Is Medical Insurance Like Car Insurance? No, Which is Just One Reason Why it Shouldn't be Compulsory.

In the wake of U.S. District Judge Henry Hudson's ruling yesterday that compelling people to buy health insurance is unconstitutional, defenders of the Patient Protection and Affordable Care Act (i.e., ObamaCare) are fond of pulling out car insurance mandates. If the state can force you to buy car insurance, the argument goes, how can it not be able to make you buy something so much more important, like health or medical insurance?

To wit, this piece in Mother Jones by Nick Baumann about the state of Virginia's successful (so far!) challenge to the mandate:

In the state of Virginia (ahem), for example, drivers who refuse to purchase auto insurance have to pay the state $500 a year. In making this claim, Hudson has "rewritten the Commerce Clause," Tim Jost, a professor at Washington and Lee University law school,told reporters on Monday....

Should the feds be able to require people to buy insurance for health care, a universally used good that society is expected to (and does) provide? Or does the Congress of the United States have less power to regulate health care than the Legislature of the Commonwealth of Virginia has to regulate who pays to fix your Jetta after a fender-bender?

Baumann notes that a couple of other federal judges have upheld the mandate and that the case will certainly reach the Supreme Court. But he frets that the "conservative" majority may reject an expansive reading of the Commerce Clause that "allows Congress to regulate economic decisions, not just economic activity." Which, to be honest, puts us in the realm of a Rush song, fer crying out loud.

(Sidebar: Based on the court's ruling in the medical marijuana case Gonzales v. Raich case, in which the Supes ruled that non-commercial, homegrown marijuana affected interstate commerce and was thus subject to government oversight, Baumann might rest easy.)

He further worries that Hudson's ruling "shows how the court could neuter the entire federal government" and blood the path to the "slippery slope to the libertarian paradise" of, well, you know, limited government. And that can only lead to child labor, 25-hour workdays, non-mandatory calisthenics, and a whole host of awfulness not seem since the dreaded Lochner ruling in 1905, one of the most misunderstood decisions in SCOTUS history.

More pressing, is Baumann's analogy between auto and health insurance illuminating? In a word, no. As John Eastman of Chapman University notes in the video below, "The act of driving is not a constitutional right, it's a privilege, and so we can impose conditions on the exercise of that privilege under the state's police power. Living is not a privilege, it's a right, and I can't impose a condition on the mere act of living, which is what the ObamaCare mandate does."

Watch this video, featuring law profs Erwin Chemerinsky of UC-Irvine and Eastman, which carefully presents the thinking behind broader and narrower interpretations of the Commerce Clause as they relate to ObamaCare and government generally. Who you gonna side with? It's about 10 minutes and worth every second.

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  • ||

    "The act of driving on someone else's road is not a constitutional right, it's a privilege, and so we can impose conditions on the exercise of that privilege under the state's police power...."

    Fixed.

  • anarch dah guv'nuh||

    All your roads are belong, etc.

  • Zeb||

    And yet somehow you can get DWI for driving drunk on your own property.

  • funlol||

    Yup. Government's roads so they make the rules!

    - Drew from New York motor Insurance

  • karen mo||

    the obamacare fiasco is a mess. it should definitely be more like car insurance. i'm self employed and tried all day yesterday to get health insurance quotes... everything out there was confusing, all the sites required tons of paperwork and verification to get a simple quote, etc.
    compare this to car insurance - i just entered my address and car information to http://4autoinsurancequote.com and found a quote for 45$ for my toyota within 2 minutes. why can't health insurance be like this?

  • Almanian||

    No recognition of the "governtment's right [sic] to impose" a healthcare insurance mandate ------> SOMALIA!!!!!1!

  • Oliver Wendell Holmes, Jr.||

    If we can force someone to be sterilized, we sure as hell can force someone to buy insurance. Three generations of uninsured are enough!

  • Mad Max||

    No, I can't see any distinction, for purposes of the Commerce Clause, between Congress and the Virginia legislature.

  • Vermont Gun Owner||

    That is the point I came here to comment on. Not sure why Nick left it out of his post.

  • Jerry||

    I can't wait for the federal government to start regulating breastfeeding, since you know, it affects interstate milk prices.

  • La Leche League||

    Yo quiero mi chichita.

  • Old Mexican||

    +10000

  • ||

    they can have my breast milk (well, the breast milk of my woman friend - of course, that is a hypothetical, as I don't have any women friends, :( but it is a point about freedom) when they pry my girl friend's juicy boobs out of my hot sweaty fingers...

  • Anonymous Lurker||

    Don't you mean imaginary girl friend's juicy imaginary boobs?

    just hatin

  • rhea||

    The role of the government is to blame ALL the misfortune that of this country to its people. Why don’t they blame themselves just for once… http://www.pathtoasia.com/jobs/

  • wackyjack||

  • TheOtherSomeGuy||

    In the video clip, The Dean from Irving Law (I believe that was the school) states that he thinks the words written down on paper by the Founders shouldn't bind us today, 200 + years later, then turns around and says the basis for his whole argument is the premise that the words written down on paper by USSC Justices 100 + years ago should bind us today.

