“Obamacare” debate: Healthcare mandate unconstitutional, but auto insurance mandate just peachy

by on March 27, 2012 · 71 comments

in Economy, Election, Health, Politics, Popular

As the Affordable Care Act has its day in front of the Supreme Court, at issue is the individual mandate that is the very heart of the law.  So if the healthcare mandate is declared unconstitutional, does that mean that auto insurance mandates are similarly unconstitutional?

Unless you’ve been hiding under a rock, then you’ve probably heard that the Supreme Court’s hearing on the Affordable Care Act, or “Obamacare” as Republicans so love to derisively call it, has begun in earnest over the last two days.  At issue is the matter of whether or not the individual mandate—the requirement that everyone who can afford to purchase some form of health insurance does so or face a penalty—is constitutional under the Commerce Clause.  Republicans, despite their zeal for the idea not too long ago, and despite the fact that Republican presidential frontrunner Mitt Romney pioneered a nearly identical plan as governor of Massachusetts, are vehemently opposed to the federal government “taking away our freedom” by forcing its citizens to buy a health insurance plan that they will with near absolute certainty need to use at some point in their lives.

Let’s set aside for a moment that the individual mandate was originally a Republican idea that was passionately advocated by Republicans just a short time ago.  Set aside the fact that ever since President Obama adopted the mechanism and incorporated it into his historic healthcare reform initiative Republicans have suddenly done a complete 180 and decided that it’s the absolute worst idea since banking regulation and in no way constitutional.  ‘Cause, you know, there’s some sort of not-so-secret pact amongst Republicans to oppose absolutely everything that Obama says he’s in favor of.  I mean, if Obama said that he liked puppies, Republicans would suddenly embark on a crusade to rid the nation of those vile, nasty, anti-American puppies.

So let’s set aside the fact that the entire plan from top to bottom has Republican fingerprints all over it.  The question before the Supreme Court is whether, under the Commerce Clause, the government can mandate the purchase of health insurance.  The argument goes that since health insurance is something that absolutely everyone is going to need at some point in their lives, those that don’t have it and who subsequently find themselves in need of medical care but cannot afford to pay for it themselves affect the cost of health care for absolutely everybody else.  Current estimates say that the uninsured add an extra $1,000 to everyone else’s healthcare costs.  And by mandating that everyone have some form of health coverage, it increases the risk pool which brings down the cost for everyone since there will inherently be more healthy people in the market and far fewer without coverage and unable to pay for medical care when they need it……and they will need it.

That’s the basic argument on the part of the government:  That because the cost of healthcare effects absolutely everyone at some point or other, then Congress has the authority to regulate it.  Besides, everyone pays into Social Security and Medicare, and those are deemed perfectly constitutional.

The opposition—the 26 states that are suing to overturn the law—asserts that “Obamacare” is a bridge too far.  If the government can force its citizens to buy health coverage, then what’s to stop them from mandating a gym membership?  What’s to stop the government from forcing people to buy broccoli, as Slate’s Dahlia Lithwick put it in an appearance on “The Rachel Maddow Show,” “because, after all, broccoli is even more highly correlated to good health outcomes than health insurance.”  The opposition, she says, is giving us the old slippery slope argument that first health insurance, then broccoli, then all of a sudden the government will mandate that everyone buy a GM car in order to boost the economy.

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The opposition decries the fact that, for the first time, instead of the government regulating activity, now the government is seeking to regulate inactivity (i.e. the desire to not purchase health insurance).

Ok, so the argument is that the government should not be allowed to mandate the purchase of insurance because, you know, “freedom” and “liberty” and all that good stuff.  The government shouldn’t be allowed to mandate health insurance but it should be allowed to mandate medical procedures totally and completely unnecessary to abortion services (ultrasound laws).

But here’s another one that’s even more relevant to the current argument:  The government is not allowed to mandate health insurance coverage, but they can mandate auto insurance?  Every state with the exception of New Hampshire and Wisconsin require liability insurance in order to legally drive a car.  Without proof of auto insurance, you cannot register your car, and if you cannot register your car, you cannot legally drive your car.  And if you are pulled over and don’t have valid insurance or a valid registration, you are penalized in the form of a hefty fine and possibly the suspension of your driver’s license, not to mention the impounding of your car.

And don’t give me this “state’s rights” B.S.  A mandate is a mandate.  Why should the state be allowed to force me to buy something that I have never once used in all of the years that I have had a license to drive <*knocking firmly on wood here, throwing salt over my shoulder, and whatever other superstitious countermeasures I can think of*>, but the federal government is not allowed to mandate health insurance coverage?  And it is an Interstate Commerce issue, since an uninsured person could just as easily get sick or injured in Arizona as he or she could in their home state of, say, California (Arizona is one of the states suing to overturn the law, but oddly enough they, like 47 other states, mandate auto insurance).  And if an uninsured person from California gets sick or injured in Arizona, then it’s the fine people of Arizona that are stuck footing the bill if he or she can’t pay.

