We can compel military service (the draft), but we can't compel health insurance?

[OneAngryDemocrat]

Everyone is hung up on the commerce clause - and I agree that the HCA individual mandate is legal because of it, but what about the necessary and proper clause?

The arguments against the mandate are, to be frank, STUPID.

[Art_from_Ark]

1. The US hasn't had a draft for nearly 40 years

It was abolished because it was unpopular.

[SickOfTheOnePct]

2. But it can be brought back at any time

Males still have to register at age 18

[Art_from_Ark]

3. Sure, there is registration for Selective Service

but there is no draft.

[lumberjack_jeff]

12. Distinction without a difference.

All it takes is a phone call.

[OneAngryDemocrat]

5. "Unpopular" doesn't mean "Unconstitutional"

Just keeping things real. The draft was never abolished. It just hasn't been implemented recently. That doesn't mean it went away. 18 year olds still have to register for it, and the boards used to pick the lucky lottery winners are still a part of our national landscape.

[SickOfTheOnePct]

4. Not sure why you think the necessary and proper clause comes into play with ACA n/t

[Puzzledtraveller]

7. Because ACA was a piece of Democrat legislation

Had it been Republican he would be emphatically against it.

[jeff47]

21. Democratic. Not Democrat.

The attempted adjective-ification of "Democrat" is because it polls worse than "Democratic". We should not be complicit in this.

[Motown_Johnny]

48. It is Republican in it's approach to expanding coverage

The individual mandate is a Conservative idea.

[jeff47]

10. Because the mandate becomes necessary when you remove pre-existing conditions

With no pre-existing conditions, there's no reason to buy insurance until you are sick. Wait until you need it, then buy it. Now that you're covered, get medical care. Once you're healthy again, you cancel the insurance.

As a result, there's no cost-sharing, so the entire system breaks down and only the 1% can afford medical care.

Pre-existing conditions prevented this and so healthy people bought insurance. But those are being removed.

So something has to get healthy people to buy insurance for cost sharing to work. That's either a mandate, a tax, or some incentive system that's going to severely screw some people.

I'd rather a tax and do Medicare for all, but Tea Partiers mean we can't do that directly. So we'll do it through the Rube Goldberg contraption that is the ACA.

[Bluenorthwest]

11. That explains the mandates used in many other countries. It fails to address the ACA specifics

Most of our peer nations with universal health care do not use single payer, and many many of them employ a mandate to purchase health care policies. In all of those nations, it is a crime to profit from the providing of a mandated health insurance product. So to defend the ACA's mandate, you need to address the requirement to contribute to the profit of others which is utterly the opposite of all existing mandates in our democratic peer nations. Even if we agree that a mandate is necessary, you still need to convince me that profits make our mandate superior to other mandates. Why does our law enshrine profits from these products when other nations consider profit from such products to be criminal?
Let's say a mandate is essential. Now tell me how that profit requirement serves those who are mandated to purchase. Skirting that all important difference between the ACA and the many functioning heath insurance mandates around the world does not make that difference vanish.

[jeff47]

13. Actually, most "peer" nations do not use private insurance companies

Last edited Tue Jun 26, 2012, 12:43 PM - Edit history (1)

The only western nation I know of that mandates private health insurance is Switzerland. All the rest (Canada, France, Germany, etc but not the UK) government provides insurance via taxation and there is only one "insurance company" for basic care - the government.

There are add-on insurance policies you can buy from private insurance, but those policies are not providing basic care. They provide niceties like private hospital rooms instead of semi-private.

Perhaps you're trying to differentiate a single payer system like Canada with a system like the UK where the government employs the doctors? The UK system technically isn't single payer. Because they aren't paying for care, they are providing care.

Even if we agree that a mandate is necessary, you still need to convince me that profits make our mandate superior to other mandates. Why does our law enshrine profits from these products when other nations consider profit from such products to be criminal?

It doesn't. The ACA limits the "medical loss ratio". Insurance companies have to spend 80% or 85% of premiums on medical care (depends on personal vs. employer-provided). The remaining 15% or 20% covers all overhead (CEO's salary, fancy building, TV ads, office supplies, etc) and profit. If the CEO gets a raise, profit has to go down. Or some other overhead has to be cut.

In Switzerland, private insurance can profit from basic coverage, but they are limited on their profits in a similar manner. Insurance companies there make most of their profit from selling add-on insurance.

