Am I the only one who thinks mandated private insurance would be unconstitutional?

[ThomWV]

The Government can not mandate that I buy something because of my existance - and no, this is not like state mandated auto insurance. I don't have to drive, but I have to breath.

[ixion]

1. no, you're not

Insurance is, by and large, a ripoff, even the mandated stuff.

[Oregone]

2. If we strictly adhered to ONLY the basics of the constitution

Ron Paul would be a happy man, and the rest of us would be up shit creek without a paddle or public education

[John Q. Citizen]

11. That isn't what the OP asked. Or are you suggesting that nothing is unconstitutional ever?

[Statistical]

15. Actually I think he is saying the exact opposite.

If we followed the Constitution strictly as intended by the founding fathers then virtually everything the federal govt does is unconstitutional.

The constitution clearly spells out the role of the federal govt and states everything else is reserved for the states.

So dept of education, banking regulations, health and human services, social security, medicare, all forms of welfare are all unconstitutional strictly speaking.

The govt gets away with it by a few sentences in the commerce clause. The courts have blow the commerce clause so wide open that virtually anything can be linked to it and thus constitutional.

The constitutional framework has really no meaning as a limit of federal power anymore. Only the BofR does that and it is being eroded with time. Another 100 years or so and the courts likely will have ruled that there is no restriction that can be placed on the Feds.

[stray cat]

3. Make it non-mandatory but if they don't have the money up front - no treatment

that would be constitutional. If you don't want access to health care you don't have to participate.

[ThomWV]

4. Single payer removes the question entirely

[Statistical]

7. Well yeah but that wasn't your question.

Should insurance be mandated vs a more simpler single payer system? Hell no.

Can it constitutionally be mandated? Sure.

Unless somewhere you can find an interpretation that requires you to have free insurance.

[Hello_Kitty]

13. There are people who pay for their health care out of their own pockets

Plenty of them.

[RedRocco]

92. so, people like me can just die huh?

[SammyWinstonJack]

109. That's the republicans' plan.

[Statistical]

5. What constitutional protection does it violate.

We mandate lots of things.
We mandate car insurance for one.
We mandate that if you want a sprinkler system would MUST purchase and install a black flow preventer.

The interstate commerce clause as it currently is interpreted basically includes everything so unless the BofR prohibits it the govt can do it.

[Davis_X_Machina]

12. 14th adt and not some violation of the Commerce Clause, I think...

...via due process.

But the putative right violated by state action -- a right to be free of this sort of compulsory purchase -- would have to be found to be "implicit in the concept of ordered liberty.” Palko v. Connecticut, 302 U.S. 319 (1937), and there's no history of such a right, never mind it being privileged to that degree.

You've got the first eight amendments in the Bill of Rights (e.g. the Eighth Amendment), restrictions on the political process (e.g. the rights of voting, association, and free speech); and the rights of “discrete and insular minorities” presently considered 'implict etc, etc.'

I'd bet dollars to donuts it's been tested with auto insurance mandates, and given the Mass. plan I'd bet sight unseen there's a case in the pipe on health insurance mandates.

[ThomWV]

17. The get away with auto insurance because driving is a 'privilege' not a right

I suppose its also why they can license you to drive but can't require a license to be alive.

[MajorChode]

98. The jury is still out on that one

As far as driving goes, it's highly debatable whether it's a right or a privilege. Courts have ruled both ways.

Since the government can't take away a license or refuse to grant one without due process kicking in at some point, I'm inclined to believe it's a right, but as with every right you have it can be taken away.

[ThomWV]

14. 5th Amendment

"nor shall private property be taken for public use, without just compensation."

[Davis_X_Machina]

21. It's not a 'taking'...

..because possession & ownership of the good doesn't transfer to the state. Otherwise, the Fifth would preclude any taxation at all from which the individual receives no tangible benefit.

The 14th is the most likely avenue, and that's a long shot.

[Romulox]

47. The transfers of property to the city of New London with the purpose of transfer to a private entity

was held to be a taking (albeit one for a legitimate "public purpose") in Kelo v. New London (US 2005). There is no reason to believe that the City of New London could avoid passing Constitutional muster by order Ms. Kelo to sell her property directly to the developer.

[Davis_X_Machina]

86. You won't catch me defending Kelo...

...it was the con-law equivalent of a wash sale, and no one was willing to call it for what it was.

