    insurance costs for medicare are growing at less of rate than the private insurance industry. it’s easy to see why. medicare doesn’t have the massive overhead administrative costs.

    It’s not start up costs. They went from having the highest health care costs in the country to having even higher health care costs. Just what standard economic theory would predict.

    And yes, the health care companies (providers) will want to raise prices. More insurance will make that easy for them, because more consumers no longer care what the services cost.

    97% of people now have health insurance. who gives a blank?

    And while health care costs continue to grow at alarming rates, as they have nationally, the consensus of industry leaders and health care economists is that this trend cannot be fairly traced to the makeover but rather to cost pressures baked into the existing health care payment system. Massachusetts does have the highest health care costs in the nation, but it owned this dubious distinction long before “RomneyCare’’ was born.

    http://articles.boston.com/2011-06-26/lifestyle/29706413_1_overhaul-mitt-romney-health-care/2

    another success.

    Obama health care law shrinks Medicare ‘doughnut hole’
    http://abclocal.go.com/wls/story?section=news/national_world&id=8446162

    Remember Mass is just one state and it’s the wrong system. the best system would be medicare for all. the benefits of Mass’ system will show up in healthier citizens when they get to medicare. that probably won’t be captured in the cost picture.

    “They went from having the highest health care costs in the country to having even higher health care costs.”

    yeah no healthcare increases until the government came a long…

    “More insurance will make that easy for them, because more consumers no longer care what the services cost.”

    you’ve yet to prove that. why does europe have half the per-capita costs? why are medicare costs rising slower than private insurance costs? why is the VA one of the best systems. remember that private insurance only wants to cover the young and healthy. imagine if seniors or veterans had to buy insurance? oh we know what that looks like which is why we have medicare and the VA.

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  15. Kary L. Krismer

    The reason you give a blank is health care already takes up too many of our society’s resources. If health care starts taking up higher and higher percentages, eventually the economy will totally collapse and no one will have anything!

    You remind me of the politicians in California who tried to keep electricity prices low, and when that didn’t work out raised the prices mainly on businesses in California. That left the citizens of California with low electric rates but fewer jobs as businesses reacted Not a good trade off: Saving $10 a month on electricity but losing a $45,000 a year job.

    You can provide health care services without insurance. And that’s why health care expenses are a lot less in a lot of other countries.

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  16. pfft

    By Kary L. Krismer @ 112:

    By pfft @ 110:
    why does europe cover everyone at half the per-capita cost?

    You really do need to have your memory checked. We’ve discussed this several times.

    so what is the answer? why is our system which denies so many care cost twice as much and covers not as many people? by your logic it should be reversed. our system should cost less.

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  17. Kary L. Krismer

    RE: pfft @ 116 – I don’t know why you insist on going over the same points over and over and over.

    A system where government has to pay for things will not likely be a system where legislatures annually add more and more costly services. So for example, the government is not likely to pay for acupuncture or aroma therapy. In contrast, when an insurance company is present, the government has no trouble at all requiring them to pay for things. That alone makes an insurance system more expensive, even if you don’t accept the future inflation argument.

    Obamacare is a perfect example of that. The health care legislation could have provided that government pay for everyone’s health care. But that would have required some means of paying for it! So rather than do that, they simply provide that everyone has to get insurance so that insurance companies have to pay for the care. It’s a hidden tax, and the hidden tax is larger than what the real tax would have been, because the government most likely would not have had a program paying for acupuncture.

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  18. Kary L. Krismer

    Somewhere in these health care thread Pfft cited to a report that claimed Obamacare would reduce overall health care costs (as opposed to government costs). I pointed out that the study indicated its own shortcomings in that area, because they had no basis on which to calculate the future inflation caused by Obamacare.

    Well these two things reminded me of that.

    http://www.colbertnation.com/the-colbert-report-videos/403471/december-01-2011/12-1-11-in–60-seconds (Cobert Report on government study on losses due to counterfeiting.)

    http://www.pcworld.com/article/194203/government_says_data_estimating_piracy_losses_is_unsubstantiated.html (PC World report on same issue.)

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  19. Kary L. Krismer

    The Supreme Court set the schedule for oral argument. They are taking this very seriously, with three days of oral argument. The first day will focus on whether the action is premature. Somewhat surprising to me is that on the last day they want 90 minutes of argument on whether the whole thing should be thrown out if the mandate is thrown out.

    http://www.npr.org/templates/story/story.php?storyId=143958967

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  20. pfft

    sorry kary, your way of controlling health costs has fallen apart…

    “Skin in the Game” Fails As a Health Care Cost Control Idea
    http://fdlaction.firedoglake.com/2011/09/27/skin-in-the-game-is-failure-as-a-health-care-cost-control-idea/

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  21. Kary L. Krismer

    RE: pfft @ 20 – Terribly incomplete data. Like in the housing price issue I just commented on for one of your posts, you can’t look at just one factor. Other factors can override it. For example, over that same time period, how many states have imposed more and more required coverages on insurance policies? That’s highly inflationary, but not accounted for at all in the stats given. Or what about things like Viagra, which I don’t think even existed in 1999? It’s not free.

    Also, the first graph doesn’t even cover what I’m talking about. I’m talking about paying for services, not insurance.

    As to the author of that piece, all I can say is he/she doesn’t understand how things work, or they are purposefully trying to deceive.

