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Your Take: On the Healthcare Law

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Earlier this week, the Supreme Court heard oral arguments over the healthcare law over the course of three days. It’s been the subject of debate all over the news and it’s something that even my lovely wife has asked me about. This Your Take is going to be exceptionally long, I hope you read most of it and I really hope you share your thoughts. Unlike the vast majority of the comments on the Internet, I know that when it comes to thoughtful insight, you guys have enlightening me more than the other way around.

Before I get into what I think, I want to introduce the idea of the tragedy of the commons, because it plays an integral role in how I think of health care. If you have several herders sharing a common piece of land, where each herder is allowed to let their cows graze there, and each herder has an incentive to keep the pasture in good condition. If everyone starts with five cows and they agree to share the land, the grass can grow back and the pasture is kept in good condition. Then someone gets a new cow, lets it graze in the fields, then someone else gets a new cow, and it too grazes. They know they originally agreed to share the land but now two of the owners are getting a little bit more than the rest and the pasture suffers from overgrazing.

How does health care look like the tragedy of the commons? Healthcare is the pasture and everyone is a herder with one cow. Except some of the herders say they don’t want their cow to graze in the pasture, they have other pastures to graze on so they don’t pay to maintain the field. Then disaster strikes, a flood destroys their other pastures and they now need to use the common one. The problem here is that the other herders can’t stop the new herders from using the land and they pay for the addition upkeep because the pasture’s maintenance staff increases prices to help pay for the added demand for grass.

I think the individual mandate forces those herders who don’t want to pay for the upkeep of the communal pasture to pay. They may not need it today, but they will need it one day.

Let’s depart from the analogy and talk about health care specifically – I believe that health care is something all Americans should be able to access. I also believe that healthcare is expensive because our the economic incentives are built in such a way that you want to maximize procedures to maximize profits. Preventative care is cheaper than prescriptive care, so medical companies want more prescriptive care because it’s makes more money. What’s more profitable, a cholesterol drug (best selling drug ever is Lipitor) that someone has to take for the rest of their life or preventative care through healthy eating, exercise, and other mechanisms? So I like that the healthcare law did something to address preventative care, though it’s still limited.

As for the mandate and the argument that it’s the government overstepping its authority by forcing people to buy something – I agree. I also think this is an exception. When we pay for Medicare and Social Security, aren’t we being forced to buy something? I don’t know the legal arguments but I know that those payroll deductions are non-elective and mandated by the government. Health care should be the same.

Finally, on this point of healthcare overall… the problem with health care isn’t that people are uninsured, it’s that you can’t, morally or legally, stop someone from receiving treatment if they need it. If the herders didn’t have to pay for fields they didn’t need and were willing to let their cows die, then we shouldn’t require them to pay. But they won’t let their cows die, nor should we be a nation in which we let them even make that decision, so the individual mandate to pay for the pasture is necessary.

What do you think?

{ 79 comments, please add your thoughts now! }

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79 Responses to “Your Take: On the Healthcare Law”

  1. Andrew says:


    Thank you for being candid with your view on health care and the idea that everyone should share the cost due to the fact that someday they may need it.

    I must disagree with your thought that the government should be granted an exception in order to enforce the mandate. Using social security and medicare as examples to why health care should be mandated is a weak argument. Those programs have no more constitutional bearing that forcing individuals to purchase health insurance.

    That is also an issue in this argument; this law does not grant people the right or ability to receive quality health care. It simply requires that every citizen purchase health insurance. The health insurance being purchased is provided by private corporations. It is akin to every citizen being required to purchase bananas. Sure, bananas are good for you. But is it really our governments job to tell us we must buy them? Should one industry benefit so greatly from one piece of legislation?

    Then there is the constitutional side of the argument. The weak argument from the government is that the law is constitutional by use of the commerce clause. This clause has, through interpretation of the Supreme Court, come to mean the regulation of interstate commerce. I am not completely certain, but I know in my state I can’t buy insurance from any neighboring state; meaning I could never possibly engage in interstate commerce when purchasing health insurance.

