Randy Barnett at the Volokh Conspiracy quotes Kurt Lash in analyzing the recent opinion of Judge Henry Hudson striking down the individual mandate within Obamacare. Critics of Hudson believe the judge did not take full account of the Necessary and Proper clause as a justification for the individual mandate. Lash believes critics are wrong to say that Hudson ignored the Necessary and Proper clause, not just because the government itself did not articulate that argument more strongly, but because Necessary and Proper would have to be invoked in an almost blanket fashion to make the individual mandate valid. Hudson wrote, “[a]lthough the Necessary and Proper Clause vests Congress with broad authority to exercise means, which are not themselves an enumerated power, to implement legislation, it is not without limitation.”
This is a key assertion in Hudson’s opinion—one that he makes in regard to both the Commerce Clause and the Necessary and Proper Clause. If upholding the individual insurance mandate required an interpretation of federal power that removed all serious limits on federal authority, then such an interpretation could not be correct under a Constitution of limited federal power. According to Hudson, “the same reasoning,” which supported the mandate “could apply to transportation, housing, or nutritional decisions. This broad definition of the economic activity subject to congressional regulation lacks logical limitation.” Any interpretation of federal power that has no logical limit cannot be correct, regardless of the textual source of such power. As Hudson puts it, [the Necessary and Proper Clause] is not unbridled.” …
AdvertisementIn short, Judge Hudson did not ignore the Necessary and Proper Clause, nor did he reduce the Clause to a nullity. He simply concluded that assertions of unlimited power fall beyond any reasonable interpretation of congressional power, whatever its purported source.
Don Surber, reacting to the decision, agreed that the Necessary and Proper Clause had to have some limits in matter of individual mandates. Otherwise government could tell hippies to have haircuts.
Eric Holder and Kathleen Sebelius, reacting to the Hudson decision, made a public-policy rebuttal stressing the underlying reason for for passing Obamacare in the first place: the government needs to help people and no judge should really stand in the way of a beneficial intent. The suits challenging Obamacare — the judges who uphold the suits — are implicitly troublemakers, standing between the poor and the helpful state.
In March, New Hampshire preschool teacher Gail O’Brien, who was unable to obtain health insurance through her employer, was diagnosed with an aggressive form of lymphoma. Her subsequent applications for health insurance were rejected because of her condition. With each round of chemotherapy costing $16,000, she delayed treatment because she knew her savings wouldn’t last. …
That’s what makes the recent lawsuits challenging the Affordable Care Act so troubling. … As these lawsuits continue, Americans should be clear about what the opponents of reform are asking the courts to do. Striking down the individual responsibility provision means slamming the door on millions of Americans like Gail O’Brien, who’ve been locked out of our health insurance markets, and shifting more costs onto families who’ve acted responsibly.
Regarding the “hippie haircut” argument, Holder and Sebelius argue that government has long had the power to control bad economic choices. That makes healthcare different from barbers because unregulated individual choices create unwelcome economic effects. “As two federal courts have already held, this unfair cost-shifting harms the marketplace. For decades, Supreme Court decisions have made clear that the Constitution allows Congress to adopt rules to deal with such harmful economic effects, which is what the law does – it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.” And therein lies the justification for regulating this particular form of commerce.
That 68% want the individual mandate repealed is encouraging news for the Republic. A large percentage of the 32% are calculating they do not pay now and they will not pay under Obamacare, so what is not to like?
Kudos to Judge Henry Hudson for recognising that the Commerce Clause and the Necessary and Proper Clause isn’t WD-40 for the party in power, or the entire three branches of government to pass legislation under it’s rubric and shread the intent of the Constitution.
Let me address the health care issue succinctly. Our Republic never intended nor made any promise or alluded to any concept that it was going to save people from death, a necessary end.
It is shear lunacy to believe that it should undertake such a program. Yes, your loved ones will ALL die … get over it.
Some things we know are proper
Some necessary, too
Some things are both, but this we know
Sometimes it isn’t true
The government, says Holder
Is here to help us all
But helper or as scolder?
I’ll let you make the call
The Left would dip their fingers
Into our very souls
And tell us what our kids can put
Into their breakfast bowls
They warn us not to breathe and fill
The air with CO2
They know what’s good for us and shove it
Up the old kazoo
They say they do it for our good
They say it’s being fair
I say just leave us all alone
And get out of our hair
BTW …all the available WD-40 has been purchased by the FED and Treasury to continue lubricating the printing presses now producing toilet paper.
As two federal courts have already held, this unfair cost-shifting harms the marketplace. For decades, Supreme Court decisions have made clear that the Constitution allows Congress to adopt rules to deal with such harmful economic effects, which is what the law does – it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.”
Then the Supreme Court was wrong, as is the whole premise presented by Holder and Sebelius. For decades federal judges have flouted the Constitution and arrogated virtual legislative power to themselves. Therefore many modern landmark federal court decisions are illegitimate, going all the way back to Wickard v. Filburn in 1942 — a total misreading of the Commerce Clause.
“As two federal courts have already held, this unfair cost-shifting harms the marketplace. For decades, Supreme Court decisions have made clear that the Constitution allows Congress to adopt rules to deal with such harmful economic effects, which is what the law does – it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.”
Oh, really? And what is the cost of illegal immigration? What is the cost of smoking? What is the cost of not going to church? What is the cost of voting for liberal Democrats?
Once we pile up statistics in the direction we want them to point, we can do a cost analysis on wearing shoes or flushing toilets. And who gets to decide if we can or cannot? The federal government?
The law of eminent domain allows for the government to take property, but it is not without limitation. A system that would allow a state to go bankrupt or an entire nation, in order to “redistribute” entitlements, is willing to sacrifice the many in order to redistribute to the few. A cost analysis of the failure to secure the borders, a failure to rein in bloated union pension blackmail, and the advancement of the fraud of greenmail…is a government in a poor position to advocate much of anything on a cost basis.
Every sad anecdotal story would be dwarfed by the trillions of stories about how we are bankrupting the nation, one Democrat-run crumbling state at a time.
The issue isn’t “fairness” of “carrying” people who don’t have insurance, it is the opposite intent. “Redistributing” wealth through stealth….and creating a dependency upon the state for our very existence. That’s the way new Democrats are made.
I hope and pray that Judge Hudson’s ruling won’t be reversed by a higher court. If Obamacare stands then that is the beginning of the end. If the government can compel you to engage in economic activity then they can do anything to you. The money that is left to you after taxes won’t really be yours anymore. Can they create a program where you get to trade in your 401(k) for government bonds, and then force citizens to participate? ( I’m fairly sure that they are already planning this) What other rotten deals will they force people to do? Will they require that everyone must buy a season pass on Amtrack, even if they’ve never used it and probably never will?
Where would it end?
30 years or so ago there were those who argued the “promote the general welfare” statement in the preamble to the US Constitution gave permission for any and every welfare program they could think of. Invoking the Necessary and Proper clause sounds like this exact same kind of intellectual bastardization.
Ultimately it is not the Gail O’Brians who are the problem. We have enough money to take care of them; in fact we already have a program to do it, called Medicaid. The problem is the failed artists and musicians and actors and writers and Community Activists who don’t want to get a real job but want to pursue their art and still get health care. The problem is the young women who want to make themselves so fat they can qualify for disability and who still want health care and the young men who want to take illegal drugs and still have health care. The problem is the unions who have promised too much and want to offload at least some of their health care costs to Uncle Sugar. The problem is the illegal immigrants who want health care.
…it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.”
Color me cynical, but when have the Progressives ever been concerned about free riders being a bad thing? The central underlying premise of the welfare state has been that free riders like welfare Moms were always welcome at the trough and somehow, by the very virtue of their victim-hood, were morally superior to the poor bastards who are/were taxed to support them.
In this instance methinks that the whores doth protest too much.
Habu has the right of it, it is insane to declare that the Republic has the obligation to save us from death, even if it could. Death is the ultimate individual mandate. What is actually proposed here is not “saving” anybody from anything, rather it is placing control of the who, when and how into the hands of the State.
Death, I have heard others remark, is easy, its getting there that’s tough. Haven’t been there nor done that, but I’ll let you know. Nobody likes that, even those who in the end accept it. I hope to work it out when the time comes, between me and God, given the circumstances He provides and the resources I can access, not as a helpless statistic ground up in a bureaucratic healthcare machine.
That sounds definitely Orwellian: The Ministry of Healthcare.
