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rushmc

The debate is heading where it should have started

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Is what the gov done constitutional?

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Health Care Mandate Sparks Constitutional Debate
The constitution allows the federal government to regulate interstate commerce but legal experts argue the insurance requirement is just an attempt to dictate personal behavior.

By Jim Angle

FOXNews.com

Tuesday, September 29, 2009

The requirement that everyone buy health insurance -- a central element to President Obama's health care plan -- is flatly unconstitutional, legal experts argue.

"At the heart of this plan is an unprecedented imposition on individual liberty," constitutional attorney David Rivkin told FOX News.

The constitution allows the federal government to regulate interstate commerce but Rivkin argues the insurance requirement is just an attempt to dictate personal behavior.

"What’s unique about here is the mandate imposed on individuals merely because they live," he said. "Not connected with any economic activity, not because they grow something, make something, compose something. Merely because they live. And this is absolutely unprecedented."

During the Prohibition era, the federal government dictated personal behavior by making the consumption of alcohol illegal. But to do so, the nation had to pass a constitutional amendment.

Health care reform depends on the individual mandate, in part because it needs the money and good health of younger people to fund the system and spread the risk.

"When you're 25 and healthy you think you're invincible. You think you're never going to get sick, never going to get into an accident," said Doug Kendall of the Constitutional Accountability Center.

And so young people don't buy insurance. But if one gets into an accident and runs up huge medical bills, taxpayers foot the bill, Kendall said.

"The fundamental point behind pushing people into the private insurance market is to make sure that uninsured individuals who can pay for health insurance don't impose costs on other tax payers," he said.

Kendall argues the interstate commerce clause justifies such action because it regulates insurance and health care. But when the Clinton administration wanted an individual mandate in the 1990s, the nonpartisan Congressional Budget Office also called such a requirement "unprecedented."

"The government has never required people to buy any good or service, as condition of lawful residence in the United States," congressional budget officers said.

Some question why the government cannot force Americans to buy health insurance if it can regulate other behavior such as use of illicit drugs. But if the government can do that to protect taxpayers, why couldn't it force people to stop smoking or lose weight?

The Congressional Research Service looked into the mandate question and concluded only that Congress "may have" that power but called it "the most challenging question" -- meaning the centerpiece of health care reform is still open to debate.


"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

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To me this is the question I have that most bothers me.

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But if the government can do that to protect taxpayers, why couldn't it force people to stop smoking or lose weight?



Where does it stop? Where should it stop?
"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

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Where does it stop? Where should it stop?



The beginning of it stopping will be election day of 2010 (or technically 1/1/11). It will completely stop on Inauguration Day 2013.



For the topic here maybe, if it can be stopped before it can be signed.

I still think there are many laws already on the books that should have started with this discussion before they became law.

The Enumerated Powers Act should be passed IMO
"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

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Sadly, it is too late. The 1940's - 1960's broke the existing limits. The fate was sealed by Raich v. Gonzales. Since the feds can regulate wholly interstate and private cultivation of marijuana (literally, on the basis that if everyone did it it would affect interstate commerce) they can do this.

The feds could regulate how you hold your dick when you piss now. (I've everyone did it a certain way, it could lessen worker productivity and thus interstate commerce.)

If you think this is hyperbole it isn't.

It's too late. Only judicial activism or an amendment can reverse it.


My wife is hotter than your wife.

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the feds can regulate wholly interstate and private cultivation of marijuana



This seems to restrict an action that would affect interstate commerce rather than force an action to protect commerce. Is there something that exists that prevents a law to be applied from being read inversely?
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"The trouble with quotes on the internet is that you can never know if they are genuine" - Abraham Lincoln

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"The fundamental point behind pushing people into the private insurance market is to make sure that uninsured individuals who can pay for health insurance don't impose costs on other tax payers," he said.




HAAAA!! That is a good one!

Last time I checked uninsured 25 year olds weren't causing unchecked spending by health care providers, or running up the medicare deficit.

Should have said 'the reason for pushing more healthy low risk individual into the insurance market is so we can use them to subsidize the poor and ederly, and two so we can pad our P&L statements'

This a tax on the middle class plain and simple.

What a load of crap!
"The restraining order says you're only allowed to touch me in freefall"
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Last time I checked uninsured 25 year olds weren't causing unchecked spending by health care providers, or running up the medicare deficit.

