The quandary for libs

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PeacefulPartier
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Re: The quandary for libs

Unread post by PeacefulPartier »

Vrede too wrote: Sun Sep 15, 2019 5:03 pm
PeacefulPartier wrote: Sun Sep 15, 2019 4:04 pmSo, yes, the SCOTUS stated that the reason for a woman's decision for an abortion was covered under the right to privacy.
Vrede too wrote: Sun Sep 15, 2019 5:03 pm As we've said.
PeacefulPartier wrote: Sun Sep 15, 2019 4:04 pmIt is a logical conclusion that that decision would be on the medical records.
Vrede too wrote: Sun Sep 15, 2019 5:03 pmNo, that's an entirely unsupported and invented leap of logic.
PeacefulPartier wrote: Sun Sep 15, 2019 4:04 pmIf there is a lack of a medical reason listed, then the abortion would be for birth control purposes.
Vrede too wrote: Sun Sep 15, 2019 5:03 pmIrrelevant, both are legal.
PeacefulPartier wrote: Sun Sep 15, 2019 4:04 pmThe intent of the SCOTUS was to protect the right to privacy. If you are on Medicare, SCHIP or any other program, as they currently stand, they are voluntary. If medicare for all or any other government run system is instituted, it won't be voluntary. As such, individuals won't be consenting to the violation of privacy and the government will be in violation of the Roe v Wade ruling.
Vrede too wrote: Sun Sep 15, 2019 5:03 pmGood luck with that ridiculous argument. It hasn't arisen for Medicare/Medicaid yet, is not an issue in the developed democracies, all of which get comparable care for 1/2 to 2/3 the per capita cost with single payer, won't arise in the unlikely event that we go to single payer.
If you don't like single payer or abortion, fine, but you've picked a goofy, nonstarter of a case against single payer.
Before I begin, please learn how to use the quote feature properly. This took a long time to fix.

To your points:
You claim that the reason for a procedure would not be on medical records. I don't know where you got that idea. But there is always a reason for a procedure. Doctors and nurses annotate everything they do. They have to revisit what they do when a patient comes in. They can't remember every single patient. Without a record of what they did and why, they'd be mistreating people right and left. Your assertion that any procedure from administering a band aid to brain surgery wouldn't be documented is separated from reality.

You claim "both are legal" but I was talking about pre-Roe v Wade laws and abortion. Both are legal now. There were not legal then. That is why there was a ruling.
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Vrede too
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Re: The quandary for libs

Unread post by Vrede too »

PeacefulPartier wrote: Sun Sep 15, 2019 5:18 pmBefore I begin, please learn how to use the quote feature properly.

Your picky aesthetics are not my problem. It was and is OBVIOUS that black is you, red now blue is me. Careful. I might just go rainbow crazy on you.

This took a long time to fix.

What a ridiculous waste of time. We've got a color palette exactly so we don't have to create a dozen superfluous quote boxes. Pssst, you can even reply point by point by using a new unique color.

To your points:
You claim that the reason for a procedure would not be on medical records. I don't know where you got that idea.

I did not post that. I don't know where you got that idea.

But there is always a reason for a procedure. Doctors and nurses annotate everything they do. They have to revisit what they do when a patient comes in. They can't remember every single patient. Without a record of what they did and why, they'd be mistreating people right and left. Your assertion that any procedure from administering a band aid to brain surgery wouldn't be documented is separated from reality.

Wasted paragraph based on your poor comprehension.

You claim "both are legal" but I was talking about pre-Roe v Wade laws and abortion. Both are legal now. There were not legal then. That is why there was a ruling.

Irrelevant to post Roe and single payer.
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Vrede too
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 5:07 pm
Ulysses wrote: Sun Sep 15, 2019 4:59 pm This is a defective analogy.

With abortion, the presumed purpose of reviewing a woman's medical records would be to confirm that an abortion was performed, to enable the government to prosecute the women (and her doctor) for it.

With routine, emergency, and specialized medical care, there is no question that the procedures performed are not legal. Not unless some idiot conservative majority in Congress passes a law that makes such things as tonsillectomies illegal.

In other words, getting medical care is not a crime, nor should it be. As such, there is no need to invoke the privacy provision as you describe.
I don't know why libs always have to resort to name calling. But, whatever.