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  22. Kary L. Krismer

    On your incomplete data, the number of people with insurance dropped for the first time in 23 years in 2009, dropping by about 2 million people. That same year medicare/medicaid increased by over 6 million, so overall there were still about 4 million more people who didn’t care what things cost.

    http://www.kaiserhealthnews.org/daily-reports/2010/september/16/uninsured-census-statistics.aspx

    Plot that against your increasing health insurance premiums in the article you linked, and you’ll see a clear correlation between more insurance and higher prices. (23 years of more and more insurance and increases in cost all of the years covered in the article). Again though, that’s not the sole factor raising prices.

    And BTW, you can’t look at percentage insured figures. You have to look at the number insured. In setting their pricing, service providers and drug companies don’t care about the percentage that have insurance, they care about the number of people which have insurance.

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  23. findalittlehome

    RE: Kary L. Krismer @ 101

    The reason we pay so much more in this country is that we have a for-profit health care insurance industry whose profits are obscene.

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  24. Kary L. Krismer

    By findalittlehome @ 123:

    RE: Kary L. Krismer @ 101

    The reason we pay so much more in this country is that we have a for-profit health care insurance industry whose profits are obscene.

    Cause and effect.

    Too much insurance causes obscene profits. Do you think those profits would exist if people were paying their own medical bills?

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  25. Scotsman

    http://market-ticker.org/cgi-ticker/akcs-www?post=200263

    “The Federal Government went from spending $53 billion on health care (all forms) in 1980 to over $800 billion last year. Private insurance costs have risen by some 9% annually for the last 30 years. The Federal Government’s spending has tracked this rate of expansion as well, which means that the commonly-held claim that this is all about “more elderly people on the government tit” is false; the working population is roughly constant in age.

    The Republican Party (and the “Tea Party” contingent within it) have repeatedly stated that “nobody over 50″ is going to have their Federal Government medical benefits tampered with. Roughly, your life expectancy in the US is 85. This means that if you’re 50 today you have some 30 years of life left.

    At a 9% escalation per year your medical costs — whether insurance or government spending — will multiply by a factor of 13.3 over the next 30 years.

    That is, if you spend $600 a month now, assuming you did not get older or sicker, you would spend $7,980 a month in 30 years on your health insurance, or some $95,760 per year.

    The Federal Government will spend not $800 billion but $10.64 trillion on health care at this rate in 30 years.

    Neither of those things is going to happen; the money does not exist.

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  26. pfft

    By Scotsman @ 125:

    http://market-ticker.org/cgi-ticker/akcs-www?post=200263

    “The Federal Government went from spending $53 billion on health care (all forms) in 1980 to over $800 billion last year. Private insurance costs have risen by some 9% annually for the last 30 years. The Federal Government’s spending has tracked this rate of expansion as well, which means that the commonly-held claim that this is all about “more elderly people on the government tit” is false; the working population is roughly constant in age.

    The Republican Party (and the “Tea Party” contingent within it) have repeatedly stated that “nobody over 50″ is going to have their Federal Government medical benefits tampered with. Roughly, your life expectancy in the US is 85. This means that if you’re 50 today you have some 30 years of life left.

    At a 9% escalation per year your medical costs — whether insurance or government spending — will multiply by a factor of 13.3 over the next 30 years.

    That is, if you spend $600 a month now, assuming you did not get older or sicker, you would spend $7,980 a month in 30 years on your health insurance, or some $95,760 per year.

    The Federal Government will spend not $800 billion but $10.64 trillion on health care at this rate in 30 years.

    Neither of those things is going to happen; the money does not exist.

    don’t listen to karl. he is one of the tea party people. he bragged that he got a gavel from newt gingrich.

    btw- healthcare costs rose just 3.9% last year.

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  27. pfft

    By Kary L. Krismer @ 24:

    By findalittlehome @ 123:
    RE: Kary L. Krismer @ 101

    The reason we pay so much more in this country is that we have a for-profit health care insurance industry whose profits are obscene.

    Cause and effect.

    Too much insurance causes obscene profits. Do you think those profits would exist if people were paying their own medical bills?

    tens of millions are and it isn’t helping at all.

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  28. Kary L. Krismer

    RE: pfft @ 27 – You really don’t understand economics. During the real estate boom, tens of millions of people weren’t buying real estate. Actually hundreds of millions of people. That didn’t stop prices from rising.

    If you have even 50% of the people with traditional insurance, they will drive the market. The more you have, the more they will drive it.

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  29. Kary L. Krismer

    I love how this argument turns everything on its head. The Canadian system of health care is somehow better because you’re only covered if you’re in Canada!

    http://usnews.msnbc.msn.com/_news/2012/01/30/10274212-iconic-skiers-death-points-out-us-health-gap

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  30. Kary L. Krismer

    Yet another example of a politician treating money from insurance companies as being “free money!”

    http://seattletimes.nwsource.com/html/politics/2017470954_apusbirthcontrolpolitics.html

    Capping weeks of growing controversy, Obama announced he was backing off a newly announced requirement for religious employers to provide free birth control coverage even if it runs counter to their religious beliefs. Instead, workers at such institutions will be able to get free contraception directly from health insurance companies.