Till overturned it's still good law, though... :-(

[Statistical]

26. You are given just compensation.... access to medical services.

The govt could win by simply showing that the cost of the uninsured is borne by the govt and the govt needs to collect sufficient revenue to offset that cost.

As long as the govt provides via Emergency rooms, free clinics, and other subsidized / no cost services you really have no case.
So unless you want a system where uninsured = you are forced out of emergency room at gunpoint and bleed to death in the streets I think such a lawsuit would be very difficult to establish.

None of this implies I support a mandate just that you have no constitutional right to avoid one as long as the govt picks up the tab for uninsured.

[Davis_X_Machina]

32. The legislation required to create...

...a right to health care as positive law, as opposed to the courts discovering one in the Constitution via substantive due process, e.g., is sketched in Cass Sunstein's The Second Bill of Rights: FDR's Unfinished Revolution, And Why We Need It More Than Ever.

[Romulox]

39. You're approaching the problem backwards: the Gov't requires an *affirmative grant* of power

in order to have the jurisdiction over a particular matter.

Of course, as I mention downthread, no matter how twisted the logic and how contrary to the Founder's intent, under current precedent, any human activity can be said to "affect interstate commerce" to provide this jurisdiction.

[Statistical]

44. So are you agreeing or disagreeing.

As intended by the founders I agree it would be unconstitutional. The constitution clearly spells out what the feds can do and the rest is reversed for the states and the people.

However the courts have expanded the power of the interstate commerce clause so much that the Constitution provides no meaningful limit on the scope of the federal govt.

If dept of health & human services, education system, mandating DUI limits, mandating seatbelts, gun control act, social security, medicare, welfare, etc are constitutional (which the courts have ruled they are via the commerce clause) then this mandate is to.

Virtually nothing the feds do the constitution grants them however interpertation of a single sentence has made all that moot.

The ONLY thing that would prevent mandate from being constitutional would be a challenge via the Bill of Right which the courts at least give grudging respect too.

[Romulox]

55. There is no practical limit to the Congress' power under the current interpretation of the ICC

ICC ("Interstate Commerce Clause", and its imaginary friend, the "Negative Commerce Clause".)

So I agree with your conclusion. But I thought I should point out that onus still remains with the Federal Government to find some jurisdictional hook to hang its hat on. That is at least theoretically how our Constitution works, even under the tortured logic of our Commerce Clause jurisprudence.

As I mentioned in another thread: my choice not to engage the services of a prostitute are sufficient to "affect interstate commerce" under current precedent such that the Court should have little trouble holding that the Congress could regulate my sexual relationships under the Interstate Commerce Clause.

[Statistical]

58. I understand now.

I agree with both points (ICC removes virtually any useful limit on federal expansion & they would need a hook).

[closeupready]

45. The Bureau of Reclamations?

What is the BofR?

[Statistical]

53. Sorry Bill of Rights (BofR).

Since the commerce clause has removed the limit that anything not named is prohibited the only remaining protection is the BofR which provies explicit limits.

Constitution = what govt can do, anything not named is prohibited (greatly weakened by interpretation of commerce clause)
Bill of Rights = what the govt can not do, anything name can not be infringed.

[brendan120678]

57. Bill of Rights?? (nt)

[Davis_X_Machina]

6. It would require a narrow reading of the Constitution...

...a reading so narrow that it would also exclude any right you might claim to health care, or even treatment.

Originalism is a two-edged sword.

[ThomWV]

25. Could the Federal Government mandate I eat chocolate icecream monday nights (brand optional)

?

[joeybee12]

29. That serves no beneficial cause to the government...or society....n/t

[Romulox]

59. Of course it does: his refusal eat ice cream "affects interstate commerce"

such that Congress may regulate his intake of chocolate ice cream under current precedent.

[joeybee12]

71. I want a video of you arguing that in court....

that would be interesting.

[Romulox]

80. It's repugnant logic, but it is controlling precedent: Wickard v. Filburn (US 1942)

Which was affirmed in Gonzales v. Raich (US 2005).

[joeybee12]

96. Logic and the law are often polar opposites, and justice does not

equal the law.

[mmonk]

94. Does private for profit insurance?

[GoesTo11]

64. aka just calling balls and strikes

What an idiotic phrase. Anyone who has any experience with any aspect of the legal system knows that real life is more complicated than balls and strikes.

