Political Discussion about Healthcare Reform Law

[whitey]

The main purpose of car insurance is to protect the property of others if you have an accident.  If you choose to drive a vehicle, the state requires you to carry XX,XXX amount of coverage to cover the property loss you may cause.  If the state did not have that law, loan companies would require insurance on any cars they financed.

Again, its apples and oranges

[JagFan07]

The goal in this is control. The next step is to include the Public Option to supposedly compete with the current Insurers. The current Insurers run at a 2% profit margin (not much wiggle room). The Public ("Government") Option will not have to run at a profit. In fact, they will be able to run at incredible deficits. Private insurers will no longer be able to afford to be in business and will fold, leaving the Public Option as the only option. Then years from now we will be hearing how the Public Option is insolvent (see SS, Medicare and Medicaid). This will result in a decrease in benefit and an increase in either expense or taxes (probably both).

[whitey]

pathetic stephendare.  I expected more from you after this whole mind numbing process.  You went all this way for that?  I'll tell you what, I'm gonna go to bed, go to work tomorrow and then check in here at some point.  That gives you at least 12 hours to come up with something substantive

[JeffreyS]

Mandate is just a buzz word it is a tax. The government can tax you. Now they have given us a way to opt out of the tax but it is a choice. I know both sides have called it a mandate but the legislation calls it a tax.

[St. Auggie]

And of course the requirement doesnt affect people who already have insurance, or who are too poor to afford it, so its not really going to affect anyone except the 40 million who are uninsured at the present.

Stephen, I have heard you make many intelligent comments, but come on.  Not going to affect anyone else? You have got to be kidding me.  This is some of the most significant reform in the past 4 decades.  And it was done in dispicable manner to boot.  This affects EVERYONE more than is being appreciated.  I have said numerous times that I believe in healthcare for all, but this was not the way to do it.  Just because it was wrong before does not mean we go to the extreme of bullrushing this through and making wrong in a unsustainable manner.  I am glad your friend will get some help, but this is a mess, and it does affect everyone.

[Tripoli1711]

The car insurance comparison is totally without merit.  You are required to have car insurance to protect the rights of others.  You are prohibited from murder and burglary to protect the rights of others.  The imposition of legal authority upon one individual to protect the rights of other individuals is what our codified law was initially founded upon.  They force me to purchase auto insurance if I choose to avail myself of the privilege of driving.  That way, if I cause an accident with the inherently dangerous instrumentality of an automobile and injure someone, I will have the means to compensate them. 

That is not even in the same universe as the government forcing me to purchase health insurance under threat of having my personal property seized by the federal government.  I get to choose whether I want to drive a car.  I understand that if I do, I must purchase auto insurance to protect the victims of my potential negligence.  I don't get to choose whether I want to purchase health insurance and I put nobody but myself in danger if I am negligent with my own health.

[Shwaz]

The car insurance comparison is totally without merit.  You are required to have car insurance to protect the rights of others.  You are prohibited from murder and burglary to protect the rights of others.  The imposition of legal authority upon one individual to protect the rights of other individuals is what our codified law was initially founded upon.  They force me to purchase auto insurance if I choose to avail myself of the privilege of driving.  That way, if I cause an accident with the inherently dangerous instrumentality of an automobile and injure someone, I will have the means to compensate them. 

That is not even in the same universe as the government forcing me to purchase health insurance under threat of having my personal property seized by the federal government.  I get to choose whether I want to drive a car.  I understand that if I do, I must purchase auto insurance to protect the victims of my potential negligence.  I don't get to choose whether I want to purchase health insurance and I put nobody but myself in danger if I am negligent with my own health.

Exactly!

[Tripoli1711]

I cannot feature how you consider the two situations to be "identical".  Yes I drive.  I also cannot possibly be more clear or more logical in pointing out the obvious difference between the two mandates.  I did forget one point, however.  The State of Florida makes me buy car insurance.  The federal government is going to make us buy health insurance.  The when the founders developed the new idea of federalism, it was always their intent to allow the state and local governments more capacity for power.  They were the governments closest and more responsive tot he people.  So, in addition to my previous two paragraphs, there is another irrefutable difference between the two.

