Health Care Reform: Potential Winners and Losers

Binary events -- clinical trial results and FDA approval decisions -- are nothing new to health-care investors, but they usually only affect one or two companies (and perhaps their competitors indirectly).

This week, however, we've seen the prelude to an event that could have an effect on the entire industry: The Supreme Court heard arguments over the constitutionality of the health care mandate in the health care reform bill.

Call it a trinary event
The high court basically has three options when making its ruling:

  • The Supreme Court could strike down the entire law.
  • It could strike down just the insurance mandate that requires individuals to pay a $700 penalty for not having health insurance coverage and a fine of $2,000 for a company that doesn't offer a plan to its employees.
  • It could leave the law alone.

Let's break those options down in more detail and see which companies might prosper in each case.

The new status quo
The Supreme Court's upholding the law wouldn't be so bad for most of the health-care industry.

Drugmakers are certainly getting dinged now with taxes and rebates to help pay for the expenses in the bill. They helped close the Medicare doughnut hole with discounts, which disproportionately hurt companies with drugs used by the elderly -- cholesterol drugs such as Merck's (NYSE: MRK  ) Vytorin and Pfizer's Lipitor, for example. And the bill required a discount for drugs sold to Medicaid, which especially cut into margins at Gilead Sciences (Nasdaq: GILD  ) and Biogen Idec.

But drugmakers should make up for those costs as more people are insured and taking medications. When the health-care law was coming to a vote, the drug industry was generally behind it, figuring it was close to a long-term wash on their bottom line.

Health insurers are basically in the same boat. Competition with government-run insurance pools might put a little pressure on costs, but large insurers like UnitedHealth Group (NYSE: UNH  ) and WellPoint (NYSE: WLP  ) should be just fine since they can use their size to limit overhead.

Back to the grind
If the Supreme Court nullifies the entire bill, we're back to where we were before, which wasn't so bad for the health-care industry.

Except, of course, for the fact that the increasing prices weren't sustainable.

If the health-care law is shot down, something will need to come around and replace it eventually. That iteration could be better or worse for the industry than the current version. In the interim, there will be a cloud hanging over health-care companies, which can't be good for valuations.

The one exception is likely the medical device industry, which by most estimations has companies like Intuitive Surgical (Nasdaq: ISRG  ) scheduled to pay more than their fair share of the costs to institute whole health-care reform. Throwing the whole thing out would give the lobbyists for the medical device sector a do-over in negotiating fees.

And here's where things get interesting
The third option -- striking down the insurance mandate, but leaving the rest of the bill alone -- would be disastrous. The insurance mandate brings healthy people into the insurance pool, which balances out those with pre-existing conditions. And the added insured patients help reimburse drug and medical device companies for their discounts and fees.

We don't have a mandate now, which is tolerable for most Americans with independent insurance, because the most risky people are kept out of the insurance pool through pre-existing condition clauses. Employer-sponsored insurance usually accepts those patients, but employer-sponsored health care is much like an insurance mandate; employers guarantee a certain percent of the employees, perhaps 100%, be covered under the insurance, bringing in the low-risk patients as balance. Those that are fairly healthy are paying for those with chronic illnesses.

If insurers were required to take all comers in their general policies without a mandate that everyone was covered, you'd see spiraling health-care costs to cover those with high medical bills who are sure to sign up. As prices increase, it no longer becomes feasible for the "mostly healthy" to keep insurance, which makes the pool even more risky and pushes prices up further. And the cycle continues.

If the Supreme Court wields a paring knife rather than a machete striking down the entire law, Congress could repeal the rest of the law or somehow attempt to repair the hole the Supreme Court made. I think it's safe to assume lawmakers would go that route, but the uncertainty about what changes would be made and when -- lawmakers tend to be procrastinators until there's a deadline -- would likely put negative pressure on health-care stocks.

Which one?
I'm not a lawyer, nor do I play one on the Internet. And if you asked 10 real ones, you'd probably get a range of predictions about what the Supreme Court might do in June. Justice Anthony Kennedy, as seems to be the case in most rulings of late, is likely the swing vote. Chief Justice John Roberts seems to be a wild card, making comments for and against striking down the law.

