"the judges opened the arguments by saying they knew of no case in American history where the courts had upheld the government's power to force someone to buy a product."
And Acting U.S. Solicitor General Neal K. Katyal raising the point:
"... that healthcare is unique and unlike purchasing other products, like vegetables in a grocery store. "You can walk out of this courtroom and be hit by a bus," he said. And if such a person has no insurance, a hospital and the taxpayers will have to pay the costs of his emergency care..."
Interesting if facile questions all around by the bench. Really the only issue at stake here is can the government mandate an individual to purchase a product?
So let's think about it - you are required (by law, duly passed decades ago and in force since in every state that I know of) to purchase auto insurance as part of owning and operating a car - so we've opened the door on mandating purchase of a service already. (Although arguably you do have the choice of NOT owning and operating a car, just good luck getting anywhere or earning a living without one in our auto-centric communities) So to through out that they've never heard of government having these powers before is either a disingenuous belief, or an outright falsehood-which is it?
On this topic remember George Bernard's prostitute joke (see The Independent- at the bottom of the article) which certainly applies:
"Best joke about prostitution ever done was by Bernard Shaw. He was at a party once and he told this woman that everyone would agree to do anything for money, if the price was high enough. `Surely not, she said.' `Oh yes,' he said. `Well, I wouldn't,' she said. `Oh yes you would,' he said. `For instance,' he said, `would you sleep with me for... for a million pounds?' `Well,' she said, `maybe for a million I would, yes.' `Would you do it for ten shillings?' said Bernard Shaw. `Certainly not!' said the woman `What do you take me for? A prostitute?' `We've established that already,' said Bernard Shaw. `We're just trying to fix your price now!'
The second issue raised here (and frankly immaterial from a legal standpoint, but important to understand from a healthcare reform standpoint) - is whether we want to admit it or not, you and I already pay for all the uninsured - and at the absolute highest rates you can think of.
The uninsured wind up in Emergency Rooms with life threatening conditions, often at end of life. Our laws prevent ERs from turning anyone away in this condition (can you imagine a society where someone with a GSW to the head is turned away from the hospital because they can't show proof of insurance? Not sure I want to live in that country). Because of this, the state agrees to pay the ERs for anyone who can't pay - and where does that money come from? Well you and me in the form of taxes.
So to put everyone into some form of a health plan is actually a cost savings device - it should lead to earlier, lower cost interventions for many of these people, and should also ensure that we're paying negotiated rates and not rack rates. (as an example I just had lab work done - rack rate if I didn't have insurance - $650, with negotiated rates - $54. Sort of begs whether Healthcare providers are engaged in discriminatory pricing in violation of Robinson-Patman, something I'll leave to another day.)
Lastly on this point - by mandating coverage, the state can entice private insurers to come to the market with products designed to be compliant with the regulators mandated design for minimally compliant healthcare plans. Without creating the market for 50 MM new members, the insurance companies will not bother. Plain and simple. (I used to manage Product Development for one of the major West Coast healthcare insurers ...) The only other reasonable alternative would be to go to socialized medicine from the start, by-pass how we entice private ensurers to enter the market and deliver the services directly. But we don't want to go there. Do we?
There's lots that is wrong with "Obamacare" that should be changed. But if we're going to challenge its consitutionality let's stay focused on the powers of the Congress to act, and not mix that up with whether it's a good bill that should be continued and implemented - that's not a question for the Judiciary, that's for the Legislative branch of the government.
7 minutes ago ·
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