April 8, 2010

Can You Hear the Sly Taxation?

Justin Katz

Here they go again:

Bills have been introduced by Sen. William A. Walaska (D-Dist. 30, Warwick) to increase medical insurance coverage for hearing aids and to require insurance coverage for surgery and services associated with hearing aid implants.

Without a doubt, hearing loss increases the difficulty of one's life. So does poor eye sight and any number of other ailments and disabilities. There are two problems with this continuing trend of legislating mandatory insurance coverage for related aids, medication, and surgeries:

  1. It essentially turns insurance premiums into a tax to fund redistributed wealth, without allowing voters a direct influence on those increasing the cost/tax. In other words, the government is making the insurance companies levy a tax and block the political heat.
  2. Determining how much addressing each health difficulty is worth works best on a case-by-case basis, and when somebody else is forced to pay for the remedy, nobody in the chain from provider to patient has significant incentive to make actual, often difficult decisions, thus driving up costs all around.

But, as I said, there's a firewall against political heat built into this practice, so the politicians will keep doing it until we all decide to reassert basic principles of good governance.

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As the parent of a deaf person, I find it hard to even grasp what you are getting at, but am afraid if I do it would not make sense anyway.

Case by case basis? Justin, you are acting like a complete fool.

Let me make it clear how both business and health insurance work. The person who stands up at a meeting and says "let's pay more claims" gets fired or demoted, while the one who says "I have a good way to avoid claims and increase profit" gets promoted.

That is it in a nutshell. So, of course, they act just like you would expect! If you give rewards for turning people down, someone will gladly take that job.

You mention voters? Voters have nothing to do with it! A voter with cancer will vote for more protection for cancer, while one with missing limbs will vote for more for prosthetics.

Insurance IS BY DEFINITION redistribution of wealth. If I "collect" on my life insurance policy, it comes out of someone else's money.

If I were to come to a conclusion based on this particular rant, I would say you are arguing for Universal Health Coverage without the overhead of profit making insurance companies who make decisions for the wrong reasons.

But, really, I think you just wanted to write something, so came up with this drivel. If I were you, I'd erase it. It does not reflect well on your religion or outlook.

Posted by: Stuart at April 8, 2010 3:27 PM

"Insurance IS BY DEFINITION redistribution of wealth."

There is a slight difference between a voluntary private redistribution of wealth and a violently coerced government-mandated redistribution of wealth, Stuart. Just a slight difference. Of course, morally speaking, it's all the same to you because progressives believe that the ends always justify the means.

Posted by: Dan at April 8, 2010 3:47 PM

Nice try on the talking points, Dan, but you don't quite have it. It is a question of basic responsibility. Since everyone is alive and has blood, insurance companies which sell health care cannot sell you a policy with a "no blood for this guy Dan" rider.

Car insurance is mandated if you have a car, because every human being with a car could hit a pole or another car or injure someone. Health insurance can be mandated for the same reason - because we all have ears, and blood and eyes and because if they break we all want to fix them.

I sense that right wing radicals try to frame everything as some kind of forced violent action, when the real situation is that we all must take responsibility - which is what insurance is!

The person without it is gaming the system, because if they "win" (get sick), they get to collect the winnings anyway (health care) even though they didn't put anything into the pot.

But, honestly, I never thought Justin was THAT much of a radical right winger to want to deny people tools which allow them to see or hear or walk better. That would seem to be against his religion - but maybe he does not represent his religion? If not, who does he represent - United Health Care?

Posted by: Stuart at April 8, 2010 4:29 PM


I spent some of the idle time while driving home thinking about how I might respond to Stuart if it were even remotely possible to engage him in an actual discussion in which each side considers what the other says and responds accordingly. But I concluded as I'll advise you: Don't bother.

I'll note, though, that your reference to coercion, while apropos, isn't necessary because insurance isn't redistribution of wealth in the sense that people typically mean. Any exchange of money for any reason could be called "redistribution," but it's not really useful to think in those terms.

Insurance is the provision of risk management, operating by pooling money and risk. Everybody pays in and gets, in exchange, peace of mind and some security. Some people receive their money back, and some people receive more than their money back as a function of the service for which they've paid.

It's a somewhat fine distinction, I'll grant you, which is why politicians love the insidious practice of mandating that other people make you pay for something.