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  31. Kary L. Krismer

    And the same policy provides yet another example of President Obama telling companies how to run their businesses.

    http://www.reuters.com/article/2012/02/10/usa-contraceptives-aetna-idUSL2E8DAEKD20120210

    “When asked about the insurer concerns, the White House cited a report from the U.S. Health and Human Services Department that estimates the costs of providing free birth control can be offset by reducing expenses associated with unintended pregnancies.”

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  32. Kary L. Krismer

    After thinking it over, the Catholic Bishops are opposed to the compromise.

    http://online.wsj.com/article/SB10001424052970203646004577217181415407806.html

    Not too big of a surprise. Given that there was no real proposal, and instead just an idea floated, the cost of the coverage could have possibly been built into the premiums these entities would have had to have paid. So the result would not be any different under the compromise. Or if it was, a larger group of insureds would be paying for the coverage that they object to. If you object to something on religious grounds, does it matter who is paying for it? That would sort of take the legs out from under their position on abortion.

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  33. pfft

    By Kary L. Krismer @ 130:

    Yet another example of a politician treating money from insurance companies as being “free money!”

    no it’s called providing basic healthcare.

    don’t look now kary.

    New Study: Health Care Costs Fall When Poor Get Health Care Coverage
    http://crooksandliars.com/susie-madrak/new-study-health-care-costs-fall-when

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  34. pfft

    By Kary L. Krismer @ 28:

    RE: pfft @ 27 – You really don’t understand economics. During the real estate boom, tens of millions of people weren’t buying real estate. Actually hundreds of millions of people. That didn’t stop prices from rising.

    If you have even 50% of the people with traditional insurance, they will drive the market. The more you have, the more they will drive it.

    home sales were rising…the number of people insured has increased steadily by millions.

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  35. Kary L. Krismer

    RE: pfft @ 33 – That’s based on billing, not cost. ER billing is a joke, and has little or nothing to do with cost.

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  36. Kary L. Krismer

    By pfft @ 34:

    By Kary L. Krismer @ 28:
    RE: pfft @ 27 – You really don’t understand economics. During the real estate boom, tens of millions of people weren’t buying real estate. Actually hundreds of millions of people. That didn’t stop prices from rising.

    If you have even 50% of the people with traditional insurance, they will drive the market. The more you have, the more they will drive it.

    home sales were rising…the number of people insured has increased steadily by millions.

    Nice non-responsive argument which indicates further you simply don’t understand economics.

    But out of curiosity, what do you think has been happening with health care costs while the number of insured have increased? What statistic do you have indicating that the health care costs of the entire country have been going down? Oh wait, they haven’t been! What! They’ve been increasing at a rate much higher than inflation? What could possibly be causing that rise? /sarc

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  37. pfft

    By Kary L. Krismer @ 135:

    RE: pfft @ 33 – That’s based on billing, not cost. ER billing is a joke, and has little or nothing to do with cost.

    ha ha. really? I don’t think you really understand how goods are produced. this means there is a scarcity of ER resources…

    in the end it doesn’t matter you still have to pay. just because the cost of producing gas is a lot lower than the cost at the pump doesn’t mean the price at the pump isn’t the price you pay.

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  38. Kary L. Krismer

    RE: pfft @ 37 – Completely none responsive.

    You claimed something showed costs were going down. I pointed out they were just looking at billings and that billings are different than costs. You then respond with total gibberish that has nothing to do with what something costs to society, but instead what people are billed.

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  39. pfft

    By Kary L. Krismer @ 138:

    RE: pfft @ 37 – Completely none responsive.

    You claimed something showed costs were going down. I pointed out they were just looking at billings and that billings are different than costs. You then respond with total gibberish that has nothing to do with what something costs to society, but instead what people are billed.

    huh?

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  40. Kary L. Krismer

    RE: pfft @ 39 – This is pretty simple stuff.

    You go to a Lexus dealer and the MSRP on the vehicle is $60,000. That doesn’t mean that it cost $60,000 to build the car.

    You’re looking at hospital billings and confusing those with costs.

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  41. pfft

    Obamacare is going to be in front of the Supreme Court…should be awesome.

    I can’t wait for the right’s reaction when it’s declared constitutional.

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  42. pfft

    By Kary L. Krismer @ 40:

    RE: pfft @ 39 – This is pretty simple stuff.

    You go to a Lexus dealer and the MSRP on the vehicle is $60,000. That doesn’t mean that it cost $60,000 to build the car.

    You’re looking at hospital billings and confusing those with costs.

    it doesn’t matter if you still have to pay $60,000.

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  43. Kary L. Krismer

    RE: pfft @ 42 – Maybe that’s the different between you and me. I’m concerned Obamacare will bankruptcy the country because too many resources will be diverted to healthcare. You’re focused on the individual, and think that as long as they have health care coverage they’re okay, ignoring the impact of the economy collapsing on its own weight.

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  44. Kary L. Krismer

    By pfft @ 41:

    Obamacare is going to be in front of the Supreme Court…should be awesome.

    I can’t wait for the right’s reaction when it’s declared constitutional.

    I never try to predict what the Supreme Court will do, but if the individual mandate is declared constitutional, God help us all. That would be a huge expansion of federal power, and I’m afraid what might follow.

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  45. pfft

    By Kary L. Krismer @ 143:

    RE: pfft @ 42 – Maybe that’s the different between you and me. I’m concerned Obamacare will bankruptcy the country because too many resources will be diverted to healthcare. You’re focused on the individual, and think that as long as they have health care coverage they’re okay, ignoring the impact of the economy collapsing on its own weight.

    link please? you know that healthcare spending is is already on an unsustainable path right?