Risk-averse investors may want to reduce or eliminate their exposure to health-care stocks, but longer-term investors probably don't have much to worry about. The price of health care can't go up forever. If the law is struck down, something will be done to solve the problem. Eventually.

The other option is to find health-care companies growing so fast that any affect the Supreme Court decision has on the industry will be a minor blip on their path upward. Fool analysts think they've found one with multibagger potential. Find out the name of the company and why they like it so much in our new free report: "Discover the Next Rule-Breaking Multibagger."

Fool contributor Brian Orelli holds no position in any company mentioned. Click here to see his holdings and a short bio. Motley Fool newsletter services have recommended buying shares of UnitedHealth Group, Gilead Sciences, Pfizer, Intuitive Surgical, and WellPoint. The Motley Fool has a disclosure policy. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. Try any of our Foolish newsletter services free for 30 days.


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  • Report this Comment On March 29, 2012, at 6:18 PM, xetn wrote:

    Question: what health care reform? Do you mean health care socialism? If so, that is the reform; an expanded version of Medicare, mandated for the masses.

  • Report this Comment On March 29, 2012, at 10:09 PM, minto1959 wrote:

    xetn,

    Oh, really? Do you even have a clue how snobbish and elitist you sound? The masses, the middle class, is what made this country great. If the middle class is so squeezed by ever increasing health care cost, they stop spending on other things. This is a consumer driven economy and the best investment we can make in future prosperity is to have a vibrant middle class. Health care costs are breaking my family - we have two family members with cancer and another with a severe mental illness. Health care reform would really help us.

    I think the only people really against health care reform are people for whom money is not a concern or those who have never experienced a health crisis with little or no insurance.

  • Report this Comment On March 29, 2012, at 11:09 PM, wolfman225 wrote:

    ^Just a question minto, believe me, you have my greatest sympathy for the health concerns for your family members.

    Just try, for a second, to put your emotions aside and answer one question. You tragically have two members of your family stricken with cancer and a third with "severe mental illness".

    Objectively, how do you come to the conclusion that it's the obligation of someone else to come to your aid and pay your medical costs?

  • Report this Comment On March 30, 2012, at 9:55 AM, MrChapel wrote:

    I live in the Netherlands and we do have a mandated healthcare system. I too feel for Minto, however, I am categorically against mandated insurance.

    Why, you ask? Here's an example. Every person over the age of 18 is forced to get the basic package, whose coverage is decided by the government, which is the SAME for EVERY.SINGLE.PERSON.WHETHER.THEY.BE.MALE.OR.FEMALE.

    Read that line carefully. Now, the basic package contains a number of things, one of which is pre- and post-natal care among other things that only impact females. Now read the previous paragraph again. Can you spot the problem yet? No? Well, let me explain it to you in small words.

    I am a male, 42 years old. I have never nor will ever get pregnant, thus negating the need for pre-/post-natal care. Nor any of the many other things that are female-care only that are part of the basic package yet which I'm forced to pay for. Now, if your knee-jerk reaction is to say "What about your wife/girlfriend? You don't want her to have coverage?" and under-your-breath mumbling what an evil bastard I am, I refer you to the starting words of the paragraph: 'Every person over the age of 18'.

    Yes, indeed, my wife/girlfriend/partner has the same basic package, whether or not she is with the same insurer as I am. When we go to the doctor or the hospital or any of the other medical entities, according to law, she has to use her insurance, I have to use mine. I can't put her on my insurance nor can she put me on hers. The only people who we can put on our insurance are our children so we have to decide on whose insurance we'll put them.

    Is it clearer now? Us males in the Netherlands are paying for things that aren't used by males. We can not get them removed from the insurance because it is government-mandated and decided what is part of the basic package. Apparently, it is too hard to differentiate between males and females for the government. The fact is, the male population is being robbed blind by the government to pay for medical bills for the large number of people that illegally enter the country each year, the 20.000 people whom, after trying for years to stay here but had exhausted all legal possibilities got a general pardon from the then ruling socialist parties because 'they will be the new working class, replacing the babyboomers who retire' but actually are costing the taxpayers at the very least several billion euros a year in unemployment benefits, free housing, medical and a bunch of other things.