Just finished reading and love it. Thank you, Richard.
P.S.The only thing that seems somewhat unnatural is the Alex was allowed to take compromised chip with him instead of extra virgin phone (or two).
These government nannies and especially the “main-stream” media, always trot out a single “victim” who has for some lame reason has fallen through the tiniest rupture in our massive safety net. One person adversely affected out of 250 million automatically constitutes conclusive evidence that the system requires immediate repair, otherwise this poor shmuck (or shmuckette) will most likely not withstand such neglect. Whether it’s being upside down in a home or owing a medical bill or becoming unemployed and being unable to afford the Christmas to which they have become accustomed-it matters not. Most of these “victims” are completely unworthy of any sympathy-an unfortunate “pauper” who paid a million bucks for a house and now can’t make the payments; an heiress so down on her luck that she can’t afford Lanvin sneakers, etc. Last week I had to choke back tears as a woman in a Burberry scarf, carrying a designer dog and accompanied by a teenager tethered to her Android, told her catastrophic and heartrending tale of woe to an overwrought reporter-her unemployment benefits would probably expire before she died, rendering her “scarfless.”
(BTW-As I type this, I just read that a group calling themselves, “Let the Flame Light the Way” are organizing a candlelight vigil to mourn any time limitation on benefits. (See the Facebook rallying cry at http://www.facebook.com/event.php?eid=154561994589952).
We have devolved into “government by anecdote.” Our busybody lawmakers seek to remedy the smallest inconvenience even when only a handful are affected and no matter the cost of the redress. The only way all this madness will cease is for the government fisc to run dry-this will provide adequate cover for the poltroons in DC.
10. Tamquam
It is indeed Orwellian as is a growing body of “institutions” thrust upon the public in the name of “Our” welfare. It has reached the level with the advent of the Interent, and blogs such as this one, that the citizens are now informed to the extent to which we are now forceably bound, finacially and usurpatiously “legal” to the dictates of our solipsistic government and its’ leviathan bureaucracy.
This was never to be. States have rights that become more impotent every day and our citizenry for the most part is ignorant of the Bill of Rights which are OURS, not the governments.
Currently because of the US and world economy and the ignorance of our population to the deconstruction of a world they believe they know but don’t, I believe we are in for a return to some darker ages…..sooner rather than later.
Wretchard, you wrote:
No matter how you slice it, baloney appears to be baloney…
This puts me in mind of my days at the UCLA Neuropsychiatric Institute, as a resident in psychiatry, when one of my mentors, the formidable Joel Yager, used to say of psychiatric nosology — then as now a vexed and contentious subject — that dealing with it was like going into a Jewish deli, “No matter how they slice it, it’s all baloney.”
Jamie Irons
Thinking about Habu’s point, this whole debacle gets us right into Brave New World territory. It’s not just death that must be prevented but unhappiness, i.e. Dysthymic Disorder, Major Depression, Depression Not Otherwise Specified, Mood Disorder, and a number of other “diseases”. Then there’s always the need to eliminate fear: Generalized Anxiety Disorder, Adjustment Disorder with Anxiety, Anxiety Not Otherwise . . .
The thing I notice, on top of it all, is that the better we get at treating people, the sicker they seem to get.
maineman (#15)
How surpassing strange that you should raise the issue of psychiatric nosology just then!
Jamie Irons
15. maineman
Defining medicalization as the perception of nonmedical conditions as medical problems and nondiseases as diseases, society has devoted much of its’ energy and much money to exposing the dangers of “medicalizing” the conditions of some who simply refuse to conform to society’s expectations. It is argued that modern psychiatry’s tireless ambition to explain the human condition has led to the treatment of life’s difficulties and oddities as clinical illnesses rather than as humanity revealed in its fullness.
( Don’t mean to step on your toes Jamie but that argument is out there )
I see the whole thingie as a win-win. If a Socialist administration can force people to buy insurance, then a conservative administration can force people to buy handguns. Works for me. Elections should have consequences, or there is no point in holding them.
The whole issue is really welfare for insurance companies. It won’t be acknowledged as such but that is the reality. Insurance Companies see 30 million customers at 6K per year that don’t have any choice but to pay. Makes Madoff, AL Capone, Bonnie and Clyde, et. al. look like amateurs.
stoicheion…
You’re way behind the curve on this one: the Resident has already induced millions of prospective victims to purchase firearms.
In fact, such manufacturers have been a one-way bet ever since he slipped in.
Other one-way bets: silver and gold miners. The way Benny and the Press operate — think Canadian.
BTW, did you catch the export tax imposed by Oz on her mineralizations?
———–
68% is a number that seems to recur frequently in polling data.
I bet if you did a survey it would turn out that the other 32% of the population were in heavily government related jobs. In this case their health care would be unaffected because the feds/state/local were picking up the tab regardless.
6. cfbleachers
What is the cost of not going to church?
………..
Interestingly, I’ve seen a couple insurance outfits spring up in the last couple of years to serve the church going crowd with lower premiums ….. because their actuaries figured out that people who go to church are healthier on average than others. that is, they have fewer “lifestyle” ailments.
stoicheion…
Other aspects of Obamacare assure destruction of private label insurance.
Obamacare also has poison pills for medical independence on the part of physicians.
Once physicians come up to speed on these provisions — they all want out.
Expect a monumental doctor shortage — dead ahead.
No physician wants to function by ‘telemedicine’ — i.e. Washington calls the shots – calls the tests – calls the plays. The attending physician is not permitted ‘judgement calls’ under Obamacare.
Since most of ones medical expenditures occur in the last moments of life — the route to lower outlays is clear. Kill’em quicker! That is of its essence.
Habu,
It is argued that modern psychiatry’s tireless ambition to explain the human condition has led to the treatment of life’s difficulties and oddities as clinical illnesses rather than as humanity revealed in its fullness…
To be honest, psychiatry hasn’t had much luck with its efforts, such as they have been, to “explain the human condition.” Most practicing psychiatrists regard such labors with contempt. Neither the psychoanalytic nor the neuro-biological approach has so far provided much of deep and lasting “explanatory” value.
The Australian philosopher David Chalmers approaches our understanding of the human condition with, in my view, the right sort of humility:
“I think it is widely acknowledged that consciousness is the biggest obstacle to a reductionist program in neuroscience, and I think most people in the field, both in science and in philosophy, agree that so far neuroscience has at most addressed the easy problems of consciousness and not the hard problem,” Chalmers says….
Chalmers’ “hard problem” is, of course, precisely the one that differentiates human experience from everything else that goes on around us. Psychiatry has difficulties even with the “easy” problems.
Jamie Irons
23. Jamie Irons
Jamie, sounds good to me and I even got confirmation from the other voices in my head.
Best
H
Sorry, I forgot to give at least a brief indication of what Chalmers means by “the hard problem.” Here it is:
The [hard] problem is put succinctly by Michael Lyvers, professor of psychology at Bond University. “They [neuroscientists] might be able to describe the neurobiological process of what happens when we see the colour red, for example, but I’m not sure they will ever be able to describe what it feels like to see red,” Lyvers says.
It is that subjective experience, that precise and ineffable feeling, that is so hard to account for.
Jamie Irons
When you get right down to it, fair is just a weather report. It has nothing to do with life beyond that.
25. Jamie Irons
OK, now the voices in my head are bickering. One says it’s red, the other deep rose …I’ll just let them work it out.
……..Socialist Democrats bill
…. New spending bill totals $1.1 TRILLION!
$575 per page
Re.18. stoicheion.
“If a Socialist administration can force people to buy insurance, then a conservative administration can force people to buy handguns.”
What conservative admin?
“The whole issue is really welfare for insurance companies. It won’t be acknowledged as such but that is the reality.”
Agreed. That’s why the only workable approach to med. financing prob., namely, catastrophic coverage with very high deductible financed through taxes + 100% (to induce usage) well defined preventive care coverage + medical accounts will never be implemented.
I would probably have agreed with most of the postings here had I not found myself in the “victim” role more than a couple
of times in the past decade. I dutifully paid my healthcare bills via payroll deduction so I don’t think of myself as a
freeloader. I used the bulk of my unemployment “benefit” to pay for COBRA until I found another employer. I also ran up
my credit card to pay for the necessities of living.
I have never made six figures, so I don’t consider myself wealthy. I just want to point out that anyone can lose their health care benefits because their firm goes belly-up (shareholder profit priorities) or their district budget gets slashed (state government appropriation of local government funding). These things really happened to my wife and I, and more than once.
