Check out this fantastic video/rant/musical piece on growing up Catholic, and sitting through the sermons:

I’m going to have to rent this guy’s DVD from netflix, at a minimum.

(From Friendly Atheist)

Ah, another day, another pathetic argument in favor of requiring Americans to pay Wellpoint a tithe or else the IRS comes after their paychecks.

After a bit of rambling on how health-care and health insurance aren’t the same thing (no shit, Sherlock), and a bit of history on how ERs are supposedly forced to cover the uninsured (a practice that works far better in theory than in reality, as hospitals deny urgent care all the damn time), Kay over at BJ rolls out with this chestnut:

You don’t have to buy health insurance. You don’t have to pay a private insurer. What you do have to do is contribute to the costs of covering the pool called “the uninsured” because if you don’t purchase the subsidized policy and instead pay the tax penalty, you’ll be uninsured. And it costs to provide emergency care to “the uninsured”. A lot. And the federal government reimburses part of that cost.

This is fantastic logic! When a law extends penalties enforced by the executive branch, it’s not really saying you *can’t* do something, or that you shouldn’t, it’s just, you know, trying to recoup costs. Let’s extend the reasoning:

You don’t *have* to avoid beating your neighbor to death with a ball-peen hammer; you just have to contribute to the costs of burying them by working the rest of your life making license plates.

Oh wait; that’s fucking stupid sophistry, isn’t it? The law’s primary purpose is clearly to deter murder, just like the primary purpose of the Individual Mandate is *clearly* to coerce people into paying for insurance. Handy hint, Kay: that’s why it goes up from 1 to 2.5% of income. It doesn’t do that because ER costs are anticipated to go up 150% in two years.

But, riddle me this, Kay: if the penalty for the Individual Mandate was really to cover emergency room care, as you claim, then surely it would, in fact, be collected into a separate fund and dispersed to hospitals as needed to reimburse said care, or else set aside specifically to reimburse the costs of ER care in some other fashion, perhaps pooled with other money that goes to that purpose and so forth.

So, is it? Is the Individual Mandate in fact used to raise money for ER care?

Show me the section of the bill where that occurs. I’m intensely curious to know how fining people who don’t want to spend up to 20% of their income annually on insurance they can’t afford to use ends up paying for ER beds under this legislation, because I just can’t find the section. Please, illuminate me on the funding mechanism you’ve outlined here; specific citations to relevant portions of the law would be helpful.

Please do that, or stop making shit up.

Update: The law Kay cites that forces hospitals to cover (limited) ER care regardless of insurance? The Emergency Medical Treatment and Active Labor Act? It doesn’t provide any funding to hospitals for covering said care. Rather, it uses a big stick, that you have to do so to participate in Medicare.

So, in other words, Kay’s entire argument is full of shit, since the Federal government does not pay for uncompensated ER care today. There is absolutely no mechanism in place to do so, and therefore the Individual Mandate penalty must serve some other purpose.

I wonder what that could be.

The dirty little secret about Obama’s preferred HCR plan (besides the part where he sold the public out on the public option, then went before Congress and lied about it still being on the table) is that much of the expansion in coverage doesn’t come from the vaunted (and largely useless, massively overpriced) Exchanges, but through an expansion in Medicaid.

That’s not really the dirty part of the secret, it’s just common sense; the Exchanges will see premiums soar so quickly, and cost so exhorbitantly much, that there was no hope, ever, of even getting them off the ground if the truly poor got to buy ‘private’, ie corporatist, insurance. They’ll fall apart due to prices eventually, but it would be better if it took a while, politically at least.

So they expanded Medicaid, and rolled up the popular SCHIP programs into it. All sounds good, right?

Wrong. First of all, many doctors won’t touch Medicaid with a ten foot pole, because it pays so little. Nor is there any legal requirement to accept it.

Secondly, however: Medicaid is a jointly funded operation, part federal, part state… and the states are broke.

So for the first few years, the expansion is paid for entirely by the Feds, to make sure it actually happens; then in 2017, the Feds cut the subsidy back dramatically, and the states are expected to pick up the tab. These subsidy rates are actually more generous than I would have expected; for poorer, IE, more typically Republican states, the Feds might still pick up the whole tab. Others, like California, will get stuck with a quarter of the bill for the newly eligible, plus the usual rate for the rest in the program.

What happens if they don’t, or even can’t, pick it up? And keep in mind, the boosted subsidies only apply to the ‘newly eligible’. So what if they cut the overall program to the bone?

Like, say, they’re considering now in Washington:

Some 500,000 Washington adults whose prescriptions are covered by Medicaid could soon lose that benefit unless lawmakers provide special funding when they reconvene in January.

Medicaid’s adult drug program, which provides medication to the state’s poorest individuals through a combination of state and federal funding, will be eliminated in March if the Legislature can’t come up with $40 million before Feb. 1, according to the Department of Social and Health Services (DSHS).

…

The adult-prescriptions program cannot be protected in the DSHS cuts because federal law requires states to maintain many other Medicaid benefits, Porter said. Those federally required benefits include pharmaceutical coverage for children and prescriptions dispensed in health-care facilities such as hospitals and nursing homes.

Got that? States can, and will, slash Medicaid to plug holes in their budget, and something as simple as a basic prescription drug benefit for adults is on the table.

So, much like in the exchanges, people will be given a lousy service, full of holes and light on doctors, that they can’t effectively utilize, and lo, it will be called ‘health care reform’ by Obama’s wide-eyed and incredibly gullible followers.

Lather, rinse, repeat.