Justices don’t understand insurance, health care, economics …

Non-cognitive elites

The depressing news from the U.S. Supreme Court isn’t just that several of the more conservative justices seem willing to upend a century of legal precedent if it would score a win for their party.

The depressing news is that these justices do not seem to understand the Affordable Care Act, the Emergency Medical Treatment and Active Labor Act of 1986, the purpose and function of health insurance, the American health care system, or even the most basic aspects of economics.

I knew they were this partisan. I did not realize they were this ignorant.

Here’s a roundup of the lowlights:

Steve Benen: “There is no ‘Cornhusker kickback’

Scalia doesn’t seem to realize that the so-called “Cornhusker kickback” wasn’t included in the Affordable Care Act; it was taken out before passage. Scalia probably heard something about it on Fox News, assumed it was true, and internalized his party’s talking points. More than two years later, the conservative justice is still parroting a claim that has no basis in fact — indeed, he’s practically boasting about it during Supreme Court oral arguments.

Scalia is bringing to the discussion all the sophistication of a House freshman appearing at a Tea Party rally.

And while this was a glaring example of policy ignorance, the larger issue is that the Scalia and other justices have routinely struggled this week with the basics of health care economics and the details of the law itself.

Charlie Pierce: “Tony Scalia’s Retirement Has Started Early

It is plain now that Scalia simply doesn’t like the Affordable Care Act on its face. It has nothing to do with “originalism,” or the Commerce Clause, or anything else. He doesn’t think that the people who would benefit from the law deserve to have a law that benefits them. On Tuesday, he pursued the absurd “broccoli” analogy to the point where he sounded like a micro-rated evening-drive talk-show host from a dust-clotted station in southern Oklahoma.

Jared Bernstein quotes from Henry Aaron:

Perhaps the most glaring instance of the failure to appreciate what an externality really is came from Justice Alito who at one point challenged the solicitor general by positing that the cost of all of the care currently used by those who are uninsured is less than would be the cost of the insurance they would be forced to carry. That being the case, Alito asked, how can one say that the uninsured are shifting costs to the insured? This query is painfully detached from an understanding of what an externality really is, how insurance works, or what the impact of insurance would be on service use.

Dahlia Lithwick: “The Supreme Court’s Dark Vision of Freedom

It’s always a bit strange to hear people with government-funded single-payer health plans describe the need for other Americans to be free from health insurance. But after the aggressive battery of questions from the court’s conservatives this morning, it’s clear that we can only be truly free when the young are released from the obligation to subsidize the old and the ailing.

… Freedom also seems to mean freedom from the obligation to treat those who show up at hospitals without health insurance, even if it means letting them bleed out on the curb. When Solicitor General Donald Verrilli tries to explain to Justice Scalia that the health care market is unique because “getting health care service … [is] a result of the social norms to which we’ve obligated ourselves so that people get health care.” Scalia’s response is a curt: “Well, don’t obligate yourself to that.”

John Cassidy: “Obamacare Supreme Court case is a bad joke

Justice Anthony Kennedy, the swing vote on the court, said that the U.S. government had a “very heavy burden of justification” to show that an individual mandate to purchase health-care insurance was constitutional. Really? Only if Kennedy and his Republican-appointed colleagues are willing to throw out economic logic as well as seventy years of legal precedent, which, judging by their harsh questioning of Solicitor General Donald Verrilli, Jr., they may well be.

The economics isn’t very complicated. The health-care industry, which makes up about a sixth of the economy, is rife with inefficiency, waste, and coverage gaps. In seeking to remedy some of these problems, the Obama Administration made a deal with the private-insurance industry — the same deal Mitt Romney made when he was governor of Massachusetts. On the one hand, the federal government barred the insurers from discriminating against the sick and the elderly, thereby raising the industry’s costs. On the other hand, the feds obliged uninsured individuals to purchase coverage, thereby expanding the insurers’ revenues. … It was a straightforward instance of the central government seeking to redress the failures of the private market—something akin to imposing fuel standards on auto manufacturers, providing state pensions, and forcing banks to hold adequate capital reserves.

Charles Fried: “Health care is interstate commerce. Is this a regulation of it? Yes. End of story.

There is a market for health care. It’s a coordinated market. A heavily regulated market. Is Congress creating the market in order to regulate it? It’s not creating it! The market is there! Is it forcing people into it in order to regulate them? In every five-year period, 95 percent of the population is in the health-care market. Now, it’s not 100 percent, but I’d say that’s close enough for government work. And in any one year, it’s close to 85 percent. Congress isn’t forcing people into that market to regulate them. The whole thing is just a canard that’s been invented by the tea party and Randy Barnetts of the world, and I was astonished to hear it coming out of the mouths of the people on that bench.

 

Mark Thoma: “Why We Need an Individual Mandate for Health Insurance

Just read the whole thing. It’s short. It’s clear. And if you read it now, then in five minutes you will know and understand more about the individual mandate than either Antonin Scalia or Samuel Alito will ever bother to know or understand.

Scott Lemieux: “The Individual Mandate: Not a Slippery Slope

The contention that upholding the ACA would allow the federal government to regulate **everything** hinges on the supposed distinction between regulating economic “activity” and “inactivity”; with the ACA, some conservatives claim, it is **not** having health insurance that’s being regulated — and the commerce clause only authorizes regulating economic activity. Of course this distinction proves essentially meaningless once you realize that not buying health insurance now means paying out of pocket later. Combined with the fact that states generally require hospitals to treat the uninsured in the case of emergency, to say that the uninsured are making a “free choice” is highly misleading. It’s government regulation that makes these choices possible in the first place.

But the distinction is irrelevant anyway. Whether “activity” or “inactivity” is involved, the Court has well-established standards on what the commerce clause authorizes. Generally, the problem being addressed plausibly requires a federal solution, and the proposed regulation — even if it does not itself regulate interstate commerce — is part of a larger regulatory scheme.

As Yale law professor Jack Balkin explains in a recent article, the individual mandate — whether it regulates “activity” or not — clearly meets this existing standard. Widespread problems with access to health care and skyrocketing costs are certainly big enough to plausibly require a federal solution. Furthermore, the individual mandate is an essential component of the ACA’s broad regulatory framework. Americans are generally okay with barring insurance providers from discriminating against people with “pre-existing conditions,” but this creates a “free rider” problem. Without the individual mandate, people could game the system by buying insurance only once they are sick, which of course would affect the whole country, not to mention bring down the entire insurance industry in the process.

The Rude Pundit: “Five Ways Broccoli Is Not Like Health Insurance

1. Broccoli is a nutritious vegetable. Health insurance is a guarantee that medical care will be paid for by the individuals receiving it through their insurance companies and not by you and all of us.

Kevin Drum: “Explaining the Mandate in Language Conservatives Can Understand

“For the 8 percent of people who didn’t have insurance, we said to them, if you can afford insurance, buy it yourself, any one of the plans out there, you can choose any plan. There’s no government plan.

“And if you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care. So we said, no more, no more free riders. We are insisting on personal responsibility. Either get the insurance or help pay for your care. And that was the conclusion that we reached.

“Everyone has a requirement to either buy it or pay the state for the cost of providing them free care. Because the idea of people getting something for free when they could afford to care for themselves is something that we decided in our state was not a good idea.”

Mitt Romney, January 2012

Ed Kilgore: “An Unexpected Attack on Medicaid

The Court wouldn’t strike down the Medicaid expansion unless it were willing to question the constitutionality of Medicaid itself, and it sure wouldn’t do that, right?

That’s not quite so clear after today’s concluding oral arguments.

Jon Green: “The Founding Fathers loved health care mandates

Green points us back to a New England Journal of Medicine article from January, quoting this bit:

[In] 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves. In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm. This history negates any claim that forcing the purchase of insurance or other products is unprecedented or contrary to any possible intention of the framers.

and Green adds:

Not only did mandates pass muster with the Framers in Congress, they were signed into law by George Washington and John Adams. Those who say that the Founding Fathers would object to any governmental regulation of the free market should double-check their history. They won’t like what they find.

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  • JessicaR

    But someone might get something they did not expressly deserve bwaaaaaaaaaaaaaaaaaawwwwwwwwwwwwwwwwwwww. By the way, I also belive that is what is also going to be engraved on our national tombstone.

  • Dan Audy

    The US Supreme Court really worries me and the coverage of the ACA arguments by both the left and the right really clarify to me what is wrong with it.  Nobody actually expects the decision to be made based on the merits of the law but rather the whether each side can provide adequate justification of their pre-judged opinion and whether the cost in public perception regarding the legitimacy of the Supreme Court would be adversely harmed by that decision in the wake of Bush v Gore and Citizen’s United.  The Supreme Court has held for decades that there is literally no limits to the power of the government to regulate Interstate Commerce even when there is neither any ‘interstate’ or ‘commerce’ aspect to the behaviour being regulated and while I actually generally disagree on the legitimacy of that legal approach if it reverses course on the ‘Individual Mandate’ it shows exactly how political the court has become and in effect only permits conservatives to make new laws.

  • P J Evans

    They don’t have any problem with giving the government all the power it wants – not needs, just wants – in dealing with drugs and national ‘security’. They haven’t done anything to require that the government follow its own laws and regulations, even when people sue based on things that the government actually did to them. Maybe it’s because those activities support the conservative view of the world as being dangerous to them.

  • Anonymous

    Maybe the Supreme Court was wrong all of those years for letting authoritarians  get away with using the interstate commerce clause to pass whatever laws they felt like. So basically, you don’t like bad precedent, but when they actually ignore bad precedent and make sound judgement against something you like you  like bad precedent again?

  • Lori

    Maybe the Supreme Court was wrong all of those years for letting authoritarians  get away with using the interstate commerce clause to pass whatever laws they felt like. So basically, you don’t like bad precedent, but when they actually ignore bad precedent and make sound
    judgement against something you like you  like bad precedent again? 

    This might be a good argument if it bore any relationship to reality, but it doesn’t. The Right wing of SCOTUS is not trying to correct “bad precedent”. This is ideological all the way. (You can tell because Scalia the supposedly brilliant legal scholar was quoting Right wing blogs, not legal reasoning.)

  • P J Evans

    The justices haven’t had to deal with insurance companies since they went on government payrolls – and most of them are millionaires who can afford to buy it if they weren’t already getting it. (Unlike most of the rest of us.)

  • Anonymous

    The justices haven’t had to deal with insurance companies since they went on government payrolls…

    Yeah, the situation would be funny if it weren’t so threatening to those of us who can’t afford insurance independently and can’t find a job right now to get insurance through an employer.

    Is it just me or has there been a concerted effort in the past year or so to take away human dignity from individuals in multiple areas? 

  • P J Evans

    Not just you: I keep wondering why people who hate government so much are so eager to be in government (and tearing it down).