Maybe as more bad things happen to more everyday people our points of view may change. The polarized view ignores this
perspective. The freeloaders certainly exist. I certainly don’t care to subsidize behaviors that I deplore. But, unless you have to face the choice of foreclosure versus ensuring
adequate insurance for a cancer survivor, you may never appreciate that health insurance costs in our times needs to be brought to heel, and not in the some distant alternative reality.
gov’t is not the answer. free the health care market across america.
Regarding the “hippie haircut” argument, Holder and Sebelius argue that government has long had the power to control bad economic choices.
What on Earth can this possibly refer to?
The government outlaws the *offering* of unsound instruments, but that is a million miles away from dictating what a *buyer* must, can, or should do.
Should I buy a Bentley? Does the government dicate my decision? SHOULD the government dictate my decision?
I heard Erwin Chemininsky (sp?) bloviating about this on the radio this morning, making really dumb arguments in favor of Obamacare.
Legally, however, I really do wonder about this. If Congress *could* simply nationalize healthcare and tax us for it, surely it is less intrusive to do it by mandate … right? I’m not sure that any series of courts will agree on finding a bright line anywhere in these areas, so will it really come down to what Justice Kennedy has for breakfast, as to how the republic goes?
Grotesque.
What I really like about Judge Hudson’s decision is that it brings the question of whether there are limits to federal power to a head. Jurists usually go to extreme lengths to avoid these basic questions, and just the kick the can down the road for another jurist to tackle the truly crucial defining issues of Constitution. This process has allowed the Left to slowly redefine and enlarge the limits of Federal Power to their liking, because no Jurist has wanted to take them on directly. Now Judge Hudson has taken them on.
In this case, if Judge Hudson’s decision stands, we can use it to begin to dismantle the Nanny State,
If it is overturned, we are in effectively a police state, and the Cold Civil War will turn hot and bloody quickly. This is a real tipping point.
H@28: $575 per page
That’s $575 million per page.
grrr @ 29,
That’s why the only workable approach to med. financing prob., namely, catastrophic coverage with very high deductible financed through taxes + 100% (to induce usage) well defined preventive care coverage + medical accounts will never be implemented.
It’s coming sooner than you think…
Cheers,
L3
re 35. “It’s coming sooner than you think…”.
How come? Insurance Cos will never allow this.
YBR 34 Or 1.9M pages. Big bill.
Habu @ 28 said:
Yup, $575m/page.
All can be cured for about 25 cents a dose.
The idiot institutional Republicans have now shown their true colors. They should be screaming from the rooftops about the new fleecing of the American people but Boehner and his type just smirk and go along. I hate them all.
#30 Middleman
That changes in healthcare/insurance practices are needed is not in question. The need is to require that insurance companies actually absorb the risks they are “selling” to their customers. Legislation should require that they advertise ONLY what they are willing to provide. If they are not covering customer risk (i.e. they are unwilling to take subscribers with existing conditions or worse dump subscribers who develop a risky condition) THAT information should be required to be provided in BOLD LETTERS to all.
With that information available, participation and subscription could be used by large groups and by united or co-beligerent small groups to eliminate poor risk takers from the option pool.
By the way, I am myself in a very similar situation to the one you were in but Obamacare is not the answer.
grrr…
What are you posting about…?
That’s a perfect description of reinsurance as a business model… i.e. the NORM for the insurance world.
It’s freakishly expensive care that causes health insurance to ‘blow up.’ The same is true for all other coverages. That’s why primary insurers ALWAYS try and lay off the ‘tail’ risk to someone like General Re or AIG.
You see the same phenomenon in nuclear risk — reinsurance for a total fiasco is unobtainable.
Not withstanding the sugar and plums…
Obamacare is designed from the inside to DESTROY private health insurance. It can’t work any other way. After the full transition, the bulk of the current insurance industry employees are destined to fold into the Federal Government as union employees. The equity investors will see their assets vaporize.
Obamacare is destined to completely hamstring the private insurers and HMOs like Kaiser. Like GM their destiny is to be folded into the Federal corpus.
What exactly did you expect from a socialist Congress?
Josh @ 32: “The government outlaws the *offering* of unsound instruments, but that is a million miles away from dictating what a *buyer* must, can, or should do.”
The Federal Government already has laws which will require citizens to buy only those nasty compact fluorescent light bulbs and those worthless Euro-style front-loading washing machines. Square that with the Constitution and the explicit language of the 10th Amendment.
I used to get annoyed about over-reaching government, until I realized that Western liberal government was on the road to collapse. It is “not sustainable”, as they like to say. Good thing too!
What should be done for “preschool teacher Gail O’Brien?” For the small number of such cases, it would be churlish to suggest that Democrats raise them in the basement, is it necessary to do violence to the Constitution and the economy? Charity would meet her needs far more efficiently than the efforts of a thousand GS-7s. If it is true that there is no rational way to treat her, then charity is what treatment will be and the provision of it will ennoble the giver. If she is not treated and dies which is the worst outcome for society; 1. a business says no and absorbs the cost of bad publicity, 2. a charity says no and suffers both from publicity and moral anguish, 3. the government says no via a “Death Panel” and blood is on the hands of the citizenry?
One reason time has been against the argument for Obamacare is that it gave people an opportunity to hear from their physicians. No one has to my limited knowledge examined the difference between Doctors and Lawyers. The later as a group largely chose to serve the State against the interests of the public, and have found ways to profit from doing so. The former, despite being as likely to be “liberal” as other members of the Middle Class and above, have according to polls largely voiced their intention to quit rather than advance the expansion of the government in their field.
In a trivial instance of the Government Uber Alles mindset, tonight there was a hyperventilating young “reporter” on the local news (WNBC) all in a lather because [GASP] people in Muppet costumes were standing around in Times Square hoping that tourists would want to take their picture with them, and give them a buck or two.
“Why isn’t this REGULATED?” he demanded, indignantly. “Who is in charge of this? Do they have a LICENSE?” He admitted, lamely, that this activity isn’t illegal, or harming anyone, but he was genuinely outraged that it should proceed without some quango oversight/interference/taxation.
Unreal. I’ve seen those folks around. They never bother anyone; they always wait for the tourists to approach them, and it’s an utterly harmless way for them to make a living ($80 to $100/day, barely getting by). Yet this little reporter prat was outraged that they weren’t regulated.
K @ 41: The Federal Government already has laws which will require citizens to buy only those nasty compact fluorescent light bulbs and those worthless Euro-style front-loading washing machines.
Strictly speaking, no, you don’t have to buy either.
But of course realistically, you’re right.
That’s what I mean by no bright lines.
And the laws on toilets and showerheads, not to mention car bumpers … actually, you *do* have to buy airbags if you buy a car, now that you mention it. But you do not have to buy a car, and there is no fine if you don’t.
Maybe it is better to think in terms of replacing rather than simply repeal Obamacare. The Healthcare system is probably broken in serious ways. The problem is that its been ‘fixed’ in ways that break it some more. That is manifested in the gloomy numbers that are coming out of the CBO.
This is the root cause of Obamacare’s current problem. If it were looking good it would gradually be gaining adherents. But in reality it is looking like losing proposition.
So, the anti-Obamacare forces won in court today? But this isn’t the end of it. The damn thing is still in court. There’s very little succor in thinking that today’s finding means much. As long as it’s in court, it’s a crapshoot. No logic, no reason, no common sense, nothing but randomness exists in the judicial realm anymore.
And of course, nothing truly human is truly random. So by characterizing court outcomes as random I do them a big, unwarranted favor. God only knows what drives the courts these days, but it isn’t justice, it isn’t the Constitution, and it isn’t the common law sense of what is right and fair. We’re into the airy realm of theorists, and all the concordant absurdities, when we deal with the courts these days.
The only thing that saves the day is political pressure, but this comes at a time when the courts are more emboldened and self-righteous than ever before. Just ask ‘liberal’ California.
God knows what bile these Mandarins on the federal bench are capable of coming up with, and then enshrining it in Constitutional trappings.
I’ll be happy when it is over, I hope, but it isn’t over by a mile.
Hell, the legislature and the executive forced this on us, against demonstrable popular will, and these two groups are the ones who are directly accountable. The guys who supposedly have their ear to your concerns are the ones who whistled devil-may-care. What are the chances unaccountable judges are going to start listening to you, little guy?