If a system of health coverage works in Massachusetts—a system that was created by a Republican Governor that is now running for President of the United States but now opposes his own health care plan—why should that plan not work on a national level?  And why should we listen to that guy who created that very system tell us now why it’s such a craptastic idea for the country when just three years ago he was telling anyone who would listen what a brilliant idea it was for the country because it was working so well in Massachusetts?

If the healthcare mandate is unconstitutional on a national level, then it should be deemed unconstitutional on the state level.  And if it’s unconstitutional on the state level, so is the requirement to purchase car insurance.

If the healthcare law is overturned, I for one will look forward to the ensuing repeal of all auto insurance mandates.  ‘Cause, you know, the guvmint shouldn’t be allowed to force me to buy something I don’t want, no matter how much my actions affect those around me.

{ 71 comments… read them below or add one }

Bearded OBcean March 27, 2012 at 3:18 pm

Hmmm, so the government forces people to drive cars? Isn’t that a privilege and not a right?

It’s also worth noting that grass root conservatives have never been in favor of a mandate. Some republican polticians have been. But there have also been pro-life democrats. So what does that tell us? Nothing really as it relates to healthcare.

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CHY March 29, 2012 at 3:24 pm

using your line of thought, but to put it in a drastic way:
It follows that so the government cannot force people to live. But if you wanna live, you’d better buy health insurance…. ?
Doesn’t work right?

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RB March 27, 2012 at 3:25 pm

You are not required to buy auto insurance. You don’t have to buy auto insurance, if you are not going to drive. You don’t have to buy auto insurance, if someone let you drive their insured car. You are not fined or taxed because you don’t buy auto insurance.

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Andy Cohen March 27, 2012 at 4:13 pm

But if you are going to drive (and here in California, unless you live in San Francisco or Oakland you really don’t have much of a choice), then you are absolutely required to purchase liability insurance, without exception. Yeah, yeah, yeah…..driving is a privilege not a right. No, driving is not a privilege; in most of the country driving a car is an absolute necessity! It’s a necessity and yet the law says that you cannot drive without insurance. So why do we differentiate?

Oh, and by the way: Republicans are basing their voter restriction—-I mean voter ID laws on the premise that most people have a driver’s license, and if you don’t, too bad.

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RB March 27, 2012 at 4:52 pm

Oh, and by the way: Your argument is that everyone has to drive, but the fact that everyone does not have a driver’s license available for voting means this is not true.
Also, nobody is fined or taxed for not having a driver license.

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Paul March 27, 2012 at 6:02 pm

http://www.dmv.state.pa.us/pdotforms/fact_sheets/fs-inla.pdf
*********This is the State Of Pennsylvania Law: And Yes they are fined for not having Car Insurance!!!!!*******
WHAT HAPPENS IF YOU ARE STOPPED AND DETERMINED TO BE OPERATING YOUR VEHICLE WITHOUT
INSURANCE?
If your motor vehicle is not insured with liability insurance, you could face the following penalties and expenses:
???? A minimum of $300 fine for driving uninsured
???? A three-month suspension of your vehicle registration
???? A three-month suspension of your driver’s license
???? $50 restoration fee to restore your vehicle registration
???? $50 restoration fee to restore your driver’s license
???? That vehicle may not be driven by anyone while the registration is suspended.

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rusureuwant2know August 11, 2012 at 8:14 pm

Here’s the deal for those that can’t see how the car insurance issue is the same as the health insurance issue: Mandated car insurance was so drunk drivers (who couldn’t get car insurance) would be able to get high risk insurance – mandated health insurance is so people who can’t get health insurance will be able to get coverage.

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Frank Gormlie March 28, 2012 at 7:11 am

No, they’re arrested and cited for driving without a license.

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paul March 28, 2012 at 7:41 am

Oh okay that’s why I got that Information word by word off of the PA DMV Website which I have listed. I
sighted it and its all there.

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justsid June 16, 2012 at 10:46 pm

I lived in P.A. If you let your insurance lapse over 21 days and you do get fined irregardless of whether you own a car or not. If you have a license in P.A. yo0u must have insurance. I had an auto accident in P.A. years ago and lost my car for 2 years because I couldn’t afford one. I was forced to continue paying insurance on my non existent car for the entire 2 years or have my license suspended and pay numerous fines. If you have a license in P.A. you must own auto insurance. Car or no car.

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Goatskull March 27, 2012 at 4:56 pm

“I mean voter ID laws on the premise that most people have a driver’s license, and if you don’t, too bad.”

For those who don’t drive there’s still state IDs no? Not saying I agree with ID rules for voting but don’t all states still have non driving IDs?

