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What's in it? (Score:5, Insightful)
I'm not from the US, but isn't that the main bit of you guys' healthcare system that's most in need of fixing?
In my country, pre-existing conditions just mean that you can't claim anything for 12 months after joining. It doesn't affect premiums or anything, and no health insurance provider can reject your application.
So, I guess, welcome to the 20th century!
Re:What's in it? (Score:5, Informative)
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Re:What's in it? (Score:5, Insightful)
Actually, the health insurance exchanges are very similar to the federal health plans. All federal employees are given a choice of option and able to pick what benefits they consider most affordable. Everyone in federal government gets these options.
In addition, the government, being so large, has been able to negotiate terms like bans on "pre-existing conditions" out of many of the contracts, for the benefit of all federal employees.
So, basically, this health insurance bill gives we, the people, the same health insurance options they have. That all federal employees have. And it gives us their protections, and potentially a public option in states where the local monopoly or duopoly has control of the market.
How horrible.
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Re:What's in it? (Score:5, Insightful)
Since government care is so damn wonderful, why is there a need for private car in the UK?
Nobody is saying that the NHS is perfect, or even wonderful. However, it is a good baseline for people that need it in an emergency or can't afford better. If you want more than that, you have the option to pay someone else to provide it. It's as simple as that.
And second, why did the college girl let herself be denied access to a PAP smear when the UK Health service said no? Why didn't she go get a PAP smear from the private option?
I don't know, I'm not responsible for her decisions and I don't know her personally. Maybe she couldn't pull together the £60 it would cost her to get one, or maybe she was incredibly stupid. So many possibilities.
Overall it sounds like the UK's not the promised paradise either.
That's because you'll infer your preferred conclusion from any data, even if it doesn't make sense. "Didn't think to go to a private hospital? That's the government's fault! I knew it wasn't a perfect system, even though nobody claimed it was!"
I'm pretty much done with arguing with you, because it's patently clear from your last few comments that you have no idea what you're arguing against and you have no willingness to find out. I could speculate as to why you're so invested in the current system, but as the answers range from somewhere between being paid to advocate for the insurance companies right the way down to the possibility that you'd rather other people die than you have to pay for health insurance, I don't really want to know the answer.
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Re:What's in it? (Score:5, Insightful)
Isn't that what U.S citizen do to Canada now? and wasn't America built on immigrant labor?
Seems to me insurance company profits would be better spent on just providing health care.
What happened to the nice America that looked after all her children?
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Re:Banning illegal aliens is shortsighted (Score:5, Insightful)
WRONG!!
Very few illegal immigrants are paid cash under the table. Most are paid in the same fashion as legal employees, and have taxes and social security withheld.
In fact, illegal immigrants are a net contributor to the social security fund, as many use fake social security numbers for which they will never be able to collect benefits:
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Re:What's in it? (Score:5, Informative)
Come again?
Preexisting conditions mean exactly the opposite of that - It means you did have the condition diagnosed before getting your current run of uninterrupted insurance coverage. The original idea behind such clauses actually had some merit - You couldn't skip out on having insurance, find out you have cancer, then get insurance solely to pay for your treatment.
Of course, the insurance companies, interested solely in profit rather than patient outcomes (hey, I hate them as much as anyone, but won't fault them (just) for doing exactly what they exist to do - Make money), discovered they could use this not just for acute conditions, but to deny treatment for things like diabetes or the standard cardiac cocktails most older males take, based on nothing more than the fact that you went one day too long without coverage between jobs.
But if no doctor ever diagnosed your condition, consider yourself good to go. Now, we do have some grey area here... If you had an X-Ray for a broken arm ten years ago, and it has a fuzzy patch near your current tumor, well, the insurance companies have whole teams of people looking for just such meaningless data as an excuse to deny benefits.
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Re:What's in it? (Score:5, Informative)
I thought it was interesting that Associated Press published an article recently [ap.org] on the profits of the health insurance industry, something railed against persistently by various politicians. They found that the usual average profit margin for health insurance companies was 6%, and last year it was only 2%. From 2003 to 2008, the growth in their costs exceeded the growth in their profits.
But then, as the article itself notes, no one seems interested in the actual facts of the debate.
