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Republican Health Care Plan (Part II: The Senate Version)

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The Obamacare replacement being worked on in secret by Senate Republicans is now out in the open. It's very similar to the House version, as expected. Mostly it's full of cuts.

Cuts Medicaid
- Medicaid is a national health insurance program for the poor
- Cuts money for expansion of Medicaid which a bunch of states have already started doing and will probably have to stop doing.
- Creates spending caps based on how much a state has already spent on Medicaid, meaning that after a few years the cuts become severly deep, about $800 billion (which was the estimate based of the House version). This is in addition to the $600 billion in cuts proposed in the budget out of the White House.

Cuts subsidies
- Under the ACA (Obamacare), subsidies - financial assistance to help cover insurance costs - were based on income, meaning that the less money you had the greater the subsidies you'd get.
- Under the Senate plan this is switched to age, forcing older people, regardless of income, to pay more.
- The amount given in subsidies is being cut across the board, meaning the cost of having insurance will go up for many people.

States would be able to apply for waivers
- On essential health benefits coverage, meaning plans would not be forced to cover things like hospitalizations, prescription drugs, emergency services, pediatric services, maternity care, addiction help, and so on.
- On annual and lifetime caps, meaning you could get cut off completely if your insurance costs "too much" after a year or over your lifetime
- Obviously not all states will opt for these waivers, but some definitely will

The preexist condition clause from Obamacare is being kept
- However it could get taken out when the Senate and House get together to merge their two bills. (America has two sides to Congress who eat come up with their own versions of laws which are usually not exactly the same so committees have to get together to make changes until the versions match. Things can and do get taken out during this process.)
- Your coverage could still be too expensive even if it does cover your preexisting condition​

To summarize:
- Less money given to people without much money
- Costs of everything will go up
- People whose medical costs become too high can have insurance stop covering them
- Republicans are heartless bastards
 

Desert Stream~

Holy Kipper!
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yeah this is a terrible plan. the fact that democratic members of the snete is just horrible imo.
 

Trev

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Ah, I get it now. The solution is die or die. Well, that makes it easy. (dies)
 

Nah

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So the vote on this bill has been delayed to sometime after July 4th, and several Republican senators have apparently voiced their issues with the bill or have supported the decision to delay the vote: https://www.aol.com/article/news/20...ous-force-against-healthcare-bill-a/23005027/

A few of them seem to (kinda just glanced at it really) oppose the cuts to Medicaid. Not all of them do, and there's other things some of them seem to take issue with though.
 
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A few of them seem to (kinda just glanced at it really) oppose the cuts to Medicaid. Not all of them do, and there's other things some of them seem to take issue with though.

Some are worried about Medicaid expansion in their states (and/or are up for re-election soon) and some, like Rand Paul and Ted Cruz, think the proposed bill doesn't do enough to cut things. So, for once in our lives we can be thankful for Ted Cruz. He's doing the right thing for all the wrong reasons.

And FYI, the Congressional Budge Office (CBO) estimates that 22 million people will lose health insurance if this things becomes law, 15 million of them in the first year alone. All to save billions of dollars that will go to tax breaks for the wealthy.
 

twocows

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It also cuts the individual mandate, which IMO is a very good thing. One of the things Obama campaigned on, and one of the main reasons I voted for him in 2008, was that he said he did not support the individual mandate. I'm no stranger to politicians lying to me, but I was pretty hurt when it showed up in the ACA several years later with his seal of approval. I didn't buy the argument that "it's necessary to run the healthcare system" then and I don't buy it now. Moreover, as a matter of principle, healthy people shouldn't be forced into paying for other peoples' medical care. I don't expect other people to pay for me when I'm sick and neither should anyone else. If people, out of the goodness of their hearts, want to donate money to charitable organizations to assist those in need, that's commendable and I wholly support it, but I do not think people should be forced into it, especially when many health problems are related to peoples' personal lifestyle choices. The individual mandate is a clear case of government overreach into peoples' lives and wallets and I'll be very glad to see it gone (assuming it goes away, which it's looking like it will).