[Armchair QB]

8. No, you're not

People who choose not to have insurance, shouldn't be forced to purchase it.

I also think health insurance should be like auto insurance, where you pay for the coverage you need and can buy a policy from any company in the nation who will sell it.

If we had the ability to buy from a company like Progessive, where we only bought the coverage we needed, at the deductible we chose, and the rates were set on how we live our lives much like how we drive our cars, insurance would be much more affordable

[truedelphi]

79. Also if like Progressive, we weren't msitreated for the age

OF our bodies, )Progressive does not care about the age of the cars Iahve on the policy) etc we would be in good shape.

[surrealAmerican]

9. I think it's a bad idea, but not a constitutional issue.

[ejpoeta]

10. this is why a public option --a TRUE public option--- must be available.

when I went to UB, we had to have insurance. We could have our own insurance, like that of our parents or whatever or else we were put on the student insurance. and the cost was included in our bill. i don't remember what it was, but I remember that. And i was on the school insurance, so that meant that if I was sick or needed to see the doctor I went to the student clinic and got tests where they sent me to get tests. Like when I found out I was pregnant... Now, that sounds about right as far as mandates go. the student plan was not expensive.

[John Q. Citizen]

16. Did the government mandate you attend UB, or was that your own idea?

[ejpoeta]

33. you are not hearing what i am saying. i think everyone should be covered.

i think we should have single payer. and i do not generally support a mandate... especially when it would just require us to buy into the system as it is now. If there were a mandate, thee would have to be a viable option for people to get. This 'public option' is meaningless unless it is a true public option.

[John Q. Citizen]

48. I am completely opposed to a mandate to purchase private insurance. That would be

fascist health care.

Governments can tax people for services. But can they force people to buy products from private vendors simply because the person exists?

[ejpoeta]

65. i totally agree regarding mandating private insurance. i personally don't think there should be any

mandates until there is a viable public option and a lot of things are changed regarding rules and such. then we can see where we are. i am confident that given the opportunity, most poeple WOULD be insured. i am confident that with a true public option and other things like changing the rules regarding the private industry and their tactics, that most people will get coverage on their own. but i definitely do not support forcing people to buy into the system as it is today!!

[fascisthunter]

18. it is in fact fascist

the antithesis of both democracy and freedom.

[SammyWinstonJack]

111. I think the Obama Admin. and Congress are gonna regret this.

It's gonna piss off a whole lot of people. Especially those who have employer provided health care insurance and it's suddenly canceled. :yoiks:


I see Angry People. Lots and lots of them. :evilgrin:

[MADem]

19. In MA it is "mandated," but you don't "have" to have it.

You pay a fine if you don't have it, though...but it's not a fine--it's an additional tax for not complying with the law.

[greguganus]

113. Fine...tax...it still costs the same out of pocket. n/t

[MADem]

116. Of course. That's how they get around any issues WRT the law, though. NT

[Birthmark]

20. I definitely agree

Been meaning to start a thread about this, but I figured it was pointless. I'm glad you saw the point because upon reflection, I agree that the Constitutionality of this requirement is dubious at best.

[Hello_Kitty]

22. I consider it taxation without representation

I have no say over who runs private insurance companies. If I'm not a major shareholder I don't get to "vote the bum out" if I don't like the way the CEO is running Blue Cross.

[JenniferJuniper]

23. I'm sure good arguments can be made that it is but

whether it is or it isn't, it's the complete opposite of where we should be going.

Just at look at the Massachusetts disaster.

Universal Health CARE, not Universal Health INSURANCE!

[winyanstaz]

24. k & R

I agree 100 percent

[Xithras]

27. Heard a couple of locals discussing this on the radio yesterday.

It probably would end up being unconstitutional, simply because there's no legal precedent for the government to mandate that private citizens purchase from private companies. It would effectively amount to a tax paid directly to the corporations, and there's no legal framework in the U.S. to permit that sort of thing.

It would be perfectly legal for the GOVERNMENT to take the money via taxation and hand it over to the corps, but a law requiring us to directly contribute to the profits of a private party has never been attempted before. It's unlikely to survive a Supreme Court review.

[Hello_Kitty]

30. Interesting. eom

[Statistical]

31. Simple solution; tax everyone, rebate those who have insurance.

If you are right the govt could make it constitutional by just reversing it.

EVERYONE'S tax goes up $1000, no exceptions. There is a $1000 tax rebate if you have insurance.