    • Jim says:

      I understand your point of the bananas (or broccoli, as seems to be the super food of choice of politicians) but the issue isn’t with buying insurance, it’s with health care. Unfortunately the law decided to address this by focusing on insurance. You need insurance to help pay for health care and people won’t stop getting health care simply because they don’t have insurance. They’ll just go and, if they can, pay. If they can’t pay, hospitals don’t get paid. Hospitals know they won’t collect 100% so they just make everything else more expensive. How do we solve that problem? Seems like politicians don’t want to (or can’t because of partisan issues)

      I agree with many that the law wasn’t good enough, this is one of its shortcomings.

      My gut feeling is that to get the preexisting condition and dependent coverage, they traded this provision.

      I don’t think the commerce clause applies either but I’m not a lawyer, Constitutional lawyer, or Constitutional expert. 🙂

      • Andrew says:


        The idea that you need health insurance to pay for health care is a modern one (as in the past 40 or 50 years modern). The government over-regulation plays a huge part in the drastic increase in health care cost. Talk to those in generations older that yours and mine. It used to be that a doctor visit was paid out of pocket. Insurance was reserved for catastrophic events.

        Since most people tend to live healthy lives, insurers weren’t paying nearly as frequently as they do now. Not because people are less healthy now, but because the old model was that insurance was reserved for illnesses that required hospitalization, etc.

        Rather than legislating through the mess of reforming our health care to come up with a more cost effective, more efficient system; we should be looking at systems that work, and remove burdensome legislation and red tape from the equation.

        • Jim says:

          The problem I have with that argument is that you point to the health insurance system and say “there’s a problem, we’re not dealing with it in a way that I approve.” That’s all well and good but reform comes in steps. You saw how contentious the debate was over this, how it’s still being debating and fought over, and this did relatively small things. It’s like trying to fix the problems with Microsoft Windows – it’s so big that it would be impossible to start from scratch. Now add (more) politics.

          I also believe that it wasn’t legislation that caused this, it’s basic human nature and the profit motive, right? Why are people less healthy than before? They eat more calories and expend less. Portion sizes are bigger as restaurants compete for business, leading people to eat more. Entertainment is more enticing, leading people to watch movies and TV rather than do other things? It’s a stretch of an argument but I think you get my point.

          That said, I do believe legislation contributes to the problem. I believe college is so expensive because of government aid in education. A student can only pay so much and a college can only charge as much as a student can pay, assuming they want him or her. With loans and grants, a student can send more money to a college but still have it cost the same to them. They can use a loan to get cash now, to pay for school, against future earnings. Colleges know this and that’s why they can charge tens of thousands of dollars for a liberal arts degree. Legislation has helped students get into college, yes, but it’s also helped colleges earn more money. Look at the for profit education space for an example of capitalism at its finest.

          Andrew – I think we agree on the problem and in an ideal world, your approach would be better. Unfortunately, our world is hardly ideal. 🙁

          • Sarah in Alaska says:

            Unfortunately with the subsidies that the government is going to be giving out (under health care reform), what has happened to higher education, may well also happen to health care. The last thing we need are higher costs, but that is the structure that was built under PPACA.

  2. Andrew says:

    If the majority of our citizens, and therefore a majority of our government representatives feel that it is in the best interest of everyone to require the purchase of health insurance, then go about the legislative process properly. This does not mean passing a voluminous bill in an extended session of Congress on Christmas Eve before most of those voting have even had an opportunity to read the text. It means following the process of amending the Constitution. It also means having open public debate (similar to what is happening all over the internet).

    The government needs to return to a government by the people, and not some all powerful overlord assuring us that everything they are doing is in our best interest.

  3. tom says:

    You choose to pay Social Security and Medicare taxes.

    You choose to do this by having a job.

    You do not have to have a job.

    You do not have to do anything at all.

    You can live shelter to shelter, soup kitchen to soup kitchen. You can go live off the grid in the mountains where no one will bother you. You do not have to do anything.