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  46. pfft

    By Kary L. Krismer @ 44:

    By pfft @ 41:
    Obamacare is going to be in front of the Supreme Court…should be awesome.

    I can’t wait for the right’s reaction when it’s declared constitutional.

    I never try to predict what the Supreme Court will do, but if the individual mandate is declared constitutional, God help us all. That would be a huge expansion of federal power, and I’m afraid what might follow.

    huge expansion how? it will most likely be ruled constitutional.

    if it is ruled unconstitutional then basically everything the government has ever passed will be declared unconstitutional.

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  47. Kary L. Krismer

    By pfft @ 45:

    By Kary L. Krismer @ 143:
    RE: pfft @ 42 – Maybe that’s the different between you and me. I’m concerned Obamacare will bankruptcy the country because too many resources will be diverted to healthcare. You’re focused on the individual, and think that as long as they have health care coverage they’re okay, ignoring the impact of the economy collapsing on its own weight.

    link please? you know that healthcare spending is is already on an unsustainable path right?

    We’ve gone over this many times. The more insurance the less people care what anything costs. The less people care what anything costs the more they use (increased demand). Increased demand means higher prices.

    The spending is on an unsustainable path because there was already too much insurance in the system, at least too much insurance which provided too much coverage (the traditional plan).

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  48. Kary L. Krismer

    By pfft @ 46:

    By Kary L. Krismer @ 44:
    By pfft @ 41:
    Obamacare is going to be in front of the Supreme Court…should be awesome.

    I can’t wait for the right’s reaction when it’s declared constitutional.

    I never try to predict what the Supreme Court will do, but if the individual mandate is declared constitutional, God help us all. That would be a huge expansion of federal power, and I’m afraid what might follow.

    huge expansion how? it will most likely be ruled constitutional.

    if it is ruled unconstitutional then basically everything the government has ever passed will be declared unconstitutional.

    Except for auto insurance, which only applies to people who undertake a voluntary activity, the government has seldom if ever required people to enter the marketplace and buy things, or be punished. Rather than regulate commerce, they are creating commerce.

    If they can do this, then Cash for Clunkers was an incredible waste of money. They should have just fined everyone $3,000 if they kept a car that would have qualified for CFCs.

    They could probably easily do this as a tax, with a government program providing the benefits. That isn’t what they did.

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  49. pfft

    By Kary L. Krismer @ 147:

    By pfft @ 45:
    By Kary L. Krismer @ 143:
    RE: pfft @ 42 – Maybe that’s the different between you and me. I’m concerned Obamacare will bankruptcy the country because too many resources will be diverted to healthcare. You’re focused on the individual, and think that as long as they have health care coverage they’re okay, ignoring the impact of the economy collapsing on its own weight.

    link please? you know that healthcare spending is is already on an unsustainable path right?

    We’ve gone over this many times. The more insurance the less people care what anything costs. The less people care what anything costs the more they use (increased demand). Increased demand means higher prices.

    prove. you’re wrong though. most healthcare spending is based on a very limited number of people. this won’t control costs.

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  50. Kary L. Krismer

    RE: pfft @ 149 – We’ve gone over this so many times. I’m getting tired of it. But I don’t know how you consider over 50% of the population to be a very limited number of people. Look what under 10% of the population did to real estate prices in 2007.

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  51. pfft

    By Kary L. Krismer @ 150:

    RE: pfft @ 149 – We’ve gone over this so many times. I’m getting tired of it. But I don’t know how you consider over 50% of the population to be a very limited number of people. Look what under 10% of the population did to real estate prices in 2007.

    your position wrong by these two points.

    1. medicare costs are growing slower than private insurance costs so you are wrong on that point.

    2. 5% of people represent 50% of healthcare spending. No amount of rationing through the market is going to solve that.

    5% of patients account for half of health care spending
    http://www.usatoday.com/news/washington/story/2012-01-11/health-care-costs-11/52505562/1

    lastly most healthcare systems have an all you can eat system and they half 1/2 the costs.

    game over.

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  52. Kary L. Krismer

    RE: pfft @ 151 – LOL.

    First, you’re going to have to explain how something rising slower than the insurance system proves that more insurance isn’t going to result in more problems. I think you have that proof backwards. It’s proof of my position.

    Second, that 5% of patients account for 50% of costs also doesn’t prove anything, other than that when people don’t have to pay a lot of money gets spent. Again, that’s my point.

    BTW, you obviously don’t understand rationing if you don’t think rationing would solve that problem. I’m sorry to be cold hearted, but at some point society needs to realize that you can’t keep your parent alive on a respirator and feeding tube indefinitely at no cost to you, just because you can’t bring yourself to say goodbye. If someone wants to torture their parents in such a manner, they should do so on their own dime. Unfortunately today it’s the taxpayer that often picks that cost up.

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  53. Kary L. Krismer

    One more reason Obamacare might be unconstitutional is the revenue side. The tax or penalty for not having coverage might not be constitutional.

    Without that the individual mandate disappears, and the rest of it then becomes unworkable (or really the illusion that it is workable completely disappears).

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  54. pfft

    By Kary L. Krismer @ 152:

    RE: pfft @ 151 – LOL.

