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Sabireley
12-10-2009, 12:55 PM
Why the Personal Mandate to Buy Health Insurance Is Unprecedented and Unconstitutional

http://www.heritage.org/Research/LegalIssues/lm0049.cfm?utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell

This is an interesting read.

Julie R.
12-10-2009, 01:59 PM
Thanks for posting that--very interesting indeed. Any mandate for all U.S. citizens to buy health insurance is nothing more than a left wing money grab/wealth transfer. Nowhere in the Constitution is health care listed as a 'right'.

I personally am very worried about how much my health insurance premiums will skyrocket after this Administration's "Health Care Reform". As it is now, we can barely afford our premiums even though both of us are healthy and have not once ever used our insurance, nor even come close to our minimum. We're both of an age where we simply cannot find any affordable minimal insurance because we're self employed.

When I was in my 20s and early 30s I didn't have health insurance. Like many young people I couldn't afford it and didn't think I needed it as I was rarely ever sick. But unlike today's entitlement/welfare generation I also didn't go running to the emergency room for every sprain and sniffle. When I did need check ups and minor things, costs were affordable. I did have one emergency surgery when I was 30 which cost $8000, a huge sum in those days that took me 3 years to pay in full. But it was still less than the costs I would've paid for health insurance over that 8 year span.

I simply don't understand why there's a need for a comprehensive reform packaged in one enormous bill authored by special interests and so loaded down with pork and expensive trappings and so complicated no one, not the President and not the Congress, even has a clue what's in it? Why not break it down and tackle real reform first? What's wrong with a step by step approach, that would seem to be much more productive. Why not tackle things like fraud, duplication and artificially high prices for things like Tylenol and bandaids first?

Steve Amrein
12-10-2009, 02:38 PM
mandated insurance IMHO will only hurt the poor and and lower class. So if it cost 5000 a year to someone making 35000 vs 200,000 Also if mandated that employers pay they will either raise prices or cut saleries to ofset cost. In the end lower income folks will be much worse off. They were better off showing up at ER and not pay the bill. Wait till folks figure out that free health care will actually cost $$

YardleyLabs
12-10-2009, 03:25 PM
The article is interesting and fun, but in the end seems to rest on specious reasoning. The fundamental economic activity involved is the consumption of health services -- either voluntarily or by virtue of a medical emergency -- and that is undubtedly an interstate form of commerce that has a major impact on our econpmy as a whole. To make the arguments suggested in the essay would, in my opinion, require identification of a class of persons that have not, do not and will not be consumers of health services. One such class, explicitly exempted by the proposed bills, are American citizens permanently resident in other countries.

Eric Johnson
12-10-2009, 05:39 PM
Jeff-

I'll ask again since no one has ever answered....

How will more persons be offered health care at less expense with the same finite personnel resources that we have now.

It defies logic!

Eric

YardleyLabs
12-10-2009, 05:50 PM
Jeff-

I'll ask again since no one has ever answered....

How will more persons be offered health care at less expense with the same finite personnel resources that we have now.

It defies logic!

Eric
Actually, the supply/demand relationships hold little water in health care. The primary area in which personnel limit accessibility of services is in primary care and that is what is most likely to be negatively affected as more people receive coverage. The impact on usage for more advanced care is less clear since improved primary care would be likely to reduce the incidence of more severe ailments and people who have more severe ailments end up qualifying for either unreimbursed care or Medicaid. Increased demand for drugs and medical appliances is also likely, but the unit cost of these goes down dramatically with increased volume since the primary costs are for development and clinical testing, not manufacturing.

Perversely, there is also a lot of evidence that health care providers create demand based on their own schedules. Thus, a doctor with a small caseload is more likely to have you come back for a "follow up" appointment while a doctor with a larger caseload will tell you to come back if the problem doesn't go away. These patterns have been documented repeatedly beginning with the publication of Doctors, Patients, and Health Care (Hermann Somers) in the late 60's and continuing through today.

Cody Covey
12-10-2009, 06:33 PM
If you want to argue the interstate commerce clause Jeff I think you would win since it has been perverted to include any sale of any good what so ever even though health insurance can't be bought across state lines. But the bigger question is how can it be constitutional to require people to have health care or face jail time.

code3retrievers
12-10-2009, 09:01 PM
The article is interesting and fun, but in the end seems to rest on specious reasoning. The fundamental economic activity involved is the consumption of health services -- either voluntarily or by virtue of a medical emergency -- and that is undubtedly an interstate form of commerce that has a major impact on our econpmy as a whole.

You sure know how to stretch things.

You know that health care has nothing to do with Interstate commerce. This concept of being forced to buy a commodity by the federal government has never been attempted before.

There are some that believe that everyone should own a weapon for self defense. They believe society would be better for it. You may never need the weapon but if the majority wanted this law, would that make it constitutional?

