Why do we need to repeal the ACA at all costs?

[sokoloff]

Sounds like a perfectly rational theory for a 100% estate tax. How about we use the money on healthcare :)

I can't think of a greater handout to the life insurance and trust lawyer/trustee business than the creation of a 100% estate tax...

[radram]

Sounds like a perfectly rational theory for a 100% estate tax. How about we use the money on healthcare :)

I can't think of a greater handout to the life insurance and trust lawyer/trustee business than the creation of a 100% estate tax...

I can.... TAX CUTS :)

[Roland of Gilead]

There are many treatments at a lower cost, with a lower cure rate, and a more inconvenient regiment (injection vs pill). There is a huge time frame to treat (20 to 30 years from detection). As many as 80% have no symptoms and do not even know they have it.

The standard of treatment before the one pill a day cure had a much lower cure rate as you say, used interferon with some pretty harsh side effects, and I think was around $300,000.

A liver transplant operation and the meds needed after that were even more.

Yes not everyone dies of HepC but I think it is a good example of modern medicine actually coming through with a cure and not just a couple month extension of life.

[radram]

There are many treatments at a lower cost, with a lower cure rate, and a more inconvenient regiment (injection vs pill). There is a huge time frame to treat (20 to 30 years from detection). As many as 80% have no symptoms and do not even know they have it.

The standard of treatment before the one pill a day cure had a much lower cure rate as you say, used interferon with some pretty harsh side effects, and I think was around $300,000.

A liver transplant operation and the meds needed after that were even more.

Yes not everyone dies of HepC but I think it is a good example of modern medicine actually coming through with a cure and not just a couple month extension of life.

Edit for clarity: Total of $44,000  for 11 months of treatment, as of July 2016. http://www.healthline.com/health/hepatitis-c-medications-costs-side-effects-and-more#Traditionaldrugs2
 
I agree regarding modern medicine advancement. This article believes a course of treatment for Hepc might fall to as little as $200 by 2025. http://www.infohep.org/Hepatitis-C-treatment-costs-could-fall-to-200-per-treatment-course-for-much-of-the-world-after-2025/page/2701845/

I believe future medical advancement is going to soar and I hope it raises the bar for all. Time will tell.

[Metric Mouse]

One life is not worth more than another, and you as the armchair critic certainly don't get to decide it.

That is your opinion, perhaps, but as a society, we certainly act in ways contrary to that position. Some treatments are restricted by age, others rationed by other medical condition, we have literally thousands of people working full-time to keep POTUS alive.

Fair point, don't disagree.

Ask yourself though. If you needed expensive healthcare and couldn't afford it entirely yourself, would you want Metric Mouse* deciding whether you live or die?

*Sorry to pick on you MM, but you were the one with an equivocating opinion on whose life is worth saving...

While I wasn't actually advocating for one life over the other, as I struggle to define the line myself, I understand that I could be inserted for any other person who is drawing that line. It's a tough question, for sure. I think this thread has brought up many good points on the issue.

[Metric Mouse]

why don't we give every person on the day they are born a set amount of money to be used for the rest of their lives for their health care? if you're a sickly kid, you blow through the money early. if you stay healthy you get to use the money to prolong your life as you see fit.

Because that's patently unfair?

Some people will need an awful lot more health care than others, through no fault of their own and they have the greatest need.  At the same time, some people can skate through life with perfect health . . . why would you reward someone with money for being a lucky accident of birth?  Particularly when it's money that should go to the person with greatest need.

Sounds like a perfectly rational theory for a 100% estate tax. How about we use the money on healthcare :)

It could work. But then the stay-at-home spouses, or young children, would have no assets when their partners/parents died.

[GuitarStv]

why don't we give every person on the day they are born a set amount of money to be used for the rest of their lives for their health care? if you're a sickly kid, you blow through the money early. if you stay healthy you get to use the money to prolong your life as you see fit.

Because that's patently unfair?

Some people will need an awful lot more health care than others, through no fault of their own and they have the greatest need.  At the same time, some people can skate through life with perfect health . . . why would you reward someone with money for being a lucky accident of birth?  Particularly when it's money that should go to the person with greatest need.

Sounds like a perfectly rational theory for a 100% estate tax. How about we use the money on healthcare :)

It could work. But then the stay-at-home spouses, or young children, would have no assets when their partners/parents died.

That's a good point.  There could easily be an exemption for dependents, that expires when the dependent turns a certain age (or in the case of a dependent spouse, dies).

Personally, I really like the idea of a 100% estate tax.  I'm too close to the issue to tell if this is simply because of my situation (will likely receive no money at all when my parents die) or because of a weighted analysis of the social benefits though.