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Re:What's in it? (Score:5, Insightful)
The problem with that is that in the US system, if you're unemployed, unless you're also independently wealthy, you almost certainly will not be able to afford to maintain your insurance premiums. Self insurance is insanely expensive, most employed people wouldn't be able to cover it.
This means that if John Smith is covered by his parents till hi finishes college, gets a job works hard and pays his premiums for 20 years, and then gets cancer and can't work(and therefor can't continue to make his insurance payments) he's screwed. If he passes that time limit and they're allowed to call it a pre-existing condition no HMO will cover him.
It's one thing to say you can't get in a car accident and then get insurance to cover it, that's perfectly fair. It's another to say that because you lost your job, or your husband or wife lost their job through no fault of their own that you're not going to be covered even if you paid premiums your whole life.
There are some pretty easy ways to solve patients rorting the system anyway. You can either make coverage mandatory and pay for it with taxes(which is what we do for our public health insurance here in Australia) or you can put a waiting period for hospital cover(which is what we do on our private insurance).
The US pays an absolutely extraordinary amount for health insurance, far more per capita than pretty much any other nation in the world. Which is pretty damned impressive when you consider how many people in the country are uninsured. If you took all that money that everyone is paying, and pumped it into a public system, like the one which pretty much every western nation in the world other than the US has and runs reasonably successfully, you could have a top notch system with great coverage for everyone without anyone paying one dime extra. You could probably distribute the costs better and get some better efficiency and offer a great system and cut the expenditures it costs an awful lot to run an HMO after all, not even counting profits.
That won't happen of course since the US is so desperately afraid of actually letting their government do anything actually productive with their tax dollars like actually offering halfway decent public services and would much rather pay for guns or bailing out wall street millionaires, but at the least this new system might not screw over people who just have bad luck.
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Re:What's in it? (Score:5, Informative)
On what basis are you concluding that? A quick look suggests that a good estimate of the poor (by official poverty line) in the US is 39 million, while the illegal immigrant population may be something around 11 million. That says that at the most about a quarter of the poor are illegal immigrants, and that's assuming that all illegal immigrants are poor (which isn't strictly true, though I don't know how far off it is). In any case, the bill bars illegal immigrants [factcheck.org] from getting aid in buying health insurance, although it remains to be seen how that would be enforced.
While the situation with malpractice suits may be unreasonable, it's probably not a major contributor to health care costs [factcheck.org]. It sounds plausible on the surface that it would be, but apparently the total expenditure on malpractice insurance is less than $7 billion per year, which is totally dwarfed by total healthcare spending (something like $2.5 trillion). The cost of doctors practicing defensive medicine is, of course, harder to pin down, but it sounds like most studies still peg it as small. In any case, the CBO is estimating the savings on healthcare spending from malpractice award caps at 0.5%. I think this gets talked about a lot by politicians because it sounds plausible, there are some legitimate problems with malpractice suits, and, most importantly, people making malpractice claims are a convenient scapegoat since most of us won't ever be one or probably even know one.
In terms of the other costs I agree, though. We pay an absurd amount for drugs and a lot more for medical procedures than most other developed democracies. I'm not certain of all of the reasons for that, but the most likely major reason is that in most of those places the government collectively bargins with providers on behalf of all citizens, setting prices for drugs and medical procedures (even in many countries where insurance is still provided by private companies, like Japan and Germany). You can certainly debate the merits of such a system, but its one indisputable advantage is cheap prices.
I don't know what the will was among the Democrats to change the rules on drug purchasing by the government, but I'm sure that even those who supported it would not have lobbied for inclusion in this bill only because this bill had uncertain prospects in the first place, so adding something else potentially controversial probably would have killed it. It's bad strategy. If they want to make that change, it should come in a different bill.
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Re:What's in it? (Score:5, Interesting)
I once tried to switch to a less expensive plan, but Blue Cross Blue Shield of Arizona would not let me switch. I have never had any significant health problems, other than being somewhat overweight and having very slight high blood pressure. It was only during the last year, that I finally needed to start taking a mild diuretic to lower my slightly high blood pressure. I am a non-smoker in good health who walks 45 minutes per day, wears my seatbelt, and does not eat junk food. Despite that, I need to pay 1/3 of my net take home income (after taxes) on Medical insurance. How much would I have to pay if I had more significant health problems?