Posted by: Justin Katz at April 8, 2010 5:50 PM


Car (liability) insurance is for the protection of other drivers from the purchaser's reckless driving. Health insurance is for the purchaser, not other people. If I pay my own health bills (cash to the doctor, hospital, etc.) with the money I earn from a job, why is it okay for the government to force me to purchase insurance. I take responsibility for all of my actions. I don't expect anyone else to pay for my problems (health or otherwise). I reluctantly pay into Social Security and Medicare, but I know the way that progressives (Democrats and Republicans)have grown the government to an unsustainable size, that I will never see that money back after retirement. And if that money were still there, I wouldn't accept it anyway. I would insist it go to pay down the national debt so that future generations can have the same opportunities at success that I did. My retirement will be provided by a 401K and IRA.

Posted by: Tommy Waugh at April 8, 2010 6:52 PM

Quite right, Justin. That was the point I was trying to make to him, but I forget that when talking with Stuart one needs to S-P-E-L-L E-V-E-R-Y-T-H-I-N-G O-U-T.

I, like you I'm sure, become particularly frustrated when people start referring to insurance as a right, a necessity, or a fundamentally different type of service. It is none of those things. It is a risk reduction service with different value to different people, and people can purchase various levels of it accordingly.

Posted by: Dan at April 8, 2010 8:45 PM

Dan and Joe, you are welcome to talk with Stuart and his cohorts all you want. I have recently found it much more pleasant to give them exactly the attention they deserve - none.

Trolls crave attention like obese welfare queens crave snack foods. The best cure is to starve them. They can eat again when they change their attitude.

Posted by: BobN at April 8, 2010 9:34 PM

>>>Why is it okay for the government to force me to purchase insurance. I take responsibility for all of my actions?

Sure, I would be cool with what you are asking for. But here is how it would have to be done.
1. You would have to prove a net worth of at least $500,000 free and clear and ready to pay bills.
2. You would have to sign a statement that you would be willing to allow this account to be accessed to pay your bills - whether you approve or not (after all, you might be in a coma of a vegetable.
3. Said account would have to be able to be checked by the medical establishment on a constant basis, so that they never were able to get stiffed (like they put a credit card hold on your card when you check into a hotel.

So, yeah, if you are one of the tiny percentage of Americans who would be willing to sign over your entire net worth - and/or get others to cosign, be my guest!

My guess is that almost no one would take us up on that deal - which is why we have this brilliant thing called INSURANCE.

Again, it is practical to spread out risk. If you want to protect your $500,000 in net worth, you can buy insurance for $1,000 a month for the family.

So, yeah, if you think that would be widely subscribed to, try to get it implemented. I would vote for it - as long as the controls are in place.

But I would not subscribe to it. I would buy insurance.

So tell us honestly. Would you choose that program over paying insurance premiums?

The reason I would not is that I know three people, even without thinking much, that ran up $200,000+ in medical bills recently. None of them paid a cent....because of insurance. I don't know a single soul who every spent 100's of thousands of their own money to pay bill hospital bills.

So, what would your choice be?

hey, Bob, kiss my grits. Apparently, you only like to debate with other boneheads that think just like you.

Posted by: Stuart at April 8, 2010 10:09 PM

"when people start referring to insurance as a right, a necessity, or a fundamentally different type of service."

Yes, a fatal error. Health care coverage cannot be a right, prima facie, because it costs money - lots of money - to ... er, keep that right supplied. (Even the idea of keeping a "right" "supplied" like a commodity doesn't seem to work).

Actually, from a selfish prospective, looking at the all too real prospect of losing my own coverage, either soon or at some point in the future, I really wish health care coverage were a "right". Unfortunately, it doesn't work that way, unless doctors, nurses and staff members, not to mention the Democrats' precious (no offense) tort lawyers are willing to work for free.

Posted by: Monique at April 8, 2010 11:37 PM

BobN-I think you may be right-people like Stuart have a very rigid response cycle-they use catchphrases and make insane allegations to divert from the emptiness of their position.