    This health insurance mandate FORCES you to buy health insurance against your will. You are being penalized for simply living. This is the problem.

    Justice Kennedy said it best: the mandate “changes the relationship of the federal government to the individual in the very fundamental way.”

    The core argument is quite simple.

    • tom says:

      I’ve said it before, on here I think, if the government wants to tackle heath CARE, they need to get to the root of the problem…

      Why does aspirin cost $20 per pill? Why does an MRI cost $800? Why does a pregnancy ultrasound cost $900?

      They need to start asking why. In an industrial environment, where efficiency is necessary to be competitive, we ask “why?” 5 times. Usually on the 4th or 5th answer to the “why?” you get to the root of the problem. From there, you can perform a root cause and corrective action to fix the issue. THIS is what needs to happen.

      Also, for the love, please open state lines for insurance competition.

      • Jim says:

        Why does it cost $800? In part because some people don’t pay. Same idea why when you pay cash for something, you’re subsidizing people who pay with credit cards. When you show up, they don’t know if you have insurance or not and by law, in emergency rooms, they have to treat you. So they charge everyone more based on the historical data on the % who do or don’t have insurance.

        • tom says:

          In part, yes… but how big of a part?

          How big of a part is the fact that there is no interstate competition in the insurance world to keep prices down?

          How big of a part is the fact that there is no consumer oversight, i.e. no consumer shopping for the best price?

          How big of a part is medical malpractice insurance and the litigiousness of our society?

          We just named 4 huge reasons it’s so expensive. The Gov’t “solved” the first by saying everyone is required to have insurance. They have done nothing to address 3 other huge areas of concern that I see each being equal to the coverage problem.

          • Sarah in Alaska says:

            Why on earth would I want to buy a health plan out of state? I still haven’t been able to find anyone who could explain how that would benefit me. Health care is typically local. If I bought a plan from Nebraska, I can guarantee you that my coverage would not go very far in Alaska. I would have to fly to Nebraska for care in order to have my claims reimbursed at reasonable levels.

          • tom says:

            It’s not an “out of state” plan. It’s an in-state plan insured by an out of state company.

            Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act. The cost for an insurer licensed in one state to enter another state’s market is often high. Prohibitively high.

            Therefore, a state’s current insurance pool is only state regulated companies. If we remove this law, we allow many more companies to setup shop in any given state allowing for greater competition among insurance providers causing prices to decrease.

  4. Matt says:

    I should not be forced to buy insurance so someone who has had three heart attacks can afford it. This is a socialist plan that sounds great until everyone’s taxes get raised to subsidize this plan.

    • tom says:

      Especially because they always eat the triple heart attack burger and smoke all day.

      According to the CDC, 1 in 3 adults over 20 are obese. Why should I, as a non-smoking, healthy and fit individual, subsidize your unhealthy and lazy lifestyle?

    • Jim says:

      I never understood why socialism was a bad word, it’s not the 60’s. In a perfectly capitalist world, you pay for your services. So people start dying if they can’t afford things, is that a good thing?

      It’s easy to point to someone who eats hamburgers all day, is obese, and say you don’t want to cover their health insurance costs. It’s easy to say you hate welfare systems because of the single mother with 8 kids. But the reality is that those “bad” cases are just the extremes. What about the perfectly healthy twenty-six year old marathoner who is a waiter and discovers he has cancer?

      • tom says:

        1 in 3, Jim.

        1 in 3 adults are obese and it’s getting higher. This is not a select few “bad” cases. This is the norm.

        As a non-lazy, healthy eating, individual, I do not want to be forced to pay for these people.

        A little less than 20% of Americans smoke. I do not want to be forced to pay for these people.

        And to your point about the marathon runner… Yes, I would absolutely want to cover him/her.

        • Jim says:

          The problem is you can’t pick and choose who you want to cover. 🙂

          • Matt says:

            You could disqualify smokers or people over 275 pounds.

          • Jim says:

            Good luck with that.

          • tom says:

            That’s exactly my point.

            I don’t want to be forced to pay for those people.