    That's a bit of nonsense, eh? That guy shouldn't be dean of a daycare with logical processes like that.

  • ||

    In the state of Virginia (ahem), for example, drivers who refuse to purchase auto insurance have to pay the state $500 a year.

    Yeah, so what?

    Why should I have a duty to protect your property through the mandatory purchase of insurance? Your car is your property. If you want it protected from accidental damage, you cover it yourself, just like you do with your house. Should we mandate that everyone carry personal homeowner's insurance in case we damage someone's home?

    It may make sense from a standpoint of financial prudence to cover yourself against judgments against you for negligence, but mandating that I preventively cover your losses is bullshit.

  • MNG||

    You're mandated to have liability insurance on your car, that's the hole in your analogy I think...Your operation of your house is not likely to create hazards for other houses but your operation of your car is.

  • ||

    No, I'm mandated, at a minimum, to carry insurance cover your losses in the case of an accident, not my own.

    The operation of my home can cause fires, have trees fall on other homes or electrical lines, etc. Hell, we had a house explode on our street about 10 years ago from a gas leak. The explosion damaged about a half dozen homes around it.

    As a guest, I can cause a fire in your home or casue flooding that can seriously damage it. Why aren't we mandated to carry personal insurance that will cover losses to any damage you cause to someone else's property, other than a car? I've been driving for 25 years and have never had a claim aginst me, yet, I've had a tree fall on a neighbor's fence.

    Note that I'm not saying that it doesn't make financial sense to protect yourself against economic claims against you, but I don't buy the argument that you should be forced to cover potential losses to someone else.

  • ||

    No-fault states are essentially changing the way insurance works so you become a statistic rather than an at fault party. It also gets rid of the concept of liability insurance, though it shifts some of the cost into the comprehensive sections. Really its just meant to cut down on the cost of litigation between the parties since the overall cost shouldn't change to undo the damage.

  • Xenocles||

    "Why aren't we mandated to carry personal insurance that will cover losses to any damage you cause to someone else's property, other than a car?"

    The cynical answer is that I would suffer emotional anguish and/or physical injury as a result of my negligence, and since it happened on your property I would sue you.

  • ||

    I see your point, JW. I've never thought about it that way. Two wrongs don't make a right. If mandating liability car insurance is wrong, mandating the carrying of health insurance is also wrong.

    Another argument against justifying the mandating of health insurance on the basis of the mandating of liability car insurance is that liability car insurance is a state law not prohibited by the Federal Constitution unless you invoke the 9th and 14th Amendments. The mandating of health insurance at the federal level on the basis of an overexpansive interpretation of the Commerce Clause is another thing altogether.

    A third argument against comparing the two types of insurance is that one is for protecting against damages done to another, whereas mandatory health insurance is for your own protection like seat belt laws which I'm also opposed to. Is it Constitutional that the Federal Government protects us against ourselves and our foolish decisions?

  • ||

    "whereas mandatory health insurance is for your own protection like seat belt laws"
    Not so according to proponents of obamacare, their argument is by not having health insurance, you are costing others when you go to the emergency room and don't pay your bills, ie "damages done to another".

  • ||

    I realize this. That's why in a lower post I put down that the truly needy could be provided with charity care paid for from voluntary contributions. Those who aren't needy, can pay out their bills on time.

  • ||

    Oh, it will go deeper than that.

    "Do you know how much fat is in the glazed doughnut and how that will increase everyone's health costs? And say, do you know how risky that skiing trip you took is? You should be wearing a helmet when you ski and have mandatory speed limits on the slopes as well."

  • ||

    how about fast red cars?
    and how about fast women in red dresses - coronary on two legs. No sir, nothing but plain, but nice girls for you - wouldn't be healthy otherwise.

  • ||

    Mandatory car insurance is one instance where I think it best to lock the logic behind it away in a lockbox and throw it into the ocean. I only accept it because I believe it to be interpreted very narrowly and it in practice doesn't step on too many civil liberty toes. However, the logic that defines it has gotten so carried away that I almost want to get rid of it so liberals will stop using it as an argument for making decisions for me.

  • meeko||

    Based on what you said, your operation of your body may end in some kind of accident or you just may got ill.
    Then, when you get to hospital, they have to help you, and when you go uninsured, who bear the cost of saving your life or health? They cant sold you in pieces, they might sue you, but it may take ages and so on...
    Now it divides into 2 categories:
    1.Since the beginning of human history people tend to process the tasks that may repeat, so that they are done next time the most effective way (but i am afraid hospitals cant deny service to uninsured people ) => if someone needs help, find out if he is insured, if not, kick him out, is that acceptable for you?
    2.As resources are scarce, your operations of your body is likely to create hazards, removable only by medical aid, so we mandate you to buy insurance, as your aid has to be paid, or accept point 1.