Posted by: joe bernstein at April 9, 2010 12:53 AM

Liberals like Stuart ALWAYS deflect away from the pure facts because the facts never suit their argument. They have to spin and hide in order to keep arguing and arguing the blacks and whites of an argument into shades of gray.
Most of us here believe in the tenant of private property, i.e. our own money and the fact that we should be able to spend and save the way we see fit. Liberals believe we made that money for them to take from us to give to others who didn't earn it. So we can argue about insurance or any other thing but the fact still remains that people like Stuie will insist that we pay for everyone else's needs and wants in life and when we disagree we get attacked by his side for being "bad" people.
This way of operating is good for NO ONE. Not good for the people receiving said "free" money and certainly not good for those who earned that money.
We'll begin to get better around here when we decide to assign responsibility and accountability to EACH individual for their own life. We all have enough to worry about in our own lives without having our politicians pile the recipient class on our backs to support them too.
Stuart, try approaching your problem solving with your head and not your heart, that'll help you to come up with resolutions that are rooted in common sense and not some pie-in-the-sky scenario of rainbows, sweet smelling flowers and sunshine. Life can't be about demanding "stuff" from others at the end of the Government's gun because that gun make backfire one day.

Posted by: taxedtoomuch at April 9, 2010 1:47 AM

State of Hawaii enacted strict health care reform close to 40 years ago and is exempted from "Obamacare" because it would lower state healthcare insurance standards.

Since moving from RI to HI my health care (medical. dental and prescription drug) insurance has dropped $100 a month with same or higher service with same insurance carriers.

Posted by: Ken at April 9, 2010 3:09 AM


If I don't have the money to pay for the medical treatment, I don't get the treatment. In the case of a coma, my wife will have documents (living will, DNR order) that will halt any medical intervention. That may sound cold-hearted to you, but that is the way I want it. This country is about freedom and liberty. Not about you or anyone else forcing me to pay for insurance that I don't need or desire.

Posted by: Tommy Waugh at April 9, 2010 9:14 AM

>>If I don't have the money to pay for the medical treatment, I don't get the treatment

Again, give me the practical end of this? How does the system work? I had a friend who recently had pancreas problems and had a horrible attack of pain and nausea. So, is this your solution?

1. The Ambulance comes and identifies him and checks online into a public database to see if they are going to get paid for hauling him. If not, they leave him at home.
2. Assuming he has a few thousand dollars of net worth, they haul him to the ER>
3. The ER notices he had $12,000 left in his account, so they inform him he can have 3 days of hospital care and tests, and then will be discharged even if those tests mean he needs an operation. However, if he signs his house away, or if his kin show up to offer 2nd mortgages on their houses, his life might be spared.

You might say that is a reach - but it is exactly what you are saying. There is such thing as REALITY - where the rubber meets the road.

The fact is that such a patient would be covered for VAST amounts of health care in every country in the civilized world - meaning Europe, Japan, Australia, Canada and MANY more.

But what you are saying is that the "greatest and richests" country in the world cannot afford to do what all those "lesser" countries can do?

I say we are better than that. You seem to propose a Mad Max world with tents of dying people set up outside the hospital for when they are discharged in sad shape since their money ran out.

That is a sad dream for the world, IMHO.

Posted by: Stuart at April 9, 2010 11:08 AM

Stuart-your"dream" is a little cockeyed because I have gotten the message from your posts that you think everyone who manages to sneak into this country or violate the terms of their admission should be granted amnesty and given all the non-emergency care they want.I say no to both of those things.No amnesty and no care for illegal aliens,except for life-threatening conditions.
You'd do well to even get the latter in those third world sh*tholes you have so much "empathy" for.
You and your ilk,Stuart,want one world.Or you think you do.I'd love to see you try and explain to a hoodlum from some hillside slum in a "never to be developed country"why he shouldn't take your house and throw you in he street.
Your ideal countries like Denmark have some pretty tough immigration laws-that's something you gloss over while you have wet dreams about adopting their system here.
We cannot afford to watch out for everyone who just fels like showing up here.

Posted by: joe bernstein at April 9, 2010 11:36 AM

Joe, don't be crazy.

Immigration has absolutely nothing to do with the subject we are discussing. You do a disservice to your side of the aisle by spewing out talking points when you are backed up against the wall.

Next thing, you are going to answer a health care concern with "drill baby drill" or "don't take away my guns".