    First, you’re going to have to explain how something rising slower than the insurance system proves that more insurance isn’t going to result in more problems. I think you have that proof backwards. It’s proof of my position.

    Second, that 5% of patients account for 50% of costs also doesn’t prove anything, other than that when people don’t have to pay a lot of money gets spent. Again, that’s my point.

    no you don’t seem to understand. for 95% of the people who are treated shopping around won’t make a difference. cost cutting won’t matter. for those whom we do spend a lot of money on they can’t shop around if they have a heart attack.

    your math simply does not add up.

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  55. pfft

    By Kary L. Krismer @ 53:

    One more reason Obamacare might be unconstitutional is the revenue side. The tax or penalty for not having coverage might not be constitutional.

    Without that the individual mandate disappears, and the rest of it then becomes unworkable (or really the illusion that it is workable completely disappears).

    the penalty will be ruled constitutional because the government has laws saying you can’t turn people away at ERs. since this is law even if you don’t have insurance someday you may need medical treatment that the state may have to pay for.

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  56. Kary L. Krismer

    RE: pfft @ 154 – Your English doesn’t add up.

    Rate this comment: Thumb up 0

  57. Kary L. Krismer

    By pfft @ 55:

    By Kary L. Krismer @ 53:
    One more reason Obamacare might be unconstitutional is the revenue side. The tax or penalty for not having coverage might not be constitutional.

    Without that the individual mandate disappears, and the rest of it then becomes unworkable (or really the illusion that it is workable completely disappears).

    the penalty will be ruled constitutional because the government has laws saying you can’t turn people away at ERs. since this is law even if you don’t have insurance someday you may need medical treatment that the state may have to pay for.

    That has absolutely nothing at all to do with the power of the government to tax you. There are limits on the power of the government to tax you, which is why we have a Constitutional Amendment allowing the income tax. But the government is trying to treat this penalty different than the income tax, which is what makes it constitutionally suspect.

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  58. Kary L. Krismer

    Here’s something on the tax issue.

    http://taxprof.typepad.com/taxprof_blog/2010/07/wsj-the–1.html

    I’m not saying the analysis in the link is the correct analysis, but that the issue is there.

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  59. pfft

    By Kary L. Krismer @ 156:

    RE: pfft @ 154 – Your English doesn’t add up.

    Better than you logic. Pointing out grammar mistakes is so 2005…

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  60. pfft

    Legal experts: Court won’t strike down ‘Obamacare’
    http://maddowblog.msnbc.msn.com/_news/2012/03/26/10867648-legal-experts-court-wont-strike-down-obamacare

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  61. Kary L. Krismer

    By pfft @ 59:

    By Kary L. Krismer @ 156:
    RE: pfft @ 154 – Your English doesn’t add up.

    Better than you logic. Pointing out grammar mistakes is so 2005…

    I’m not pointing out grammar errors. I’m pointing out that your words don’t mean anything. It’s just a bunch of words put together that don’t make thoughts. I have no idea what you were even trying to say.

    Your sentences were like this one: Building fence dog run car rabbit sunny.

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  62. Kary L. Krismer

    RE: pfft @ 60 – Are you really that gullible? You think there are no legal experts in the country that think Obamacare will be struck down?

    Reminds me of an article I wasted my time reading today. Some reporter decided that the Justices wouldn’t avoid a decision based on that tax injunction statute (which BTW, if different than the constitutional issue I’ve been mentioning). There are two things lawyers know very well: 1. You can’t tell what a judge is going to do by what they ask and say at an oral argument; and 2. You shouldn’t even try to get an interpretation of a legal issue from press reports.

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  63. pfft

    By Kary L. Krismer @ 161:

    By pfft @ 59:
    By Kary L. Krismer @ 156:
    RE: pfft @ 154 – Your English doesn’t add up.

    Better than you logic. Pointing out grammar mistakes is so 2005…

    I’m not pointing out grammar errors. I’m pointing out that your words don’t mean anything. It’s just a bunch of words put together that don’t make thoughts. I have no idea what you were even trying to say.

    Your sentences were like this one: Building fence dog run car rabbit sunny.

    of course you don’t understand what I am talking about…

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  64. pfft

    By Kary L. Krismer @ 62:

    RE: pfft @ 60 – Are you really that gullible? You think there are no legal experts in the country that think Obamacare will be struck down?

    Reminds me of an article I wasted my time reading today. Some reporter decided that the Justices wouldn’t avoid a decision based on that tax injunction statute (which BTW, if different than the constitutional issue I’ve been mentioning). There are two things lawyers know very well: 1. You can’t tell what a judge is going to do by what they ask and say at an oral argument; and 2. You shouldn’t even try to get an interpretation of a legal issue from press reports.

    you didn’t really read did you? I did not say that you couldn’t find an expert that said it was unconstitutional.

    National Journal surveyed former Supreme Court clerks and lawyers who have argued cases before the high court about the health care law, and the consensus was that the Affordable Care is likely to prevail.

    the problem clearly is you and not me.

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  65. Kary L. Krismer

    Speaking of not understanding, I don’t know how this could have possibly been more clear!

    By Kary L. Krismer @ 162:

    2. You shouldn’t even try to get an interpretation of a legal issue from press reports.

    Translation: Your article is worthless.