  • Anonymous

    The mandate is wrong for one very simple, easy-to-understand reason: it criminalizes those too poor to get it. Don’t give me crap about the practicality of it, because it is wrong. It doesn’t help the poor, it only hurts the poor. If you want health insurgence for all, then pay for it. The mandate takes the poor and feeds it to the very bloated, corrupt, backwards, greedy, unfeeling machine that ground them under for years.

  • Dan Audy

     I’m firmly behind universal healthcare but even so I think the mandate is an improvement over what came before.  Sure it feeds the poor to a bloated, corrupt, backwards, greedy, unfeeling machine but it is a less bloated, corrupt, backwards, greedy, unfeeling machine than they were being fed to before and it is less punitive on the families of those with the audacity to get seriously ill.  I think it is terrible but I don’t think the US could do better at the moment.

  • Anonymous

    There are some times where the compromise is more insulting and outrageous than leaving the problem alone. Do the words “three-fifths of a person” ring a bell?

  • http://plantsarethestrangestpeople.blogspot.com/ mr_subjunctive

    I was under the impression that the federal government would be paying for all or some of one’s insurance costs, if one fell under certain income levels, so the poor would be subsidized by the rest of the public. This isn’t the case?

  • Anonymous

     I’ve heard murmurings of such, nothing very big, and it would be good if they offer that kind of an olive branch, but it is still a poor substitute for just paying for it outright.

  • http://www.facebook.com/people/Alan-Alexander/502988241 Alan Alexander

     The ACA subsidizes insurance purchases for people making up to 400% of the poverty rate. For an individual, that’s about $44k a  year. That’s not “the poor.”

  • Ursula L

    The ACA subsidizes insurance purchases for people making up to 400% of the poverty rate. For an individual, that’s about $44k a  year. That’s not “the poor.”

    Poor is relative.  
    As Fred pointed to in this link the other day – http://www.workingamerica.org/blog/2012/03/28/basics-out-of-reach-on-minimum-wage-paycheck/ – the premiums on a family health insurance plan are equal to what a full time worker making the federal minimum wage earns in a year.  That’s $7.25x40x52.  Or $15,080.  

    For someone making $44K a year, that’s over a quarter of their income. And they still have to pay for food, and housing, and clothing, and transportation and all the other necessities of life.  They also would have to pay copayments and other associated costs, in order to actually get the benefit of the health insurance they’re paying for. 

    The need for reform isn’t merely to help “the poor.”  It’s because even if you aren’t “poor” you’re likely not going to be able to afford health insurance and health care. 

  • Grogs

    Two things. First, you’re comparing the cost of a *family* health plan to the *individual* poverty rate. I don’t know what the poverty rate for a family of 4 is, but it’s probably at least 18K or so, making a $72,000/year cut off. Secondly, the penalty only applies if there is available insurance below x% of your AGI. Somebody quoted that x was 8% earlier, so if the minimum insurance available cost $15K, a family at 4X the poverty line wouldn’t be subject to the penalty.

  • Ursula L

    Two things. First, you’re comparing the cost of a *family* health plan to the *individual* poverty rate. I don’t know what the poverty rate for a family of 4 is, but it’s probably at least 18K or so, making a $72,000/year cut off. Secondly, the penalty only applies if there is available insurance below x% of your AGI. Somebody quoted that x was 8% earlier, so if the minimum insurance available cost $15K, a family at 4X the poverty line wouldn’t be subject to the penalty.

    And?
    Being taxed and evaluated for benefits at the individual rate doesn’t mean that you don’t want to have a family policy.

    For several years after we were out of college, my younger brother and I lived together.  I had a job that offered health insurance.  His job didn’t offer health insurance.

    We are, clearly, family.  And we were a household, the two of us living together.  I can’t think of any sane reason why a sister and brother, working and living together as family, shouldn’t have their situation be considered when deciding if they can buy an family health insurance policy.  

    I would have been willing to pay the family rate to keep him covered, if I had the option and could have afforded it.  And even if my eligibility for aide was evaluated as single coverage rather than family coverage.  

    This wasn’t just about getting him health insurance.  It was also about protecting my health.  Whenever he caught something contagious, I was put at risk, because he couldn’t see a doctor and get medicine.   So I had a greater chance of catching something contagious, missing work, and costing my health insurance company when I became sick because he couldn’t get treated.  

    Coverage for one’s family, one’s household, is important.  Whatever shape that family takes, and even if your benefit eligibility is “single.” 

  • Lori

    For several years after we were out of college, my younger brother and I lived together.  I had a job that offered health insurance.  His job didn’t offer health insurance.

    We are, clearly, family.  And we were a household, the two of us living together.  I can’t think of any sane reason why a sister and brother, working and living together as family, shouldn’t have their situation be considered when deciding if they can buy an family health insurance policy.

    I’m not sure what this has to do with the terms of the insurance mandate. Currently you can not put your brother on your family health insurance policy. Possibly you should be able to but you can’t, so I don’t see how it pertains to the rules for the mandate. In our current reality a single person is not going to be buying a family insurance policy. Changing the mandate rules will not change who can and can’t be covered on a family insurance policy. They’re separate issues.

    Coverage for one’s family, one’s household, is important.  Whatever
    shape that family takes, and even if your benefit eligibility is
    “single.”

    Even if the rules changed and you could put your brother on your insurance policy, you wouldn’t be a single person buying a family policy. You and your brother would be a 2 person family with 2 incomes and one insurance policy. You would be evaluated for the mandate based on your combined income in relation to the federal poverty level for 2 people and the cost of a 2 person insurance policy. I really don’t think there is any possibility that the rules will change such that people can be considered family for the purposes of buying insurance, but single for all other purposes.

  • Ursula L

    Even if the rules changed and you could put your brother on your insurance policy, you wouldn’t be a single person buying a family policy. You and your brother would be a 2 person family with 2 incomes and one insurance policy. You would be evaluated for the mandate based on your combined income in relation to the federal poverty level for 2 people and the cost of a 2 person insurance policy. I really don’t think there is any possibility that the rules will change such that people can be considered family for the purposes of buying insurance, but single for all other purposes. 

    Ideally, that would be the case.

    But whether or not they allowed me and my brother to be evaluated as a “family” for determining benefit eligibility, it doesn’t change the fact that I was in the market for a family plan.  A plan that covered me and my family, the people to whom I am related by blood or law, with whom I share a household.  

    Similarly, under DOMA, there are people who are legally married in their state, but who are considered single by the federal government when evaluating for federal benefits.  They’re in the market for a family plan, which they may be able to get under their state’s insurance laws, even if the federal government is calling them “single.”  

    The way the federal government evaluates your family status is different from what your family status actually is, and is not directly related to whether or not a family plan is what you want when buying health insurance. 

  • Lori

    But whether or not they allowed me and my brother to be evaluated as a “family” for determining benefit eligibility, it doesn’t change the fact that I was in the market for a family plan. A plan that covered me and my family, the people to whom I am related by blood or law, with whom I share a household.

    Similarly, under DOMA, there are people who are legally married in their state, but who are considered single by the federal government when evaluating for federal benefits. They’re in the market for a family plan, which they may be able to get under their state’s insurance laws, even if the federal government is calling them “single.”

    The way the federal government evaluates your family status is different from what your family status actually is, and is not directly related to whether or not a family plan is what you want when buying health insurance.

    I still don’t see what this has to do with the mandate rules. You were in the market for a product that doesn’t exist. Why is the mandate bad for not assuming that you are buying a product no one will sell to you?

  • Ursula L

    I still don’t see what this has to do with the mandate rules. You were in the market for a product that doesn’t exist. Why is the mandate bad for not assuming that you are buying a product no one will sell to you? 

    You’ve got it backwards – I support the health care reform, the mandate.  

    I was explaining part of the problem – I was living as part of a family household, and could neither buy insurance for my family household nor afford the family rates at what would be the cutoff for aide for a single person, since my family household wasn’t recognized as a family.  

    The new laws, including the mandate, solve the problem I had back then.  In the same situation, my brother would have his own insurance.  

    The closest we managed to get under the old system for sorting out insurance for my brother was to try to get my employer and my insurance company to recognize the obvious – that my brother and I are family.  

    It didn’t work.  But if we’d managed to convince them, I’d have been paying the family rate, while being taxed as single, and evaluated for any assistance as single.  

    Maybe someone else, somewhere, had better luck with their employers.

    But as long as the law defines “single” and “family” as it does, there are families where the individuals in the family are being evaluated as “single,” despite being a family.  That’s where DOMA comes into play – couples married under state law are being treated as single under federal law, which might screw them over with this reform.  Which is a reason to improve the reform and get rid of DOMA.  

    But it’s also reason to consider the cost of family coverage to some one labeled “single.”  There are families, who need family insurance, but who can’t afford it, because the individuals within the family are treated as “single”.  We currently have a system that refuses to recognize some families as families, makes it impossible to buy family insurance for some families, and where the price of family policies are beyond the reach of those families whose existence is overlooked and who are therefore being treated as “single.” 

    Getting the other so-called single people in those families access to insurance on their own is an improvement.  But it doesn’t change that the availability and price of family insurance is a problem even for people who are single.  Because siblings are family, married same-sex couples are family, etc. 

    Or, sing it with me “We are family…” 

  • Lori

     

    Maybe someone else, somewhere, had better luck with their employers.

    No one did. It’s not just about the employer, it’s also about the insurance company. There is no insurance company that sells family polices to cover adult siblings*. That coverage just does not exist and I don’t foresee any time in the future where it will exist. We’re more likely to get single payer than we are to get that.

    *The exception being if one of the siblings is in some way considered not competent and the other sibling is his/her legal guardian.

  • txredd

    Yes, the government will subsidize the cost of insurance based on income.  In no way is failure to carry insurance criminalized.  If you fail to carry insurance, you have to make a payment to the IRS.

  • Anonymous

     Yeah, you get a penalty. That’s punishment. That’s punishment for being too poor.

  • Don Gisselbeck

    Let’s remember the fundamental problem the predator class has with universal health care; that it is a key part of a civilized society allowing us untermenschen to live the good life, the life that is above our station.

  • http://blog.trenchcoatsoft.com Ross

    In the impossible fantasy world I’d rather live in than this world,  the court would determine that the individual mandate is indeed unconstitutional, but that the government is nonetheless _required_ to ensure healthcare to all its citizens, and therefore order the government to provide a public option.

    Sadly, Justice Scalia appears to be having his argument written for him by Fox, while Justice Thomas is, I believe this was established pretty thorroughly ahead of time,  on the take.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    Would it be too much to hope Scalia keels over and dies, like, in the next five minutes so Obama can appoint a better judge?

  • Anonymous

    “Would it be too much to hope Scalia keels over and dies, like, in the next five minutes so Obama can appoint a better judge?”