I would like to see more willingness for Congress to ignore the lobbyists, and work on the causes of it being so expensive such as tort reform, big pharma, and the insurance industry.
Is this bill going to make my insurance less expensive, or perhaps subsidise my insurance?
Our government is already spending way more than it collects for taxes, so is this something which our country can afford without having to inflate our money supply more or borrow even money from China and elsewhere? I seem to recall Nancy Pelosi claiming that they had found some way to pay for it all. I have not really been following the news closely enough to know about those details.
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Re:It's Not About Health, It's About Control (Score:5, Insightful)
Once the government is paying for your health care, they can pretty much mandate what you eat, what you smoke, what you drink, how long you live, etc. Hey, the repercussions of "bad" behavior are on their nickel, right?
Funny you mention that. We have universal health care up here in Canada, and last time I checked, we can still buy cigarettes and unhealthy food, we can buy alcohol at a younger age than you can, and anything that is controlled as illegal (e.g. marijuana) is only illegal because of pressure the freedom-loving Americans.
- RG>
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I think I can I think I can (Score:5, Insightful)
Re:I think I can I think I can (Score:5, Insightful)
Doesn't sound like they will.
So this new bill leaves 4% uncovered - that's 4% of nearly 300 million people!
Whereas the healthcare systems of all other civilised nations leave no-one uncovered. Not even the tramps in the street.
NB UK NHS user here - Our system has its faults, but at least one of those isn't "Sorry, we can't give you that treatment because you can't afford it...so just hurry up and die."
-Nano.
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Re:I think I can I think I can (Score:5, Insightful)
B) You probably don't understand that a healthy person will contribute more to society than an unhealthy one. In my country, there is some abuse of the medical system, but we are ok to have it. Because we all understand, that that is what it takes to have a population that is not afraid to go to a doctor at an early stage of an illness(to have the illness shortened). Out of that, there are more healthy people that contribute more and longer in form of taxes and other common wealth.
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Re:I think I can I think I can (Score:5, Insightful)
When I hear comments about how it's not right that the government provides 'free' things I sometimes wonder what people are smoking. Look, health care is a necessity and because we have such an insanely high gini coefficient [wikipedia.org], without either employer or government help most households could simply not afford it. And yes people do DIE when they lack proper health care, its not just a matter of going to the ER. They will stabilize you but not provide long term treatment. Good luck getting chemotherapy if you don't have insurance.
It's easy to go about limited government if you are in the top 25% in terms of income in the population. But median family income is $50,000. That is not a lot. How is a household in the 35% percentile earning $33,000 supposed to fork out $13,400 a year? [nchc.org] And that figure is assuming that they get the same discount that a large business gets which for an individual is not going to happen.
Why don't the limited government crazies say the same thing about medicare? After all why should the government provide free services? The most f**ked up thing about it all is that those without insurance are expected to pay taxes (medicare tax) to provide other people with the very thing they lack.
And for those who love to go on about what the government should or should not do get this: Why do we spend over 4% of our GDP on defense and spend insane sums in Afghanistan and Iraq... ans: supposedly to protect our country. Now what does it mean to 'protect'. It means to prevent death and destruction. Well what is the point of spending $651.2 billion [wikipedia.org] to maybe prevent an attack when way more people are suffering and dieing because of lack of adequate health care?????
The whole issue is insane. The free market simply does not work in health care. And I am some one who is pro free market. But at some point you have wake up and smell the coffee.
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Re:I think I can I think I can (Score:5, Insightful)
I hear this theory a lot - that despite the fact that no other country in the world has figured out how to use the free market to provide health care for all - somehow we could, if only the government was not in the way. OK well how about this? Let's follow you deregulatory path for 20 years as an experiment and if we have significant numbers of Americans without adequate health care then you admit it was a failure and it's immediately back to some government based system for everyone. How about that?
By the way if you are earning $8 how are you going to afford health care without government help under any system?
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Re:I think I can I think I can (Score:5, Insightful)
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Re:I think I can I think I can (Score:5, Informative)
Health care in this country is about the best in the world.
That is a lie.
"The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland."
