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ACA Arguments before SC 11/10/2020


immamac

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  • immamac changed the title to ACA Arguments before SC 11/10/2020

The court needs to decide, they are arguing both sides fairly well though.

If it's a mandate that causes bad things for Texas, they need to prove it actually does not just talk about the potential of the harm. 

OR

if it's not a mandate, why would striking down an entire piece of legislation make any sense at all? 

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WHAT IF THEY HAD A RECORD FOREVER WHETHER OR NOT YOU HAD HEALTH INSURANCE!?!?!?!

Lawyer was like, uh...there is no record of that, and even if there was it wouldn't matter because it's the IRS not your HC provider or something like that lol

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2 minutes ago, Neonmoon said:

Why do I feel like they're just going through the motions? 

I don't think the court wanted to hear this case from some of the judges comments. Gorsuch asked some clarification questions but he sounds like he thinks it's real stupid to overturn ACA

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The lawyer for California needs to be working for some sound bites here.  Make the GOP own this in digestible clips so that people understand that the GOP is absolutely trying to fuck them out of healthcare during the pandemic.

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22 minutes ago, immamac said:

I don't think the court wanted to hear this case from some of the judges comments. Gorsuch asked some clarification questions but he sounds like he thinks it's real stupid to overturn ACA

thats what I got from Breyer's questioning right now to the Texas SC in talking about other statutes that have "mandates" but don't carry penalties and that they are seen as more of a "hey plant a tree today" type thing (his example was a statute to plant trees or something) and in that case if they were to side with Texas and other states they'd have standing challenges for  a bunch of statutes.

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3 minutes ago, CowboyFred said:

thats what I got from Breyer's questioning right now to the Texas SC in talking about other statutes that have "mandates" but don't carry penalties and that they are seen as more of a "hey plant a tree today" type thing (his example was a statute to plant trees or something) and in that case if they were to side with Texas and other states they'd have standing challenges for  a bunch of statutes.

The ACA doesn't even have a "mandate." It doesn't even pretend to require that everyone get insurance. It just gives you a choice between paying the tax or getting insurance in lieu of paying the tax. That's why the original litigation was so stupid and why this litigation, when that tax has been reduced to zero, is absolute nonsense.

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1 minute ago, wildcat09 said:

The ACA doesn't even have a "mandate." It doesn't even pretend to require that everyone get insurance. It just gives you a choice between paying the tax or getting insurance in lieu of paying the tax. That's why the original litigation was so stupid and why this litigation, when that tax has been reduced to zero, is absolute nonsense.

completely agree with the above and with immamac's comment that you can tell the judges don't even want to be there. 

6 minutes ago, Neonmoon said:

 

1234

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3 hours ago, elfenix said:

So either no standing or mandate severed if it's actually a problem

That's what it'll be and what should have happened in the first place in 2010.  Keep the Act, but you cannot fund it compulsively.

This decision is needed though, because it'll knock out the ability of a future congress to go in and re-set a monetary penalty for not coercively paying directly into Obamacare (vs. legislative earmarking for Medicare, etc.).  Even Kagan said as much today.

The long, tortuous path of direct coercive payment, knocked out in 2017, will end permanently, and the program will stay.  It took 10 years but they finally got it right (if this is what will be decided, which seems like a slam-dunk).

Edited by phdhorn
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16 minutes ago, phdhorn said:

That's what it'll be and what should have happened in the first place in 2010.  Keep the Act, but you cannot fund it compulsively.

The mandate was not a funding mechanism.  It was the stick intended to prevent adverse selection, and the mandate was essential to the viability of the ACA in terms of creating a functional risk pool that could draw diverse benefit designs. Scuttling it just creates further inertia around narrow network plans in the marketplace, the exact types of benefit design that create the most abrasion.  If we are going to do the ACA, the mandate penalty needs to be much higher, not dissolved.  