    Yes; because, as a U.S. Supreme Court Justice and government worker (Ooooooooh, the irony!), he’s entitled to some of the best medical care that money — *TAXPAYER* money! — can buy. I predict that he’ll live a long, fulfilling (for the Conservative value of “fulfilling” — i.e. reversing the New Deal, helping the rich get richer, comforting the comfortable and afflicting the afflicted, etc.) life. In fact, the way things are going, he may even have the dubious pleasure of outliving his Country.

  • Anonymous

    You know what’s weird is that I haven’t seen a whole lot of people talking about Clarence Thomas’s input.

    Ha! Ha! Just kidding.
    Of course Thomas hasn’t asked any questions, because he’s the shittiest judge of them all!

    (And in my impossible fantasy world, he’d be in a Guatemalan prison for the rest of his life.)

  • http://twitter.com/jclor jclor

    The judicial approach from the left seems to be that the restrictions of precedent are an obstacle to be overcome.  From the right, it’s an excuse not to do anything at all.  “Sure, we’d love for everyone to have healthcare in the richest nation on Earth, but you’ve got to understand—our hands are tied …”

    Are these naysaying ne’er-do-wells truly from the same nation that pulled the free world out of the ashes of a world war and put astronauts on the Moon?  I’d love to ask them when it suddenly became impossible for the country they fetishize to fix problems as meager as getting everyone in America appointments to see a doctor without going broke.

  • Anonymous

     I don’t get the arguing over precedent. It’s SCOTUS: it’s their job to set precedent.

  • Anonymous

    If the mandate is overturned, don’t blame the Supreme Court.  Blame Congress.

    Health care is not a unique market such that the only solution to the problem of the uninsured is to implement unprecedented mandate that requires every American resident to purchase a product from a private company.

    Congress could have chosen to implement universal health care.  Congress could have chosen to increase taxes to pay for universal health care.  The Democrats could have passed such a law and all of the evil Republicans would have been powerless to stop them.  Such a law would have been clearly constitutional, and despite the wailings of Republicans and Libertarians about the wisdom (or lack thereof) of passing the law, any lawsuit (which deals with the legality of the law) probably wouldn’t have even reached the Supreme Court.

    For political reasons the Democrats chose not to increase taxes to pay for a universal health care system.  For political reasons the Democrats chose to pass a health care law that depends on an unconstitutional insurance mandate.  If the mandate is correctly ruled unconstitutional, a century of legal precedent will not be overturned.  Rather, Congress will still have the opportunity to implement health care reform that aligns with the Constitution.

    Yes, I know.  I doubt many of you will want to listen to me.  You go ahead and blame the five conservatives on the Supreme Court.  Even blame the dastardly aunursa.  But know that your wrath is misdirected.

    Maybe you’ll listen to a former constitutional law professor:

    Both of us want to provide health care to all Americans. There’s a slight difference, and her plan is a good one. But, she mandates that everybody buy health care. She’d have the government force every individual to buy insurance and I don’t have such a mandate because I don’t think the problem is that people don’t want health insurance, it’s that they can’t afford it. So, I focus more on lowering costs. This is a modest difference. But, it’s one that she’s tried to elevate, arguing that because I don’t force people to buy health care that I’m not insuring everybody. Well, if things were that easy, I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t.

    Or maybe you’ll listen to a former Secretary of Labor:

    So if the individual mandate to buy private health insurance gets struck down by the Supreme Court or killed off by Congress, I’d recommend President Obama immediately propose what he should have proposed in the beginning — universal health care based on Medicare for all, financed by payroll taxes.

  • Baeraad

    Uhm… you appear to be under the impression that most people here hero-worships the Democratic Party. This is not an impression I have ever gotten. Here is the impression I have gotten:

    1) The Republicans are evil scum.

    2) The Democrats are supposed to oppose the Republicans. However, the Democrats are wussbags who fold over the moment the Republicans glare at them.

    So, yes, this could all have been avoided if the Democrats had acted with resolute liberalism instead of trying to appease the conservatives with the exact clause that the conservatives are now gleefully using against them. True. What’s your point?

    None of this, of course, changes the fact that Republicans are evil scum. And given the choice between blaming the bad guys for being bad, and blaming the good guys for being too ineffectual in fighting the bad guys, it’s not so strange that people choose the former.

  • Anonymous

    Whether or not you like or are disappointed with the Democrats and whether or not you think the Republicans are evil scum are not my concern.

    What’s your point?

    You got my point.  In fact you agree with my point.

    “this could all have been avoided if the Democrats had acted with resolute liberalism”

  • Baeraad

     But apparently you do think it’s your concern, since you stick your head in here and holler, “stop talking about how the Republicans are bad! None of this would have happened if the Democrats hadn’t been wusses!”

    You’re right – I agree with your point, such as it is, in that I think it is factually true (however, after reading the replies of people more knowledgable than me in USian politics, I am starting to think that I was mistaken – perhaps it was simply not possible to push through anything better than this bill). However, I completley fail to see why we should stop talking about how Republicans are evil shits just because Democrats are whimps. And I certainly fail to see why we should stop talking about how Republicans are evil shits because you don’t want to hear it. I mean, I don’t want to hear a single damn thing you say, you fucking excuse for a human being, but that hasn’t caused you to shut up so far.

  • Anonymous

    Feel free to talk about how Republicans are evil and Democrats are wimps.  (On conservative blogs, I read the opposite reaction from far-right commenters.)

    My point was not about whether or not Republicans are evil, or whether or not Democrats are wimps.  My point was that the Democrats are responsible for the fact that this law may be found unconstitutional.

    And if you don’t want to read a single thing I say, you’re welcome to ignore my comments.

  • Anonymous

    Wait, you’re saying “Republicans are evil scum” unironically? How’s the 8th grade going for you, buddy?

  • Anonymous

    Wait, you’re saying “Republicans are evil scum” unironically?

    You’re not? Republicans declared war on Iraq, a country that had never done anything to us except have a leader that our leader didn’t like. I’m not gonna say getting Saddam out of power was a bad thing, but killing all those Iraqi civilians, not to mention American and allied soldiers, in the process was sure as hell not a good thing. Oh, and Republicans authorized torture and other war crimes. On the domestic front, Republicans are standing between us and equal rights for women, people of color, gender and sexual minorities, people of nonChristian religions and no religion, people in or near poverty, people who will be in poverty the minute a medical crisis hits, and people who are comfortably off but still can’t afford to donate a million dollars to a political campaign. Oh, and making sure there’s a planet left for my grandchildren to live on. Not only are Republicans holding up our efforts to achieve equal rights for all people and environmental sustainability, they are actually trying to roll back previous gains toward that end. I won’t call the rank and file Republicans ‘evil scum’, or much of anything nasty. But the elected officials, and the leadership? Hell yes.

  • Anonymous

    Are you just being disingenuous on purpose?  “Congress could have chosen to implement universal health care”.  Really?  And how would they have accomplished this with conservatives (including conservative Democrats) who now believe that universal health care is a moral evil on par with Stalinism?

    Would you have supported universal health care?  How about the increase in tax to pay for it?

    I know it is now fashionable in conservative circles to pretend that the health insurance mandate was something that was first dreamed up by hippies at Woodstock, but the truth is the idea originated at conservative think tanks like the Heritage Foundation as the only way that the US could deal with its health care problems while avoiding the dreaded socialism.  Whatever one might think of the Heritage foundation and its works, it’s clear they do not see themselves as radicals who want to push the envelope on constitutional matters.  The health insurance mandate was tossed around in conservative circles for years and no one said a peep about its possible unconstitutionality.  Then the mandate is appropriated by a Democratic president and suddenly the unconstitutionality of the mandate is glaringly obvious.

    Universal health care based on Medicare for all?  Do conservatives support that now?  Last time I checked, conservatives believe the Medicare we have now should be abolished and replaced with vouchers.

  • Tonio

    Some commentators theorize that a Court decision against the mandate will bring us closer to having a single-payer system. I’m not so optimistic.

    I’m not surprised that opponents of ACA would dismiss an idea that originated with the Heritage Foundation. They couldn’t give a rat’s ass about think tanks. even conservative ones, because they equate such things with intellectual snobbery. This isn’t about political philosophy but about Obama and white privilege. Listen to the rhetoric that wrongly treats ACA as simply another welfare program, as if poor people were going to get free health care on the taxpayers’ dime. Listen to the Southern Strategy euphemisms like “freeloaders” and “welfare class.” Much of the opposition to the contraception coverage was framed the same way.

    It would be easy to say that Scalia knows better given his law education. But having such a degree doesn’t make one immune to fears over privilege. This is the same man who misinterprets government neutrality among various religions as hostility to all religion. If someone like Santorum ever becomes president, he and Scalia may become co-conspirators in undermining the separation of church and state.

  • Anonymous

     I think it would if Democrats turn around and rewin majority control of the House and Senate. Oh, and grow spines. Yeah, it’s not happening.

  • Anonymous

    And how would they have accomplished this with conservatives (including conservative Democrats) who now believe that universal health care is a moral evil on par with Stalinism?

    Democrats controlled 60 votes in the Senate and more than 250 seats in the House.  If the liberal Democrats had convinced their moderate allies to support a universal system funded by a tax increase, then they would have passed a law that aligns with the Constitution.

    Would you have supported universal health care?  How about the increase in tax to pay for it?

    To be honest, no.  I support different methods of health care reform.  Conservatives support different solutions.

    But my support or opposition would be irrelevant.  I didn’t control the Legislative or Executive branches that enact laws; the Democrats did.  This wouldn’t be an issue if congressional Democrats had chosen a constitutionally valid method.

  • Nathaniel

    If the health care law gets over turned and tens of thousands of people die due to lack of coverage, it’ll be because of politicians elected by people such as yourself and those who are afraid of you. You are the reason we can’t have single payer. Because of you we can’t have nice things.

    TLDR; Fuck off gas bag.

  • Anonymous

    Because of you we can’t have nice things.

    I like that.  I think I’ll take it as my new signature quote.

  • Brandi

    annursa: Dead-set on proving that in his family the good die young.

    (Hey, there’s already a chunk of commenters here who think I’m shit. Might as well be hanged for a sheep as a lamb.)

  • Nathaniel

     You like the thought of thousands of people dying due to lack health care? Cause that’s what the sentence was referring to. That’s part of “nice things.”

    Fuck off you ghoul.

  • Anonymous

    In consideration of past responses you have made to my questions, aunursa, I would respectfully suggest that this is something you should reconsider being proud of having applied to you.  Those ‘nice things’ are health care in this case.  Those ‘nice things’ are things that will let my nephew live to see 30 without being bankrupted.  Those ‘nice things’ are what will allow Lliira to live an active life again.

    I am uncomfortable with the mandate, but at this time I know it is the only bipartisan compromise that would have passed — and make no mistake, it was a compromise.  The Progressive goal of universal health care was not even put on the table when this started.  A universal “public option” was shot down by “blue dog” Democrats and Republicans alike.  The mandate WAS the compromise, simply because it was proposed by a Republican governor, and it, generally, worked.