:roll: As you well know, cons name call all the time. Plus, YOU were not called any names and "idiot" here is an adjective, not even a name. Please limit your whining to real stuff.

If there is a medicare for all system, there will be restrictions on what it pays.

Just like Big Insurance.

If you go to a doctor and the doctor performs a procedure, even if it is covered, the government will look at whether or not it was covered. If it was not covered, it could be fraud.

That's not how medical fraud works. If the procedure was done, is billed accurately and is then denied, it's just denied, NOT "fraud".
-- ER RN


So, the government would be violating the patient's right to privacy by looking for fraud without evidence or a warrant. There will be no judicial oversight.

Just like Big Insurance already does, and you ignored what I posted about government being limited by enabling legislation.
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neoplacebo
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 5:07 pm
Ulysses wrote: Sun Sep 15, 2019 4:59 pm This is a defective analogy.

With abortion, the presumed purpose of reviewing a woman's medical records would be to confirm that an abortion was performed, to enable the government to prosecute the women (and her doctor) for it.

With routine, emergency, and specialized medical care, there is no question that the procedures performed are not legal. Not unless some idiot conservative majority in Congress passes a law that makes such things as tonsillectomies illegal.

In other words, getting medical care is not a crime, nor should it be. As such, there is no need to invoke the privacy provision as you describe.
I don't know why libs always have to resort to name calling. But, whatever.

If there is a medicare for all system, there will be restrictions on what it pays. If you go to a doctor and the doctor performs a procedure, even if it is covered, the government will look at whether or not it was covered. If it was not covered, it could be fraud. So, the government would be violating the patient's right to privacy by looking for fraud without evidence or a warrant. There will be no judicial oversight.
Yes, like I've been saying all along, some medical procedures are not now, and probably never will be, covered by Medicare even if only one person is on Medicare or if everyone is. As for your (in my opinion) unreasonable and illogical assertion regarding privacy rights, since Medicare started in (1965?) I figure procedures are reviewed by Medicare administrators for purposes of preventing fraud and for facilitating payment to providers. These days all medical procedures are given a CPT code and I don't find it out of the realm of reason that those codes do not necessarily have to have a name attached to them to determine if a procedure is covered or not. As for whether or not looking for fraud is some sort of legal threat to general rights to privacy, I find that kind of a lame argument. How do you feel about how any mom and pop business in the country can force an applicant to pee in a bottle in violation of their 4th Amendment rights? There's no warrant involved with that as well as no judicial oversight. I consider it a violation of my rights to have to pee to get a job. What's wrong with relying on the supervisor to determine if a worker is drunk or high? Are they not capable of that? Not to mention the violation of privacy and 4th Amendment rights, especially in cases of false positive drug testing. I would be willing to bet that 2nd Amendment cheerleaders would not want to give up their gun to get a job. What do you think?
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Re: The quandary for libs

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Vrede too wrote: Sun Sep 15, 2019 5:34 pm
PeacefulPartier wrote: Sun Sep 15, 2019 5:18 pmBefore I begin, please learn how to use the quote feature properly.

Your picky aesthetics are not my problem. It was and is OBVIOUS that black is you, red now blue is me. Careful. I might just go rainbow crazy on you.

This took a long time to fix.

What a ridiculous waste of time. We've got a color palette exactly so we don't have to create a dozen superfluous quote boxes. Pssst, you can even reply point by point by using a new unique color.

To your points:
You claim that the reason for a procedure would not be on medical records. I don't know where you got that idea.

I did not post that. I don't know where you got that idea.

But there is always a reason for a procedure. Doctors and nurses annotate everything they do. They have to revisit what they do when a patient comes in. They can't remember every single patient. Without a record of what they did and why, they'd be mistreating people right and left. Your assertion that any procedure from administering a band aid to brain surgery wouldn't be documented is separated from reality.

Wasted paragraph based on your poor comprehension.

You claim "both are legal" but I was talking about pre-Roe v Wade laws and abortion. Both are legal now. There were not legal then. That is why there was a ruling.

Irrelevant to post Roe and single payer.
If you aren't even going to admit to what you wrote THAT IS QUOTED, then reality is divorced from you.
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Vrede too
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 5:53 pmIf you aren't even going to admit to what you wrote THAT IS QUOTED, then reality is divorced from you.
Funny that you can't produce the QUOTE of me saying "that the reason for a procedure would not be on medical records."