    BTW i dont support it, just playing devils advocate here.

  • ||

    Then, when you get to hospital, they have to help you, and when you go uninsured, who bear the cost of saving your life or health? They cant sold you in pieces, they might sue you, but it may take ages and so on...

    This is the logic that gets me the most. When did society become responsible for our sickest members. The cost of most regular emergencies (poisonings, appendage breakage, wounds) is pretty well known and easily remedied without imposing a large cost on society. The costs that this mandate is supposed to fix isn't those, its the large costs associated with long term diseases (cancers, nerve diseases, etc). That's why there's a pre-existing clause in the law. This is all about transferring wealth from the young and healthy to the old and sick. Its the most self-destructive law I've ever seen introduced in a society and can only result in a weaker and less free society.

  • meeko||

    True, but then explain me, lets say i am retard, 25y old, i dont care for being old and have no insurance whatsoever.
    We have a party and firework ends in my face, nothing really bad, a little bit of sewing and some plastic surgery.
    I am not US, so i have no idea how the bill would look like, so here i appreciate some help.
    But once i get treated, who gets to pay it? As someone has to.

    I am not arguing pro ObamaCare, as here in EU we have analogy of it and its working, though no wonders, i am just being curious and as majority of people here are antiObamaCare, if i want discussion i must inevitably be pro :)

  • Xenocles||

    As I understand it, you would go to an emergency room, where they would stabilize you and probably manage your pain with drugs for a while. That much would be free to you (i.e., borne by the hospital or taxpayers). It would probably include the stitches but not any reconstruction. You would not get the surgery until you answer the question of who pays, mooting that part of your question.

  • ||

    I favor a system of charity hospitals paid by voluntary contributions to take care of the needy. I don't see this as the business of the Federal Government.

  • ||

    Well there is keeping you alive (treating the burns) and restoring your long term quality of living (plastic surgery). Hospitals will do the former and absorb the costs (minus what they can extract out of you through payment plans and such), but the latter is not something society should have to worry about.

    I agree that emergencies should be treated no questions asked to repair damage or stabilize someone long enough for decisions to be made. Its simply a cost of society and its a small enough price to pay. However, after the emergency is over, society has no more responsibility to prolonging individuals lives and absorbing long term costs.

    People forget that most EU countries take the stance that low cost healthcare is paid for all (generic drugs, low tech procedures and maintenance), but individuals are on the hook after a certain point (what the medicare recipients would call rationing or "death panels"). Hence why we're stuck. We won't accept low cost care, but we can't afford the premium service some of us have become accustomed to.

    So I think the only solution is to get rid of the insurance and keep our coverage the way we've been used to it, minimal and short.

  • meeko||

    That makes sense, but where is the borderline for what is hospital supposed to pay and where it ends?
    When i get shot or have car accident and spend 2 weeks on IC, how is the hospital going to pay for it? How much is IC in US? Not very often, but sometimes its hell of a cost to bring someone into stabilized state, sometimes it even requires many expensive "operations" ( sorry missing the word ).
    Sure, i might be nitpicking here, but those questions should be answered.

  • ||

    I think if you looked at the costs of healthcare in the US, stabilizing shooting victims as a percentage wouldn't even register. Long term care is what's really growing the system.

    And most operations are not emergency work, but planned and require a great deal of prep, like removing tumors or replacing organs. Things people have time to plan for. You don't show up to a hospital with multiple kidney failure and expect to walk out anytime soon. They can keep you alive long enough to make a decision whether to keep living or not. Hard decisions then need to be made.

  • ||

    I agree about the cost of shooting victims, as well as accidents victims being inconsequential.
    Americans look at Europe and have this totally naive idea that their health care is totally free, and they get all the transplants and kidney care they want. Well, they get all the aspirin and band aids they want. But as far as the other things, ...well, you can call it death panels, or rationaling, or efficacy standards, but Europeans don't get as much high tech as us. They are actually wiser about the limits of medicine - they actually seem to understand that people selling medicine make money by selling medicine - not whether it helps you or not.

  • Fatty Bolger||

    Not a single state in the country requires that you carry collision or comprehensive insurance. The coverage you are required to carry is for the protection of others, not yourself.

  • ||

    And does that make sense in light of states going to "No-fault"?

  • Fatty Bolger||

    What does no-fault have to do with it? No-fault just requires insurers to pay claims without regard to fault, and restricts the ability to litigate for additional damages.

  • ||

    Exactly, which in effect makes liability coverage moot if your insurer pays for your damage without first establishing liability. Its very close to doing away with the idea of liability.

  • ||

    No state is truly no fault. Most have limits on no fault, than traditional tort kicks in. Except for maybe Michigan. But they like there no fault laws since the enable massive fraud.