    I don’t like the fact that it requires purchasing insurance from a murderous private industry that has a profit motive to provide as little service as it can.  I would be much happier with universal health care, or even just a public option for all.  But that was compromised away.

    The last plan completely conservative health care reform plan I heard was… muddied.  It was Romney saying ‘Well, of course we need to do something about it.’  But no plan.  No proposal.  McConnell has said in fact said that he’ll overturn the ACA without any replacement plan.  The last time I asked a libertarian what should be done for cases like my nephew, the response was “Charitable donations.”

    I, too, believe that at this juncture the only way we can achieve some sort of lasting, or even a first step in, health care reform is bipartisan.  When a quarter of the country identifies as liberal and a quarter of the country identifies as conservative, we have to start somewhere.  But universal health care is where the left is starting from.  Where is the right starting from?

  • Anonymous

    I agree that that the only way to achieve lasting health care reform is via a bipartisan effort.

    With all due respect, the “nice things” does not refer to health care.  I did not prevent you from having “nice things.”  I did not prevent Congress from passing legislation that would have given tens of thousands of people health care.  The Republicans did not prevent Congress from passing legislation that would give tens of thousands of people health care.  The Democrats could have passed single-payer legislation that would have given your nephew and tens of thousands of others health care regardless of what the Republicans or aunursa did.  If the law that was passed is struck down because of an unconstitutional mandate, the Democrats still can pass legislation that would provide health care for your nephew and tens of thousands of others — once they decide to work with their Republican colleagues to achieve bipartisan reform.

  • P J Evans

     Bweckwit.
    The REPUBLICANS are the ones who are refusing to be bipartisan. At every possible occasion when it would help average people, they refuse. When it comes to helping millionaires and corporations to become even richer, however, they’re always ready to vote yes.

  • Anonymous

    When a quarter of the country identifies as liberal and a quarter of the country identifies as conservative, we have to start somewhere.  But universal health care is where the left is starting from.  Where is the right starting from?

    According to those who are in the know, market-based solutions.

  • Anonymous

    Please just stop. Nobody really believes that you’re as dense and unreachable as you act like you are. And we’re tired of calling you out on it. You come here, provide your barely factual challenges, don’t honestly listen to anything said in reply, and then act like you came out the winner.

    Go find a blog of like-minded people. You’re not changing anyone’s mind here. 

  • Anonymous

    I do participate at blogs of like-minded people. 

    I also participate at blogs of un-like-minded people.

    All of you were shocked at the train-wreck* because you live in your echo chamber and rarely venture outside.  You don’t want to acknowledge contrary intellectual opinions.  If you did venture outside and browsed conservative legal blogs, you would have recognized that arguments presented this week against the mandate were introduced, developed, criticized, and refined over the past 2 1/2 years at blogs such as The Volokh Conspiracy.  In fact, it certainly would have been beneficial for the administration’s legal team to have read such blogs.  They wouldn’t have been blindsided by the questions they encountered this week, and their responses wouldn’t have been so incoherent.

    By the way, I rarely if ever claim to * win * an argument here.  If that were my primary purpose, then I wouldn’t participate in a blog where the deck is so stacked against me.  All you can say is that I’m not changing your mind here.  As long as our host reviews the Left Behind series allows me to participate, I will return.

    * According to CNN’s legal analyst Jeffrey Toobin.  Toobin originally predicated that the mandate’s constitutionality was a slam-dunk.  After the Tuesday session, he called the legal arguments “a train wreck for the Obama Administration.  He added, “This law looks like it’s going to be struck down. I’m telling you, all of the predictions including mine that the justices would not have a problem with this law were wrong.”

  • Lori

    All of you were shocked at the train-wreck* because you live in your echo chamber and rarely venture outside. 

    Unless you’ve figured out a way to remotely install spyware you know shit about what we do or do not read.

     

    You don’t want to acknowledge contrary intellectual opinions.  

    For someone living in a glass house you sure are throwing a mighty big stone. The fact that you hang out here doesn’t mean that you’re acknowledging contrary intellectual opinions. Outside the LB threads the vast majority of the time you do no such thing. You just toss out poll numbers and poorly thought out talking points and then either run away or repeat yourself while patting yourself on the back. None of that constitutes meaningful intellectual engagement.

  • Tonio

    Yet another rant accusing Democrats of hypocrisy. As someone who doesn’t belong to a political party and doesn’t consider himself either a liberal or conservative, I urge you to drop this nonsense. The mandate was originally a conservative idea and it’s obvious that Democrats offered it as an attempt at compromise, since Republicans were opposed a single-payer plan. If they had come out pushing single-payer from the outset, the cries of “Socialism!” would have been far louder than anything we have heard to date, and reform would have been doomed for at least another generation.

  • http://lliira.dreamwidth.org/ Lliira

    I was uninsured when I threw out my back. My life is, at the moment, destroyed because of this and because I live in the United States, rather than a sane country.

    Aunursa, because of you and people like you, I am in excruciating physical pain every day of my life.Because of this pain, I am unable to work in order to get the health insurance that would get me the surgery that would stop the pain.Because of you and people like you, I am unable to get Medicaid because, in my state, I have to be declared officially disabled to get Medicaid. The disability people have said that while it’s true I cannot have any job like a job I have had before, it is theoretically possible that I could perhaps have some kind of job, like writing on the internet for an hour a week. Which only an insane system would claim was a job that could realistically provide for anyone. No lawyer in the state will take my case because it is not winnable because I am only 35, and the state will do anything to keep from paying disability to someone as young as I am, fearing they’d have to pay for 50 years. I don’t give a damn about disability, I’m lucky enough to have family that can keep a roof over my head, but I need Medicaid for this $30,000+ operation. But I can’t have Medicaid without disability because our country is broken. I had the bad luck to be born with a genetically weak back — my aunt threw out her back at the same age I did, my mother has back pain all the time, and my grandfather had back problems his whole life. I didn’t do enough flexibility exercises. I didn’t always bend my knees when I bent to pick stuff up. I was in college full time, and uninsured. My family is not rich.

    For these grievous sins, I am tortured every day. I never know when the pain will be like it is today, like someone is slowly twisting and untwisting my spine, which they have filled with glass shards, and I start to wonder if it’s even worth going on living. 

    And if medicine had no way out of this, and if we lived in a society which treated disabled people like people, I would work very, very hard to find silver linings. To be philosophical. But if I lived in one of the many, many countries which recognized that health care is a basic human right, I would not be in this situation. And people in my country, people with whom you side, aunursa, tell me that it was my own fault that I did not have health insurance and so I should just get used to being in horrible pain for the rest of my life.

    If I lived in one of those countries with universal health care, I could be a productive member of society. Even in the countries which would bar me from employment and other basic rights because I am a woman, I could cook and clean and bathe every day

    The mandate which you are hoping will be overturned would get me on Medicaid in 2014. Two years more — an end in sight. My one real hope for life as a free, productive woman who is not in excruciating pain all the time is that mandate. And you and your buddies want it gone.

    Republicans don’t want me to be a productive member of society. I can’t leave my house, work, or even do housework. I can’t pay taxes. I am a drain on my parents’ income, a drain on their retirement funds and on any expendable income they might have otherwise chosen to use to buy stuff and stimulate the economy. My situation doesn’t only hurt me; it hurts the economy and the country. 

    Republicans are working to keep me in pain and not working. Aunursa, you and your buddies are hurting me. And you expect to be treated with anything but contempt? I’m not Jesus — I don’t forgive people while they’re torturing me. 

  • Anonymous

    I am sincerely sorry to learn that you are in such pain.

    I wish that Congress had chosen wiser and constitutionally-valid methods to improve the health care system for your benefit.

  • Anonymous

    The way Democrats had to fight and pull teeth with Republicans on a health care plan that was mostly their idea to begin with, do you really believe that a single payer system would have had a snowball’s chance in hell?  

    Hypothetical Republican Congressperson:  A plan of universal health care that largely benefits the poor and middle class that is paid for by a tax increase?  Sure!  I know it defies everything I’ve ever said about how private industry is always the solution to all problems, but I’m just feeling generous today!
    Get real aunursa.  This mandate was the best chance this country had to finally make some positive changes in the woeful healthcare situation in this country, and the right wing is using their Supreme Court sock puppets to liken it to forced broccoli feedings.  Your political philosophy is sad and contemptible, and the lack of empathy you show for the people suffering in this nation speaks volumes.  I hope you are happy that your political party has staked the decks so thoroughly that this nation is unlikely to ever again improve upon the standard of living of its average citizens.  What a wonderful world you’ve helped to make.

  • Anonymous

    No, I don’t believe that single payer system would pass this Congress.  But I don’t believe that it would be a wise law.

    Instead of forcing through a partisan measure that affects 1/6 of the national economy, Democrats will have to work with Republicans to effect bipartisan health care reform that a majority of Americans can support.  Democrats and Republicans working together to improve the health care system — I believe that can happen and will happen.

  • Tonio

    The reason that the mandate should be constitutional is the same reason
    that the driver’s insurance mandate is constitutional. Insurance is
    about spreading risk so that no members are left destitute by
    catastrophic illness. Under our current system, people who do have insurance already shoulder the health costs for people who don’t.

    Now, instead of the mandate, I would have preferred either a single-payer system, or low-interest loans to start non-profit membership corporations for insurance. The reason for the latter is that insurance should not be a for-profit enterprise – the only way that shareholders can benefit is if the company raises premiums or cuts benefits.

    So if you oppose the mandate AND single-payer AND Medicare for all, what’s left? Just the current system where both policyholders and providers are screwed while a relative wealthy shareholders grow wealthier.

  • Anonymous

    The auto insurance requirement is constitutional because (1) it’s a state mandate not a federal one.  It is also distinguished from the health care mandate because (2) only those who own or drive a car on public roads are required to carry insurance.  One can avoid the mandate by not owning or driving a car that is used on public roads, and (3) the requirement covers liability insurance to protect third parties who may suffer (physical and/or financial) injury as a result of the insured’s actions.

  • Anonymous

    The auto insurance requirement is constitutional because (1) it’s a
    state mandate not a federal one.  It is also distinguished from the
    health care mandate because (2) only those who own or drive a car on
    public roads are required to carry insurance.  One can avoid the mandate
    by not owning or driving a car that is used on public roads, and (3)
    the requirement covers liability insurance to protect third parties who
    may suffer (physical and/or financial) injury as a result of the
    insured’s actions.

    (1) How is state vs federal relevant?

    (2) Only those who do things that might lead to needing auto insurance are required to carry auto insurance. Ditto health insurance. It’s hardly our fault that ‘those who do things that might lead to needing health insurance’ is a longer way to say ‘everybody’.

    (3) Huh?

