Larry Tribe: The Health Insurance Mandate Is So Clearly Constitutional That I Don't Even Know Why I'm Bothering to Write This Op-Ed Piece

In a New York Times op-ed piece published yesterday, Harvard law professor Laurence Tribe explains why there is no suspense about where the Supreme Court will come down on the constitutionality of ObamaCare's individual health insurance mandate. "Only a crude prediction that justices will vote based on politics rather than principle," he says, "would lead anybody to imagine" that the outcome is at all uncertain. The law on this question is so clear, Tribe claims, that only a bunch of partisan hacks could conclude that the insurance requirement exceeds Congress's power to "regulate commerce...among the several states," and even the more conservative justices have too much "intellect" and "integrity" to do that.  (Tribe does make an exception for Clarence Thomas, not because he has less integrity than the others but because "he alone has publicly and repeatedly stressed his principled disagreement with the whole line of post-1937 cases that interpret Congress’s commerce power broadly.") Ann Althouse analyzes Tribe's rhetorical strategy:

It reminds me of an old-fashioned mother exerting moral pressure on a child by telling him how sure she is that he is such a good little boy that he could never do whatever it is she doesn't want him to do. Put more directly, it's an assertion of authority: I'm telling you what's right and if you don't do it, you'll be wrong. Could the Justices possibly yield to pressure like that? It's crude to think that they would, isn't it? It's an insult both their intellect and their integrity.

And yet, Larry Tribe does think it, right? That's what's behind his rhetoric. I believe. Crudely.

As Althouse notes, Tribe conflates economic "activities," which have always been involved in cases where the Supreme Court has upheld laws on Commerce Clause grounds, with "commercial choices," thereby eliding the distinction at the heart of the two rulings against the insurance mandate. The Supreme Court may well decide that the activity/inactivity distinction is not crucial, but that is not by any means a foregone conclusion. Tribe is also tricky in defining the choice made by someone who does not buy the medical coverage Congress thinks he should have:

Individuals who don't purchase insurance they can afford have made a choice to take a free ride on the health care system. They know that if they need emergency-room care that they can't pay for, the public will pick up the tab. This conscious choice carries serious economic consequences for the national health care market, which makes it a proper subject for federal regulation.

As I've pointed out before, this "free ride" is mandated by federal law, which requires hospitals to treat patients without regard to their ability (or willingness) to pay. The government therefore is arguing (as it often does) that further intervention is needed to address the consequences of a previous intervention. In his ruling against ObamaCare last week, U.S. District Judge Roger Vinson noted that the insurance mandate is also presented as a "necessary and proper" response to the adverse selection problem created by ObamaCare's requirement that insurers cover everyone and charge the same rates regardless of expected claims. If this rationale counted as a constitutional justification, he noted, the federal government could expand its own powers indefinitely by creating new messes to clean up:

The individual mandate is actually being used as the means to avoid the adverse consequences of the Act itself. Such an application of the Necessary and Proper Clause would have the perverse effect of enabling Congress to pass ill-conceived, or economically disruptive statutes, secure in the knowledge that the more dysfunctional the results of the statute are, the more essential or "necessary" the statutory fix would be. Under such a rationale, the more harm the statute does, the more power Congress could assume for itself under the Necessary and Proper Clause.

Vinson also pointed out that failing to buy health insurance does not automatically translate into imposing costs on others:

The uninsured can only be said to have a substantial effect on interstate commerce in the manner as described by the defendants: (i) if they get sick or injured; (ii) if they are still uninsured at that specific point in time; (iii) if they seek medical care for that sickness or injury; (iv) if they are unable to pay for the medical care received; and (v) if they are unable or unwilling to make payment arrangements directly with the health care provider, or with assistance of family, friends, and charitable groups, and the costs are thereafter shifted to others. In my view, this is the sort of piling "inference upon inference" rejected in Lopez [the 1995 Supreme Court decision that overturned the Gun-Free School Zones Act].

In this light, the "commercial choice" that Tribe says obviously justifies federal intervention is no different from myriad inactions that may (or may not) ultimately result in higher costs for others (often through government-mandated cost shifting)—an effect that, in the aggregate, could be called "substantial." These choices would include not just failing to buy other forms of insurance or protective products such as sunscreen and motorcycle helmets but failing to quit smoking (buy nicotine patches), lose weight (join Weight Watchers), eat properly (buy vegetables), exercise (buy a gym membership), get enough sleep (buy a good mattress), or practice good dental hygiene (buy toothpaste and dental floss). By Tribe's logic (which is also the Obama administration's), all these and many more health-improving, cost-reducing actions could be mandated under the Commerce Clause.

More speculation about the Supreme Court's response to ObamaCare here, here, and here. For more on the ill-defined boundaries of the Commerce Clause, watch Reason.tv's video on the subject (which Vinson cited in his ruling):

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  • ||

    Tribe's logic

    A contradiction in terms.

  • sevo||

    "The law on this question is so clear, Tribe claims, that only a bunch of partisan hacks could conclude that the insurance requirement exceeds Congress's power to "regulate commerce...among the several states," "

    Graveyard's about a mile to your left; whistling instructions available.

  • ||

    Tribe knows better, as the mandate is clearly breaking new ground. This is what happens when you're more interested in politics than in legal scholarship.

    Allowing the mandate to stand would allow the government to do virtually anything under the Commerce Clause. That is not the law, even with the expansive (and, frankly, unconstitutional) view taken of the Commerce Clause in the last hundred years. No surprise when the foxes get to appoint foxes to protect their access to the hen house.

  • ||

    Yeah, I can (grudgingly) respect people who have a legally-credible basis for believing ObamaCare is constitutional (and I do think one can be made based on current case law), but it's the whole "Everybody knows it's constitutional and if you don't agree then you're an idiot" thing that pisses me off. We've now had two federal judges rule it unconstitutional, so to say the law is clear is simply a lie.

  • Paul||

    Individuals who don't purchase insurance they can afford have made a choice to take a free ride on the health care system. They know that if they need emergency-room care that they can't pay for, the public will pick up the tab.

    Whoa...whoa...whoa! Wait a second. What happened to our third world healthcare system where uninsured people simply don't get any healthcare?

  • ||

    Oh, that. That was a lie. But a noble one!

  • Neu Mejican||

    What happened to our third world healthcare system where uninsured people simply don't get any healthcare?
    reply to this

    That has never been the claim. The claim is that "uninsured people simply don't get access to appropriate healthcare and end up having to use the emergency room instead."

  • sevo||

    "That has never been the claim."
    Bull.............
    shit.

    "The claim is that "uninsured people simply don't get access to appropriate healthcare and end up having to use the emergency room instead.""
    Please define "appropriate healthcare".

  • Neu Mejican||

    Please define "appropriate healthcare".
    reply to this

    That would depend on the specific situation. Very few healthcare needs are appropriate for the emergency room.

  • sevo||

    "That would depend on the specific situation. Very few healthcare needs are appropriate for the emergency room."
    So you'll make it up as you go?

  • modern quixotic||

    Of course you make it up as you go. How else? Obviously, the treatment for a broken leg is different from the treatment for a stomach flu, cancer, or a hernia. The healthcare people should receive depends on the healthcare they need.

  • ||

    That is absolute nonsense. Who were those millions without healthcare trumpeted during the debate? I remember quite vividly some opponents pointing out that emergency room access was open to all, but that was never part of the main discussion.

  • Neu Mejican||

    that was never part of the main discussion.

    It was always part of the discussions I have had on this topic. To be fair, the "emergency room" part of this is just short hand for "the emergency room, or go without."

  • ||

    The problem is that we had this ridiculous bill shoved down our throats largely because of the idea that tens of millions of us couldn't afford healthcare. By making that absolute argument, the public proponents of the bill sacrificed most of their credibility.

    Whether you or anyone else knew better, that was where the debate was. Facts like the problems with Medicare and Medicaid were ignored, too, just as were things that actually need reform, like how states regulate insurance carriers. Because the push was and is about socializing medicine, period, and the arguments and means are just a detail.

  • Bill||

    We'll find out what's in it once it's passed. And then after another 10-20 years once it is implemented.

  • Zeb||

    The "emergency room or go without" claim is bullshit. People without insurance can still make an appointment with a doctor and pay for it. Usually there is some financial aid available and a payment plan can be set up. There are options for uninsured people besides the ER. Many don't take responsibility for themselves and make better arrangements than going to the ER. And going to the ER without insurance isn't an automatic free ride. They will still bill you (unless you give a false name or something). And believe it or not, even some poor people find paying ones debts to be an important thing. Don't get me wrong, the current system is stupid, but being without insurance does not mean ER or nothing.

  • Pip||

    This^^

    I was self-employed for years and when I needed medical care, I went to a regular doctor and paid for it with money.

  • ||

    I went to a regular doctor and paid for it with money.

    My God! And did you do that before or after picking up your monocle from the polishing shop?

  • Esteban||

    Hey, I'm one of those people on a payment plan (interest free!) paying off a medical bill because my insurance didn't cover out of state.

  • ||

    And, since all of our health problems stem from obesity (so I've been told), the poor could certainly afford to NOT EAT a cheeseburger.

  • Bill||

    And by not eating a cheeseburger, they are definitely affecting interstate commerce. Sounds like we need to regulate this!

  • ||

    Rich people should be compelled to eat cheeseburgers to narrow the obesity gap.

  • ||

    Obesity and wealth are inverse correlated. Therefore, making rich people fatter with also close the income gap.

  • Restoras||

    Irony alert!

  • Michelle Obama||

    And by not eating a cheeseburger, they are definitely affecting interstate commerce. Sounds like we need to regulate this!

    I'm on it.

  • Paul||

    It was always part of the discussions I have had on this topic. To be fair, the "emergency room" part of this is just short hand for "the emergency room, or go without."