[sokoloff]

All that will do is create a lot of work for trust attorneys and a lot of sales for life insurance companies and multiple-survivor annuity products.

If you managed to acquire any substantial sized estate, it would take a vanishingly small amount of time and imagination to figure out how to get around the tax...

[Metric Mouse]

All that will do is create a lot of work for trust attorneys and a lot of sales for life insurance companies and multiple-survivor annuity products.

If you managed to acquire any substantial sized estate, it would take a vanishingly small amount of time and imagination to figure out how to get around the tax...

I think this is correct. Rich people would liquidate and tranfer into insurance or gifts, while poor people with little assets or possibly multi generational housing will be hit hardest.

[mxt0133]

All that will do is create a lot of work for trust attorneys and a lot of sales for life insurance companies and multiple-survivor annuity products.

If you managed to acquire any substantial sized estate, it would take a vanishingly small amount of time and imagination to figure out how to get around the tax...

Can someone explain to me how you can get around estate tax using a trust?  I thought the only benefit to a trust was avoiding probate unless you actually transfer ownership of the assets to your children.

One way is to put assets in a trust that would be above the life time exclusion, which at the moment is $5.49M, the trust can be a perpetual trust that give distributions to your children that fall below annual personal exclusion gift amount, currently $14K a year.  It can also be directed to pay for educational or medical expenses of the beneficiary that circumvent the exclusion gift amount.

This way when that individual passes his estate can be kept under the $5.49M to avoid the 40% estate tax while structuring the assets to distribute funds to the individuals descendants.  If done correctly and early enough the trust can continue to grow provide the descendants funds for many generations.  Think Rockefellars, Rothchilds, Mellons, ect...

[radram]

All that will do is create a lot of work for trust attorneys and a lot of sales for life insurance companies and multiple-survivor annuity products.

If you managed to acquire any substantial sized estate, it would take a vanishingly small amount of time and imagination to figure out how to get around the tax...

Can someone explain to me how you can get around estate tax using a trust?  I thought the only benefit to a trust was avoiding probate unless you actually transfer ownership of the assets to your children.

The simplest way is to just not die for a few more years. I think there is little chance there is anything other than a 0% estate tax by the time Trump leaves office.

[Metric Mouse]

All that will do is create a lot of work for trust attorneys and a lot of sales for life insurance companies and multiple-survivor annuity products.

If you managed to acquire any substantial sized estate, it would take a vanishingly small amount of time and imagination to figure out how to get around the tax...

Can someone explain to me how you can get around estate tax using a trust?  I thought the only benefit to a trust was avoiding probate unless you actually transfer ownership of the assets to your children.

The simplest way is to just not die for a few more years. I think there is little chance there is anything other than a 0% estate tax by the time Trump leaves office.

I'd take $50 on the other side of that. But I've been wrong on everything else Trump has accomplished, so the odds are at least fair.

[Neverstop]

Im surprised nobody has brought up fat people. What effect do they have on prices?

[sokoloff]

If I'm in a situation where my wife and I have $10MM+, the fact that money that I place in trust for my kids is no longer accessible to me is not a significant barrier to doing that, especially if the alternative is that it 100% goes to the government as a death tax.

Would I rather have it go 100% to my kids or 100% to the government? Not a hard question.

[nereo]

Im surprised nobody has brought up fat people. What effect do they have on prices?

There's a parallel thread to this one, but short answer: It has, but there's evidence that obese people actually use less total healthcare because on average they die decades earlier than non-obese, and they tend to have rapid declines before death instead of a decade+ of declining health as with otherwise fit 80 year olds.

[GuitarStv]

Im surprised nobody has brought up fat people. What effect do they have on prices?

There's a parallel thread to this one, but short answer: It has, but there's evidence that obese people actually use less total healthcare because on average they die decades earlier than non-obese, and they tend to have rapid declines before death instead of a decade+ of declining health as with otherwise fit 80 year olds.

Yep.  A good cure for out of control health care expenses appears to lie in convincing people to become obese and smoke.

[Abe]

That link is tenuous at best due to the heterogeneity of obese patient's health. Obesity defined as BMI >35 in itself is not a major health cost. What is expensive are the resultant diseases it predisposes one to: diabetes (major cost), heart disease, stroke, certain cancers, etc. Studies that show obese patients die earlier and thus may save somewhat on healthcare costs neglect the economic costs of people being on disability and/or unemployed at an earlier age.