Edited by Anastasis
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12 minutes ago, Anastasis said:

 

The mandate was not a funding mechanism.  It was the stick intended to prevent adverse selection, and the mandate was essential to the viability of the ACA in terms of creating a functional risk pool that could draw diverse benefit designs. Scuttling it just creates further inertia around narrow network plans in the marketplace, the exact types of benefit design that create the most abrasion.  If we are going to do the ACA, the mandate penalty needs to be much higher, not dissolved.  

All of this. 

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3 minutes ago, gyroprotagonist said:

so i am a bad citizen and know fuckall about the ACA

- the mandate was to 'punish' people who opted out of ANY insurance and just went yolo, correct?

Why are Trumpkins against this?  Are they for just letting people use the ER as their health care provider and skipping on the bill?


Obama = bad 

healthcare = socialism

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i saw an article (This was in west virginia) about regular poor people being mad they they had to pay for medicare(?) and super poor people got to pay less/zero for medicade(?).  so the regular poor people are all Trump voters and did not believe that Trump would actually get rid on the ACA but would get rid of Obamacare (not realizing it was the same thing) but they definitely wanted to stick it to the super poor people who are all lazy and just exist to get free stuff.

- i may have gotten medicare and medicade mixed up. 

 

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20 hours ago, gyroprotagonist said:

so i am a bad citizen and know fuckall about the ACA

- the mandate was to 'punish' people who opted out of ANY insurance and just went yolo, correct?

Why are Trumpkins against this?  Are they for just letting people use the ER as their health care provider and skipping on the bill?

Insurance works poorly if you can just purchase it after you get sick.  Prohibiting insurance companies from exempting pre-existing conditions means that someone could purchase a policy after getting a cancer diagnosis.  The mandate was meant to compel more people to buy insurance to mtitigate that impact.  By getting rid of the mandate, they are destabalizing the market.  If people can't find policies, or if those policies are really expensive because insurance companies are pricing in pre-existing conditions, then the public will be frustrated with the ACA and support Republican efforts to repeal it.  

In other words, getting rid of the mandate is a way to torpedo the ACA, without saying you are trying to remove the popular pre-existing condition portion.  

Edit: Also, the mandate itself is unpopular.  People don't like being forced to pay for things.  So it is more politically expedient to attack this, knowing it will destabilize the market, than it is to attack the ACA head-on. 

Edited by Tuco
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20 hours ago, gyroprotagonist said:

i saw an article (This was in west virginia) about regular poor people being mad they they had to pay for medicare(?) and super poor people got to pay less/zero for medicade(?).  so the regular poor people are all Trump voters and did not believe that Trump would actually get rid on the ACA but would get rid of Obamacare (not realizing it was the same thing) but they definitely wanted to stick it to the super poor people who are all lazy and just exist to get free stuff.

- i may have gotten medicare and medicade mixed up. 

 

Medicaid is for poors.  Medicare is for olds, and people with end-stage renal disease and ALS.

Medicaid traditionally has pretty narrow qualifications so that working poor can't get it.  Medicaid expansion under Obamacare was supposed to mitigate that some.  Medicaid is administered almost entirely and exclusively by states with some federal funding.

Medicare is not completely cost free unless you purchase a medicare supplement on the open market. 

With the subsidy, an ACA plan for someone with some income can be free or almost zero cost.  So this would be available to working poor, but maybe not destitute, who would be stuck with Medicaid.

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21 hours ago, gyroprotagonist said:

so i am a bad citizen and know fuckall about the ACA

- the mandate was to 'punish' people who opted out of ANY insurance and just went yolo, correct?

Why are Trumpkins against this?  Are they for just letting people use the ER as their health care provider and skipping on the bill?

Without the mandate only sick people will buy insurance leasing to adverse selection.  Insurance survives on the principal that the money of many pay for the loses of the few.