    Incorrect. I work for a large healthcare organization which provides a significant amount of "charity care". A very large segment of our patients are "self pay" which is an industry euphemism for "uninsured" and they are seen in clinics- outpatients, inpatients, emergency room. They run the full gamut.

    The suggestion that healthcare is "emergency room only" when you're uninsured is demonstrably false.

  • Neu Mejican||

    Point taken...and true from my experience. I do know, however, also working in healthcare, that lots of folks do without needed care because they can't afford the "self-pay" options available. There is a paucity of information available about these options, for sure, but they are out of reach of many families.

  • ||

    The dearth of (cheaper) market options has something to do with state regulation of insurance and federal regulation/intervention in medicine. There's also the question of whether we'd be better off with private charity and mechanisms like mutual aid societies for poorer people.

  • Paul||

    Point taken...and true from my experience. I do know, however, also working in healthcare, that lots of folks do without needed care because they can't afford the "self-pay" options available. There is a paucity of information available about these options, for sure, but they are out of reach of many families.

    The problem is we've got such a mishmash of public interference in the market, it's hard to know where one thing begins and another ends.

    Some people who are uninsured are also uneducated and may not know their options. Passing a law saying you will do thus and so certainly makes that problem a little easier to deal with.

    Also, part of the reason many healthcare organizations can see as many self-pay patients as we do is because we receive government compensation for a certain percentage of those. What percentage I cannot say.

    However, many of those self-pay people won't be able to afford to purchase their own insurance anyway-- it's not an economic calculation for them: they simply can't pay it. So they will still be on "the public teat", if you will, by virtue of the fact they'll remain on Medicaid or possibly the state's "low cost" insurance option which, like Massachusetts is in dire financial condition.

  • ||

    Allow me to second Paul's statement in every particular.

    The Vinson quote in the post does a nice job of eviscerating the claim that not buying insurance = a burden on the public fisc.

  • Abdul||

    Caption: "Argument? What do you mean 'What's my constitutional argument?' don't you see me jerking my hand here?"

  • Neu Mejican||

    As Althouse notes, Tribe conflates economic "activities," which have always been involved in cases where the Supreme Court has upheld laws on Commerce Clause grounds, with "commercial choices," thereby eliding the distinction at the heart of the two rulings against the insurance mandate.

    This is, indeed, the heart of the controversy. One of the primary things the SCOTUS will be deciding is if the particular "choice" of not buying insurance counts as economic "activity." This seems to me to be the primary distinction between those who see this as constitutional and those that don't. Those that see the choice as an "activity" see it as constitutional...those that don't see it as an "activity" see the mandate expanding government reach into new territory.

    Of course, specifics matter. If the choice to not buy insurance is considered by SCOTUS to be economic activity that can be regulated at the federal level...there are not many other choices-not-to-buy that would seem to be analogous (fill me in if you see 'em, cause I don't). SCOTUS can, of course, set up a strict test for when choices-not-to-buy constitute economic activity that can make even these analogous choices (if they exist) unlikely to fall under Congress's regulatory power.

    It seems.

  • ||

    Wouldn't all other inaction constitute the same "choice" because by not acting you affect things? That's what the inaction of not buying health insurance (not health CARE, but health INSURANCE...you know how f'ing stupid this is yet feign ignorance because of your political will) does, it affects things as the article correctly stated to be obvious, that are all problems created by earlier government ACTION. You know this, because it's been repeated by everyone, would grant the US Federal Government unlimited power. If SCOTUS decides how you want them to, don't be surprised in the least when the party you don't like abuses such power, as they always do.

  • Neu Mejican||

    If SCOTUS decides how you want them to, don't be surprised in the least when the party you don't like abuses such power, as they always do.

    Are you pretending that you know how I want SCOTUS to rule?

    I am simply discussing the topic. My personal opinion hasn't been put into the discussion at this point.

    Wouldn't all other inaction constitute the same "choice" because by not acting you affect things? That's what the inaction of not buying health insurance (not health CARE, but health INSURANCE...you know how f'ing stupid this is yet feign ignorance because of your political will)

    The logic goes: if this choice-not-to-buy is an economic activity where others aren't it is because the choice not to buy health insurance is made, but the actor access the health care anyway...and is very likely to end up as a free rider in a system that is set up to share costs/risks when the individual can't afford it. The choice to not buy health insurance is part of a larger activity, it is argued; the larger activity is the utilization of healthcare that is often, without insurance, beyond the individual's means and results in others having to cover the cost.

    Part of the problem that this highlights, of course, is the WAY that our system is set up. Catastrophic healthcare costs are conflated with routine costs and insurance covers both. It may be more sensible to leave routine costs to the individual and have insurance only for catastropic costs.

  • Pip||

    Do you have any idea how expensive funerals are? And do you know who covers the cost for the indigent? You and I, buddy, via the state.

    So I think the govenment should mandate the purchase of life insurance for every American. And those who refuse? Fine the fuckers.

  • fish||

    Rest assured it's coming. After they pilfer your retirement savings!

  • ||

    Was I wrong regarding how you want SCOTUS to rule? Maybe I shouldn't jump to conclusions based on your history, but was I wrong?

  • Neu Mejican||

    I haven't decided.
    But I have been pretty consisting in my position that there is a need for health care reform in this country and that this bill went about it in the wrong way.

  • Neu Mejican||

    As for "my history" on this site. I typically engage on issue for which I have not made up my mind...typically. One reason to come here is to get opinions from the libertarian perspective fleshed out through discussion.

  • robc||

    It may be more sensible to leave routine costs to the individual and have insurance only for catastropic costs.

    May be?

    Its abso-fucking-lutely clear that that is the best way to go.

  • Pip||

    What??? And return to the horror years when people had Major Medical insurance policies???

  • Vermont Gun Owner||

    if this choice-not-to-buy is an economic activity where others aren't it is because the choice not to buy health insurance is made, but the actor access the health care anyway...and is very likely to end up as a free rider in a system that is set up to share costs/risks when the individual can't afford it. The choice to not buy health insurance is part of a larger activity, it is argued; the larger activity is the utilization of healthcare that is often, without insurance, beyond the individual's means and results in others having to cover the cost.

    Then the activity would be getting the health care at the later point.

  • Paul||

    SCOTUS can, of course, set up a strict test for when choices-not-to-buy constitute economic activity that can make even these analogous choices (if they exist) unlikely to fall under Congress's regulatory power.

    I believe that the SCOTUS cannot set up a strict test. It is, by definition, a whim of a political racket.

    No matter how erudite and flowery the language, or complex the math, it's a political whim which is justified ex post facto.

  • ||

    there are not many other choices-not-to-buy that would seem to be analogous (fill me in if you see 'em, cause I don't).

    Once you cross the Rubicon of saying that anything an individual does or does not do, which has the potential effect of increasing the cost imposed on others for their health care . . .

    You're pretty much all the way home in giving the federal government jurisdiction over any aspect of your life which affects your health.

    "Unhealthy" choice X -> increased use of healthcare -> increased cost of healthcare -> higher premiums for your pool/higher expenditures by Medicare/Medicaid.

    Rinse and repeat ad infinitum, ad nauseum.

    It may be more sensible to leave routine costs to the individual and have insurance only for catastropic costs.

    Now we're getting somewhere.

  • Neu Mejican||

    You're pretty much all the way home in giving the federal government jurisdiction over any aspect of your life which affects your health.

    Nah...that slope ain't that slippery.

  • ||

    Alright, then, tell me the principled argument that stops us from sliding all the way to the bottom.

  • Neu Mejican||

    The quick answer is that this mandate is only about how health care is paid for. Other choices/activities that are not about how health care is paid for are of a different class. Really, the world and its people are more reasonable than all that...and can make distinction even more subtle than this.

  • Vermont Gun Owner||

    The health care that they aren't even using?

  • Neu Mejican||

    Who is this person that uses no health care again? The "not using" refers to health insurance. Keep it straight.

  • Old Mexican||

    Individuals who don't purchase insurance they can afford have made a choice to take a free ride on the health care system.


    This is what normal people would call a false dichotomy. Tripe ... sorry, Tribe seems to believe that if you don't buy health insurance, is because you're already decided to shaft the system, and not because you decided you don't need it or because you take good care of yourself.

    They know that if they need emergency-room care that they can't pay for, the public will pick up the tab.


    This is moronic, as hospitals always offer payment plans to their customers.

    This conscious choice carries serious economic consequences for the national health care market, which makes it a proper subject for federal regulation.


    This is a clumsy non sequitur. Even IF there were some consequence of some people's actions affecting a market, does not confer the Federal Government any power to regulate people's actions.

  • Neu Mejican||

    Tribe seems to believe that if you don't buy health insurance, is because you're already decided to shaft the system, and not because you decided you don't need it or because you take good care of yourself.

    I agree. It is a false dichotomy. However, there are few people who can take care of the costs themselves when something major actually occurs. Even just a week's stay in your typical hospital can cost more than the average American makes in a year. So the decision to "take care of it yourself" is often just so much denial- thinking that catastrophic costs only happen to others.

  • ||

    The cost of a week's hospital stay is largely the result of government intervention, including but not limited to limited access to the market by would-be hospitals and doctors, taxes, regulations, and mandates.

  • Old Mexican||

    Re: Neu Mejican,

    However, there are few people who can take care of the costs themselves when something major actually occurs.


    Possibly, Neu, but hardly relevant - Tripe... Sorry, Tribe already made up his mind that people who don't buy insurance MUST BE so-called "free riders" by sole virtue of their inaction!

    So the decision to "take care of it yourself" is often just so much denial-thinking that catastrophic costs only happen to others.


