…you keep framing your arguments around the word “wise.” And in context, based on what you have said in this thread, “wise” means “give the citizens a lesson in civics.”
I don’t think that argument is good enough. The Feds obviously can. You think they shouldn’t. Can you argue for why you think that they shouldn’t, based on something stronger than what could be taught in the classroom?
Such a system would be under realistic threats before and after implementation.
Prior to implementation, I would assume Congress would be under a great deal of pressure to stop “Northeast Medicare” from health insurers, ideologues, and possibly companies that are found only in the regulated area to name a few. These groups have every right to lobby Congress on their own behalf but they would be lobbying Congresspersons who have no stake in the game other than what these groups offer them. You would need some critical mass of states involved in the system to reduce Congress’ chance of blocking it to reasonable limits. Actually, now that I think about it, there may already be laws preventing a regional health insurance system.
A feasible route by which such a system could get killed after its implementation is through federal competition. Let’s say some form of Romneycare finally gets through Congress, well they need the states from the Northeast Medicare system to participate in order to make it financially viable. So they kill Northeast Medicare for Romneycare. I would probably support such a thing because I would be happy to see all Americans have a decent chance to afford health care, but it would be completely upending for those using the system.
In a nutshell, it’s just too tenuous for me.
I see what is happening with the federal government and sanctuary cities, and, as a closer analogy, recreational marijuana. The former may result in cities losing federal funding unrelated to cooperation with border agents, and the latter already has Attorney General Sessions completely unwilling to say he won’t go after states with a recreational marijuana economy.
No. That’s indeed an effect, but the primary goal is to correctly apply that lesson in civics to our government. The lesson aspect only arises because so many of our citizens have never learned the federalism concept.
Yes, I gathered.
The United States was created when sovereign states agreed to cede part of their sovereign power to a central government. The United States is the world powerhouse that it is because of adherence to that bargain. Breaching it has led to undesirable results. In my opinion.
…so you want to teach the government a lesson? House passed “repeal and replace” to teach the house a lesson in civics to itself? That is what this thread is about?
Well you didn’t really answer my question at all. Yeah, we get it, America is great, bla bla bla, wave the flag. But you can hardly call that an argument in favour of repeal and replace.
The United States is also the world powerhouse at “throwing money down the drain” in regards to healthcare. Nobody spends more money for poorer outcomes than you guys. Is that something you are proud of? Is this what makes America so exceptional?
When was it breached exactly? What are those undesirable results?
I gather the US is a powerhouse because the other powerhouses were flattened by two wars, not through anything intrinsic to its system of government.
I’m beginning to notice that you’re rephrasing what I say in ways I didn’t say. And that almost without exception, your rephrasing has two characteristics: it is inaccurate, and it’s inaccurate in ways that make my position sound weak.
Why is that happening, do you think?
To answer this attempt at a rephrase: no. The purpose of legislation is to create policy. This is not teaching a lesson to government; it’s implementing a wiser government policy than the one in place antecedent to the legislation.
Once again, you have elided enough of my argument that what remains can hardly be called mine.
If someone were doing this to you, how many iterations would you accept before you concluded that for whatever reason, you were unable to reach your interlocutor with the correct vision your words were explaining?
I argue that “repeal and replace” is a wise step. I argue it’s wise because the current ACA vitiates the distinctions that should exist between state and federal government, so that the ACA represents an unwise role for the federal government to play.
That is clearly an argument in favor of repeal and replace. You may not find it compelling for any number of reasons; you cannot credibly claim it does not exist.
Never said anything like that.
Are you familiar with the phrase “nibbled to death by ducks?”
The phrase means that rather than one definitive killing blow, death arises from thousands of small injuries, the aggregate effect of which is death.
In like manner, it’s not possible to point to a single moment in which federal power crossed the line, because each step has only been a slight extension of previous steps.
There have been some moments, though, which stand out. The decision to fine Roscoe Filburn $117.11 was one such. But that’s hardly relevant to the current thread, is it?
I gather you’re not correct (or at least complete) in that assessment.
I’m sorry, but the whole point of my argument is that Congress should stop acting unwisely. If your rebuttel is, "That can’t happen, because if it does, Congress will screw it up by acting unwisely. . . " then while I certainly see the history that supports your view, it’s really begging the question with respect to my argument. That is, you’re assuming the truth of your rebuttal to prove the truth of your rebuttal.
I have a question, only because we’ve all heard this sort of thing before – there were similar debates about Social Security, and some of us actually remember hearing the claims by Republicans that Medicare, if enacted, would not only undermine the republic but would harm it fatally, so that “we are going to spend our sunset years telling our children and our children’s children, what it once was like in America when men were free”, quoth a young Ronald Reagan, condemning and blasting the thing as “socialized medicine” and an existential thread to the American way of life.
So maybe you can tell us, in a few sentences using simple concepts, how the enactment of Social Security in 1935 under the “general welfare” provision of federal power has harmed the United States and undermined its status as a “world powerhouse” and harmed the well-being of its citizens. Then tell us how you think that Medicare, enacted in 1965, has undermined the status of the US as a world power and harmed the well-being of its citizens.
Because ISTM that the US has only grown stronger since these measures, its citizens more prosperous, with better provisions for a social safety net and for affordable health care in retirement. So that society as a whole has also become gradually stronger, less threatened by the possible loss of the basic necessities of life. But you obviously have a different view, so please tell us how either of these federal measures have been harmful to the nation. Please be specific.
