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Supreme Court On Health Care

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Sure, except your judge usually doesn't rely on precedent to determine FX-T.

 

 

That aside, I don't see what the big deal is--we're already mandated to have auto insurance if we drive.

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That aside, I don't see what the big deal is--we're already mandated to have auto insurance if we drive.

 

Lol. Because driving is a choice, you can just choose not to drive. Choosing not to live is harder. That said, i do support it, just not that metaphor.

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The arguments they've been using to support it are pretty ludicrous. Not buying things obviously effects cost through supply and demand, but if that's commerce than literally everything is commerce. It would expand government power to hypothetically infinitely larger because there is a finite amount of commerce in the sense of things being actively bought and sold but there is an infinite number of things that people aren't buying. Granted, this is kind of a stupid argument, but it reflects the fact that it would be a big deal if the government can penalize us for not buying certain things. I don't like that idea.

 

I also don't really understand why liberals are supporting the individual mandate except for the fact that some are bizarrely in love with everything Obama does, because it seems like it will be pretty awful for unemployed people and the poor. Fining poor people for making difficult personal financial decisions doesn't seem like something the Left or Right should or would be supporting. Most people who make a good living have health insurance anyway, so I really don't understand what purpose this has besides hurting poor people.

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Yeah I think it will be overturned.

 

The supreme court already has precedent on this, and guess what, they voted on FX T. Coincidentally this is also where the Lopez CP came from.

 

United States v. Lopez determined that the federal government does not have the power to restrict guns on schools. Defenders of the law stated that school violence hurts commerce and tourism so it would be protected by the commerce clause. Opponents stated that this would make commerce mean basically anything and infinitely expand the power of government. So it was ruled unconstitutional.

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Lol. Because driving is a choice, you can just choose not to drive. Choosing not to live is harder. That said, i do support it, just not that metaphor.

 

Yeah, I suppose that's true in a vacuum, but I live in Los Angeles, and let me assure you--driving is not a choice. (We can thank GM and Goodyear for purchasing and destroying our Public Transportation Infrastructure in the 1950s). By your logic-- living in the USA is technically a choice. [redneck] IF YOU DONT LIKE IT, YOU CAN GEEEET OUT! [/redneck]

 

 

The arguments they've been using to support it are pretty ludicrous. Not buying things obviously effects cost through supply and demand, but if that's commerce than literally everything is commerce. It would expand government power to hypothetically infinitely larger because there is a finite amount of commerce in the sense of things being actively bought and sold but there is an infinite number of things that people aren't buying. Granted, this is kind of a stupid argument, but it reflects the fact that it would be a big deal if the government can penalize us for not buying certain things. I don't like that idea.

 

I also don't really understand why liberals are supporting the individual mandate except for the fact that some are bizarrely in love with everything Obama does, because it seems like it will be pretty awful for unemployed people and the poor. Fining poor people for making difficult personal financial decisions doesn't seem like something the Left or Right should or would be supporting. Most people who make a good living have health insurance anyway, so I really don't understand what purpose this has besides hurting poor people.

 

I like your first paragraph, but disagree with the 2nd. I'm quite conservative myself, but i'm always in favor of government involvement in healthcare and education-- These two things are prerequisites for making a capitalistic free market society function because the core assumption of that structure is that all individuals have equal opportunity. (Which, IMO you can't have when you don't have equal access to health and edu) When those living without health insurance need to go to the hospital, they can't be denied treatment, but the costs are real, and are borne by the rest of society--including mainly those who DO pay their health insurance. This process has increased everyone's insurance premiums to the point where you NEED to work for a large corporation that can provide you the subsidized healthcare benefits that they are required to do by law--this ultimately hurts corporate profits and retards the growth rate of the corporations, limits their ability to hire, and thus stalls the growth rate of the US GDP at large. Further, people who work for small businesses as well as the owners of those small businesses get screwed over in the current system because neither can really afford a health insurance premium. The poor get especially screwed in the current system whereby they either can't go to the hospital or doctor at all because they simply CANNOT afford to. Even if they get checked out, they never get their prescription medicine that they need because again--without insurance, those medicines are cost-prohibitive. People are only upset about the govt. mandated cost because it's immediate and tangible, but Public Health is a responsibility of a free society and the government should regulate on it when needed. Aside from all that, the new policy would lower the costs across the board. Auto insurance is affordable--why? Because everyone needs to have it. So you can find a cheap, affordable minimum coverage company like Mercury or eSurance. Or if you're in a higher income bracket, homeowner, have a boat or RV or something else, you can get a better coverage through AAA or State Farm. Currently, there are VERY FEW basic health insurance providers because it's straight up not profitable.