[Bluenorthwest]

22. And what about Japan, the Netherlands, Austrailia, France, Germany...

And you do understand that a percentage of a number the industry names does not promise affordability. What aspect of the law caps the price of mandated products? And what aspect of their profits is so important that actual care should be reduced to maintain that profit?
Keeping those crooks in the loop, huge error, and exactly why the 'reform' is not well liked. That is political reality, Americans loathe that industry, while the government seems to love that industry. The company one keeps, and all of that...

[jeff47]

31. None of those countries do use private insurance for basic care.

And you do understand that a percentage of a number the industry names does not promise affordability.

It means they do not have unlimited profit, which was your concern in your previous post.

Affordability will depend on the cost of care itself, which has to be controlled using other methods. If we had single payer paid via taxes, that would still be the case. Arbitrarily setting the price low doesn't make the care affordable, it creates a shortage.

And what aspect of their profits is so important that actual care should be reduced to maintain that profit?

You have that backwards. The medical loss ratio limit means reducing care reduces their profit. Reducing care means they pay less for care, which reduces the 15/20% they can use for overhead and profit.

Keeping those crooks in the loop, huge error, and exactly why the 'reform' is not well liked.

Blame your Tea Party neighbors. Medicare for all would work much better, but that is not going to pass by itself for decades.

But instead of sitting there steaming over the mandate, make it lead to the outcome we want.

We will all be insured via state exchanges in the relatively near future. The "Cadillac plan tax" will basically make it too expensive for employer-based coverage. That is actually a good thing - health care and employment should not be linked.

So what we need is those exchanges to be single payer or have a public option. This will be relatively easy to accomplish in the blue states. Once established in the blue states, the lack of dead blue-staters and the lower costs will make it easy to pass in purple states, and then eventually in some red states.

Once people are in de facto single-payer through the exchanges, a national single payer will be easy to pass because Republicans won't be able to create fear over "government healthcare".

Yes, the ACA has parts that suck. But we can use the law itself to eliminate those parts that suck. Throwing it away over the parts that suck will cause healthcare reform to be abandoned for another 20 years. Just like last time. And the time before that. And the time before that. And the time before that. And the time before that.

[Selatius]

37. Actually, Germany does use private health insurance.

Their system is set up like the ACA but with one major difference.

The Germans have a robust "Public Option" that competes with private insurance on costs, and the laws in Germany mandate a standardized policy that covers all the basics and major necessary medical procedures.

In the United States, you can pick and choose whichever policy you want, but each policy is different with different costs and what is covered and not covered. In Germany, they all have to cover the same things for simplicity's sake and for people's welfare's sake, so people picking a bare-bones "disaster-only" insurance policy to save on premiums never happens.

The Public Option in Germany is robust precisely because it is open to the entire population and not just the poorest segment of the population as conceived in the United States. As a result, something like 85% of the people in Germany are currently enrolled in the public plan because it is run at-cost with no profit mark-ups. The remaining 15% are enrolled in private plans, and many of those are the gold-plated plans that company executives, managers, and board members are given, yet those private plans must also cover the mandated basic care and major necessary medical procedures.

And people are also free to purchase supplemental insurance to enhance their care, such as luxury amenities, premium food, etc., and that's fairly often that Germans do this.

[Puzzledtraveller]

68. That sounds like an excellent solution.

[SickOfTheOnePct]

25. You've misunderstood what the necessary and proper clause is

It isn't "necessary and proper" as in what it takes to make something happen that we want. It refers to any legislation that is necessary and proper in order for the government to carry out the duties and powers given to government by the Constitution.

[jeff47]

33. Those powers include regulating commerce.

And the commerce being regulated is health insurance. And those regulations require a mandate in order to create cost sharing when pre-existing conditions are eliminated. That mandate can either take the form of a literal mandate to buy insurance or taxes. Whether you buy insurance or the government taxes you and then buys insurance for you doesn't change the practical result.

[SickOfTheOnePct]

35. Yes, commerce can be regulated

The question is, can that regulation include forcing people to take part in commerce?

I agree that in practical terms, there is no difference between forcing someone to buy insurance and collecting taxes and then buying insurance. But there is still a huge difference.

[jeff47]

49. They already have regulations that force people to take part in commerce.

You have to eat.

If you buy food, it's pretty obvious you are taking part in commerce.

If you grow your own food from seed you harvest from your own property, and you don't ever leave your property, you are still taking part in interstate commerce according to Wickard v. Filburn.

So how about health insurance? Well, your non-purchase of health insurance will affect interstate commerce - health care providers are required to treat you, and when you can't pay they will recoup the costs from other patients. That's a much more direct effect on commerce than in Wickard v. Filburn.

So either the SCOTUS needs to reverse prior precedents, or it's constitutional.

