Hoo Boy… You're really dancing aren't you?
FIRST – Obamacare, Romneycare, ACA call it what you will - my point was: I don’t care. But on that point – just exactly how is “Romneycare” working for Massachusetts on the financial side? If we’re going to use THAT program as a model, let’s honestly evaluate how it’s doing in the Real World before leaping to the conclusion that Sliced Bread can move to the side. I’ve heard reports (but have not personally confirmed) that Massachusetts health care costs are rising significantly with no tangible improvement in actual care being provided. But there *are* significant changes in Who Pays and How Much… Here’s a link I am still trying to digest on this topic – but IMHO it should be taken with a grain of salt since it is a government report on how THEY think THEY are doing… I’d like a truly non-partisan review of the raw data. I'm sure its out there, but I'm trying to weed through the chaff myself.
SECOND – Yes, the EMTALA is troubling. My understanding of the act itself mandates access to services but doesn’t directly address how to *pay* for those services, e.g., "paving the road to Hell", etc. And before you accuse me of callousness (you came close, but dodged at the last second: thanks), yes: I’m worried about Joe too. Lots of scenarios out there, and you mentioned only one; some get really nasty on both sides.
Regardless, I don’t think Joe should be able to walk away from his (assumed) financial obligations. You neatly dodge the issue of whether or not Joe wanted care or not. His decision might be affected by WHO is going to pay for it, or other reasons. If Joe knows he *will* be held accountable, he *may* (if able) want to think about exactly what he is getting into. *THAT* is the biggest problem with EMTALA... Joe makes decisions (doesn’t get insurance for whatever reason), but then is absolved by Uncle Sugar from suffering consequences of that decision. What to do?
I’m not sure I like the easy solution (proposed by some) of a return of indentured servitude. Once that particular door is opened - especially as the designated beneficiary is the State! – it has entirely too much potential for abuse on multiple levels. *sigh* There is no easy or ‘fair’ answer. Good Heavens… how did our founding fathers manage to survive all those years without a Big Brother looking after them?
Also - I don’t remember exactly how the Federal government is actually “charged with regulating the insurance industry”, as you put it. My experience, limited as it may be, shows that authority has been assigned to the States: hence, the existence of Insurance Commissioners (some elected, some appointed) and their duly assigned powers, legal requirements, and responsibilities which are applied on a state-by-state basis. I’d rather see this power grab be honestly presented to the public by Washington bureaucrats, with the state bureaucracies being bluntly told, “you guys are out of here; we’re taking over.” This would have a beneficial effect of reducing state budgets (by cutting back on staff, salaries, etc.), to say nothing of having fireworks between the states and federal bureaucracies for its entertainment value alone. (If it’s working, don’t mess with it, and if it ain’t working, get rid of it… you can’t have it both ways...)
THIRD – Yes, the Individual Mandate is the key problem. I deeply resent being informed by others exactly what actions are deemed to be ‘in my best interest’ and then threatened with legal force (deadly force?) to make certain *I* comply with *THEIR* demands should I choose to disagree.
I do not, and have NO intention of, assigning *any* level of authority over *MY* continued existence to an unaccountable bureaucrat (of any stripe).
The point is quite simple… If you wish to be self-reliant, you should be allowed to follow your conscience. If you wish to reject your personal responsibility in favor of largess to be provided others, that’s your choice - but in that case, you should have NO CHOICE in defining the rules, conditions, and end-user benefits of such largess (tail wagging the dog, bread and circuses, etc.). Worse, attempting to force both ends of that spectrum into the same pool is WRONG. Let's be honest for a moment - the ACA doesn't address the 'equalization' of WHO PAYS, only WHO GETS (because more of them do the voting).
Funny thing about that.. have you noticed that those self-reliant folks are typically more than capable of not only supporting the needs of themselves, but also voluntarily helping others? And the other group typically just has an abundance of *claims* upon the resources and efforts of others, to be acquired for THEIR personal and direct benefit, and have little else they are willing to contribute to the collective as a whole.. Does the ACA assist in the creation of a (so-called) "moocher-class"? Hmmm...
FOURTH – You bring up the obvious point: the wide-open funnel of (taxpayer) money to private industry. That concept is wrong here and in other areas. I *DO NOT* like the idea of government bureaucrats being given the power to pick-and-choose which companies win or lose. Compete for your customers. Don't try to rig the game by forcing participation.
Glad I was able to elevate your blood pressure: you can skip the next round of aerobics, I guess.