No way. If you want to pass this crap then change the constitution.

Captain Mike D
12-10-2009, 09:19 PM
The article is interesting and fun, but in the end seems to rest on specious reasoning. The fundamental economic activity involved is the consumption of health services -- either voluntarily or by virtue of a medical emergency -- and that is undubtedly an interstate form of commerce that has a major impact on our econpmy as a whole. To make the arguments suggested in the essay would, in my opinion, require identification of a class of persons that have not, do not and will not be consumers of health services. One such class, explicitly exempted by the proposed bills, are American citizens permanently resident in other countries.

Damn Jeff,

I knew we could count on you to be smarter than a whole think tank of intellectuals!! What a friggin crock.

Go sell your snake oil somewhere else.

YardleyLabs
12-10-2009, 09:35 PM
If you want to argue the interstate commerce clause Jeff I think you would win since it has been perverted to include any sale of any good what so ever even though health insurance can't be bought across state lines. But the bigger question is how can it be constitutional to require people to have health care or face jail time.Actually, you face fines that are paid into a trust fund used to pay costs incurred treating uninsured people. I don't believe you face jail time.


You sure know how to stretch things.

You know that health care has nothing to do with Interstate commerce. This concept of being forced to buy a commodity by the federal government has never been attempted before.

There are some that believe that everyone should own a weapon for self defense. They believe society would be better for it. You may never need the weapon but if the majority wanted this law, would that make it constitutional?

No way. If you want to pass this crap then change the constitution.
As eildydar noted, the inter-state commerce clause has been stretched repeatedly over the last century and is actually the basis for most governmental action. There have been virtually no instances where the courts have overturned an act of congress that was predicated on commerce no matter how thin the rationale. In the case of health care, however, it is not much of a stretch. Most employers purchasing health benefits for their employees are operating inter-state. Most providers of health care (measured by dollars of revenue) are interstate businesses. The insurance industry that provides health insurance is also interstate. Health care expenditures are approaching almost 20% of GDP. How could you fail to consider health care regulation not to be a matter of interstate commerce.


Damn Jeff,

I knew we could count on you to be smarter than a whole think tank of intellectuals!! What a friggin crock.

Go sell your snake oil somewhere else.
The Heritage Foundation makes no pretense of being objective. It is a think tank selling a particular perspective. I fully expect similar arguments to be made in court assuming health benefit reform is adopted. I doubt the arguments will be won, but the current make up of the SCOTUS makes all such bets risky. Having spent much of my career as a think tank "expert", I would have to say that familiarity does not necessarily breed contempt, but it certainly does not create feeling of awe..

ducknwork
12-11-2009, 07:16 AM
Actually, you face fines that are paid into a trust fund used to pay costs incurred treating uninsured people. I don't believe you face jail time.


What happens if you don't pay the fines?;)

YardleyLabs
12-11-2009, 07:43 AM
What happens if you don't pay the fines?;)
The same thing that happens if you don't pay your taxes. Generally it means that your assets would be seized to pay off your debt. I don't think you will find anyone in prison for non-payment of federal taxes in the absence of fraud.

Bob Gutermuth
12-11-2009, 10:39 AM
How typical of the liberal mindset is compulsory health insurance: take from those who work and give to the indolent.What a crock.

Eric Johnson
12-11-2009, 10:53 AM
Jeff-

I think that the actual charge for failing to pay Federal taxes is fraud. Thus, your arguement is sort of moot. As a matter of fact, I believe Wesley Snipes would argue with you. He's free pending appeal but has been sentenced to 3 years for failure to pay his income taxes.

Eric

ducknwork
12-11-2009, 11:41 AM
The same thing that happens if you don't pay your taxes. Generally it means that your assets would be seized to pay off your debt. I don't think you will find anyone in prison for non-payment of federal taxes in the absence of fraud.

So, if you don't buy health insurance, the government can seize your property? Sounds reasonable.:rolleyes:

YardleyLabs
12-11-2009, 11:48 AM
Jeff-

I think that the actual charge for failing to pay Federal taxes is fraud. Thus, your arguement is sort of moot. As a matter of fact, I believe Wesley Snipes would argue with you. He's free pending appeal but has been sentenced to 3 years for failure to pay his income taxes.

Eric
His case is a little extreme. He socked money into foreign accounts over a period of a decade to avoid paying around $15 million in taxes. He was acquitted on a felony charges but convicted on three misdemeanor charges. The judge threw the book at him and sentenced him to the max for the three counts because of the egregiousness of his efforts to not pay. I suspect he will be eligible for parole in about half that time and his sentence is still under appeal.