    Uh... Right, Neu... Right. If I don't buy flood insurance, then I am in denial about potential flood damage (as you say, because I may foolishly think flooding only happens to others) even if I happen to live IN THE MIDDLE OF THE FUCKING DESERT.

    There's a big difference between certainty and likeliness, Neu. I am certain I am going to DIE one day, but as to having a catastrophic even happening to me... I can only figure out the LIKELINESS of it. YOU can't foresee the future any better than I can, so don't say people that don't buy insurance are somehow in DENIAL and you happen to be Cassandra.

  • Neu Mejican||

    Uh... Right, Neu... Right. If I don't buy flood insurance, then I am in denial about potential flood damage (as you say, because I may foolishly think flooding only happens to others) even if I happen to live IN THE MIDDLE OF THE FUCKING DESERT.

    That analogy is not apt. The apt analogy would be the person who lives on the banks of a large river that decides not to buy flood insurance. The likelihood that any individual will have an expensive health care intervention in their lifetime is very high. Yep, even if they are healthy in general.

  • ||

    The likelihood that any individual will have an expensive health care intervention in their lifetime is very high.

    Fear will get the proles in line. Fear of getting sick and losing everything. We must play on that fear.

  • Old Mexican||

    Re: Neu Mejican,

    The likelihood that any individual will have an expensive health care intervention in their lifetime is very high.


    Like, how high, Neu? Let's see what else you can pull out of your ass.

  • cynical||

    Isn't insurance mainly for unlikely occurrences?

  • ||

    If the probability of an event is 1, then you don't need insurance either. You need a savings account.

    What is the point in buying "insurance" for an event that is 100% certain to occur? Just set aside enough money for that utterly certain date that you know will need it.

    You only buy insurance if you AREN'T certain you need to set aside the money, and want to use it for something else.

  • Fluffy||

    Neu, sorry, but this is fucking stupid.

    When I was 24, the ONLY events that could POSSIBLY have led to me being in the hospital for a week were all accidents that would be covered by other insurance.

    My car insurance would kick in if I crashed my car.

    My homeowner's insurance would kick in if I fell off a ladder.

    Etc.

    In fact, I can personally testify to the fact that this logic is asinine.

    I made an emergency room visit less than 10 years ago at a point in time when I was voluntarily uninsured. Total cost: less than 3 grand. That means that if that emergency room visit occurred at any point in time three months or more into my period of voluntary non-coverage, I made the correct economic decision in foregoing insurance.

    There's a real math problem involved in asserting that people can't afford a few grand for a hospital visit, but can afford to pay $1000 a month or more to satisfy the government mandate. WTF, dude? If I go uninsured for a year I save $12000 or more. What about the medical care I could pay for with that 12 grand?

  • Neu Mejican||

    There's a real math problem involved in asserting that people can't afford a few grand for a hospital visit, but can afford to pay $1000 a month or more to satisfy the government mandate. WTF, dude? If I go uninsured for a year I save $12000 or more. What about the medical care I could pay for with that 12 grand?

    I think I have already mentioned that I think catastrophic insurance is needed but that covering routine costs doesn't make as much sense.

    That 12,000, btw, barely covers the pharmacy costs for my last unexpected stay in the hospital. Food poisoning in a healthy young man (this was 15 years or more ago)...10 day stay in hospital...lots of tests...total around $90,000 dollars. So the 12,000 insurance was the better choice. Now...lifetime costs? I am sure I would come off better for those years that all I need is a vaccination.

    Our system needs reform. The current approach may not be the best way to go...but this is a discussion about constitutionality...not optimal reform approaches.

  • ||

    If you had a high deductible plan, with a deductible of $10000, at a monthly cost of $70, you would have spent $10840 that year.
    Which would STILL have been cheaper than comprehensive coverage.

    It doesn't make financial sense to buy comprehensive coverage unless you are certain to spend more than the premiums. In other worse, unless you are already sick and the government is forcing the insuerer to cover you.

  • ||

    My homeowner's insurance would kick in if I fell off a ladder.


    Fluffy, I agree with the thrust of what your saying in this post, but, seriously, what homeownwers policy covers injuries to any residents of the property?

    I'll have to reread mine. AFAIK, it has a liability section which covers third parties who might be injured as a result of my negligence or because of a structural defect (known or unknown to me) but I'm pretty sure that neither I nor anyone actually residing here (whether related to me or not) is not covered.

  • Neu Mejican||

    Yeah... I noticed that too.

    And car insurance typically doesn't cover my injuries, but injuries I cause others.

  • robc||

    Maybe Fluffy is a damn good driver and assumes he would only be injured by others.

  • ||

    NM, Florida has mandatory Personal Injury Protection on auto policies (at one point it was the only coverage you were mandated to have). It covers both the insured and third parties. The mandatory limit is fairly low, as I recall.

    I realize that other states may have other requirements so I won't go any further on that.

  • Neu Mejican||

    OK.
    I don't know how common that is.

  • Fluffy||

    So the decision to "take care of it yourself" is often just so much denial- thinking that catastrophic costs only happen to others.

    And, actually, this is also false.

    "Take care of it yourself" is, for single adult males with no glaring genetic deficiencies or inferiorities, a recognition of the indisputable fact that the odds of such "catastrophic costs" occurring are vanishingly small, and can in no way justify expending thousands of dollars a quarter on insurance you'll never use.

  • Neu Mejican||

    a recognition of the indisputable fact that the odds of such "catastrophic costs" occurring are vanishingly small, and can in no way justify expending thousands of dollars a quarter on insurance you'll never use.

    This is a good example of the denial. The chances that you will need health care intervention that is very expensive sometime in your life is very high. And predicting when it will happen is next to impossible. This is, essentially, a black swan problem.

  • Gilbert Martin||

    "The chances that you will need health care intervention that is very expensive sometime in your life is very high. "

    Prove it.

  • Neu Mejican||

    Plenty of research on this topic. The typical male will have about 8 high-medical-cost years in his lifetime. Women, slightly more than that.

  • Gilbert Martin||

    You can't prove that either.

  • Neu Mejican||

    Pony up...prove it to be a false assertion.

  • Gilbert Martin||

    No you pony up, NM.

    I, like everyone else, am not required to prove a negative.

    The burden of proof always lies on those claiming the affirmative condition. And that usually puts liberals (such as yourself) generically on the wrong side of the burden of proof (as in proving that some govt intervention has "worked" better than the free market).

    And of course the proof of the claim being made has to be unequivocally quantifed as absolutely 100% accurate by measurement in the physical world.

  • Neu Mejican||

    The burden of proof always lies on those claiming the affirmative condition.

    Not true.

  • Poor Substitute||

    Prove it

  • Old Mexican||

    Re: Neu Mejican,

    The burden of proof always lies on those claiming the affirmative condition.

    Not true.


    The Statist Credo - "I don't have to prove a positive, YOU have to prove a negative! So there!"

  • Neu Mejican||

    OM,
    The Statist Credo -...

    If Gilbert's assertion is true, it is his burden to prove to me that it is true. If I am correct, then I have a burden to prove my case.

  • Neu Mejican||

    "I don't have to prove a positive, YOU have to prove a negative! So there!"

    When one person in a discussion makes an assertion that is easily verifiable or taken generally to be true, it may be the person questioning that assertion who must take the burden of proving their case.

    Whether my stated fact falls into the category is debatable, of course, but as a general principle Gilbert is full of shit when he asks for proof of simple facts in these kinds of discussions. The burden in that case falls on him to show why he doubts the veracity of a claim made in good faith.

  • Pip||

    "The chances that you will need health care intervention that is very expensive sometime in your life is very high."

    Bullshit.

  • ||

    The chance of you dying at the end of your life is even higher.

  • Neu Mejican||

    Millions now living will never die.

    http://www.seanet.com/~raines/millions.html

  • ||

    Show up at my door and you'll get a lead salad.

  • robc||

    "Sometime in your life" is bogus.

    Deciding to wait until you are 30 to buy insurance leads to a different calculation.

    The odds of a healthy 21 years old not having a catastrophic condition in 9 years is pretty good.

  • Neu Mejican||

    "Sometime in your life" is bogus.

    Deciding to wait until you are 30 to buy insurance leads to a different calculation.

    The odds of a healthy 21 years old not having a catastrophic condition in 9 years is pretty good.

    Yeah...you see the whole "spread the risk" thing is always based on your lifetime costs. That 21 year old will be sucking resources like mad in 40 years. If he hasn't paid in when he is healthy...guess what? He's the free-rider being discussed. If you don't start paying into the system until after your risks are high, then the whole idea of insurance doesn't work. This is why insurance companies try to exclude high risk individuals.

    Like I said, I have not made up my mind on this, but the argument you make here works in favor of the idea that the "choice not to buy" is indeed an economic activity because it is really a "choice not to buy yet because I will save money in the end by letting others cover more of my costs later." (or something worded more elegantly).

  • Vermont Gun Owner||

    Yup. The free rider who didn't use any resources. What a jerk, not contributing to others for something he didn't need.

  • robc||

    Umm...insurance costs should be based on risk. So not paying in during your 20s doesnt change a thing.

    Insurance costs more in your 60s because the risk is higher.

  • Neu Mejican||

    See the comment above about allowing the industry to price based on risk. Not the current situation, as far as I can tell.

  • robc||

    See the comment above about allowing the industry to price based on risk. Not the current situation, as far as I can tell.

    1. If it isnt based on risk, it isnt insurance. Now that may be the case, but Im discussing insurance here.

    2. As far as I can tell, in my state (I cant comment on the other 56, being this is an intrastate only commerce item), it is risk based. I have seen the chart from my insurance company with gender and age groups and the cost of each. Numbers on the chart get added up to determine what my company pays.

    The Female one is interesting as they actually get cheaper mid-40s, before starting to go back up (and, yes, I know why).