Afterthought: I might be more receptive to the individual mandate if they classified medical problems into two categories: those related to lifestyle choices and those unrelated to lifestyle choices. I wouldn't mind as much if my money was going to pay for people who got in car accidents or acquired cancer, but I really don't like that part of my paycheck goes to people who have health problems because of choices they personally made.
 
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Any and all republican healthcare bills are just going to boil down to "kill the poor and give to the rich" and i'm glad to see that even republican voters can see through the smokescreen and demand something better

I don't expect other people to pay for me when I'm sick and neither should anyone else.

I don't really get this mindset, sure Obamacare's medicare-lite existence isn't anywhere near as good or worth the money as Australia's Medicare/The english medicare system but the idea you should leave something as crucial as medical care up to the largely unrestricted free market seems incredibly counter productive to your best interests.

I know i'm spoilt by being from a country that subsidises healthcare but the idea of medical bills as massive as they are over in the US just really appals me
 
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twocows

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I don't really get this mindset, sure Obamacare's medicare-lite existence isn't anywhere near as good or worth the money as Australia's Medicare/The english medicare system but the idea you should leave something as crucial as medical care up to the largely unrestricted free market seems incredibly counter productive to your best interests.
That's not what I suggested, though. I'm saying that people should pay for their own healthcare, especially when their health problems are a result of their own choices. It's the individual mandate I take issue with and that has nothing to do with free versus controlled market. If anything, I think the healthplace exchange system that the ACA implemented was a good idea, though the implementation may have been a bit rough.
 

Sir Codin

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The biggest issue I have with healthcare being controlled by markets is that it's not profitable to cure someone.
 

Trev

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I'm saying that people should pay for their own healthcare, especially when their health problems are a result of their own choices.

Okay, but the overwhelming majority of health problems aren't from personal lifestyle choices. The only ones that really are (that I could possibly think of besides some obvious "I jumped off a roof for fun" ones) are addiction/alcoholism (which isn't really because drugs/alcohol rewire the brain to the point of needing the drug/alcohol) and suicide (which is 99% of the time the result of not getting help for depression/mental problems). Some other diseases can probably occur from lack of exercise/lack of proper diet, but otherwise, most health problems occur because of factors out of our control. So paying for healthcare is pay for all healthcare. Furthermore, this argument sounds insane when used in actual situations. "I don't want to contribute to a healthcare system that would help a diabetic receive treatment." "I don't want my money to be used to help people who broke a bone from choosing to climb a tree."

If you're paying for healthcare, you're paying for the healthcare of everyone and all types of healthcare that cover all types of health problems. Some people can't afford it and people paying into it make it cheaper for everyone.
 

twocows

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So paying for healthcare is pay for all healthcare.
This doesn't follow. Regardless of how common they may or may not be, there are conditions that are caused by lifestyle choices and other people shouldn't have to pay for those. It's entirely possible to come up with a system that excludes such conditions.

"I don't want to contribute to a healthcare system that would help a diabetic receive treatment." "I don't want my money to be used to help people who broke a bone from choosing to climb a tree."
Type 1 diabetes is not caused by a lifestyle choice. Type 2 can be, and when it's caused by someone living decades with bad dietary choices, then yes, they should be the one to pay for it. As far as paying for someone who broke a bone climbing a tree... yes, I would completely expect them to pay for their own treatment in that case. If it was me, I know I would expect to; it's why I don't go doing stupid things and it's why I save up my own money in case something does happen to me rather than spending all of it on crap I don't need.
 

Trev

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This doesn't follow. Regardless of how common they may or may not be, there are conditions that are caused by lifestyle choices and other people shouldn't have to pay for those. It's entirely possible to come up with a system that excludes such conditions.