  • The Devil Inchoate||

    Both parties have to pay for coverage for no-fault to make sense.

  • Old Mexican||

    Re: MNG,

    You're mandated to have liability insurance on your car, that's the hole in your analogy I think[.]

    A person chooses to own a car WITH the potential liabilities that such entails. A person does NOT choose to be born. The analogy is NOT appropriate.

  • meeko||

    What you do with car you no longer want?
    What you do with life you no longer want?

  • ||

    If I no longer want my car I can sell it, give it away, or dispose of it. If I want to end my life that is my right, even if the government says I am not permitted to do so. Rights are inherent, both my right to own property and my right to live or die. They exist even in the absence of government.

  • ||

    Like I indicated above. Differentiating in the logic is very tricky. So I prefer to just ignore it and call for a narrow interpretation.

  • Mr. FIFY||

    MNG, if one does not OWN a car... should they still be forced to buy car insurance?

  • emerson||

    Erwin Chemerinsky is a cross-eyed douche. I can't believe the man's books are largely responsible for teaching a decade of law students constitutional law.

  • ||

    I can't hate Professor Chemerinsky, only because I probably wouldn't have passed Con Law without him (nor the bar exam, since he taught the Con Law portion of the BarBri course). Though as Con Law professors go, I obviously much prefer Professor Epstein.

  • cynical||

    Well, ok, progs, I see your point. I can see the states forcing people to buy insurance to cover cases where they get other people sick while they are in public buildings.

  • ||

    That should be fun to track down.

  • Xenocles||

    The real problem with the analogy is that the only insurance a driver is required to have (in most places) is liability coverage for damage to others. The state doesn't give a damn if you insure yourself. Health insurance, of course, covers the purchaser, making it a fundamentally different requirement.

  • Steve Chaos||

    Bingo.

    However, let me propose the inevitable counter-argument: "But those who can't pay for themselves inevitably put their cost on society!" In other words, the analogy of medical coverage to liability insurance.

    While the libertarian position of getting rid of widespread entitlements largely undercuts this objection, this is probably the slippery slope to Libertopia they refer to.

    On the other hand, the argument above (i.e., costs imposed to society), when made to Republicans (who have protected and expanded the status quo with respect to entitlements), carries a lot more weight. Given that public entitlements aren't going anywhere, not carrying insurance does act as a burden on the public finances. Given that the predominant opponents are, alas, not us, the argument begins to (unfortunately) have some relevance to the debate.

    So, given that Medicare/Medicaid's not going anywhere for awhile, how do we address this argument?

  • Xenocles||

    The answer is not to run away from our principles, but to embrace them again. We're not going to convince liberals to abandon the idea of universal coverage unlimited free stuff, so why bother trying? I'm content to simply demolish the bad analogy.

  • Steve Chaos||

    You misunderstand me; I'm not advocating we run away from our principles, but I'm arguing we have a time-order problem. Given that eliminating the mandate is likely to precede the elimination of widespread entitlements, how do we defeat the inevitable analogy of passing off the cost to the public to motorists lacking liability insurance? Both through their actions, impose a cost to others when an event strikes. And we agree to do so is wrong. (And bear in mind, I agree completely that mandatory health coverage is bogus).

  • Xenocles||

    Well, we both know the real solution to the problem: "the public" should refuse to assume the burden. If we're not paying the cost, there is no cost to others --> problem solved.

    I interpreted your original comment to imply a concern that this solution would scare off liberals. This is probably true, I just don't see any honest way to avoid that impasse. To the extent that this was a misreading, I apologize.

  • creech||

    But in this case the liberals are arguning against "unlimited free stuff." They are making the libertarian argument against free riders. Trouble is, the won't agree to the libertarian solution which is to
    get kicked off the bus if you don't pay the fare.

  • Standard Liberal||

    Individual bus pass mandate!

  • Xenocles||

    The mandate is only half of the problem. The other half is the guarantee of coverage at a capped price regardless of expected claims. This amounts to a provision of a good disconnected from the cost of that good, which I simplify to "free stuff." The fact that the policy is designed to mitigate the ruinous cost imbalance by forcing other people to buy the product regardless of need or desire only exacerbates the offence.

  • ||

    But they're not making an argument against unlimited free stuff, they're arguing for more free stuff. I mean, if we're going to force everyone to buy insurance we also must make sure they can afford to buy insurance, so we're going to subsidize the cost for people who earn less than 4 times the poverty rate. So what Obamacare really does is force people to be 'responsible' buy giving them more handouts.

  • Xenocles||

    That too.

  • ||

    Yeah, but they're saying, "Lets get of theose free riders .... by PAYING FOR THEIR HEALTH INSURANCE".

    How is someone NOT a free rider if we're required to pay their way anyhow?

  • Steve Chaos||

    Also, like clockwork: Holder and Sebelius are arguing that the cost imposed to the public by the uninsured is the rationale for the individual mandate.