Supplementary questions. Maybe you can also tell us why none of the Congress critters who voted for this bill are promoting this supposedly vaunted principle of federalism. Why, instead, do we have Republicans like Raul Labrador running around claiming that health care is not a basic human right? How come none have had the courage to respond to an invitation to appear on an MSNBC show to defend their position – not a single one?
Well, no. If you did, you would have said that’s what led to the US having been a powerhouse. I’m sure you’ll explain why the US’s place in the world is due to its philosophy of government and not its actions and the circumstances in the world and, more in line with the topic, why legislature providing for adequate health insurance will change that.
…because you are being unclear? Because you are using subjective measures like “wiseness” without explaining how you are measuring the degree of wiseness?
How is this policy objectively wiser than the one that was in place before?
The thing is I asked you a question, and you didn’t answer it. You are obviously of the opinion that separation of Federal Government from State Government is what has made “America a powerhouse.” I am not of that opinion at all. But even if you are correct: it still doesn’t answer my question.
How many times are you not going to answer my question before I can conclude you have no intention of answering my question?
I’m not trying to answer for you. I’d much rather you answer for yourself.
You aren’t arguing this at all. You are merely asserting it.
Why should these distinctions exist? What is it, objectively about these distinctions, that makes America a powerhouse? Why is the ACA an unwise role for government to play? What makes you the arbiter of the distinctions between state and federal government?
It isn’t really an argument. They are assertions based on what you consider wise.
But I’ll try and help you out. Are you arguing for any flavour of “repeal and replace”, or this particular “repeal and replace”, or a different “repeal and replace”? Because all three are very different arguments. Can you settle on one, and we can go from there?
I never claimed you said anything like that. I said that. I asked you if you agreed. Do you agree?
And what are the undesirable results?
I disagree. This is the crux of this thread. It isn’t really about just this piece of legislation is it? This is entirely about how you feel about the separation of the Feds and the State. Healthcare, and this bill in particular, is entirely incidental.
OK, that’s fair – but there’s a difference between simply pointing out that I have not provided supporting detail, and inserting your own version. This post I’m replying to now, #611, is a set of pointed but fairly crafted questions, as opposed to what I was complaining of before. So, thanks.
And you’re right:
Essentially correct, although it’s also fair to answer why the military and immigration policy are more wisely kept federal and healthcare more wisely kept with the states.
I’ve pointed out one reason: that we have reached the point that people are astounded to learn that there is any difference between federal and state power at all. We are fast losing the ingrained sense of what kinds of things should be federal, and that means an increase in the power of the federal government at the expense of the states.
Why, then, is that unwise?
One of the chief reasons is that we lose the laboratory effect, a phrase I have stolen from Supreme Court Justice Louis Brandeis:
There can be, in my opinion, little doubt that we as a country do much right with healthcare, and do much wrong. The U.S. has twice as many MRI scanners, per capita, as Canada does. More than twice as many CT scanners, per capita, are in the U.S. than are in the United Kingdom, another oft-presented champion of national medicine.
Those are good metrics.
We have poor metrics as well – many highlighted in this thread – that show inconstant access to care.
But in my opinion, we don’t know what will work best, and even discounting evil conservatives, there is disagreement among liberals as to the wisdom of a single-payer system or a public option or a continuation of the ACA model.
This is the perfect times to realize we have fifty pteri dishes. That’s the strength of the model. We can experiment and see what works.
That’s wise.
Which is cute and all, until the poor and sick start migrating towards California for medical treatment.
Then couldn’t other states partner with California? Couldn’t California impose residency requirements?
:hijack: When I visited England last year, they stamped on my passport something like “this individual is not to receive welfare benefits”: I guess that Canada and Spain have similar provisions but not as explicit. California does not have this luxury of preventing medical migration.
I live in CA, and I have no worries about people moving here without a job and thinking they’ll get great healthcare. Not going to happen, and even if it does, there are ways to stop it pretty easily. (I can see Bricker already brought up residency requirements.)
It’s funny how whenever someone mentions that people in depressed areas should move to where the jobs are, we are hit with a litany of “reasons” that they can’t do that. Everything from can’t afford the actual move, to having to take care of a sick grandmother (and granny doesn’t want to leave her home). But when Healthcare is involved, suddenly people are human road runners. Beep Beep!!
Hold on a second. Every time there’s a thread about someone living where there are no jobs/reliable transportation/affordable housing, and a suggestion is made that people move to where such things ARE available, there’s a hue and cry about how such people can’t afford to move.
But now, you’re positing that sick people are going to up and move to California for medical treatment.
You guys can’t have it both ways.
I think the idea that large states are in a practical position to be a laboratory for single payer health care is pure fantasy. Once insurance companies start getting the slightest concern about their profits, they will either lobby as hard as possible within in the state to get the plan defeated, or run – not walk – to Congress to get laws passed that cripple any such effort.
This idea that states could just go off and do this if they wanted to is fantasy-land thinking.
The amount of money to be gained by moving to where the jobs are, for people with questionable means to move, is only around an order of magnitude more than the costs of moving. The health costs for the sickest people, the ones who would move strictly for the health care, is an order of magnitude higher on top of that, if not more. So someone could simultaneously hold both views if they thought that the breaking point past which people will move is somewhere in between.
How could I be begging the question when you recognize a history supporting my view? It sounds like you are begging the question and not willing to recognize interstate agreements will be tenuous even when the government runs as wisely as you envision.
So to clarify, my rebuttal is simply that multistate health insurance cooperatives of any type will be subject to federal regulation. Via acting wisely, according to your definition, such a cooperative agreement is subject to all kinds of legislation enacted by parties with no stake in the cooperatives’ success. This is particularly true of the types of states mentioned in the original post - small New England states and sparsely populated Western states.