[RangerOne]

There were a number of reasons for the Republicans to come out against the ACA early on. First and foremost it was an easy line of attack against Obama and Democrats in general:

Government Expansion (overreach check)
May force certain religious groups to provide insurance which pays for birth control (check)
Cost the government money for a social service for the poor (check)

Lastly it ended up costing people more money, generally because everyone was forced to pay for a better minimum level of insurance. That made the law prime pickings for attacking Democrats and rallying voters to come out against the law. I am certain they have won votes simply based on people feeling like they couldn't afford health insurance under the new law. Especially in states that didn't agree to expand medicare.

At this point they are cornered into acting against given the public outcry they have riled up. It is now probably a double edged sword because if they truly gut the program people in their own voting base will get hurt.

The ACA has some real issues and even in a fixed state their may be better options. But it does not "need" to be repealed. They stand to hurt and help people when they chose to start meddling with the law.

[sol]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

[pbkmaine]

Well, I think the birth control thing all comes down to controlling women. If you let them have birth control, they will all go out and screw anything that moves, because they are all evil seductresses.

[GuitarStv]

Well, I think the birth control thing all comes down to controlling women. If you let them have birth control, they will all go out and screw anything that moves, because they are all evil seductresses.

If it only took birth control to turn women into evil seductresses I suspect that teenage boys around the world would happily foot the bill and we could all stop arguing about this.

[nereo]

Well, I think the birth control thing all comes down to controlling women. If you let them have birth control, they will all go out and screw anything that moves, because they are all evil seductresses.

If it only took birth control to turn women into evil seductresses I suspect that teenage boys around the world would happily foot the bill and we could all stop arguing about this.

That's funny, I would have sworn there was an inverse relationship between the number of condoms a teenage boy carried on his person and how often he scored.
...if only I had known!

[okonumiyaki]

i find it kinda funny.
Obama helps get it into law, then trump will remove it then put something else just as bad in itself place.
Two people, 2 sides, 1 coin.

Anything that takes money from someone and gives it to another is morally wrong. Just that simple in my book.

So buying things at a supermarket is morally wrong?  After all, it takes money from you and give it to someone else.  Should everything be free?

[Unique User]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

I always equated along the lines of the pro-lifers that are for capital punishment or were for the war in Iraq. 

[GuitarStv]

i find it kinda funny.
Obama helps get it into law, then trump will remove it then put something else just as bad in itself place.
Two people, 2 sides, 1 coin.

Anything that takes money from someone and gives it to another is morally wrong. Just that simple in my book.

So buying things at a supermarket is morally wrong?  After all, it takes money from you and give it to someone else.  Should everything be free?

The libertarian argument is typically that paying for explicit services rendered (like buying things at a supermarket) is good, but paying for implicit services rendered (pollution control, police, firefighters, a national park system, a network of roads/highways, etc.) is bad.

[Just Joe]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

I always equated along the lines of the pro-lifers that are for capital punishment or were for the war in Iraq.

The many contradictions of the conservative party lines.

[nereo]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

I always equated along the lines of the pro-lifers that are for capital punishment or were for the war in Iraq.

The many contradictions of the conservative party lines.

This is the inherent problem when religion gets involved in the politics of a multi-cultural state.
Oddly enough, one lesson many never learned is that the entire concept of "separation of church and state" was driven by church not wanting the state to interfere with religion, not the other way around.  Now certain groups want to push "Christian Values" into law, not appreciating that it's a two-way street; when religion meddles in politics, politics meddles with religion.

[Metric Mouse]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

I assume they can be outraged at more than one thing at a time. The ACA one was thing where their imput was asked. I'm not certain that religious groups were consulted about the creation of torture facilities.

[nereo]

May force certain religious groups to provide insurance which pays for birth control (check)

This is a line of argument I have never understood.  These people claim they are morally offended that their taxes are being used to provide birth control, but not offended at anything else the government uses their taxes for?  Where was this same level of outrage over government torture?

I assume they can be outraged at more than one thing at a time. The ACA one was thing where their imput was asked. I'm not certain that religious groups were consulted about the creation of torture facilities.

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

[Metric Mouse]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

[former player]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

There is perfectly rational and consistent reasoning behind those abortion/death penalty views -

1.  There is a right to life.  Neither State nor other individuals may interfere with that right.
2.  The right to life necessarily includes the right to bodily integrity.  An individual controls what is done to their own body, and neither State nor other individuals may interfere with that bodily integrity.
3.  The State may imprison a person in order to maintain the rights of others, but should do so only to the extent necessary, and the death penalty is not necessary when imprisonment (including in rare cases imprisonment for the rest of a person's natural life) is available.
4.  The individual's control of their own body includes the right to control any medical or other procedures done to that body by others.
5.  A foetus which is within the body of another person is necessarily subject to the control that other person exercises over their own body, including any procedures which result in the foetus no longer living within that body.