To cling so stubbornly to that position on the side conversation does substantial harm to the credibility of your position in the "debate" at large. 

[redglittercoffin]

Another reason the car insurance point is a total malarkey is because it only takes one half of the equation.  If StephenDare, et. al want to use that point, then the must also accept the rules by which auto insurers operate.

My auto insurance policy that I purchase today will NOT cover the the paint job for the sideswipe that occurred two weeks ago (pre-existing condition).  The auto insurer WILL increase my rates as I engage in risky behavior like being caught driving over the speed limit.  

Furthermore, my auto insurer, nor my the government, will subsidize my auto insurance rates by forcing those who have policies on their Mercedes and BMWs to pay higher premiums for the express purpose of making mine more affordable.  

Lastly, auto insurance is NOT a requirement in all states -- and the federal government doesn't mandate as such.

[Tripoli1711]

What does this mean?  "provided that, as Wyden puts it, "they can meet the coverage requirements of the bill."?

Posting an article with a couple of quotes doesn't give any opportunity to evaluate what the terms are. 

If a state is made to come up with a plan of it's own, how many does it have to cover?  What does it mean to meet the coverage requirements of the bill?  It seems quite clear that there are rules attached.  It isn't simply: Well, the state can opt out of individual mandate so long as they make some sort of plan.  It seems obvious they are going to have to make the right kind of plan.  Without knowing the rules, it's impossible to propose anything.

[Shwaz]

Schwaz.  Despite the fact that this whole side conversation is wholly without merit, the two situations are identical.   Insurance that you are required by law to purchase.

In any case, the argument over the individual mandate is moot.  

Show all of us the power of your convictions and provide Florida with a Plan of its own.

Im sure I eagerly await your proposal.  I hope it simply gets rid of all the insurance companies and makes it illegal for them to ply their evil trade here.

At the end of the day, just remember to thank the Republicans for demanding that this idea be included in the bill.

It was actually part of John McCain's campaign against Hillary Clinton's effort to pass health care in the 90s, and the Republicans have been pushing it for a while.  The Dems have been advocating single payer, but your fellow travellers in the republican party were very concerned about the poor criminals in the insurance industry.

But you were just dancing in the streets when god spoke through legislation mandating everyone to start funneling money to these evil evil companies.

Trip couldn't have explained this any better.

Do you drive is not remotely the same as do you live.

[Tripoli1711]

Great points redglittercoffin.

The preexisting condition mandate is perhaps the most absurd thing in entire bill.  Why would anyone purchase health insurance until they get sick.  All that is going to do is cause premiums to skyrocket.  Or, in other words, do exactly what happened in New York:

Massachusetts may have a universal health insurance mandate, but it is New York state that has experimented for the longest time with key components of the new federal health care package, most especially with a mandate that insurers must offer coverage to all comers, and also that insurers have limits on how much they can vary the price of a policy for different demographic groups. Whether the feds can figure out how to avoid all of the pitfalls that have plagued this system in New York remains to be seen.

New York enacted a health reform package with these two mandates - known as guaranteed issue and community rating - in 1993, making it unique among the states (only five others have both mandates but none has requirements as strict as New York's). Back when the state instituted the reforms about 752,000 residents were buying health insurance directly from insurance companies in the individual market. But premiums immediately started to soar, and as residents realized they could purchase insurance at any time, even after they got sick, New York's individual health insurance market disappeared, shrinking by 95 percent all the way down to a mere 34,000 individuals. Meanwhile, the ranks of the uninsured spiked to 20 percent by 1997.

New York's response to its vast increase in uninsured residents was to offer more state-subsidized insurance. When the price tag on these plans began to weigh down the state budget, New York slapped new taxes on residents and businesses to pay for them, including a new $275 million assessment against insurance companies on top of some $3 billion in assessments they already pay in the state. All of this so that the state's uninsured rolls would soar as costs spiraled upward and then declined again as government stepped in with subsidized coverage.