If the legislators and executives have got it in their mind that they are your betters who will corral you along despite your howls, why in the hell should anyone think a dang judge appointed years ago, feeling impregnable, and wanting more bling in the latest cocktail parties won’t follow suit?
http://townhall.com/columnists/BruceBialosky/2010/02/08/real_healthcare_reform__kill_the_lawyers
Bruce Bialosky
Real Healthcare Reform: Kill the Lawyers
When you get right down to it, fair is just a weather report. It has nothing to do with life beyond that.
Weather report? Huh, I always heard it was what you gave the bus driver.
But Wretchard’s right, the real issue isn’t repealing Obamacare, it’s replacing it. I once heard that “most problems started out as solutions.” (my addendum, the rest – like Obamacare – were simply posing as solutions).
There are fundamentally broken aspects to how medical care is financed in this country, most of them due to government intervention warping more and more of the business into third-payer horrendously inefficient systems. The “reforms” of the past few decades have all tended to make this worse, not better. Perhaps the saving grace of Obamacare is that it caused the regulatory equivalent of an integer overflow – keep adding numbers on a computer and eventually they “wrap around” and come up negative, at which point it’s clearly obvious that you’ve got a bug. Nobody can look at the suddenly negative number and credibly claim it’s an improvement.
But they’ll still try, the Pelosi’s, Holders, and other dead-enders of the Progressive party. And they lose a little more credibiilty every time.
Oh, not with me. They never had any with me. But then I’m not a swing voter.
Cowboy says If the legislators and executives have got it in their mind that they are your betters who will corral you along despite your howls, why in the hell should anyone think a dang judge appointed years ago, feeling impregnable, and wanting more bling in the latest cocktail parties won’t follow suit?
And f47 Real Healthcare Reform: Kill the Lawyers
combine to remind me that laywers are the larval forms of judges.
a couple of observations.
Examples like Mz O’Brien, appear to be one way only. Individual cases are aired by politicians when they are pushing for something, but, when someone brings up an adverse experience, the stock reply is
“I can not comment on individual cases”
*******************
Is depression* a socialist “disease”?
Depression (and suicide) are virtually un-known in the third world, but they continue to increase in the increasingly socialist first and second world, with disproportionate suicide rates in the former soviet satellites.
Depression is ultimately a “giving up”, a resignation to sinking into the doldrums, a learned helplessness
(yeah, I know about expensive SSRI anti depressants and the side effects and once took a friend to A&E and sat and waited all night for him to be seen when he came off them too quick (friend has spent far to many years in universities exposed to toxic concentrations of leftist self hate memes).
Cognitive behavioural therapy (a talking cure) has as good a recovery rate as the drugs and much lower re occurence rate showing depression is not a chemical or physical illness).
Depression seems to be an almost perfect disease for life long dependency on expensive drugs.
Brave new world’s “soma”, the all purpose happy pill.
*Not to be confused with bi Polar (know a couple of folks with that, both amazingly intelligent an creative)
I think the number one problem with Obamacare is the timing. We are smack dab in the middle of an economic crisis. But Obamacare isn’t about healthcare as much as it is about trying to save Medicare. The government cannot control its runaway spending so it is inventing ways to bury its bloody books into a new venture. The reason the gov is looking at taking over 401ks and any other means of wealth creation is they have promised too much to too many and now need to rob the kid’s piggy bank to keep the bill collector off of the porch.
Government could have “fixed” healthcare laws to level the playing field but decided to raze the system to the ground so they could plunder the storefronts while printing dollars to prop up their partners in the banking industry. The government is wholly fixated on generating new operating capitol and could give a fig about your health or anybody else’s. In fact, if you’re a white male they want you to die. Money is power and power is life and they want your money so give it up.
What they need is a convoluted rubric to obfuscate the problem in order to launder their soured debts and the Obama bill provides just that. It is too big of an idea to fail. It just can’t because this is the beginning of the rest of the Plan. Remember, they need to fix social security, and god knows what other crisis that has been swept under the rug of secrets while they follow their lust for gold. The present is bankrupt, the best they can do is loot the future.
“As two federal courts have already held, this unfair cost-shifting harms the marketplace.”
Why “unfair”? Is someone doing this to her on purpose? Did she not have an opportunity to purchase health insurance instead of some other goods/services prior to her diagnosis?
And can I get a rock solid definition of the word “unfair” as it applies to every good and service in life?
Isn’t pushing for equal outcomes in health care coverage “unfair” to those who have more skills and smarts and money and work ethic and take care of themselves, and are forced to be just like someone who isn’t any of those things or has an immature value system and would rather buy an ATV and a snowmobile than, say, get their teeth fixed?
The word for the example of the cancer patient isn’t “unfair”, it’s “unfortunate”. Grownups know this instinctively. Leftists never seem to figure it out. And Stoicheon is right. There are a lot of cynical people who give lip service to this outcome egalitarianism in order to push for a system which concentrates power in their own hands.
And, as a commenter suggested, is it “unfair” to deny someone the right to a firearm to defend their life and property, so that all state gun laws regulating ownership must go and funding be made available to every individual so they can buy one?
Beyond that, concerns about cost shifting by people like Holder et al are false and hollow when you consider their support of government programs like Medicare and Medicaid which are based almost entirely upon the concept – the government compensates doctors at a rate less than what it costs to produce the services they provide, knowing that the docs will simply raise fees on their private and insurance patients to make up the difference. If you really wanted to do something about cost shifting in a big-governemnt way, Mr Holder, you would be pushing for Medicare and Medicaid to pay doctors what the going market rate was. Not that that would be a very American thing to do.
Also, kudos for the comments on the “medicalization” of personality quirks in order that parents and the psychiatry industry can make more money. This process has to stop.
Annoy mouse:
“But Obamacare isn’t about healthcare as much as it is about trying to save Medicare.”
They MUST save Medicare, Medicaid, and Social Security, but not for the reasons they give (fairness, compassion, etc.)
Saving those things is an imperative because failure to do so would be public proof, once and for all, that the government takover of the charity industry that occurred in the 1930′s and was extended in the 1960′s has been an abject failure, and that the system of private charity that existed prior to that time was, despite it’s faults, a better way.
Think any Dems will ever want that to happen? I’m guessing they’d cut their arms off with plastic butterknives and set their own kids on fire before they’d let that happen.
No mo, I think it goes beyond saving face, which is compelling enough, and boils down to papering over their unfunded debt with new programs. I guess it is a two sided coin but when you are a Democrat and you are losing the game it is high time to change the rules rather than change your tactics. It worked in the third grade.
Buddy L,
Link to interesting David Kopel article
http://www.alphecca.com/?p=249
seems the Obarmensch has been pretty effective in sowing anti 2A seeds out of the public view.
In March, New Hampshire preschool teacher Gail O’Brien, who was unable to obtain health insurance through her employer . . . With each round of chemotherapy costing $16,000, she delayed treatment because she knew her savings wouldn’t last. …
Ah, the freedom of choice . . . here it is folks.
I am sad that Ms O’Brien had the unfortunate experience of developing cancer, it is a truly devastating health crisis.
Loss of health is loss of a priceless personal item.
Yet it is also a freedom of choice to commit all of YOUR personal resources to the conservation of such bodily condition.
Therefore, should not Ms. Obrien have been forced to turn over her entire estate to government control as part of the governments committment to saving her life?
So there is a cost benefit . . . Ms Obrien can delay the cost to the net loss of the benefit . . . or she can say my health is priceless (as is my life) and spend every penny she has on regaining her health.
T@37: YBR 34 Or 1.9M pages. Big bill.
Point noted but now is not the time to be dropping decimals.
The omnibus spending bills are always big – well over 1000 pages. Earmarks for “pork” run in the 1% to 3% range – 2% in 2008 (1400 pgs), 3% in 2009 (1400 pgs) and not sure for 2010. (Good 2009 summary here.) At issue is the process (the rhetoric vs the reality of earmarking) and the trend lines ( annual increases in discretionary spending well above inflation clearly indicative of failure to execute course reversals at the federal level), not to mention the timing.
Health care is and has always been an individual mandate; the same is true of diet, housing, education, clothing, transportation, etc. Our caretakers, both at the state and federal level, have interceded in our mandates on their own behalf.
Individuals have heretofore organized themselves along the family and clan lines primarily to provide the security only numbers may provide. Clans, in their turn, organized themselves around religions and other federations to further soften the effects of major disasters.