    Just out of curiosity, how many articles in the press did you read that predicted that the Supreme Court would find the Second Amendment to be an individual right? They almost all focused on the single word “militia” and got it wrong, probably quoting many of the same law professors as experts. You know who else largely made that mistake? Democrats. Will history repeat itself with healthcare? Who knows. It will be a close decision, and it wouldn’t surprise me that it will turn on something hardly discussed, like the tax issue I’ve been mentioning.

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  66. Kary L. Krismer

    If anyone is interested, here is a copy of the transcript of the hearing today, dealing mainly with the tax injunction statute.

    http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-398-Monday.pdf

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  67. pfft

    By Kary L. Krismer @ 165:

    Speaking of not understanding, I don’t know how this could have possibly been more clear!

    By Kary L. Krismer @ 162:

    2. You shouldn’t even try to get an interpretation of a legal issue from press reports.

    Translation: Your article is worthless.

    Just out of curiosity, how many articles in the press did you read that predicted that the Supreme Court would find the Second Amendment to be an individual right? They almost all focused on the single word “militia” and got it wrong, probably quoting many of the same law professors as experts. You know who else largely made that mistake? Democrats. Will history repeat itself with healthcare? Who knows. It will be a close decision, and it wouldn’t surprise me that it will turn on something hardly discussed, like the tax issue I’ve been mentioning.

    it was not a press report. You can’t read. Nothing to do with the media or media accounts regarding arguments made before the courts.

    National Journal surveyed former Supreme Court clerks and lawyers who have argued cases before the high court about the health care law, and the consensus was that the Affordable Care is likely to prevail.

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  68. Kary L. Krismer

    RE: pfft @ 67 – Again, compare what you read in the press about the Second Amendment to what you’re reading today about Obamacare.

    The press is largely liberal. Law professors are largely liberal. The result you’re seeing is not surprising. It also means nothing. What really matters is the opinion of one to three Supreme Court Justices.

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  69. Kary L. Krismer
  70. Kary L. Krismer

    Here’s today’s transcript:

    http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-398-Tuesday.pdf

    The part starting at about page 7 involving the burial insurance hypothetical is pretty funny.

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  71. Kary L. Krismer

    From the transcript:

    JUSTICE BREYER: I’m just picking on something. I’d like to just — if it turned out there was some terrible epidemic sweeping the United States, and we couldn’t say that more than 40 or 50 percent — I can make the number as high as I want — but the — the — you’d say the Federal Government doesn’t have the power to get people inoculated, to require them to be inoculated, because that’s just statistical

    Amazing how some people thing that the federal government can do anything it wants. Scary that it’s a Supreme Court Justice who thinks that.

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  72. pfft

    By Kary L. Krismer @ 168:

    RE: pfft @ 67 – Again, compare what you read in the press about the Second Amendment to what you’re reading today about Obamacare.

    The press is largely liberal. Law professors are largely liberal.

    my god can you read?

    National Journal surveyed former Supreme Court clerks and lawyers who have argued cases before the high court

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  73. pfft

    By Kary L. Krismer @ 71:

    From the transcript:

    JUSTICE BREYER: I’m just picking on something. I’d like to just — if it turned out there was some terrible epidemic sweeping the United States, and we couldn’t say that more than 40 or 50 percent — I can make the number as high as I want — but the — the — you’d say the Federal Government doesn’t have the power to get people inoculated, to require them to be inoculated, because that’s just statistical

    Amazing how some people thing that the federal government can do anything it wants. Scary that it’s a Supreme Court Justice who thinks that.

    Supreme Court Justices are the last people in the world who think the government can do whatever it wants. I mean they are SUPREME COURT JUSTICES. we don’t even know if that’s his view or if he’s playing devil’s advocate.

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  74. Kary L. Krismer

    RE: pfft @ 72 – What do you think people who clerk for the Supreme Court do after they clerk? They become law professors.

    But in any case, members of the press pick who they question.

    Do you seriously think that their results mean squat?

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  75. Kary L. Krismer

    By pfft @ 73:

    By Kary L. Krismer @ 71:
    From the transcript:

    JUSTICE BREYER: I’m just picking on something. I’d like to just — if it turned out there was some terrible epidemic sweeping the United States, and we couldn’t say that more than 40 or 50 percent — I can make the number as high as I want — but the — the — you’d say the Federal Government doesn’t have the power to get people inoculated, to require them to be inoculated, because that’s just statistical

    Amazing how some people thing that the federal government can do anything it wants. Scary that it’s a Supreme Court Justice who thinks that.

    Supreme Court Justices are the last people in the world who think the government can do whatever it wants. I mean they are SUPREME COURT JUSTICES. we don’t even know if that’s his view or if he’s playing devil’s advocate.

    I hope he was playing devil’s advocate, but I don’t think he was.

    But incorrect about what Supreme Court justices think. Some of them think women should not be allowed a constitutional right to an abortion. Some of them think just about any warrantless search is valid. Some of them think that politicians can pass laws so that their opponents cannot attack them weeks before an election. The members of the court hold many different views.

    On topic, if the individual mandate stands, the government can do whatever it wants. There will be no limit on what government can do. That’s what part of the argument today was about–the limits if it is valid. About the only thing that the supporters of Obamacare could point to is health care is special and unique. Everything is special and unique.

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  76. pfft

    By Kary L. Krismer @ 174:

    RE: pfft @ 72 – What do you think people who clerk for the Supreme Court do after they clerk? They become law professors.

    oh god. that is the worst backtrack I’ve ever read on the internet. you are stretching there.