[Bake]

38. The mandate isn't necessary for the govt. to be able to regulate commerce.

It has regulated commerce without it for two centuries. The N&P Clause isn't an issue here.

Bake, Esq.

[jeff47]

47. It is necessary for regulating this commerce

The government can't order farmers to not grow wheat...unless they're regulating the wheat harvest.

[kenny blankenship]

6. The good news is you can compel health CARE.

That is if you really give a damn.

[AngryAmish]

8. No one is saying we can't compel health care

As a matter of constitutional law the commerce clause does not give congress unlimited powers. It cannot make me wear a funny hat because that hat is involved in interstate commerce.

What they can do is tax us. Call it a tax, make it universal and be done with it.

[4th law of robotics]

9. Drafting someone forces them to buy a private product

how exactly?

[freshwest]

28. Soldiers going to war to protect our 'national interests' in oily nations isn't crossing the line?

The entire country subsidizes the military but at times it is going to protect private business interests. When Blackwater was operating in Iraq, we all had to buy their private product at outrageous rates with our tax dollars.

Those analogies are not perfect, but I hope you understand what I am saying is that we are being forced to buy private products even if we object. And those products don't save lives as directly as health care would, but they have great advertising firms, the major media in all its forms.

So we don't dare question that money flying out of our pockets, but look askance at health care. What do you think?

[4th law of robotics]

56. You're talking two different things

the OP is comparing the draft to the personal mandate.

Completely different things.

Now you're going on about a specific war (which BTW did not entail a draft).

[freshwest]

57. The complaint is money.

[4th law of robotics]

58. Ok . . . ?

So one requires you purchase a private product and send your money to some private entity.

The other does not.

How are they the same?

The issue isn't that the government is forcing you to do something you don't want to do. Governments always do that. And it was never in question.

It's whether our government has the right to force citizens to purchase a product simply for existing.

Make it something else. Proper footware is important to health and maybe you'll be chased by bears today. So the government is going to require that you purchase one pair of new sneakers from a private company per year. Ok?

[Bluenorthwest]

14. The Constitution gives the Congress the authority to raise and support armies. Specifically.

That same document says that all powers not specifically given to the Federal Government belong to the States and to the People. The Constitution also promises equal protection for all under the law, yet the ACA will treat my family differently than 'approved families' in that the subsidies and tax breaks are doled out to 'families' and my family for the last few decades is considered 'single strangers' under the bigoted law.

[NCTraveler]

15. Please Read the Constitution.

Not a very good follow up from this one. Keep trying.

http://www.democraticunderground.com/1002855846

[ProdigalJunkMail]

20. it's actually quite comical

tomorrow it will be, "The gov't can force you to get a passport, so why can't it force you to buy life insurance...and a sportscar?"

sP

[phleshdef]

23. The point is moot. The ACA doesn't force anyone to buy health insurance.

The fact that it gives the option to pay the penalty means that it isn't forcing you to purchase anything. Period.

[treestar]

26. good point, that is exactly what would happen

And it's strange people are thinking of it as being "forced" to have insurance - wasn't it a bad thing they didn't have it? Isn't health care pivotal? It's not like having a sports car. The whole reason there is an ACA is to try to get a way to pay for people's health care without leaving anyone out of that system. It's like being "forced" to go to schools, provided in public school. It doesn't occur to anyone to see it as being "forced" to go because it's desirable. People with half a brain don't have to be "forced" to participate in good things.

[Vincardog]

34. Some people seem to equate INSURANCE with HEALTHCARE. They are not the same

[treestar]

46. Some people act like health care does not have to be paid for somehow

That meme is dumb, give it up. Having insurance at least gives you a way to pay for health care that you didn't have before. It's better than not having insurance on it. Then you lose and can't afford it at all.

[Vincardog]

62. Some people seem to think that other people are suggesting that they don't want to pay

and want health care for free. That meme is dumb. Give it up.
Health Care is and should be a RIGHT.

It should be available to EVERYONE without anyone PROFITING by denying health care to anyone.

The For PROFIT insurance model is the PROBLEM.

The point is not that some people are too cheap to pay for insurance,
it is that the profit driven insurance model make health care unaffordable to too many people.

[phleshdef]

64. Do you realize how stupid that argument sounds?

Thats like saying "some people equate farming with eating, they are not the same thing".

"Some people equate electricity with air conditioning, they are not the same thing"

"Some people equate a paycheck with buying stuff, they are not the same thing"

"Some people equate oxygen with breathing, they are not the same thing"

Thats an impotent argument in every single way, shape or form.