    People, this fundamentally is the argument we're going to have to be able to defeat. And to do that means being able to square off against the immediate consequence of how we deal with large-scale entitlements still in place.

  • ||

    Maybe this is a little unsentimental of me, but its easy...

    Kill them, kill them all (mostly medicare and long term care in medicaid)

  • ||

    the only reason there would be a cost imposed to the public is because the frickin legislation requiring hospitals to not turn away people who won't pay for service. so we have a law which adversely affects the marketplace which in turn results in costs being imposed on others which in turn gives the libs the main reason to impose more legislation adversely affecting people who do pay for their service. there you have it.

  • ||

    Yep. Bingo. This is ultimately the Level 1 foundation of this whole debate. Most of the arguments around Obamacare, however, have been taking place at Level 2 (libertarians) and above (conservatives/leftists).

    But the truth is, it's that ground-level premise -- that hospitals should be mandated to provide care to all -- on which the rest of this debate is built. Once that premise has been granted, everything else is just quibbling over details.

  • ||

    more recently i've heard arguments from nannies that goes something like this. because obesity is resulting in health care costs rising, the government has the authority to regulate school lunches, nutrition infromation labels, happy meal regulation, and on and on.

  • ||

    Also, subsidizing health insurance imposes costs on society ANYWAY.

    I wonder why noone has done a study to determine what is more expensive - the cost of providing health care to the uninsured through uncomspensated emergency room visits, or the cost of subsidizing health insurance purchases and expanding medicaid.

  • ||

    without the benefit of seeing the results of the study you refer to, i would think "cost of subsidizing health insurance purchases and expanding medicaid" would be far greater. Also the cost of employer sponsored health insurance (including the tax deductable status of said employer sponsored health insurance) would dwarf the cost of providing health care to the uninsured. My above comment was to address the administration's newest main talking point about the cost posed by the uninsured to society as the reason for the individual mandate.

  • ||

    There are significant numbers of the uninsured who never visit emergency rooms. Those individuals impose zero cost on the public, so there is no justification for the individual mandate.

    How about a year in federal prison for going to the emergency room uninsured and failing to pay for your services? I could get behind that before the individual mandate.

  • ||

    Well, it is stealing, so sure. I'm on board with that.

  • ||

    very insightful point.
    I really don't believe a good analysis would show that poor people getting medical care is much of a cost driver.
    The costs come from older people with chronic conditions. If one has read http://www.newyorker.com/repor.....ct_gawande
    one sees that a government program can enrich government program enterpreneurs despite all the cost controls in the world - and like all rule based systems, does a pretty good job of bolixing necessary care but allowing rent seeking and profit for unnecessary care.
    Thats why I'm against such bureacratic systems - you get the best results when the customer and doctor come to an understanding on price and care.
    The other problem with the mandatory insurance scheme is that it makes the government the final arbitrer on any number of treatments where the answer is unknown, and often can't be known. Try that new 1 million dollare experimental treatment or go to hospice? Indeed, the very expense of many treatments gives the impression that they are more effective than they are.

  • ||

    There's a simple, cold answer to this bullshit: if the uninsured are imposing unsustainable healthcare costs on the public, then stop subsidizing deadbeats. Require them to either pay their own way or make do without. If this results in a significant number of them dropping dead from otherwise-preventable illnesses, good; there'll be that much less drain on other unsustainable social-welfare entitlements.

  • Fatty Bolger||

    Technically, not having insurance acts as a burden on the health care providers, not the government. Yes, some local & state governments choose to subsidize non-insured patients, but they are not required to. Also, the providers are not required to provide the services for free, they just are not allowed to deny services based on the patient's ability to pay. If you're in the hospital without insurance, you will still be billed & eventually put into collections for what you owe, and the providers or the owners of the debt could potentially sue you for payment.

  • meeko||

    True, but, lets say you run a hospital, what is your choice, treat someone who cant pay and sometimes in distant future get some money trough suing him, or deny the service and bear no costs?
    Remember, that when you argue against ObamaCare based on libertarianism, then you should give the hospital´s owner right no to treat anyone he does not want to.

  • ||

    I think even libertarians would be hard pressed to argue that hospitals should deny emergency service to anyone based on their lack of proof that they can pay for treatment.

  • robc||

    I dont think hospitals SHOULD, but I think they COULD.

  • ||

    Even if the mandate wasn't in place for hospitals to accept emergency patients, I don't think society would accept turning people away at the door.

  • robc||

    I don't think society would accept turning people away at the door.

    I agree. And they would boycott the hospital and peer pressure them into changing their procedure.

    And Im okay with that.

  • meeko||

    Huh boycott for what? Why you differentiate between car repair shop and human repair shop? Why people mix emotions and facts when it comes to medicine? What is the economical difference between you pay, you have car vs. you pay, you are healthy (or you get medical aid if you are not)
    Do you find acceptable ( not legal, that is for sure ) to boycott someone because he required others to pay for services they consumed, especially when most of those consummates were just lazy to spare money and they knew, they will need the service sooner or later ?