            If you refuse to care for yourself, why should I have to subsidize your inevitable health problems.

            It’s bad enough I have to pay for the program that started this whole mess, Medicare.

      • David R says:

        Oh, Jim, because you didn’t grow up in a socialism society. I did, in China. It never worked, works.

  5. Jon says:

    One quick thought I mentioned to my wife last night. The way insurance (of any sort) works is by spreading the risk. The more people – especially low risk healthy ones – are in a health care plan, the lower the costs for everyone in that plan.
    Rather than the federal government forcing people to join health care plans, wouldn’t a “good start” be to get all the businesses who offer their employees health care insurance to automatically sign them up for the plan, instead of making it an option. As part of the contract between employer and employee, it would be far from illegal or unconstitutional, and it would solve a large part of the problem. Many employers have begun doing this with 401K plans – forcing folks to intentionally opt out if they don’t want the plan.
    Folks who are unemployed would probably fall under federal guidelines for some sort of healthcare insurance assistance program, perhaps tied to unemployment compensation insurance.
    Just a thought.

    • Jim says:

      With the 401k, they open it but they don’t force you to contribute.

      • Jon says:

        Is there any legal reason why an employer couldn’t, though? Not sure what the point is of signing someone up for automatic participation and then not funding it – that sounds odd.
        At a former employer, I had a young friend who believed he and his wife were too young and healthy to need health insurance, so he didn’t sign up for the very cheap(at least in my opinion) employer-subsidized premium. Later, his wife discovered she had cancer of the stomach, and they weren’t covered. Tragic, but the financial hardship could have easily been averted.

    • Sarah in Alaska says:

      That’s what they do at my job. And if you don’t select which plan you want, they put you in the family plan — to make sure if you have dependents they are covered.

  6. NateUVM says:

    Everybody is born. Everybody lives. Everybody ails, everyone dies and everyone will need health care…eventually. And even those that haven’t paid into the market receive a benefit when they truly need it… How capitalist is that???

    As such, Health Care is a special market where everyone participates, whether they “want” to or not. If it requires a Constitutional Amendment to get it done, then let’s do that. At least the administration/Congress’ attempt at tackling the issue has brought the issue to the forefront.

    Health costs are skyrocketing (duh). And if only those that are forced to make costly (to the rest of us) trips to the ER were able to get cheaper preventative care, maybe that would help.

    Let’s try to have some common sense and do some good in this world instead of pointing to a 225 piece of paper and saying we can’t. That piece of paper was designed to be changed, after all…

  7. Emily says:

    As a non-smoking, healthy, exercising, broccoli-eating 25-year-old, I got cancer. I was lucky and had health insurance.

    The year before that, my non-smoking, healthy, exercising 24-year-old best friend had an ovarian cyst rupture and had to have emergency surgery. She didn’t have health insurance because she was working as a contractor. She spent ten years paying off her debt to the hospital, and I’m pretty certain that they gave her a discount that was spread around to the insurance pool.

    After my cancer (which I’ve survived for 26 years, by the way), I lived in dread of losing my job because I would lose my health insurance and be unable to get it on my own due to my pre-existing condition.

    Unless you drop dead after a healthy life, you WILL use health care, and if it’s for any kind of chronic condition it WILL cost so much that you will be ruined if you don’t have insurance. And many of those chronic conditions are not anybody’s fault. Think MS, ALS, Parkinson’s Disease, many cancers. Maybe the current plan is not perfect, but something has to be done to provide catastrophic care for all of us, even if we’re 23 and think nothing will happen to us.

    Living healthy is important, but it is not insurance.

    • Kurt says:

      Well said Emily. I agree with Jim on this topic. I also agree with Tom in that I am frustrated with the lack of work being done to reduce health care costs. Of course, to cut those costs, might require government regulation, and that would not make many readers of this site happy. Lastly, socialism is not a bad word and capitalism is not a bad word. Pure forms of either are bad ideas though.

    • tom says:

      First… 26 years! Awesome!