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Andy Cohen March 27, 2012 at 5:25 pm

Yeah, they do, but they’re not always very easy to get. And if you don’t drive, there’s the issue of having to get to a DMV or wherever else other states provide government issued ID’s. If you’re poor, or you’re old, and you don’t drive, and you don’t have an ID, then you’re completely hosed. And if you’ve ever tried to get a passport, you know how difficult those can be to get. The State Department reports that only 12.6 million out of 330 million Americans have a passport.

Bottom line: Most states regard those applying for something other than a driver’s license as somehow suspicious.

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RB March 27, 2012 at 5:35 pm

Poor government service from the State Department and the DMV are great examples of why the government should not run our healthcare. And let’s fine everyone who does not have a driver license or auto insurance so we conform to spirit of the new healthcare law.

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Arthur Banks March 29, 2012 at 11:07 am

RB, Isn’t Medicaire being run by the government?

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Mike March 28, 2012 at 6:50 am

Correction: 109.8 million have valid passports. So basically 1 in 3 have passports.

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Andy Cohen March 28, 2012 at 7:52 am

You’re right. In my haste, I didn’t look far enough down the page. The 12 million was how many passports were issued in the last year.

Apologies.

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Cheen March 28, 2012 at 10:16 am

I am pretty sure you can get an ID in any state just as easy as getting a driver’s license. Probably easier. Not sure what that argument was about.

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Chris March 27, 2012 at 5:01 pm

You could choose not to live, thereby guaranteeing the rest of us won’t be burdened by your future health care costs.

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Sherrie Roberts March 27, 2012 at 5:24 pm

So you aren’t going to drive. That’s a choice that affects NO ONE else. You choose to not carry health insurance, when you get sick, I pay for your medical bills. Get it?

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Andy Cohen March 27, 2012 at 5:31 pm

Except that if you are going to drive a car–which is an absolute necessity for most Americans–then that choice (or necessity as the case may be) affects everyone else that’s on the road. It’s not a false equivalency.

As I argued above, driving is not a privilege, it’s a necessity for most……..unless you live in a place like New York or Chicago with excellent public transportation. Unfortunately, very few places have the kind of public transit system that makes driving a car optional. So since the overwhelming majority of Americans over the age of 16 drive a car, then it becomes very much like the healthcare mandate. You MUST by law have insurance.

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Cheen March 28, 2012 at 10:22 am

Our nations health has been terrorized by the likes of processed foods and binge intake of pharmaceuticals. The government supports the companies that pump out product by the billions in order to subdue the population. This is a pretty good indicator as to why this is another easy way out all the while deepening our spiritual oppression. Yeah, it’s such a great idea to have big brother looking out for us. The INCB report notes that in the United States alone, an estimated 6.2 million people were addicted to prescription drugs in 2008, or roughly 2 percent of the population. Among illegal drugs, only cannabis use exceeds this figure. That is staggering. Do you think that the companies that lobby for our leaders are at all involved here? Legalize weed. That will be our universal healthcare.

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CHY March 29, 2012 at 3:28 pm

but we all have to live. it the “auto-world” its kinda like everyone has to drive.
if driving means we need auto-insurance. Sounds to me like living means we need health-insurance.
bottom line is, I’m still not convinced that auto-insurance mandate is constitutional but health insurance mandate is not.

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Anna Daniels March 27, 2012 at 3:43 pm

Andy- you are quite right about the states rights aspect. From what I understand, the court decision, if it is against the individual mandate, does not mean the overturn of mandated health insurance in Massachusetts. Conservatives hate federal regulations except when they love them. As in we need a federal law to abolish abortions. As in we need a federal law to maintain the Defense of Marriage Act.

So I can see the state legislation now: Women seeking an abortion will be required to eat broccoli before undergoing a state mandated transvaginal sonogram and then being forced to watch the sonogram. All of that is true in the state of Texas- except for the broccoli part.

Here’s to universal health care. Here’s to Medicare for all.

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Sherrie Roberts March 27, 2012 at 5:34 pm

there ya go, Anna! And I live in Texas (I love Texas, I hate their conservative leanings).

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Kim March 27, 2012 at 3:59 pm

What doesn’t make sense is letting people not contribute then come screaming “I’m an American” (you know they will) when they need help. Why is it that when we try to do something for all of us we still divide into teams and have a fight? It doesn’t really make much sense!
I recently went on Medicare so now everyone contributes to my health (I thank you for that) how is that not a national mandate? What am I saying keep the governments hands off my Medicare! Might as well act as stupid as possible get my full load of unwarrented attention.

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Maurice Danger Cobbs March 27, 2012 at 4:41 pm

“As the Affordable Care Act has its day in front of the Supreme Court, at issue is the individual mandate that is the very heart of the law. So if the healthcare mandate is declared unconstitutional, does that mean that auto insurance mandates are similarly unconstitutional?”

No.

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

State governments can do things that the federal government cannot. By design.