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  77. Kary L. Krismer

    RE: pfft @ 176 – I’m not willing to generalize about people who argue before the Supreme Court. Some are liberal, some are conservative.

    If you clerk for the Supreme Court you can get a job virtually anywhere. The smart ones, IMHO, become professors, or work in government, rather than practicing lawyers.

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  78. Kary L. Krismer

    Here’s a good story about the disaster in Washington state when Democrats tried to cover pre-existing conditions without a mandate. What amazed me at the time is that an insurance Commissioner would push something that would lead to such an obvious result, and that the obvious result (insurers pulling out of the state) would take so long.

    http://seattletimes.nwsource.com/html/localnews/2017852301_insurancemandate28m.html

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  79. Kary L. Krismer

    On the topic of the press, go back and see how the press dealt with the Florida court throwing out all of Obamacare based on severability. Then realize that today the court is having an entire day of argument addressing the issue.

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  80. Kary L. Krismer

    Today’s argument’s link: http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-393.pdf

    And nothing better than a good Eight Amendment joke (at least there’s nothing better if you’re in the courtroom and the person telling the joke is a Supreme Court Justice);

    JUSTICE SCALIA: Mr. Kneedler, what happened to the Eighth Amendment? You really want us to go through these 2,700 pages?
    (Laughter.)

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  81. Kary L. Krismer

    After reading most of the transcripts, the most likely outcomes seem to be the whole of Obamacare surviving, or the whole thing being wiped out. Having part survive seems less likely.

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  82. pfft

    By Kary L. Krismer @ 181:

    After reading most of the transcripts, the most likely outcomes seem to be the whole of Obamacare surviving, or the whole thing being wiped out. Having part survive seems less likely.

    I agree. there is no way that you can have the prexisting condition clause in there and strikedown the mandate w/o bankrupting the insurance industry. in my mind this makes the case for the mandate. the supreme court already has let the government regulate the insurance industry. in order to regulate it the mandate is all wrapped up in that.

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  83. Kary L. Krismer

    RE: pfft @ 82 – If you read the transcript there are three positions being advanced if the individual mandate is held to be unconstitutional.

    1. Just strike the mandate.
    2. Strike the mandate, the pre-existing coverages and insurance markets (whatever they’re called).
    3. Strike the whole act, including things that have nothing to do with healthcare, like ethanol provisions, things pertaining to native americans, etc.

    Apparently no one found a case where the provision struck goes to the heart of an act, and they were having problems expressing a limiting principal. That was the same problem with the individual mandate–if you force people to buy something, what is the limitation on the government’s power to do that?

    BTW, “individual mandate” apparently equals “minimum coverage provisions,” depending on whether you are for or against the mandate.

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  84. Kary L. Krismer

    BTW, the arguments were fairly interesting, not because of the quality of the debate. Instead because there’s apparently very little prior case law on many of these issues, such as forcing people to buy something (as opposed to forcing them to buy something configured a certain way if they buy something) or striking a major component of legislation.

    Given all the novel issues it wouldn’t surprise me to see four or more opinions generated by the case.

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  85. Kary L. Krismer

    RE: The Tim @ 85 – LOL, but based on the question in post 171 apparently some Justices think there isn’t any limitation.

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  86. pfft

    By The Tim @ 185:

    By Kary L. Krismer @ 183:
    …if you force people to buy something, what is the limitation on the government’s power…

    You still believe there are limits to the federal government’s power? How quaint.

    by your reasoning the government could never pass anything. the income tax is unconstitutional because why couldn’t the top rate just be 100%?

    anyways you are wrong.

    Plenty of ‘limiting principles’ to go around
    http://maddowblog.msnbc.msn.com/_news/2012/03/29/10926548-plenty-of-limiting-principles-to-go-around

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  87. pfft

    By Kary L. Krismer @ 150:

    RE: pfft @ 149 – We’ve gone over this so many times. I’m getting tired of it. But I don’t know how you consider over 50% of the population to be a very limited number of people. Look what under 10% of the population did to real estate prices in 2007.

    you’ve got your facts wrong, 5% of the people are accounting for 50% of health costs.

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  88. Kary L. Krismer

    By pfft @ 87:

    By The Tim @ 185:
    By Kary L. Krismer @ 183:
    …if you force people to buy something, what is the limitation on the government’s power…

    You still believe there are limits to the federal government’s power? How quaint.

    by your reasoning the government could never pass anything. the income tax is unconstitutional because why couldn’t the top rate just be 100%?

    anyways you are wrong.

    Plenty of ‘limiting principles’ to go around
    http://maddowblog.msnbc.msn.com/_news/2012/03/29/10926548-plenty-of-limiting-principles-to-go-around

    First, you probably need to know before making absurd arguments that the income tax is only legal because there’s a constitutional amendment that allows it.

    Second, I love how you don’t even read your own link. The link to the choices was within that link–here: http://balkin.blogspot.com/2012/03/limiting-principle.html

    Third, just because someone can come up with limiting principles doesn’t mean the court (or anyone) will be happy with them, or that there is any basis to impose them. Also, one of those three limiting principles is problematic in and of itself–the tax one. Which gets back to the first point–the income tax is only constitutional because there’s an amendment which allows it. Just because it’s a tax doesn’t mean it’s constitutional. One of the arguments made was that it is an unconstitutional tax.