In the past sixty years, the clan has all but disappeared and the responsibility for the care of children and the elderly has transitioned from the family/clan to the government. Today, our children are taught by pedagogues while grandparents stultify in retirement communities. The tremendous costs of these changes are just now being recognized but are often wrongly associated with simple waste and inefficiencies.
As a society, we have adopted a false and irresponsible independence that we seem reluctant to surrender. We blame business, insurance companies, unions and government for our own failures.
Speaking of numbers, as of July 2009, Facebook users numbered 250 million. One year later that number doubled to 500 million. Time magazine named Mark Zuckerberg Person of the Year using the number 600 million. That’s one in ten world wide. If you consider that most users are probably located in developed countries, that consolidates to something around one in five or less. Zuckerberg is donating his fortune to the Gates Foundation.
It’s the sheer magnitude of the modern world that astounds.
Judd Gregg will guest host Squawk Box on CNBC tomorrow. I expect he will have something to say about QE and the Rand Paul proposal to audit the Federal Reserve, and possibly some health care insights.
The Healthcare system is probably broken in serious ways.
Yes this is true, and too easy to forget when a moron like Obambus comes along and breaks it much further.
All the ER rooms are closing because they are flooded with uninsured poor who cannot (or do not) pay for care. Everyone’s medical bill is larded at least 30% with fees to pay for the indigent. Medicare pays humongous amounts to extend very senior citizens’ lives by a few more generally unpleasant weeks or months. The average quality of medical care is dubious, but hidden by doctors’ unions and insurance company sophistries.
What about fat children and people who smoke, are those health care (cost) problems? Only when the public is involved in their health care – as is somewhat true today, and will be *truer* under Obasmus-care. Is it the tribe’s duty to take care of people, is it to the tribe’s benefit to coerce kids not to be fat, given the tribe’s humanitarian interest in funding their health care? Slippery slope there. Isn’t it in the tribe’s interest to inculcate socialist and progressive ideas into all members, optizing them against their wills, or if that doesn’t fly politically how about at least to survey the ideas and assure that children’s political views match those of the electorate to the the third decimal point?
Our government has recently failed to enforce market discipline in the finance area, with horrible results already, and catastrophe still a mere slip away. Should they not try to fix the health care *market*, if not health care itself, given the known problems that are tearing it down slowly if nothing is done? That strikes me as a reasonably strong argument. Unfortunately. I just want the response to be much, much better structured than Obambuscare, throwing gasoline on a fire is not a good response no matter supposed good intentions.
The flawed reasoning applied in this national discourse resolves to this: We have found certain individuals who need welfare to cope with medical expenses. Therefore we must abandon free market liberties, as well as restrictions on the power of federal government. We must institute rigorous controls and provide a welfare state solution.
Power to regulate commerce, necessary and proper. So federal government can specify the gauge and route of railways to ensure that, at the border of Utah and Nevada, the tracks actually join. Trains can operate unimpeded by differing gauge tracks in interstate commerce.
Can federal government then take possession of all railroad operators? That is not necessary and proper. Can federal government require only government built trains ply the routes? An overreach – not necessary and proper.
Similarly, the necessary and proper role of federal government in health care is to ensure that the regulations of one state do not cause inappropriate restraint when goods and services transcend state boundaries.
Overreach of government drives costs higher and permits clever individuals and corporations to exploit the system. It leads to de facto rationing controls and inefficiency, while destroying research and innovation.
In Michigan, Blue Cross will give you an individual policy–there are a number of choices with varying premiums–whether you have an existing condition or not.
To avoid the problem of somebody hitting the BC office on his way to the Cleveland Clinic, planning on swapping a $500 premium for a $200,000 treatment, BC won’t cover pre-existing conditions for six months. So if you’ve got the Big C, you’re on your own for six months, after which you’re covered. If you break your leg in the first week, that’s covered, not being pre-existing. Seems to work, except for the government-by-anecdote folks who try to swap a $500 premium for $200,000 treatment and are denied.
IIRC, all the anecdote folks trotted out by the Clintons during the push for Hilarycare were bogus one way or another. Wonder whether the pre-school teacher passed up a chance…?
Middleman @ 30 – Sharon offers sound insight. While there will always exist tragic circumstances, such as those you reference, the solution for the tragedies of life is not government control of health care or welfare state.
Should we deprive our progeny of liberty so that we can be cradled in the benevolence of socialism? If so, then all those soldiers and sailors whose lives tragically ended on some battle field were fools. They could have stayed home and lived long, if oppressed, lives.
Government interference is probably the most significant reason that health care costs have skyrocketed.
Can anyone show me where in the Constitution the Federal Government finds the authority to take money from one person to provide food, housing and medical care for another person? If a person is a druggie, drunk or criminal that has caused their own medical condition through their behavior, why does any one owe them care? If the Government can ” means test” for qualification in any program should there not also be drug, alcohol and even nicotine tests for health care, food stamps and unemployment insurance? After all if you have money for booze, drugs or tobacco could you not have afforded health care if you wisely used your money/ About 47% +- people in this country pay NO Federal taxes. Just asking.
stoicheion @ 26 & no mo uro @ 53 – You are shooting at the target, but we have not yet hit the bull’s-eye.
Our national discourse often seems to conflate ‘unfair’ with ‘unjust’. Justice demands a standard or basis against which to judge the evidence. Government has an obligation to provide justice, but not fairness.
Is it unfair to be born without arms and legs? Is it unfair that the profligate trust fund libertine can live a dissipated life without every being productive? Is it unfair that Philo Farnsworth never realized wealth after inventing television?
Most would say ‘yes’ without hesitation.
Of course, none are unjust according to our standards of law. Someone needs to do this topic justice, perhaps here at BC. I’ll bet Wretchard could do the subject justice.
WE had the debate on Health care last summer. At least here at the BC. Not sure if Congress, the world’s greatest deliberative body, ever had any debate on the subject. Throughout our debate I kept asking for evidence that there is something wrong with the US health care system.
None was ever produced.
It seems that the USA has the best health care in the world. It is just expensive. You don’t get a Mercedes for the cost of a Yugo. You get a Yugo for the cost of a Yugo. Most of you don’t remember what a Yugo is. There is a reason for that.
So the real issue is one of expectations.
Voters want something for nothing. That isn’t the way it works and until voters learn that, they will keep voting for politicians that promise them something for nothing. NONE of America’s problems, minor though they are, will be resolved until that basic paradigm is changed.
Maybe we should go back to the Roman Republic base of only allowing land owning taxpayers to vote? One person, one vote isn’t working out so well.
Stoicheion @ 67: “One person, one vote isn’t working out so well.”
Democracy as a means of government isn’t working out so well. Gallup’s latest poll shows that only 13% of US citizens approve of the job Congress is doing. And we citizens supposedly control Congress through our votes! Since we can’t control Congress, what chance do we have to control the bureaucrats and judges who are the real power in the land?
I find this Gallup poll particularly interesting since I participated in it — first time in my life.
The pollster asked questions on some rather disparate topics, presumably reflecting the interests of whoever was paying for this poll. Most unexpected Gallup question was — ‘Is there a place within 1 mile of your home where you would be afraid to walk?’ I guess this means we can soon expect the Obama Safe Communities Act; maybe we will all have to wear GPS anklets at all times, so that Big Sis can keep track of us. For our own good, of course.
The conservative thing to do right now is to drastically reduce spending, the so called across the board 10% haircut and to re-scope government back to core principles. Pulling back the tendrils of federal domain and acceding to the rights of states. We can have only one federal government but it is fair that a state like California, that is a stocking horse for federal progressive expansionism, compete, economically, democratically, if you will, with a state like Texas. Let Americans vote with their pocket books and the feet and see what the market will bear.
Democracy has not failed, government has. It has run an unmitigated course of wild ideas, wild spending, and wild controls and impediments to domestic commerce; it is after a FERAL government.
In the best case Obamacare will marry the insurance companies and health care providers to the government creating enormous amounts of wealth for those who best play the insiders game. The quality of health care will be a distant consideration.
In every case the current plan will add millions of people to the rolls of public sector unions creating enormous sums to be used for electing and retaining politicians who will dance to the union leaders’ tune. Think California x 50.
America has provided more wealth to more people regardless of their family and political connections because government and the economy have been kept separate (for the most part). Join them together, or even 1/6 of the economy, and individual liberty and economic choices will get buried in the corruption that is certain to follow, as it has in every case in history.