Moreover, the profile of the uninsured changed. Today, according to a recent Manhattan Institute study, about one-third of all the uninsured in New York earn $50,000 a year or more. Many would be able to afford insurance in most other states, but not in a place where a monthly premium for a single person ranges between $500 and $700, while a family policy costs between $1,400 and $2,600 a month.

The new federal legislation, of course, aims to fix the problems that New York has experienced by requiring that everyone carry insurance, which is a controversial mandate now but will be so much more so if costs spike as they did in the Empire State, or if taxes must rise further to subsidize premiums and keep them affordable. Those without insurance will face a federal fine that has been set at either $695 annually or 2.5 percent of your taxable income, whichever is greater. But that might be a small price for many people to pay for the privilege of not carrying pricey insurance.

To understand how this will work, look to another state, Massachusetts, the first to begin fining people for not having health care coverage. Massachusetts defines acceptable insurance as a policy with a deductible no greater than $2,000 a year. But policies at that level can be very expensive, so taking the fine is worth it, as Massachusetts resident Wendy Williams found. In a Wall Street Journal piece last October, she described how she and her husband were threatened with a $1,000 fine because they had given up their gold-plated and expensive health plan and were paying about $3,600 a year for catastrophic care policy that protected them from big hospital bills but didn't qualify as acceptable coverage in the state. For Williams the choice was easy. To increase her coverage to acceptable limits would have cost her about $6,000 a year more in premiums, because costs jump sharply as the deductible on a policy declines even moderately in a highly regulated place like Massachusetts. So she paid the fine instead and stuck with her "unacceptable" coverage.

Given that there is so little in the federal bill designed as incentives to restrain costs, there's no reason to believe that the nation will escape the fate of New York or Massachusetts once guaranteed issue becomes commonplace, leaving the choice to policymakers of higher taxes, higher premiums, or higher fines for those who go uninsured. Likely, you wind up with all three.

Just how much has government design produced the circumstances we now see in New York and Massachusetts? In a study of New York, the Manhattan Institute estimated that the Empire State's mandates increased the cost of health premiums by a whopping 42 percent to the highest in the nation (this was before RomneyCare spiked Massachusetts' premiums even higher). The study estimated that up to 37 percent of those who were uninsured in the state could afford coverage if the state junked its expensive mandates, especially the guaranteed issue and community rating mandates. Many of the rest of the uninsured were low-income residents already eligible for Medicaid who never signed up for it. The remaining small group of uninsured were largely those with pre-existing conditions who would have to be covered by a risk pool.

The irony of the current situation is that Congress has embedded in the new federal health care bill just such a risk pool, but only as a temporary measure to insure the uninsurable until the new federal bill goes into effect and nationwide guaranteed issue and community rating change the entire market. In other words, the designers of the federal legislation understand the problem, which is that there are a small number of uninsurable Americans who need a special solution, while what the rest need are lower premiums. But like New York, the architects of federal reform have chosen to change virtually the entire system in a way that doesn't address costs.

In New York, politicians never acknowledged the errors they made. They just seemed to hope that residents wouldn't understand that it was bad policy that destroyed the individual insurance market. Those same politicians used the problem they created to extend government control over health insurance until the costs helped bust the state's budget. Now you can hear radio ads in New York run by hospitals and other advocacy groups pleading with government not to cut health subsidies any more.

There are few things these days about government in New York that would qualify as ‘best practices' to be emulated by others. In truth, state policy makers have become a laughingstock, even among the state's own residents.

But not, apparently, in Washington.

http://www.realclearmarkets.com/articles/2010/03/24/health_care_reform_welcome_to_ny_america_98390.html

[Shwaz]

lol.  Do you drive Schwaz?