  • http://www.facebook.com/people/Charity-Brighton/100002974813787 Charity Brighton

    (1) How is state vs federal relevant?

    The whole issue before the Supreme Court is whether or not the mandate falls under some version of Congress’s enumerated powers or generally-accepted implied powers. If not it, then only a state government would have the authority to require it. 

    (3) Huh?

    The states that I’ve lived in only require you to carry third-party liability insurance, to protect the other driver in case you cause an accident. If you want, you can choose to only carry that level of coverage and take care of any damage to you/your vehicle yourself.

  • P J Evans

    You can avoid the auto insurance mandate by not owning a car.
    You can’t avoid being sick or needing surgery except by being dead.

    FAIL.

  • http://www.facebook.com/people/Charity-Brighton/100002974813787 Charity Brighton

     

    Instead of forcing through a partisan measure that affects 1/6 of the
    national economy, Democrats will have to work with Republicans to
    effect bipartisan health care reform that a majority of Americans can
    support.  Democrats and Republicans working together to improve the
    health care system — I believe that can happen and will happen.

    Can you describe what something like that would look like? Because as far as I can tell, we started with the conservative position, and they still rejected it out of hand. What alternatives did Republicans propose during the last debate that would have achieved the same level of coverage? (That’s not a rhetorical question — I really do want to hear what their suggestions were, and why they abandoned the individual mandate idea after they campaigned hard for it during the Clinton era health care debate.)

  • Anonymous

    Republican proposals have included ideas such as
    * health savings accounts
    * refundable tax credits ($2300/person, $5700/family)
    * additional $5000 for low-income citizens
    * reducing medical costs through caps on non-economic awards in medical malpractice cases
    * allowing consumers to purchase policies from out of state carriers
    * various incentives to states to reduce premium costs
    * a safety net that guarantees access for those with pre-existing conditions

  • Tonio

    Those ideas would do a very minor amount of good, but ultimately they’re (ahem) Band-Aid approaches. They do nothing to change the basic nature of the current system. They are based in the incorrect assumption that health care works like any other market driven by consumer choice. But no one can opt out of being sick, so the for-profit insurers hold all the power. Money to help the people at the bottom doesn’t change the fact that the wealthy aren’t participating and thus aren’t sharing the risk.

    One flaw in capping malpractice awards is that the profession needs to do a better job of weeding out the bad practitioners – in my state, a tiny percentage of doctors is responsible for perhaps half of the claims, as they go from community to community leaving a trail of malpractice. But the big flaw is that these essentially protect the wealthy at the expense of the non-wealthy. Those awards have far less to do with health care costs than the simple fact that shareholders are making money in an endeavor that isn’t supposed to be about making money.

    Of course one can avoid the mandate for driver’s insurance by not driving. But being sick is unavoidable no matter what type of healthy lifestyle one lives. That’s the reason for the health insurance mandate, because wealthy people who don’t buy insurance aren’t contributing to spread the risk more evenly. If our current approach to health care were used in education and national defense, there would be no public schooling, only schools for those who could afford the tuition, and the only militaries would be private ones.

    The point is that wealth shouldn’t determine what level and quality of health care one receives, and the measures you propose do nothing toward that goal.

  • Tonio

    But the big flaw is that these essentially protect the wealthy at the expense of the non-wealthy.

    To clarify, that’s quote accurate in all cases. A more precise definition of the flaw is that the effect is protecting the people with more power at the expense of those with less power.

  • Anonymous

    Republican proposals have included ideas such as
    * a safety net that guarantees access for those with pre-existing conditions

    Isn’t that one of the things that goes byebye if the ACA is struck down?

  • Lori

    Instead of forcing through a partisan measure that affects 1/6 of the national economy, Democrats will have to work with Republicans to effect bipartisan health care reform that a majority of Americans can
    support.

    You mistyped. That’s supposed to read “forcing it down our throats”. They’re going to take away your talking point regurgitation badge.

    These two things can not both be true.

    -The structure of the bill is all the Dems fault because they supposedly had 60 votes and should have just passed a different bill

    -The Dems should not “force through” anything the Republicans don’t like. They must instead be bipartisan, even when the Republicans’ entire goal is to oppose anything the Democrats try to do.

    Also, the idea that the national legislative body should not be legislating something because it it effects a large chunk of the national economy is a fairly ridiculous notion to anyone capable of any thought on issues that goes beyond “states’ rights” rhetoric.

  • Tonio

    Yes, the whole “forcing through” argument doesn’t make sense. It wrongly implies that advocates didn’t want single-payer because they were attracted to the mandate as a naked power grab. Taking power from whom? It benefits insurers will benefit by having more customers. It’s the same mentality that fights any kind of business regulation as a power grab, as though the government were simply a competitor trying for unfair advantage.

  • Tonio

    Uh, I mean that “insurers will benefit by having more customers.”

  • Anonymous

    Well, yes, they can both be true.

    The Democrats should have passed a bill that conforms to the Constitution.  If they have 60 votes in the Senate and 250+ votes in the House, they control the structure of the bill.

    And while they are entirely responsible for the structure of the bill, the Democrats should have instead worked with Republicans, especially on legislation that has such a huge effect on all Americans.*  If the Republicans win control of both houses of Congress this November, I would say the same thing; they should work together with the Democrats.  The Democrats and Republicans should work together to achieve bipartisan legislation that will be accepted and welcomed by more Americans rather than either party force through its own agenda.

    I did not say, as you implied, that the legislature should not enact a law that affects a large chunk of the national economy.  What I said was that the legislature should enact a partisan law that affects a large chunk of the national economy. Rather, such massive legislation should be enacted by both sides working together — that’s what politics is about, after all.

    * Among many reasons, it makes both parties responsible.  One of the reasons that the GOP achieved such gains in the 2010 congressional election is that Republican and independent voters recognized that the Democrats bore complete responsibility for the PPACA.

  • Lori

    The Democrats should have passed a bill that conforms to the Constitution.  If they have 60 votes in the Senate and 250+ votes in the House, they control the structure of the bill.

    Saying that the Dems need 60 vote to pass a bill in the same sentence in which you chide them for not conforming to (the Right wing interpretation of) the Constitution is pretty rich.

    If the Republicans win control of both houses of Congress this November, I would say the same thing; they should work together with the
    Democrats. 

    I find this rather difficult to believe coming from someone who converted to the Conservative cause during the reign of Bush 43.

    Among many reasons, it makes both parties responsible.  

    Not to put too fine a point on it, Bullshit. The GOP never takes responsibility for anything and it has Fox News acting as its propaganda arm to make sure that the rules are always IOKIYAR and It’s Always the Liberal’s Fault.

    One of the reasons that the GOP achieved such gains in the 2010 congressional election is that Republican and independent voters recognized that the Democrats bore complete responsibility for the PPACA.

    No, the GOP achieved such gains in the 2010 congressional election because there was a black man in the White House.

  • Lori

     

    What I said was that the legislature should enact a partisan law
    that affects a large chunk of the national economy. Rather, such
    massive legislation should be enacted by both sides working together —
    that’s what politics is about, after all. 

    Again, it is very difficult to believe that someone who went Conservative during the Bush 43 years actually believes that the parties have to work together for laws to be legitimate. Every time you talk about the necessity of bipartisanship you demonstrate that you’re not being intellectually honest. No honest look at the last several decades of American politics can cast the GOP as the party of meaningful bipartisanship.

    You may have forgotten this because it took place prior to your fear-induced conversion, but after Bush was handed the White House by a partisan SCOTUS decision the GOP pushed through a partisan tax cut focusing on the wealthy (that continues to negatively effect the entire county). When asked about the fact that so many Dems hated the bill Dick Chenay’s response was that he didn’t care what they thought about it. Winners make the law and elections matter. Bush won and passing the tax bill they wanted was their “due”.

    If you’re supporting the GOP you’re supporting the party of “When we win, you do what we say because we won. When you win, you still have to do what we say because bipartisanship, that’s why”. That’s total bullshit.

  • http://www.facebook.com/people/Alan-Alexander/502988241 Alan Alexander

    No Republican will ever support Health Care reform in any fashion. Mitch McConnell has already announced that if the ACA is struck down or repealed, the GOP will not even attempt to replace with anything at all. Because the GOP honestly believes that anyone making less than $250K a year is subhuman and deserves to die. That is what the GOP believes. That is what you believe.

  • Anonymous

    the GOP honestly believes that anyone making less than $250K a year is subhuman and deserves to die. That is what the GOP believes. That is what you believe.

    Please do not attempt to put words in my mouth or beliefs in my mind.  You are not in a position to state what I do or do not believe.

  • Lori

     

    You are not in a position to state what I do or do not believe.

    Right back at ya.

  • Tricksterson

    Obama tried that, the Republicans weren’t playing.  The truth is that the Obama health plan as passed was a Republican one.  What parts weren’t lifted from Romneycare had been proposed years ago by socialist radicals like Bob Dole and Bush Sr.  This btw, I got not from a leftist blog but from David Frum, a former editor of national Review before it, like most of the rest of the right lost it’s marbles.

  • Anonymous

    Remember how you had a chortle over me being ‘literally incoherent’ or some such when you pulled this lie a while back, shithead? I wasn’t just angry at you for the usual stuff. To watch the President reach out, again and again, for nearly four years now, to a pack of rabid fucking animals who kept biting that hand over, and over, and over…

    Negotiation is only possible with the absence of bad faith. Your entire movement has been a work of genius on the subject of demonstrating what bad fucking faith means when taken in the context of national politics.

    The President tried way too hard because he still had faith in the humanity of conservatives and especially the leadership of your movement, an error that I (and vast swaths of liberals) can only hope he corrects in his second term.

  • Anonymous

    I think I remember that.  I seem to recall your response was something like, “After reading your comment I am literally speechless with rage.”

    On the one hand, if you are so deluded that you really believe that President Obama acts in a bipartisan manner, seeking to craft legislation with Republican contributions, then you most of all need to escape the echo chamber and venture out into the world of politics beyond your comfort zone.

    On the other hand, given your anger management problem, perhaps it’s best that you stay home where you are not a danger to yourself or others.  Preferably in a room with padded walls.

  • P J Evans

    So we have the Republicans in the House proposing to kill Medicare, because it’s supposedly less expensive to force all the people who are elderly to buy insurance that won’t be affordable and won’t cover what they need covered.

    Thanks for nothing, GOP: you’re trying to destroy the country as well as the government. Explain why we shouldn’t call it treason?

  • http://www.facebook.com/people/Charity-Brighton/100002974813787 Charity Brighton

     

    So we have the Republicans in the House proposing to kill Medicare,
    because it’s supposedly less expensive to force all the people who are
    elderly to buy insurance that won’t be affordable and won’t cover what
    they need covered.