 

I also don't see what the big deal is overall--no one's up in arms over the idea that the government makes you send your kid to school. Or the idea that there exists a school in your region where you can send your kids for free, or at taxpayer expense rather, or the idea that many people who don't have children pay taxes that get allocated to schools. But thankfully (as many policy debaters are aware) if you're of financial means, you can send your kids to a better, private school. You still have to pay taxes that go to public schools, but hey, looks like everyone's cool with that concept. Why is health so different?

 

I think this legislation is the first step to be able to tax subsidize the nation's health insurance needs and create a model that looks like our national education system--far from perfect, but at least everyone's basically literate and can add/subtract/multiply/divide and in theory do basic algebra.

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<p>

I like your first paragraph, but disagree with the 2nd. I'm quite conservative myself, but i'm always in favor of government involvement in healthcare and education-- These two things are prerequisites for making a capitalistic free market society function because the core assumption of that structure is that all individuals have equal opportunity. (Which, IMO you can't have when you don't have equal access to health and edu) When those living without health insurance need to go to the hospital, they can't be denied treatment, but the costs are real, and are borne by the rest of society--including mainly those who DO pay their health insurance. This process has increased everyone's insurance premiums to the point where you NEED to work for a large corporation that can provide you the subsidized healthcare benefits that they are required to do by law--this ultimately hurts corporate profits and retards the growth rate of the corporations, limits their ability to hire, and thus stalls the growth rate of the US GDP at large. Further, people who work for small businesses as well as the owners of those small businesses get screwed over in the current system because neither can really afford a health insurance premium. The poor get especially screwed in the current system whereby they either can't go to the hospital or doctor at all because they simply CANNOT afford to. Even if they get checked out, they never get their prescription medicine that they need because again--without insurance, those medicines are cost-prohibitive. People are only upset about the govt. mandated cost because it's immediate and tangible, but Public Health is a responsibility of a free society and the government should regulate on it when needed. Aside from all that, the new policy would lower the costs across the board. Auto insurance is affordable--why? Because everyone needs to have it. So you can find a cheap, affordable minimum coverage company like Mercury or eSurance. Or if you're in a higher income bracket, homeowner, have a boat or RV or something else, you can get a better coverage through AAA or State Farm. Currently, there are VERY FEW basic health insurance providers because it's straight up not profitable.
This was a pretty long paragraph and I skimmed, but my impression is that while these problems are real it's a much better solution to pay for the poor people's healthcare than it is to fine everyone without healthcare. The law might make costs lower, but they'll still exist and some people will have to choose to go without healthcare and to pay the fines. These type of people are the ones who this law is supposed to help. Give the poor free healthcare, but don't fine the poor for not having healthcare. The latter is a very backwards way to go about helping the poor and creating equal opportunity.This seems pretty simple to me. But that makes me wonder if I'm misinterpreting what you're saying.
I also don't see what the big deal is overall--no one's up in arms over the idea that the government makes you send your kid to school. Or the idea that there exists a school in your region where you can send your kids for free, or at taxpayer expense rather, or the idea that many people who don't have children pay taxes that get allocated to schools. But thankfully (as many policy debaters are aware) if you're of financial means, you can send your kids to a better, private school. You still have to pay taxes that go to public schools, but hey, looks like everyone's cool with that concept. Why is health so different?
I agree, basically. I'm not concerned with having to pay for other people's healthcare, but I am concerned about the law because I think the precedent it would set allows the government to penalize economic inactivity for the reasons in the first paragraph which you liked.People who get all outraged about freedom but who accept other equivalent forms of coercion are annoying.
I think this legislation is the first step to be able to tax subsidize the nation's health insurance needs and create a model that looks like our national education system--far from perfect, but at least everyone's basically literate and can add/subtract/multiply/divide and in theory do basic algebra.
I know nothing about the educational system. For whatever reason, that's the policy topic which I'm most completely ignorant about.