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It should be noted that, at least so far, things seem to be holding up relatively ok without the mandate. This is certainly to the surprise of the wonks who designed the ACA. Maybe it's just too soon and we'll see the death spiral after a few more years. I don't know shit about health insurance markets.

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3 minutes ago, TexEx15 said:

Without the mandate only sick people will buy insurance leasing to adverse selection.  Insurance survives on the principal that the money of many pay for the loses of the few.

Insurance doesn't survive on that principal at all. It thrives on it. They are making in excess of a combined 30B per quarter. 

The whole concept of health "insurance" instead of health care is fundamentally broken. 

ACA is a bridge legislation to actual healthcare reform, and I think the SC agrees that throwing out this mega legislation because of a nothing burger clause is detrimental both in a real and legal sense. 

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6 minutes ago, wildcat09 said:

It should be noted that, at least so far, things seem to be holding up relatively ok without the mandate. This is certainly to the surprise of the wonks who designed the ACA. Maybe it's just too soon and we'll see the death spiral after a few more years. I don't know shit about health insurance markets.

ACA was honestly not even supposed to last this long. Instead of legislating properly our senate has been too busy with political theater to actually fix America.

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Having Medicaid is not a walk in the park. They get many doors shut in their face when looking for a doctor. Mainly because most practices cannot earn enough if they see too many Medicaid patients. The reimbursement from the govt is too low. 

 

1 hour ago, Tuco said:

Insurance works poorly if you can just purchase it after you get sick.  Prohibiting insurance companies from exempting pre-existing conditions means that someone could purchase a policy after getting a cancer diagnosis.  The mandate was meant to compel more people to buy insurance to mtitigate that impact.  By getting rid of the mandate, they are destabalizing the market.  If people can't find policies, or if those policies are really expensive because insurance companies are pricing in pre-existing conditions, then the public will be frustrated with the ACA and support Republican efforts to repeal it.  

In other words, getting rid of the mandate is a way to torpedo the ACA, without saying you are trying to remove the popular pre-existing condition portion.  

Edit: Also, the mandate itself is unpopular.  People don't like being forced to pay for things.  So it is more politically expedient to attack this, knowing it will destabilize the market, than it is to attack the ACA head-on. 

I think the old method of pre-existing coverage was extremely fair. You were covered as long as you maintained coverage, even if you switched plans. The new insurance plan had to cover you. The plans all had to accept that risk.

We can't have a system that allows you to buy fire insurance when your house is on fire. I feel bad is someone doesn't buy fire insurance and their house catches on fire but I don't want my home ins premiums to cover their bad decision/luck. It's unfair.

The ACA mandate will never work unless it's extremely punitive, or the govt deducts the penalty/insurance premium from your paycheck like a tax. Obviously the premium deduction happens (not by the govt) if you have an employee plan. I'm referring to personal health plans.

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9 minutes ago, Nice Guy Eddie said:

We can't have a system that allows you to buy fire insurance when your house is on fire. I feel bad is someone doesn't buy fire insurance and their house catches on fire but I don't want my home ins premiums to cover their bad decision/luck. It's unfair.

The issue is that the insurance industry is trying to create a security out of a thing that is basically guaranteed to happen. People are going to get sick. People are going to need extra levels of care to maintain a human standard of living. Handling those things in a humane manner while also meeting shareholder expectations evidently isn't gonna happen. The middlemen want their cut

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37 minutes ago, wildcat09 said:

It should be noted that, at least so far, things seem to be holding up relatively ok without the mandate. This is certainly to the surprise of the wonks who designed the ACA. Maybe it's just too soon and we'll see the death spiral after a few more years. I don't know shit about health insurance markets.

 

yeah, I was just coming to post this. NPR had a story on it in the last few days. But its only working because of the large subsidies the poors get. Their SCOTUS reporter, who seems pretty sharp, predicted this crap lawsuit wouldn't fly.

 

31 minutes ago, immamac said:

Insurance doesn't survive on that principal at all. It thrives on it. They are making in excess of a combined 30B per quarter. 