    As to price. In 2006 it was stated it would be much cheaper for the insured since the costs would be controlled thanks to everyone having the same coverage. Funny thing, the year wasn't out yet when the insurance companies complained to the government that costs where rising exponentially and they had to jack up the rates. In fact, in the last six years, insurance rates have gone up at least 6 percent a year and as much as 10 percent. The basic package went from 100 Euros to a bit over 140 now. Many in the middle class have had to drop the extra packages because it is getting too expensive.

    Welcome to the place where there's no competition. Welcome to the place where there is no choice but government choice. How's it taste?

    Remove the 'pre-existing condition' clause? I whole-heartedly agree. Remove barriers for insurers to work all across the US? I agree again. Give insurer and client the ability to negotiate what coverage they want/need/can afford? HELL YES! But force me to pay for someone else's problems? Get lost! But hey, I'm not a millionaire so I can't just pack up and leave and am forced to grind my teeth and cut down all my other expenses as more and more goes to my government-mandated health insurance.

    I heard a quote somewhere, a long time ago: A woman's money is her money. A man's money is his woman's money. I think it needs to be changed to your money is the government's money.

  • Report this Comment On March 30, 2012, at 11:35 AM, wolfman225 wrote:

    ^ I agree with the above, MrChapel. However, to be fair, aren't there things covered in the mandated insurance that are exclusively male? Such as ED treatments? Male pattern baldness treatments/hair transplants?

    I completely agree that it makes no sense to pretend that everyone is the same. There's no reason for a male to have to subsidize elective procedures such as cosmetic surgeries, lipo, breast augmentation, fertility treatments, abortion, etc. Just as there is no reason for a female to have to subsidize similar vanity procedures for middle-aged men trying to hold on to their virility.

    If there's going to be government-mandated coverage, it should be strictly limited to major medical and catastrophic care ONLY. The only cosmetic surgeries covered should be those required to correct birth defects or for reconstructive procedures following serious accidents.

    All other coverages should be offered a la carte by private insurance companies competing across state lines, as opposed to each state limiting competition and imposing additional mandates.

  • Report this Comment On March 30, 2012, at 1:03 PM, MrChapel wrote:

    Just checked to be sure. ED treatments are not covered in the basic package. Baldness both for male and female is covered up to 393 Euros so wigs, hairpieces and even transplants are covered up to that price. As for most other vanity procedures, those aren't covered at all in the basic insurance. IVF is part of it, though.

    I don't agree with you that government should mandate major medical and catastrophic care ONLY. They decide what is major or catastrophic? Really? No chance that won't backfire, correct? No, they need to be completely out of mandating anything relating to healthcare apart from the FDA's main purpose, namely insuring the efficacy, safety and reliability of medicines.

    In such a scenario, if you don't have insurance or insufficient insurance, you can ask for government assistance. Which you are obligated to pay back. Think of it as a loan guarantee. That's what the current administration is so good at lately. Combined with nationwide competition, it's a lot more ideal.

    We've had government-mandated insurance here in one form or another for decades. Before the current system, we had a two-tier system. The first tier was the 'Health Fund' where if you earned up to a certain amount of income a year, you paid about 25 Dutch guilders a month. It was run by county-owned insurance coops. If your income rose even a cent above that, you were summarily thrown out of the Health Fund and had to get insurance. If you were working for a company, you'd get company supplied healthcare, which was the exact same as the Health Fund but your payments started at 100 and up. I eventually paid about 125 guilders a month. When we changed to the Euro, it was 55 Euros. Then, we went to the current, single-tier system and suddenly, from one month to the next, my bill doubled from 55 to a little over a 100 Euros.

  • Report this Comment On March 30, 2012, at 1:21 PM, 123spot wrote:

    Prostate cancer? Testicular cancer? Testosterone replacement?

  • Report this Comment On March 30, 2012, at 1:24 PM, 123spot wrote:

    Epidydymitis, testicular torsion, prostatitis.

  • Report this Comment On March 30, 2012, at 1:27 PM, 123spot wrote:

    Isn't prenatal care resulting in a healthy child an equal benefit to both parents? Did the woman get pregnant by herself? Where's your responsibility? Come on, guy. Spot

  • Report this Comment On March 30, 2012, at 1:29 PM, 123spot wrote:

    100 euros a month? You think that is high? You really don't have a clue as to how good your system is, do you? Spot

  • Report this Comment On March 30, 2012, at 2:08 PM, wolfman225 wrote:

    Spot, cancers of all kinds are certainly considered "catastrophic" events. In contrast, "pre-natal care" is not. It is part of the costs of creating and raising a family. It should be the sole responsibility of the couple having the child.