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I like your first paragraph, but disagree with the 2nd. I'm quite conservative myself, but i'm always in favor of government involvement in healthcare and education-- These two things are prerequisites for making a capitalistic free market society function because the core assumption of that structure is that all individuals have equal opportunity. (Which, IMO you can't have when you don't have equal access to health and edu) When those living without health insurance need to go to the hospital, they can't be denied treatment, but the costs are real, and are borne by the rest of society--including mainly those who DO pay their health insurance. This process has increased everyone's insurance premiums to the point where you NEED to work for a large corporation that can provide you the subsidized healthcare benefits that they are required to do by law--this ultimately hurts corporate profits and retards the growth rate of the corporations, limits their ability to hire, and thus stalls the growth rate of the US GDP at large. Further, people who work for small businesses as well as the owners of those small businesses get screwed over in the current system because neither can really afford a health insurance premium. The poor get especially screwed in the current system whereby they either can't go to the hospital or doctor at all because they simply CANNOT afford to. Even if they get checked out, they never get their prescription medicine that they need because again--without insurance, those medicines are cost-prohibitive. People are only upset about the govt. mandated cost because it's immediate and tangible, but Public Health is a responsibility of a free society and the government should regulate on it when needed. Aside from all that, the new policy would lower the costs across the board. Auto insurance is affordable--why? Because everyone needs to have it. So you can find a cheap, affordable minimum coverage company like Mercury or eSurance. Or if you're in a higher income bracket, homeowner, have a boat or RV or something else, you can get a better coverage through AAA or State Farm. Currently, there are VERY FEW basic health insurance providers because it's straight up not profitable.

 

This was a pretty long paragraph and I skimmed, but my impression is that while these problems are real it's a much better solution to pay for the poor people's healthcare than it is to fine everyone without healthcare. The law might make costs lower, but they'll still exist and some people will have to choose to go without healthcare and to pay the fines. These type of people are the ones who this law is supposed to help. Give the poor free healthcare, but don't fine the poor for not having healthcare. The latter is a very backwards way to go about helping the poor and creating equal opportunity.

 

This seems pretty simple to me. But that makes me wonder if I'm misinterpreting what you're saying.

 

I also don't see what the big deal is overall--no one's up in arms over the idea that the government makes you send your kid to school. Or the idea that there exists a school in your region where you can send your kids for free, or at taxpayer expense rather, or the idea that many people who don't have children pay taxes that get allocated to schools. But thankfully (as many policy debaters are aware) if you're of financial means, you can send your kids to a better, private school. You still have to pay taxes that go to public schools, but hey, looks like everyone's cool with that concept. Why is health so different?

 

I agree, basically. I'm not concerned with having to pay for other people's healthcare unless it would be incredibly expensive and inefficient (which is why I support rationing), but I am concerned about the law because I think the precedent it would set allows the government to penalize economic inactivity for the reasons in the first paragraph which you liked. People who get all outraged about freedom but who accept other equivalent forms of coercion are annoying.

 

I think this legislation is the first step to be able to tax subsidize the nation's health insurance needs and create a model that looks like our national education system--far from perfect, but at least everyone's basically literate and can add/subtract/multiply/divide and in theory do basic algebra.

 

I know nothing about the educational system. For whatever reason, that's the policy topic which I'm most completely ignorant about.

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One simple idea to throw in on the individual mandate:

 

When they force more people to get healthcare, the cheaper premiums get from the large influx of insurance customers, making it a more affordable system despite insurance companies having to pay for pre-existing conditions.

