Is the "individual mandate" really that bad?
The "individual mandate" (buy health-coverage or pay a fine) is the political focus for the week. I hope the SCOTUS decides the "mandate" is unconstitutional and also rejects all of Obamacare.
The problem with health-care: The problem with the U.S. healthcare system is that it is already heavily statist. Medicare and Medicaid control a big part of healthcare spending. Just as important, the government has imposed huge costs on private insurance via mandates, making it impossible for the poor to afford legal health-care.
Existing mandates: While the SCOTUS was debating the "individual mandate", the GOP in Michigan was mandating that anyone who buys private insurance must also buy coverage for autism. To someone with private health-insurance a mandate that says "you must also buy cover for disease XYZ, whether you want to or not", costs money. Compared to this, a mandate that says "you must buy health insurance" has no immediate impact, since they already buy it. Both Republican and Democratic state governments across the country have enacted all sorts of health-insurance mandates. Clearly, the GOP's focus on the individual mandate is hypocritical. If GOP leaders were to be honest they would admit that by their own premises the individual mandate is not that big a deal.
Mandate-like regulations: The government already mandates what you must buy if you buy insurance. In addition the government mandates who may or may not provide health-services, and mandates the ways in which health-services may be delivered. Virginia Postrel recently argued that birth-control pills should be over-the-counter. It is often a good idea to consult a doctor before taking medication, but that does not justify a government mandate, forcing one to do so. People should be allowed to decide this for themselves. The argument against all these government mandates is the same as the one against Obamacare's mandate.
"Free-riders": The government also mandates that hospitals working with Medicare or Medicaid cannot turn people away from their emergency rooms (ERs). People without insurance have been priced-out of health-care by government mandates. So, they bring their kids to ERs with coughs and colds. The ER is mandated to treat them, so it passes on the cost to the people who do have insurance. The existing mandate means people who have private insurance subsidize those who do not. The latest (Obamacare) mandate basically charges some of these people (assuming they earn a certain amount) something toward the existing forced subsidy. As Ari Armstrong explains, force begets force. Forcing people to buy insurance is the "logical" next step of having forced people to behave in all sorts of other state-directed ways on health-care.
GOP approaches to free-riders: The "individual mandate" is a GOP idea just as much as it is a Democratic one. Among its advocates: The Heritage Foundation, Newt Gingrich and Mitt Romney. In the face of Obamacare, the GOP is disavowing their previous support for the individual mandate. However, just this week GOP Senator Tom Coburn MD, was on CNBC saying he would support something very much like a mandate. Instead of fining people who did not have insurance, he would give a tax-credit to those who did have cover. In the end, the person without insurance would pay more tax. So, the exact same fine would apply. As for those who do not pay tax, even the GOP plans have government subsidies for them. So, in essence, the GOP ideas on an individual mandate are almost identical to the Democrats.
Go Scalia! though you're a fraud: I hate Obamacare. It is another big step in a long list of things that have made health-care so statist in the U.S. There are third-world countries with health-care industries far freer than the U.S. At times like this, I cheer for judges like Scalia who will use the individual mandate as an excuse to vote against Obamacare. As for the court as a whole, if the SCOTUS can say the government may order someone to fight a war in Vietnam, or can take one person's house and give it to another private individual, then surely the government may order someone to pay a fine if they do not buy some product. People like Scalia say there is no constitutional right to abortion; he thinks the constitution allows the Feds to ban marijuana in states that have legalized it. No matter: if this unprincipled person will use the "individual mandate" as an excuse to vote against Obamacare, I'll take what I can get.
Broader Constitutional impact: Allowing the individual mandate will be consistent with the myriad other rights-violations the SCOTUS has condoned. Shooting down the individual mandate cannot be done by any principled basis, if one continues to think other rights-violations are constitutional. Yet, despite all this, if this mandate is shot down, the court will be saying that there is some limit to what government can force people to do when if comes to economics and their health. Nobody will quite know what the line is, and politicians will find a way around it with ease. Yet, it would be a slender peg on which some future judge might base some future decision, to throw a small speed-bump in the way of statism.
Breathing time: If the individual mandate can toss out Obamacare, we will get some breathing time. There's very little hope that the GOP will come up with a better plan. Still, a slender hope is better than none. If the SCOTUS only throws out the mandate, but keeps the entire act, I think it will have negligible impact to the future of health-care. In that case, Obama would probably stick to his guns, and recommend that mandates go into effect state by state. (The GOP love "states rights".)