    Males start cheap and increase thruout their life.

  • robc||

    it is risk based

    At least, it is risk based for age/gender/marital status/family status. Other risk factors may not be allowed.

  • Neu Mejican||

    For an individual plan, this is closer to true. But with employer-based insurance, the individual's cost is not based on risk. The majority of health care coverage under this bill would be employer-based. Doesn't current coverage in the US favor these employer-based plans by about 6 to 1?

  • robc||

    I was discussing an employer-based plan. This is my company's plan. It has covered as many as 9 employees plus families at times.

  • Neu Mejican||

    I have never worked somewhere where the plan looked like this. But, of course, experience will vary.

  • robc||

    It seems to be fairly standard in KY for small businesses. Above a certain size (not sure what the cut off is) the plans change to more like what you are used to.

    Also, if the company covers the insurance, why would an employee ever know how the plan worked? I doubt my employees know how much is being paid or how its calculated.

  • cynical||

    "The majority of health care coverage under this bill would be employer-based."

    So long as employers are allowed not to comply with the bill, so as to not feel like it's an awesome idea to drop coverage for their employees, yes?

  • robc||

    If he hasn't paid in when he is healthy...guess what? He's the free-rider being discussed.

    This is the 2nd stupidest thing you have said on reason.com.

    I dont have life insurance (my company has some on me, but different story). Why? Because no one depends on me or my salary, if I die my estate can cover everything and then my hiers get some money.

    If someday I decide to buy life insurance, it will cost more than if I bought it younger because I am a higher risk. I wont be free-riding life insurance. Health insurance is no different (or shouldnt be, some states may not allow proper risk pricing, but that isnt the individual's fault).

  • Gilbert Martin||

    "Like I said, I have not made up my mind on this, but the argument you make here works in favor of the idea that the "choice not to buy" is indeed an economic activity because it is really a "choice not to buy yet because I will save money in the end by letting others cover more of my costs later." (or something worded more elegantly)."

    Only in liberal la la land.

    In actual Constitutional terms it's total BS.

    The power delegated to Congress it to regulate interstate commerce. And commercial is actual transactions - AS THEY OCCUR - not regulating something based on the nebuolous claim that it MIGHT impact some future transaction.

  • robc||

    The power delegated to Congress it to regulate interstate commerce.

    The most amusing thing is that laws mandate that health insurance *only* be intra-state commerce.

  • Neu Mejican||

    And commercial is actual transactions - AS THEY OCCUR

    Prove it. That is quite an assumption.

  • robc||

    commerce - an interchange of goods or commodities...(blah blah blah, more words that neither add nor subtract meaning).

    Comes from a latin word meaning "to trade together".

    Commerce requires transactions.

    The primary reason the Raich ruling was wrong.

  • Neu Mejican||

    That is a pretty narrow definition of the word. But even so, it doesn't include any "as they occur" requirement for it to be "commerce" particularly in terms of regulation of "commerce."

  • robc||

    Its from the dictionary. If you think its too narrow, take it up with them.

    Interchange of goods means "transactions as they occur". The commerce occurs at the point and time of transaction. which could be smeared across many points and many times.

    Lets take an example: Im selling you some pot. I grow it - not commerce. You call me asking to buy (the time of the commerce starts there), I deliver it to you (the place of commerce stretches from my house to yours, possibly across state lines, making it interstate) and hand it off (ending the commerce).

    The fact that the courts/laws have tried to spread commerce wider than that doesnt make them right. You said the defintion of commerce is narrow, I agree actually, it is a very narrow concept. Trying to widen it dilutes the word.

  • Neu Mejican||

    So, yes, commerce is smeared across a wide time frame that includes, according to your description, an inquiry about availability and then the subsequent decision making process including negotiation for how that product is paid for. The regulation of commerce, it seems, can take place anywhere during this process. The argument being made that "commerce" isn't happening except at the point at which the transaction occurs. That is too narrow.

    As for you "dictionary" definition. It is only one of many in any dictionary. It typically includes the broader context and infrastructure surrounding large scale operations supporting the individual to individual transaction.

    Just saying.

  • Pip||

    transactions created or saved

  • robc||

    Also, what about Christian Scientists and other anti-health care whackadoodles?

    They have zero need for catastrophic coverage.

  • Vermont Gun Owner||

    And predicting when it will happen is next to impossible.

    I'm going to go out on a limb and say it's a bit more likely to happen to me in around 60 years in the future than now.

  • Paul||

    This is a good example of the denial. The chances that you will need health care intervention that is very expensive sometime in your life is very high.

    "Some time in your life" is a far cry from "the years between 18 and 32" for instance.

    Personally, had I never paid a dime in health insurance-- or let me be more clear, had my employer paid me cash instead of paying in with the benefit, I'd have earned a large sum of cash over that (approx) 27 years I've been working.

    I admit the math is very rough, but calculating that my monthly healthcare benefit has averaged $500 (unadjusted) dollars a month for the last 27 years, I'd have earned an extra $162,000. I could go out today while I'm still a very healthy, not-so-young man and pick up insurance now, as I begin to approach the age where higher healthcare costs are more likely.

    The bottom line is, if people aren't allowed to make economic decisions, we're not very free.

  • robc||

    I admit the math is very rough, but calculating that my monthly healthcare benefit has averaged $500 (unadjusted) dollars a month for the last 27 years, I'd have earned an extra $162,000.

    This varies with location but, at age 41, Im paying about $250 per month. I doubt yours averaged $500 over 27 years (assuming 22ish-49ish age range).

    But, yeah, even if its 80k instead of 162k, same idea.

  • Fluffy||

    This is a good example of the denial. The chances that you will need health care intervention that is very expensive sometime in your life is very high. And predicting when it will happen is next to impossible.

    It's not difficult to predict at all.

    When insurance companies are allowed to freely price, they make this actuarial judgment all the time.

    In any event, my 20's are over. I judged at age 20 that my likelihood of requiring catastrophic services was extremely small, and that judgment was proven to be absolutely, positively 100% correct.

    It's foolish - and shows a distinct lack of understanding of statistics - to try to now prove that my decision was wrong, or constituted "denial". Now that the event series is over, we retroactively know that my chances of needing catastrophic care were 0, and always were 0.

  • Neu Mejican||

    I used the term "in your life" for a reason.

  • Fluffy||

    Right - to be deceptive and non-responsive.

  • Neu Mejican||

    No. To be precise and avoid misunderstanding. It didn't work, I guess.

  • robc||

    "In your life" is bogus, as I pointed out above.

  • Neu Mejican||

    In an ideal world, perhaps it is bogus. In our current system, not so much.

  • robc||

    As I said above, it that isnt the way it works, we arent discussing insurance any more. And Im discussing insurance.

  • robc||

    Step 1 in fixing the current system is to make sure insurance is insurance.

    Step 2 is ending the employer tax benefit by giving the same benefit to the individual (or getting rid of it for both).

    Step 3 is to allow interstate purchases of health insurance (in same ways this prevents the need for step 1 - as states with stupid mandates dont have insurance companies anymore).

    At that point, rational discussions can begin on where to go from there. I would let that shake out for 5+ years because I think it fixes a large part of the problems. I know if the tax benefit went to individuals too, I would have a rockin HSA.

  • ||

    I'll gladly purchase a catastrophic insurance policy to cover the costs of that week's stay in the hospital.....

    Oh wait, The government has deemed a catastrophic insurance policy as insufficient coverage.

  • ||

    One point that gets overlooked in these free rider arguements is all the people getting lower premiums by people who will die quickly and without partaking of the health care system. All that money paid in and no benefit. No refund to survivoers.
    But...but...but...thats insurance!
    It sure is, and you get to choose if you think it is a good value proposition.
    Its like social security - how many groups in the US have substantially shorter lifespans, but will pay in their whole lifetimes and get less benefit?
    I am a person who uses a lot of medical care - I also have nicely paid for insurance. I thank all of you who are poorer than me for assuring that I pay much less for health insurance. But I would never fool myself that being sickly is a reason I should get subsidized by the poorer. And that is what it is - the younger, poorer, darker paying for the older, wealther, and whiter.
    And seriously, the amount of money lost due to the indigent at hospital emergency rooms is a pittance.
    No, this is a big fraud to take from the poorer and give to the better off.

  • Zeb||

    You leave out one other choice regarding health care that people could reasonably make. One could choose to go without insurance and simply accept that if they get sick or injured, they will either pay out of pocket, or go without treatment. I don't see why people should not be able to chose to go without health care altogether. You can't be a free rider if you choose not to go on the ride.

  • ||

    THIS^^

    Man-up and die, people. Man-up and die.

  • ||

    I remember one of these free riders Tribe is talking about. She was a spoiled rich kid in Vermont who gave a false name at the ER when she broke her finger or her feelings or something like that. She wasn't taking Daddy's money at the time because he was a greedy capitalist 9who paid for her college), and she was working in a coffee shop while her art career floundered. So she ripped off the hospital and doctor who treated her rather than ask her wealthy family for "dirty money." She became a thief that day.

  • Old Mexican||

    Stephan Kinsella's take on Tripe's... Sorry, Tribe's Op-Ed:

    http://www.lewrockwell.com/blo.....more-77616

    "Individuals who don’t purchase insurance they can afford have made a choice to take a free ride on the health care system."

    "Those judges made the confused assertion that what is at stake here is a matter of personal liberty — the right not to purchase what one wishes not to purchase — rather than the reach of national legislative power in a world where no man is an island."

    How disgusting and fascist. Criticizing independence as being a "free rider." Using trite bromides like "no man is an island" as a pathetic pretense at a justification for totalitarian state control over individual lives.


    Boldface in the original blogpost.