Three further points -

6.  The death penalty is a hangover from the days when imprisonment was not a practical option because 1) cost and 2) inadequate facilities (in particular, until the nineteenth century the lack of sewage systems made keeping more than a handful of people in the same building for any length of time completely impractical).

7.  The regulation of people carrying out procedures on other people (ie doctors and clinics providing contraceptive and abortion services) should be limited to what is necessary for those services to be provided safely.  Regulation in much of the USA appears to go well beyond this standard.

8.  The State has a duty to prevent individuals from interfering with the right to life and bodily integrity of others.  It therefore has a duty to protect the provision of contraceptive and abortion services from individuals who would interfere with the provision of those services.

[69mach351]

Well, I think the birth control thing all comes down to controlling women. If you let them have birth control, they will all go out and screw anything that moves, because they are all evil seductresses.

I never really got the "controlling women" argument.  It is nothing more than who pays for the birth control, most of which can be had relatively cheap, with or without insurance and before/after the ACA.

I got a vasectomy last year and had to pay just over $600 out of pocket for it.  Is someone trying to control me because I had to pay for my birth control?  I would argue if any birth control should be covered, the vasectomy should be pretty high on the list.  A woman can only have one pregnancy at a time, but a guy can cause multiple at a time.  Joking aside, it is something to think about.



In the broader scheme of the thread, as far as the ACA goes, it needs to be repealed or drastically changed.  I help with our company insurance policy at work and even switching companies to lower priced, higher deductible plans (and even now on to partially self-insuring) the minimum that we have been able to keep the increases to over the last two years is 59%.  It simply is not sustainable.  Even half of it is not sustainable.  If you want to talk about something that could put a serious hurt on the economy if gone unchecked.

I am very close to the healthcare industry.  I personally think that everyone needs skin in the game for it to work.  It makes me sick to see someone that pays little to nothing for healthcare, be able to utilize services without a second thought, then have someone that waited until the last minute to go get a needed service, because it is going to cost them thousands.  I have watched someone go from the ER to the pharmacy, then back to the ER, because they did not want to pay a $3.20 copay on a $400+ medication - all of this while most people won't make it out of the ER for less than a few grand out of pocket. 

So in short, we created a system that subsidizes and creates bad habits, punishes people that have to pay for most of it, and it is quickly becoming less affordable than it was.  This is far from the only problem, but the ACA helped create it.  There are good portions of it too, but it requires an overhaul.  Currently, there are too many ways to work the system.  If we are going to keep privatized insurance and make it affordable, loopholes need to be closed.  I personally think it was designed to fail with the hopes of implementing a single payer system.

[radram]

It makes me sick ...

I see what you did there :)

[69mach351]

It makes me sick ...

I see what you did there :)

Ha!  Completely unintended, but nice catch.

[iris lily]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

Thank you Metric Mouse. You are a consistent voice of reason.

It is silly to not be able to understand, or pretend to not understand, the difference between an "innocent life" (terminology used by those who support pro-life choices) and adult lives lost in war when sometimes those adults made choices to end up in war.  Granted, there are plenty of "innocent" lives lost in war and that is a tragedy.

I tire of the broadbrush characterization of conservatives as anti abortion, anti birth control, anti sex.

The conservatives I know range from "don't care about abortion" to " abortion is wrong" with some in between who have changed ncern about it taking place too often and for frivolous reasons. But NONE of them wish to restrain birth control access. not a one. In fact, the opposite characterizes their opinions.

I am not a hypocrite in the eyes of poster above because I support both abortion AND capital punishment. But here's the thing--it doesnt concern me that poster above thinks I may  be a hypocrite. I dont care.  I am using a different decision grid than he is, and I come to those conclusions from a separate reasoning process.

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

[iris lily]

69mach, excellent point about skin in the game. That is essential.

[former player]

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

If women are buying health insurance (through work or otherwise), then they are "paying for their own birth control", just as much as they are paying for any other health services through insurance.  If your point is that men should not be required to pay for women's birth control, then you are missing half the problem.

Removing the question of money, the question is then: should insurers be required to cover health services providing birth control as they cover other health services.  Well, why not?  What is so special about birth control health that it should be excluded?  Even if your mother and grandmother haven't talked about the consequences of not having access to birth control, the health and social consequences of not having access to birth control are still, in the 21st century, being played out across the poorer parts of the world.  I wouldn't wish those consequences on any woman.

[Malloy]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

Thank you Metric Mouse. You are a consistent voice of reason.

It is silly to not be able to understand, or pretend to not understand, the difference between an "innocent life" (terminology used by those who support pro-life choices) and adult lives lost in war when sometimes those adults made choices to end up in war.  Granted, there are plenty of "innocent" lives lost in war and that is a tragedy.