The whole concept of health "insurance" instead of health care is fundamentally broken. 

ACA is a bridge legislation to actual healthcare reform, and I think the SC agrees that throwing out this mega legislation because of a nothing burger clause is detrimental both in a real and legal sense. 

 

29 minutes ago, immamac said:

ACA was honestly not even supposed to last this long. Instead of legislating properly our senate has been too busy with political theater to actually fix America.

 

Both of these, especially the bolded, are spot on.

 

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38 minutes ago, Nice Guy Eddie said:

We can't have a system that allows you to buy fire insurance when your house is on fire. I feel bad is someone doesn't buy fire insurance and their house catches on fire but I don't want my home ins premiums to cover their bad decision/luck. It's unfair.

 

 

 

https://www.opposingviews.com/money/man-won-t-pay-for-fire-protection-firemen-watch-home-burn

 

When firemen respond to a fire, they usually work very hard to put out the fire to limit injury and damage. Well, firefighters in Tennessee simply watched a house burn to the ground -- all over $75.

The rural town of Obion County does not have its own fire department. So homeowners there have to pay $75 per year to the neighboring city of South Fulton if they want protection.

Gene Cranick didn't want to pay, and when his house caught fire last week he found out what the expression "penny wise, pound foolish" means. He tried to put out the fire with his garden hose. When he couldn't control it, he called 911, offering to pay all expenses to the South Fulton fire department for its services.

But firefighters refused because Cranick didn't pay the fee. They only responded to the scene when Cranick's fee-paying neighbor called with concerns that the fire could spread to his house.

They stood ready with the fire hoses and watched fire ravage Cranick's house. They only jumped into action when the fire reached the neighbor's property.

"I hadn't paid my $75 and that's what they want, $75, and they don't care how much it burned down," Cranick told WPSD-TV. "I thought they'd come out and put it out, even if you hadn't paid your $75, but I was wrong."

The incident has somehow sparked a debate between the left and the right. Writing for the right-leaning National Review, Daniel Foster, a self-described "conservative with fairly libertarian leanings," was outraged:

"What moral theory allows these firefighters (admittedly acting under orders) to watch this house burn to the ground when 1) they have already responded to the scene; 2) they have the means to stop it ready at hand; 3) they have a reasonable expectation to be compensated for their trouble?"

But Foster's colleague Kevin Williamson took the opposite view:

"The South Fulton fire department is being treated as though it has done something wrong, rather than having gone out of its way to make services available to people who did not have them before. The world is full of jerks, freeloaders, and ingrates — and the problems they create for themselves are their own. These free-riders have no more right to South Fulton's firefighting services than people in Muleshoe, Texas, have to those of NYPD detectives."

 

 

I bet this idiot could have saved more than $75 per year on his homeowner's insurance if he had paid for the fire protection.

 

Edited by High Plains Drifter
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26 minutes ago, Nice Guy Eddie said:

I think the old method of pre-existing coverage was extremely fair. You were covered as long as you maintained coverage, even if you switched plans. The new insurance plan had to cover you. The plans all had to accept that risk.

Fair is a value statement.  

The reality is that there were people without coverage. If they got sick, one of three things could happen:

1. The insurance companies took that risk.  (Current system.)

2. The hospital took that risk.

3. The person took that risk. 

In reality, pre-ACA it was split between 2 and 3.  You can make the case that the person who made the decision should bare the risk.  But, as a society, we don't like to watch people die without treatment, just because they (or their parents) took a risk. I can see the logical argument for it.  But I don't agree with it, because it's based on a value system I no longer subscribe to. I believe people should have access to health care.  The previous system really sucked at that.  The current system sucks slightly less. It's past time for universal coverage.  

