Friday, August 12, 2011

Health Care Mandate Ruling

A US Court of Appeals ruled that the health care mandate specified in the Obamacare legislation was unconstitutional. This makes one appellate court which has ruled the legislation valid, one which has ruled it [partially] invalid, and two which are still pending; all of which are a waste of time, of course, since eventually the Supreme Court will obviously need to consider and rule on it, making all the other deliberations and rulings a colossal waste of time, money, effort, and attention.

I could take issue with the procedure, I suppose, and complain about how absurd the process is which takes years to resolve anything, and serves no valid societal purpose aside from enriching lawyers (which has questionable social value). I could also of course address just how ridiculously overreaching the government's position is: that everyone indirectly affect inner-state commerce by their existence, and thus the government is entitled to dictate every part of their life. There's certainly plenty of low-hanging feces in both of those areas, but I'm not going to get into either of them in this post, per-se. Instead, I'm going to take issue with the courts themselves, and how the recent ruling, while more or less obvious, was not even unanimous, and how bad that is for America in general.

Sure, the government's position is an absurd abuse of power. You know what, though? I don't blame them too much. I mean, it's not like any of the corrupt power-hungry scum drafting or approving this legislation have any obligation, explicit or implicit, to honor or respect the Constitution (at least, as far as I can tell). Rather, like any power-hungry business-person, they are taking every advantage the system allows, and doing whatever they can do advance their own agenda/position. We don't expect them to be magnanimous or ethical; rather, we rely on the system and the laws thereof to keep their actions in check. For the politicians, this falls to the court system, which is supposed to be on the side of the people.

Here, I think, is where it's fair to be upset. In what scenario is it even plausible to have a judge, representing the interests of the people, decide that the government should be allowed to rule over and dictate every part of peoples' lives, by arbitrary extension of a clause in the Constitution designed to make sure states play nice in business transactions with each other? Moreover, having ruled such, how is that judge allowed to continue to be judging anything, much less reside outside the walls of a mental institution? Have we really progressed so far down the road to idiocy, as a society, that something like the Constitutionality of the purchase mandate of Obamacare can now be considered a reasonable question, rather than the utterly obvious extra-Constitutional abuse of power it clearly is?

I'd like to demand more from our judiciary. I'd like them to take a dim view toward small overreaches of legislative power, much less enormous egregious ones such as this. I'd like them to take a more proactive role in striking down such actions, rather than waiting years for test cases, and the entire appeals process to play out. I'd like them to uphold the limits established in the Constitution, rather than decide if the government is pushing out their boundaries of control "just enough", or "slightly too far". I want a court which is actually on the side of the people and the country, not a "yes man" for government abuses which only occasionally, and seemingly accidentally, acts in the peoples' interests. Is that too much to want?


  1. I can't understand the indignation at the mandate. For decades we had an informal system of socialized medicine. Hospitals treat people who do not have money or insurance for free. Revenues from paying customers has to cover it. I don't know why hospitals do that, but I imagine they would face some gov't pressure if they refused.

    So now the gov't says those people have to pay for their own insurance instead of free-riding off paying customers. Gov't pressure was already forcing me to insure against their illnesses; now they're going to force the people receiving the informal insurance to buy real insurance using mostly their own money. If they don't, they pay a penalty that's far too light; it should be equal to the cost of insurance, since they're informally insured anyway.

    If the mandate were unconstitutional it would be so only on a technicality. In practice, responsible people who pay for their own medical care are forced to pay for informal insurance for the poor and irresponsible. The mandate portion of the overhaul law tries to make these people pay their own way. Criticizing it on a constitutional technicality seems like either a call to let the irresponsible die or to keep a hodgepodge system of informal socialized medicine in which the responsible subsidize the irresponsible.

  2. This comment has been removed by the author.

  3. The hospitals do so because they are required by law. That might go a ways toward filling in the blank for the start of the slide toward socialized medical care.

    I'm not at all asserting that the end-result, financially speaking, of a health insurance mandate is significantly dissimilar to the current situation. I am, however, stating that there's a huge difference, legally and Constitutionally speaking. Moreover, if you wanted to formalize the wealth distribution aspect of mandated hospital care, why in the world would you also enrich the insurance companies at the same time? Why not just force the people with money to pay for everyone else's care directly?

    I would like to see a government run health care safety net program for people who legally work in the US; I have said so previously. However, my version is dissimilar enough from the Democrats' plans that it would be hard to call it the same thing: I want a minimal care safety net, and only for legal, working people (and their immediate families). I'd also not be opposed to a minimal number of government-run health care facilities offering free basic care at minimal cost, but clearly the standard of care would be low, and the waits would likely be long.

    The issue that a lot of the people in my camp dance around is what you nailed: either you commit to the government providing an equal standard of care to everyone (socialized medical care), or you have an unequal system where you "let the irresponsible die" (maybe less dramatic, but the same idea). I am for the latter: I don't think responsible people should be forced (at "gunpoint") to pay for equal medial care for irresponsible people (ie: people who do live an unhealthy lifestyle, take excessive risks, live beyond their means, etc.) to what they would strive to provide for themselves and their family. If that makes me a heartless capitalist, then so be it.

  4. The fact that the mandate is not a significant practical change from the current situation is why I'm calling a technicality.

    And a truly equal standard of care is not something we can achieve.

    I wonder if there's any practical realistic way to let people who are irresponsible, those who could have saved money or purchased insurance but didn't, completely go without.

    I keep hearing about a similar issue with Medicaid. Many people who are elderly or think they may have big medical expenses coming try to divest their wealth, sometimes hundreds of thousands or even a million dollars, so they can get on Welfare. They're actually indignant that it's a hard maneuver to do. Some people with a half million dollars feel it's morally wrong to deny them Welfare.

    The gov't is currently trying to stop this. They're saying if you give away, let's say, $100k to your kids and then within five years try to apply for Medicaid, you need to retrieve that money you gave away and spend it down before you can receive Medicaid. If the people you gave it to spent it or lost it, the theory is you won't be eligible for Medicaid until you run up $100k in bills. Will people who need round-the-clock nursing care be put on the street? No one knows. The gov't clearly doesn't want to provide Welfare to these people but simply not helping them because of an improper divestment years ago seems harsh.

    That was a tangential topic. My point is if we were willing to let the irresponsible go with almost no care (not just inferior care), then the constitutional argument would make sense. If the affluent and responsible will be forced to pay for the poor and irresponsible one way or another, I'm calling the exact mechanism by which they're forced a technicality. Either way they're out the money and have no choice.