I get that, I do -- I get all of that. I would be ok with a system that is actually administered by the government -- or at least more ok than having an extra layer of crap on top of a private for-profit insurance group (which is kind of what Medicare in the US is right now, and needs fixing, but whatever -- undoubtedly better than nothing for a lot of people). I would even be ok with paying something like the Social Security tax for health care -- if if was set up in such a way that such payments went to either the government fund if you were on the government health insurance, or to whatever provider you picked if someone else. But that isn't what they're doing at all.
My main beef is with the fact that they set this thing up as a income tax penalty -- if you don't have health insurance that they see as being fit, you pay the "tax penalty". That is not how things are done here. That is never how things have been done here. That is like smacking someone on the wrist for a personal decision made to not buy a product, except it's the government and several thousand dollars of money you have to pay out per year.
There are also, from what I understand, no real safeguards from abuse -- who decides whether an insurance company is meeting the necessary standards? what -are- all the necessary standards? who controls the list? and who controls the reporting and the time the tax penalty kicks in so that people won't be caught in the lurch? (Because it would be very easy to tweak things such that someone can have the 'proper' insurance 364 days of a year, and still end up paying out for the "tax penalty", and nobody would be happy with those shenanigans, but it's much more difficult to sue a government office than a private company when they try and pull stupid shit.) Plus, when the "tax penalty" kicks in, it hits the individual, not the insurer (and sometimes the business, if they're the ones doing the insuring to individuals, so there may even be some double-taxing going on if somebody suddenly ends up in the lurch through no fault of their own).
I might even feel a little better if it had a sweeping "everybody over 65 gets on the Medicare plan" dealy, because at least then I would know that once I hit retirement, I would be covered, having sort-of 'paid my dues' up-front a bit any year that I might have pitched in on the tax penalty. The only problem is, getting Medicare once you hit retirement isn't automatic here, and you need to be careful when and how you apply, and with all that fun paperwork. (I'm fairly sure that the bill didn't change that, at least.) And I had mixed feelings about the provision trying to force expansion to all poor people in each state, where a state wouldn't receive any federal funding at all to help pay for Medicaid if they didn't do the expansion, because that's kind of bullying the states to go along with the expansion or go it alone. --But that was the one provision out of the whole mess that they struck down! Which means that many states won't be pushing the expansion, if they can get the same amount of money for the same number of people, especially if they already hadn't been getting enough to cover everybody already on the previous rolls and having to pull funds from the state tax coffers elsewhere. So that pretty much kicks any 'all poor people will be covered' idea right out the window (assuming that the state(s) in question offered Medicaid in the first place).
I don't know -- I know it isn't and wasn't going to be perfect, but it -easily- could have been made better with a few changes, or at least a few lines of clarifications. The thing was several thousand pages long already!
I think the main crux of my worry in general is that, now that it's been passed, it'll stick around for all eternity as-is (which tends to happen with the larger bills that go through -- they don't usually get repealed). These beasts tend to only get minor changes in future bills, in very nontransparent ways. Complete overhauls are few and far between. Even worse might be a repeal -- because if that happens, I can't see that actually going through except for the entire bill (because nothing else any less drastic would gain enough momentum to get anywhere), and if that happens then we'll be in a huge chaotic flux all over again, and quite possibly or probably end up with something much worse (because hey, they did a whole bunch of backroom closed-door deals with the drug companies and the health insurance industry before, and didn't listen to the experts the first time... why would they do it any differently this time?). --Sorry if I'm a bit of a downer and jaded on all this BS. I tend to be very pessimistic about my federal government's ability to avoid drastically fucking things up these days (goes to show how high my expectations are, huh?)
But yeah, back to the original matter somewhat: I wouldn't mind paying more taxes to help pay for things we all need and use -- hell, even to bring down are debt with China (especially that). I don't like the national debt, and I understand that that means getting taxed more. I don't doubt that most people do. And I wouldn't mind paying a health care tax like a social security tax, if I knew that the funds wouldn't just be used to line the pockets of the private insurance industry and wouldn't be raided to pay for other shit rather than their intended purpose (health care for people who need it). But the way they've implemented it as of right now is in a very bad way, and opens the door for more shenanigans in the future (see previous post re: private companies begging the govt. to basically force a private product to be paid for, or a penalty levied).
Oh, and parting shot (which I think you agree with, but who knows who else might or might not be reading my crap): the bill ended up not really being about "health", "health care", or "reform" -- it was about expansion of private health insurance coverage. And people did end up talking about health care reform a lot -- but almost none of that made it into the bill. And a big, very real impact this thing is gonna have is a polarizing effect on the voters come the fall. A lot of people are probably gonna get booted out of office for this one, and a majority lead in Congress of either major party over here tends to not be a good thing -- stuff gets rammed through on either side when that happens; I don't like the idea of that in general, and especially not when it happens in practice.