Team 44′s solution to the widespread opposition of the “individual mandate” is to rebrand it the “individual responsibility”. I submit that it is our individual responsibility to oppose tyranny.
“Freedom is the greatest addiction of all”
The subject of the post – the constitutionality of the individual mandate – is actually quite interesting, even though my response and insight are limited.
Couple of things I knew immediately. Universal coverage was never economically viable without an individual mandate to create an adequately sized risk pool.
Second, increasing coverage would require increased expenditure. Period. Revenue neutral was not in the cards.
A tag-along issue was the exact number of needy citizens without adequate health care, an important consideration in my view but the number seems to have settled around 30 million (I suspect it is closer to 10 or 15 million.)
Lastly, the current health care system is most definitely broken. Cost escalation and the impact on families and business competitiveness make that case.
However, of all the reform bill provisions, frightening if some of which are ever fully realized, the one that bothered me the most was the mandate. I think there is a possibility it will be struck down but scheduling means several (?) years away.
What is broken is government (as per AM above who beat me to it.) I see no technical fix to health care pricing mechanisms that can be implemented at the federal level, which does not include mandates and/or rolling the current system into single payer (as per blert.) Maybe there is a way but I don’t see it.
Which leads me to the conclusion that Leo Linbeck’s concept of Interstate Compacts might be the only way to escape a massive increase in government scope and involvement in individual lives.
Much of the escalation in the price of health insurance is due to government meddling. When the law mandates, for example, that all insurance policies must provide coverage for “mental health” it drives up the price for people who have no desire to have such coverage. And in many states it is illegal to sell an insurance policy that only provides for catastrophic illnesses, which for many people is just the only kind of coverage they want.
If we really wanted to “fix” much of the problem the Feds should allow individuals to purchase health insurance across state lines.
stoich raises an interesting point. If they were truly concerned about health care, where were the debates on Capitol Hill? Why did the Obama administration full of the best and brightest team of rivals not write a bill, but merely ask Congress to come up with one? Why did Congressmen farm the crafting of it out to staffers and lobbyists, then not read it or allow it to be read before the votes?
I suspect that’s because health care itself was not the primary goal, but merely the means. The primary goal was and is control, power. It is why nationalized health care has been the Holy Grail of the left for 100 years in this country. It changes the nature of one’s relationship to the state, making the citizen a truly dependent ward, a vassal of the unlimited power of the state to manage the most personal of affairs. “From each according to his ability, to each according to his need” is driven past the goal line at last. Even the individual life of the citizen itself takes on a new valuation, it is now subject to a cost-benefit basis on how it affects the communal whole, and that life itself is very much ‘alienable’ should it become too costly or inconvenient.
Meanwhile the state will have finally got itself firmly entrenched in the business of “positive rights”, and the world’s your oyster if you’re an aspiring bureaucrat or policy wonk with a fistfull of studies and new claims for expanded rights. You are free to shape and guide social policy towards new heights.
That’s what it is all about, not helping a poor school teacher in New Hampshire, or some such business. That sort of detail is in the noise, and only useful as a way to achieve the goal.
On a related note, next week marks Christmas, and whenever holy days have crossed the path of the 111th Congress and the Obama administration, freedom has been a casualty. Last Christmas they were having a crucial health care vote in the dead of night the Sunday prior. On Chrismas Eve, Treasury simply announced, with no vote or prior authorization, that they’d decided to backstop the GSE’s (Fanie Mae, Freddy Mac, etc.) and make us all liable for them. Then at Easter we found them smashing Obamacare across the goal line despite Scott Brown and all the polls mounting against them. On the holy days, when people have turned their eyes to family, to friends, and to presonal matters, when people’s eyes are so averted, this is high time for doing dirty deeds. This next week will mark the last hurrah of the 111th, the most despicable Congress ever to gather on Capitol Hill, so look out. Regardess that they completely lack the moral authority to govern as they lay up lame duck, yesterday’s amazing, pork laden, $1.1 trillion omnibus bill that was horrific enough may not be the last thing up their festering sleeves.
T@73: Much of the escalation in the price of health insurance is due to government meddling.
Agreed – all regulation correlates positively with cost. However, under the Couric-Rice thread, the discussion addressed the general futility of “what if” hindsight. One can ask “what if” for health care in the (near) complete absence of regulation: Industry consolidation, in spite of regulatory climate.
“As one medical group executive said, ‘We are making out hand over fist.’”
• A large multi-specialty physician group in Washington, D.C., charges all competing health plans 8% more than what it charges the Blues due to a ‘most favored nation’ clause.
• A hospital in suburban New Jersey — the only hospital in its community — is demanding that health plans pay an extra 15-16% to compensate them for Medicaid and Medicare payments that are rising by 4-5% less than the hospital’s own costs.
• A hospital in the Northeast charges health plans 50% more than what it charges the plan owned by its own hospital system.
T@73: If we really wanted to “fix” much of the problem the Feds should allow individuals to purchase health insurance across state lines.
Agreed. The only rebuttal I’ve heard – interestingly enough – is that this is a State issue, not something that can or should be initiated at the federal level. Enter Interstate Compacts.
C@74: If they were truly concerned about health care, where were the debates on Capitol Hill?
and I suspect that’s because health care itself was not the primary goal, but merely the means.
I agree with the general tenor of the post except to remind people that (1) the research into this subject extends back 17 years to HRC in 1993, which implies that the insiders were well aware of the ‘congested’ areas requiring industry negotiation, and (2) business has been complaining for the last decade or so about the competitive burden of rising health care costs.
Also, in the case of health care, the responsibility seems to belong with the Pelosi-led Congress:
As a candidate for the Democratic presidential nomination, Obama insisted that the health-care reform plans of his rivals were misguided, because they envisioned forcing Americans to buy health insurance or risk a fine. Over and over, he said on the campaign trail that such a mandate was unnecessary.
“My belief is – is that if we make [insurance] affordable, if we provide subsidies to those who can’t afford it, they will buy it,” Obama put it during a January 2008 debate in Los Angeles against fellow candidate Hillary Rodham Clinton, who favored a mandate.
Rahm Emanuel argued for supporting an abbreviated version when public debate threatened the Congressional vote, but Pelosi argued for the Full Monte.
How about moving towards a workable solution? Obamacare didn’t just appear overnight. Richard Nixon proposed universal health care in the 70s. Hillary Clinton tried again in the early 90s. Why no progress? If laissez-faire health care is the solution, then let’s implement it. If a socialist option makes the most sense, then lets get practical and work out the best compromise.
What we have now is like the ersatz “war” in Star Trek where factions make calculated attacks and then the victims report to destruction stations.
M@79: Why no progress?
In the Putin thread Mr X makes the point that George Soros represents a (the?) corporatist global cartel that hijacked State Dept. I would suggest that much of the federal government has been hijacked. Energy and Middle East policy being front and center to the thesis, but closer to home, one could note the unconscionable cost of drugs in this country or that the AMA seems to be restricting the number of medical students as a form of lifetime compensation control, not to even mention the AMA’s abysmal performance record in monitoring and sanctioning their own professional community of practitioners.
It looks to me like an integrated solution is required since the medical community demonstrates no inclination to self-police or provide for the common good, let alone compete to provide services/drugs. Again, that brings me back to the IC approach.
I am not advocating this at all, but if we must have the government sticking its nose into health care I would like to see a hybrid system. Everyone would be required to provide for their own health care costs period. When and if the individual no longer has the resources to pay the government would loan (not give) the individual the money needed (within limits and payable to the health care providers). The individual would then have to pay the government back over time. If you die before the loan is repaid the government gets first dibbs on your estate. I realize that many of these loans would never be repaid, but it seems to me that if government has to be involved this might be a way to go.
Does this court decision mean I won’t get free Viagra after all?
82. Whitehall
You’re a very naughty boy Whitehall. Go stand in the corner for thirty minutes, and keep your cell phone off the entire time.
This is absolute farce. The Congress saying they know enough about ANY business to pass legislation like this, is insane.
If they had a ‘business model’ that WAS coherent, there would have been debates, and this garbage would not have been shoved into law as it was.
The Constitution is turning into a love letter for nostalgic conservatives.
Washington D.C. is now officially a REGIME. No ‘Separation of Power’, but CONCENTRATION of power.
“No matter how you slice it, baloney appears to be baloney. ”
Al Smith would be proud.