I don't blame you for giving up, you're outclassed here. Creating excuses for it blaming me is pretty lame, though.
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Re: The quandary for libs

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neoplacebo wrote: Sun Sep 15, 2019 5:50 pm
Yes, like I've been saying all along, some medical procedures are not now, and probably never will be, covered by Medicare even if only one person is on Medicare or if everyone is.
I didn't deny that.
As for your (in my opinion) unreasonable and illogical assertion regarding privacy rights, since Medicare started in (1965?) I figure procedures are reviewed by Medicare administrators for purposes of preventing fraud and for facilitating payment to providers.
Again, we are not talking about Medicare as it exists right now. The only similarity between Medicare today and medicare for all is the name. After that it is 100% different. Right now, Medicare is funded (partially) by the federal government, managed by each state and administered by private insurance companies. Medicare for all will be funded, managed and administered by the federal government. That brings up a lot of different issues that don't exist today.
These days all medical procedures are given a CPT code and I don't find it out of the realm of reason that those codes do not necessarily have to have a name attached to them to determine if a procedure is covered or not.
If that is carried forward, how do you know if a patient's procedure is funded if you don't attach the patient's name and account number to the codes? You don't. The federal government will have to know who is getting what and why. That is a clear violation of your right to privacy.
As for whether or not looking for fraud is some sort of legal threat to general rights to privacy, I find that kind of a lame argument. How do you feel about how any mom and pop business in the country can force an applicant to pee in a bottle in violation of their 4th Amendment rights? There's no warrant involved with that as well as no judicial oversight. I consider it a violation of my rights to have to pee to get a job. What's wrong with relying on the supervisor to determine if a worker is drunk or high? Are they not capable of that? Not to mention the violation of privacy and 4th Amendment rights, especially in cases of false positive drug testing. I would be willing to bet that 2nd Amendment cheerleaders would not want to give up their gun to get a job. What do you think?
I don't know why people can't separate the government from a private entity. If a mom and pop shop asks you to pee in a cop to verify you aren't drunk or high, it is a condition of employment. Employment is not a right, it is a mutual agreement...a contract. They can include anything they want (within the law) in a contract. You can refuse anything they want by negotiating new terms or not accepting the position. As for those that are required by regulation, that is a completely different topic that would be a complete side track. I just don't want to get into that here.

Now, if the government comes to your door and says we want to look around without probable cause or a warrant, that is a right to privacy issue. We all accept that. The government coming to your doctor and demanding your medical records to see if you are committing fraud is no different than showing up at your door.
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Re: The quandary for libs

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Vrede too wrote: Sun Sep 15, 2019 6:04 pm
PeacefulPartier wrote: Sun Sep 15, 2019 5:53 pmIf you aren't even going to admit to what you wrote THAT IS QUOTED, then reality is divorced from you.
Funny that you can't produce the QUOTE of me saying "that the reason for a procedure would not be on medical records."

I don't blame you for giving up, you're outclassed here. Creating excuses for it blaming me is pretty lame, though.
I literally quoted you in the response. I'm not going back to quote you again.
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Vrede too
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 6:05 pmI literally quoted you in the response. I'm not going back to quote you again.
Your misinterpretation of what I did post is NOT a quote. Now you're just making excuses for having screwed up.

The really funny thing here is that there are thousands of arguments for and against single payer. You think you’re special and that you’ve come up with a killer case when in reality it’s all just a goofy movie playing in your head, easily corrected with legislation if anyone ever shares your delusion. That’s why no one else is making the case.