Type 1 diabetes is not caused by a lifestyle choice. Type 2 can be, and when it's caused by someone living decades with bad dietary choices, then yes, they should be the one to pay for it. As far as paying for someone who broke a bone climbing a tree... yes, I would completely expect them to pay for their own treatment in that case. If it was me, I know I would expect to; it's why I don't go doing stupid things and it's why I save up my own money in case something does happen to me rather than spending all of it on crap I don't need.

Okay, but what if you need healthcare and then can't afford it? You're going to get slapped with bills if people haven't paid into the system and you're going to drown under the ridiculously high medical costs. If everyone has your attitude, then the people who literally do not have the money to afford treatment for their health problems will either die or spend so much money that their life starts to crumble. I don't think you're getting that. We are paying for ALL forms of healthcare for EVERY person in the country. We are not specifically paying for x individual who did y or was afflicted with z. We don't get to cherry pick what the money is used for. It's used for everyone so that no one has to make a choice between dying without treatment or ruining their life with it. What you're suggesting is levelling an orchard because you don't like three trees.

Also, this is just my personal opinion, but it's pretty vindictive to say that you'd rather see a person suffering and possibly dying from a fixable problem than spend a bit more in taxes so they can live. You also seem to be speaking from a place of privilege, since your last sentence implies that every person who struggles to pay for healthcare is just wasting their money on other things, when that's not at all the reality for most people.
 
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Somewhere_

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As a conservative, I would rather see Obamacare kept until the Republicans can get their crap together. Its obvious there hasn't been much forethought, both in terms of the actual bill and appealing to citizens. They have had 8 years to prepare and have failed on both accounts.
 

twocows

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Okay, but what if you need healthcare and then can't afford it? You're going to get slapped with bills if people haven't paid into the system and you're going to drown under the ridiculously high medical costs. If everyone has your attitude, then the people who literally do not have the money to afford treatment for their health problems will either die or spend so much money that their life starts to crumble.
Again, I'm talking specifically about conditions people brought on themselves. The consequences of their actions are of their own doing; you reap what you sow. It's one thing if we're talking about children or the mentally disabled, people who are incapable of fully comprehending this, but part of being an adult is understanding that your actions have consequences and taking responsibility for those consequences. People who choose to ignore what might happen shouldn't expect others to pay for their negligence. For example, if someone spends all their money gambling and loses everything they own, it's not reasonable to force other people to pay to cover those losses. Likewise, if someone knowingly engages in dangerous or unhealthy behavior and ends up with some sort of medical problem or condition as a result, they shouldn't expect other people to cover those costs.

The reason insurance works is because people are willing to pay into a system that protects them from the unforeseen; by definition, such things can happen to anyone through no fault of their own. But when you extend the system to cover self-inflicted injuries and illnesses, two things happen. First, it trivializes risk-taking to an extent. People start to say things like "it's not really a big deal if I do this really dangerous or unhealthy thing." Then they get sick or injured and become a burden on the people who do choose to respect their own health and safety. That leads to the second problem: it discourages those people, the ones supporting the system rather than taking from it, from buying into the system at all. "Why should my hard-earned money go to cover an entirely preventable injury someone inflicted on themselves?" If this happens, people lose faith in the system, and when people lose faith in the system, it stops working.

It is unfortunate that excluding medical problems that are self-inflicted would lead to financial problems and in some cases permanent injury or death, but the harsh reality is that, by definition, self-inflicted problems are your fault. What's more, the destabilization of the system is potentially far more ruinous. These safety nets are created by people and they need people to exist; if people don't buy into them, then as you and others have said, they cease to work. You can, of course, force people to buy into a bad system, but such a thing is unfair, authoritarian, and doesn't really fix the underlying problem.

We don't get to cherry pick what the money is used for.
I don't believe that's the reality of how health insurance works. Certain things are already excluded from health insurance coverage; I'm not sure of the specifics, I'm just speaking specifically to a category of injuries and illnesses that I think should be excluded.

Even if that was how things worked, I'm making an argument as to how things should be, not necessarily how they are. I don't think it's beyond the realm of practicality to have a healthcare system that excludes certain types of afflictions and I believe it's perfectly reasonable to have that system exclude self-inflicted maladies.