Done and done.

Note I think mandates are likely a bad idea however they could be made constitutional.
I think mandate + public option (with sliding scale based on income) is a good idea.

[inna]

119. omg, i so want this to be true, but i'm afraid we're screwed.

your argument makes a whole bunch of sense though, it's just that i don't think it'll go anywhere because.... as we all know, we have the best congress money can buy, and it is not the american people whose interests they serve.

[underseasurveyor]

28. No you're not

Why should I be forced to buy into a system that I see as corrupt, greedy and harmful and that I have absolutely no faith in as it is now. Screw the big corporate drug pushers.

[Zywiec]

34. The Constitution is so passé, didn't you know? n/t

[underseasurveyor]

73. It really is SOOOO last century

isn't it :evilgrin:

[Hoopla Phil]

35. Agreed. K & R

[progressoid]

36. Depends on how it's written and implemented.

Regardless of it's constitutionality, I think it's going to encounter some rsistance.

[BR_Parkway]

37. Either way, I'm not buying it - won't be able to, there won't be a way to

tax penalize me into it either - we, the very small self employed are getting nothing but screwed (again) by the Blue Dogs and their corporate masters.

[Romulox]

38. The Commerce Clause is broad enough to regulate ANY human behavior

It is an abuse of the Constitution, but there is no practical limit on the power of our Congress to regulate any human activity under the rubric that it "affects interstate commerce".

[Davis_X_Machina]

40. Not true, actually.

There are limits to the Feds' ability to regulate guns using the Commerce Clause.

And it is limited when it is invoked to protect women.

Otherwise not.

[Statistical]

51. However in US v Lopez the courts gave guidance on what is acceptable

# the channels of interstate commerce,
# the instrumentalities of interstate commerce, or persons or things in interstate commerce<12>, and
# activities that substantially affect or substantially relate to interstate commerce

"activities that substantially affect or substantially relate to interstate commerce" will enable a mandate of healthcare.

Currently in the US law requires an emergency room to admit someone without insurance and without method to pay. Unless that changes then the govt is regulating an activity that substantially affects interstate commerce.

Contrary to school gun ban in which the govt couldn't prove that guns in schools have a material affect on commerce (some affect no doubt but not material) emergency room costs paid for by interstate insurance agencies are massive in size and scope.

The govt will be able to provide substantial stats to show the "substantial affect" this burden creates, hence a mandate that reduces this affect is constitutional.

[Davis_X_Machina]

54. See my #52. n/t

[Statistical]

61. I am not seeing the relevence of #52.

Why would the govt conceede the point?

Instead they would simply say you not having health insurance and using ER affects interstate commerce in a material way.
Anything that affects interstate commerce in a material way can be regulated.

So pay that mandate now. In all actuality you won't even have a choice payment will likely be via IRS. Witholding from your paycheck which can be removed if you prove you have insurance (insurance provider notifies your employer to change witholding rate). Extra tax added to tax return as the penalty.

[Davis_X_Machina]

68. What I was getting at...

...was the continuing existence* of a (sub-optimal) option outside the mandate (walking, in the case of auto insurance, pot-luck in the ER, in the case of health insurance) keeps the respective mandates from being so coercive, so violative of 14th adt. rights that the courts would be interested.

People expecting the actually-existing state of US con law to rescue them from a mandate are bound to be disappointed.

*I've seen nothing suggesting the existing Federal must-treat laws would be affected by any of the proposals out there.

My personal master plan is NHS-USA, so I don't have a dog in the fight.

Mandate-based plans seem to work, and even work well, in some places. That they don't work here, or wouldn't work here, is an indictment of their implementation, not the basic idea. After all the fact that my dog can't sing Mozart very well doesn't mean Mozart is a bad composer, it means my dog can't sing.

So pay that mandate now. In all actuality you won't even have a choice payment will likely be via IRS. Witholding from your paycheck which can be removed if you prove you have insurance (insurance provider notifies your employer to change witholding rate). Extra tax added to tax return as the penalty.

This was a feature of Howard Dean's 2003 health care proposal, with the further fillip that if you were walking around naked, so to speak, at 1040 time, the IRS would assign you to an appropriate plan, be it Medicaid, Medicare (they know your AGI and your age right off the bat) or one of his two other alternatives.