You've been shown many different ways why it's goofy, but your ego just can't handle it.
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 6:04 pm
neoplacebo wrote: Sun Sep 15, 2019 5:50 pm
Yes, like I've been saying all along, some medical procedures are not now, and probably never will be, covered by Medicare even if only one person is on Medicare or if everyone is.
I didn't deny that.
As for your (in my opinion) unreasonable and illogical assertion regarding privacy rights, since Medicare started in (1965?) I figure procedures are reviewed by Medicare administrators for purposes of preventing fraud and for facilitating payment to providers.
Again, we are not talking about Medicare as it exists right now. The only similarity between Medicare today and medicare for all is the name. After that it is 100% different. Right now, Medicare is funded (partially) by the federal government, managed by each state and administered by private insurance companies. Medicare for all will be funded, managed and administered by the federal government. That brings up a lot of different issues that don't exist today.
These days all medical procedures are given a CPT code and I don't find it out of the realm of reason that those codes do not necessarily have to have a name attached to them to determine if a procedure is covered or not.
If that is carried forward, how do you know if a patient's procedure is funded if you don't attach the patient's name and account number to the codes? You don't. The federal government will have to know who is getting what and why. That is a clear violation of your right to privacy.
As for whether or not looking for fraud is some sort of legal threat to general rights to privacy, I find that kind of a lame argument. How do you feel about how any mom and pop business in the country can force an applicant to pee in a bottle in violation of their 4th Amendment rights? There's no warrant involved with that as well as no judicial oversight. I consider it a violation of my rights to have to pee to get a job. What's wrong with relying on the supervisor to determine if a worker is drunk or high? Are they not capable of that? Not to mention the violation of privacy and 4th Amendment rights, especially in cases of false positive drug testing. I would be willing to bet that 2nd Amendment cheerleaders would not want to give up their gun to get a job. What do you think?
I don't know why people can't separate the government from a private entity. If a mom and pop shop asks you to pee in a cop to verify you aren't drunk or high, it is a condition of employment. Employment is not a right, it is a mutual agreement...a contract. They can include anything they want (within the law) in a contract. You can refuse anything they want by negotiating new terms or not accepting the position. As for those that are required by regulation, that is a completely different topic that would be a complete side track. I just don't want to get into that here.

Now, if the government comes to your door and says we want to look around without probable cause or a warrant, that is a right to privacy issue. We all accept that. The government coming to your doctor and demanding your medical records to see if you are committing fraud is no different than showing up at your door.
Your initial post on this alluded to the violation of privacy for women getting an abortion; all my replies have pointed out that abortion is not covered by Medicare now and is not likely to be in any Medicare for all system. Because of that, there's not issue of privacy being violated via the use of medical records.

My comment about CPT codes and my assertion that a name not necessarily be attached to that code for purposes of payment of services I stand by; the code itself defines the procedure; who gets that procedure is irrelevant. Why do you consider a name being attached to a medical code is a necessity? Not doing so would certainly provide a measure of medical record privacy, or more accurately anonymity. The point is that the code for the procedure is either covered or it's not, no matter who gets that procedure.

Separating the government from a private entity is not what we're talking about; we're talking about violation of privacy rights, or I thought we were. The "government" has allowed this violation of 4th Amendment rights, and the government has no dog in the fight; they're not paying money for anything or giving anyone any benefits; they're just allowing private businesses to unilaterally violate citizens rights against unreasonable search. The Amendment states that persons shall be secure in their persons, papers, and effects, and be free from unreasonable search without a warrant specifying who is to be searched and what is being searched for. That, to me, is a severe violation of privacy rights, which is what your original post was all about vis a vis Medicare for all which you finally admit would be no different except in name. And as I stated initially, abortion is not covered by Medicare and is not likely to be covered by Medicare. The government is not demanding your personal medical records; it's only looking at codes for procedures that were performed and if they were covered by the plan. The issue of fraud is not in any way involving you as a patient, only the provider of service. You're not being paid by Medicare; the doctor is. They don't want him committing fraud.
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Re: The quandary for libs

