*shaking head*

[henry quirk]

"The inherent problem is employer-provided insurance"

Only when it's mandatory.

If Joe wants to provide catastrophic insurance to all of his employees, that's on Joe.

If Joe wants to pay (some or all of) his employees enough so that each can attend to his or her medical needs as each sees fit, that's on Joe.

If Joe enters into idiosyncratic contracts with (some or all) individual employees to provide or make accessible 'this' or 'that', that's on Joe.

It's the mandatory nature of employer-based insurance that's the problem.

[henry quirk]

"So if an employer sexually exploits woman and grab their asses, well, the women should simply go elsewhere to work."

Or: punch the fucker in the head.

[henry quirk]

I'll say it again: the SC ruling sets a bad precedent.

I can see all manner of unintended consequence extending out from the ruling.

Better the HL folks had attacked the problem from the position of 'property' (the right of owners of property to do with said property as the owners like).

[Clodfobble]

Originally Posted by henry quirk

"The inherent problem is employer-provided insurance"

Only when it's mandatory.

If Joe wants to provide catastrophic insurance to all of his employees, that's on Joe.

If Joe wants to pay (some or all of) his employees enough so that each can attend to his or her medical needs as each sees fit, that's on Joe.

If Joe enters into idiosyncratic contracts with (some or all) individual employees to provide or make accessible 'this' or 'that', that's on Joe.

It's the mandatory nature of employer-based insurance that's the problem.

Except when employer-provided coverage is the norm, then rates are artificially inflated, a one-size-fits-all policy is chosen by someone in HR rather than the individuals it's supposed to serve, and anyone who doesn't have employer coverage is effectively barred from getting a policy at all because they have no collective bargaining to offer.

All of which were addressed by Obamacare, and slowly we are seeing good things from it (a huge increase this year in the number of insurance companies offering new plans on the open exchanges, for example, with competition driving down prices as it should,) but we have a long way to go before people really give up this stupid idea that your job should be in charge of those decisions for you.

[DanaC]

I see what you're saying Henry. And to an extent, I agree. But - if those employers are making that decision in the face of scientific evidence that shows quite clearly that there is no difference in function between the contraceptives they will allow and those they won't (prevention of fertilisation, versus prevention of ovulation) then they are effectively penalising those women who, because of their particular medical history need one kind rather than the other (some contraceptives are suitable for some women but not others) - and they are doing so on the grounds of something that is untrue.

[henry quirk]

Clod,

"..employer-provided coverage is the norm..."

I agree, and I should clarify: 'mandatory' (as I use it) is not only the legal mandate (law) but also the cultural imperative (this is now things are done).

Where we disagree: if you want services and products to assume 'proper value' in a market, take out as many of the extraneous players in the market as you can.

If the market (buyer and seller; demand and supply) is allowed to operate with only minimal restraint all products and services assume a proper value, a value that may fluctuate wildly for any number of reasons, but a value in keeping with the buyer and the seller; demand and supply.

Every extraneous player simply adds to 'cost' without adding to 'value'.

#

Dana,

"they are doing so on the grounds of something that is untrue"

I get that and -- within the context of the SC ruling -- I see your point.

Which, again, is why I think the ruling is a fertile ground for unintended consequence.

If HL had taken the route of property ownership instead of religious objection then -- as I say up-thread -- 'how a body uses his or her property may not make any sense to me, but it doesn't have to make sense to me cuz it ain't 'my' property'.

I got an idea why the HL folks didn't assert this as a property matter, but I'll leave that for another time.

[sexobon]

Originally Posted by DanaC

soldiers refusing to fight get court-martialled, surely?

I was referring to soldiers refusing to fight claiming conscientious objector status. Courts Martial is a judicial procedure. Those claiming conscientious objector status go into pretrial diversion in which an administrative process either validates or invalidates the claim. Validation means the petitioner is authenticated as a conscientious objector and administratively separated from military service. If the claim is determined to be invalid, then the soldier proceeds to trial.

[sexobon]

Originally Posted by tw

First, not doing something is an action. ... Nonsense reasoning; semantics that lawyers succesfully [sic] play to confuse reality. ... Not doing something is an action.

First, not doing something is a choice, that choice is called inaction. There can be dozens of valid reasons for individuals to choose inaction and you don't get to sit in judgment of any of them. But then the English language isn't your forte is it? You're well known for making up your own definitions for words.

Originally Posted by tw

Second, the employer is imposing his religion on others.

Second, the employer is imposing its will on its insurance company. The insurance company is limiting benefits to the employees and the insurance company is free to distribute those benefits as long as it's no cost to the employer.

Originally Posted by tw

A conscentious [sic] objector does not impose his religion on anyone else.

Conscientious objectors continuously impose their religion on others as others have to accommodate them.

Originally Posted by tw

Only so called 'evil' people (ie [sic] [Fundamentalist terrorists) impose their religion on anyone else. This is not about imposing his religion on himself. This is only and completely about imposing his religion on others.