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Bill Werts March 27, 2012 at 5:06 pm

Forcing people to pay for another’s insurance is Unconstitutional. The bsad comparison you attempt to make between this and auto insurance has flaws such as:
1. Not everyone is required to buy auto insurance, only those that choose to own a car.
2. Those who don’t drive are not being forced to pay for insurance for those that do.
3. I will not use insurance near as much as many unhealthy people who have made poor choices regarding their health, yet those odf us that actually care for our health will be penalized by this Unconstitutional mandate.
4. I know you don’t like to hear states rights, but the Constitution is very clear on this. We have an Amendment process. Don’t bypass the Constitution, change it.

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Andy Cohen March 27, 2012 at 5:33 pm

Again, driving a car for the majority of Americans is not a choice, it’s a necessity.

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Carol March 27, 2012 at 8:09 pm

As an insured, healthy person who rarely goes to the doctor and hasn’t spent a day in the hospital, I am not sure where I stand on an individual mandate, but if I were UNINSURED and healthy, I could just as easily require emergency medical services (in the event of a car accident or something similar). Unless a medically uninsured person (by choice) has the means to pay out of pocket for medical care, I don’t think that person has the right to be a financial burden on others, either directly or indirectly. On the other hand, I do not agree that people on Medicaid should be entitled to pay nothing for their medical care. I still think a sliding scale for low-income individuals is more than fair.

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Alan March 28, 2012 at 8:42 am

“Forcing people to pay for another’s insurance is Unconstitutional”?

WITHOUT the healthcare mandate, who is FORCED to pay for the uninsured people receiving medial cares? The answer is: everyone else!

That is, Non-Mandate system is literally “forcing people to pay for another’s insurance” by definition. HOW CAN NON-MANDATE BE CONSTITUTIONAL, then?

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Goatskull March 27, 2012 at 5:32 pm

“3. I will not use insurance near as much as many unhealthy people who have made poor choices regarding their health, yet those odf us that actually care for our health will be penalized by this Unconstitutional mandate.”

OK. What about unhealthy people WHO DIDN’T make bad choices?

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Andy Cohen March 27, 2012 at 5:36 pm

Exactly. At some point in their lives, EVERYONE will have to visit a doctor or hospital. EVERYONE will at one point require medical care. And if you require medical care and don’t have insurance and can’t pay for that care, it affects everyone else in the form of higher healthcare costs.

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derek March 28, 2012 at 12:50 pm

yes most people will see a dr….and at one point i didnt have insurance. i told my Dr. and guess what? he made it work. and said hey even thou you dont have insurance we can still work around that.

hmmmmm, so maybe talking and arranging somethign with your dr instead of asking for handouts…wow what a concept. but i guess a union would get in the way. andy i used ot live in ny. you know what was aweosme see construction workers, teachers and all the unions slack off and get paid for it.

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Andy Cohen March 28, 2012 at 2:54 pm

Here we go…….the ‘ol “Chickens for Checkups” plan again……..I’m sure your cardiothoracic surgeon would gladly take a couple of batches of cupcakes for that triple bypass he performed on you as payment.

Hey, derek: You gettin’ your talking points from Sue Lowden?

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James March 27, 2012 at 11:24 pm

In my mind there is no question that we should have a national health care plan with coverage for all legal citizens. Single payer. The constitutional question of mandate is a not so comical sideshow. If we are to make health care a “right” individual responsibility is inherent.

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Steve March 28, 2012 at 7:31 am

Perhaps we need to drop the idea of hospitals and doctors being forced to help those that choose to remain uninsured. Lots of people would possibly die, but that is a choice they made so let’s free the health care industry of that burden. I believe this was actually one of the more rational statements I heard Ron Paul make. but you can’t have it both ways.

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Mike March 28, 2012 at 7:51 am

So how is this to be done? How does EVAC/Emergency personnel identify a person worthy of extraction in a car crash or transport to a hospital? Sounds like we’ll have to create a National Registry of everyone who HAS insurance or proof of finances set aside in a trust to be eligible for emergency care. And even if you do have coverage, the level of actual coverage varies so much that emergency providers still stands to lose money based on default of the patient on the debt. Sounds like we then need to create a National Registry and regulate what is covered as a standard insurance policy. Doubt Americans will stand idle at a crash scene if their fellow citizen doesn’t have insurance coverage.

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Andy Cohen March 28, 2012 at 7:59 am

That’s pretty much what it’ll come down to, and it’s the only way to really make the system work fairly if this healthcare law gets overturned and short of a single payer system. If you don’t have insurance, and you don’t have the means to pay for your medical expenses out of pocket, then you get turned away.

If you’re going to provide medical care to everyone regardless, then you have to have a way to pay for that care. And if you’re not willing to find a way to pay for it, then some tough decisions have to be made. And I would really like to see Republicans introduce this kind of bill, because at least then we’d know without any doubts whatsoever where they really stand. It would go a long way toward waking people up to what the issue of healthcare is really all about. It’s cruel, but sometimes the only way to get the point across is to be cruel because some people are just too thick headed to get it otherwise. Hell, maybe some Democrat should introduce it just to make the point (but not actually vote for it, of course). We gotta do something.