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neoplacebo wrote: Sun Sep 15, 2019 6:27 pm
Your initial post on this alluded to the violation of privacy for women getting an abortion; all my replies have pointed out that abortion is not covered by Medicare now and is not likely to be in any Medicare for all system.
I never said Medicare now did cover it. I never even said Medicare in the future would. I am using Roe v Wade to compare how the right to privacy was interpreted regarding abortion (a medical procedure) to how it would be interpreted in a government mandated system/single payer system/medicare for all. I've just used medicare for all as an inclusive term for all.
My comment about CPT codes and my assertion that a name not necessarily be attached to that code for purposes of payment of services I stand by; the code itself defines the procedure; who gets that procedure is irrelevant. Why do you consider a name being attached to a medical code is a necessity? Not doing so would certainly provide a measure of medical record privacy, or more accurately anonymity. The point is that the code for the procedure is either covered or it's not, no matter who gets that procedure.
I said right in the post above that it is necessary to assign payment. Essentially, you can't balance the books without knowing what account was approved for payment of the debt.
Separating the government from a private entity is not what we're talking about; we're talking about violation of privacy rights, or I thought we were. The "government" has allowed this violation of 4th Amendment rights, and the government has no dog in the fight; they're not paying money for anything or giving anyone any benefits; they're just allowing private businesses to unilaterally violate citizens rights against unreasonable search. The Amendment states that persons shall be secure in their persons, papers, and effects, and be free from unreasonable search without a warrant specifying who is to be searched and what is being searched for. That, to me, is a severe violation of privacy rights, which is what your original post was all about vis a vis Medicare for all which you finally admit would be no different except in name. And as I stated initially, abortion is not covered by Medicare and is not likely to be covered by Medicare. The government is not demanding your personal medical records; it's only looking at codes for procedures that were performed and if they were covered by the plan. The issue of fraud is not in any way involving you as a patient, only the provider of service. You're not being paid by Medicare; the doctor is. They don't want him committing fraud.
You need to separate the government from a private entity. As a condition of employment (aka a contract) the employer can require the employee to do any number of things. The employee has the option of accepting or denying employment. If the government, on the other hand, requires an individual to submit to a search without cause or warrant, the individual has no other option. The lack of an option makes the requirement a violation of the individual's rights.
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O Really
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Re: The quandary for libs

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It's not like there aren't a bunch of working examples out there to follow. What - is America the first to tackle the problem of universal healthcare coverage? Pretty much every first world country has a system better than the US system. Why keep thinking up obstacles and straw people?
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Re: The quandary for libs

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They're terrified of honestly looking at the many real world examples. They contradict their Big Insurance/Big Pharma sponsored con dogma, and they don't have the spine to handle it.
PeacefulPartier wrote: Sun Sep 15, 2019 6:41 pm
neoplacebo wrote: Sun Sep 15, 2019 6:27 pm
Your initial post on this alluded to the violation of privacy for women getting an abortion; all my replies have pointed out that abortion is not covered by Medicare now and is not likely to be in any Medicare for all system.
I never said Medicare now did cover it. I never even said Medicare in the future would. I am using Roe v Wade to compare how the right to privacy was interpreted regarding abortion (a medical procedure) to how it would be interpreted in a government mandated system/single payer system/medicare for all. I've just used medicare for all as an inclusive term for all.
How the right to privacy is defined varies throughout our society dependent on the Constitution, court rulings and law. It's just silly to grasp Roe and say, in effect, 'Aha, this is exactly how privacy will be applied to single payer." Your entire premise is faulty.
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Re: The quandary for libs

Unread post by O Really »

Most Medicare fraud comes not from the patients but from the providers, such as Florida Senator Rick Scott's former hospital that received the largest fine for Medicare fraud in history (yet). I have no problem with the government investigating fraud of any sort, and reviewing any records necessary to do so. Actually, Medicare is not the only "gummint-run" health plan that does a good job. Maybe somebody should suggest Tri-Care for all. That would work, too.
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Re: The quandary for libs

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I suppose we could all become Calvinists and resign ourselves to the concept of predestination; this would eliminate the need for any medical care at all. I thought this whole thing was about privacy rights being allegedly violated because of the adoption of a Medicare for all type system presenting some sort of quandary for "liberals" and did not and still do not see what abortion has to do with it in any way. The SC decision regarding abortion does not involve medical records or the associated privacy rights attached to them; it's solely about a woman's right to the choice to have an abortion, which has never been a covered procedure by Medicare and probably never will be. When I first started applying for jobs, there was always the question on the application "Are you now or have you ever been a member of the Communist Party of the United States." Now it doesn't matter if you're a Communist applying for a job but you're immediately suspected of being a drug addict these days when you apply for a job, which I see as a blatant violation of a citizen's 4th Amendment rights. Just as the gun nuts rant about 2nd Amendment rights and invariably refer to the verbiage in the text "the right to keep and bear arms shall not be infringed." What they never seem to mention or realize is that when those words were written, the only "arms" to be had were pistols, rifles, and cannons; all single shot weapons that took considerable time to reload for another shot. I guess my point is that you can't seize on one particular aspect of any given subject and base your entire argument on that one aspect. And I really don't see what the big deal is about the government or anyone else seeing your medical records. They would seem to me to be of no interest to anyone other than persons in the medical field. I had a hernia when I was an infant, numerous bouts of strep throat, measles, mumps, pneumonia, four way bypass surgery in 2010 and that pretty much covers my medical records. Anyone here can do as they wish with that information. Since you don't have my name, I cannot think of what possible use you would have for them.
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Re: The quandary for libs