"Yet another study, cited in a recent report by the Robert Wood Johnson Foundation and the Urban Institute, looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. What Senator Shelby called “the best health care system” ranked in last place."
It's early, I'm lazy, but the facts match up. http://www.nytimes.com/2009/11/05/opinion/05kristof.html?em [nytimes.com]
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We rank 37th in infant mortality (Correction...) (Score:5, Interesting)
We rank 37th in infant mortality
The US ranks 37th in *reported* infant mortality. The main difference is what is considered a live birth vs. still birth. Most countries don't count it as an infant death if the baby dies within 24 hours of birth, and in countries with less capable neonatal intensive care that happens a lot. Premies simply die and don't get counted, except in the US.
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Re:37th because... (Score:5, Insightful)
Is that why American women are 11 times more likely to die in childbirth than a woman in Ireland? Too much giving birth while driving?
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Bill Itself: 220-215 (Score:4, Insightful)
Pushed just far enough (Score:5, Insightful)
The close vote is intentional. The leaders realize that this is a once in a generation opportunity to reform healthcare, so they're going to push that reform as far as they can. They could propose some really minor changes that everybody agrees with. They could propose some really radical changes that almost nobody agrees with. Or they could push the biggest change they could get without failing.
As for the party split, the Constitution does not entitle all political parties to equal happiness. In a time when reality has a liberal bias, the wishes of the electorate are reflected in the composition of the legislative bodies. Aside from their role in achieving a majority of votes in Congress, the Republicans are no more entitled to appeasement than are the Greens, Libertarians, or Communists.
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Re:Bill Itself: 220-215 (Score:5, Insightful)
And why should your ability to produce enough for society be measured by how much money you have?
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Re:Bill Itself: 220-215 (Score:5, Insightful)
Because that's how society works.
Are you one of the investment bankers who caused stockmarkets to crash, housing costs to soar and then crash and burn leaving people homeless and cause huge ripple effects in the world wide economic markets leading to millions and millions of people losing their jobs, money and homes?
Congratulations, you have had such an impact on society, that you will be rewarded with insane bonuses. You are worth saving.
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Re:Bill Itself: 220-215 (Score:5, Insightful)
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Re:Bill Itself: 220-215 (Score:5, Insightful)
Why should someone who is sick, and hence can't produce anything for society not be allowed to get good quality health care that will lead to them being a productive member of society?
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Re:Bill Itself: 220-215 (Score:5, Insightful)
The logic here in the UK is that
a) You might be able to pay for it, but not when you are sick
b) People contribute to society in other ways than materially
c) Desperate people may be driven to commit crimes "I stole it to pay for my sick other/child's operation"
d) The disease might spread to _ME_
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Re:Those aren't the same (Score:5, Insightful)
Spot on! Consider garbage collectors; no other profession has had a larger impact on the health of society as a whole. Without them rampant cholera would actually be the least of our troubles.
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Fixing all the WRONG problems (Score:4, Insightful)
Let's see... Buy insurance, or go to jail. It sounds like Massachusetts.
How would this get paid for, I wonder? It's written by the same people that brought you "Cash for Clunkers" and the "Stimulus Package", and we know what came of THEM.
The Senate isn't expecting to make a vote on their version until next year. Hopefully it will die a horrible death. This bill has no business at ALL being the Law of the Land.
Re:Fixing all the WRONG problems (Score:5, Insightful)
How would this get paid for, I wonder? It's written by the same people that brought you "Cash for Clunkers" and the "Stimulus Package", and we know what came of THEM.
When it comes to this recession, the first stimulus package happened on George W. Bush's watch.
Also, Ronald Reagan passed a massive stimulus package as well. When inflation is factored in, it was larger than Obama's stimulus.
Even factoring in the Obama stimulus package, the vast majority of U.S. debt was accrued under the watch of Republican presidents.
Let's try to stay grounded in reality and realize that both dominant political parties in the U.S. spend too much. There is plenty of blame to go around. Partisan bickering is blinding Americans to the fact that the real problem is that the government is even allowed to spend money it doesn't have.
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Re:Fixing all the WRONG problems (Score:5, Insightful)
"under the watch of Republican presidents"
Repeat after me: "Congress is the only government branch that can raise money and spend it."