    Reason? Pregnancy is not an insurable event, so the ancillary expenses ought not be covered under any insurance mandate. For example: I have no intention of having children and it's up to me to do what is necessary to see to it that I don't get in that situation. However, if I either mess up and don't take precautions (or if those precautions fail, or are insufficient) it is up to me to deal with the situation. It is not the responsibility of anyone else.

    Personal responsibility is the key. Insurance should be reserved for only those things that are unforeseeable and/or financially devastating, such as accidental injury or illness.

    Keeping with the pregnancy example, if you aren't able financially to cover the expenses associated with having a child (not raising the child for 18yrs, just preparing for and having the child), including IVF and fertility tests, office visits, pre- and post-natal care, etc., you should put off having a baby until you are more financially secure.

    Contrary to popular belief, it is NOT someone else's obligation to subsidize your life choices. So much of what is erroneously called "insurance" today is more correctly termed pre-paid medical. You are paying for coverage for things that you are certain to need, not insuring against the unknown.

  • Report this Comment On March 30, 2012, at 2:15 PM, wolfman225 wrote:

    @MrChapel--

    I'm not disagreeing with you about getting government out of the healthcare/insurance business. My point about the catastrophic/major medical coverage was reflective of the fact that getting government totally out of the business of what is/is not covered under healthcare insurance is now impossible. Since we can't get government out of the insurance business completely, the best we can do is attempt to limit their ability to mandate coverages. Let them settle on basic catastrophic care and let the market decide the rates and coverages for the rest.

  • Report this Comment On March 30, 2012, at 2:26 PM, MrChapel wrote:

    @wolfman225

    I can see your point and while I don't agree, you ARE correct. It is one of those topics that politicians will use to get their way because it impacts everybody. The problem is that we all know how the government, any government, actually looks at what is supposed to be mandated as catastrophic/major medical coverage and they will slip in things that will benefit those they need as voters. Before long, it will spiral out of control like it usually does.

  • Report this Comment On March 30, 2012, at 2:28 PM, MrChapel wrote:

    Oh and wolfman?

    You are absolutely correct that personal responsibility is paramount. It just seems that people seem to forget that.

  • Report this Comment On March 30, 2012, at 3:37 PM, wolfman225 wrote:

    ^True. We can't be too hard on them, though. Government has spent the last several decades encouraging them to forget that concept.

  • Report this Comment On March 31, 2012, at 12:27 PM, Nomiw wrote:

    Do men have nothing to do with a woman's pregnancy, child birth, child rearing?

  • Report this Comment On March 31, 2012, at 12:50 PM, jssiegel wrote:

    Here's a data point for the current situation, where the "anyone can play for the same price" parts of the law have kicked in but the mandate has not: my high-deductible health insurance went up 25%, with no change in status, no claims, just got a year older. And it went up about 10% the year before.

    I'm well educated enough to know that correlation does not equal causation, but it's a pretty good clue that a cause is lurking nearby.

  • Report this Comment On March 31, 2012, at 12:57 PM, Pinpress wrote:

    You can't legislate personal responsibility. You can only control your response to it. In our modern western society, we do not just let people die because of their bad choices (logical consequences aren't popular). If an uninsured gangbanger with a head wound is brought to a trauma center, he will receive treatment, and if crippled for life will receive some kind of dole as well as continued medical care. Start letting people die, refuse medical care for the uninsured and unable to pay. You will still have people who choose high-risk lifestyles and no medical insurance but at least the rest of us won't be paying for it.

    It is ridiculous that decent medical insurance should be tied to employment. Plenty of older workers can't retire for this reason alone.

    I don't mind having prenatal care covered by insurance under the premise that it will, overall, save money for the insured pool by avoiding later medical expenses. Ditto birth control, sterilization, vaccinations, etc. Covering fertility treatments, OTOH, makes no sense.

  • Report this Comment On March 31, 2012, at 2:33 PM, woolibulli wrote:

    This thing of picking and choosing what is covered, it could go on forever.You choose not to cover knee replacements, maybe I choose not to cover your stupidity on the sports field, or your diabetes care. After all, I have been active, exercise, etc.