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The reason for protection of confidentiality of medical records is to avoid people such as employers, insurers, lenders, etc. using that information to discriminate against you. Used to be, employers could and actually did make employment decisions based on what their opinion of a candidate or employees medical history. That by-pass you had? Don't want to hire somebody with a heart problem, never mind that you don't actually have a heart problem anymore since you got it fixed. But given that most of the abuses have been by non-governmental entities, I don't see why a health plan administrator or fraud investigator who works for the government would be any greater risk to ones privacy than what exists otherwise. Of course, a person whose medical records show a bit of paranoia might worry that the government has targeted them personally as part of a conspiracy to use their record in nefarious manner.
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Re: The quandary for libs

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O Really wrote: Sun Sep 15, 2019 10:10 pm The reason for protection of confidentiality of medical records is to avoid people such as employers, insurers, lenders, etc. using that information to discriminate against you. Used to be, employers could and actually did make employment decisions based on what their opinion of a candidate or employees medical history. That by-pass you had? Don't want to hire somebody with a heart problem, never mind that you don't actually have a heart problem anymore since you got it fixed. But given that most of the abuses have been by non-governmental entities, I don't see why a health plan administrator or fraud investigator who works for the government would be any greater risk to ones privacy than what exists otherwise. Of course, a person whose medical records show a bit of paranoia might worry that the government has targeted them personally as part of a conspiracy to use their record in nefarious manner.
Yeah, I suspect that I myself have been a victim of this; when I was laid off from my job about five years ago, initially I wasn't too concerned about it. I told myself "you're good; you can get another job." I probably applied for fifty different ones, one of them was a position at Mission Hospital in Asheville; the job was as a liaison between the hospital and vendors that do additions, modifications, or any alterations to existing hospital infrastructure such as fire alarm, nurse call, paging, and voice/data systems. In the job I lost after fifteen years, one of my duties was to prepare work orders for changes to such systems at the hospital. By virtue of that, I was intimately familiar with the hospital's standard procedures relative to infrastructure systems, a book of standard procedures that was over two inches thick, as well as having initiated hundreds of work orders at the hospital's request to do such work. Anyway, this job posting by the hospital I figured I had it in the bag but after submitting my resume to them, I never even got an acknowledgement from them. I wondered why and after a few days it hit me; Mission Hospital is where I had my bypass surgery four years prior to applying for this job they wanted to fill.
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Re: The quandary for libs

Unread post by neoplacebo »

Opps! I forgot to say in the post above that this all occurred before I was on Medicare, and I've never had an abortion.
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Re: The quandary for libs

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PeacefulPartier wrote: Sun Sep 15, 2019 4:11 pm


Big Insurance and the government are vastly different in what they can and can't do. The government's actions can serve to limit rights. As citizens, if the government takes an action it has the weight of law. If an insurance company does something, it has the weight of a contract. Contracts can be broken by either party and no individual must remain with a business if they choose not too.
Ahoy mate, there be pigs flying


"no individual must remain with a business if they choose not too"


Let me guess, you're 16 and just finished reading some ayn rand bullshit.
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Re: The quandary for libs

Unread post by O Really »

billy.pilgrim wrote: Fri Sep 20, 2019 9:45 am
PeacefulPartier wrote: Sun Sep 15, 2019 4:11 pm


Big Insurance and the government are vastly different in what they can and can't do. The government's actions can serve to limit rights. As citizens, if the government takes an action it has the weight of law. If an insurance company does something, it has the weight of a contract. Contracts can be broken by either party and no individual must remain with a business if they choose not too.
Ahoy mate, there be pigs flying


"no individual must remain with a business if they choose not too"


Let me guess, you're 16 and just finished reading some ayn rand bullshit.
Peaceful Partier must work for Microsoft. Writes stuff that is technically correct but totally irrelevant to real life. Of course, a person can indeed refuse to do business with an insurance carrier - but then they have to go somewhere else, who will treat them the same or worse. Or they don't get coverage at all.
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