Obamacare Goes to Court - Page 25 - Politics and Economics

__w__ · 03-27-2012, 07:19 PM

Exactly. There are other ways to skin this cat.

awval999 · 03-27-2012, 07:26 PM

Quote:

Originally Posted by mpethybridge

As a policy choice, I think this is a bad one. My personal opinion is that I would have less problem with socialized medicine if you also implemented wage controls on doctors. But right now, middle class people are being taxed/mandated/whatever to protect the incomes of rich doctors, and I have a problem with that independent of my commerce clause problems with the mandate.

3. Most state bars require their attorneys to engage in X number of hours of legal services for clients who can't afford them. Do doctors have a similar professional requirement? If not, why not? If so, why not just up the number of hours? Doctors are the primary beneficiaries of the existing regulatory environment. Why not attempt to make the primary beneficiaries incur the primary cost through a pro bono publico requirement?

First of all, lol.

Most hospitals that employ physicians are 501(3)c not-for-profits which are required to have a certain percentage of their revenue, etc. dedicated for charity care.

Nevertheless, I think agree with you the reason that health care is so ****ed up is that it isn't a free market, there is all these protections, unfunded mandates, etc. The whole thing is a cluster****.

But don't make doctors, and other health care providers out to be the enemies. Then again I don't think you are, but I just get annoyed when people say that.

**mpethybridge** · 03-27-2012, 07:32 PM

Quote:

Originally Posted by awval999

But don't make doctors, and other health care providers out to be the enemies. Then again I don't think you are, but I just get annoyed when people say that.

Can a mod give me a green or red light on responding to this? I feel like we are getting off track from the OP, and don't want to make matters worse, but I would like to respond.

13ball · 03-27-2012, 07:53 PM

Quote:

Originally Posted by __w__

But is it constitutional to force the young and healthy pay for an 80 year old man to have a procedure done?

Of course, and it happens all the time already. (See veterans.)

We are arguing about whether a specific method is constitutional.

I would like someone to answer why there needs to be a limiting principle. People keep saying that there needs to be some limit on the commerce clause, but that idea doesn't seem to be in the Constitution. Where does this idea come from?

(Note that I am not saying that the SC can't impose some limit for one reason or another, but why must they?)

zikzak · 03-27-2012, 08:00 PM

Quote:

Originally Posted by mpethybridge

There are no people in the group you describe.

That said:

1. I disagree, simply because there is no logical necessity for payment to be made at the time services are rendered. This is the prevailing custom, but the prevailing custom is not logically necessary. If somebody is going to save your life by giving you cancer treatment, I don't see any problem with you paying them $X/month for the rest of your life, or you being compelled to pay a tax for the purpose of prepaying for such services, or both.

2. One of the main reasons that health care is so expensive in this country is that the regulatory atmosphere drives up the cost of health care. As an easy example, doctors command a high premium over average wages because it is so difficult and expensive to become a doctor. It is difficult and expensive to become a doctor in part because of mismanagement of government insurance for student loans and because existing regulations create high barriers to entry (~10 years of education or so).

Right now, the bankruptcy laws that allow for the dischargeability of medical expenses operate as a tax on the income of doctors, who pass all or a part of that tax along to their paying customers.

The mandate substantially alters the flow of money to the benefit of the doctors and at the expense of uninsured people. There exists a group of healthy low income people who do not need or want insurance who are going to be forced to subsidize the currently-artificially inflated-by-government-regulation incomes of wealthy doctors. (And insurance executives, etc. etc.).

As a policy choice, I think this is a bad one. My personal opinion is that I would have less problem with socialized medicine if you also implemented wage controls on doctors. But right now, middle class people are being taxed/mandated/whatever to protect the incomes of rich doctors, and I have a problem with that independent of my commerce clause problems with the mandate.

3. Most state bars require their attorneys to engage in X number of hours of legal services for clients who can't afford them. Do doctors have a similar professional requirement? If not, why not? If so, why not just up the number of hours? Doctors are the primary beneficiaries of the existing regulatory environment. Why not attempt to make the primary beneficiaries incur the primary cost through a pro bono publico requirement?