Either the people control the government or the government controls the people.
That’s the core issue.
They’re gambling that they can get the thumb screws on before we get really angry.
They’re wrong about that.
“30. Middleman
I would probably have agreed with most of the postings here had I not found myself in the “victim” role more than a couple
of times in the past decade. I dutifully paid my healthcare bills via payroll deduction so I don’t think of myself as a
freeloader. I used the bulk of my unemployment “benefit” to pay for COBRA until I found another employer. I also ran up
my credit card to pay for the necessities of living.”
That is because you were purchasing “full coverage” insurance via COBRA…unless you had a serious pre-existing condition, you most likely could have bought temporary “wipeout” insurance…..i.e. a high deductible with no copays etc, that would cover major medical expenses only, at a fraction of the cost of the COBRA
#52 AM: The present is bankrupt, the best they can do is loot the future.
Brilliant! We should get this meme public.
YBR:
“one could note … that the AMA seems to be restricting the number of medical students as a form of lifetime compensation control, not to even mention the AMA’s abysmal performance record in monitoring and sanctioning their own professional community of practitioners.”
Wrong on both counts.
The ADA has literally nothing to do with the number of seats in any given class at any medical school nor does it have anything to do with the total number. (In fact, only about 35-40% of the physicians in the country belong to the AMA, it does not have the majority in membership like dentists or optometrists do.) The AMA is not a governmental organization but a private one. Medical licensure is handled by the states and their registration boards, not the AMA, not even indirectly. And given the fact that the applicants to medical school, taken from the top tenth of a percent of each years college grads, flunk out at a rate of anywhere from 10% to 15%, I don’t see how creating a lot more medical schools and populating them with ever decreasingly qualified applicants is a road to anything but lower quality medicine, if the students can even handle the work to graduate in the first place.
Secondly, there are both regional and national databases for finding out about badly performing or malfeasant doctors. I understand that these were created not by government mandate but by the physicians themselves with money from some of their own private organizations.
Docs have lots of problems, but let’s lay off the urban mythology.
40. blert
You’re right. The objective is to fold private insurance carriers into providers via the Accountable Care Organization model (ACO) where the the payer and provider are one (the payer essentially transacts with the appropriate DOH -since the bulk of insured will be Medicare and Medicaid)), and the rates they are paid are dictated by the Federal gov’t. The private insurers will go away but be around for a little while through exchanges, then die a quiet death. Only self funded plans will exist. Or so I’ve been told. This will also drive inefficient providers (that can’t survive on Medicare rates-which will be cut significantly) and private practitioners out of the market.
You can do the rest of the Math.
One of the simplist consolidated legal reads; Re: Necessary and Proper Clause
http://caselaw.lp.findlaw.com/data/constitution/article01/44.html
Simply put, the federal government, through the [abuse] of this clause, and the commerce clause, will grant to itself, all the [extended] authorities the PEOPLE will allow.
So, I will continue my 35 year quest of subscribing to an Amendment of the Constitutions Article I, Section 8, Commerce Clause which will have vast direct and indirect limiting powers of the Federal Government.
With health care insurance came the beginning of the end of equal health care for all, regardless of ones income or ability to pay at the time of services….and community charity.
With federal government intervention into health care insurance and health care…came the END of civilized and [reasonable] health care for all citizens.
Just as before health care insurance, the nations liability from health care like so many other soci-econimic liabilities, comes from the over populated and unemployed “cancer centers” (Metro Cities) of America.
Then comes the whole issue of influence on health care insurance by the labor unions and their strong armed, arbitrary circular inflation of value for good and services in America.
The truth is Holder, Sebaliuos, Obama, Pelosi, Reid, et al, are petty tyrants who need to be removed from the body politic. They have no honor as shown by their blatant violation of their oaths of office to protect and defend the constitution.
If you are saying that there should be NO government regulation of Health Care, I agree.
Scanning the comments reveals people are now more accepting of some kind of government (‘national’) regulation of our health care system.
That is scary.
I’m sure what she really meant was:
“it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.”
without the government being the grafting and all powerful middleman.
According to Hudson, “the same reasoning,” which supported the mandate “could apply to transportation, housing, or nutritional decisions. This broad definition of the economic activity subject to congressional regulation lacks logical limitation.”
The “necessary and proper” clause applies only to those enumerated powers designated to the government by the Constitution.
Almost as ludicrous is citing the Commerce Clause as justification for the healthcare bill’s individual (purchase) mandate.
The controversy over the “healthcare” bill is about far more than health or care. A no holds barred insertion of federal control and authority into every aspect of human existence is the object of the Obama philosophy of governance.
Ideologues of very limited intelligence but hot for all inclusive government (poster children are Holder & Sebelius) abound inside the Obama regime.
(under the tutelage of people like Lisa Jackson, Eric Holder envisions turning the EPA into an arm of his “environmental justice” movement. See what can happen to any bureaucracy when the idiotlogues get the reins in DC ?)
These people will never give up. The November 2 election was just the beginning of a long process of cleansing, which may, or may not, someday come to successful fruition.
…what the law does – it regulates how we pay for health care by ensuring that those who have insurance don’t continue to pay for those who don’t.” And therein lies the justification for regulating this particular form of commerce…The current Congress has asserted it can control one sixth of the American economy to prevent unfair cost-shifting and promote its desired outcomes.
Sounds like a crock to me.
I see the individual (purchase) mandate as requiring all kinds of healthy people to purchase health insurance (that they won’t be using much) to pay for the government’s boondoggle.
And requiring a doctor to dial up some federal bureaucrat so that doctor can get Dr. Zeke’s (Emanuel) handy QALY #, a Quality Adjusted Life Years score, to find out the course of treatment he/she is allowed to administer to any given patient.
And as a travesty for patient treatment, start to finish.
No matter how you slice it, baloney appears to be baloney.
Ya think ?
Cg@94: Scanning the comments reveals people are now more accepting of some kind of government (‘national’) regulation of our health care system.
That is scary.
Blert came up with the concept of ‘peak government’ (if I have the credits correct). It’s a good sound bite capture, one with which I agree. I also see that commenters are raising some of the scholarship that provides a theoretical framework for addressing institutional evolution and decay, of which socialism and other political ideologies are but one component, as predictive models for the kinds of institutional dysfunction that we are dealing with today. Again, much of which I agree with.
However, as we – in the USA (who may presumably still have the cache, the smarts and the courage to lead the rest of world in a ‘better’ direction) – as we work our way back from ‘peak government’, it is worth remembering two things.
The Gramscian push was important but the vision of socialist utopia was not the sole driver of growth in government. A more prosaic and very possibly more enduring driver of government growth was containing private sector markets – call it capitalism for short-hand.
One example (of many): the EPA. Chemical dumping, urban smog. Anyone who has visited China recently will have their memories jogged. Manufacturing did not ‘self-correct’ until government applied pressure.
The insurance industry went through a similar regulatory arc. The hospital administrative industry has begun the process of consolidating into exclusive cartels (refer to link in #76 above), not at all unlike the banker cartel currently controlling derivatives trading, as mentioned by Habu in the Roubini thread. No structural difference.
Last example: failure of SEC and ratings agencies to fulfill their oversight and regulatory mandate. Nothing but cops on the take. Referring back to the social engineering of the CRA legislation is no rebuttal. Out system is based on redundant controls, all of which have or are failing.
To summarize, the failure of market industries to self-regulate and their aggressive corruption of the public regulatory environment (certainly a dual assignment of blame) contributed to growth in government as much as any long-term Gramscian-inspired socialist dream. The old saying: never attribute to intent that which can be explained by [fill in the blank with your own favorite epitaph.]
The second point is derivative from the first and that is self-regulation is a human condition normally distributed throughout the population, one well recognized by the founders of this country who intentionally designed the institutions of power to guard us from our worst nature. Those who argue for market forces as the sole form of regulatory constraint implicitly exclude the importance of The Commons and the contributions therefrom that accrue to a society that presumes to bear the mantel of civilized.
Current government needs to be peeled back and overhauled. But it had a lot of help getting to this condition. What is scary to me is that government is the only thing standing between me and the global corporatist cartel(s). I tend to think that others (Habu, blert et al) are right that power and money are already too consolidated to permit any exit other than military aggression.
Kinu #68:
“Is there a place within 1 mile of your home where you would be afraid to walk?”
Unfortunately I would have to say yes to that poll. There are wild, untamed, free roaming alligators within a mile of where I live.