 

Also, emergency room costs from uninsured people are ridiculously high, this eases up some taxpayer money.

 

Also also, poor people will get government help in paying for it, and medicaid will be widened to include more.

 

Really, the only people the bill fucks with are rich people who get taxed on their expensive plans.

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the cheaper premiums get from the large influx of insurance customers

 

Excuse my ignorance on this, I haven't done a lot of reading about it.

 

But how does this happen? I would think more demand would increase prices.

 

Also, emergency room costs from uninsured people are ridiculously high, this eases up some taxpayer money.

 

I don't think a fine will help the poor people. It might help the public taxpayers at large but it doesn't seem like that's the intended purpose of the bill.

 

Also also, poor people will get government help in paying for it, and medicaid will be widened to include more.

 

I doubt that will be sufficient. Even if it is, why do we need a fine then?

 

A fine can only hurt the poor.

 

Really, the only people the bill fucks with are rich people who get taxed on their expensive plans.

 

That is the popular perception, but I've never seen much to justify that perception. I think the conservative criticisms of the bill have sort of seeped into everyone's understanding of the healthcare law and that the bill doesn't hurt the rich too much. And regardless of the overall bill, I don't think the individual mandate will do that.

 

You don't really justify the individual mandate / fine, you just say the other parts of the bill are good.

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I don't think a fine will help the poor people.

 

I think the one thing that bears noting (I'm not sure if this was mentioned) but the massive expansions of medicaid in the bill will to a lot to help people. Especially because there is, Like SpiderCat said, it does save a lot of money because of the influx of healthy people paying and also because it literally costs more to go without insurance. Lastly, people who don't have insurance or money still get care; they just have that money drained from the system.

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I think if you want to lower healthcare costs, you don't force new consumers into the market. Instead you tax the rich to pay for those who do want it.

(Also I'm still not clear on how increasing demand would decrease the cost of healthcare).

 

One of the issues I'm seeing is that although the mandate might decrease costs, paying for even cheap healthcare insurance might be an impossibility for some or perhaps many. I think most of the people who aren't paying for healthcare now would be willing to undertake a fine if that allows them to continue to keep taking classes to get their GED, or whatever. Healthcare insurance is a systemic drain on people's pocketbooks. And unfortunately, I think the fine will just make it harder for these people to achieve their goals.

 

Either way, I think we can agree that there hasn't been much discussion in the news about how much healthcare actually is doing for the poor. There's been ideological clash, but no one seems to be arguing that the bill is ineffective, only that it is or is not desirable. That doesn't seem like a very good outcome. Even if the answers to all of my questions and suggestions are the opposite of what I tentatively think they are, I think it's still worth questioning the effectiveness of the bill.

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I think if you want to lower healthcare costs, you don't force new consumers into the market. Instead you tax the rich to pay for those who do want it.

Wut

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(Also I'm still not clear on how increasing demand would decrease the cost of healthcare).

 

I'm pretty sure this bill isn't forcing people to get more healthcare. People can already go to the emergency room and get care. It just has to be paid for now (other than the massive medicaid expansions)

 

 

 

 

I think if you want to lower healthcare costs, you don't force new consumers into the market. Instead you tax the rich to pay for those who do want it.

 

It lowers healthcare costs because uninsured people cost a lot. Especially because they will be less likely to go in early which means by the time they get treatment for real problems, said problems are in more advanced stages, which is more expensive to treat.

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I think it'd be hilarious if PPACA were found unconstitutional and the bottled-up pressure led to an actual single-payer system.

 

An utter fantasy, but a funny one nonetheless.

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I'm pretty sure this bill isn't forcing people to get more healthcare. People can already go to the emergency room and get care. It just has to be paid for now (other than the massive medicaid expansions)

 

It lowers healthcare costs because uninsured people cost a lot.

 

See, this is the part that doesn't make sense to me. Insurance companies make money, so it's not as though by making people pay for insurance you automatically save money. I understood that sick people make for bad economies, but since uninsured people get helped anyways, simply saying that uninsured people get insurance doesn't really mean that it lowers the costs at all.