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Steve March 28, 2012 at 8:22 am

Perhaps we should also implement a term health care premium so you dont have to buy insurance but its way cheaper for you if you start buying at an early age. We give everyone a 1 year grace period to get coverage or not and then implement the published term schedule. As example, at age 21 you buy the policy then it costs $500 a year for your entire lifetime, if you wait at age 45 it would cost you 12,000 a year for the rest of your lifetime. You get an insurance card to carry with you at all times like your drivers license, you are in a national database, and if your current you get coverage, if not you get NO coverage. Lots of CHOICE here and the individual carries the RISK as to when and if they choose to get coverage.

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Andy Cohen March 28, 2012 at 8:27 am

But that would be a guvmint run program, with terms dictated by the guvmint. Can’t have that, remember? We’re supposed to lay ourselves at the mercy of insurance company executives, ’cause they know what’s best for our health care needs…….

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James March 28, 2012 at 5:32 pm

Ah! A key point made! Please convince me that you do not really believe that health care insurance will cost $1000 less per person if the mandate stands. Ripping this system from the hands of private insurance companies would be a giant leap forward yet that begs the question of where to place it. With both hands of Congress occupied (one on their genitals and the other in the pockets of corporate America) what are we to do?

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Mike March 28, 2012 at 8:36 am

And I can see we’re going to get into another situation similar to the firefighters standing by while someones house burns down because they didn’t make a payment or were late. But now its not property we’re talking about, but someone’s life. I’m sure there is a better way, but insurance needs to be disconnected from being a benefit at employers.

http://usnews.msnbc.msn.com/_news/2011/12/07/9272989-firefighters-let-home-burn-over-75-fee-again

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Andy Cohen March 28, 2012 at 9:07 am

Along this line of thought:

On MSNBC’s “Morning Joe” this morning, Donny Deutsch made this very point: “I want to also talk to those people about their Constitutional rights who don’t think there should be an individual mandate, and get into a car accident and wander into a hospital and the hospital says, ‘Sorry…….no thanks. You’re not part of the insurance (system). Can’t help you.’ Then we’ll hear what they have to say about the Constitution.”

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Anna Daniels March 28, 2012 at 8:20 am

Steve- “Let them die?” Do you really believe that? A breathtaking cruelty and callousness pervade all the personal freedom and free market happy talk coming from the libertarian fringe. Are you so quick to dismiss our social contract and replace it with social Darwinism?
Should the new motto of this country be Let Them Die? Or maybe Shoot First? Excuse me- I need to go take a shower to get the stink off….

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Jeff July 7, 2012 at 7:25 pm

Amen Anna.

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JohnnyRebel March 28, 2012 at 11:58 am

You are ignorant of U.S. Constitutional law, and you are wrong.

Article VI, Section 2, of the U.S. Constitution provides that the “… Constitution, and the Laws of the United States … shall be the supreme Law of the Land.” This Supremacy Clause has come to mean that the national government, in exercising any of the powers enumerated in the Constitution, must prevail over any conflicting or inconsistent state exercise of power. The federal preemption doctrine is a judicial response to the conflict between federal and state legislation.

If the Supremes overturn the health insurance mandate under the commerce clause, there can be much broader implications at play here. Auto insurance mandates by individual states are in jeopardy as well. In Massachusetts, the individual health insurance mandate may become unconstitutional and unenforcable.

Essentially, if the U.S. Federal Government, through our Federal court system, says that it is against our constitutional rights as citizens to force us to buy a commodity (such as insurance) at the Federal level; the states have no right to thumb their nose at our U.S. Constitution by enacting conflicting laws. The Law of the Land is our U.S. Constitutional Law, not state law.

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derek March 28, 2012 at 12:41 pm

this is a bad arguement. you are comparing apples and oranges.

a car can be a dangerous weapon that can hurt other people and property. not having insurance doesnt put other people at risk.

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Frank Gormlie March 29, 2012 at 4:51 pm

Oh, yeah? What if the parent doesn’t have health insurance, gets sick and is hospitalized for a long time, or even dies. What happens to those that parent left? Bad argument derek.

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Anna Daniels March 29, 2012 at 5:38 pm

When an insured person ends up in the emergency room for treatment, the rest of us pay in the form of higher premiums. This was the crux of the conservative support for the individual mandate- it puts the rest of us at risk. Now conservatives don’t want to have anything to do with their own position.
I support universal health care. Medicare for all.

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newshead12 March 28, 2012 at 3:41 pm

I was mandated to buy auto insurance because my school and job would not allow uninsured cars to get a parking decal to park in their parking lots. So this is an interesting comparison.