[Romulox]

60. Tell me the rule laid out in Lopez, and how it applies to other activity...

Lopez is limited to its facts, as they say in the biz. :hi:

[Statistical]

63. If anything Lopes supports or reinforces a mandate

In a 5-4 decision, the Supreme Court affirmed the decision of the Court of Appeals. It held that while Congress had broad lawmaking authority under the Commerce Clause, the power was not unlimited, and did not extend so far from "commerce" as to authorize the regulation of the carrying of handguns, especially when there was no evidence that carrying them affected the economy on a massive scale.<11>

Chief Justice Rehnquist, delivering the opinion of the Court, identified the three broad categories of activity that Congress could regulate under the Commerce Clause:

* the channels of interstate commerce,
* the instrumentalities of interstate commerce, or persons or things in interstate commerce<12>, and
* activities that substantially affect or substantially relate to interstate commerce<13>


Carrying handguns either legally or illegally doesn't cause a substantial change in interstate commerce. Health Insurance mandate would.

Based on the categories provided (especially 3rd one) it is clear a mandate would meet the test in Lopez.

Lopez strengthens the case for mandates.

[Romulox]

76. LOL! The point is that the decision had more to do with a gun fetish than a logic fetish

"Carrying handguns either legally or illegally doesn't cause a substantial change in interstate commerce. Health Insurance mandate would."

Do you believe this, or are you just mouthing the stated justification?

Hand guns obviously travel through the channels of interstate commerce, and they obviously "substantially affect interstate commerce"--from the revenues generated through their sales (both legal and illegal), the metal detectors the school in question no doubt had installed to prevent said gun's entry into the school, the police funds expended to combat their use, and the medical care needed to treat their aftermath. A decent argument could be made that handguns are "instrumentalities" of the interstate drug trade, as well. :)

I noticed you modified this relatively meaningless phrase "substantially affect...interstate commerce" to "cause a substantial change in interstate commerce". No worries--both standards mean whatever you want them to mean. :silly:

[Statistical]

87. Gun affect interstate commerce, "guns in schools" don't

The court didn't say all gun regulation is prohibited. No there are hundreds of gun regulations and bans that haven't been struck down.

The court said guns in schools don't substantially affect interstate commerce.

With health insurance mandate their clearly DO have a substantial affect on interstate commerce and thus Lopez decision while striking down federal guns in schools laws would actually support this mandate.

[Romulox]

117. That's a silly argument.

Guns in school affect interstate commerce, too. Moreover, the right to regulate guns in school is clearly a subset of the broader right to regulate guns, full stop.

"The court said guns in schools don't substantially affect interstate commerce."

Justice Scalia could hold that the moon is made of green cheese. That doesn't make it so.

[SnoopDog]

41. Unfortunately, I do believe there IS a constitutional provision to mandate this...

The good news is that this would prove that Health Security is provided for in the Constitution...



Article 1.
Section. 8.

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

[SnoopDog]

97. This is actually a good idea... Health care is Constitutional...

Since no on has responded to my post - let me further explain my point...

Section 8 most directly permits Congress to 'lay and collect taxes, imposts, and excises' to 'provide for ... general Welfare of the United States'.

My first thought when it was proposed that everyone would be Forced to buy Health Insurance - I was livid - 'they' don't have that right. But
after looking at Section 8 - it clearly states that it can Mandate this impost for the General Welfare of the US and provided it is 'uniform' throughout the United States.

I would argue that this IS the means to implement a Single Payer Health Security Administration. We implement a law stating that Everyone is subject to
the Health Security Impost.

Case Closed. The Obama Administration's 'Health Security Act of 2009' is placed along side FDR's equally awesome Social Security Act.
And a humane fair non-profit comprehensive American health care system is enacted.

[timeforpeace]

42. Of course. But what does that matter these days?

[KamaAina]

43. Also note that the states, not the Federal government, mandate auto insurance

also it has been well established that driving is a privilege, not a right (i.e. you can lose your license for DUI or, in some states, even for non-driving-realted offenses such as truancy).

[Davis_X_Machina]

52. I'm guessing that...

...the courts will simply find that just as mandated liability insurance keeps you from driving, but not from walking, participating in any health care scheme beyond charity care in in the local ER is a privilege, not a right. In other words, you want to take ER pot-luck, go for it.

[Romulox]

56. Is aerobic resporation a privilege or a right?

Because this appears to be a mandate related to simply being alive, not exercising a "privilege".