  • biersal||

    Don't doctors still have to take and practice under the rubric of the Hippocratic Oath? The oath would preclude denial of emergency services on the basis of ability to pay. So technically a doctor cannot turn someone away without losing his license to practice.

  • biersal||

    P.S. Even in a world of private licensing agencies, I can't imagine that at least one if not all medical licensing agencies would require the doctors it licenses to adhere to the Hippocratic Oath. The Oath is too ingrained in our culture.

    At that point, it would be up to the patient or the person taking the patient to receive emergency care to be knowledgeable about where to seek treatment. (licensed or unlicensed and if licensed under which agency)

  • ||

    Under the current state of the law, if someone walks into the emergency room with a paper cut, the hospital cannot turn them away. They can't even tell them to go to the non-emergency urgent care center a block away.

    Many of the people in the emergency room are not suffering from life-threatening conditions...that's a huge part of the problem. Repealing the ER mandate law is probably not going to result in hospitals kicking people with gunshot wounds out to die on the sidewalk; it would result in telling people with minor injuries to take a hike, though, which is a good thing.

  • robc||

    Remember, that when you argue against ObamaCare based on libertarianism, then you should give the hospital´s owner right no to treat anyone he does not want to.

    Okay. Whats the problem?

  • ||

    Yeah, and what about those surgery trucks that park in front of a hospital offering cut-rate appendectomies. They can just drive away whenever a person who can't pay walks up, and avoid violating the ER laws. That's not fair to the hospital, is it?

  • meeko||

    This really exists or you are just pulling my leg here?

  • ||

    Tulpa is just made because he lost yesterday's battle over cupcake trucks.

  • ||

    In your warped mind, perhaps.

  • ||

    As if subsidizing the purchase of health insurance doesn't impose a cost on society.

  • ||

    To tie this argument to the VA ruling, the state can mandate those who choose to participate in the activity of driving an automobile to purchase insurance. In order for car insurance to be analogous to Obamacare, the state would have to require everyone, even unlicensed drivers, to purchase auto insurance because at some point during their life their is a high probability that everyone will operate a vehicle. By waiting until you own a car, you make auto insurance more expensive for the rest of society. We can't tolerate free riders, so even if you don't plan to drive today, if we allow people to wait until the plan on engaging in the activity of driving we increase the cost to everyone.
    This, of course, would be a completely bullshit argument for a car insurance mandate, but that is how the statists are arguing for Marxistcare

  • Steve Chaos||

    I see where you're going with this, but that's not quite right. People want to wait until they're already sick - i.e., when medical insurance pays out - to buy health insurance. And the other provisions of ObamaCare pretty much encourage that by turning the notion of "insurance" on its ear.

    Basically, the individual mandate is the lynchpin which prevents ObamaCare from completely imploding financially - because otherwise anyone can simply game the system. Working this back to auto insurance would mean that one could somehow acquire liability coverage just before they have an accident. In either case, it's no longer a hedge against an uncertain future risk, it's a means of paying for current, known risk. And that's not insurance, anymore - that's welfare. Without an individual mandate, no insurer would be able to sustain a profit.

  • ||

    Working this back to auto insurance would mean that one could somehow acquire liability coverage just AFTER they have an accident.

    Fixed. You can't predict accidents or illnesses well enough to buy before, so what people will do is buy after.

  • ||

    I completely agree. I was just trying to make an argument for what congress could do if they wanted to mandate all citizens to purchase auto insurance in order to reduce the cost of insurance, because if some drivers drive without insurance it must be because they can't afford it. If everyone had to purchase insurance, even if they don't drive, this would expand the size if the risk pool even though the number of accidents would remain the same. It's a stupid argument, just like the argument for the individual mandate

  • ||

    He further worries that Hudson's ruling "shows how the court could neuter the entire federal government"

    I tremble with anticipation.

  • Old Mexican||

    To wit, this piece in Mother Jones by Nick Baumann about the state of Virginia's successful challenge to the mandate:

    In the state of Virginia (ahem), for example, drivers who refuse to purchase auto insurance have to pay the state $500 a year.




    But if one is not a driver, then you don't pay, right?

    Should the feds be able to require people to buy insurance for health care, a universally used good that society is expected to (and does) provide?

    Society is expected to provide a certain good? See, I told you - lefties LOVE to revel in question-begging, like happy pigs in the muck.

  • creech||

    A letter in the WSJ the other day prattled on about an heir's "moral obligation" to devote a huge chunck of one's inheritance to the public good.

  • ||

    That letter writer should immediately have 55% of their wealth taken from them. If that entire wealth is simply their house, so be it.

    I can't fucking stand people telling everyone else how to spend (or give) their money.