[JagFan07]

It's called the "Empowering States to be Innovative" amendment. And it would, quite literally, give states the right to set up their own health care system -- with or without an individual mandate or, for that matter, with or without a public option -- provided that, as Wyden puts it, "they can meet the coverage requirements of the bill."

Stephen,

I have had some time to peruse the Bill and can't seem to find this language in it. At least not in the actual bill that was passed. Now maybe I am missing something, but if you could show me where this phrase is worded in the bill I would like to read it.

To help you http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.+4872:

[JagFan07]

If Huffington Post is a reliable resource, then Reason should be also.

Don't Buy It
The crazy constitutional logic of the individual insurance mandate

Jacob Sullum | March 24, 2010

A few weeks before Congress passed a law that orders every American to buy health insurance, the Virginia legislature passed a law that says "no resident of this Commonwealth…shall be required to obtain or maintain a policy of individual insurance coverage." Two weeks later, Idaho’s governor signed a law that declares "every person within the state of Idaho is and shall be free to choose or decline to choose any mode of securing health care services without penalty."

Supporters of ObamaCare say such legislation, which more than 30 other states are considering, has no force, since the Constitution makes congressional enactments "the supreme law of the land." But that is true only when federal laws are authorized by the Constitution, and the individual health insurance mandate is not.

The mandate's defenders say Congress is exercising its power to "regulate commerce…among the several states." Yet a law that compels people to engage in an intrastate transaction plainly does not fit within the original understanding of the Commerce Clause, which was aimed at facilitating the interstate exchange of goods by removing internal trade barriers.

Even a Commerce Clause stretched by seven decades of deferential Supreme Court rulings is not wide enough to cover the failure to buy insurance, a noneconomic inactivity. The two cases that led to the Court's broadest readings of the Commerce Clause both involved production of a fungible commodity for which there was an interstate market regulated by Congress.

In the first case, decided in 1942, the Court ruled that a farmer could be penalized for exceeding federal crop limits aimed at controlling supply and boosting prices even though all of the extra wheat he grew was consumed on his farm. The Court reasoned that homegrown wheat "exerts a substantial economic effect on interstate commerce" by reducing the total amount of wheat sold.

In the second case, decided in 2005, the Court ruled that Congress could ban homegrown marijuana used for medical purposes authorized by state law. Although the marijuana, like the wheat, was never sold and never left the state, the Court said, its production undercut the federal government's attempt "to control the supply and demand of controlled substances in both lawful and unlawful drug markets."

Unlike growing wheat or marijuana, the decision not to buy medical insurance does not produce anything, let alone a commodity traded between states. Maybe so, say ObamaCare’s defenders, but that decision has an impact on the demand for insurance and on the health care market (one-sixth of the economy!), which the federal government is trying to control in the same way that it tries to control the marijuana trade (with similar prospects of success).

This sort of reasoning leaves nothing beyond the reach of Congress, since anything you do (or don't do) can be said to affect interstate commerce. In its 1995 decision overturning a federal ban on possessing guns near schools, the Supreme Court cautioned against the temptation "to pile inference upon inference in a manner that would bid fair to convert congressional authority under the Commerce Clause to a general police power of the sort retained by the States." That kind of analysis, the Court warned, threatens to "obliterate the distinction between what is national and what is local."

In a recent Heritage Foundation paper, Georgetown University law professor Randy Barnett and two co-authors note that the decision upholding wheat quotas does not mean "Congress can require every American to buy boxes of Shredded Wheat cereal on the grounds that, by not buying wheat cereal, non-consumers were adversely affecting the regulated wheat market." Likewise, federal regulation of carmakers does not mean "Congress could constitutionally require every American to buy a new Chevy Impala every year."

Yet this is the logic of the health insurance mandate, an unprecedented attempt to punish people for the offense of living in the United States without buying something the federal government thinks they should have. Don't buy it.

Jacob Sullum is a senior editor at Reason and a nationally syndicated columnist.

http://reason.com/archives/2010/03/24/dont-buy-it