[Davis_X_Machina]

72. Insofar as you can be merely kept alive...

...by the existing must-treat legislation that governs medical care provision -- in other words, charity-case ER bingo, that's a right, protected under status quo, and all proposed plans I've seen.

Participation in a scheme of health provision beyond that? Pay your mandate -- with appropriate subsidy, or prove that because of age, indigency, or student status, the mandate doesn't apply. Same choice you'd have as a citizen of the Netherlands, Germany, or Switzerland. among others.

[Romulox]

84. You're not answering the question.

What analogy is there between a healthy person being forced to pay profits to a private insurance company simply for the "privilege" of being alive and being forced to buy auto insurance for the "privilege" of driving?

The answer, of course, is that the analogy is weak and misleading, since you can opt out of the latter,and not the former.

"Same choice you'd have as a citizen of the Netherlands, Germany, or Switzerland. among others."

Don't all of these countries have a guaranteed minimum income (i.e. a "dole")? The choice is quite different under such circumstances, and not the same as it exists here at all.

[Davis_X_Machina]

85. Your privilege of being alive...

...is protected by federal and state must-treat laws that cover every ER in the country.

What you want to do is participate in a comprehensive health care delivery system beyond that legally protected minimum and not be compelled to pay a private firm, or for all I know, pay anyone, even the state, for your care.

And that's different.

As far as removing the profit from the system, guess what? I agree with you. If I could magick up 60 votes in the Senate, I'd have a UK-style national health service. As a card-carrying socialist, I have a weakness for state solutions, I guess.

But I don't expect to see one here, and I don't expect actually-existing constitutional law will provide much of a remedy to anyone fighting the imposition of an insurance mandate provided there's a reasonable system of subsidy.

[yodoobo]

46. If its done as a tax it'll pass

If its passed as an extra tax on people who don't buy insurance, then it will be as constitutional as any other tax measure.

Ultimately, "mandated insurance" will technically be voluntary. Exactly as filing a 1040 on April 15th is still deemed a voluntary act by law.

[BlooInBloo]

49. Nah - there's lots of idiots in America.

[gorfle]

50. Mandated private insurance is simply mandated profit.

I think it is outrageous that we are considering a system where you would be mandated to buy private insurance.

[TheWraith]

62. I agree with you.

And for the record, I don't think state mandated auto insurance is a terribly good idea either.

[question everything]

66. Fits nicely with: where, in the Constitution does it say that we have a right

for a health care?

This is what the conservatives have been saying for the almost 20 years that I have followed this debate.

As liberals, as Democrats, we accept the fact that we are all in this together. That we are part of a community.

If we subscribe to the notion that we have health insurance, then, yes, everyone should. The way insurance works - of health or of cars - is that you have a large pool so that most pay for the ones who need it. As simple as that.

I once was negotiating with carriers for a company where most of the employees were young, single males, around 25 and I was "commended" for this fact that allowed us to keep rates low.

So, yes, young health people should be part of the pool to keep costs down. This is what the insurance companies rightly complain: that too many wait until they are old and sick to purchase a policy.

[Romulox]

69. It is unprecedented that the government force us to buy a product from a private entity, though...

Moreover, your "pool of risk" concept ignores the role of profit in private, for-profit insurance. This mandate will be for all American citizens to provide profits to private businesses. This is something very new in American history, and nothing like car insurance--many people chose not to drive, after all.

[Davis_X_Machina]

77. Regulate the insurance companies...

...as public utilities, then, and require them to be non-profit, or mutually held.

This is what happens in, among others, the Netherlands and Switzerland, and in Germany, too (mostly).

[Romulox]

81. That would essentially be a true Public Option.

I would support that. Not many of our Congress persons would, however.

[Davis_X_Machina]

83. Well, you've identified the problem...

...and I will contribute to your House or Senate campaign to the maximum extent made possible by my mortgage. :-)

[Davis_X_Machina]

82. Here's the crux that a lot of people don't want to grapple with.

Every universal plan requires coercion, or it isn't universal.

You can apply the coercion in several ways.

You can compel the payment of a hypothecated tax to the state, and have the state provide your health care, or use general revenues. But if you don't pay your taxes, you are coerced into doing so. This is the UK model.

You can compel the payment of a hypothecated tax to the state, and have the state pay other entities -- doctors, hospitals, etc. to provide the services, or use general revenues. But if you don't pay your taxes, you are coerced into doing so. This is the Canadian model.