      Second… I don’t completely disagree with catastrophic care as a minimum.

      I also don’t disagree with the pre-existing conditions and parents-insurance-till-26 provisions.

      I just don’t want to be forced to pay for treatment of illnesses caused by such things as smoking and obesity. Diseases that you, as a non-smoking, exercising, broccoli eating person have very little risk contracting.

  8. Steve T says:

    I just want to weigh in here. I rarely comment on news/blog articles and have inly been receiving the Bargaineering emails recently, but this is an issue I feel strongly about for personal reasons.

    I am a 32-year-old father waiting for a heart transplant. I have already had two surgeries in my life and now have an ICD/Pacemaker. I am also on a low sodium diet which requires that I special order many items online and have expensive grocery bills. My health is due to a birth defect, not my lifestyle. This is not the result of anything I did or didn’t do. My health and the expenses that come with it are not my fault.

    That said, they are no one else’s fault. They are not my fault but they are my responsibility. Sure, I got a bad deal in life, but that is for me to deal with. My doctors have encouraged me to quit working and start drawing disability, they will sign off on all the forms. I can’t do that. I am psychologically unable to stop working, and physically able to continue at a desk job. Despite a lifetime of dealing with this the only time I felt depressed was when I lost my job due to a bankruptcy in August. I had a new job by January and never took a tax payer dime in the interim. I was able to do that because I knew my worst case scenarios and prepared for them in advance. I never lost insurance coverage and never missed a payment. In fact, I got my car paid off.

    I am not opposed to charity. I will allow people to voluntarily help me, but I will never ask for or support a government plan that forces people, via taxes, direct payments, insurance mandates, or national debt increases, to pay for me involuntarily.

    Do not confuse my statements as supporting our current health care system. It is broken. I fear it is broken beyond repair by any reform that stays within the Constitutional boundaries set on Congress. Every time I run up against a problem I have a high risk of being told that they have to do it that way. My previous employer was based out-of-state, so my insurance was too. The hassle of the local insurance communicating with the out-of-state was ridiculous and guaranteed everything cost more, as well as left added steps for paperwork mistakes and human error to occur.

    Ultimately, I see the major issue we have now. The consumer has been removed from the cost. I read all my statements from the insurance and the doctors. I see that the cost is different everywhere and insurance pays a different price. I have to believe that if the doctors all had people calling to ask how much a procedure was and then saying they think they will go with someone who is cheaper that I would be quoted rates much closer to what insurance pays, possibly less as price competition would be an added factor.

    In the end, I know the reform act could help me, but I don’t want it. I feel the cost is too high and I don’t want to set a precedent of exceptions for Constitutional violations. We did that with “security” already and the result has been devastating to our civil rights. I’m already planning to put a message on my roof for unmanned drones. Considering the health-based attack on foods (and other vices) has already begun without this kind of precedent I can only imagine what will happen when health reasons become an exception to the constitutional rule and can be argued that it will directly impact taxpayer’s financially.

    I apologize for any typing or editing errors. I did this whole post on my iPhone.

  9. A.C says:

    I agree overall with Jim’s take but I also see the point of some of the posters above who do not want to subsidize people’s bad/unhealthy behavior. Maybe there can be an incentive program implemented where those who choose unhealthy activities: smoking/eating fatty foods would pay higher premiums. Maybe co-pays can be increased and premiums kept slightly lower so those who use healthcare more, would be end up paying more. Also, another thing that bothers me is that I pay the same premiums for the family plan (as a married couple) as someone who has 5 kids.

    • Harry says:

      A.C.’s suggestions are exactly what scares me most about this law – the initial mandate is only the superficial start. It will open the floodgates for the government to begin to micro-manage many other aspects of my life; and I can assure you that the government is a very poor manager. Just take a look at how well it has done managing our national debt!

    • Michael says:

      Well said,

      Life insurance and Car Insurance is based on risk.
      Why not the most expesive type of insurance? Health Insurance

  10. Kurt says:

    What if insurance companies were forced via regulations to charge all of their customers the same rates for identical coverages. This would essentially force the insurance companies to pool all of their customers into one giant pool.