    Well, it would be less expensive for the government, in the sense that it would have to pay for the externalities of people going without health care indirectly rather than pay for the coverage. Mitt Romney made a brilliant point on this a while back when he was

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    Ironically, you can thank conservative icon Ronald Reagan for that
    situation. Reagan’s 1986 Emergency Medical Treatment and Active Labor
    Act is what prohibits hospitals from turning away patients who don’t
    have health insurance.

    As that scene from Sicko shows, though, what it means is that they just get dinged for it later, or if they absolutely can’t pay, get shoved out the door ASAP and they’re on their own for calling a taxi.

  • Anonymous

    Why increase taxes? They could pay for it by gutting that financial black hole called the military.

  • P J Evans

    All they have to do is let Bush’s tax cuts expire. All that takes is not doing anything to extend them.

  • Anonymous

    Should do that anyway, since it’s becoming one of, if not the, big contributer to the deficit.

  • Anonymous

    Oh and in case anyone’s wondering, conservatives bloggers and legal analysts are hopefully optimistic, but most definitely not celebrating (yet).  Because we all know that despite the oral argument circus, the Court could surprise everyone and uphold the mandate.  It all depends on the result of Justice Kennedy’s coin flip.

  • Anonymous

     As Charlie Pierce says… it all depends on where the roulette wheel in Anthony Kennedy’s mind stops.
    But how unprecedented is the individual mandate? It’s essentially the Republican alternative to Hillarycare from the 90’s… means tested fairly well by the Governor of Massachusetts… who was that guy?

  • Anonymous

    But how unprecedented is the individual mandate? It’s essentially the Republican alternative to Hillarycare from the 90’s… means tested fairly well by the Governor of Massachusetts… who was that guy?

    Correct.  If the law is overturned, then Romney comes out the big winner.  He can point to Massachusetts and say that he enacted health care reform on a constitutionally-valid state-wide basis. And overturning the law would effectively neutralize his greatest weakness among conservative voters.

    Aside from the Tenth Amendment limitation, one difference between a statewide mandate and a national mandate is that it’s much easier for Bay State residents who oppose a mandate to relocate to a non-mandate state than it is for Americans who oppose a mandate to move to a different country.

  • Anonymous

    Oh and in case anyone’s wondering, conservatives bloggers and legal analysts are hopefully optimistic, but most definitely not celebrating (yet).

    You do realise, don’t you, that if the law is struck down as you and your blogger buddies hope, the people who have already been helped by the ACA are going to experience  a lot of anxiety and hardship?

    But hey, party on, dude.

  • http://www.linkmeister.com/wordpress/ Linkmeister

    They sure don’t have a problem giving government a pass when it shares private medical info with another Federal department. “Sucks to be you,” Alito said in his majority opinion, but you’re not entitled to damages just because SSA told FAA you were HIV positive when FAA was trying to determine if you were healthy enough to keep your pilot’s license. It then publicized your HIV status in a press release, thereby telling your friends and family you had the virus, which you’d been keeping private.

  • http://twitter.com/FearlessSon FearlessSon

    I kind of wish that they would have me arrested for lack of insurance.  I would love to have it, but my income is exactly zero, and what money I do have I need in order to put food on my table.  Those times when my income goes up are sporadic, lasting one year at most, often only a few months or just one, and prone to end without warning.  Continuous payment is not something that I can reasonably afford.  What medical expenses I cannot avoid I have to pay out of pocket.  I had a five-hundred dollar dentist bill a couple weeks ago as a matter of fact, because I did not have the insurance to cover more frequent preventative care. 

    A low-cost government option would have been even better.  I do not care how long I have to queue to see a physician, better that than be unable to afford to see one at all. 

  • Tonio

    From the Mark Thoma piece: “since we do not want people financially ruined or unable to get care when they are struck with a costly health problem…” Six months ago, I might have said that even Tea Partyers supported the basic premise and simply objected to compulsory taxes to pay for it. But after the cheering and booing at the GOP debates, even that theory is far too charitable for them. Maybe it’s more than just possessiveness about privilege or material things, it may be a watered-down version of the survivalist mentality. A core belief that life is a competition and that the danger of being absolutely powerless lurks around every corner.

    But what undermines my theory is that the Tea Partyers don’t act fearful. Their anger is palpable, as if they see themselves as truant officers dealing with juvenile delinquents. It’s the complete opposite of timidity.

  • Charles Matthew Smit

    I was a canvasser and community organizer working to pass the Affordable Care Act — so while I strongly support the law in general,  the individual mandate is a terrible idea.  It’s not about policy or the larger ramifications or whatever.

    It’s simply that I cannot, at the wage I make, afford insurance.  Not at all.  Not any insurance.  Not even MinnesotaCare, one of the best and least expensive insurance-for-poor-people deals out there, from what I’ve seen. 

    And I’m not that poor.  Never missed a month’s rent, haven’t spent one day hungry and unable to eat in the last decade.  I’m poor, but most poor people in the U.S. are  worse off than me.  So I’m going to guess they can’t pay either.  And like so many other things, the individual mandate is going to make us pay for our inability to pay.  As always, the more money you have, the less things cost.

    So however tone-deaf and idiotic the Supreme Court is (and I’m going to go with VERY), I will still be pleased if they repeal the mandate. I need insurance coverage– not another fine because I can’t afford insurance.

  • Anonymous

    I sympathize with Roberts and Kennedy here. Accepting the individual mandate at face value is essentially giving up on limits to the Commerce Clause at all, doing an end run around the Constitution to give the federal government broad powers over anything that costs anyone money. This is why there are all these questions about a unique market, etc. – it’s an attempt to find the mandate constitutional on as narrow grounds as possible, so they can uphold the near-contradictory commerce clause precedents of the last few years.

    Now, I’m not saying anything about whether the ACA is desirable because the Roberts Court never thinks about that anyway. (See: Citizens United.) Similarly, universal health care would be perfectly constitutional and a much better idea, but we’re not getting that any time soon. I do blame Congress for not including a severability clause in the ACA. They knew this was coming and specifically decided to gamble all of health care reform on this one case.

  • Tricksterson

    It doesn’t really matter what Scalia or Alito says.  They, Thomas and probably Roberts made up their minds long before the case ever came to court as, to be fair, have Greenberg, Breyer and probably Kagan and Sotamayor.  The only one we should be paying attention to is Kennedy.  Also, keep in mind, or at least this is the way it’s seemed to me that the judges often like to play devil’s advocate, especially Kennedy, and often ask questions that would seem to put them on the opposite side from how they eventually vote.

  • ChrisH

    I think this falls into Fred’s “Ideology Makes You Stupid” theory, Scalia especially.  How else does one explain a magna cum laude from Harvard referencing Jack Bauer in one of his decisions?

  • Anonymous

    Okay, two things.

    Thing one:

    To people complaining about the mandate because they can’t afford it:  If you makes less than $80,000 a year (and most of the people here probably do) you are (or… you were going to) get subsidized premiums.  If you make less than $30,000 a year – welcome to Medicaid!  If you make less than $90,000 a year, can’t find insurance for less than 8% of your AGI you’re not subject to the mandate.  If you make less than $90,000 a year and CAN (say you find it at 6%) the penalty is a maximum of 2.5% of AGI (right now – I’m not sure what it eventually goes up to) (I bet you can do the math.)

    Basically, the only people who are going to find that they have a significant increase in costs are people making more than $90,000 a year who are not carrying insurance.

    That helps pays for the care you’re guaranteed to receive at the hospital.  In terms of government solutions, it’s really not that bad.

    Thing two:

    I don’t understand why we’re not arguing about insurance as a type of liquidity hedge.  Frankly, medical expenses are the only expense you’re likely to encounter that are almost guaranteed to be beyond your available liquidity.  We required banks to have a certain amount of liquidity so that they can pay a bunch of deposits in the event of a catastrophe.  Why can’t we do the same for people.  Since the federal government checking your bank account every day to make sure you have $2 million dollars or so in there is ludicrous, impossible, and intrusive – the least intrusive way to require a certain amount of liquidity for catastrophes is to require that you carry health insurance.  The government can’t make you buy a cell phone or broccoli or anything else, because it’s not going to be financial disaster for other people if you can’t afford your broccoli or cell phones a couple of times.

  • LL

    Yeah, hearing/reading some of the comments from the allegedly brilliant members of the U.S. Supreme Court is like hearing/reading the brilliant commentary on most website comment threads. Not exactly awe-inspiring. 

    The comparison of healthcare to broccoli … (shakes head). 

  • Lori

    Yeah,
    hearing/reading some of the comments from the allegedly brilliant
    members of the U.S. Supreme Court is like hearing/reading the brilliant
    commentary on most website comment threads. Not exactly awe-inspiring. 

     

    I would like to think that this case will finally end Scalia’s wholly undeserved reputation as a great legal mind. Sadly, I’m not holding my breath.

  • Anonymous

    Unfortunately, if Scalia defending torture couldn’t, I can’t imagine this will.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    At every step the Republicans seem determined to simply throw roadblock after roadblock in the way of health care reform.

    You know all that whining about welfare Republicans do about those zomg single mothers?

    And how omg they won’t get joooooooooobs?

    News flash: It’s been worked out that if single-payer health insurance were in place, the welfare rolls would drop at least by 25%.

    That’s right, that socialist idea, single-payer, would cut welfare costs!

    Guess what got shot down by the Republicans so well the Dems took it off the table before they even got started.

    Could it be

    single-payer health insurance?

    DING DING DING DING.

    In short, I do not believe any Republican is sincere about meaningful health care reform no matter how much he or she mouths the old bromides about bipartisan anything.

  • Tonio

    And that’s why, if I was ever of a mind to join a political party, it wouldn’t be the GOP. Whatever agenda it may have had has devolved into simple preservation of privilege based on wealth and personal characteristics.

  • Anonymous

    News flash: It’s been worked out that if single-payer health insurance
    were in place, the welfare rolls would drop at least by 25%.

    have you got a reference for this, Neutrino?

    Not that I have any trouble believing it – it seems pretty clear that all it takes is a couple of unlucky breaks with health and insurance and you’ve gone from being moderately well-off to impoverished and in some kind of hideous catch-22 situation *and* still have an on-going health issue with the American health-care ‘model’.  It’d just be nice to see (and be able to cite) the analysis :]

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    I’m pretty sure James Carville wrote it in his book “We’re Right, They’re Wrong”, back in 1996. I’ve got the book, I’ll pull it out and find the exact page number if need be. :)

  • Anonymous

    If you did venture outside and browsed conservative legal blogs, you would have recognized that arguments presented this week against the mandate were introduced, developed, criticized, and refined over the past 2 1/2 years at blogs such as The Volokh Conspiracy.

    Wait, you’re pointing to a person who would LITERALLY (and I mean that literally) rather see the world destroyed than taxes raised or government infringe on your “freedom”, as an authority on this subject.

    I think you need professional help.

