I keep seeing this bizarre argument that the PPACA (“Obamacare”) is unconstitutional because Congress doesn’t have the authority to make individuals buy a given product.
I’m bewildered at the thinking here:
1a) PPACA massively expands Medicaid eligibility, so those who can’t afford health insurance should be able to get it from the government.
1b) Why the hell would anyone who can afford health insurance not want it? when people like me were calling for single-payer, the middle class were all, “but private health insurance is so cheap (by middle-class standards). Everyone should just buy that!” Is there some large contingent of middle-class people who want to just be put down like lame horses if they ever get ill?
Is this at all about being forced to buy insurance, or something else?
When we bring up that states require car insurance for drivers, then two arguments get thrown around:
a) Well, the law doesn’t make you buy a car. (I live in small-town central US. Reality makes people buy cars.)
b) Congress supposedly doesn’t have the right to pass laws except in very specific limited domains, because of the Tenth Amendment. State governments are supposed to be sovereign.
So, then, would it be OK for the state or city government to demand you buy health insurance? Would that be hunky-dory with you? If so, why?
c) Compulsary car insurance is insurance for harm to other people. Obamacare is more like if you were required to buy insurance for damage to your own car.
Unfortunately, when uninsured people are hospitalized, the rest of us pay for it in higher premiums and healthcare costs. So it really is the same as car insurance; it protects the commons.
I’m not all that familiar with their law, but didn’t Massachussetts have something like you describe? Forced insurance coverage/purchase for everyone in the state? And while I have no idea what their state (commonwealth?) constitution actually says, I don’t see anything wrong with that mandate under the Federal constitution. In fact, the 10th amendment surely implies that such things are fine.
Of course, if this were a political board :rolleyes: we could argue that it was the fact that the Massachussets-ians were most familiar with Obamacare based on their own state’s experience, and that familiarity was what got a single-issue Republican senator elected in what could be the most liberal state in the country. A senator whose entire election platform was “vote for me and I’ll vote against the healthcare law you’re so familiar with”
Healthy young (18-30) people are, on average, better off with no insurance at all, or else only catastrophic coverage. My insurance before I was married was $240 a month, or almost $3000 a year. Leaving out elective surgeries, I’ve used under $3000 in health care probably 22 out of the last 23 years.
Some financially comfortable people who don’t like the hassle would be happier with no insurance at all, or else only catastrophic coverage. Some boutique/concierge medical arrangements do not require normal health insurance.
Some people who for whatever reasons do not wish to involve themselves with the medical system would be happier with no insurance at all, or else only catastrophic coverage. Those whose religion shuns modern medical treatment, survivalists who live in a cabin, people who spend the bulk of their time overseas, etc.
Some people who have access to free medical care would be happier with no insurance at all, or else only catastrophic coverage; e.g., my family includes four doctors.
Those 18-30 year olds will grow up to be 40, 50, and 60 year olds, and the time will come when they do need it. If we allow younger adults to game the system to their (short term) advantage by not paying now, it will just end up hurting them in the long run when they are paying much higher premiums decades down the line.
And to add to that, people that don’t have health insurance most likely aren’t getting regular checkups. In fact, they probably stay away from the doctor for minor things as well (odd pain in foot, sinus infection etc…). While those things may clear themselves up, it’s also a good chance for a Doctor to ask about that mole you didn’t know you had or ask how long you’ve had that cough. So now, you’ve got a 40 year old with melanoma when if he’d been seeing a doctor (for any reason) it’s more likely they would have caught it much earlier on.
Let me tell you about this guy named Cranick. He was given the choice to pay $75 for fire services from a near-by municipality. He chose not to. Now he lives in trailer next to a burned out shell of his once great double-wide.
Cranick is in no way unique or special, as far as I can tell he represents the 95th percentile. Humans are stupid, and are terrible as assessing risk, don’t believe me, go to a casino or gas station and watch people spend hundreds [that they don’t have] on bogus long shot odds.
It’s not “gaming the system” to correctly identify that a business is deliberately ripping you off to subsidise someone else’s services and therefore refuse to buy their product. This is a problem manufactured by the insurers by their own flawed understanding of their market. If they charge young people a fair price and make up for the loss by charging older people a fair price (instead of claiming they have any moral right to hold on to your money for you in the meantime), the problem disappears.
This is what I hate about Obamacare supporters: if an insurer does something stupid that doesn’t work, the solution is for them to stop doing stupid things. It isn’t to force everybody else to do stupid things so that their stupid system works.
I didn’t say health insurance was stupid. I said overcharging people now so you can give them a discount later is stupid, if it means the people you’re trying to overcharge don’t want to buy your product.
The problem with this is there is no real fair price for older people. Except for a small percent who get hit by buses or whatever, everyone is going to need medical care when they get older and it’s probably going to be expensive. So you remove young people from the risk pool and you leave the premiums unaffordably high.
Now you’ve got old people with no insurance and no money to buy healthcare. What do you do? let grandma die on the street of something that’s treatable?
I really, really hate the ‘individual mandate’ but I can’t think of a better solution. It’s a bad situation all around with no easy answers.
It’s not gaming the system, it’s refusing to buy a service that isn’t providing value for them. Young people have no obligation to subsidize the healthcare of the old.
True enough. But do you believe that it would be unconstitutional for a state government to require full coverage auto insurance? Forget whether or not is is unwise. Would it be against any provision of the Constitution?
I’m a bit confused as to why a conservative would be thrilled about possibly dropping the mandate. One of us has a very big misunderstanding of what’s going on.
If by chance the Supreme Court did decide that the mandate was unconstitutional… that would leave the other parts of the bill intact, right?
The mandate is the edifice that Obamacare is built on. GREAT says the Republican partisan… let it all burn! But no matter what happens, Republicans are not going to be able to get rid of the ban on discrimination based on pre-existing conditions. That leads to a system careening toward disaster because of a plank that’s broadly and deeply supported by Americans not being situated in a proper policy framework.
As a confirmed lefty, nothing would make me more excited for the prospects of real reform than the mandate being struck down. If you think that somehow the politics of it leads to a return to the old status quo (or something even more right wing), well, I’ve got some equities in insurance companies I’d like to sell you…