    When I was no longer covered by my parent's health insurance, I took out my own until I found a job. That's only responsible. Doesn't your state require Motor Vehicle Insurance? Some employers are now forcing the employee to choose one Health Insurer. Corporations are the ones that have to much influence over our lives.

  • Report this Comment On March 31, 2012, at 3:15 PM, helpisnowhere wrote:

    My intent here is not to argue, but to understand...and I veer somewhat from the present conversation. I want to look at this from a different perspective.

    I think that the concept of "all men are created equal" does not mean equal in all ways, but in the sense of "of equal worth".

    We may all be of equal worth, but we certainly are not equal in terms of who our parents are, how rich or poor they are, how many genetically negative predispositions they gave us, what their IQs are, or into what familial culture they were immersed at the time of our birth.

    An example: "J" was born to an unwed mother who has three other children - all under the age of 5. He has a cleft palate and lives in a rented apartment on the "poor side of town". His mother never finished high school and she smokes weed. She is extremely immature and often leaves "J" with his grandma. Oh yea - the school system here sucks.

    Though I may have some idea as to what you think the government should do with his Mom, tell me what the government should do with "J" - a human "of equal value" and - how would they pay for it if indeed you thought they should intervene?

    And so with that kind of inequality, just what is the role of government in this situation. Is it "too bad, tough luck, find a good church/organization and get some help"? Or does the government play some role in the "of equal value" concept.

    It all gets down to the nitty gritty. It's too bad about the cancer, but really why should I pay? If not you, who? The government?, the church?, the thousand points of light?, a rich relative?, the ER room?

    To me it is a question of what do we want of our government. Is part of the role of the government there to help those who can"t - and if not, who should?

    Hope I'm not too far off base here regarding the topic at hand.

  • Report this Comment On March 31, 2012, at 5:21 PM, Chgallos wrote:

    With insurance there will always be some people that pay for less than what they take and others pay more than they receive. It's the whole point. 100 people pay an extra dollar for the one guy that needs the 100 dollar thing that none of the rest of them need. That way if YOU end up needing that 100 dollar thing in the future you only have to pay a dollar for it.

    I know that few people will like my position on this, but I think that the government should establish a whole series of diversified insurance pools and various plans that cover each of these pools, then every 5 or 7 or 10 years all of the health insurance companies get to bid on each of the plans. The lowest bidder gets the contract for that plan. This could be done in such a way that the end user has a level of constancy with who their providers are, billing methods, how each plan compares with the others, etc.

  • Report this Comment On April 01, 2012, at 12:46 AM, CaptainWidget wrote:

    <<With insurance there will always be some people that pay for less than what they take and others pay more than they receive. It's the whole point.>>

    This is categorically untrue. The point is for everyone to break even on payment, and the insurer makes their money on float. You pay 100 dollars today when you have 0 dollars worth of bills, and tomorrow insurance pays 100 worth of bills when you have 0 dollars worth of income.

    Insurance is not some socialized risk, it's a business transaction that puts a price on risk transferrance. We deem you to be X risky, so you pay us X divided by Y probability over time plus Z percentage of interest for our troubles.

    This is why individual policies exist. In theory an insurance company should be just as solvent with one customer as they are with a million, otherwise it's just a ponzi scheme. This is why individual policies exist.....if what you said were true, individual policies would be economically unfeasible.

    Insurance is not borrowing against your neighbors to pay for your ailments, insurance is borrowing against your past (and sometimes future) healthy self to pay for your current ailments.

    Aside from this readers bit of bad info....great article. I wouldn't touch health stocks right now with a 10 foot pole. The Supreme Court is extremely consistent at being inconsistent when upholding the constitution. No one knows how this is gonna play out.

  • Report this Comment On April 01, 2012, at 10:30 AM, xetn wrote:

    The existing health insurance system is expensive for several reasons, but the biggest reason is government regulation on the insurance industry, the restrictions by groups such as the AMA which severely limit which schools of medicine are "approved" by them, which in-turn, results in much higher pay for doctors. Then there are the licencing requirements which differ for every state. The individual state's insurance regulations, which is a nightmare for insurance companies. Another area is the requirement that all risk be pooled, which means that you subsidize poor health with your good health. And, lets not forget the good ole FDA which can extend the time for drug approval to years, with little or no increase in benefit. Since when has an FDA approval prevented bad drugs from getting approved?