Unless, of course, they suffer some sort of devastating injury doing what 25-year-olds tend to do (i.e. take more risks than 50-year-olds on average).

Then they cost at least as much as the older insured people.

Wendy P.
There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

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Last time I checked uninsured 25 year olds weren't causing unchecked spending by health care providers, or running up the medicare deficit.

Unless, of course, they suffer some sort of devastating injury doing what 25-year-olds tend to do (i.e. take more risks than 50-year-olds on average).

Then they cost at least as much as the older insured people.

Wendy P.



I don't disagree that on an individual level a 25-year-old with no health insurance will incur an large expense in the event of a major health event. But you can't look at insurance on the individual level.

Overall younger people incur less health costs. If that wasn't true then you wouldn't have people trying to get them pushed into the system.

Actuaries know that young people are the least expensive to insure.

People who have to lowest need of insurance, are going to be paying inflated premiums (because they are subsidizing the poor and high risk individuals).

More money for the insurance companies, more money for the welfare nation. In return the younger individuals who are forced in will use on average a small small fraction of the premiums they pay in. Maybe a annual checkup here and there. This is money out of there pockets, that has little benefit to them.

The average income of younger people drops every year, and now they are coming back for some more wealth distribution.
"The restraining order says you're only allowed to touch me in freefall"
=P

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People who have to lowest need of insurance, are going to be paying inflated premiums (because they are subsidizing the poor and high risk individuals).



You don't think that's happening already? Well, I guess it only currently happens to people who have insurance, so they are getting hit with a double whammy. By making everyone get insurance, you are spreading out the pain, and putting some of that burden on the people who are actually causing the burden to begin with.

- Dan G

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Insurance is a gamble. And it is an expensive gamble. And depending on how much money you make sometimes it doesn't make sense to buy it! I don't like forcing people to gamble against their will.

The insurance company is gambling, based on their actuaries calculations, that your premiums will exceed your costs.

You are gambling that the you will have a major health event that will make the premiums money well spent.

If I didn't have health insurance through my employer I wouldn't carry it. The current cost of private premiums, and my lowered quality of life from having much less in cash flow, wouldn't cut it.
I doubt that "spreading the pain around" is going to bring premiums to an affordable level. So what you have is a money grab. People are being forced to take a big hit to their quality of life, for little benefit.

How about spreading the pain around to the noncontributing individuals, instead of the young middle class.
"The restraining order says you're only allowed to touch me in freefall"
=P

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I think forcing the non-contributing individuals to buy insurance is the only way to spread the pain to them.

I totally see the arguments from a Constitutional standpoint. On the other hand, the Constitution doesn't say that ER's have to treat emergent cases, but most people think that is good public policy. The current system incentivizes people to avoid the doctor until they become emergent, and then we all have to pay for their problems. Encouraging preventative care, focusing on medical based treatment (not profit based), tort reform, and encouraging not-for-profit insurance companies through tax breaks are the only ways I see to reduce overall cost, and therefore overall pain.

- Dan G

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I think forcing the non-contributing individuals to buy insurance is the only way to spread the pain to them.


The people who will actually have the cash to buy insurance currently, not taking into account the impact of such an outlay, are not the individuals who I am referring to.

Those individuals have jobs and already contribute in the form of payroll and income taxes. You are forcing them to buy insurance for others who don't do the same.

So how does the guy getting the free lunch pitch in?

This may seem cynical, but you don't encourage better behavior with hands outs.

I see it in my own town all the time. Single mother, no job, government assistance, and more kids than my girlfriend and I could responsibly afford with both of our incomes combined. But that is just us, responsibility goes out the window when the goverment foots the bill.
"The restraining order says you're only allowed to touch me in freefall"
=P

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Insurance is a gamble. And it is an expensive gamble.



Not really. Insurance is a different type of contract. Even law views insurance contracts as different beasts. for example, breaching a contract you just get damages because a contract is a non-feeling commercial transaction.

Insurance contracts have a different purpose - insurance is for peace of mind. What are my kids gonna do if I die? How will they get by without my working. I've got peace of mind in knowing that I have life insurance.

So, if you don't don't have insurance you simply are not paying for peace of mind. It's not a gamble that will cause you to lose your shirt. It's to reduce the risk that you will.

Of course, covering pre-existing conditions empowers gaming the system. Nobody thinks that a person should be able to wreck a car and then go insure it after-the-fact. But people think that a person should be able to have a heart attack and then have it covered after the fact.