You can compel the purchase of insurance from a (usually highly regulated) non-state actor, and have that non-state actor reimburse you for the provision of your health care, or reimburse the provider directly. But if you don't purchase the insurance, you are coerced into doing so. This is the model in the Netherlands, Switzerland, or with a few twists, Germany.

(This third kind of system in practice has various ways of protecting the aged, the indigent, sometimes students, the unemployed, etc. either by having a special category of patient to which they belong, or subsidies, or both.)

Or you can take ER pot-luck as a charity case. None of those countries will let you die in the street, but what they'll do beyond basic casualty care is a decision each nation has made for itself. What they demand that you do is a decision each nation has made for itself. They all have pluses and minuses.

Our status quo is presently free of coercion. It's also expensive, inefficient, and unjust. Nothing comes without a price.

[jberryhill]

67. Disagree

The question is whether you have a right to health care.

Can health care providers be relieved from any obligation to treat you if you can't pay for it? Yes.

Since no one is compelled to treat you, then you can be required to have insurance as a condition of treatment.

[wroberts189]

70. If it is they will just ignore it. After all its just a "piece of paper" . nt

[GodlyDemocrat]

74. Unfunded mandates (on either citizens or industry ...) is not good, but I doubt its unconstitutional

Let me qualify that I believe that, neglecting the future prospects of health care reform, merely forcing community ratings on insurance companies and enacting mandates with a minimum of relief for the poor is better than what we currently have in that the "John Q" type cases of people just dying without health care funding will probably drop off dramatically. However, the conservatives have a point when they say "RomneyCare" is a failure in that the insurance companies have an incentive to artifically create health care shortages because it is now no longer profitable to guarantee quick access to health care because of both the required purchase mandate and community rating mandate.

[TransitJohn]

75. No, you're not.

And all that a personal mandate would do is bring out into the open what insurance is: extortion and racketeering.

[PatSeg]

78. You state it so simply and very well

Mandated private insurance implies that "rights" belong to the insurance industry, not the individual. This would not be progress, except for insurance companies. We need to phase insurance out of health care, not give it opportunities to grow. "Insurance" is protection against an unexpected disaster (i.e. auto accident, house fire), whereas health care is an ongoing process.

[Thickasabrick]

88. And if you drop in the middle of the street someone HAS to pick you

up in an ambulance and take you to a hospital - unless of course you could wear a sign that says please do not try and save my life, I didn't want to buy insurance - I prefer to die.

[kimjamey69]

89. What would be best

People that can afford to pay or we all get taken care of equally?? Just asking new and young want opinions.

[New Dawn]

90. Forcing people to buy a product from a private company is fascist economics.

[fascisthunter]

91. it amazes me how little people say it...

[earth mom]

99. Yep. nt

[kimjamey69]

93. KNR (nt)

[tritsofme]

95. Wouldn't you have to apply that same standard to single payer as well?

Is participation not mandated under a single payer system?

Could I choose to get out of it and not pay taxes toward it?

The government mandates lots of things, I doubt this would face serious constitutional questions.

[MajorChode]

100. The government already forces you to buy things every day

Roads, bridges, police and fire protection, education, social security, and even...

Wait for it...

Heath care insurance.

You may know it better as Medicare.

[WinkyDink]

103. The government-funded (tax-funded) items you mention are not FOR-PROFIT PRIVATE COMPANIES.

Now do YOU get it?

[MajorChode]

122. No, because many of the items I mentioned ARE for "FOR-PROFIT PRIVATE COMPANIES"

Every dollar medicare pays in claims goes to someone working for profit. A huge chunk of the government's business is done with for-profit contractors. The government is little more than a fiduciary, and such will almost certainly be the case with health care reform. The only question right now is will there or won't there be a public option, but even without one I can't imagine the government not acting as an intermediary if not the full blown purchasing agent.

[Lydia Leftcoast]

101. No, especially if the mandated private insurance is as bad as

most individual private insurance is these days.

If my insurance company gets obnoxious enough (e.g. raising my premiums enough so that I can afford only a $10,000 deductible, which would have me bankrupt WITH insurance), I want the option of dumping them.

If we were mandated to join a PUBLIC insurance system with no deductibles (modest co-pays would be fine) or exclusions, that would be fine.

But mandated private insurance is just plain corporate welfare.