  11. Healthcare is cheapest in those areas where there are no third party payers such as government and insurance companies who hide the true costs from the ultimate consumer. Lasik is a great example of this…… or walk-in clinics for flu-shots and many other routine procedures where a visit may cost $40-$50 bucks instead of $300 or $400. Disconnecting the consumer from price discrimination with “free” healthcare just creates an inexhaustible demand that keeps driving up costs. No government scheme can change this human behavior. The problem with universal healthcare is that sooner or later you run out of other people’s money.

    • Sarah says:

      I went to the doctor in one town 6 years ago. I made an appointment and they ran 3 lab tests. Because I didn’t have insurance at the time I was told I had to pay $175 in advance. I actually thought this was the cost of the visit. I had Lyme disease. Bummer take these and your good. I later got a bill from them for $1300. Obviously I demanded an itemized bill cause, well, seriously? The bill was for ALL the tongue depressors in the room,ALL the cotton balls, ALL the gloves, and well….I paid for the Lymes and other labs actually performed which amounted to $378 and have not paid the rest. I had a recurrence so I went in at a clinic 28 miles away. They charged me $65 for the visit and $80 for the test. They are also in different counties.

  12. mannymacho says:

    Health care is currently a battle between large insurance companies and large druge companies, where the consumers and doctors have little say. Also, you employer buys insurance for you. This leads to a very quirky system that must be reformed before insurance becomes mandatory.

  13. Texas Wahoo says:

    “As for the mandate and the argument that it’s the government overstepping its authority by forcing people to buy something – I agree. I also think this is an exception. When we pay for Medicare and Social Security, aren’t we being forced to buy something? I don’t know the legal arguments but I know that those payroll deductions are non-elective and mandated by the government. Health care should be the same.”

    One major difference is that to the extent that Medicare and Social Sercurity are forcing you to “buy” anything – as opposed to being a tax – you are buying it from the government. The individual mandate requires you to purchase something on the market from an insurance company.

    • Courtney says:

      Public option. Problem solved.

      • Texas Wahoo says:

        Having everyone receive their insurance from the government (like Social Security) would certainly solve the problem. However, it was not done that way because it was not politically feasible.

  14. Steve says:

    I have very mixed feelings regarding this. On the one hand I agree with everyone who says they do not want to subsidize others poor health choices. On the other hand we ALREADY ARE subsidizing this behavior because hospitals cannot deny care. Health care is outrageously expensive precisely because we are subsidizing those who do not pay. As Jim has pointed out the underlying problem is the focus of health care is reactive. There is no, or very little, incentive for preventative care.

    That being said I am always skeptical of governments motive and/or ability to do anything efficiently. I am interested to hear the Supreme Court’s ruling and reasoning as well as the dissenting opinions.

    Good discussions. Thanks.

  15. Emily says:

    So would it be reasonable to offer Medicare to people who otherwise cannot get insurance? From what I’ve heard, it’s a program that basically does work.

    • Sarah in Alaska says:

      Please define “cannot get insurance”. Are you talking about people who have been denied private insurance? Typically these individuals have the option of a state high risk pool – which is expensive. So, would you include people who “cannot afford insurance” as well? This is where the line gets muddy – defining who cannot get insurance, afford insurance and who choose not to buy insurance.

      Problems with opening Medicare to individuals include:
      1)It is an entitlement program that we a offer to people who have “paid their dues”. It was designed for the elderly and disabled – not for people who choose not to cover themselves.
      2)It is expensive for the country. My understanding is that Medicare is the real retirement financial problem – not Social Security.
      3)Doctors would have to get on board. Medicare fee schedules are much lower than what private insurers pay for care.
      4)There is very little preventive care in Medicare (at least prior to health care reform).
      5)There is no out of pocket max for Medicare. You pay 20% of the cost. That is why a market for Medicare Supplement policies exists.