It's abhorrent to me.


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Overall younger people incur less health costs. If that wasn't true then you wouldn't have people trying to get them pushed into the system.

Overall middle-aged people have fewer automobile accidents. But most (all?) states still require auto liability insurance at least.

In the case of cars, the cost of not having liability insurance is borne by someone besides the driver. And in the case of healthcare, if the person doesn't have other assets, then the cost of not having health insurance is generally borne by the taxpayer.

In Texas, you at least used to be able to ride a motorcycle without a helmet if you could prove that you either had $10,000 (not sure about the number) set aside, or health insurance. I thought those were pretty good caveats; you could be responsible in any way you chose.

But you can't guarantee that you won't have an accident, and statistics are pretty clear that the consequences of an accident without a helmet are generally worse than the consequences of an accident with a helmet.

Wendy P.
There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

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Let's say that I have a heart attack while I have insurance. My insurance company dumps me (they are a private corp and should be able to do that for no reason, right?) and now I can't get insurance from anyone else because I have a pre-existing condition. You think this is fair, how?

- Dan G

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We can refuse to insure a car for collision and comprehensive because someone can get rid of their car.

Refusing to insure a person is a little harder -- it's tough for more people to turn their body in on a newer one.

I wouldn't be opposed to having a reduction in insurance for evidence that someone is learning about healthy living, or increasing the cost for people who aren't living healthy.

But in the long run, as long as we value human life more highly than we value cars, we're going to be faced with the fact that irresponsible humans will not make appropriate provisions, and responsible humans won't just kick them aside.

To take that straw man again -- who here would refuse to call the EMS if a skydiver that they knew didn't have insurance were to biff their landing?

Wendy P.
There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

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Insurance is a gamble. And it is an expensive gamble. And depending on how much money you make sometimes it doesn't make sense to buy it! I don't like forcing people to gamble against their will.

The insurance company is gambling, based on their actuaries calculations, that your premiums will exceed your costs.

You are gambling that the you will have a major health event that will make the premiums money well spent.



Correct. Insurance companies are very similar to casinos. The odds are always in favor of the house. In the both cases, that slim margin is the profit and operating costs.

That's why a public option is a good idea. By removing the profit margin, it increases the odds to nearly even. Since private insurance companies tend to have higher administration costs than public policies (e.g. Medicare), a public option would further shift the odds favorably for the consumer.

The odds will still be against the average consumer, but much less so with a public option that the current private market.
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. Since private insurance companies tend to have higher administration costs than public policies (e.g. Medicare)



How do losses due to waste, fraud, and abuse compare between medicare and private insurance?

I may be way off, but I'm betting that losses due to these things either come close, or exceed the savings in administration costs.

It'd be interesting to see a comparison, but I haven't been able to find any recent statistics online.

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Insurance is a gamble. And it is an expensive gamble.



Not really.



Really. Insurance is gambling. We just don't call it that because that wouldn't portray the image that we want portrayed. There's no real difference, functionally speaking.

Do you know the difference between an actuary and a successful professional poker player? They use the same tool set, and make very similar calculations. The biggest differences are the actuary's credentials and that the poker player calculates in real time.
Math tutoring available. Only $6! per hour! First lesson: Factorials!

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. Since private insurance companies tend to have higher administration costs than public policies (e.g. Medicare)



How do losses due to waste, fraud, and abuse compare between medicare and private insurance?

I may be way off, but I'm betting that losses due to these things either come close, or exceed the savings in administration costs.

It'd be interesting to see a comparison, but I haven't been able to find any recent statistics online.



Agreed, it would be an interesting comparison. Waste, fraud and abuse occur on both the private side and public side, so I doubt they would have a large effect on the comparison. However, I don't have the data to examine to support or disprove that hypothesis.
Math tutoring available. Only $6! per hour! First lesson: Factorials!

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Agreed, it would be an interesting comparison. Waste, fraud and abuse occur on both the private side and public side, so I doubt they would have a large effect on the comparison. However, I don't have the data to examine to support or disprove that hypothesis.



I'm basing my theory on the difference in incentives between the two entities. Insurance companies have a vested interest in looking out for their profits (without them they'd cease to exist), I'm still struggling to find the incentive for the government to look out for taxpayer dollars (other than political reasons).

I'll dig around later and see if I can find any numbers.

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