 

Especially because they will be less likely to go in early which means by the time they get treatment for real problems, said problems are in more advanced stages, which is more expensive to treat.

 

This part makes the overall argument make sense. Without it I don't think the argument is really coherent. I doubt this has very profound effects though, or that the bill does much to change this.

 

And, why doesn't more demand in HC insurance increase the cost of HC insurance? Or, if demand does increase costs, why does the other factor outweigh? I asked something similar earlier and your response was that everyone gets HC in the status quo, but not everyone gets HC insurance in the status quo, so what is it about HC insurance that makes it immune to supply and demand? It's still a consumer good...

 

And still no one's made it clear why we're fining those who don't participate. The fine would only serve to motivate change among those in extremely difficult financial situations, and we probably shouldn't fine people with that level of income simply because they have to make tough decisions. I also don't really think forcing the extremely poor who decide this makes economic sense into the market will substantially lower costs for anyone else, and while it might help the poor in terms of health it will hurt them in other areas. I would rather let the poor negotiate their own financial tradeoffs without a fine, or better yet, make it so they don't have to have a situation where, for example, they have to choose between completing a GED class but being fined each month or getting a decent healthcare package. I think doing nothing is superior to fining, but that helping is superior to both those other options.

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See, this is the part that doesn't make sense to me. Insurance companies make money, so it's not as though by making people pay for insurance you automatically save money. I understood that sick people make for bad economies, but since uninsured people get helped anyways, simply saying that uninsured people get insurance doesn't really mean that it lowers the costs at all.

 

The bill actually put a minimum on the percentage of revenue that can be taken as profit. Legit, the more I've invoked different parts of the bills in discussions, the more I've realized how nuanced it is. for a lot of the rest, I'm not quite sure why individuals have to pay so much more than insurance companies. I think it has a lot to do with the bargaining power of insurance companies; that said, the facts speak for themselves.

 

This part makes the overall argument make sense. Without it I don't think the argument is really coherent. I doubt this has very profound effects though, or that the bill does much to change this.

 

And, why doesn't more demand in HC insurance increase the cost of HC insurance? Or, if demand does increase costs, why does the other factor outweigh? I asked something similar earlier and your response was that everyone gets HC in the status quo, but not everyone gets HC insurance in the status quo, so what is it about HC insurance that makes it immune to supply and demand? It's still a consumer good...

 

I maintain that in the squo, the vast majority of people get healthcare, they just don't get it when they need it. But the problem is by the time they get care, it's way more xpensive. It's like, for example, how those who can might go to the hospital with tightness in tehe ches, but others have a heart attack, and that is much, much more expensive to pay for. (granted, that's actually a sort of bad example. Consider a sort of cancer that is terminal, and thus ridiculously expensive to treat, by the time they get care). It ends up being a pretty big effect by the time it's done. And, like I said, supply and demand is fixed the the limits on how much money insurance companies can use as overhead and/or profits, which virtually nullifies s/d.

 

And still no one's made it clear why we're fining those who don't participate. The fine would only serve to motivate change among those in extremely difficult financial situations, and we probably shouldn't fine people with that level of income simply because they have to make tough decisions. I also don't really think forcing the extremely poor who decide this makes economic sense into the market will substantially lower costs for anyone else, and while it might help the poor in terms of health it will hurt them in other areas. I would rather let the poor negotiate their own financial tradeoffs without a fine, or better yet, make it so they don't have to have a situation where, for example, they have to choose between completing a GED class but being fined each month or getting a decent healthcare package. I think doing nothing is superior to fining, but that helping is superior to both those other options.

 

I see it working for like this, everyone else is paying either way but the fines at least compensate a little bit, but I think it should be made abundantly clear that Medicare underwent massive expansions under the bill, which fixed lots of those problem. If someone is really that close to the brink, they're probably able to gain federal money. I agree with you that 'helping is superior/ and we do that, but at the same time people who simply aren't in the system because they don't want to but still get care at the expense of everybody else. What I'm trying to say is that those extremely poor will get gvt. paid care.