Also, this is just my personal opinion, but it's pretty vindictive to say that you'd rather see a person suffering and possibly dying from a fixable problem than spend a bit more in taxes so they can live.
My personal feelings are that if someone, through negligence, ends up with a medical condition, they should pay for their medical condition. However, it's not just about my personal feelings. It's also about the bigger picture, and it is my belief that the system works better when people believe it to be fair.

You also seem to be speaking from a place of privilege,
Frankly, you have no idea what my situation is. You don't know me, you don't know my personal struggles, and you certainly don't know what informs my opinion. It is the height of arrogance to assume anything about my background when you haven't so much as talked to me.

Moreover, "you are privileged" speaks nothing to the actual content of what I said. If I am "privileged," as you suggest, and this colors my worldview... then what? That's not a counter-argument. Point out what I said that is incorrect or insufficient. Attempting to an exclude an argument purely on the basis of the background of the one making it is a form of logical fallacy. And again, in this case, it's an assumed background; as I said, you don't know me.

your last sentence implies that every person who struggles to pay for healthcare is just wasting their money on other things, when that's not at all the reality for most people.
That's not even close to what I said. I said that people who do unhealthy or risky things should take responsibility for the consequences of their actions. If I break my leg climbing a tree, I should pay for the cost of fixing my leg. If I spend most of my adult life eating unhealthy food and contract an illness as a result, then I should expect to pay for any problems that result from that. I'm not saying people can't do those things; I'm saying that if they do, they should be willing to take responsibility for what happens.

I did not say anything close to what you suggested I said. I have no idea what people struggling to pay for healthcare spend their money on and I wouldn't presume to know something like that.
 

Trev

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Again, I'm talking specifically about conditions people brought on themselves. The consequences of their actions are of their own doing; you reap what you sow. It's one thing if we're talking about children or the mentally disabled, people who are incapable of fully comprehending this, but part of being an adult is understanding that your actions have consequences and taking responsibility for those consequences. People who choose to ignore what might happen shouldn't expect others to pay for their negligence. For example, if someone spends all their money gambling and loses everything they own, it's not reasonable to force other people to pay to cover those losses. Likewise, if someone knowingly engages in dangerous or unhealthy behavior and ends up with some sort of medical problem or condition as a result, they shouldn't expect other people to cover those costs.

Gambling does not equal getting a health problem. Any health problem can occur for a number of reasons, and people 90% of the time aren't "knowingly" making decisions that give them a health problem. There are a billion reasons someone could end up with a health problem, and most of those reasons aren't informed negligence.

The reason insurance works is because people are willing to pay into a system that protects them from the unforeseen; by definition, such things can happen to anyone through no fault of their own. But when you extend the system to cover self-inflicted injuries and illnesses, two things happen. First, it trivializes risk-taking to an extent. People start to say things like "it's not really a big deal if I do this really dangerous or unhealthy thing." Then they get sick or injured and become a burden on the people who do choose to respect their own health and safety.

What? Are you seriously trying to suggest that people willingly would put their own lives in danger just because they know any injuries/problems that they get from it would be covered? That is completely nonsensical, sorry.

That leads to the second problem: it discourages those people, the ones supporting the system rather than taking from it, from buying into the system at all. "Why should my hard-earned money go to cover an entirely preventable injury someone inflicted on themselves?" If this happens, people lose faith in the system, and when people lose faith in the system, it stops working.

But everyone takes from it. There are very few people in this country who don't use the healthcare system at some point in their life. And, again, as I've said several times already, these people aren't just covering "self-inflicted injuries" but all health problems, all the time. That's the point.

It is unfortunate that excluding medical problems that are self-inflicted would lead to financial problems and in some cases permanent injury or death, but the harsh reality is that, by definition, self-inflicted problems are your fault.

Stop. If you literally think someone deserves to die from a treatable injury just because they can't afford to pay for treatment, then that's really bad.