Gerry Clinchy
12-11-2009, 01:49 PM
The same thing that happens if you don't pay your taxes. Generally it means that your assets would be seized to pay off your debt. I don't think you will find anyone in prison for non-payment of federal taxes in the absence of fraud.

But you could end up homeless and destitute as the IRS placed liens on your home and raided and froze your bank accounts ... as they can do.

In what way would that help get those people insured? Of course, once destitute, they would join those receiving subsidized insurance and care from that trust fund that their assets helped enlarge.

Gerry Clinchy
12-11-2009, 01:50 PM
Julie R

I simply don't understand why there's a need for a comprehensive reform packaged in one enormous bill authored by special interests and so loaded down with pork and expensive trappings and so complicated no one, not the President and not the Congress, even has a clue what's in it? Why not break it down and tackle real reform first? What's wrong with a step by step approach, that would seem to be much more productive. Why not tackle things like fraud, duplication and artificially high prices for things like Tylenol and bandaids first?

Ditto!
==============

Gerry Clinchy
12-17-2009, 06:06 AM
The primary area in which personnel limit accessibility of services is in primary care and that is what is most likely to be negatively affected as more people receive coverage.

Last time I read parts of the bill that related to the primary care professional, that professional could be a PA, rather than an MD. I suppose that is how they expect to cover that aspect of personnel deficit.


Increased demand for drugs and medical appliances is also likely, but the unit cost of these goes down dramatically with increased volume since the primary costs are for development and clinical testing, not manufacturing.

That might be true in a free market situation. However, the Senate voted no on the option to import drugs from Canada to lower costs.



A bipartisan plan to allow Americans to buy cheaper prescription drugs from suppliers in other countries, such as Canada, failed Tuesday in the Senate. The Wall Street Journal (http://online.wsj.com/article/SB126093494955393151.html?mod=googlenews_wsj) reports the two top supporters of the plan, Sens. Byron Dorgan, D-N.D., and John McCain, R-Ariz., said shopping overseas via the Internet and mail-order companies could save consumers up to $80 billion over a decade if their amendment were added to the health overhaul legislation. Drug makers had opposed the bill. The Journal reports: "In June, the industry agreed to put up $80 billion over 10 years to support a health overhaul, including steps to improve drug coverage for seniors in Medicare, provided they wouldn't be asked for further contributions to the cost-cutting effort. The deal continued to hold up in the Senate Tuesday as the drug-importation measure opposed by the industry fell short." It failed by a vote of 51-48, nine votes less than the 60 needed to approve the amendment (Mundy, 12/16).

Bloomberg (http://www.bloomberg.com/apps/news?pid=20601103&sid=ar4.zkHgCZfQ) reports, "Proponents said the plan would have allowed pharmacies, wholesalers and consumers to buy medicines made by U.S. companies sold at lower cost in other nations. Drugmakers, who have to contend with foreign health systems that regulate prices, said they need the open market in the U.S. to thrive and warned of safety risks from counterfeiting." After the amendments failed, AARP executive Nancy LeaMond, a supporter of the plan, said, "Tonight, senators had a choice between meaningful savings for their constituents and higher profits for the drug industry" (Gaouette and Jensen, 12/15).

Yes, the highest costs are in development. OTOH, it is the profit margins that allow the pharma companies to continue development of new drugs and devices. If those margins are reduced, to what degree would that affect R&D? A step further, to what degree would cutting profits affect employment in the pharma industry?

My neighbor is a nurse who has spent 20 years in the long-term care field. Her opinion was that your best bet in long-term care is to be penniless. Facilities subsidized by the counties (here in PA), must accept all people in need. The caregivers "on the floor" can't tell which are paying patients & which are on assistance, so they all get equal care. Since medical assistance only pays $150/day for a person who may have had a stroke and is on life supporting services like IVs, etc. this reimbursement is not nearly enough to cover the care; so it is paid for either by the county subsidy (through overall taxes on the population) of the facility and/or the amounts charged to paying patients.

I think we have fully discussed that you simply cannot give health care or insurance to 30 million more people without somebody paying for it. If a large portion of those 30 million will have their insurance "subsidized", that subsidy will come from higher general taxation of all income levels.

I believe that it is human nature that people will still complain about the taxation level they are faced with. If you are making $88,000/year for a family of 4, that's generally a pretty decent income level to most people. If that family receives a break on health insurance, they may still find themselves with a smaller paycheck from higher income taxes needed to maintain the govt mandates (even without a govt option). This won't become obvious until the whole thing is "operational".

txbadger
12-17-2009, 09:35 AM
While our employees have demonstrated little regard to what We the people want I'm not sure calling insurance companies an interstate commerce would pass the smell test. Each state has it's own mandates & each company, even if a national company, must segregate their premiums. Further evidence is many companies have a different company for each state. i.e. Blue Cross of TX or Blue Cross of CA.....