    The whole system needs to be tossed and reset.

    A start would be to eliminate the FDA and AMA from restricting supplies of both drugs and doctors. We could also eliminate license requirements which do nothing to guarantee quality doctors. Tort reform would be another need, but with most congress members being attorneys, the is not much hope for that.

    Here is a good idea, if the government thinks that Obamacare is such a godsend, why don't we require them to use it instead of them opting out with the far superior system fully paid by the taxpayers?

  • Report this Comment On April 01, 2012, at 3:22 PM, Kauaicat wrote:

    "Health insurers are basically in the same boat. Competition with government-run insurance pools might put a little pressure on costs, but large insurers like UnitedHealth Group (NYSE: UNH ) and WellPoint (NYSE: WLP ) should be just fine since they can use their size to limit overhead"

    I completely disagree with this assessment of the effect on insurers. The new law is designed to eventually destroy private insurance and force single payer insurance on the U.S. Heres why: The new law requires that 85% and 80% of premiums be paid as benefits for large and small group insurers respectively. This will leave only 15% or 20% of premium revenue to to pay for G&A costs, much less any shareholder profit. With interest rates so low, the reserves held by insurers will barely generate any additional revenue to make up the difference. In 2009, the New York Times stated that the average benefit paid was only 71% of premiums collected, but the average insurer profit at that time was 4%. Although the larger health insurance companies will be better able to survive, eventually they will succumb to escalating costs as only those with existing illnesses will continue to be insured.

    Considering that after Jan. 1, 2014, all pre-existing conditions are covered, insurance companies will have to drastically raise premiums, causing many individuals to drop their insurance, and either pay the fine or tax (even the government can't make up their mind) or join one of the government pools. On Jan. 1, 2014, companies with 50 or more employees will also be required to provide insurance to their employees or pay a fine. The problem is that the individual and company fines will be less than the after-tax cost of paying for health insurance, so fewer and fewer will purchase health insurance.

    As premiums continue to rise exponentially, the public will demand the single payer system.

    ObamaCare is a carefully planned recipe for eventual insurance company bankruptcy, first the smaller insurance companies, and then the larger companies. As usual, government creates or aggravates the problem, and then "fixes" it.

  • Report this Comment On April 01, 2012, at 4:36 PM, CaptainWidget wrote:

    <<ObamaCare is a carefully planned recipe for eventual insurance company bankruptcy, first the smaller insurance companies, and then the larger companies. As usual, government creates or aggravates the problem, and then "fixes" it.>>

    Exactly, couldn't have said it better. Anyone who thinks otherwise is a nearsighted fool. Obamacare has nothing to do with health, it's just another system of control.

  • Report this Comment On April 06, 2012, at 12:52 PM, tuckdude wrote:

    I would like to pay only $140 euros a month for government insurance. Mine is $1100 a month (I pay $300 of that), medical, dental, vision, and I have co-pays and a $2,000 out of pocket per family member. I am assuming he is saying he is paying around $280 a month for him and his wife......kids?

    The problem is government mandated insurance, where they control the basic package, is that the lobbyist will have to lobby only a few people to get their products covered by the government base package. So, let's say it starts out not covering hair pieces, plastic surgery, etc. The people that sell these services/products will lobby to get them included, heavily contributing to the controlling politicians campaigns, and they quietly make there way into the basic coverage. Costs then go up even further.

    Plus, if you cannot afford to pay into the system,the government will just give it to you. So, you know have people on welfare, getting luxury apartments, and we now pay for their insurance. Those people vote to. So, if you work, you are penalized.

    Typically socialist system.

  • Report this Comment On April 08, 2012, at 1:35 PM, hedgehopper62 wrote:

    xetn,One of the best posts i have read in years on here.

    A movement should be started, That congess use obamacare, or do not support it,vote them out if not

    tks hedge

  • Report this Comment On April 12, 2012, at 9:30 AM, gageaa wrote:

    I was surprised to see that relief from baldness is covered by MrChapel's health insurance. I didn't know that was a sickness/disease. There are a lot of bald guys that look really healthy. How much does baldness reduce life expectancy? (Ok, someone is going to say that cancer patients go bald sometimes, but wouldn't wigs be covered under cancer treatment?)