A funding mechanism has to exist in order for people to afford healthcare. Insurance is a funding mechanism. I've had to use that very funding mechanism to afford certain medical procedures and medications myself. So yea, in that respect, my insurance was my means to the end that was healthcare. This stupid argument needs to be called out for what it is.

[Vincardog]

70. Why should my health CARE depend on a private finance company making PROFITS?

[phleshdef]

71. I'm in complete agreement that there should be non-privatized option available to everyone.

Thats the thing that those of who are pro-ACA aren't getting credit for. I'm pretty sure the vast majority of us are FOR single payer or, at the least, a public option.

Regardless, that doesn't change the fact that access to private health insurance enables many people to get access to vital healthcare needs.

[OneAngryDemocrat]

40. Yesterday...

Yesterday, it WAS the governent compelling me to pay for a war I didn't want... and an arsenal to go along with it. The arguemnt that the government can't make you pay for things you don't want or need is lame: the government does it ALL of the time.

[SickOfTheOnePct]

44. Wars are paid for by taxes

The government has the right to compel one to pay taxes. Whether or not they have the right to compel one to take part in commerce or pay a fine for refusing to do so remains to be seen.

[progressivebydesign]

16. But I've wondered how they can require car insurance...

.. and you have to have home insurance to buy a home, but they can't compel you to buy health insurance? What is the difference?

[Bluenorthwest]

17. You need home insurance to carry a mortgage, not to buy a home. Not the same thing.

I know folks like to say 'homeowner' when they just hold a mortgage, but the fact is one can simply purchase a home, without a mortgage and thus own the place. A mortgaged property belongs to the bank, which requires you to protect that which you do not yet own. People with a mortgage do not own their homes, they are buying them slowly and the actual owners require the insurance.

[hughee99]

19. The federal government doesn't require car insurance

the state government does. State governments have some powers that the federal government does not.

[Bake]

39. The state can require that you purchase auto insurance IF YOU CHOOSE TO BUY A CAR.

If you don't want to buy a car, hey, you don't need insurance.

Bake

[OneAngryDemocrat]

41. Therein lies the crux of my question...

The government can STILL compel you to purchase something you may not want to purchase.

Just because it is conditional is irrelevent. It is NOT optional if you want to drive.

[Bake]

45. Here's the difference: driving itself is optional. You don't have to have a car.

And many people don't have a car. Don't like the mandate? Don't buy a car. Take public transportation.

With healthcare, EVERYONE must purchase insurance or else pay a penalty.

Bake

[meaculpa2011]

54. But if everyone was forced...

to buy car insurance, whether they own or drive a car or not, car insurance premiums would be more affordable for everyone. Plus, the owner of a 1990 Malibu should be forced to buy collision and comprehensive in addition to liability rather than getting a free ride.

Same with homeowners insurance, business insurance, life insurance, disability insurance, long-term-care insurance...

Get it?

Once this massive giveaway to the insurance cartel gets engraved in stone, where will it end?

Single provider healthcare NOW!

[hughee99]

18. Because the constitution explicitly gives the federal government the power to

"raise and support Armies" but I don't see where it explicitly gives the federal government the constitutional authority to require that everyone buy healthcare from a private company (or punish them for not doing so).

It's not clear that the "necessary and proper" clause allows this, unless you use a very broad interpretation of it.

[treestar]

27. It doesn't say that there can be public health care either

What is so bad about having to buy healthcare from a private company? The whole idea is to make it so it can be paid for. It's looking a gift horse in the mouth, so to speak. Complaining about the government forcing you to use its schools, roads, or anything else.

[hughee99]

51. It's not about forcing you to use it, it's about forcing you to buy it.

If the government decided to tax the citizens and PROVIDE health insurance (like single payer), I wouldn't see an issue (it would be just like schools, roads, etc...) but it's not doing that. It's mandating that you pay a private company for a service that you may or may not wish to buy.

[treestar]

53. How would that be so much different?

The government would still have to pay for it all. It would have to buy insurance itself or invest tax money in order to have enough money to pay for it. Don't make right wingers look right. We know it has to be paid for somehow and would not magically fall from the government and nowhere.

[hughee99]

59. Sadly, I think they might be right in this one instance.

The federal government has the constitutional authority to tax you (like raising your taxes to help pay for health care). It has the authority to provide services to you (like health care). I'm not sure that it has the authority to tell you you have to give your money to a PRIVATE, for-profit business for a service that you may or may not want. The thing is, if there were a public option available to everyone, then people would at least have the option to chose the government option instead of plans provided by corporations.