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23 hours ago, Anastasis said:

 

The mandate was not a funding mechanism.  It was the stick intended to prevent adverse selection, and the mandate was essential to the viability of the ACA in terms of creating a functional risk pool that could draw diverse benefit designs. Scuttling it just creates further inertia around narrow network plans in the marketplace, the exact types of benefit design that create the most abrasion.  If we are going to do the ACA, the mandate penalty needs to be much higher, not dissolved.  

All you need to do is take insurance regulation away from the states. If you could buy a plan from any state premiums would drop. Republicans won’t do that because the carriers will lose money and dems won’t do it because demand for a government option will drop

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9 minutes ago, High Plains Drifter said:

 

 

https://www.opposingviews.com/money/man-won-t-pay-for-fire-protection-firemen-watch-home-burn

 

When firemen respond to a fire, they usually work very hard to put out the fire to limit injury and damage. Well, firefighters in Tennessee simply watched a house burn to the ground -- all over $75.

The rural town of Obion County does not have its own fire department. So homeowners there have to pay $75 per year to the neighboring city of South Fulton if they want protection.

Gene Cranick didn't want to pay, and when his house caught fire last week he found out what the expression "penny wise, pound foolish" means. He tried to put out the fire with his garden hose. When he couldn't control it, he called 911, offering to pay all expenses to the South Fulton fire department for its services.

But firefighters refused because Cranick didn't pay the fee. They only responded to the scene when Cranick's fee-paying neighbor called with concerns that the fire could spread to his house.

They stood ready with the fire hoses and watched fire ravage Cranick's house. They only jumped into action when the fire reached the neighbor's property.

"I hadn't paid my $75 and that's what they want, $75, and they don't care how much it burned down," Cranick told WPSD-TV. "I thought they'd come out and put it out, even if you hadn't paid your $75, but I was wrong."

The incident has somehow sparked a debate between the left and the right. Writing for the right-leaning National Review, Daniel Foster, a self-described "conservative with fairly libertarian leanings," was outraged:

"What moral theory allows these firefighters (admittedly acting under orders) to watch this house burn to the ground when 1) they have already responded to the scene; 2) they have the means to stop it ready at hand; 3) they have a reasonable expectation to be compensated for their trouble?"

But Foster's colleague Kevin Williamson took the opposite view:

"The South Fulton fire department is being treated as though it has done something wrong, rather than having gone out of its way to make services available to people who did not have them before. The world is full of jerks, freeloaders, and ingrates — and the problems they create for themselves are their own. These free-riders have no more right to South Fulton's firefighting services than people in Muleshoe, Texas, have to those of NYPD detectives."

 

 

I bet this idiot could have saved more than $75 per year on his homeowner's insurance if he had paid for the fire protection.

 

Makes sense. If you can wait until your house catches fire and then pay the $75 during your 911 call, everybody would just stop paying, and the department would lose all that funding. Homeboy fucked around and found out

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8 minutes ago, High Plains Drifter said:

 

 

https://www.opposingviews.com/money/man-won-t-pay-for-fire-protection-firemen-watch-home-burn

 

When firemen respond to a fire, they usually work very hard to put out the fire to limit injury and damage. Well, firefighters in Tennessee simply watched a house burn to the ground -- all over $75.

The rural town of Obion County does not have its own fire department. So homeowners there have to pay $75 per year to the neighboring city of South Fulton if they want protection.

Gene Cranick didn't want to pay, and when his house caught fire last week he found out what the expression "penny wise, pound foolish" means. He tried to put out the fire with his garden hose. When he couldn't control it, he called 911, offering to pay all expenses to the South Fulton fire department for its services.

But firefighters refused because Cranick didn't pay the fee. They only responded to the scene when Cranick's fee-paying neighbor called with concerns that the fire could spread to his house.

They stood ready with the fire hoses and watched fire ravage Cranick's house. They only jumped into action when the fire reached the neighbor's property.

"I hadn't paid my $75 and that's what they want, $75, and they don't care how much it burned down," Cranick told WPSD-TV. "I thought they'd come out and put it out, even if you hadn't paid your $75, but I was wrong."