What's more, the destabilization of the system is potentially far more ruinous. These safety nets are created by people and they need people to exist; if people don't buy into them, then as you and others have said, they cease to work. You can, of course, force people to buy into a bad system, but such a thing is unfair, authoritarian, and doesn't really fix the underlying problem.

How are you agreeing with me and disagreeing with me at the same time? Yes, we do need people to exist to maintain a healthcare system, and yes, we do need people to buy into it. But the problem isn't that people are being forced to buy into it, it's people who think that others don't deserve the same level of healthcare as them because they can't afford it. Every person is going to need healthcare at some point in their lives, and it's not ethical to pick-and-choose which people are deserving of healthcare based on their income.

I don't believe that's the reality of how health insurance works. Certain things are already excluded from health insurance coverage; I'm not sure of the specifics, I'm just speaking specifically to a category of injuries and illnesses that I think should be excluded.

Here's some info about what is covered by most health insurances. If you'll notice, the essential services provided here would definitively cover what I believe you would call "self-inflicted injuries."

Even if that was how things worked, I'm making an argument as to how things should be, not necessarily how they are. I don't think it's beyond the realm of practicality to have a healthcare system that excludes certain types of afflictions and I believe it's perfectly reasonable to have that system exclude self-inflicted maladies.

Except... not really. That kind of medical system opens itself up to opportunities for insurance companies to limit their coverage in an effort to save money. If I'm involved in a car crash and my leg is broken, and my insurance provider decides not to cover any necessary surgery and rehabilitation I need to fix it because I was involved in a car crash and they deem it as "self-inflicted," I'm going to get royally screwed over with medical bills that I have no choice but to pay because I need my leg. If I suddenly developed Type 2 diabetes without realizing that I have until I start passing out, and my insurance decided not to cover my preventative treatments because they believe it was self-inflicted, I'm going to be footing $400 to $500 a month just to pay for insulin to not pass out.

My personal feelings are that if someone, through negligence, ends up with a medical condition, they should pay for their medical condition. However, it's not just about my personal feelings. It's also about the bigger picture, and it is my belief that the system works better when people believe it to be fair.

A healthcare system that discriminately chooses who gets covered is not a fair healthcare system. And as I've said, not every "self-inflicted" problem is from negligence. People can not know things and be undereducated about health problems (it's not like health education in America is that great anyway). Many people may not even realize that they're having a health problem until it gets really bad. It's very common for people to think their symptoms are normal occurrences.

Frankly, you have no idea what my situation is. You don't know me, you don't know my personal struggles, and you certainly don't know what informs my opinion. It is the height of arrogance to assume anything about my background when you haven't so much as talked to me.

You have enough privilege to assume that everyone has the ability to save money. For many people, they're simply unable to do that because they're spending so much on their mandatory life expenses that saving money is out of the question.

Moreover, "you are privileged" speaks nothing to the actual content of what I said. If I am "privileged," as you suggest, and this colors my worldview... then what? That's not a counter-argument. Point out what I said that is incorrect or insufficient. Attempting to an exclude an argument purely on the basis of the background of the one making it is a form of logical fallacy. And again, in this case, it's an assumed background; as I said, you don't know me.

The reason I said it is privileged is because it's people with your attitude that helped create the financial problems that come out of healthcare. People have been protesting paying into the system for the same reason for a long time, and it creates problems for people who actually need to take the healthcare but don't have the resources they need because of bad financial situations that often times are out of their control. "It's why I don't go doing stupid things and it's why I save up my own money in case something does happen to me rather than spending all of it on crap I don't need." That is a statement loaded with assumptions about the type of people who have to depend on publically-funded healthcare, and that type of attitude is one that stems from the privilege of not knowing the situation of the people you are saying should be perfectly able to pay for their own healthcare. The reality is that it's really hard for many people to find the money needed for their healthcare. It's not cheap and just "saving money" isn't an option considering how much work people have to do and how much money they have to spend just to get by, let alone pay for expensive medical costs. People literally cannot afford healthcare, and that's a major problem that isn't going to be fixed by leaving the people who can't afford it out to hang.