Let's stick to the point. Give your interpretation of how the above or similar situations would work. Do they simply refuse to transport or admit people without the cash? That is the way it works in capitalism (at the theater, at disney world, etc.).

If your view is realistic, you should be able to take it to it's logical conclusion....that is, what happens when someone without money has a heart attack or get's hit by a falling tree?

Posted by: Stuart at April 9, 2010 12:34 PM


What I meant was, if I get cancer and can't afford the treatment, I will choose to live with cancer and if at some point I die at home, so be it. (On a side note, my mother was diagnosed with breast cancer that spread to her liver and brain. She did the chemo, and felt worse than before the treatment. It was probably the treatment that actually killed her, not the cancer.)

As for comparing our system to other countries, the United States leads the world in healthcare innovation. If it wasn't for our capitalism, other countries would never have 95% of the treatments that are available. You hardly ever hear our citizens going to other countries for treatment, but everyone comes here when they can't get it in their country. Being in the healthcare field, I know several people who were doctors in their country who came to the U.S. to work (as non-doctors) because they could make a better life here.

I am perfectly fine with other people voluntarily purchasing health insurance for their peace of mind. But the federal or even state government forcing you to buy it is another thing completely, especially when insurance companies are financially supporting (bribing) the Democrats who voted for "reform" so that the insurers can get more payors into the pool. I know, you're going to say that it is the Republicans that the big corporations support, but I seem to remember that in the Massachusetts Senate campaign, Martha Coakley was the one who was at a fundraiser courting the health insurance companies and big pharma, not Scott Brown.

The bottom line is this: If you want health care, don't expect it to be free. Especially if one's salary comes from the government. Because in the end, one's fellow taxpayers are paying the bill. You said "The reason I would not is that I know three people, even without thinking much, that ran up $200,000+ in medical bills recently. None of them paid a cent....because of insurance." If they paid no percentage of the premium, no copay at treatment, no deductible, then they have no incentive whatsoever to use our health resources wisely and prudently. Eventually they bleed us dry. Once there are no more people to pay into the system to support all of their "rights" and "needs", where will they be. SOL

Please notice that I do not attack you personally, because that is the type of person that I am.

Posted by: Tommy Waugh at April 9, 2010 1:15 PM

>>You hardly ever hear our citizens going to other countries for treatment, but everyone comes here when they can't get it in their country

Kings from Saudi Arabia come here, that's for sure. But the stats show something way different than what you said! The fact is that millions of Americans go to Mexico for treatments and drugs they cannot afford here - many more go to Canada for drugs and treatments (eye laser, etc.).

The ratio is 10 to 1 or more - Americans leaving as opposed to others coming - so it's time to correct your stats. In fact, there is a whole new field called Medical Tourism where hospitals are being built in Mexico and India, etc. to serve Americans who cannot afford the high prices here.
"In 2008, it is estimated that approximately 1.3 million Americans traveled abroad to seek healthcare and this figure is expected to double by 2010"

As to attacking me personally, I would hope not. That is not really relevant to the conversation!

I think it is important not to exaggerate when you want to prove your point. To say that 95% of medical innovation happens here is just plain wrong. #4,5,6 and 7 of the worlds largest pharma companies are in Europe. Same with some of the largest medical device companies.

I'm not denying that we, as a large and advanced country, have great innovations in most fields - we are talking about whether that care gets to US, the populace! Those are separate issues.

You also seem to gloss over that these giant US pharma and medical companies spend MORE on marketing than they do on R&D. Marketing....meaning ads on TV, etc.

"In 2005 money spent on pharmaceutical marketing in the US was estimated at $29.9 billion with one estimate as high as $57 billion"
"Evidences show that marketing practices can negatively affect both patients and the health care profession.[1] Many countries have measures in place to limit advertising by pharmaceutical companies."

So, yes, we have the best system money can buy - but not the best one for our patients.

Tommy, you still are picking and choosing one particular situation - that of cancer, which is rarely an emergency. Please address for us what you think should happen when someone who chooses not to have insurance has a massive heart attack or a tree fall on them? I know a young mom whose child died of meningitis a few years ago. Are you suggesting that when this child had her symptoms (in school) that she should not have been admitted to a hospital if she didn't have insurance or cash?