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Re:Fixing all the WRONG problems (Score:5, Insightful)
The only branch that can pass laws, too. So how does Obama always get mentioned with health care and economic stimulus?
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Re:Fixing all the WRONG problems (Score:5, Insightful)
Then why is this called "Obamacare" by the Republicans and Conservatives?
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Re:Fixing all the WRONG problems (Score:5, Insightful)
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1.2T = 120B per year (Score:5, Informative)
A Step Into the Dark Ages (Score:5, Insightful)
How healthcare should be fixed (Score:5, Insightful)
This is how I would fix the problems:
1.Eliminate company health plans (the providers of these plans have little to no incentive to offer any actual benefits to the employees as the companies cant change to someone better due to lock-in contracts and the huge costs of changing, nor can the employees generally switch without paying a lot more)
2.Give every citizen a certain amount of tax-free money they can use to buy health insurance. i.e. the first $x of their health insurance costs are tax free. This makes up for the loss of company health plans (which are generally tax free)
3.Make it super-easy for people to switch to another health provider anytime they choose without penalty (i.e. if they switch to a similar plan from a different provider, the new provider cant suddenly deny coverage for all your pre-existing conditions just because you switched providers)
4.All health care providers must charge the same amount for the same treatment no matter who is paying. If a hospital charges $2000 for a procedure to one person, they must charge the same $2000 to everyone who gets the procedure (no matter if its the government via medicare, a large health plan, a small insurance company, an individual paying out of pocket or whatever else). Obviously they can increase the price anytime they want but again they need to charge the same new price to everyone
5.Take away all incentives for doctors and hospitals and others to order "unnecessary" tests (including a reform of medical malpractice law so that lawyers cant argue "I sue the hospital for $$$$$ for failing to carry out when carrying out would have saved my clients life/heart/kidney/good looks/whatever")
6.Remove any laws and red tape that make it harder to start up a health fund. Making it easier to run one (and reducing the administrative costs) may encourage new players into the market who offer better value much the same as what companies like Jet Blue did for air travel)
7.Remove any rules/laws/etc that in any way restrict what health insurance companies are allowed to offer coverage for. If an insurance company wants to offer coverage for prescription glasses (for example), they should be allowed to do so.
8.Low income earners and the poor (who cant afford health insurance) would get subsidized cover. Not government run cover but money from the government paid to the individual to cover part or all of their health insurance costs
9.Health insurance companies would be banned from doing deals with specific hospitals or doctors (i.e. "you will only get coverage if you go to OUR hospital"). Further to this, companies that own health insurers would be prohibited from owning any operation involved in the provision of health care (e.g. hospitals, drug companies, medical equipment makers etc). Also, Health insurance companies would be banned from dictating treatment terms to doctors (i.e. if you want us to give coverage for this heart operation, you will do it the way we specify)
and 10.Health insurance companies would be required to disclose upfront how much they will pay on a given treatment before the treatment is carried out and they must pay up. No more cases of saying one thing before you go into hospital and then changing their mind and denying payment AFTER the patient has racked up the big medical bills.
Re:12 million people excluded? (Score:5, Funny)
>What's with the remaining 4%? How come not everyone will be covered?
That 4% will be lawyers.
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Re:On behalf of rest of the civilized world (Score:5, Insightful)
Slashdot is not just a news site. That's its primary motivation. Its secondary existence is the discussion, and for some that's their primary reason for returning to
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Re:Strikers Vow (Score:5, Insightful)
Seems the adults also know that you cannot rely on the private sector to provide for people. Capitalism isn't about compassion.
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Re:Strikers Vow (Score:5, Insightful)
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Re:Strikers Vow (Score:5, Insightful)
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Re:Strikers Vow (Score:5, Insightful)
The point of it is that it can be changed through amendments as changing times require changing purpose.
Yes, if the government cared at all about the rule of law, they'd be trying to amend the constitution to permit this kind of blatant power-grab. The problem is that the people let FDR get away with all kinds of things that should have gotten him hanged, and now the power-grabbers see no need to even consider the constitutionality of anything they want to do.