I tire of the broadbrush characterization of conservatives as anti abortion, anti birth control, anti sex.

The conservatives I know range from "don't care about abortion" to " abortion is wrong" with some in between about it taking place too often and for frivolous reasons. But NONE of them wish to restrain birth control access. not a one. In fact, the opposite characterizes their opinions.

I am not a hypocrite in the eyes of poster above because I support both abortion AND capital punishment. But here's the thing--it doesnt concern me that poster above thinks I may  be a hypocrite. I dont care.  I am using a different decision grid than he is, and I come to those conclusions from a separate reasoning process.

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

The bolded is incorrect.  The list of no cost drugs as set forth in the PPACA does include a long list of birth control.  However, it also includes pre-natal vitamins, aspirin for the elderly, vitamin D supplements for the elderly, and certain medicines and supplements for children.  Why haven't I seen anyone sputter about the indignities of being forced to subsidize aspirin for grandma (WHY DIDN'T GRANDMA MAKE BETTER LIFE CHOICES?!?!?!)? Why do basement-dwelling dudes on the internet always bring up the indignity of having to pay for insurance that covers pregnancy when they don't get pregnant but never seem to bring up the fact that insured women also pay for insurance that covers prostate cancer that they will never use? If the examples that make people angry always come back to women's reproduction, maybe it's because people have issues with it that they don't want to face.

Birth control is medicine.  It is used by the vast majority of parents of reproductive age.  It is used by the vast majority of women of reproductive age.  It is used by people who are not sexually active.  The percentage of American women who use medical or barrier contraceptives for any reason over the course of their lifetime is over 90%.  Thus, because birth control is one of the most common medicines used by women, has numerous medical benefits, and has positive outcomes for society in general, I see no reason that it would not have special status as a no cost share prescription.  It is not the only medicine that has been given such status.

https://www-static.bouldercolorado.gov/docs/No_Cost_Preventative_Medication_List-1-201609081026.pdf

[iris lily]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

Thank you Metric Mouse. You are a consistent voice of reason.

It is silly to not be able to understand, or pretend to not understand, the difference between an "innocent life" (terminology used by those who support pro-life choices) and adult lives lost in war when sometimes those adults made choices to end up in war.  Granted, there are plenty of "innocent" lives lost in war and that is a tragedy.

I tire of the broadbrush characterization of conservatives as anti abortion, anti birth control, anti sex.

The conservatives I know range from "don't care about abortion" to " abortion is wrong" with some in between about it taking place too often and for frivolous reasons. But NONE of them wish to restrain birth control access. not a one. In fact, the opposite characterizes their opinions.

I am not a hypocrite in the eyes of poster above because I support both abortion AND capital punishment. But here's the thing--it doesnt concern me that poster above thinks I may  be a hypocrite. I dont care.  I am using a different decision grid than he is, and I come to those conclusions from a separate reasoning process.

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

The bolded is incorrect.  The list of no cost drugs as set forth in the PPACA does include a long list of birth control.  However, it also includes pre-natal vitamins, aspirin for the elderly, vitamin D supplements for the elderly, and certain medicines and supplements for children.  Why haven't I seen anyone sputter about the indignities of being forced to subsidize aspirin for grandma (WHY DIDN'T GRANDMA MAKE BETTER LIFE CHOICES?!?!?!)? Why do basement-dwelling dudes on the internet always bring up the indignity of having to pay for insurance that covers pregnancy when they don't get pregnant but never seem to bring up the fact that insured women also pay for insurance that covers prostate cancer that they will never use? If the examples that make people angry always come back to women's reproduction, maybe it's because people have issues with it that they don't want to face.

Birth control is medicine.  It is used by the vast majority of parents of reproductive age.  It is used by the vast majority of women of reproductive age.  It is used by people who are not sexually active.  The percentage of American women who use medical or barrier contraceptives for any reason over the course of their lifetime is over 90%.  Thus, because birth control is one of the most common medicines used by women, has numerous medical benefits, and has positive outcomes for society in general, I see no reason that it would not have special status as a no cost share prescription.  It is not the only medicine that has been given such status.

https://www-static.bouldercolorado.gov/docs/No_Cost_Preventative_Medication_List-1-201609081026.pdf

I havent seen the list of special drugs singled out for apecial treatment. That doesnt change my question, why some and not others are free? It is ALL pandering,,  but some off the choices at least seem to address groups of people who may reside in poverty (elderly and children.) and the fact that the ACA requires a free annual exam once a year is yet another pandering action. While it partially addresses preventitive care, it also sets up everyone to belly up to the freebie table.