  • Anonymous

    The Volokh Conspiracy is not an individual blog, but a group blog of law professors who offer a variety of opinions on primarily legal issues.  The fact that you might consider some of the ideas explored there to be insane does not change the fact that (1) the contributors are widely influential in the legal world, and (2) the administration’s lawyers would have been much better prepared this week if they had read some of the anti-mandate arguments posted on the VC over the past 2 years — rather than simply assume that they had a slam dunk 8-1 case.

  • Anonymous

    The fact that you might consider some of the ideas explored there to be
    insane does not change the fact that

    I’m sorry, but that’s not an issue “explored” that was Sasha Volokh actual opinion.  And it is not my “consideration” that that is insane, it’s an objective fact.

    So, in the spirit of not just dousing you with insults and my opinion of your self-justifying amorality, I’ll concede that SG Virelli hit a bunch low and away pitches right to the first baseman — but the government legal team doesn’t need to read the unhinged rantings of a bunch of rationalizing libertarian ghouls to be able to cogently defend a perfectly reasonable law.  They probably didn’t expect to have to re-argue 70 years of precedent, or to have defend something so ethically self-evident as “we shouldn’t allow the less-than-filthy-rich to die in the street for the crime of poor liquidity management.”

    But – you know what you’ve basically supplied everything I need to know about everybody.  Man is not a rational animal, he is a rationalizing animal – because of what happened at Volokh.   Basically, they all thought (for years) that the mandate was constitutional (particularly Adler and Ilya Solmin) then suddenly, a DEMOCRAT passes it and it becomes the worst thing done to the citizenry since we were all burdened with the evil income tax.

    So fuck them.  They’re good at justifying their own opinions, but that’s what they’re doing.

  • http://www.facebook.com/people/Charity-Brighton/100002974813787 Charity Brighton

    I still really want to know what Democrats and Republicans can compromise on that would solve the same problem as the PPACA. Democrats started by offering essentially the Republican plan, with the public option. Then they took away the public option, and it still got shot down. The last Republican president to even attempt a universal healthcare proposal was Richard Nixon. I don’t think Republicans even care about universal healthcare as an issue…

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    The very idea that bipartisanship is a worthwhile goal has been amply disproven by Republican behavior since 1994.

    When they get in the driver’s seat or anywhere near it, they show no desire to compromise except when absolutely forced to (as in the case where Gingrich lost a lot of political potency after looking like a chump trying to engage in brinkmanship with Clinton over the government shutdowns).

    And when there is any chance at all of throwing rocks in the wheels of the smooth operation of government, they’ll take it. Remember all the exploding-like-Krakatoa they did over the OMG RECONCILIATION RULES HOW DARE U DO THAT U NARSTY DEMOCRATS?

    The reason WHY the Dems used reconciliation was precisely because the Repubs stood wall-to-wall against any progress, and were able to enlist enough Blue Dogs as catspaws to ensure the lack of any progress at all.

    And now we are being asked to believe that really, honestly, this time bipartisanship really will accomplish something!

    Good god, has anyone realized the definition of the most utterly Sisyphean-scale level of futility is in doing the same thing multiple times and expecting a different result than the one you keep getting?

  • Anonymous

    I’m glad that we are in agreement. =)

  • Lori

    I’m glad that we are in agreement. =) 

    We are not in agreement you ass. Your continued attempts to be cute, complete with smiley emoticons for fuke’s sake, just confirm that you’re half a step above a troll.

  • Anonymous

    Saying that the Dems need 60 vote to pass a bill in the same sentence in which you chide them for not conforming to (the Right wing interpretation of) the Constitution is pretty rich.

    I didn’t say the Democrats need 60 votes to pass a bill (although it’s true.)  What I said was the Democrats had 60 votes — enough to pass any bill they wanted.

    The fact that they could pass any bill they wanted does not mean that (from both a political policy perspective) they should pass any bill they want.

    No, the GOP achieved such gains in the 2010 congressional election because there was a black man in the White House.

    Obviously.  The Evil Republicans zapped the minds of all those conservative Democrats, independents, and progressive Republicans who voted for Obama in 2008.  They Evil Republican zapper removed the veil from their eyes, so that they realized to their horror that they had installed a black man in the White House, and the only way to correct this injustice was to vote against all  Democrats.

  • Lori

    What I said was the Democrats had 60 votes — enough to pass any bill they wanted. 

    First
    of all, no they didn’t. This is yet another
    bit of proof that you don’t know anything about the politics you are
    persistently determined to faux-discuss.
    But
    let’s assume the counterfactual for a minute that they in fact did have the
    votes and could have passed any bill they wanted to. So why didn’t they? You
    claim they didn’t attempt to work with the GOP to get a bipartisan bill, but
    they obviously didn’t use the 60 votes you claim they had. And since they
    didn’t use the 60 votes you claim they had, how exactly did they force the bill
    through?

    The Evil Republicans zapped the minds of all those conservative Democrats, independents, and progressive Republicans who voted for Obama in 2008. The Evil Republican zapper removed the veils from their eyes, so that they realized to their horror that they had installed a black man in the White House, and the only way to correct this injustice was to vote against all Democrats. 

    The Tea Party swung the 2010 election and the Tea Party was all about race.

  • Anonymous

    First of all, no they didn’t.

    First of all, yes they did.  From 7/7/09-2/4/10* the Democrats held 58 seats and controlled 2 seats held by independents who caucused with the Democrats.  58 + 2 = 60 votes – enough to prevent a filibuster.

    * with the exception of one month from the death of Kennedy until his replacement was sworn in.

    But let’s assume the counterfactual for a minute that they in fact did have the votes and could have passed any bill they wanted to. So why didn’t they?

    If they had all supported single-payer, the Democrats had enough votes to enact it without Republican support.  Some Democrats (and all Republicans) were not willing to support single-payer.

    And since they didn’t use the 60 votes you claim they had, how exactly did they force the bill through?

    In December 2009 the Senate passed a law that they planned to revise in joint House-Senate conference committee.  After the suprise Republican victory in the MA special election in January 2010, the Democrats controlled only 59 votes — insufficient to end a filibuster — and decided to send the bill as passed to the White House rather than work with Republicans to enact a bipartisan solution.

    The Tea Party swung the 2010 election and the Tea Party was all about race.

    Obviously.  It’s a shame no one told “Tea Party star” Allen West and the 31 other black Republicans who ran for Congress that the Tea Party was all about race.

  • Lori

     

    It’s a shame no one told “Tea Party star” Allen West and the 31 other
    black Republicans who ran for Congress that the Tea Party was all about
    race. 

    Some of my best friends are black. That one never gets old.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    When i first heard about the Log Cabin Republicans I thought it had to be a bad joke. Why would GLBT (this was the 1990s) people willingly try to stay members of a party that hates their fucking guts?

    Look, everybody proposing tortuous alternatives to the ACA without mentioning single-payer* is trying to avoid a solution to a problem that’s been employed, in some degree or other, by any other country in this world with even relatively modest means, like the Netherlands, for example. Or Canada.

    Back in the late 1990s when the Canadian dollar kept slipping and the USA was starting to really get rolling in the tech boom, I knew people who’d keep asking me why I didn’t want to try and get a job there. And I’d always say, “Because I would lose my government provided health insurance.” As broke-assed as I was, the one thing I could still count on was not having my wallet get plundered in addition to getting seriously injured or sick.

    —-

    * American Exceptionalism at work, once again. Only this time it’s the bizarre scenario of loudly and lustily proclaiming that Americans are free because they go broke when they get hit with a major illness or injury.

  • friendly reader

    In defense of the Log Cabin, their entire purpose is to change their party’s feelings on homosexual civil rights. They agree on economic and foreign policy issues, probably anti-choice for many as well, and they can’t bring themselves to vote Democrat. So they lobby the Republicans to change, and they’re optimistic/naive enough to believe it can be accomplished.

    To my knowledge, there is no organized movement among African-Americans within the GOP trying to get them to change their stance on affirmative action and hate crimes, to stem the tide of black imprisonment, or deal with any other racial issues facing our nation. And while the Log Cabin struggles on the edge of acceptability, the GOP feels more than happy to trot out token African Americans into the mainstream to disprove its racism.

    Now, I happen to think that many right wing economic policies will have as damaging an effect on marginalized groups as explicit discriminatory laws, and think that the Log Cabin is wasting their time at the moment, but they are at least actively advocating change. Most African-American Republicans seem happy to not shake the boat – and when they do, well, witness what happened to Colin Powell.

  • Tonio

    I would go further and suggest that the Log Cabin objective is fundamentally incompatible with the GOP agenda. Without getting into a debate over whether the party aims to preserve privilege, its agenda has the effect of preserving it. To be more specific, the currently party is an alliance of groups whose agendas would preserve economic privilege in some cases and social privilege in others. As Thomas Frank has noted, the former includes people who don’t economically benefit themselves from such an agenda. The Log Cabins are about doing away with privilege based on sexual orientation, and I doubt their fellow GOPers would accept such an agenda without questioning the whole concept of privilege itself.

  • friendly reader

    That’s part of it, but there’s more to it than that, I think; take the recent New Hampshire vote where a majority of Republicans voted against repealing same-sex marriage. To me this indicates that the biggest reason the GOP is still digging its heels in on civil rights for sexual minorities is because of how thoroughly it has wed itself to the religious right. In a less religious state like New Hampshire (a recent survey had something like 25% of the state identifying as “religious”) you’ve got a higher chance of Republicans being content with the privileges of race, gender, and particularly class (since Americans hate to talk about that last one).

  • Lori

     

    In defense of the Log Cabin, their entire purpose is to change their party’s feelings on homosexual civil rights.

    That’s their stated purpose, but their actions don’t do much to actually promote that purpose. Unlike GOPRoud the Log Cabin Repubs aren’t actively evil, but they’re certainly not making any headway on their supposed goal.

  • http://blog.trenchcoatsoft.com Ross

    I suppose it’s not that hard to believe that a person could say “Y’know, civil rights would be nice and all, but *tax cuts*? Give me enough tax cuts and I’ll barely miss my civil rights at all.”

    After all, is it that much stranger than women who put tax cuts ahead of their right to control their own bodies, or people who put tax cuts ahead of the fact their own health?

  • Lori

    I suppose it’s not that hard to believe that a person could say “Y’know, civil rights would be nice and all, but *tax cuts*? Give me enough tax cuts and I’ll barely miss my civil rights at all.”

    After all, is it that much stranger than women who put tax cuts ahead of their right to control their own bodies, or people who put tax cuts ahead of the fact their own health?

    I don’t find it hard to believe at all. Hard to stomach, yes. Hard to believe, no. There have always been people like this and there likely always will be. There’s a reason that one prominent gay blogger refers to the GOProud as “kapos”.

  • P J Evans

     our conservative friend has clearly never figured out that Allen West would have a hard time figuring out how to get to DC.

  • P J Evans

     And the eight or ten Blue Dogs who reliably vote Republican count as votes for the Democrats because why?