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Ernie McCray March 28, 2012 at 6:43 pm

Man, Andy, you sure put this together solidly, making points all Americans should look at and consider. It’s just amazing that there can be such animosity towards an idea that is intended to protect people in case of illness. I mean to the point that some are saying scrap the whole deal as opposed to maybe tweaking it here and there and improving it, using it as a start to something that is so needed. We can be so dumb as a nation sometime. But this piece is pretty smart.

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Andy Cohen March 28, 2012 at 10:49 pm

Yup…….and the 5 Supremes who are going to vote to dismantle the whole thing are about to bring holy hell to our entire system of government. Roberts, Alito, Scalia, Thomas, and Kennedy, according to a bunch of legal analysts I’ve read over the last couple of days, are about to turn the government’s ability to fund just about every discretionary program on the books on its head. Some have said that in effect they’ll be virtually eliminating government altogether with the precedent they’re poised to set.

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Bearded OBcean March 29, 2012 at 3:05 pm

Some have also suggested that the 4 Supremes in the bag for healthcare are going to vote to allow the federal government to intrude into our lives unlike anything that we’ve ever seen according to a bunch of legal analysts that I’ve read.

See, that argument goes both ways.

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JMW March 29, 2012 at 2:39 am

Your argument seems to be based on three main ideas: 1. health insurance is a necessity (which I dispute); 2) auto insurance is mandated by many states, and, therefore, so should health insurance be (two different things, only one of which could possibly impact you directly in any significant way); and 3) to lower the individual cost to you personally, everyone must pay for health insurance (Com’on, quit whining. If we’re going to talk about sharing pain for the common good, then there are many other issues of this size and bigger to be considered. Further, why should I contribute at all. Our society seems to be set up on the principle of “Tough Luck, Loser.”).

Item 1. The Inevitable Necessity of Needing the Services of a Physician
According to my dictionary, necessity means: “the fact of being … indispensable.” Your definition seems to mean, “something, the use of which during a lifetime, is almost certain.” These don’t mean the same thing. Many things are likely to be a part of almost everyone’s future: Plastic, toilet paper, hamburger, milk, socks, well, the list goes on and I’m sure a complete one is not necessary to get the idea across, but there doesn’t seem to be any urge to make insurance for these things a federal mandate.
Health insurance is not indispensable. It is easily possible to continue to live without it. I managed the first twenty years of life adequately without it. If we want to talk about ensuring to each American the availability of necessities, the indispensibles, why not Water Insurance, Food Insurance, Air Insurance, Sanitation Insurance, and Shelter Insurance? Plus, there are alternatives to the dominant style of medical practice in the U.S., and there are other countries where medicine is practiced.
The population of the world has survived and been fruitful for a time period that started so far back in the past we don’t really know how long it is. Something less than 100,000 years, I guess would be safe, but let’s be conservative and say humans have been on the earth for only 50,000 years. Still, in that span, lots of people have come and gone, and all the people who lived on the earth before what, 1950?, managed to live lives without health insurance. So, how is it a necessity? How is it indispensable?
Your most important point seems to be the inevitability of each person needing health care at some time during their life. Since it is proven by actuaries and numbers and statistics, it must be true, and, therefore, insurance is mandatory. One problem with this argument is the potential manipulation of data, and another is that though accurate, valid statistics can tell how many times an event will occur in a given number of cases, it can never tell what will happen in any given individual case. Maybe God will smile on me and I’ll never need medical care. Could be.
Health Insurance is hardly a necessity.

Item 2. Auto Insurance Is the Same Thing
I see little similarity between auto insurance and health insurance, though they are both forms of insurance.
Auto insurance is necessitated by the possibility that I might injure you while I’m driving; should I, you’re taken care of. You are, theoretically, guaranteed no loss because of my behavior.
However, I’m not obligated to drive or even own a car. If I so choose, I can live a life and never even know how much gas is costing today much less be afraid I won’t be able to eat if it goes up again. Few people in Manhattan need cars; one could move to such a place. In this case, the bell curve rewards those who don’t use.
Besides, if I get sick, what’s it to you? Nada. If I do receive medical care and you pay for it, yes, that’s a problem for you, but we have no assurance that situation will occur, regardless of the state of my insurance portfolio. Also, the bell curve would suggest that there are, very likely, people who will live and die in modern America without any of the benefits of modern medicine being administered by a recognized professional. So, some will be forced by the federal government to spend income on a product they will never use. The reason this group will be so burdened is so that your monthly cost will be lowered by adding these people to the paying pot. How is that fair? Your genes, your lifestyle, your diet, your choices, your problems, your tough luck; not mine. You pay your way and I’ll pay mine.

Item 3. All Must Pay So I Can Save
As far as I can tell from your post, the only reason I should pay for health insurance is so your cost will go down. How does that benefit me? Am I just supposed to sacrifice for the common good? Oh, right, you are certain that I will need care, and you also want to be certain that my care won’t cost you a dime. Okay. Fine with me. Hire a Pinkerton, have me followed. I’ll pay for mine. I’ll take my chances and deal with the results.