Now I am curious to see the complete list of drugs that must be furnished for free to be ACA compliant, so I am off to Google that. I can see, theoretically, an insurance company deciding to pay all or a large part of the cost of birth control because it might (theoretically) save them money over costs of pregnancy and delivery. But that would be a capitalistic cost-benefit decision entirely within their purview for furnishing a product, insurance.

[Malloy]

I first interpreted your statement about torture facilities to be about abortion clinics.  I'm sure to some extremists on the anti-abortion spectrum that's what they are.

Regardless, I think the broader point is that the self described 'compassionate/religious conservatives' wish to ban all abortions and limit contraceptives and sex-ed courses, while being very pro-military and extremely hawkish in our international dealings. They are among the loudest voices for constricting immigration.
To those of us that do not share their views, it seems very hypocritical to claim to be "pro-life" yet also advocate for killing more people and blocking others. It comes off as caring more about embryos than non-citizen human adults.

Sorry for any confusion. My comment was not related to women's clinics.

I see both sides of the issue. I know that many would view someone who would allow a baby to be killed but argue that a murderer should be spared the death penalty to be hypocritical. It's a fine line, no doubt.

Thank you Metric Mouse. You are a consistent voice of reason.

It is silly to not be able to understand, or pretend to not understand, the difference between an "innocent life" (terminology used by those who support pro-life choices) and adult lives lost in war when sometimes those adults made choices to end up in war.  Granted, there are plenty of "innocent" lives lost in war and that is a tragedy.

I tire of the broadbrush characterization of conservatives as anti abortion, anti birth control, anti sex.

The conservatives I know range from "don't care about abortion" to " abortion is wrong" with some in between about it taking place too often and for frivolous reasons. But NONE of them wish to restrain birth control access. not a one. In fact, the opposite characterizes their opinions.

I am not a hypocrite in the eyes of poster above because I support both abortion AND capital punishment. But here's the thing--it doesnt concern me that poster above thinks I may  be a hypocrite. I dont care.  I am using a different decision grid than he is, and I come to those conclusions from a separate reasoning process.

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

The bolded is incorrect.  The list of no cost drugs as set forth in the PPACA does include a long list of birth control.  However, it also includes pre-natal vitamins, aspirin for the elderly, vitamin D supplements for the elderly, and certain medicines and supplements for children.  Why haven't I seen anyone sputter about the indignities of being forced to subsidize aspirin for grandma (WHY DIDN'T GRANDMA MAKE BETTER LIFE CHOICES?!?!?!)? Why do basement-dwelling dudes on the internet always bring up the indignity of having to pay for insurance that covers pregnancy when they don't get pregnant but never seem to bring up the fact that insured women also pay for insurance that covers prostate cancer that they will never use? If the examples that make people angry always come back to women's reproduction, maybe it's because people have issues with it that they don't want to face.

Birth control is medicine.  It is used by the vast majority of parents of reproductive age.  It is used by the vast majority of women of reproductive age.  It is used by people who are not sexually active.  The percentage of American women who use medical or barrier contraceptives for any reason over the course of their lifetime is over 90%.  Thus, because birth control is one of the most common medicines used by women, has numerous medical benefits, and has positive outcomes for society in general, I see no reason that it would not have special status as a no cost share prescription.  It is not the only medicine that has been given such status.

https://www-static.bouldercolorado.gov/docs/No_Cost_Preventative_Medication_List-1-201609081026.pdf

I havent seen the list of special drugs singled out for apecial treatment. That doesnt change my question, why some and not others are free? It is ALL pandering,,  but some off the choices at least seem to address groups of people who may reside in poverty (elderly and children.) and the fact that the ACA requires a free annual exam once a year is yet another pandering action. While it partially addresses preventitive care, it also sets up everyone to belly up to the freebie table.

Now I am curious to see the complete list of drugs that must be furnished for free to be ACA compliant, so I am off to Google that. I can see, theoretically, an insurance company deciding to pay all or a large part of the cost of birth control because it might (theoretically) save them money over costs of pregnancy and delivery. But that would be a capitalistic cost-benefit decision entirely within their purview for furnishing a product, insurance.

Yes, and if children are residing in poverty, the women raising them are likely also residing in poverty and would benefit from effective birth control to prevent adding additional children to the mix.  However, what  you call pandering I call providing incentives.  No co pay annual exams incentivize people to check in with their doctor once a year.  The high deductibles of many plans out there provide the skin in the game.  You can go to the doctor for free, but you can't go hog wild with additional treatments without an additional 4 figures of your own money.  But if the additional treatments are, say, chemo, you'll find the money.  If the additional treatments are, say, surgery to address your knee pain, you might rethink it and try losing weight or changing your exercise regimen.  It's not a perfect system, but it does provide some real improvements over the pre ACA landscape.