      If you are meaning Medicaid (health care coverage for the poor), broadening the scope of the program is part of PPACA and is an issue under deliberation in the Supreme Court.

  16. Charles says:

    Jim, The Constitution states (amongst other wonderful words)”to provide a common defense.” Substitute mandatory military service and gun ownership for “broccoli.” Yes the slope is slippery.

  17. Charles says:

    My largest issue with healthcare as it stands now? Getting insurance carriers to follow the terms stated in the policy. I had “government health care” (retired military) thanks but no thanks.

  18. Jonathan says:

    You really have several options, if you are honest.

    1. Continue the current system. In my opinion this is unsustainable because of cost. Right now about 25% of my health plans costs go towards covering the uninsured. To make it sustainable, society has to be willing to say, “we will not cover the uninsured.” However, the majority will not deny coverage to the uninsured.

    2. Single Payer or Medicare for all. This makes them most sense if you are fiscally conservative. Employers and individuals could still purchase supplemental insurance.

    3. Provide subsidies to buy insurance, mandate that all people buy insurance or pay a tax penalty, and forbid insurance companies from discriminating against the sick.

    There are no small changes to the current system that makes it financially sustainable. The plan I am on went from $450 in 2002 to $1200 today (family plan) and the coverage has been reduced. This can’t continue.

    • Kurt says:

      I’ll have the #2 family serving.

      As I told my wife, my pay has not gone up over the past 6 years. Every year we are going backwards financially because of health insurance, health care and future college tuition for my kids. It is not a trajectory that has a happy ending.

  19. Evan says:

    “I also think this is an exception”

    No! The government should not be allowed exceptions to ignore the Constitution. What kind of SCARY world would we live in? Imagine if the police were allowed to just ignore a couple of the Amendments found in the Bill of Rights…just because?!

    I agree with 82% of your post there is a problem, but the government is rarely the solution.

    • Jim says:

      It’s not an exception to ignore the Constitution, don’t throw up that straw man argument. Just give me whatever reason we currently use to justify Social Security and Medicare.

      • govenar says:

        Maybe the reason for Social Security and Medicare is “two wrongs make a right”. I’m not sure what three wrongs make.

      • Drew T says:

        The comparison between healthcare and Social Security/Medicare must be made after examining the constitutional justification on which each body of law is based. Social Security and Medicare are based on the taxing and spending power of Congress. (Whether such justifications are valid is an entirely different issue.) In contrast, I believe that the administration’s argument in support of the PPACA rises and falls on whether or not the law is a valid exercise of Congress’ power under the Commerce Clause (there are some nuanced issues dealing with whether or not the requirement to pay for health insurance constitutes a tax, but I haven’t reviewed the transcripts of the oral arguments to really get into those). As you can see, the PPACA and Social Security/Medicare are different types of entitlement programs with different purported constitutional justifications.

  20. Matt says:

    Most Americans and most doctors want this repealed, that alone is why it should repealed. But that doesn’t even take into account what socializing medical care will do, it will lead to worse care and lower bottom lines for healthcare providers. With less income coming in some of our nations brightest minds will look for a more lucrative career then becoming a doctor or surgeon. A capitalistic healthcare system, which is not in place now, would increase competition and reward the best performers in the industry. That is why specialized surgeons such as hand surgeons earn over $600,000 a year, under this plan those days would come to an end creating jobs that might not be worth the time to prepare for some of America’s brightest minds.

  21. patriotamerian says:


    I completely agree with your position on health care.

    Also would like to point out that individual mandate was an idea originally floated by republicans/conservatives and that time the repubs didn’t have any issues with it. Also if people remember Bill Clinton’s health care plan failed because it lacked individual mandate as was stated by republicans than.

    Will be very honest here, the people on the blog or 5 replublican appointed supreme court justices don’t like the plan is because the plan was approved by democratic president ( and that too black…I know it will be provocative but I have been to may tea Party rallies in florida and for better or worse have been exposed to the realities of opposition to the health care plan).

    It is also interesting to note that same replublicans who are in arms against the president that has passed a historic bill had no issues when romney care was enacted.