That's not even close to what I said. I said that people who do unhealthy or risky things should take responsibility for the consequences of their actions. If I break my leg climbing a tree, I should pay for the cost of fixing my leg. If I spend most of my adult life eating unhealthy food and contract an illness as a result, then I should expect to pay for any problems that result from that. I'm not saying people can't do those things; I'm saying that if they do, they should be willing to take responsibility for what happens.

I already explained above that even situations like these can be brought on by a million different causes and are usually not the fault of the person who is afflicted with them. Life is unpredictable and people get hurt, but if they can't afford healthcare, we shouldn't be leaving them to suffer. No one deserves to go through ridiculous financial hardships just because some people are stingy with their money.

I did not say anything close to what you suggested I said. I have no idea what people struggling to pay for healthcare spend their money on and I wouldn't presume to know something like that.

"It's why I don't go doing stupid things and it's why I save up my own money in case something does happen to me rather than spending all of it on crap I don't need."
 

Nah

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It's not necessarily wrong to not want to help pay for the medical bills for some of the health problems caused by certain choices. Like let's say I suddenly decide to drink an entire bottle of wine by myself every single day, and I keep doing this for a long enough time to get cirrhosis or liver cancer or whatever fun things I could get from drinking that much alcohol all the time. Does anyone really want to help pay, even the slightest bit, for all the medical bills I would incur from then on, for something like that?

This is not to say I agree with everything twocows is saying. I would explain, but I've sat here for like half an hour trying to find the words to do so but haven't been able to =[



This is an unrelated but mildly important note to everyone--this bit:
Moreover, "you are privileged" speaks nothing to the actual content of what I said. If I am "privileged," as you suggest, and this colors my worldview... then what? That's not a counter-argument. Point out what I said that is incorrect or insufficient. Attempting to an exclude an argument purely on the basis of the background of the one making it is a form of logical fallacy. And again, in this case, it's an assumed background; as I said, you don't know me.

Is absolutely spot-on. It's the argument itself that matters, not the person it's coming from.
 
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Flip the question around this way: how many people must abuse a single-payer healthcare system (through willful and obviously unhealthy lifestyle choices) to sufficiently undermine the overall healthcare gains from a single-payer system? Posed another way: how many dollars wasted on people who don't "deserve" it would justify against having a system that overall would provide better care more affordably?
 

Trev

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It's not necessarily wrong to not want to help pay for the medical bills for some of the health problems caused by certain choices. Like let's say I suddenly decide to drink an entire bottle of wine by myself every single day, and I keep doing this for a long enough time to get cirrhosis or liver cancer or whatever fun things I could get from drinking that much alcohol all the time. Does anyone really want to help pay, even the slightest bit, for all the medical bills I would incur from then on, for something like that?

Does anyone want to? No. Do we have an inherent social responsibility to care for the members of our nation and to view their health and wellbeing as important enough to warrant spending a bit more in taxes for their benefit? Yes.

This is an unrelated but mildly important note to everyone--this bit [about privilege] is absolutely spot-on. It's the argument itself that matters, not the person it's coming from.

No, the person does matter. This doesn't make the opinion better or worse (exceptions withstanding), but it's important to recognize what factors lead a person to having an opinion. The opinion that twocows is expressing is one I've seen several times over from people in real life and online, and majority of the time, the opinion is coming from a person that likely doesn't have to worry about whether or not they're going to be able to afford healthcare. I maybe jumped the gun a bit on twocows - I am human and I make mistakes - but the point still stands: if others are saying that you have privilege, it's important to assess what advantages you might have that inform your opinion and how that affects your perspective of others who struggle.
 

Sir Codin

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"Checking your privilege" is a message that your experiences in life are not the same as everyone else's, so you should take care not to make any kind of assumptions about someone else, as that too is a fallacy.

A white straight male is not going to have the same experiences in life as a black lesbian.
 
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