  • ||

    The whiny looking law prof arguing for Obamacare tries to explain why the commerce clause could never give congress the power to mandate what food we eat because, we have the right to control what goes into our body. I guess he just doesn't feel we have a right to control WHO does things to our bodies. Obamacare doesn't just mandate everyone to purchase insurance, you have to purchase insurance that the government says is acceptable. That is the reason high deductible plans, which Obama likes to call "ACME insurance", will go bye-bye. As far as congress is concerned, it's not just enough to buy catastrophic coverage, they want to ensure that you are covered for drug counseling, marriage counseling, chiropractic care, massage therapy and a Brazilian wax.
    If Obamacare is upheld as constitutional I am going to start a 501c advocating for to mandate mastectomies and vasectomies for people on public assistance. People having babies they can't afford effects interstate commerce because the rest of society is forced to support them. Also, we should create a law that fines parents if their kids don't maintain a B average or higher. Dumb kids effect interstate commerce because an educated workforce is essential to the US economy

  • ||

    "massage therapy"
    better cum with a very, very happy ending!!! damn gubermint, giving me that skanky 55 year old massage therapist with arthritic hands...

  • ||

    Mastectomies? I think you mean hysterectomies.

  • ||

    No, mastectomies. I'm fine with women having babies, but breast feeding is where I draw the line.
    Thanks for clearing that up for me. A world without boobs would be a terrible place

  • robc||

    Big difference between auto insurance and healthe insurance mandates is STATE vs FEDERAL.

    ICC doesnt apply to the states. They can regulate intrastate commerce all they want.

    The Feds cant require auto insurance.

  • robc||

    And Intrastate non-commerce too.

  • ||

    For now. But you might drive across state lines at some point and buy a pack of gum. You just engaged in interstate commerce.

  • robc||

    The courts might differ, but no I didnt.

    The gum purchase was intrastate commerce in the state I happened to be in at the time.

    If I had the gum shipped to me, only then would it be interstate commerce.

    Im an ICC minimalist, and Im pretty sure my view is 100% accurate. Lets say the gum is manufactured in Illinois (being Wrigley) and then shipped Indiana and I drive from KY to Indiana to buy it and then drive home.

    Manufacture - not interstate commerce, occurs only in Illinois, unregulatable by feds.

    Shipping to store - interstate commerce, Feds can regulate shipping.

    Sale in Indiana - intrastate. No regs.

    My driving over and driving gum back - Interstate, but not commerce, just personal travel. No regs.

    Chewing gum back in KY. - Not interstate, not commerce. Nough said.

    Odds of any Supreme buying this argument? 1 in 9.

  • ||

    You drive to Ky and buy 5 tons of gum at a lower price. The drive home and sell it for a profit. Still ok?

  • ||

    That's probably a better argument. Not a libertarian argument, but a more valid one.

  • robc||

    Exactly. Constitutional, not libertarian.

  • ||

    How about a federal law stating that a driver from a state with no insurance requirement can't drive in a state that does have such a requirement without getting insurance?

  • Irresponsible Hater||

    The act of driving is not a constitutional right, it's a privilege

    Says who? I hate this line. Where does this idea come from and always go unopposed? I can't think of may activities that are so completely integral in so many people's daily lives as driving. The state could just outlaw driving, and our rights wouldn't have anything to do with it? Who grants this privelege, the driving fairy? The state's not our parents, holding on to the keys until our grade improve.

    Just because some specific activity may not be a "right" written down in the constitution, doesn't mean its a privilege. Seems like it's just bound up in the "what fucking business is it of the states if I'm driving this car or not". Is buying clothes a privilege? Is ice skating a privilege?

    Unrelated:

    - no car insurance required to buy or register a car

    - no car insurance required to operate car on private land (registration not even required)

    - passengers and non-drivers aren't required to be insured

    - the infraction of driving without insurance is only discovered and punished after another infraction is committed (cops can't pull people over for suspicion of driving without insurance)

    - states mandate car insurance, not the feds

  • Jill||

    "The act of driving is not a constitutional right, it's a privilege"

    Driving should not be privileged by any government. It is the privilege of those who own cars.

  • ||

    It's only driving on public roads that's a privilege, actually. If you want to drive a vehicle around your own property with no license or registration or insurance, with a BAC of .40, not wearing seat belts, there's nothing illegal about that.

  • Robert||

    In NY, the traffic laws (including insurance) apply even on some types of private property.

  • ||

    I agree - its in those penumbras and enanimations.

  • ||

    Yes! Mr Irresponsible Hater! You are a Reasonable gem in a sea of constitutional ignorance! TRAVELING is a right, not a privilege! DRIVING for commercial purposes IS a privilege. So many court cases uphold this 9th Amendment right! Who owns the damn roads, anyway? The taxpayers! WE have a right to travel on them. The only privilege is commercial driving for hire. Autos for private use: RIGHT. Trucks to transport goods: Privilege.