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So many mixed feelings on the ruling. Healthcare costs are destined to skyrocket in the interim. I agree with most liberal leaning individuals that expanding healthcare coverage to all citizens is inherently a good idea. I disagree strongly with the mechanism. For those who think insurance costs will go down, you're not understanding what insurance does. Insurance is basically at its core a pooled risk which means that the insurance company, for a given plan, needs X many healthy individuals paying premiums to cover X minus Y individuals' healthcare (because healthcare always costs more than your premium and deductible).

 

So let us say that there are 10,000 people in a plan and in any year, about 1,000 (10%) of them require hospitalization at an average cost of $5,000 per hospitalized person (heart attacks cost more than little Jimmy breaking his leg after a bicycle accident). So this means that in order for the insurance company to at minimum break even, they more or less need to charge $500 per person as an annual premium. That sounds reasonable except for two things, health care is far more expensive, and more people use it in reality. But for the purposes of math, thats neither here nor there. Now, we all know that uninsured people tend to have the worst health because they cannot afford to go see the doctor for preventative health maintenance and have gotten to the point where they see no one until they have a heart attack, so not only are their conditions worse (which cost more) but they are sicklier as a whole. If its true that 1/3 of Americans are uninsured/underinsured, then let us adjust our numbers. To the initial plan, we add 5,000 people to the plan and their average hospitalization rates are 2,000 (40%) at an average cost of $10000. So readjusting figures, we now have 15,000 people enrolled in the plan, with 3,000 (20%) of them requiring hospitalization at an average cost of $8333 ($25MM total). Now to break even, everyone's annual premium has jumped to $1666 - a 200+ percent increase. Insurance companies loved poor people because they don't buy insurance and are off the hook for paying for them. Now that poorer people will get healthcare coverage, it will be worse coverage (which more or less might as well be no coverage) and they will be underinsured. What you will end up seeing is poorer people purchasing the bare minimum coverage - like those "stay legal" auto insurance coverages - which will cover very few healthcare services. I fully expect to see healthcare plans pop up in Texas which are sold to people living in McAllen... but the only hospital "in network" is in Amarillo.

 

But this isn't the worst part. When you do the math, we don't have a healthcare problem in America, we have a health problem. Diabetes is single handedly the largest driver of healthcare. Aside from being an expensive disease condition on its own, it THE leading cause of amputations, blindness, chronic kidney disease (which leads to kidney dialysis) and neuropathies. It is a leading cause of heart disease and clot formation which can lead to heart attacks, strokes, or deep vein thromboses. And rates of diabetes have increased from 3% to 7% in the past 20 years (CDC figures) and hospital admissions alone for diabetic patients amount to about 100 billion dollars! Incidence rates are skyrocketing for every disease from allergies to osteoporosis, with the exception of cancer which is pretty stable. Some people like to claim that it is because of peoples' poor access to healthcare that is driving up the rates of illness. But this is only about 5% true. The rates of the costly illnesses are irrespective of the healthcare coverage problem. Childhood obesity is leading to an epidemic of diabetes, heart disease, etc. I fully expect life expectancy in this country to go down due to the rate of disease.

Play with this: apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx

 

Until we get control of HEALTH, adding more layers of complexity behind who pays for what is simply a shell game. Quite honestly, if anyone thinks that the SCotUS ruling will improve the state of health in America, they are delusional. The objective of any healthcare policy NEEDS to be to get a handle on the health problems in America and until then, its doomed to more failure.

 

And that means I am okay with taxing any meal over 700 calories an extra $5. I am okay with taxing any food product with trans fats an extra $10. I am okay with taxing any food other than fats/oils for having more than 50% of its calories come from fat an extra $20. I am okay with subsidizing local farmers markets. I am okay with giving millions and millions to public transportation. I am okay with throwing gobs of money to fitness clubs to lower their rates (or just subsidize memberships). And its okay to charge an extra $1000 a year to own a vehicle.

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