The Slippery Slope
Aside from the the apparent belief shared by most commenters that making medical care a commercial, corporate product under the guidance of the insurance industry will improve it, an assumption I doubt to my core, I also wonder what else might end up being justified by this same logic. We’ll all use cars so why not have Have-A-Car Insurance? Gotta have gas: Exxon Insurance. Gotta keep that car in good shape: Mr. Goodwrench Insurance. Unavoidably, at some time in everyone’s life, tinfoil will be important: Tinfoil Insurance. We all eliminate waste: Toilet Paper Insurance. Again, the list goes on …

The Last Word
Lastly, some of the commenters seem to want to dismiss the idea that the country could provide quality medical care at a national level to anyone who happened to be here and needed it. I disagree. I think we could. I think we should.
But, I am utterly opposed to being threatened by the federal government into buying a commercial product from a private business that I do not wish to have.

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Goatskull March 29, 2012 at 8:05 am

Bottome line JMW is you don’t have a damn about others and people will will suffer because of people like you. But hey, you’re getting yours right?

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Goatskull March 29, 2012 at 8:27 am

Also, everyone can’t just pick up and move to a place like Manhattan so that was a lame example.

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JMW March 29, 2012 at 11:32 am

So, you didn’t care for the comments, huh? Well, we disagree. I gather you see this legislation as a push forward for health care for all Americans. I don’t. I see it as the first direct line, the first tentacle, of the insurance industry into our pockets, into our paychecks. So that forever more, Americans will be paying AIG or Farmers or SutureSelf, Inc. for paper which says the payees will be made well, if approved.
Also, even if bad decisions have been made in the past, as referenced here, like Social Security and others, so what? Does that mean we have to support bad ideas now?

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Frank Gormlie March 29, 2012 at 4:55 pm

Really??? You say “why should I contribute at all. Our society seems to be set up on the principle of “Tough Luck, Loser.”). You’re just repeating what you seem to think is society’s view – tough luck loser. But society is much more compassionate than that – and so are you. When you get back, you’ll be eligible for social security and Medicare. Are you going to simply refuse to take those? No, because you’ll say, well, I am the one who contributed to Social Security, so it’s mine.

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JMW March 30, 2012 at 2:04 am

Yes, really, at least when indulging in hyperbole. It is a tough-luck-loser world, Frank. Our views of how compassionate society is diverge. Individuals, sure. Our society? Only if you’re on TV and sympathetic. And then only for as long as you’re news. If our society is compassionate, why do we have this problem of health care? Why is getting the bottom of the barrel, and that with strings, such an accomplishment?
A compassionate, for that matter, even a reasonably intelligent society devoid of compassion should easily be able to find reasons enough to foster and maintain a healthy society. After all, we might need soldiers sometime. Increased productivity and reduced expenditures might be two more reasons thought to be good.
However, the question of to what degree our society is compassionate is tangential relative to the possibility that all of us may soon face a federal requirement that we buy health insurance from a private, commercial provider.
Of course, when the contract conditions say it is permissible for me to do so, I’ll make every effort to regain the money I was unable to keep from lending the Federal Government via payroll deductions for SSI during my wage earning life. That’s the deal they presented and the one I accepted. Didn’t like it, but saw no viable option.
As to Medicare? I don’t know; haven’t given it a thought.
But, so what? What do either of these things, these side issues, prove? A deal’s a deal?
This mandate effectively puts the medical/insurance industry, profit-driven corporate entities with only financial goals as guides, in charge of almost all the health care in the U.S. and legislates that we become participants, willingly or not; us and every American to follow. A nightmare waiting for caricatures. My thought is that the affected industries would not have surrendered to the logic of this mandate were they less than certain they would benefit from it.
Soon, we might well be faced with the prospect of rejoicing over having finally attained the bottom of the barrel. Well, sometimes, that is the best choice.
Congratulations to supporters!
Say, can you spare a dime for my legal fund? I’ve been busted for not buying health insurance.

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JMW March 30, 2012 at 2:33 am

Also, to ask “Why should I contribute at all?” is not the same as saying, “I refuse to contribute.”

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Frank Gormlie March 31, 2012 at 8:08 am

True. I hate to argue wit ya, since we rarely see your words here.

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Monty Kroopkin March 29, 2012 at 6:37 am

Progressives should advocate that the individual mandate be ruled unconstitutional. It is bad enough that state constitutions already allow individual mandates for citizens to purchase private for-profit goods and services (think smoke detectors; think car insurance). We do not need nor want the federal government to expand its powers and begin doing the same favor for the insurance industry.

Instead, we need to kick the insurance industry out of our healthcare system. We need publicly funded universal healthcare. Expanded Medi-Care for all (with improvements that bring the Medi-Care coverage up to at least the higher standards of Veterans Administration healthcare) is what we need to demand.