  • ||

    Vinson's logic turns on the political value-judgment that, by enacting the statute, Congress created a "mess" that can only be "cleaned up" with a mandate, but that, in his view,the best way to deal with the "mess" is to throw it and the mandate out together.

    With all do respect (meaning none), it is for Congress to decide as a political matter whether a given regulatory regime on interstate commerce is a "mess" or is something better than a "mess" and thus, to be furthered by "necessary and proper" corollaries to the regime.

    The war on pot is arguably a "mess", but, under Raich, it is for congress to decide whether this "mess" is best solved by legalizing pot or by cracking down on domestic intrastate drug cultivation of pot.

    If Raich is going to be overturned and a pre-1937 "constitution-in-exile" version of the commerce clause is going to be resurrected in 2011-2012, fine. But let's not kid ourselves about what can and cannot fit the logic of current precedents.

  • Professional Critic||

    Inactivity (NOT buying insurance) is not the same as activity (growing marijuana, even if interstate).

    Try again.

  • ||

    There is no such precedent. No case law says that intrastate inactivity is to be analyzed differently than intrastate activity. The only current question is whether that intrastate activity or inactivity has the requisite effect on interstate commerce.

    If there is to be an activity/inactivity distinction, it will have to be manufactured anew, today, because there is nothing to support it anywhere in the past history of our commerce-clause law.

    Try again.

  • Professional Critic||

    So show me a single example where Commerce Clause jurisprudence has been applied to inaction. You can't. That's because no one in their right mind would have thought it possible to regulate nothingness through the CC before this monstrosity.

  • Old Mexican||

    Re: Danny,

    There is no such precedent. No case law says that intrastate inactivity is to be analyzed differently than intrastate activity.


    World - meet yet another, of many nitwits who believe that, somehow, case law defines reality.

  • ||

    Our legal history includes plenty of generic prohibitions on inactivity. Misprision of Felony, the hue and cry, mandatory fire-fighting assistance, involuntary jury and grand jury duty, militia service and equipping -- all these things entailed not being left alone and having to stir from "inactivity."

    If the commerce clause is somehow weaker or more limited than the rest of the law generally as to "inactivity", including congress's other enumerated powers (like raising up military forces), that is a new and novel concept, and it will have to be declared anew from out of the blue, because no precedent can be cited for it, and much can be cited against it.

  • Professional Critic||

    Utter nonsense. As I suspected you would, you reach to non-Commerce Clause issues to support Commerce Clause interpretations. That's not "precedent", that's analogy, and the CC is not analogous to common law rules that aren't even valid anymore such as Misprision of Felony.

  • ||

    Vinson's logic .... ?

    I believe it was the government that argued the mandate is necessary and proper because it addresses problems created by other sections of the law.

    He further said that because the government was arguing you need all the parts to make the law work, then losing the mandate meant the rest of the law couldn't stand.

  • Fluffy||

    Vinson's logic turns on the political value-judgment that, by enacting the statute, Congress created a "mess" that can only be "cleaned up" with a mandate, but that, in his view,the best way to deal with the "mess" is to throw it and the mandate out together.

    No, it doesn't.

    The logic "turns" on the observation that in the absence of a considerable federal scheme to regulate health insurance and the delivery of medical care, the failure to purchase health insurance would not have any interstate impact.

    The question arises: can the state argue for the "interstate impact" of a class of activity that did not have interstate impact, prior to a previous federal intervention?

  • creech||

    A state trooper friend once lamented that the smokies spend an inordinate amount of their patrol time tending to broken down motor vehicles. Clearly we need a law mandating people buy new cars every three years so that the taxpayers don't have to hire so many troopers to patrol the highways.
    {I guess a law mandating gun purchases would work the same way!}

  • ||

    I do not know much about US commerce law, so please forgive me if this sounds like a stupid question.

    Does the regulate states clause also include foreign countries ? Are people allowed to buy insurance lets say in India and go there for medical reasons, would that make them compliant with the new law, or are they only compliant if they use US hospitals.

  • ||

    The clause in question covers commerce with foreign nations, and among the several states, and with the Indian Tribes.

  • Restoras||

    Watch the video at the end of the post. It is most....illuminating.

  • ¢||

    Laurence Tribe explains

    Libel!

    We have no evidence or reason to believe that Laurence Tribe has ever written anything published under the name of the fictive composite author "Laurence Tribe."

  • ||

    I see almost no chance of the mandate surviving the Court (the appellate decisions seem to agree, for the most part, that the mandate itself is unconstitutional). What's at stake is whether the rest of the law will be allowed to stand or not.

  • Jersey Patriot||

    The Supreme Court may well decide that the activity/inactivity distinction is not crucial, but that is not by any means a foregone conclusion.

    There is no history of an activity/inactivity distinction in Commerce Clause cases. This distinction is similar to kinds invented in the 19th century that the Court did away with in the 20th. I would be surprised to see them revive that sort of thing in the 21st.

    By Tribe's logic (which is also the Obama administration's), all these and many more health-improving, cost-reducing actions could be mandated under the Commerce Clause.

    I think, under current Commerce Clause cases, all of those required purchases are constitutional. It shows just how out-of-hand the Substantial Effect and Aggregation doctrines are.

  • ||

    What this diatribe shows me, is that Harvard has very low standards when it comes to granting tenure to law professors. Tribe is either delusional, or flat-out lying.

    -jcr

  • wayne||

    Unfortunately, I have heard Tribe described as the greatest living constituional scholar.

  • fish||

    Yeah...you usually hear that from journalists.....nuff said!

  • B. Obama||

    Uh - what?

  • alan||

    If Tribe's purpose here was to prove that he is a jackass of the highest order, I must say he may be the finest rhetorician this nation has ever produced.

  • ||

    Althouse nails it. Tribe is desperate and he's using rhetorical tactics to try to sway a Justice or two. That the trick is so obvious proves just how far in a corner the lefties have gotten themselves.

  • GILMORE||

    Someone translate this for me please =

    Those judges made the confused assertion that what is at stake here is a matter of personal liberty — the right not to purchase what one wishes not to purchase — rather than the reach of national legislative power in a world where no man is an island.

    I dont really see how 'no man being an island' equates to 'necessarily limitless national legislative power'.

    Or is that what he's even saying?? Its poorly written. Minus points for cliche as well. He's saying it's *not really* an issue of liberty - but rather a question of where legislative power ends; ISNT THAT THE SAME FUCKING THING??

    This from a man who wrote a book called 'invisible constitution'... which is the one I presume only Harvard Law professors can see.

  • wayne||

    God, what a mess all these incremental decisions by SCOTUS have made of the constitution.

    Stick to a simple, literal reading of the constitution and we would not be at a point where a guy growing wheat in Ohio to feed to his cattle is considered a criminal, and where the precedent of the Ohio case is used to justify criminalizing a guy in Florida not buying something.

    The law of unintended consequences...

    RC's iron law: "me today, you tomorrow", in action...

  • Jersey Patriot||

    I'm not convinced the consequences were unintended.

  • wayne||

    point taken.

  • ||

    Lawrence Tribe: It is interstate commerce if I say it is interstate commerce.

    Enrico Pallazo: It is a strike if I say it is a strike.

  • ||

    Both are reading from the script.

  • MNG||

    Wacky Tribe, he dares suggest that the power to regulate (make rules concerning) commerce among the states (interstate commerce) allows for the mandate (a rule concerning) on health insurance (interestate commerce). What a frigging nut, he must be some kind of judicial activist with that reasoning!

  • fish||

    Haven't you been slapped around enough for using this weak assed argument. I knew you were a masochist....but this is pathological.

  • MNG||

    Er, is the mandate not an attempt "to regulate...commerce among the several states?" It's a proscriptive rule (that's the "regulate part") applied to the interstate health insurance market (that's the among the several states part).

  • Barely Suppressed Rage||

    Except that it is not a rule regulating the health care market. It is a rule requiring people who are most decidedly NOT engaging in the "interstate health care market" to spend their money and purchase insurance, or else be fined by the federal government.

    You're like a broken fucking record on this, for god's sake. We've had this discussion over and over. You've made your argument, which is wrong, and I and others have expressed our disagreement with it.

  • MNG||

    "Except that it is not a rule regulating the health care market."

    Of course it is. It is a prescription to go and buy products from the existing health care market. You admit as much "to spend their money and purchase insurance"

    "You've made your argument, which is wrong, and I and others have expressed our disagreement with it."

    You realize I can say the exact same thing to you, right?

  • Vermont Gun Owner||

    You realize I can say the exact same thing to you, right?

    But not accurately.

    Also, how do square the fact that the Constitution is very clear about using the terms 'state' and 'people' separately, yet you claim the commerce clause allows for regulation of the people?

  • MNG||

    Because it would be absurd to think it meant to regulate "commerce among the state" goverments? Instead they were using "states" as geographical things.

  • Cyto||

    We've plowed this ground before, but:

    1. There is no interstate commerce in health insurance. There is in fact a federal law creating this reality - the McCarran–Ferguson Act - which via a cascade of effects creates a reality where interstate commerce in insurance is not allowed and cannot occur.

    2. Not buying insurance is not commerce. that's pretty straightforward. Buying insurance = commerce in insurance. Not buying insurance = not commerce in insurance. I myself am currently not engaging in commerce in fried dough. And not engaging in commerce in fine wine. It is really amazing how many things you can *not* do - all at the same time.

  • Vermont Gun Owner||

    So you're saying that they are using different meanings in this one instance than every other time they use the words in the document?

  • GILMORE||

    Not to interrupt ... but you seem unaware that insurance is in fact not sold 'across states'; each state regulates insurance independently and companies offering policies much register said products individually in each state and comply with each individual state's regulations re: insurance. Anyone marketing said products has to be certified in *each* state (even though many of the same rules apply)

    In short - according to current law, there is no 'interstate' commerce when it comes to insurance. Its entirely intrastate.