Only un-American subversives would deprive employers of their freedom of religion by forcing them to act in a manner unconscionable to them. This is only and completely about freedom of religion.

The Supreme Court agrees with me 'cause I'm right and you're wrong ... get over it.

[Big Sarge]

TW,

Kitty was on birth control. That's why no one intervened. BTW, you really fucked up your facts in that case. Who were these hundreds?? Two people saw different parts of the attack. It was believed to be a lover's quarrel. It was finally properly reported as an assault and the police responded. This happened 50 years ago. What the fuck does this have to do with Hobby Lobby?? I'm worried you are becoming quite senile in the twilight of your life.

Yeah for Obamacare. We are moving towards socialized medicine. I think the VA is a shining example of what everyone can expect in the future.

[Big Sarge]

I'm sorry tw. the above was uncalled for

[DanaC]

Socialised medicine:

The NHS has been declared the best healthcare system by an international panel of experts who rated its care superior to countries which spend far more on health.

The same study also castigated healthcare provision in the US as the worst of the 11 countries it looked at. Despite putting the most money into health, America denies care to many patients in need because they do not have health insurance and is also the poorest at saving the lives of people who fall ill, it found.

"The United Kingdom ranks first overall, scoring highest on quality, access and efficiency," the fund's researchers conclude in their 30-page report. Their findings amount to a huge endorsement of the health service, especially as it spends the second-lowest amount on healthcare among the 11 – just £2,008 per head, less than half the £5,017 in the US. Only New Zealand, with £1,876, spent less.

In the Commonwealth Fund study the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at. It got top place on measures including providing effective care, safe care, co-ordinated care and patient-centred care. The fund also rated the NHS as the best for giving access to care and for efficient use of resources.

The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th. The authors say that the healthcare system cannot be solely blamed for this issue, which is strongly influenced by social and economic factors. Although the NHS came third overall for the timeliness of care, its "short waiting times" were praised. "There is a frequent misperception that trade-offs between universal coverage and timely access to specialised services are inevitable. However, the Netherlands, UK and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to speciality services,", the report added.

The NHS also outperforms the other countries – which include France, Germany and Canada – in managing the care of people who are chronically ill, the report said.

http://www.theguardian.com/society/2.../17/nhs-health

The problems of the VA aren't because it is socialised - the problems are because it is not being competently run and has been allowed to fester without proper upgrades to the records system.

[Undertoad]

There is one metric that they never ever ever study in such studies and that metric is, where are the fucking cures coming from? Because that is kind of important.

In the last 30 years, there have been 68 Nobel laureates in Physiology or Medicine.

US 38.5
UK 9.5
Germany 5.5
Australia 3.5
France 3
Japan 2
Switz 2
Italy 1
Denmark 1
Sweden 1
S. Africa 1
Argentina .5
Canada .5

The level of socialization in a system doesn't seem to matter much. The UK is clearly punching above its weight. Single-payer Canada, socialized Sweden, big underachievers. Moneyed Japan, huge underachiever. But it's clear, without the US system, 57% of the discoveries since 1945 do not happen, and the rest of the world continues to die in their systems that have not benefitted from advancements and discoveries.

~ You're welcome ~

I also feel that our metrics would be a lot better without a permanently unhealthy underclass who eat shitty, go around shooting each other, generally hate doctors, have terrible hygiene, etc. I suppose every nation suffers from that to a degree. But when it comes to longevity our ghetto males and steady trickle of Mexicans have a life expectancy of around 65, and it isn't actually due to lack of doctorin' so much as lack of maintenance. If you don't do oil changes expect your car to die.

[DanaC]

US is huge in comparison to UK and Germany (for example) - there is no way to know if the US would produce fewer innovations with socialised medicine than with private/insurance based medicine. Given the size and population of the UK the fact that it has 9 of those is remarkable - if the US had the same or similar system in place its size might still mean it having a similar number.

US population as at 2012= 313.9 million
UK population as at 2012 = 63.23 million

Approximately five times the population and produced approximately four times as many nobel laureates in physiology or medicine.

[Undertoad]

I know that and, really, what people never consider is that the US system is pretty socialized anyway. With Medicare, Medicaid and now O'care, state and federal governments pay for over half the medicine that is happening in this country.

(I had to explain to a Derby counterpart that the streets around US hospitals are not choked with the dying who have been turned away. Nobody with a serious issue is turned away.)

[DanaC]

Good point.

I do think though this is one of those areas where greater centralisation brings benefits. The cost of medicine is brought down massively by centralisation because it increases the buying power of the customer. The NHS has huge buying power with drug companies - it helps drive down costs. Drug companies want the NHS to supply their products and many times they bring the cost down drastically to make that happen - because the NHS has such massive purchasing power.



I should add all this is subject to change given we have a coalition hell bent on finishing the job of privatising the NHS.