[WinkyDink]

102. I find the idea of mandating payment for health-insurance (not "care", as some think) to be anti-

Democratic. We are shovelling money at already immensely-profitable institutions.

[Romulox]

107. Think of it as a Guaranteed Minimum Income ("dole") for insurance companies! nt

[followthemoney]

104. Mandated Private Insurance is...

just the establishment of a new economic royalty entitled to extort profits from the desperate in order to maintain their unearned lavish lifestyle enforced by the state through its monopoly on violence.

If that is not unconstitutional the free people of the U.S.A. need a constitutional convention.

[lumberjack_jeff]

105. Think of the premiums as taxes, if you wish.

You don't seem to have as much problem with the mandated premiums collected from you for your disability insurance.

http://en.wikipedia.org/wiki/Social_Security_Disability_Insurance

I expect that you'll have the option of purchasing public insurance.

[Romulox]

106. Premiums and taxes are not the same thing (hence the two different words)`

"Premiums" include the profits of private entities (many of whom are top campaign donors. odd...)

[Statistical]

110. Taxes include profits for govt contractors.

Is the govt mandate that you purchase a portion of the F-22 unconstitutional.

Your taxes led to profits on purchases by the govt to hundreds of govt contractors. Private companies who's profits only benefited shareholders.

[Romulox]

112. Right. But the power to tax and spend is specifically granted in the Constitution

There is no such grant of power to order persons to purchase products to be found in the Constitution. Which suggests the behaviors, while similar, are categorically different.

"Your taxes led to profits on purchases by the govt to hundreds of govt contractors."

Indeed. They demand that we buy billions of dollars worth of equipment that our military doesn't want, and they mostly win. It's also worth noting that the Federal Government has the right to put its wallet back in its pocket and not buy any particular product--a right they intend to remove from we private consumers.

[Statistical]

114. And we come full circle to the commerce clause.

As currently interpreted (which I disagree with BTW) the CC allows almost everything to be regulated by the federal govt as long as it has a substantial effect on interstate commerce.

The uninsured beyond a doubt have a substantial effect on the commerce of healthcare. Do you disagree? The emergency room visits are paid by a combination of tax dollars and write off by insurance and hospital companies.

1) CC allows regulation of activities having a substantial effect on interstate commerce.
2) Uninsured have substantial effect on interstate commerce
3) CC allow govt to regulate the uninsured.
4) The regulation proposed is a mandate to be insured (thus reducing the pool of uninsured and the effect of #2).

I don't like unfunded mandates and I don't like the all encompassing nature of the CC but that is the reality we live in unless we get a couple more precedents putting real limitations on the CC.

[Romulox]

121. We agree on how the issue would play out under the ICC...

Whether or not taxes and premiums are conceptually distinct or not is a separate question from what basis under the Constitution the government will rely upon to assert jurisdiction to force us to purchase insurance. We simply cannot argue about something that we agree upon any further (though I found your response re: Lopez to be a bit hard to swallow.)

I simply mention the Constitution to point out that the Founders clearly understand "taxes" to be a separate and distinct concept from "premiums". They authorized the former explictly; the latter will be shoe-horned into the government's toolbox of powers via pretzel logic. But they are clearly conceptually different, for the reasons I outline above.

[timtom]

108. No!

I think the same way.

In the Marine Corps we had a term: "half-stepping". That means not taking a full quick-march stride.

It means just pretending to solve a problem.

It means lack of engagement (just to wax a wee bit existential).

[Usrename]

115. it is exactly like state mandated auto insurance

another boon for the insurance companies and the wealthy at the expense of the poor

[inna]

118. K&R! could not agree with you more!

:kick:

[harun]

120. Nope, I agree with you. Mandatory insurance is a gift to the for-profits.

And I do think it will go down in flames once challenged in court. Maybe that is what they are hoping for. Hold off the for-profit lobby with the promise of mandatory insurance purchase, then let it get killed in court and the dem's can say "sorry insurance leeches, not constitutional".

[anigbrowl]

123. No, you're not. I can easily see a constitutional challenge

mandatory insurance is a kind of poll tax, and this is the biggest objection I have to that particular plan in Congress at present - I think it's almost guaranteed to come under legal attack. So would single-payer, most likely, but it would be a very different kind of lawsuit politically - while the insurance companies would cry foul there's no particular right to enjoy a profitable market.