    In fact, one argument has been made to deregulate insurance markets allowing them to start to offer cross-state pricing, increasing the size of their insured pools, reducing adverse selection, creating management efficiencies, etc.

    Just to be clear = all im' saying here is your declaring something the "the interstate health insurance market" is a misnomer.

  • MNG||

    You're incorrect. There are many companies like Aetna which offer plans in all 50 states. Aetna has a CEO, you can buy stock in it, it's products must meet state regulations but they are all very similar. Go check out their webpage, they brag about being a national company that operates in every state.

  • ||

    No, he's quite correct, MNG. What you will find is that big insurance companies have separate subsidiaries in each state, and that the policies sold in a given state are sold only in that state. There are minor, but real, differences in the policies sold in the varying states. And, it is a violation of, for example, Texas law to sell an Oklahoma policy in Texas.

  • MNG||

    I think the confusion is yours, though it seems to be a quite common one. Aetna sells policies in all states, but the policy they sell in each state must meet the requirements set by each state. So when you buy a policy from Aetna in Maine you are buying a different contract than one bought in Vermont, and Aetna must sell them through the reps in that state, but it is a contract with Aetna.

  • Fluffy||

    It's a logical absurdity to claim that you're a part of the market for a product when you don't buy it.

    Sorry, that's the bottom line.

    The absurdity is doubled when you try to assert that not buying a thing makes you a part of the interstate market.

    If I live in Vermont and don't buy a car, I am not part of the Vermont car market. And I'm definitely not part of the California car market. And I would have to be in order to be participating in interstate commerce.

    The "substantial effect" doctrine is a logical absurdity and an act of tyranny.

  • MNG||

    People buying or not buying things sold in an interstate market is a regular concern of people that everyday work in interstate commerce.

    But regardless, interstate commerce in health insurance already exists. This act attempts "to regulate" that existing commerce by mandating everyone buy into it.

    I don't see what the problem is.

    I find the act to be stupid and immoral (forcing people to buy into private insurance companies), but it seems to fall under the ICC rather nicely.

  • ||

    This act attempts "to regulate" that existing commerce by mandating everyone buy into it.

    I don't see what the problem is.

    Tragically, this is all too likely true.

  • GILMORE||

    You agree then disagree; Aetna may do the final underwriting but the product only exists within that state and is only regulated by that state's laws.

    You make the distiction without a difference = yes, Aetna operates in all 50 states; however, you agree each state regulates their insurance industry independently such that *each product is subject to the restrictions and oversight of that state only*.

    Tell me how this makes it a 'national' market.

  • MNG||

    See, you've given up the game. Aetna sells products tailored to each state's regs, but it is Aetna operating in each and every state. It is engaged in interstate commerce. The policies don't cross state lines but the profits and such do.

  • ||

    but it is a contract with Aetna.

    Most big insurers have different subsidiaries in each state, so this isn't necessarily true.

    But, if I can only buy the policy that I have in my state, how is that policy in interstate commerce, exactly? Even if I buy it from a company that does business in multiple states? Where's the interstate commerce in a product that, by law, can only be sold in one state?

  • Cyto||

    No, Aetna does not sell any policies in any state. There are wholly owned subsidiaries that do business under the name "Aetna" that do sell insurance, but only within a single state. Here's the web page that lists these companies. They explain right on the page that: "Aetna" is the brand name for products and services provided by one or more of the Aetna group of subsidiary companies. Please make a selection to view Aetna's name related to a state.

    But then you knew that since we've covered it before. Using the technique of repeating something loudly and often is weak. You've been confronted with a truth that conflicts with your argument... Process that information and come back with something better. It is more interesting than repeating something that is plainly at odds with the truth.

  • ||

    ---"It's a proscriptive rule (that's the "regulate part") applied to the interstate health insurance market"---

    It is still prohibited by law, to buy health insurance acrossed state lines!!!! Ergo, there is no interstate health insurance market. Ergo, nothing to regulate.

  • ||

    Beat me to it GILMORE. I need to refresh before commenting.

    MNG, you are wrong regarding health insurance.

  • MNG||

    What you cannot do is as a citizen of state A buy an Aetna policy sold in state B, but people in both states can and do buy policies from Aetna. As Aetna itself says it "Were the first national, full-service health insurer to offer a consumer-directed health plan."

    http://www.aetna.com/about-aet.....index.html

  • ||

    MNG, from your above link.

    ---"Aetna is the brand name for our products and services. In each state, our products and services are provided by one or more of our subsidiary companies. Our subsidiary companies go by many different names."---

    See, not the same company. You are buying insurance from a company "within" your state.

  • MNG||

    That's right, subsidiary's of one company operating "among the several states."

  • Gaylord||

    I work for a utility that has jurisdictions in several states. But that's no reason to force everyone in America to buy our product.

  • MJ||

    The subsidiary's are considered separate units, thus they operating in one state only.

    Do you really believe that anyone who is aware how corporate governance works would buy this load of manure you are selling?

  • MJ||

    ""Aetna" is the brand name for products and services provided by one or more of the Aetna group of subsidiary companies. Please make a selection to view Aetna's name related to a state."

    "Aetna" is the brand name of a group of companies, it is not a single corporate entity. There is not a single company called "Aetna" that selling health insurance policies nationwide.

  • MJ||

    I did not Cincator post above.

  • Destrudo||

    MNG, your existence has an effect on the health care market. Is it justified for congress to mandate you kill yourself? As an added bonus, this would also result in net positive utility for the human race and is therefore considered a good thing under your ethical sytem. So please, put the nearest 12-gauge in your mouth.

  • MNG||

    Dude, they don't even have to argue it has "effects" on interstate commerce as it is directly involved.

  • Really?||

    is the mandate not an attempt "to regulate...commerce among the several states?"

    No - the mandate is an attempt to, well, mandate participation in commerce.

    We all know that the power to regulate means the power to ban; I did not know the power to regulate meant the power to force participation!

  • MNG||

    You've never heard of a regulation that mandates that people do something as opposed to not do something? WTF?

  • Gaylord||

    Example please?

  • ||

    ---"You've never heard of a regulation that mandates that people do something as opposed to not do something?"---

    No. Never have.

  • Shorter MNG||

    There are no limits to federal power so go F yourself.

  • Dick Fitzwell||

    No. He's saying that the power to regulate commerce among the states allows for the government to force its citizens to purchase a policy from an insurance company that operates within the same state in which those citizens reside.

    You were correct, however, about him being a friggin nut and a judicial activist.

  • Jennifer||

    I went without health insurance for roughly six years in my 20s; not until about a year after I completed grad school did I finally land a proper professional job with health insurance and other benefits. During that uninsured time, I did suffer one significant health mishap -- a kidney stone -- requiring an emergency room visit. Total cost: about $950, plus another $50 or so to buy various prescribed medications. So, my total healthcare costs over six years were roughly $1,000.

    If, by contrast, I'd been required to buy health insurance all that time, even assuming a relatively cheap policy of "only" $500 a month, I'd've had to spend about $36,000 in premiums during that time. And of course, such a cheap policy would've had a very high deductible, which means it might not have covered any of my kidney-stone costs anyway.
    Bad enough that anyone would seriously propose forcing my twentysomething self to go $36,000 deeper into debt; worse yet that any asshole would have the gall to tell me this mandatory debt is for my own good.

  • fish||

    Congratulations Jennifer you cracked the code....your non-consumption of medical care is to be used to subsidize the other serfs.

    Its just what government does.

  • ||

    The whole point of keeping 20 somethings on their parent's policy is to make it more likely to score that $36,000 to transfer to granny.

  • ||

    Exactly, forced consumption of health insurance is a way of forcing healthy low-risk individuals to subsidize sickers, riskier people.

    It is NOT a means of getting people to pay for their own medical expenses.

  • Neu Mejican||

    Except that, for the most part, people survive long enough to eventually most from the low risk to the high risk category. Their paying into the same system that will support them when they are high risk.

  • Neu Mejican||

    that is intended to read "move from" not "most from"

  • Neu Mejican||

    And
    "their" should be "they're"

    Sheesh.

  • ||

    Sheesh is right. It would be wiser for an insurance consumer to purchase insurance when they were far more likely to use it. It's not an account that must be built up. It is simply a promise to pay for covered services. Trust me, the insurance companies, if allowed by the government to do so, will price their policies accurately to cover claims and make a small profit. Oh wait, they'd have to be allowed to price based on risk. The senior lobby ain't about to let that happen.

  • ||

    Say somebody doesn't buy health insurance, and doesn't use any health services.

    How are they a free rider?

    Somebody else doesn't buy health insurance, gets sick, and pays for their care out of pocket.

    How are they a free rider?

    Say somebody else buys health insurance, pays the premiums, and gets sick, and the insurance company winds up paying more than the premiums it received.

    Of the three, I would say the one who most looks like a free rider is the person who draws more from the insurance company than they paid in.

  • Neu Mejican||

    You don't seem to know what the term means.

  • Neu Mejican||

    Of course, all three are free from the accusation of being free riders...in your hypothetical.

  • ||

    Yet the proponents of mandatory health insurance characterize those who don't buy insurance as free riders, regardless of whether they use insurance at all, or pay out of pocket for what they use.

  • Neu Mejican||

    Some proponents have made this error, I am sure. Doesn't get rid of the actual free rider problem that the bill hopes to tackle.

  • Jennifer||

    Except that, for the most part, people survive long enough to eventually most from the low risk to the high risk category. Their paying into the same system that will support them when they are high risk.

    Paying into "the same system?" No, not at all. If I'd had mandatory health insurance in my 20s, it would have been through one of the relatively few companies allowed to sell health insurance to Connecticut residents. Then, when I worked in Massachusetts, I had insurance coverage with a completely different company that only operated in Massachusetts (which sucked for me because I still lived in Connecticut at the time).

