Some objections to my opinion on health care:
"The government does require that people purchase auto insurance. These laws have been upheld in court as the health care law will most likely be."
Yes, but the federal government doesn't require folks to carry auto insurance, the states do. States have a good deal of autonomy to pass laws. Secondly, auto insurance isn't mandated to protect you, the insured, it's mandated to protect everybody around you whose persons and property you might damage. You are responsible for the damage you cause and if you don't have the cash to pay up, your insurance company will. Third, you don't have to carry auto insurance if you can prove you do have the cash to 'pay up' should the need arise. Fourth, carrying auto insurance is only required if you want the privilege of driving on the road. If you don't own a car, or own one but it sits in your back yard on blocks, you don't have to have auto insurance. The health insurance mandate requires you to buy insurance just for being alive.
"The constitutional basis for this law comes from both the necessary and proper clause (congress has the power to enact laws that provide for the general Welfare of the country), and the commerce clause (regulating commerce between the states)."
The necessary and proper clause gives Congress the power to decide the government will provide it's citizens with health care, and raise taxes to pay for it, as I said here. That would be unpopular, but constitutional. The commerce clause was designed to break down the walls of commerce between states, so things could be sold across state lines without tariffs &tc. It regulates commerce, not the lack thereof.
Thanks for the discussion points.
Good points, cous, but still some things worth discussing.
ReplyDeleteHealth care is very much like auto insurance in that taxpayers bear the risk of costs associated with emergency room visits. Anyone who gets sick can go an be guaranteed care. They'll get billed, but the many who can't pay get subsidized by taxpayers (and others who have health insurance - which is another reason why universal coverage brings costs down). Unlike driving, this is something you can't opt out of because anyone who is alive has the chance to get sick or hurt. To opt out, you simply have to stop being alive.
While we disagree about the meaning of the necessary and proper clause, that's not important here as the health care law fits into your description of federal authority. The health care requirement is a tax - if you don't have healthy insurance, you pay $695 per individual in additional federal income tax. That tax is meant to pay for existing health care provisions, including guaranteed emergency room care.
The commerce clause issue comes into play because people can get sick anywhere in the country. The constitution gives the federal government power to regulate commerce between states because states can't make rules past their own borders, hence the federal government's power to regulate things like meat inspection, trucking safety and pollution released into rivers and the air. Consumers in Arizona have a right to know meat packed in Nebraska is safe, and the only body who can make and enforce rules for that is the federal government. In the same vein, Massachusetts requires citizens to have health insurance, but an Ohioan on vacation in Boston who gets sick still has to receive care at Massachusetts General even though Massachusetts can't require that person to have insurance. That's the hole in regulatory authority the commerce clause was meant to fill.
The issue of constitutionality here is an interesting one, but it's not one that is as contentious as the Vinson ruling could lead us to believe. While two federal judges have said the law is unconstitutional, fourteen federal courts have upheld the law or refused the case as baseless, and that seems very likely to hold all the way up to the Supreme Court.
There were two good articles on this last week, both were checking out. They may not persuade you on the constitutionality question, but it's hard to believe the Supreme Court would rule anything less than 6-3 or 7-2 to uphold this law (Kennedy, Roberts and maybe Alito voting with majority, though there's a chance Scalia would too).
Here's links to those articles:
http://www.latimes.com/news/opinion/commentary/la-oe-amar-health-care-legal-20110206,0,1370439.story
http://www.nytimes.com/2011/02/08/opinion/08tribe.html?_r=2&scp=2&sq=laurence+tribe&st=cse