    Deal with it. Change the insurance laws to reflect the fact that you travel at your own risk. Insure against other drivers, not your own liability.

  • ||

    - no car insurance required to buy or register a car

    In Texas at least, the second part of your statement is incorrect. I have to present proof of liability insurance everytime I renew my registration.

  • robc||

    Ditto in KY.

  • Irresponsible Hater||

    Damn, I messed that up in my rage. I'm prett sure its wrong re: california too. What I meant, or should have meant, is that there is no requirement to insure or register when you buy a car.

  • ||

    If you show up with cash in hand, probably not.

  • ||

    In NYS (the last place I bought a car), that is indeed the case; however, you aren't allowed to sell a car without an emissions/safety inspection sticker. Strange priorities.

  • ||

    Or does the Congress of the United States have less power to regulate health care than the Legislature of the Commonwealth of Virginia has to regulate who pays to fix your Jetta after a fender-bender?

    Um.. yes? Is this a trick question or something?

  • Tony||

    Let's not let a narrow interpretation of the CC get in the way of the fact that universal health insurance is a pretty good idea. Unless you're an insurance company.

  • Tncm||

    The Chony parodies have gotten pretty good since I've been away. I'll have to go read through some of the archives to catch up on the hilarity.

  • Mr. FIFY||

    But... but... forcing us to buy stuff is good! Tony said so!

  • Tony||

    If it's cheaper than the private alternative, and has the benefit of not making you a parasite on others should you happen to get seriously ill or injured?

  • ||

    By not being a private alternative it is parasitic in nature. Or haven't you heard about the subsidies?

  • ||

    Actually, if your a health insurance company, it's a pretty GOOD idea for everyone to be buying insurance.

  • Tony||

    Agreed, that's why I am not in favor of accomplishing this via the insurance mandate, or many other Republican ideas for that matter.

  • nekoxgirl||

    Seriously, how stupid are the people still making this argument? How difficult is it to understand that the US constitution deals primarily with federal law and not state law? The discussion is whether a federal law is unconstitutional. Stop comparing it to state laws you idiots!

  • ||

    yeah obama, Stop comparing it to state laws you idiot.

  • ||

    Someone should point out that mandatory auto insurance doesn't include maintainance to your car. it only covers the damamge you do to others.

  • meeko||

    So what would happen when due to bad maintenance oil spills on the road thus damaging ( ofc. repairable ) the road?
    Does the mandatory auto insurance covers it?

  • ||

    Nope.

  • ||

    Only if you have Allstate. Denzel Washington's commercial told me so.

  • ||

    If you are in the emergency room receiving care and you don't have insurance, and I am insured and come in after you, and then I have to wait and then die... then I just paid to save your life and died instead.

  • ||

    States don't mandate car insurance-- they mandate lawsuit insurance. Which of course encourages more lawsuits. It's primarily a welfare programme for lawyers.

  • road accident claim||

    Thank you for sharing the information with us. The medical insurance is as important as car insurance for us. We should take care of ourselves, we also do with our cars.

  • lawyer perth||

    Nice post, thank you. No matter who, we should purchase the medical insurance for ourselves. After all, the health is the most important issue for people.

  • public liability lawyers melbo||

    Thank you for providing so useful information for us. I think most people purchased the medical insuance for themselves. Some countries even force people to buy it.

  • ||

    It's hilarious how disingenuous the Republicans are on the entire health care issue. They fought against the public option. Because of this, the only way to make health care available without the "public option" was to force insurers to accept everybody. The only way to do this without bankrupting the insurance industry was to mandate health coverage. If these legal challenges succeed, I can't imagine the rest of the bill surviving. This is because the insurance companies won't be able to afford the new restrictions on their business practices.

    So, basically, the Republicans wanted healthcare to fail, the american people be damned. Let's see if we can get all the way up to 100 million uninsured!!!!

  • law firms sydney||

    Thank you for sharing the information with us. It is no doubt that the insurance companies and law firms are increasingly important in our life today. They could protect our rights and reduce our damage in the future. Furthermore, we could ask them for the professional advice.

  • Berrigan Doube Lawyers||

    I agree with the your point.our life is more important than anything. if cars should have the insurance, why shouldn't we have medical insurance?

  • lawyer perth||

    Medical insurance is quite similar to car insurance, it is not compulsory but there are so many options and rules that you definitely need advice before can make the best selection!

  • ||

    Living is a right and not a privilege but the inaccessibility of medical care and preventative care makes seeing the doctor a privilege many cannot afford because they don't have health insurance. Once the less fortunate get so ill that the hospitals must treat them regardless of their ability to pay that drives up medical costs for those who do pay. This is what makes health insurance like car insurance. Its the insurance companies and pharma companies who are the real bad guys who profit from those who are sick are the ones who make this a hefty price to pay for every one.

  • tomcole||

    Medical and car insurance both are important but not equally. Medical insurance is more needed than car.

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