    However, at some point in the near future -- as soon as the right opportunity presents itself, in fact -- I intend to GTFO of Connecticut and the entire Northeast, because I plain can't afford the taxes. So, when I eventually get old enough to start needing regular medical attention and services: I don't know exactly which state's health insurance industry will wind up paying for me, but I'm 99 percent certain it will not be any of the Connecticut- or Massachusetts-based health insurance companies that profited from my premiums when I was young and healthy.

  • fish||

    Yeah, I'm sure it will be as sound as all those other government promises!

  • ||

    Life insurance premiums don't get higher as you age, as long as you maintain the same policy. The reason is that the life insurance deal is to get in early at a low rate, so that you won't have to pay a hgiher one later.

    If you refrain from buying health insurance until your old, you SHOULD pay higher rates.

    I see not reason why the health insurance couldn't work more like life insurance though. Buy a policy when you are young, and if you maintain it your whole life, your rates won't go up as you age.

  • ||

    I agree completely.
    Why is it that supposedly progressive people think taking money from the young and poor is .... uh, progressive?

    Emergency room care for the indigent is a pittance and a rounding error in the sum total spent on health care.

    As far as arguments that care by a private physician would be cheaper, the data is very mixed. After all, many people argue that a lot of care is a waste - well, you can't be logically consistent and say that most care (which is provided by private physicians who get paid by piecework) is ineffective and overpriced, and somehow when you give people more access they will use less of it.

    Right now without mandatory care there is rough justice - the poor get some free care, the young and healthy with lower incomes don't have to pay but are protected, and the older, like me, who use it have to pay because healthy young non-users are not in the pool.
    Why is making people who cannot afford health insurance buy health insurance liberal?

  • Barely Suppressed Rage||

    My mother's husband of about 20 years died several months ago from liver cancer. She received a bill for his hospice care from the hospital (a Catholic institution) for nearly $5,000 - which was solely for room and board for THREE DAYS. Seriously - they charged something like $1,600 or more PER DAY for the room and hospital food - which he didn't even eat anyway, because he was in the end stages of terminal liver cancer.

    He left her with not a whole lot in the way of savings, so there really was no way she could pay the bill.

    After freaking out about it for a while, she finally called the hospital and explained that she was a senior citizen, on Social Security, which was not enough to even pay her (small) mortgage, she was still dealing with other bills and trying to figure out what she was going to do for income, and she could not see any way that she would be able to pay their bill, but could they work out a payment plan? She figured maybe they would at least work with her and let her pay it off over time.

    The accounting lady told her she would look into it and get back to her.

    Long story short, the hospital waived the bill entirely. They are a non-profit, religious, charitable institution, and decided that in this case, they would not pursue the charge. It's part of their charter to provide care free of charge when the patient cannot afford to pay for it.

    I don't know to what extent any government rule or agency was involved.

    P.S. - the irony is that he was Jewish. My mom asked them to take down the crucifix in his room, which they did.

  • ||

    Indeed, last fall, I had an emergency appendectomy. I have a cheap high-deductible plan. But my insurer ... in it's own interest, negotiated about $30,000 of bills down to $6,000. They saved themselves and myself a bundle of money in the process.

  • ||

    SOMALIA!!!11!! just happened right there. Tragic.

  • ||

    Another point I keep making is that you can';tb reconcile the claim that not buying health insurasnce is a choice about how to pay for future medical expenses with the claim that the mandate is necesarry to enforce the insurance regulations requiring insurance to cover everyone and charge the same without respect to future claims.

    The latter requirements essentially guarentee that for many individuals, buying insurance will be a means of subsidizing OTHER people's healthcare. Healthy, low-risk individuals will be forced to pay higher premiums.

    Also, the government explicitly argues, repeatedly, that the mandate is "necessary" to enforcing the requirement that insurers cover pre-existing conditions. They don't argue that the mandate is needed to make people pay for their OWN medical care. They make they explicit argument that's it's needed to prevent the adverse consequences of covering people who are already sick.

    They are trying to have it both ways on this issue. If the mandate is needed to force insurers to cover the sick, at the same rates as everyone else, then you can't claim that buying health insurance in such a system is merely a choice about how to pay for one's own healthcare expenses. It is a choice not to subsidize healthcare expenses for sicker, higher risk people.

  • ||

    If the fed were to apply the "commerce clause" they should intervene by allowing insurance providers to cross state lines, after all, that's what the commerce clause is for

  • Johnny Longtorso||

    If the fed were to apply the "commerce clause" they should intervene by allowing insurance providers to cross state lines, after all, that's what the commerce clause is for

    I'm wondering if the liberals who believe ObamaCare is constitutional want those state regulations struck down even if the mandate and ObamaCare go down also.

    No, actually, I'm not wondering.

  • ||

    As I grad student, I was only paying about $1200 per year in premiums for the student health plan.

    Nevertheless, it would still have been cheaper to go without insurance.

  • ||

    The activity/inactivity distinction is easy to justify.

    Ask yourself this:
    If you could push a button to save someone from a speeding trolly, would NOT pushing the button be morally equivalent to PUSHING a button that diverts the trolley into their path.

    In other words, unless you think that NOT pushing the button is equivalent to murder, then you agree that activity and inactivty are not morally equivalent.

  • MNG||

    Here's one for you. You sit by the trolley switch, a trolley is coming along and a person is in its path sure to be harmed. You yawn and say "well, I didn't put the trolley or the man there, so I'm going to pick my nose rather than push the button." I can't reach the button in time but I can threaten to punch you in the nose if you don't push it. Is my threat immoral?

  • ||

    If not pushing the button is morally equivalent to murder, then you should be doing a lot more than threatening to punch me in the nose.

    Why aren't you putting a gun to my head, MNG?

  • MNG||

    Why does it have to be murder? Would it be right to threaten?

  • Gilbert Martin||

    No.

    And that's that.

  • MNG||

    Now imagine what libertarianism gives you: it would be wrong of me to save this fellows life by threatening you into...pushing a button!

    What an ihuman and monsterous philosophy!

  • Fluffy||

    No matter how many times you try to assert the contrary, this argument can't survive a reductio response.

    It's utterly irrelevant to the terms of the argument if someone is close to the button.

    Therefore, if it's morally correct to assault someone if they don't push a button that's right next to them, it's also morally correct to assault someone if they don't spend their entire life seeking out buttons that might need pushing - or seeking out any and all of the other 5 billion acts you could be undertaking today to benefit someone else or save someone else's life.

    In order for your argument to be correct, it would have to be immoral for me to refrain from coming to your house right now to slit your throat and take your kidneys to give to other people [since that can save two lives, as opposed to your single life] and to take all your property to give to starving people in Africa [since that could potentially save hundreds of lives to your one].

  • MNG||

    So I take it you say it is morally wrong to threaten the guy into pushing the button to save a life? No wonder you're interested in reductio ad absurdem, you're starting from one.

  • Fluffy||

    There is a button in front of you RIGHT NOW that you could push that would save scores of lives:

    http://www.africanrelief.org/DONATE/Ways-to-Give/

    Why aren't you pushing it?

    Can I come to your house and kill you if you don't start pushing this button right now and keep pushing it until you have no money left? If not, why not?

  • MNG||

    See, if I could push the button myself then to threaten the guy to do so would not be the way to maximize human well being (same good result but with the threat subtracted). And see, you are as close to that button right now as I am...

  • Fluffy||

    So I take it you say it is morally wrong to threaten the guy into pushing the button to save a life?

    To be quite clear about it, I'm saying this:

    It can only be moral to threaten the guy if it is moral to actually follow through on the threat.

    And it can only be moral to follow through on the threat in that situation if it is also moral to do so in all similar situations.

    This means that it can only be moral to threaten the guy standing next to the button if it's ALSO moral for me to torture you until you reveal the location of all your valuables so that I can sell them and give the proceeds to the starving.

    You think it's important that the action under discussion is trivial - merely pushing a button - but that's really not important at all. If I possess the moral authority to compel trivialities to save life, I also possess the moral authority to compel extraordinary efforts to save life, as long as those extraordinary efforts stop short of causing death, or at least cause fewer deaths than they present. Once you set up the utilitarian coercion conveyor belt you don't get to turn it off just because it hurts a little.

  • MNG||

    Of course fluffy since you are aware of the logic of consequentialism you should also know that if there were any alternative to slitting someone's throat to save two lives that would still get the effect without the loss in utility you would be bound to do that instead. But you knew that.

  • Fluffy||

    Of course fluffy since you are aware of the logic of consequentialism you should also know that if there were any alternative to slitting someone's throat to save two lives that would still get the effect without the loss in utility you would be bound to do that instead.

    Um...says who?

    Maybe I don't think of those other alternatives.

    The math is still two lives to one.

    It's an artful dodge you're trying, but it doesn't work. Because if we actually put your moral premise into action consistently, eventually we would cover all the low-cost ways to save the two lives - and at that point there would be no theoretical brake remaining to stop us from employing the high-cost ones.

    It's not really an effective defense of utilitarianism to claim that we'd never reach the point of using your kidneys to save two people, because there are so many low-cost ways available we can use first - because the only reason those low-cost ways are lying fallow right now is because we haven't been employing your moral theory so far. What happens when we do?

  • Gaylord||

    Hey MNG, what if the guy in the trolly's path is someone on the FBI's most wanted list for murdering and eating children? It is possible. So are you expecting me to act to save this guy's life?

  • ||

    If you're close enough to force Hazel to push the button, why not push the goddamn thing yourself?

  • ||

    Furthermore, people coming to different conclusions than you do is neither inhuman and monsterous.