As for why most plans didn't incentivize birth control per ACA, I suspect the issue was more a narrow band of approved types rather than it being available at all.  For example, the IUD is the gold standard of birth control, but was typically only available with an $800 co pay prior to the ACA. I bet an actuary would tell me that this is because the benefit of the IUD stretches out over time (5-10 years), requires additional doctor visits for insertion, and due to plan switching, an individual provider would statistically only capture a portion of the benefit.  Therefore, it was a better cost benefit to a provider to offer only monthly birth control.  One the best, best things about the ACA is the wider availability of long acting reversible contraceptives like the IUD.  I think we are only beginning to see the huge societal benefits of more women having IUDs in place.  Fewer unplanned pregnancies (fewer abortions!) and the resultant improved economic outcomes.  I really hope that the republicans don't halt this progress, because it has the potential to change lives.

[iris lily]

...Yes, and if children are residing in poverty, the women raising them are likely also residing in poverty and would benefit from effective birth control to prevent adding additional children to the mix. ..

Mega dittos. Of course!

And your analysis anout cost of iUD is i teresting, but who k owa inthe Byzintine world of insurance charges of medical costs that are cloaked in darkness and mystery.

[NoStacheOhio]

I havent seen the list of special drugs singled out for apecial treatment. That doesnt change my question, why some and not others are free? It is ALL pandering,,  but some off the choices at least seem to address groups of people who may reside in poverty (elderly and children.) and the fact that the ACA requires a free annual exam once a year is yet another pandering action. While it partially addresses preventitive care, it also sets up everyone to belly up to the freebie table.

For the same reason we have (had?) rules about clean water. It's a public health concern.

[69mach351]

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

If women are buying health insurance (through work or otherwise), then they are "paying for their own birth control", just as much as they are paying for any other health services through insurance.  If your point is that men should not be required to pay for women's birth control, then you are missing half the problem.

Removing the question of money, the question is then: should insurers be required to cover health services providing birth control as they cover other health services.  Well, why not?  What is so special about birth control health that it should be excluded?  Even if your mother and grandmother haven't talked about the consequences of not having access to birth control, the health and social consequences of not having access to birth control are still, in the 21st century, being played out across the poorer parts of the world.  I wouldn't wish those consequences on any woman.

My point was that it isn't controlling women.  It merely puts the responsibility of obtaining a medication that most of the time can be obtained relatively cheap or free, back on the person using it.  No different than any other drug that are as, or more vital to anyone else, except there were/are more outlets to receiving it.    Nobody is saying exclude it - but I am not saying that it should receive special status and be completely covered.  Again, skin in the game.  That is also why I brought up the vasectomy, which most men have to pay for on their own - is the government controlling men by not paying for their birth control?

[Malloy]

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

If women are buying health insurance (through work or otherwise), then they are "paying for their own birth control", just as much as they are paying for any other health services through insurance.  If your point is that men should not be required to pay for women's birth control, then you are missing half the problem.

Removing the question of money, the question is then: should insurers be required to cover health services providing birth control as they cover other health services.  Well, why not?  What is so special about birth control health that it should be excluded?  Even if your mother and grandmother haven't talked about the consequences of not having access to birth control, the health and social consequences of not having access to birth control are still, in the 21st century, being played out across the poorer parts of the world.  I wouldn't wish those consequences on any woman.

My point was that it isn't controlling women.  It merely puts the responsibility of obtaining a medication that most of the time can be obtained relatively cheap or free, back on the person using it.  No different than any other drug that are as, or more vital to anyone else, except there were/are more outlets to receiving it.    Nobody is saying exclude it - but I am not saying that it should receive special status and be completely covered. Again, skin in the game.  That is also why I brought up the vasectomy, which most men have to pay for on their own - is the government controlling men by not paying for their birth control?

I get that you are arguing that you just want birth control to go back to regular drug status and not special free status.  However, I am asking you to consider why it is that birth control is the thing that bothers you instead of, say, the many, many other drugs that are also free per the ACA.  Why did the debate turn on birth control and not folic acid supplements?  These drugs all fall under the category of preventative treatments (aspirin for preventing heart attacks, folic acid for pregnant women, vitamin supplements for kids, vitamin supplements to prevent falls in the elderly).

For the record, I am all for vasectomies being covered 100%. Hell, I am for covering them 200% and paying people to get them.  Do you want a start a PAC with me and lobby for this? 

[radram]

For the record, I am all for vasectomies being covered 100%. Hell, I am for covering them 200% and paying people to get them.  Do you want a start a PAC with me and lobby for this?

