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View Diary: Justice Scalia briefing papers: Right-wing blogs (121 comments)

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  •  Insurance is sold to pools with similar attributes (0+ / 0-)

    Alito's point is that it is not rational for an identifiable group to associate in a pool with others who have different characteristics that promise they will extract more benefits than the identifiable group. Nothing you say addresses that fact - or Justice Alito's concern.

    ACA, of course, allows age differentials as high as 3 to 1 as a factor in setting premiums. That should have been pointed out to Alito because it does address his concern.

    Am I right, or am I right? - The Singing Detective

    by Clem Yeobright on Thu Mar 29, 2012 at 08:15:19 PM PDT

    [ Parent ]

    •  Isn't it the entrance fee? (0+ / 0-)

      Since it is the quid pro quo for outlawing denial based on pre-existing conditions, it is what you pay as a young person, in order to be guaranteed insurance when you get older.

      Not unlike medicare, where the younger workers pay for their elders' retirement, so they'll have the same system in place for their own retirements.

      I love how Dukakis explained social security:  a contract between generations

      •  Except (0+ / 0-)

        The relevant time-period in the ACA is a year, not a lifetime.

        Immigrants, for instance, become full 'members' of the insurance pool immediately and suffer no penalty for not having made their 'young' contributions, what you call their entrance fee. (Note that this is different from SS.)

        Am I right, or am I right? - The Singing Detective

        by Clem Yeobright on Thu Mar 29, 2012 at 08:58:05 PM PDT

        [ Parent ]

        •  You have to start somewhere (0+ / 0-)

          and sometime.  When social security was introduced in the Great Depression, all seniors got in right away, right?  

          Plus, it's still far preferable to the system we have now, where the uninsured are carried by the rest of us through ER visits and unpaid medical bills.

          •  So from 20 to 50 you've pumped in $150,000 (0+ / 0-)

            and maybe collected $2,000 and a new immigrant sits down in the cube next to yours and you each pay $5,000 this year --- sure, that's insurance, but it sure doesn't account for your lost $148,000, does it?

            You were probably lucky for those 30 years (I know I was) and you were definitely insured ... but actuarially, maybe $50,000 paid to cover your risk and $100,000 was what you call your 'entry fee' - that the other guy gets for free!

            That's the market, more or less, but as soon as it becomes mandatory it becomes a problem, don't you think?

            Am I right, or am I right? - The Singing Detective

            by Clem Yeobright on Thu Mar 29, 2012 at 10:05:13 PM PDT

            [ Parent ]

            •  I pay for lots of people in high risk pools (1+ / 0-)
              Recommended by:
              Clem Yeobright

              Every year, I pay for FEMA to bail out people who live in hurricane and tornado land.

              When I got my law school education at Cal's (then) fabulous public university system, I swore I would never complain about paying taxes.

              Were we to go to single-payer health care, wouldn't we be at the same place, the healthier paying to cover the higher risk folks, all of us under the same healthcare umbrella?  Ultimately, govt as ultimate risk pool is just the sanest, most efficient system.

              We all should only be so lucky, to pay into health insurance that we never have to use.  I don't complain about the money I've wasted on fire insurance either.

              The ramp up may have hiccups, but we have to get something going sometime.  

              Any way, aren't most new immigrants relatively healthy, given they come here for employment?  that's the only group I can think of that present new entrants, even after the ramp up period.

              •  'Immigrants' is a throwaway argument (0+ / 0-)

                just to demonstrate that ACA is based on each year and not a lifetime. To go farther afield, it's kind of like losing cell minutes I've paid for at the end of every month; I don't like it but I accept it.

                ACA does permit age differentials in premiums of up to 3:1, and personally I find it intimidating that I might have had to pay 3 times as much at 62 (a year I used $0) as my son who was 32 at that time (and had a baby that year).  Still, actuarially, ACA disadvantages the young - as you observe as well, and as Alito finds troubling.

                I've read that one or more European countries allows an opt-out from National Health at 18, but it's a one-time opportunity with no mulligans permitted. That certainly implements your concept of the pool, with which I am in full sympathy.

                PPACA is certainly not perfect, but once in place and secure it will be amended over the years to be far better, I think.

                Am I right, or am I right? - The Singing Detective

                by Clem Yeobright on Thu Mar 29, 2012 at 10:52:23 PM PDT

                [ Parent ]

                •  Once in place (1+ / 0-)
                  Recommended by:
                  Clem Yeobright

                  Let us only hope.  I truly fear this court.  It's all down to Kennedy, and I am not hopeful.

                  Thanks for the interesting discussion.

                •  Except the young people would tend to be earning (0+ / 0-)

                  less and so would get more of their insurance costs subsidized. So I don't see them being disadvantaged at all.  What they get is peace of mind that if they did have high health care costs, as some will, those costs will be taken care of.  What they would also get is the peace of mind that as they got older, and needed the care more and more, it would still be there for them. That's something we don't have now.

            •  Only if you couldn't care less if the new (0+ / 0-)

              immigrant dies because he can't get health care.

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