    Also it is very funny to see that same replublicans who hate President’s health care plan have no qualms voting for romney( romney care was the blue print of mr. president’s plan).

    It is unfortunate though that the country is so much polarised and still has an underlying racial bias that influences the decision and people try to talk legit or force themselves to sound reasonable knowing very well that the actual reason is something different.

    It is a sad story and this will result in a very sad outcome which would diminish our status in the world.

    • Jim says:

      You address the worst part about the whole debate and it’s the reality that politics matters more than results. People hate an idea because “the other side” came up with it or is in power to pass it.

      • tom says:

        It’s unfortunate, but true.

        Republicans became the party of “NO”, 100% against any idea coming from the Democrats. It’s a stupid position, but it’s one created by the Democrats.

        They did very little to entertain any Republican ideas (regardless of the history of the individual mandate). Paul Ryan set forth some great ideas in his health insurance plan, but President Obama and the Democratic majority threw it all out and forced through a bill that Republicans virtually had no say in.

        Republicans tried everything in the book to stop this bill, to put their mark and ideas in the bill. None of the big, heavy hitting ideas made it in (interstate insurance commerce, tort reform, etc.). They had no say and over the past 3 years have been harboring a huge grudge.

        Frankly, because of this, I want ALL incumbents to lose. All Republican Congresspersons passing ridiculously partisan bills, all Democratic Senators whining about Republican bills. Everyone needs to go and be replaced with Congresspersons and Senators that will compromise.

  22. eric says:

    Right on, Jim. I’ve spoken to some quite obnoxious people (well maybe I’m the obnoxious one) about this issue recently. Your post perfectly illustrates my view too.

  23. Mike says:

    The individual mandate is critical for this whole thing to work. If people want guaranteed issue coverage with no pre x, you cant just let people buy in and out of the plan when they want. I’m healthy now so I wont buy insurance,but i will wait until I get sick to buy the coverage without restriction. That’s crazy! If they can’t make everyone purchase insurance then there needs to be some sort of penalty like with Medicare Part D and B.

    Opening coverage up across state lines is a joke. How much do you really think competition can bring down? Even if they magically get our prices down 30%, the coverage will still be too expensive.

    I don’t know what the answer is to fixing everything but I have no problem with the mandate as long as they can assure us there will be an affordable, decent option. By the way, what premiums would be considered affordable????? That is a question they can’t answer. NJ heavily subsidizes the no pre x plan and barely anyone has enrolled. Its way too much money still and it is at least 30% less than other plans.

  24. elloo says:

    This mandate is all about spreading risk by enlarging the covered number of lives so that everyone is covered and can afford it. For example, way too many people are using the emergency room as their primary care doctor because they don’t have insurance. It’s the most expensive doctor visit with a bill that can be at least 10x more expensive than an office visit. This plan would ease this issue among others.

    • elloo says:

      And, there are lots of mandates to help citizens such as paying into social security and unemployment insurance to name a few. Why not a mandate to ensure better health?

  25. real conservative says:

    Lets face the FACT: Republicans (Romney, Scrotum, Paul, Bush, Rush, Beck, Paling, Fox news, etc.) are utter complete lunatics, they are the real enemy of American people.

    And the ABSOLUTE proof of this FACT, comes from Margaret Thatchers conservative party in UK, Stephen Harpers conservative party in Canada, etc. because ALL these Conservative parties are 100% for their Universal Nationalized Health care systems (NHS), what Republicans call “Socialism” and oppose. So either ALL Conservative parties in Europe, Canada, etc. are “Socialists” or Republicans in US are complete lunatics.

    So why ALL Conservative parties, repeat for Republican lunatics, ALL Conservative parties, in Europe, Canada, Israel, etc. are 100% for their NHS? Because a real conservative, would want to Conserve money while getting the Job done which is what NHS does because it SAVES 50% on cost of health care while giving health care to all.

    Lets also state: health care reform Obama/Dems passed is a near joke of a reform since it is anything but NHS.


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