  • Anonymous

    “Sustainable” is a word that seems to be increasingly popular in liberal (especially environmental liberal) circles.  Many conservative bloggers believe that the law is economically unsustainable; sooner or later, everyone will experience a lot of anxiety and hardship.  If the law is struck down, then Congress can fashion health care reform legislation that is sustainable.

  • Lori

      Many conservative bloggers believe that the law is economically unsustainable; sooner or later, everyone will experience a lot of anxiety and hardship. If the law is struck down, then Congress can fashion health care reform legislation that is sustainable.

    The fact that conservative bloggers believe it doesn’t make it true. One needs look no farther than the GOP budget plans to see that they have no actual interst in “sustainable” economics. No Congress where the GOP has any power is ever going to pass a decent health care law and allow it to stand because getting coverage for all Americans is not a GOP goal.

  • Anonymous

    While the next Congress takes the best ideas of Democrats and Republicans to fashion a bipartisan solution, some of the deep red states could implement all of the Republican proposals.  If they result in affordable health care for all, then other states could adopt them.  If they don’t work, then the red state residents will have themselves to blame.

  • Tonio

     “Affordable health care” is too small of a goal. Health care as a market is radically different from most other markets because of the fundamental imbalances in power, as Thoma explains above. The true goal is to render personal wealth irrelevant in terms of the quality and level of care. That may not be achievable in full because no system can be perfect. But no amount of tinkering, such as the types you suggest, can make health care behave like a traditional market. So it’s pointless to treat reform as trying out competing proposals as if the basic economic realities were mysteries to be solved.

    And regarding your point to Ellie, everyone already participates in the health care market simply by consuming care. And the cost of emergency room visits by uninsured patients gets shunted onto everyone else through higher costs for care, even for people who don’t themselves hold insurance.

  • Anonymous

    (1) The 10th Amendment provides that all powers not expressly granted to the federal government are granted to the states or to the people.  Therefore, states but not the federal government can regulate auto insurance.

    (2) One can escape auto insurance regulations by choosing not to participating in the regulated activity (owning or driving a car on public roads.)  One cannot escape the health care law by choosing not to participate.  The Constitution does not give Congress the authority to mandate present participation in commerce on the idea that at some point in the future, participation in commerce is inevitable.

    (3) Auto insurance laws are valid because they protect other people’s interests.  Auto insurance laws do not require the policyholder to carry insurance to cover one’s own vehicle or medical bills.

  • Anonymous

    One cannot escape the health care law by choosing not to
    participate.

    That’s good, because one can’t escape the inevitable liquidity challenges presented by the health care market either – unless you’re a go-zillionaire, in which case your objection comes down to being a WATB.

    Auto insurance laws are valid because they protect other people’s
    interests.  Most auto insurance laws do not require the policyholder to
    carry insurance to cover one’s own vehicle or medical bills.

    I tell you what – as a compromise, the government can check the bank account balance of everyone who is not carrying health insurances and is subject to the mandate to make sure they have enough money to protect the financial interests of the rest of us in case they have a heart attack.  What’s that?  That’s no good either?

    It’s everyone’s freedom not to pay for your right to be a asshole that’s at stake here, not your right to be a asshole.

  • Ursula L

    (3) Auto insurance laws are valid because they protect other people’s interests. 

    Health insurance mandates should be valid under that reasoning as well.

    Because one of the functions of proper health care is to maintain public health. To control the spread of contagious disease.  

    This winter, I came down with what was probably bronchitis, perhaps pneumonia. I didn’t have health insurance, didn’t see a doctor, toughed it out and got better.  But I know several other people who likely caught it from me, did need to see the doctor, and needed medication to get better.  

    Under the new laws, when implemented, I would have had health insurance.  I could have seen a doctor.  I would have been prescribed antibiotics.  I would have taken them, recovered faster.  Which is great for me. 

    But I also would not have spent two months as a contagious coughing mess.  Putting others at risk whenever I was around other people. 

    I have general good health and a good immune system.  I got better.  The people I know who might have caught it from me got better.  But what about the people I don’t know who were exposed to me?  People in the grocery store, the library, elsewhere?  What if some of them had compromised immune systems?  For all I know, they may be dead, because of my untreated cough.  

    A health insurance mandate is legitimate because controlling the spread of contagious disease is in the public interest, and in the interest of other individuals who are put at risk of contagious disease when people go without health care because they can’t afford insurance or aren’t eligible for coverage under the system as it is currently set up. 

  • Anonymous

    I’m sorry that you suffered from bronchitis, and I’m glad to hear that you are better.

    While it’s highly likely that someone suffering as you did will wish to seek medical services, the health care law does not mandate that someone suffering from bronchitis receive medical services in order to prevent her from infecting others.  (By contrast, in cases of disease epidemics, the authorities can require people to get vaccinated, but those are state authorities.)  I am not aware of whether the proponents ever offered your argument to any court — that the mandate is constitutional because it protects heathy individuals from exposure to contagious diseases spread by the uninsured.  I’ve read several articles and briefs on both sides of the issue, and I don’t recall reading it.

  • Anonymous

    The 10th Amendment provides that all powers not expressly granted to the federal government are reserved for the states or the people.

    We the People of the United States, in order to provide for the common defense, do ordain and establish this Constitution of the United States of America.

    …wait.

    One cannot escape the health care law by choosing not to participate.  The Constitution does not give Congress the authority to mandate present participation in commerce on the idea that, at some point in the future participation in commerce is inevitable.

    One is perfectly free not to partake of health care whether one requires it or not. Meanwhile, one is required to have a whole slate of vaccines in order to enter school, and it remains fucking inevitable that one will require health care.

    Auto insurance laws are valid because they protect other people’s interests.  Most auto insurance laws do not require the policyholder to carry insurance to cover one’s own vehicle or medical bills.

    That’s because you smashing up your own car neither picks my pocket nor breaks my leg. You getting a contagious disease and not treating it, however, might just give me a contagious disease, which I don’t want, and your uninsured self having a heart attack will compel my taxpaying self to pay for the hospital stay, unless the hospital eats the costs or throws you out on the street to die. I’d rather treat your heart attack before your arteries get completely blocked, when treatment’s cheap, and I’d certainly rather you not die when my paying for your health care would keep you from dying, because if I don’t pay and you do die, all great Neptune’s oceans won’t wash this blood clean from my hand.

  • Anonymous

    We the People of the United States, in order to provide for the common defense, do ordain and establish this Constitution of the United States of America.

    Nice try.  The preamble is an introduction to the Constitution.  It does not assign powers to the federal government and it has never been used by any court in deciding a case.

    One is perfectly free not to partake of health care whether one requires it or not. Meanwhile, one is required to have a whole slate of vaccines in order to enter school, and it remains … inevitable that one will require health care.

    Vaccine requirements as a condition of entering school are mandated by the various states.  Your point that health care is inevitable does not address my point that “inevitability” is legally irrelevant since the “Constitution does not give Congress the authority to mandate present participation in commerce on the idea that [future participation] in commerce is inevitable.”

    your uninsured self having a heart attack will compel my taxpaying self to pay for the hospital stay

    The insurance company would cover the cost of my uninsured hospital stay.  Even if your taxes were used by the government to reimburse the insurance company, you would not suffer a direct financial harm from my hospital stay in the manner that the victim or property owner suffers direct financial harm from an auto accident.

    The analogy is not to mandatory liability laws that cover third party losses, but rather mandatory comprehensive, collision, and medical coverage laws that would require the owner to cover her own financial losses.

  • P J Evans

    Nice try.  The preamble is an introduction to the Constitution.  It does
    not assign powers to the federal government and it has never been used
    by any court in deciding a case.

    Missing the point. That’s the preamble as seen by your good buddies in the GOP.

  • Anonymous

    Missing the point. That’s the preamble as seen by your good buddies in the GOP.

    Other point being, if going by the letter of the body of the Constitution requires going against the spirit of the entirety of the Preamble, something’s fucked.

  • http://blog.trenchcoatsoft.com Ross

    your uninsured self having a heart attack will compel my taxpaying self
    to pay for the hospital stay, unless the hospital eats the costs or
    throws you out on the street to die.

    It’s worth noting that one of Scalia’s comments during the arguments was that the social contract that requires hospitals to treat you even if you’re uninsured, rather than throwing you out on the street to die, is a *bad* social contract.

    “It’s a bad idea to not kick the sick out on the street to die,” is apparently:

    A. A strict construction of the founders’ original intent as set forth in the constitution
    B. A literal interpretation of “promote the general welfare”
    C. The sort of thing you’d only ever say in your official capacity if you had a job where you didn’t need to get reelected and can’t be fired.

  • Anonymous

    To TheFaithfulStone
    This is the column to which you are referring and to which you failed to include a link.

    As can be seen from reading the column, you distorted the position advanced by Sasha Volokh*.  He did not say or suggest what you claim he said…

    Wait, you’re pointing to a person who would LITERALLY (and I mean that literally) rather see the world destroyed than taxes raised or government infringe on your “freedom”, as an authority on this subject.

    Moreover, Volokh admitted that the position he was advancing was absurd and he was uncomfortable with it.

    * Sasha’s brother Eugene Volokh is the primary founder and publisher of the blog.

  • rizzo

    I’m bucking for them to shoot the whole thing down so we can get a government backed system that doesn’t just funnel even more money to health insurance companies without breaking up the nationwide trust that they’ve developed over the past 30 years. 
    Of course that’ll never happen because they pay way way too much money to politicians, but I can dream, right?

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    You know what? At this point I’d rather listen to KMFDM and wave my government-issued health insurance card in all those assfaces’ faces.

    http://www.youtube.com/watch?v=FN7zYf0Jmis

  • Anonymous

    You know the thing that struck me most about Scalia’s comments?

    His invoking the 8th amendment related to reading the bill!

    Really? Isn’t that his job?

    Oh and implying that his clerks shouldn’t have to do it either. It’s not like his clerks don’t do 3/4 of the work of reading the law and finding the precedents and drafting language anyway.

    It was already obvious that Scalia hadn’t read the law himself or he would have known that the so-called “Cornhusker kickback” hadn’t made it into the ACA.

    Maybe he should try reading something other than right-wing blogs.

    Like the Constitution.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    The fact that a Supreme Court justice has proven that he doesn’t even know or care to know what it is he’s talking about when it comes to the thing he’s going to rule on?

    That ought to be grounds to fire him for dereliction of duty.

  • Anonymous

    This country is fucked. Totally and completely fucked. We’ve left the reigns to the idiots, and they’ve won. That’s all there is to say about this. The United States has finally eaten itself. We’re boned.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    You also gotta wonder at the notion of “Log Cabin” Repubs trying to make a callback to Abraham Lincoln in a party that has so thoroughly repudiated his legacy they’re the ones now calling the Democrats carpetbaggers and scalawags.


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