Again, all I am asking for is to take the reality of these situations to their logical conclusion instead of using talking points. If we were superhuman, sure...we would not need insurance. If cars never hit anything, we would not need that car insurance either.

So, in your scenario, who is the gatekeeper - who decides not to give that child a spinal tap when she shows up at the ER?

Is that the kind of society you want to live in and leave to your children? I say no...for me.

No one wants anything for free - I pay my premiums and my deductibles, which might end up all told being 20K per year. But I think it is the opposite of what you say - those who DON'T want to get insurance are the freeloaders

Posted by: Stuart at April 9, 2010 4:00 PM


The reason that people get their drugs cheaper in Canada and Mexico is because the pharmaceutical companies sell their drugs for a huge markup in the US, because insurance companies will pay a higher price for them. If we had to pay out of pocket for every drug ourselves, we would not buy the expensive drugs, and they would then be forced to lower their prices. The insurance companies screw up the law of supply and demand. I bet if you look at the the medical tourism facilities in India and other countries, you will find that only patients from rich countries are admitted. The average, everyday Indian citizen would never be allowed inside the facility. Just like the clinics in Cuba that Michael Moore highlighted. Only the party elite in Cuba get into those hi-tech clinics, not the average Cuban (unless a camera is around).

I'm not stupid, you don't have to explain what marketing means. I find it ridiculous that any pharmaceutical company advertises to patients. The doctor will choose what he/she determines is the best remedy for the patient. No competent physician should be prescribing a certain drug to a patient because of an ad that the patient saw.

Okay, let's tackle the ER situation. The law still says that everyone that comes there must be treated whether they have insurance or not. I am not advocating any change there. The patient is free to choose to go there and be treated. Mandating purchase of insurance with a monetary fine for non-compliance is not going to change the minds of those who choose to go without insurance and pay out of pocket, or skip out on paying.

You are very naive if you believe that there aren't people out there who believe that they will get free healthcare for life thanks to the "reform" bill. "No one wants anything for free - " That is the main reason why many of the Democrats in Congress voted for it. They will receive the vote of every unintelligent constituent in the next election. Just add free healthcare to free housing, free food, free utilities - all thanks to the middle class who work for a living and pay income taxes.

Posted by: Tommy Waugh at April 9, 2010 6:28 PM

So, treat them at the ER - which costs billions per year - and stick Uncle Sam with the bill....

Then complain about government involvement in Health care?

Seems like you want to pick and choose a system which still means the government has a large involvement. For instance, if those 30-50 million uninsured PLUS some others (why not?) choose to go uninsured, that means as many as 60-70 million, or 1/5 of the country, showing up at the ER when problems arise...and you say the government should pay, but ask nothing of those people?

See, that is the difference. If I own a property in a town and my kids go to school there, I should pay property tax. If I own a property in the same town and have NO kids going to school now, then I STILL should pay the same amount of property taxes.

It's simply a question of whether we feel people should be serviced for free (at the ER, without insurance) or if we think people who are capable should pay towards the "pot".

I don't see how that is a radical stance.

Oh, these hospitals in India and Mexico are for US Citizens looking to save money on expensive operations. My point is that if things were so advanced here, medical tourism would not be growing as fast....based largely on US customers!

As to free healthcare for life from the reform bill, so - are you saying that a vast number of people will choose to remain unemployed and have low income and low quality of life....just so they can get health care when they get sick?

I don't see that. It's against human nature. Sure, you can find a few - maybe even 1% (3 million), but not enough to affect the total picture.

Of course, the same health care bill contains money to serve 20+ million with relatively low cost community health care - which should save a lot of money keeping people out of the ER.

Posted by: Stuart at April 9, 2010 7:25 PM

Stuart-I didn't mention guns or oil drilling.
You as usual threw them in to the discussion to avoid dealing with what I DID say.
I don't 'spew" talking points.I certainly believe the uncontrolled flow of people impacts health care costs.if you don't,you're a fool.
We can set the parameters for who enetrs,who stays,and who has to leave.It is our country.Maybe you don't like that.Tough sh*t.Go preach open borders in Scandinavia.You'll find out what kind of following that gets.
Frankly,if you're coming here to be a burden,don't come.
Exceptions for refugees fleeing potential atrocities is a different story.I don't oppose a sane refugee poicy.Unfortunately, political asylum has been severely abused.
We owed the Southeast Asians shelter because we helped cause that situation.I'm not sure that applies to Kosovars or Somalis.