Anyway, yeah. Very bleh all around. *sighs unhappily*
Re: It is far from Universal
My main beef is with the fact that they set this thing up as a income tax penalty -- if you don't have health insurance that they see as being fit, you pay the "tax penalty". That is not how things are done here. That is never how things have been done here. That is like smacking someone on the wrist for a personal decision made to not buy a product, except it's the government and several thousand dollars of money you have to pay out per year.
There are also, from what I understand, no real safeguards from abuse -- who decides whether an insurance company is meeting the necessary standards? what -are- all the necessary standards? who controls the list? and who controls the reporting and the time the tax penalty kicks in so that people won't be caught in the lurch? (Because it would be very easy to tweak things such that someone can have the 'proper' insurance 364 days of a year, and still end up paying out for the "tax penalty", and nobody would be happy with those shenanigans, but it's much more difficult to sue a government office than a private company when they try and pull stupid shit.) Plus, when the "tax penalty" kicks in, it hits the individual, not the insurer (and sometimes the business, if they're the ones doing the insuring to individuals, so there may even be some double-taxing going on if somebody suddenly ends up in the lurch through no fault of their own).
I might even feel a little better if it had a sweeping "everybody over 65 gets on the Medicare plan" dealy, because at least then I would know that once I hit retirement, I would be covered, having sort-of 'paid my dues' up-front a bit any year that I might have pitched in on the tax penalty. The only problem is, getting Medicare once you hit retirement isn't automatic here, and you need to be careful when and how you apply, and with all that fun paperwork. (I'm fairly sure that the bill didn't change that, at least.) And I had mixed feelings about the provision trying to force expansion to all poor people in each state, where a state wouldn't receive any federal funding at all to help pay for Medicaid if they didn't do the expansion, because that's kind of bullying the states to go along with the expansion or go it alone. --But that was the one provision out of the whole mess that they struck down! Which means that many states won't be pushing the expansion, if they can get the same amount of money for the same number of people, especially if they already hadn't been getting enough to cover everybody already on the previous rolls and having to pull funds from the state tax coffers elsewhere. So that pretty much kicks any 'all poor people will be covered' idea right out the window (assuming that the state(s) in question offered Medicaid in the first place).
I don't know -- I know it isn't and wasn't going to be perfect, but it -easily- could have been made better with a few changes, or at least a few lines of clarifications. The thing was several thousand pages long already!
I think the main crux of my worry in general is that, now that it's been passed, it'll stick around for all eternity as-is (which tends to happen with the larger bills that go through -- they don't usually get repealed). These beasts tend to only get minor changes in future bills, in very nontransparent ways. Complete overhauls are few and far between. Even worse might be a repeal -- because if that happens, I can't see that actually going through except for the entire bill (because nothing else any less drastic would gain enough momentum to get anywhere), and if that happens then we'll be in a huge chaotic flux all over again, and quite possibly or probably end up with something much worse (because hey, they did a whole bunch of backroom closed-door deals with the drug companies and the health insurance industry before, and didn't listen to the experts the first time... why would they do it any differently this time?). --Sorry if I'm a bit of a downer and jaded on all this BS. I tend to be very pessimistic about my federal government's ability to avoid drastically fucking things up these days (goes to show how high my expectations are, huh?)
But yeah, back to the original matter somewhat: I wouldn't mind paying more taxes to help pay for things we all need and use -- hell, even to bring down are debt with China (especially that). I don't like the national debt, and I understand that that means getting taxed more. I don't doubt that most people do. And I wouldn't mind paying a health care tax like a social security tax, if I knew that the funds wouldn't just be used to line the pockets of the private insurance industry and wouldn't be raided to pay for other shit rather than their intended purpose (health care for people who need it). But the way they've implemented it as of right now is in a very bad way, and opens the door for more shenanigans in the future (see previous post re: private companies begging the govt. to basically force a private product to be paid for, or a penalty levied).
Oh, and parting shot (which I think you agree with, but who knows who else might or might not be reading my crap): the bill ended up not really being about "health", "health care", or "reform" -- it was about expansion of private health insurance coverage. And people did end up talking about health care reform a lot -- but almost none of that made it into the bill. And a big, very real impact this thing is gonna have is a polarizing effect on the voters come the fall. A lot of people are probably gonna get booted out of office for this one, and a majority lead in Congress of either major party over here tends to not be a good thing -- stuff gets rammed through on either side when that happens; I don't like the idea of that in general, and especially not when it happens in practice.
Anyway, yeah. Very bleh all around. *sighs unhappily*