We need to keep reminding everybody that health care is one of the Universal Human Rights recognized in the Universal Declaration of Human Rights. The USA not only signed the Declaration, but promoted it in the United Nations.

Stop the violation of our human rights by the corporate fascist oligarchy of the “1 percent” and their bought-and-paid-for corrupted politicians of both Wall Street political parties.

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Andy Cohen March 29, 2012 at 12:18 pm

If “Medicare for all” had a prayer in hell at passing through Congress, they would’ve gone for it. But it was a complete non-starter, which is why we ended up with the ACA as it is. It would certainly be great to be able to “kick the insurance industry out of our healthcare system,” but at this point in time it’s just not a realistic goal and it would have been an exercise in futility to even try. You have to understand the political environment that they’re working within, and understand what you can and cannot get passed within that environment.

Here’s the way I see it: The ACA is a starting point. Eventually, 20 years from now, maybe we’ll work our way to true universal healthcare, or “Medicare for all.” It’s certainly what I would like to see. But from practical and pragmatic standpoint (which is how Obama has looked at this thing from the very beginning instead of an idealistic approach that would never fly) this is probably the best we could do for now. And it’s a good start, but it’s only a start. They designed this thing to morph over the coming decades.

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Frank Gormlie March 29, 2012 at 4:58 pm

If you think we live in a “corporate fascist oligarchy” – why bother to complain at all? I mean, fascism by definition cannot change from within, has to be knocked down from without. How can you on one hand, want to kick the insurance industry out of our healthcare system – an excellent goal -, but then at the same time believe we live under a fascist system? Under fascism, there are no progressives left. No anarchists either, oh, and no unions, no right to vote, and certainly, no right to health care.

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Jeannine Ford March 29, 2012 at 6:22 pm

Okay, I don’t want to purchase auto insurance! But guess what, legality I must purchase it to operate my vehicle. If you leave your car parked in the garage, you won’t need insurance but the human body is ALWAYS at risk of accidents or illnesses; and when that happens, you need health care! Mandatory insurance for people is the same as mandatory insurance for our vehicles!

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Cameron March 30, 2012 at 5:36 pm

This argument is comparing apples and oranges. Auto insurance laws are for financial liability should you hit another vehicle. In many states you simply need minimum liability coverage so if you hit another driver it covers their property. I would be pissed if I had my car totaled by uninsured driver. I walk into a hospital without insurance, I’m not doing any damage to anyone else’s health or property. Plus, if we don’t like our state’s auto insurance mandate, we have the ability to strike it down through a referendum vote. The federal law does not allow this. And show me anywhere in the Constitution where it says the government can make me do something. The Constitution was written to protect citizens from the government doing just that.

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J Zelinsky April 2, 2012 at 5:50 pm

If you have not seen” Obama’s Deal” on Public Broadcasting regarding the health care bill, go to their web site and watch it.I saw it on PB on TV 1 time and watched it twice on the PB site. It was the health insurance industry that said , “we want the American people to know that we are the ONLY ones who can supply health insurance, therefor EVERYONE WILL HAVE TO HAVE IT”. So in order for President Obama to put together any kind of health care bill, it had to have that mandate in it.

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Charlie April 2, 2012 at 10:24 pm

It is actually pretty simple. The Feds do not have the constitutional power to force an individual to buy anything! The states on the other hand do. That is the way it is written and that is the way it should be. If this is found constitutional they really could force you to buy broccoli. No longer a need for state government as the Feds could assume control of everything.

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TJ April 3, 2012 at 5:53 am

So am I to understand that you don’t realize that the states and the Federal government have different powers? This is laid out very clearly in the Constitution (specifically in the 10th Amendment). I suggest you read it sometime.

The funny thing about this rant is that you could have just researched why STATES can mandate auto insurance (notice the FEDERAL government cannot) and how that is completely different than the issue at hand instead of broadcasting your ignorance to the world.

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Chuck April 3, 2012 at 8:20 am

RE: It is actually pretty simple. The Feds do not have the constitutional power to force an individual to buy anything!

They force me to buy Social Security and Medicare.
Also this is not the first time health insurance was mandated…..

Congress Passes Socialized Medicine and Mandates Health Insurance -In 1798
The law was not only the first time the United States created a socialized medical program (The Marine Hospital Service) but was also the first to mandate that privately employed citizens be legally required to make payments to pay for health care services. Upon passage of the law, ships were no longer permitted to sail in and out of our ports if the health care tax had not been collected by the ship owners and paid over to the government – thus the creation of the first payroll tax in our nation’s history.

http://www.scribd.com/doc/29099806/Act-for-the-Relief-of-Sick-DisabledSeamen-July-1798

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candy direct April 12, 2014 at 2:52 am

I needed to thank you for this good read!! I absolutely loved every little bit
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