Posted by: joe bernstein at April 9, 2010 9:02 PM

Joe, lay off those pain pills!

What I mean is that the thread which these comments refer to is about Justin wanting NOT to help deaf people hear and blind people see.

We'll discuss immigration when that bill comes up. I want them to fix it, but being a practical person who actually gets things done, I'm open to reasonable compromises which allow for all the employers that need the help picking their fields- whatever you want to call it, we need guest workers.

Posted by: Stuart at April 9, 2010 9:07 PM

Stuart-the "pain pill" remark was so ignorant that you deserve no answer.I've dealt with severe pain for years.Guess what-I DON'T use pain meds for more than a few days post-surgically.I actually wouldn't wish what I've had on you.Go f**k off.

Posted by: joe bernstein at April 10, 2010 3:12 PM

C'mon, Joe, I know you jived when you were on the front lines!

I've been known to swallow some (legal prescribed) opiates myself, as decades in the construction and other physical business doesn't help ones spinal column!

Anyway, here's to seeing clearly.

Posted by: Stuart at April 10, 2010 4:01 PM

Stuart-the last time I was prescribed Vicodin after cancer surgery,I wound up tossing 2/3 of the bottle.
I do appreciate IV dilaudid when I really have needed it,but I don't know about you-opiates cause real bad constipation-I'd as soon deal with bearable pain.
The last time I used a "recreational"drug was around 1970-the unit I was in tended to have a lot of weed floating around-I never got much out of it-I preferred booze.
This was stateside-I never used any kind of drug in Nam,although we had some seriously f**ked up people over there-heroin and weed were always available.
I learned enough on my job to be wary of opiates unless they're absolutely necessary.I received formal training on this subject in Quantico at the DEA Academy(they shared the facility with the FBI at the time)-overuse not only causes dependence,but lessens effectiveness.
Back pain?tell me about it-I got thrown down a flight of stairs in 1980 and it has never healed.I just put up with it.
I'm allergic to ibuprofen and I like having kidneys,so aspirin is the best thing I've found.

Posted by: joe bernstein at April 11, 2010 8:37 AM

Damn, I'd never flush anything good.....

Yeah, I know about the constipation - but some hot air popcorn and a high fiber diet in general can help.

After my recreational youth, I've learned pretty good about discipline with drugs. I've had those light opiates (just codeine/tylenol) for many years, and yet never increased the dosage and made sure I stop for a month or more here and there.

As you know, they stop working anyway.....

Luckily, my pain is bearable - usually only 2-3 at most on the pain scale. I have to wonder, though, what I would do if it got much worse.

Also luckily I am still very mobile, and being able to exercise regularly gets the endorphins going - which, as you probably know, are the same thing as opiates in many ways.

And that takes us back to Justins dislike of recreational sex - since sex produces lots of endorphins.........in other words, it gets you high. That makes abstinence even tougher, although at our advanced ages it might get easier soon voluntarity.

Posted by: Stuart at April 11, 2010 2:07 PM

Level 2 or 3 is something I'd wish for many days-I've had level 7-9 pain intermittently since 2002-it has never been diagnosed or treated effectively until last week when a doctor at the VA found that I had an incisional hernia.Seven other doctors missed it!!
Nothing helped it except vomiting or dry heaves,which would usually stop it,although I had an episode lasting 20 hours non-stop-spent 3 days in the hospital and the idiot doctor wanted to take out my gallbladder!!My gallbladder is normal.In a few weeks it ought to be repaired finally.Other than that time in the hospital I never took a pain med for it because nothing helped short of IV morphine,which I can't very well take at home.
Maybe that's why I'm frequently in a choleric mood.
If you really want to experience something nasty,try having a damaged trigeminal nerve-it happened to me after cancer surgery in 2007-a solid 10-it took 2mg of dilaudid to knock it down.That's like 14 mg of morphine.
Or have a bone marrow biopsy-lotta fun.

Posted by: joe bernstein at April 11, 2010 7:34 PM

Damn, you're in a good mood consider that stuff......

Posted by: Stuart at April 11, 2010 9:07 PM
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