The group I have in mind is the entire population of the US. There are thousands, maybe millions, who will need medical treatment that they could never afford to pay for, either in advance, in arrears, as a tax, or in indentured servitude. We have pretty firmly established the precedent that we do not let those people die from treatable conditions, so we already have socialized medicine. We just do a ****ty job of it.

I'm not a big fan of the ACA either, but what alternative is there in this political climate? Facing the ugly reality of what can and can not be accomplished, the current situation is probably the best that can be hoped for.

Scenario 1: ACA is upheld, even more money gets funneled to the insurance companies (who I think are a far bigger problem than the doctors), it becomes a great big mess, and eventually we end up with single-payer UHC instead.

Scenario 2: ACA gets shot down, everything continues to get worse, and eventually we end up with single-payer UHC.

There is no market solution to health care that doesn't involve people not getting needed care, and as I said above, that isn't acceptable to society. The quicker we get to UHC the better, and if that means finding a novel interpretation of some part of the constitution, so be it. When the constitution was written, it was acceptable to let people die in the streets. It isn't anymore.

awval999 · 03-27-2012, 08:01 PM

Quote:

Originally Posted by 13ball

I would like someone to answer why there needs to be a limiting principle. People keep saying that there needs to be some limit on the commerce clause, but that idea doesn't seem to be in the Constitution. Where does this idea come from?

(Note that I am not saying that the SC can't impose some limit for one reason or another, but why must they?)

The power of the Commerce Clause is unlimited; it is one of the limited enumerated powers, but the crux of the issue is whether or not "inaction in a marketplace" is Commerce and and can be regulated by the Federal Government and be "compelled to purchase a product, ie: insurance."

**mpethybridge** · 03-27-2012, 08:06 PM

Quote:

Originally Posted by 13ball

Of course, and it happens all the time already. (See veterans.)

We are arguing about whether a specific method is constitutional.

I would like someone to answer why there needs to be a limiting principle. People keep saying that there needs to be some limit on the commerce clause, but that idea doesn't seem to be in the Constitution. Where does this idea come from?

(Note that I am not saying that the SC can't impose some limit for one reason or another, but why must they?)

You probably won't be satisfied with the answer, but it is simply that Congress' powers were meant to be limited in scope. Therefore, there must be some principled distinction between acts authorized and acts not authorized by each of the A1S8 powers. The idea that there is a limit on Congress' power is inherent in the structure of our federal system; the idea that the limit is a legal principle deducible from the text of the Constitution is inherent in the idea of having a written constitution.

I might be able to formulate a better response after some thought, which I will put in now.

CharlieDontSurf · 03-27-2012, 08:06 PM

this is the politics forum...getting off track is the point

green light

dinopoker · 03-27-2012, 08:14 PM

Quote:

Originally Posted by mpethybridge

There are no people in the group you describe.

I knew a 30-year-old girl who was an exact example of that. She was diagnosed with a brain tumor while she was on a probation period of a new job and no insurance company in the world would cover her. Her name was Marie and if you remind me I'll send you a picture of her grave sometime.

I don't know if Obamacare will be overturned or not, but I do know that if it is, a great many Americans are going to die as a result. I hope you at least consider that once in a while as you craft your arguments against saving them.

**mpethybridge** · 03-27-2012, 08:17 PM

13Ball:

Upon a bit more reflection, the idea of a limiting principle is inherent in the enumeration of a type of power. So when you list a power and say, "Congress has the authority to regulate commerce," there logically has to be some stopping point. Suppose, just to simplify the analysis, that Congress only had the power to regulate interstate commerce. It then passes a law that says "sex between a husband and wife is permitted only on weekends," and in its findings, it declares that married couples spend too much time having sex during the week that they could be spending on commercial intercourse, instead. (sorry, couldn't resist the bad pun).

You'd question whether regulating sex between a married couple was a regulation of commerce, or a valid regulation of commerce, or whether there was a sufficient nexus between the two, right?

That's basically what the idea is behind a limiting principle--the court has to draw a line between a regulation affecting interstate commerce and one that doesn't, otherwise it isn't actually a power limited only to regulating commerce.