Would they be voluntary? :)

[69mach351]

I also do not buy the "controlling women's bodies" idea, and I think that is a lazy argument. Why are women unable to  pay for their own birth control?  Nanny gubmnt dictates it be available at no cost in insurance coverage. Why this drug and not others? I'll tell you why: this is paternalistic pandering to the monolithic American Woman by the federal government to get votes. There are plenty of women who make enough money to pay for birth control they use, and for the birth control used by their daughters. Of course, poor women who cannot afford birth control or any other drug need subsidies. That is not part of this scenario.

If women are buying health insurance (through work or otherwise), then they are "paying for their own birth control", just as much as they are paying for any other health services through insurance.  If your point is that men should not be required to pay for women's birth control, then you are missing half the problem.

Removing the question of money, the question is then: should insurers be required to cover health services providing birth control as they cover other health services.  Well, why not?  What is so special about birth control health that it should be excluded?  Even if your mother and grandmother haven't talked about the consequences of not having access to birth control, the health and social consequences of not having access to birth control are still, in the 21st century, being played out across the poorer parts of the world.  I wouldn't wish those consequences on any woman.

My point was that it isn't controlling women.  It merely puts the responsibility of obtaining a medication that most of the time can be obtained relatively cheap or free, back on the person using it.  No different than any other drug that are as, or more vital to anyone else, except there were/are more outlets to receiving it.    Nobody is saying exclude it - but I am not saying that it should receive special status and be completely covered. Again, skin in the game.  That is also why I brought up the vasectomy, which most men have to pay for on their own - is the government controlling men by not paying for their birth control?

I get that you are arguing that you just want birth control to go back to regular drug status and not special free status.  However, I am asking you to consider why it is that birth control is the thing that bothers you instead of, say, the many, many other drugs that are also free per the ACA.  Why did the debate turn on birth control and not folic acid supplements?  These drugs all fall under the category of preventative treatments (aspirin for preventing heart attacks, folic acid for pregnant women, vitamin supplements for kids, vitamin supplements to prevent falls in the elderly).

For the record, I am all for vasectomies being covered 100%. Hell, I am for covering them 200% and paying people to get them.  Do you want a start a PAC with me and lobby for this?

To your first point, I only chose birth control because people (as in my first post) say it is controlling women.  I do not agree with that point of it.  Also, I am against getting almost anything for "free."  Free is not free (someone is paying for it), but it can, and a lot of time does, diminish the value.  Not to open a new subject, but that is why I am against "free" college.  I think that overall, people need skin in the game to value something, and use it as intended or to its potential.  I just think there are better ways to solve problems.

I like your idea on vasectomies.  To me, vasectomies make more sense than anything.  In a committed relationship, it ends the on going cost(s) associated with birth control.  It is just as, if not more effective.  In non-committed relationships, it could keep multiple women from getting pregnant.  Not to mention the reason I went in for it - because birth control (pills, iud's, etc.) can create a lot of problems for women, especially as they get older.  I have seen too many women have issues to ask my wife to keep taking birth control, especially if we do not want any more kids.

[Malloy]

IUDs are similar in outcome to vasectomies in terms of effectiveness, are cheaper, and are reversible.  They are basically nearly perfect birth control.   But covering vasectomies 100% could be a fairly minor tweak to the ACA that I'm completely in favor of.

Another interesting point is that there is compelling evidence that birth control use has expanded following implementation of the ACA. So, women value it sufficiently under the ACA that they use it in greater numbers.  And I agree that it isn't free.  It's subsidized under existing premium payments.  I'm ok with that. I think helping women have a planned and desired number of children one of the best things we can do for society, for men, women, and children, and I'm delighted that my tax dollars go to help pay for it.  I'd love to divert some more money to it. 

[sokoloff]

I think helping women have a planned and desired number of children one of the best things we can do for society, for men, women, and children, and I'm delighted that my tax dollars go to help pay for it.  I'd love to divert some more money to it.

Well said and completely agree!

[Metric Mouse]

For the record, I am all for vasectomies being covered 100%. Hell, I am for covering them 200% and paying people to get them.  Do you want a start a PAC with me and lobby for this?

Would they be voluntary? :)

At that price, I'd take two!

[radram]

For the record, I am all for vasectomies being covered 100%. Hell, I am for covering them 200% and paying people to get them.  Do you want a start a PAC with me and lobby for this?

Would they be voluntary? :)

At that price, I'd take two!

"You have no idea the physical toll that 3 vasectomies has on a person" - Michael Scott
https://www.youtube.com/watch?v=uJGw6wCmTcY