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  89. Kary L. Krismer

    By pfft @ 88:

    By Kary L. Krismer @ 150:
    RE: pfft @ 149 – We’ve gone over this so many times. I’m getting tired of it. But I don’t know how you consider over 50% of the population to be a very limited number of people. Look what under 10% of the population did to real estate prices in 2007.

    you’ve got your facts wrong, 5% of the people are accounting for 50% of health costs.

    Totally non-responsive and indicates you don’t even have a clue about what I’m talking about. Read it again–I pointed out a small number of people can affect the market. How is pointing out that a small number of people affected the market in any way disputing what I said?

    Also, you said the same thing in post 151. I keep saying you need to have your memory checked. You keep repeating the same things over and over and over here.

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  90. Kary L. Krismer

    I love how all of pfft’s so-called experts have apparently changed their tune based on the oral arguments.

    http://www.nytimes.com/2012/03/31/business/the-health-care-mandate-and-the-constitution.html

    Not too surprising that those who don’t understand the difference between regulating commerce and creating commerce would think that oral arguments actually mean much. The chance that Obamacare will be struck down is almost exactly what it was before the oral arguments. It’s very unlikely the arguments changed a single justices mind. Apparently though, these so-called experts were unaware of what the arguments were, so their minds were changed.

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  91. Kary L. Krismer

    The Supreme Court is voting today on the Obamacare case, and will decide who writes the opinion. I wonder if today President Obama is wishing that he hadn’t done this:

    http://www.youtube.com/watch?v=9bR_9wmNnD4

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  92. pfft

    By Kary L. Krismer @ 190:

    By pfft @ 88:
    By Kary L. Krismer @ 150:
    RE: pfft @ 149 – We’ve gone over this so many times. I’m getting tired of it. But I don’t know how you consider over 50% of the population to be a very limited number of people. Look what under 10% of the population did to real estate prices in 2007.

    you’ve got your facts wrong, 5% of the people are accounting for 50% of health costs.

    Totally non-responsive and indicates you don’t even have a clue about what I’m talking about. Read it again–I pointed out a small number of people can affect the market. How is pointing out that a small number of people affected the market in any way disputing what I said?

    Also, you said the same thing in post 151. I keep saying you need to have your memory checked. You keep repeating the same things over and over and over here.

    DO THE MATH. what it means is that because such a small portion of people have such high healthcare costs means that your idea that healthcare is so expensive because people don’t care what it costs is simply false. there are simply not enough people to make a difference.

    the report showed how a tiny segment of the population can drive health care spending

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  93. Kary L. Krismer

    RE: pfft @ 93 – So in your world, at least 5% of the people are causing prescription Prilosec to be 10 times more expensive than the same stuff in non-prescription form? I doubt 5% of the people are taking any form of Prilosec. You don’t understand how markets work. When a stock has a very good or very bad day, it’s typically a very small percentage of the stock actually changing hands. Small groups more markets.

    In any case, what percentage of the population is using their insurance in any significant way during any given year? There are probably a significant percentage of people that have insurance that don’t even do the annual visit to the doctor. That doesn’t mean that a small percentage of them wouldn’t be driving up costs by spending without regard to cost.

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  94. pfft

    By Kary L. Krismer @ 194:

    RE: pfft @ 93 – So in your world, at least 5% of the people are causing prescription Prilosec to be 10 times more expensive than the same stuff in non-prescription form? I doubt 5% of the people are taking any form of Prilosec.

    to talk about one single aspect is worthless when we are talking about the entirety of healthcare spending.

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  95. Kary L. Krismer

    That one single aspect shows the impact of having insurance. The link to Drugstore.com’s pricing is held up in the spam filter in the weekend thread, but it’s 7x the cost in prescription form. If there wasn’t an OTC version of the drug it would probably be even more expensive.

    Another example is Nasonex. Last time I looked that stuff is now twice as expensive as only a few years ago, because the ads have driven up the demand.

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  96. Kary L. Krismer

    This article indicates we are one of four nations spending over $600 a year per capita on drugs, with the US at $950. That’s roughly 1/8th of our spending, per the article. I wouldn’t really call the costs of drugs insignificant.

    http://bottomline.msnbc.msn.com/_news/2012/04/01/10922752-countries-that-spend-the-most-on-health-care

    BTW, the new version of Adblock for Chrome substitutes pictures of cats for ads. Lots of cats in that link!

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  97. pfft

    By Kary L. Krismer @ 196:

    That one single aspect shows the impact of having insurance. The link to Drugstore.com’s pricing is held up in the spam filter in the weekend thread, but it’s 7x the cost in prescription form. If there wasn’t an OTC version of the drug it would probably be even more expensive.

    Another example is Nasonex. Last time I looked that stuff is now twice as expensive as only a few years ago, because the ads have driven up the demand.

    one drug isn’t a big deal. are all drugs 7-10 times more? then we have a problem. we should have re-importation of drugs.

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  98. Kary L. Krismer

    RE: pfft @ 198 – It’s a problem with all drugs which have not had their patent expire.

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  99. pfft

    I still believe it’s going to be 5-4 or 6-3 for Obamacare being constitutional. the court has recognized that the federal government can regulate healthcare. in order to regulate pre-existing conditions and other areas we need a mandate or the health insurance system collapses.

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