When someone asked Pelosi where in the constitution the authority for this monstrosity could be found, she asked "are you serious?", and then fobbed the question off with the old commerce clause excuse. The commerce clause exists to prevent the states from erecting trade barriers against each other, not to give the federal government authority over anything and everything that is bought or sold. If the commerce clause gave that kind of power, then the rest of the constitution would be moot.
-jcr
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Re:Is mandated health care constitutional? (Score:5, Insightful)
You are trying to make it seem as if Congress has no power to do anything other than that which is explicitly granted in the Constitution, which is comically untrue.
So what the hell does the 10th Amendment mean, then?:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
The Virginia Resultion of 1798 [tenthamendmentcenter.com], written by James Madison (the main author of the Constitution and the author of the Bill of Rights, including the 10th amendment) says:
That this Assembly doth explicitly and peremptorily declare, that it views the powers of the federal government, as resulting from the compact, to which the states are parties; as limited by the plain sense and intention of the instrument constituting the compact; as no further valid that they are authorized by the grants enumerated in that compact; and that in case of a deliberate, palpable, and dangerous exercise of other powers, not granted by the said compact, the states who are parties thereto, have the right, and are in duty bound, to interpose for arresting the progress of the evil, and for maintaining within their respective limits, the authorities, rights and liberties appertaining to them.
Plus, the Kentucky Resolution of 1798 [tenthamendmentcenter.com] written by Thomas Jefferson says this:
"Resolved, That the several States composing, the United States of America, are not united on the principle of unlimited submission to their general government; but that, by a compact under the style and title of a Constitution for the United States, and of amendments thereto, they constituted a general government for special purposes -- delegated to that government certain definite powers, reserving, each State to itself, the residuary mass of right to their own self-government; and that whensoever the general government assumes undelegated powers, its acts are unauthoritative, void, and of no force: that to this compact each State acceded as a State, and is an integral part, its co-States forming, as to itself, the other party: that the government created by this compact was not made the exclusive or final judge of the extent of the powers delegated to itself; since that would have made its discretion, and not the Constitution, the measure of its powers; but that, as in all other cases of compact among powers having no common judge, each party has an equal right to judge for itself, as well of infractions as of the mode and measure of redress."
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Re:Strikers Vow (Score:5, Insightful)
"Except for every time Keynesian remedies have been tried, you mean?"
WTF?
"The first great depression, the Japanese lost decade, the second great depression that we're heading into right now..."
WTF cubed?
These are examples where Keynsian remedies WERE NOT tried (at first). During the first great depression Keynes has not even formulated keynsianism.
During the 'lost decade' Japan tried the 'fiscal conservatism' policy, by raising the interest rates and stopping the flow of money. So economy ground to a complete halt. Only after many years of low interest rates and various stimulus packages the Japanese economy started to grow again.
You simply don't understand economics.
Wanna to take bet that there will be the second great depression? Say, if in 2 years DOW falls below 7000 for period of more than 1 month then I'll give you 10 grams of gold (or its equivalent in the currency of your choice).
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Re:Strikers Vow (Score:5, Insightful)
Seriously though, you need to get a grip. People who are ill are by definition less able than those around them. Why should it fall to them to help themselves? Do you actually just strive for the destruction of society? If so, there's a group of people in the Middle East who'd love to hear from you.
We have national healthcare in the UK, and, having had both parents working within it for 25 years apiece, it's not slavery. Are the police slaves? The fire department? Your logic is flawed.
Laukei
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Re:Strikers Vow (Score:5, Insightful)
You can start by explaining how a multi-trillion dollar government program is going to make things better. Perhaps, you can cite the dozens or perhaps hundreds of other programs the government has run that efficiently made things better?
Sigh.
Has it occcurred to you that the argument implicit in your questions, the One Argument To Rule Them All (or, to use Ronald Reagan's words, "Government is the problem"), is not an argument at all? It's an idealogy. And one that's been gradually discredited since the 1980s, and especially so of late.
That said, the following quotation should address your questions about governemnts programs that run efficiently or make things better:
Credits to the orginal poster or writer.
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Re:Strikers Vow (Score:5, Interesting)
Presumably, in the same way that any other tax evasion will. Does the police force, military, court system, fire brigade etc. enslave people?
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My Issue Is... (Score:5, Insightful)
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