Perhaps the question should have been “Is there a place within 1 mile of your home where the government will not allow you to carry a gun with which to defend yourself?”
No Mo #89:
Note that a key feature of Hillarycare was that the government would consider doctors as “cost centers” and in order to reduce costs they planned to eliminate as many Cost Centers as possible. This is DC thinking: the problem is not costs but how many people you have to pay to keep happy. Obamacare does this by simply making the doctors disgusted so they will quit.
This judge deserves my admiration; he has courage.
I’ve not personally seen anyone mention what I believe is the more obvious constitutional violation of this _care_:
This _law_ prevents me or you from paying for health care which DC government has determined is not worthy,
EVEN if you want to pay for it with your own money !!!
Let’s say you’ve got a fatal disease. There is a known treatment which DC says you cannot choose. You’d be a _criminal_ ; go to jail!! if you got the treatment and it saved your life or even if you conspired to arrange for the treatment. Let me restate that: if the government deems you need to roll over and die. You have _no_ other option.
YBR @ 98 – “the failure of market industries to self-regulate and their aggressive corruption of the public regulatory environment”
Government effectively limited to enumerated powers may be more resistant to corruption. When they wander off the reservation into realms in which government is inadequate to the task, not only are market distortions more likely, but corruption by outside temptations is more worthwhile.
If congress was not busy waiving our cash around, many of the crooks would pack-up and leave DC for richer pickings.
Most of the troubles that we can identify result from congress blundering into areas where they have no business.
89 no mo uro…
I’m not going to let your assertions go unchallenged…
It is a FACT that we use massive imports of medical talent — because we don’t produce it locally.
It is a FACT that we fund and administer — de facto — medical schools off shore TOTALLY dedicated to producing MDs for the American need. ( Grenada, et. al. )
It is a FACT that the medical guild de facto controls how many seats exist in American medical schools — and that the guild is the AMA.
NONE of these ratios exist in ANY other profession: Dentistry, Law, Accountancy, Insurance — you name it.
There is NO WAY that even talented doctors trained overseas can match-up against the Americans forced into our off shore medical schools — which only exist because the AMA would not permit these institutions to operate with in the fifty states.
The AMA has CAPTURED the government in this regard. This particular guild-government axis has caused wage rates/guild pricing to be above inflation ever since the mid-sixties. Professions that used to pay well now pay extraordinarily well. When I was a child, the local doctor — living two doors away — bought a new Caprice every other year. No doctor today would be so humble. My opthamologist drives a Rolls Royce — my optometrist drives a Bentley. It doesn’t raise an eyebrow.
They can afford such spending because their craft spins off enough excess cash flow to sustain massive real estate and stock portfolios. Both ‘work’ reduced hours because of these ‘passive’ investment/business interests.
The ENTIRE medical wage base is linked to that of the DOCTORS. When he makes more… everyone expects to share: the nurses, the hospital, the vendors, the attorneys, the insurers, the …
One will quickly note that all of the above also have managed to stay ahead of inflation.
Doctors are no longer professionals, they’re PRINCES.
#98 YBR
Your analysis is a good one however, it does not go back far enough to consider two critical “root” causations. If you go back to the late 50′s progressing forward, you will note something that all the intellectual folks miss or ignore.
Its what I refer to as the beginnings of “economic consolidation and centralization era”, perpetuated by the governments SEC through the adoption of new policies. This era saw the “larger” companies across all industries merger, and dispose of OR buy outright, all their smaller market competitors around the country. The smaller privately owned community industries such as flour mills, creameries, bakeries, machine shops, grocer’s, drug stores etc eventually could not compete, destroying the mainstreets of America’s community and regional suppliers of goods and services. It has caused a devestating effect on America’s economy and employment! It also facilitated the federal government to more easily take control of America’s consolidated and centralized commerce and labor.
Next comes the most dastardly of root causation of economic destruction. The LABOR UNIONS! The labor unions, essentially led by America’s mob and crime families, introduced corruption to business and industries. Over decades, their corruption begot corruption from both sides…more as a matter of survival though, on the part of business and industries. During the labor unions 40-years of terror, they created the nations most historic arbitrary and circular inflated value for goods and services….in additional to achieving by strong arm tactics and government support, control of business and industry management.
One could write several books on each of these topics and the devastation it has brought upon America.
The absolute cure is a Constitutional Amendment of Article I, Section 8, Commerce Clause. However, the people refuse to evaluate the effects of such an amendment and how it would evenually correct about 99.999% of all the governments wrongdoings and destruction of America’s Capitalist system and the economy. Failure to effect such an amendment will only find America one morning a socialist nation or a nation in a bloody civil war…again! Both options a lose-lose for Traditional America.
Epigni #101:
Through the lawsuit absurdity, as well as other more direct means, Government has made it impossible for most industries to self-regulate.
A while back on this site I opined that Libertarianism was not a practical philosophy. Someone then said that I was for gun control. I replied that I did not Wal Mart selling guns to 3 year olds or the insane.
Unfortunately the courts have made it impossible for Wal Mart to not sell guns to 3 year olds and the insane. They would get sued for discrimination, racism, lookism, sexism, ageism, mental-healthism, you name it. So Wal Mart does not sell guns at all. Take the VA Tech shooter as an example; he was nuts but it was improper and even illegal for anyone to know.
Given that the government has made it impossible for anyone to self-regulate they have set themselves up as the only thing that can.
RWE – I’m not sure that I take your point. Libertarianism would allow Walmart to establish their policy for firearms sales.
Does the policy violate a law? There are folks who are not able-minded or able-bodied. There is an age of minority. Is it wrong to address these categories in store policy?
Without a misguided law to enforce, the courts would be powerless to enjoin Walmart to sell to minority or legally insane.
I don’t recall any express mention of such categories in the original Constitution. Perhaps misguided amendments have listed protected categories that result in unfortunate applications in courts. Just another case of wandering off the reservation to solve problems that are better solved elsewhere.
Federal government was not intended to solve all the problems of mankind. Attempts to do so often yield such unintended consequences.
We should note that, by natural law, people construct shelters, seek sustenance, and otherwise care for their own survival. Not necessarily true of those who are not able-minded. But observe that these exceptional individuals are not even discussed in the Constitution. We can conclude that it was intended to be solved elsewhere, not in federal law.
T.T. Thomas@103:
I don’t disagree with your comment, but I will assert the following, taking the two points in reverse order.
Labor unions certainly enjoy plush compensation packages and the benefits of a strong political presence. I would only note that the same is true for the medical, legal and financial professions, and I would question the extent of the economic impact of unionization on specific industries. That could set off a small nuclear explosion on this site so I will constrain the assertion by excluding health care as a separate issue to be addressed outside of the problems specific to union organizations. Recent negotiations have stalled over health care costs, a problem not created by the unions, so it seems fair to deal with that separately.
Consider the two unions that dominate the modern news cycle: the automotive industry and government workers. Much blame has been placed on auto unions for Detroit’s failure to compete using cost per labor-hour numbers that are pretty damning. Health care was the primary cost problem. It remains unfixed but it seems unfair to condemn labor unions for successfully representing a work force facing out of control cost escalation. Detroit’s recent failures have been laid at the feet of the unions, but a complete picture would include managerial issues such as failure to modernize and failure to provide leadership in directions away from the internal combustion engine technology, as well as failure to reposition the product lines to respond to changing demand scenarios. None of these managerial failures can be attributed to the labor unions.
I am not nearly as sanguine about the government unions who appear to have negotiated retirement and health care deals not available to the population financing the contracts in exchange for performance profiles that fail to produce tangible or even intangible results of either economic or visionary value.
Regarding the “economic consolidation and centralization era”, I have recently begun to (tentatively) accept the possibility that this was a planned development path, courtesy of the Ivy League elites. As someone who is very ginger around conspiracy theories, I treat this subject with some distance and as many weasel words as I can. But I do not discount the possibility of design intent, one that has, and is being, exported across borders. Course-correcting a trend with historic momentum will be very, very difficult.
I don’t particularly care for the idea of tinkering with the federal documents, certainly not with the current crop of politicians, but I would (probably) support an amendment to the commerce clause if that would disentangle the conglomerates in business and government and reduce, if not eliminate, the ‘too big to fail’ construct.
Footnote: I am fully aware that my position on labor unions is not consistent with the general tenor of this site. I would only ask that you refrain from yelling!