Collecting taxes and forcing you to give money to a private business aren't the same thing.

[treestar]

60. Why add the layer of bureaucracy of having the

government tax and then use that to buy the insurance? The government is taking your money and giving it to a private insurer. The ACA has government oversight. The government is simply eliminating a step here. There is no huge difference here, making this issue really just a talking point.

[hughee99]

61. It's the difference between entering a contract with your government

and with a private company. The government as the authority to mandate the former, I'm not sure it has the constitutional authority to mandate the latter. From a practical standpoint, you can certainly argue that it's not much difference, but from a legal standpoint, it's worlds apart.

[OneAngryDemocrat]

42. I am using a broad interpretation...

Based upon both the constitution's "welfare" clause in the document's preamble, and congress' authority to pass laws.

[hughee99]

52. I understand.

My concern is that if you broaden the interpretation in this case, it will be broadened in all cases, and "welfare" will end up being defined as "whatever the government thinks is best for you".

[OneAngryDemocrat]

67. Crappy Hubris!!!

The Constitution mandates a Post Office, too: but we all ain't out there delivering mail.

DO BETTER!!!

[hughee99]

69. What?

Are you suggesting a "postal draft"? Has the post office ever had a need for more people than it was capable of hiring? What does this have to do with the mandate at all?

[phleshdef]

24. Why does it matter? The ACA doesn't force people to buy health insurance.

[MrTriumph]

29. But it compels us to do so under penalty should we fail.

ACA is a stinker.

[phleshdef]

63. Which means you don't have to buy it. Period.

If you aren't lower income and you aren't a senior, then you should pay for your own self as a liability on the system, because if you aren't insured and you have the income to be insured, then you are, in fact, a walking liability on the system. Whether you like it or not, thats the fact. So you SHOULD have to pay some type of fee if you meet the criteria.

The ACA is already saving lives. I suppose you'd rather the people whos lives its saving would just go ahead and fucking DIE so you don't have to be subjected to any responsibility for yourself and your potential to cost the system.

[MrTriumph]

65. Hey, I do buy health insurance. But it should not be required.

And the insurance is still ridiculously expensive and the coverage is still crummy. Oh, and I hardly ever use it, phleshdef.

As for your "saving lives" comment, what ACA saved was insurance companies. The gov't option should- oh, wait, I'll put it in all caps for you, phleshdef- SHOULD have been a requirement of HCR.

[phleshdef]

66. Tell that to all the people who can personally testify to it being a life saving bill.

No matter how much you want to whine about its downfalls (and I never denied it had some), you can't run away from that.

[xchrom]

30. I don't need or want insurance.

I need and want healthcare.

Except that people invent shit - there is no need for health insurance.

[OneTenthofOnePercent]

32. Congress has the specific enumerated power to provide and maintain an effective miltary.

Given the necessary and proper clause... if that means a compulsory military is necessary to defend the United States and her interests then that is what can be done. This is also the same vein of congressional power used by the Militia Act forcing citizens to purchase a gun and military supplies for militia service.

Article I, Section. 8

The Congress shall have Power...

...

To raise and support Armies, but no Appropriation of Money to that Use shall be for a longer Term than two Years;

To provide and maintain a Navy;

To make Rules for the Government and Regulation of the land and naval Forces;

To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions;

To provide for organizing, arming, and disciplining, the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress;

...

To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof

But the ACA is not using congressional military powers to justify it's legitimacy... it's using the commerce clause. The problem is that the commerce clause only exists to regulate interstate/international commerce. If I choose not to purchase health insurance, then I am NOT involved in any commerce. Congress thus far in history has only excercised is right to regulate commerce that already or might exist and also affects interstate commerce. Has congress ever used the commerce clause to forcibly create commerce without a choice to opt out without penalty? In such a case, commerce did not already exist and nor would it have existed otherwise. Is such an act constitutional? Is there a slippery slope and where does it end (can congress force you to buy *anything*)? These are a few of the questions the Supreme court is answering.

[Egalitarian Thug]

36. Ironically, it is debatable because it requires payment to private business.

Medicare passed Constitutional muster decades ago. This is just one of the many land mines that we have been talking about since this debacle began back in '09.

[yawnmaster]

43. The answer to your question is, yes. eom

[Bonobo]

50. You honestly don't see the difference? Wow...

One is service for the country and one is compelling, by force of law, people to pay money into the pockets of profiteering insurance companies.

Using the force of law to compel citizens to line the pockets of rich shareholders.

Now do you see the difference?

[Zalatix]

55. The Draft should have never existed.