  • Report this Comment On April 12, 2012, at 12:17 PM, DJDynamicNC wrote:

    @Wolfman "Objectively, how do you come to the conclusion that it's the obligation of someone else to come to your aid and pay your medical costs?"

    I'll take this one.

    Since that is the fundamental nature of insurance in general, there's nothing radical about saying that I have the obligation to take care of somebody else while I'm healthy in exchange for them taking care of me when I'm sick.

    And since there is absolutely nobody who does NOT, at some point, interact with the health care market - a market which most assuredly transcends state lines - there is nobody for whom such a situation is not relevant.

    But it goes further than that. I am making the conscious decision to embrace a national solution to health care that requires each of us to provide for his or her fellow human being. I believe that is a more valuable proposition for material wealth than almost all of the many alternatives on which we as a nation could expend our collective productivity, and I believe it is a more ethical arrangement as well. And since I freely choose to live in a representative democracy - as do each of you - I freely embrace the results of the elected officials who passed this legislation to reflect those values, though I have personal policy preferences that vary somewhat from what we arrived at (as is only natural in a nation as big and as varied as ours). Should I find the law onerous, I am free to work to change it or to abandon the country entirely or to elect new representatives. Such is the nature of democratic government - and such is the moral imperative of legislation enacted therein.

    There is nothing subjective about this analysis.

  • Report this Comment On April 12, 2012, at 12:19 PM, DJDynamicNC wrote:

    "A movement should be started, That congess use obamacare, or do not support it,vote them out if not "

    I would love for Congress to use the same insurance system as the rest of us.

    Unfortunately, they use a completely socialized, government provided insurance system that also provides its own socialized medical care through government provided doctors. It's far more socialist than anything I'm allowed to buy, even though I'd love to have the coverage they do.

    Naturally, members of Congress refuse to give it up. They just don't let us have the same thing.

    That would be socialism, you see.

  • Report this Comment On April 12, 2012, at 12:25 PM, DJDynamicNC wrote:

    "As premiums continue to rise exponentially, the public will demand the single payer system"

    If I recall correctly, that's exactly what happened. Premiums continued to rise, insurance companies continued to make major profits, and people began to demand change, which Obama delivered, for better or worse.

    For what it's worth, I agree that Obamacare sets the nation irrevocably on the path to single payer. It's the logical outcome for a market in which every single person participates and which benefits from centralized aggregation but is resistant to price comparison, as health insurance is. The current health care system is about as far from a free market as you can get, so I can't even say it's a proper socialist vs capitalist conflict - there's no price signaling (people get sick, get treated, THEN get a bill), there's almost no flexibility in treatment options (do you choose your doctor while sitting in an ambulance having a heart attack?) and there's already a mandate in place requiring treatment regardless of income, which creates a major freeloader problem that the mandate seeks to address. And that's before we even get to the intermediary health insurance market, which is almost as lacking in flexibility and price transparency as the health care market itself.

    Given the situation, single payer is an admission that the free market has failed to take hold and a socialist solution to the problems thus presented. Surely there are free market solutions as well, but the tradeoffs presented by many of them are unpalatable to people who don't like watching human beings suffer and die for financial reasons.

  • Report this Comment On April 25, 2012, at 9:55 PM, thidmark wrote:

    "many of them are unpalatable to people who don't like watching human beings suffer and die for financial reasons."

    Sounds like you are against the abortion mandate then, although something tells me you have a more convenient definition of a human being.

  • Report this Comment On July 02, 2012, at 5:23 PM, fmonic wrote:

    Boy, did this article ever push the Universal Hot Button! All I can say to the readers is, please move your button so the next guy can't push it. We can't be fighting each other if we want to get this fixed! This is a case of Us vs. City Hall.

    It's good to hear from the Netherlands and Minto1959 (my heart goes out to you; just don't do anything rash, ok?).

    Thank God we have a Congress and they will have to do something ASAP, Because a nation of hungry, sick, homeless, and unemployed can't pay for all this. We're all in the same boat; a part of each one of us agrees with all the rest, not completely, but everyone here has a point. And all those guys we vote for know one thing:

    They better fix it -- and fast -- or they won't get re-elected. End of story.

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