So, let's hope Obamacare (aka "The Affordable Care Act") is thrown out in its entirety.
The problem with health-care: The problem with the U.S. healthcare system is that it is already heavily statist. Medicare and Medicaid control a big part of healthcare spending. Just as important, the government has imposed huge costs on private insurance via mandates, making it impossible for the poor to afford legal health-care.
Existing mandates: While the SCOTUS was debating the "individual mandate", the GOP in Michigan was mandating that anyone who buys private insurance must also buy coverage for autism. To someone with private health-insurance a mandate that says "you must also buy cover for disease XYZ, whether you want to or not", costs money. Compared to this, a mandate that says "you must buy health insurance" has no immediate impact, since they already buy it. Both Republican and Democratic state governments across the country have enacted all sorts of health-insurance mandates. Clearly, the GOP's focus on the individual mandate is hypocritical. If GOP leaders were to be honest they would admit that by their own premises the individual mandate is not that big a deal.
Mandate-like regulations: The government already mandates what you must buy if you buy insurance. In addition the government mandates who may or may not provide health-services, and mandates the ways in which health-services may be delivered. Virginia Postrel recently argued that birth-control pills should be over-the-counter. It is often a good idea to consult a doctor before taking medication, but that does not justify a government mandate, forcing one to do so. People should be allowed to decide this for themselves. The argument against all these government mandates is the same as the one against Obamacare's mandate.
"Free-riders": The government also mandates that hospitals working with Medicare or Medicaid cannot turn people away from their emergency rooms (ERs). People without insurance have been priced-out of health-care by government mandates. So, they bring their kids to ERs with coughs and colds. The ER is mandated to treat them, so it passes on the cost to the people who do have insurance. The existing mandate means people who have private insurance subsidize those who do not. The latest (Obamacare) mandate basically charges some of these people (assuming they earn a certain amount) something toward the existing forced subsidy. As Ari Armstrong explains, force begets force. Forcing people to buy insurance is the "logical" next step of having forced people to behave in all sorts of other state-directed ways on health-care.
GOP approaches to free-riders: The "individual mandate" is a GOP idea just as much as it is a Democratic one. Among its advocates: The Heritage Foundation, Newt Gingrich and Mitt Romney. In the face of Obamacare, the GOP is disavowing their previous support for the individual mandate. However, just this week GOP Senator Tom Coburn MD, was on CNBC saying he would support something very much like a mandate. Instead of fining people who did not have insurance, he would give a tax-credit to those who did have cover. In the end, the person without insurance would pay more tax. So, the exact same fine would apply. As for those who do not pay tax, even the GOP plans have government subsidies for them. So, in essence, the GOP ideas on an individual mandate are almost identical to the Democrats.
Go Scalia! though you're a fraud: I hate Obamacare. It is another big step in a long list of things that have made health-care so statist in the U.S. There are third-world countries with health-care industries far freer than the U.S. At times like this, I cheer for judges like Scalia who will use the individual mandate as an excuse to vote against Obamacare. As for the court as a whole, if the SCOTUS can say the government may order someone to fight a war in Vietnam, or can take one person's house and give it to another private individual, then surely the government may order someone to pay a fine if they do not buy some product. People like Scalia say there is no constitutional right to abortion; he thinks the constitution allows the Feds to ban marijuana in states that have legalized it. No matter: if this unprincipled person will use the "individual mandate" as an excuse to vote against Obamacare, I'll take what I can get.
Broader Constitutional impact: Allowing the individual mandate will be consistent with the myriad other rights-violations the SCOTUS has condoned. Shooting down the individual mandate cannot be done by any principled basis, if one continues to think other rights-violations are constitutional. Yet, despite all this, if this mandate is shot down, the court will be saying that there is some limit to what government can force people to do when if comes to economics and their health. Nobody will quite know what the line is, and politicians will find a way around it with ease. Yet, it would be a slender peg on which some future judge might base some future decision, to throw a small speed-bump in the way of statism.
Breathing time: If the individual mandate can toss out Obamacare, we will get some breathing time. There's very little hope that the GOP will come up with a better plan. Still, a slender hope is better than none. If the SCOTUS only throws out the mandate, but keeps the entire act, I think it will have negligible impact to the future of health-care. In that case, Obama would probably stick to his guns, and recommend that mandates go into effect state by state. (The GOP love "states rights".)
So, let's hope Obamacare (aka "The Affordable Care Act") is thrown out in its entirety.
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