Low Key · 03-27-2012, 08:17 PM

Quote:

Originally Posted by CharlieDontSurf

this is the politics forum...getting off track is the point

green light

this forum has a point?!

drugsarebad · 03-27-2012, 08:22 PM

Quote:

Originally Posted by awval999

The power of the Commerce Clause is unlimited; it is one of the limited enumerated powers, but the crux of the issue is whether or not "inaction in a marketplace" is Commerce and and can be regulated by the Federal Government and be "compelled to purchase a product, ie: insurance."

I don't think this is exactly the crux of the issue, but close. Neither side is arguing generally that the Federal Government can compel people to purchase a product. The issue is whether a clear limit can be placed on this power that includes compelling people to have a minimum level of insurance without opening up constitutional power to what you see as the issue - unlimited compulsion of action in the market place.

That's what I think most of Kennedy's questions were directed towards today. If he can author an opinion that he is sure won't be later opened up to a larger expansion, he may vote with the liberal wing. If he thinks he's going to be the author of the next Jones & Laughlin Steel Co. opinion, this law will go down hard.

dinopoker · 03-27-2012, 08:26 PM

Quote:

Originally Posted by mpethybridge

13Ball:

Upon a bit more reflection, the idea of a limiting principle is inherent in the enumeration of a type of power. So when you list a power and say, "Congress has the authority to regulate commerce," there logically has to be some stopping point. Suppose, just to simplify the analysis, that Congress only had the power to regulate interstate commerce. It then passes a law that says "sex between a husband and wife is permitted only on weekends," and in its findings, it declares that married couples spend too much time having sex during the week that they could be spending on commercial intercourse, instead. (sorry, couldn't resist the bad pun).

You'd question whether regulating sex between a married couple was a regulation of commerce, or a valid regulation of commerce, or whether there was a sufficient nexus between the two, right?

That's basically what the idea is behind a limiting principle--the court has to draw a line between a regulation affecting interstate commerce and one that doesn't, otherwise it isn't actually a power limited only to regulating commerce.

Would you say that, for example, a person growing wheat on their own land for their own consumption is an example of commerce that is outside the Fed's purview?

awval999 · 03-27-2012, 08:28 PM

Quote:

Originally Posted by dinopoker

Would you say that, for example, a person growing wheat on their own land for their own consumption is an example of commerce that is outside the Fed's purview?

I would agree that is outside the Federal Government's purview; but the Supremes disagree.

http://en.wikipedia.org/wiki/Wickard_v._Filburn

Unless they reverse it, of course.

**mpethybridge** · 03-27-2012, 08:37 PM

Quote:

Originally Posted by dinopoker

I knew a 30-year-old girl who was an exact example of that. She was diagnosed with a brain tumor while she was on a probation period of a new job and no insurance company in the world would cover her. Her name was Marie and if you remind me I'll send you a picture of her grave sometime.

I don't know if Obamacare will be overturned or not, but I do know that if it is, a great many Americans are going to die as a result. I hope you at least consider that once in a while as you craft your arguments against saving them.

Yeah, um, here was the exchange between me and zikzak:

Quote:

Originally Posted by zikzak

None of your examples solve the problem of a healthy but low income individual being treated for cancer. Either somebody else pays, or that person dies. Those are the only two options.

Quote:

Originally Posted by mpethybridge

There are no people in the group you describe.

There are no healthy people who are being treated for cancer. Is that so hard to understand? LOL.

Quote:

Originally Posted by dinopoker

I don't know if Obamacare will be overturned or not, but I do know that if it is, a great many Americans are going to die as a result. I hope you at least consider that once in a while as you craft your arguments against saving them.

lol-bad demagoguery, completely empty of any factual content.

I'm not crafting arguments against saving them; I'm crafting arguments that save them without sacrificing a cornerstone constitutional principle simply because Congress is too craven and/or power hungry to go about it in a constitutionally permissible way. That said, if Americans dying would save the constitutional principle, I'd happily volunteer to be one of the sacrificial lambs. I've defended the constitution before at the risk of my life and would happily do so again.