The incident has somehow sparked a debate between the left and the right. Writing for the right-leaning National Review, Daniel Foster, a self-described "conservative with fairly libertarian leanings," was outraged:

"What moral theory allows these firefighters (admittedly acting under orders) to watch this house burn to the ground when 1) they have already responded to the scene; 2) they have the means to stop it ready at hand; 3) they have a reasonable expectation to be compensated for their trouble?"

But Foster's colleague Kevin Williamson took the opposite view:

"The South Fulton fire department is being treated as though it has done something wrong, rather than having gone out of its way to make services available to people who did not have them before. The world is full of jerks, freeloaders, and ingrates — and the problems they create for themselves are their own. These free-riders have no more right to South Fulton's firefighting services than people in Muleshoe, Texas, have to those of NYPD detectives."

 

 

I bet this idiot could have saved more than $75 per year on his homeowner's insurance if he had paid for the fire protection.

 

Dumbass. 75 a year is nothing for that. Although since he was offering to cover costs once the fire was burning, they should have negotiated.  Let the market decide. I'm sure there was an amount that would have caused them to spring into action. Maybe 1/4 to 1/2 of the value of the home. 

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57 minutes ago, Nice Guy Eddie said:

Having Medicaid is not a walk in the park. They get many doors shut in their face when looking for a doctor. Mainly because most practices cannot earn enough if they see too many Medicaid patients. The reimbursement from the govt is too low. 

 

I think the old method of pre-existing coverage was extremely fair. You were covered as long as you maintained coverage, even if you switched plans. The new insurance plan had to cover you. The plans all had to accept that risk.

We can't have a system that allows you to buy fire insurance when your house is on fire. I feel bad is someone doesn't buy fire insurance and their house catches on fire but I don't want my home ins premiums to cover their bad decision/luck. It's unfair.

The ACA mandate will never work unless it's extremely punitive, or the govt deducts the penalty/insurance premium from your paycheck like a tax. Obviously the premium deduction happens (not by the govt) if you have an employee plan. I'm referring to personal health plans.

The old way wasn't fair.  Let's say you are healthy and lose your job.  COBRA is as expensive as fuck, so you pay it for a few months but decide that rent and food need to come first. So you roll the dice. 2 months later, still unemployed, you find out you have a serious issue. Even if you find a new job, your new policy likely won't cover it. So you're fucked. And all because you couldn't afford to drop 1k a month on insurance while unemployed. If we are gonna keep our fucked up system, maybe health insurance should be added to unemployment. 

The mandate needs to be auto enrollment in the cheapest available policy. And that premium amount needs to be the tax penalty. 

Edited by FondrenRoad
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6 minutes ago, High Plains Drifter said:

I bet this idiot could have saved more than $75 per year on his homeowner's insurance if he had paid for the fire protection.

IMO, it's a failure of the local municipality to not protect it's community. Why the fuck else would a group of citizens incorporate a city if not to improve the baseline standards of living with common services like water, sewage, power, and emergency services?

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16 minutes ago, FondrenRoad said:

Dumbass. 75 a year is nothing for that. Although since he was offering to cover costs once the fire was burning, they should have negotiated.  Let the market decide. I'm sure there was an amount that would have caused them to spring into action. Maybe 1/4 to 1/2 of the value of the home. 

The county has since added a rule that if you need help, but haven't paid the $75 fee, you're charged $3500 for assistance.

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7 minutes ago, Captainant said:

IMO, it's a failure of the local municipality to not protect it's community. Why the fuck else would a group of citizens incorporate a city if not to improve the baseline standards of living with common services like water, sewage, power, and emergency services?

 

This is a fair point, but despite the article calling it a "town", it may not have actually been incorporated. And they went with the "pay the other town" option instead of putting together some sort of volunteer fire dept.

 

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