    I honestly don't know what the fuck it is the makes you think you have a right to impose your values on others.

  • MNG||

    People come to different conclusions about whether it is inhuman to find threatening to punch a guy worse than allowing a man to die? Only in insane asylums dude.

  • MNG||

    And get off your high horse about imposing my values. You wouldn't impose your values on property rights if you had the choice? We just have different values we would impose, you're no saint.

  • ||

    Whoooooosssshhhhhh!!!!

    You really just don't fucking get it, do you?

    Like talking to a three year old.

  • Fluffy||

    http://www.africanrelief.org/DONATE/Ways-to-Give/

    Are you pressing the button yet?

    I can find more buttons if you want.

  • ||

    Fluffy, it's clear that MNG isn't really interested at all in saving the life of the poor schmuck in the path of the trolley. He just likes pushing people around.

    Otherwise, he'd push the goddamned button himself.

  • ||

    Actually, I would never consider threatening someone with bodily harm because they refused to act to protect some other person's (or my own) property rights.

  • The Ingenious Hidalgo||

    No, libertarians only want to impose their values on their property. You're free to impose your values on your own.

  • fish||

    ihuman....Apple product?

  • Boxbot||

    Would you be facing possible assault charges for threatening to punch Hazel, or would you be off the hook since the judge thought it all balanced out? In the non-hypothetical world, where there is seldom a known and quantifiable cost for each alternative, this is especially important. You could be setting up a system where people regularly threaten to use force in order to minimize harm, since the cost of being wrong would already be paid for, so to speak.

  • ||

    If you'r admitting that NOT pushing the button ISN'T MURDER, then you are admitting to a moral distinction between action and inaction.

    Period. End of discussion.

    You can argue yourself blue in the face that not pushing the button should be punishable in some way, or that it should be permissible to threaten someone into doing it.

    However, unless you want to punish them as if it were a capital crime, then you are admitting that IT'S NOT THE SAME as pushing a button that diverts the trolley into their path, and therefore that there is a MORAL DIFFERENCE between action and inaction.

  • Gilbert Martin||

    Actually your threat is meaningless because you aren't tough enough to punch anybody in the nose.

  • MNG||

    Sheesh, just imagine someone whom you'd fear to be punched by, like Taylor Swift in your case.

  • ||

    If you're in a union you're not pushing that button because it's not your job (off the clock or maybe you don't even work there but you don't want to take food out of someone else's mouth by doing their job for them potentially costing them their job). Man dies. You're an evil bastard but since you've got seniority you'll be getting that promotion regardless. Fuck that guy anyway. He was probably a scab or Republican.

  • Gaylord||

    "Is my threat immoral?"

    Yes. See, I can't push the button because I am not in the Button Pusher's Union (IBBP). I have no desire to become the target of a grievance.

  • MNG||

    Both result in the death of the person, right?

  • ||

    Here's one for you. A trolley is going to plow into 30 million uninsured pieces of shit that I don't give a flying fuck about.

  • Gaylord||

    That's impressive. Thanks!

  • ||

    If you push the button you become morally responsible for any deaths that might occur on the track you diverted it to.

    Not taking an action acknowledges that you are unaware of the past events that led to the person and the trolley being there, not involved in the existing set of decisions and responsibilities that led to it, and choosing not to becomg involved in the possible future events that might arise from taking an action.

    Taking an action causes you to assume moral responsibility for future events in a way that not taking that action doesn't.

  • MNG||

    I'm not sure the issue rests on a distinction between activity and inactivity. Can't that distinction be conceded and yet one argue that the power "to regulate" covers prescriptions and proscriptions?

  • ||

    All actions that are morally permissible are not obligatory.

    In the standard trolley case ... four people on one track, and one on the other, it is usually considered *permissible* to push the button to save the four and kill the one.

    However, NOBODY considers it morally OBLIGATORY to do so.

    By contrast, if the button involves diverting the trolley to kill four instead of one, then most people would consider it IMPERMISSIBLE to push the button.

    I.e. Inaction is often mandatory, but action rarely is. It's never obligatory to save another's life, but it IS obligatory to refrain to from taking one. And hardly ANYONE prescribes punishements for refraining from saving a life.

  • Johnny Longtorso||

    What if I abort the baby who would have grown up to push the button?

  • MNG||

    See, I think I can say that not pushing the button is not as morally bad as pushing it in the first place, and yet still only an inhuman monster would say I am wrong to "coerce" someone into pushing that button to save a human life.

    And on the other issue I think I can concede a difference between inactivity and activity and still argue that the power "to regulate" includes prescriptions and proscriptions. Many regulations order you to do things, many order you not to do things.

  • ||

    Many regulations only order you to do things IF you are doing something else.

    I can hardly name a regulation that simply orders you to do something, void of context in other actions you have performed or intend to perform.

    The only ones, such as military conscription, and morally problematic to say the least.

  • ||

    I'm afraid I will never take any politician's claim to want to reform medical insurance (a different issue from healthcare) seriously if it does not include policy changes designed to separate health coverage from employment.

    Making personally paid premiums tax deductible (or conversely taxing employer paid ones) would be a start.

    My personal preference is to have fewer deductions and lower tax rates but that's for a different discussion.

  • Johnny Longtorso||

    Hypothetical button pushing is best handled by jury nullification ("ok, it was illegal but was also a once in a lifetime rarity") instead of "I can come up w/ a hypothetical where you wouldn't be enraged if I did what I want, therefore I can do anything I want in any circumstances".

  • MNG||

    That doesn't help a whit because we are arguing the standard which would or should guide such nullification.

  • Johnny Longtorso||

    No, nullification is up to the jury to decide for themselves, not to be encoded into law, which ObamaCare is. Granted, it would mean the Unwashed Cattle making meaningful decisions instead of some faceless bureaucrat deciding for them, but that's life.

  • Gaylord||

    @MNG

    What is it with you progressives and trains?

  • Gaylord||

    BTW, the WSJ posits that the reason Tribe wrote tis piece (and the NYT published it) was to premptively influence the SCOTUS.

  • Old Mexican||

    Re: MNG,

    Here's one for you. You sit by the trolley switch, a trolley is coming along and a person is in its path sure to be harmed. You yawn and say "well, I didn't put the trolley or the man there, so I'm going to pick my nose rather than push the button." I can't reach the button in time but I can threaten to punch you in the nose if you don't push it. Is my threat immoral?


    What is the person (the "you" in your story) doing alongside the switch? Whose job is it to operate it, yours or his? If his, then he was in dereliction of his duty, showing total disregard for human safety and the good operation of the system - clearly, violating his terms of his contract. That makes your threat a DEFENSE on behalf of property and limb and, thus, moral.

    However, if it is YOUR job, then you are DOUBLY in dereliction of your duty, first for not being at your post, and second for allowing some asshole to stand in your place. All other things being equal, your threat of violence IS immoral as the person standing besides the switch is not responsible for the operation of the trolley nor for looking out for people in the vehicle or tracks - YOU are.

  • ||

    See, the way I put it is that you have to acknowledge that there is both a past an a future to events. The trolley has track behind it, and multiple paths in front of it.

    I'm not really trying to step outside the context of the hypothetical here. I'm pointing out that every set of circumstances exists in a context of prior actions that assigns responsibility to past and present actors. Such as: who owns the train system. Who is running the tracks.

    Once a person enters the stream of events by taking a positive action, they assume responsibility for what happens in the future.

    In my opinion, Not taking an action is often considered permissible because it's a way of acknowledging that the individual at the button cannot have perfect information about the existing set of responsibilities of prior actors, and the possible future consequences of his action.

    What if the person you save from the train is a future Hitler or Stalin?
    What if the reason that the train was headed that direction was to prevent a collision with a larger passenget train? What if a responsible person at the train company purposely diverted it in the past to save a dozen lives?

    You CAN'T know these things. In real life, it is impossible to know all the past and future events that have occured or may occur wit regard to that train. Therefore you cannot know that taking that action won't cause a greater harm at some future point, and therefore it is permissible not to take it.

    So, put in the context of your statement, being a conductor who is responsible for switching the tracks, means that you have already taken some past action to assume responsibility for the train's direction. It also means you probably have greater knowledge of the consequences of doing it.

    A casual bystander on the other hand, which most of us are in the broader spectrum of life, has no moral responsibility to act.

  • Old Mexican||

    Re: Neu Mejican,

    The likelihood that any individual will have an expensive health care intervention in their lifetime is very high.


    Like, how high, Neu? Let's see what else you can pull out of your ass.

  • Neu Mejican||

    See above. The typical male has 8 years in their life where they have high medical costs. Females, slightly more.

  • Old Mexican||

    Re: Neu Mejican,

    See above. The typical male has 8 years in their life where they have high medical costs. Females, slightly more.


    You know, Neu, I haven't the time or the will to sift through now 240+ posts to find the one where YOU "prove" the likeliness of an occurrence is high. Provide a linky-link or fuck off.

    Saying that "a typical male has 8 years of his life"... something-something is not unlike those statistics showing that I will be more likely to die tomorrow of emphisema if I keep inhaling second hand smoke. Maybe, maybe not, depends, however, there's more to it, yadda yadda yadda.

    AGAIN, unless you happen to be Cassandra, you cannot say a person is in DENIAL just because he or she is as healthy as a horse and puts off buying insurance for a couple more years. Your demeanor is more a reflection of your attraction towards authoritarianism than any real concern for people's lives.

  • Neu Mejican||

    You know, Neu, I haven't the time or the will to sift through now 240+ posts to find the one where YOU "prove" the likeliness of an occurrence is high. Provide a linky-link or fuck off.

    I ain't your google flunky. This shit is easy to find these days.

    AGAIN, unless you happen to be Cassandra, you cannot say a person is in DENIAL just because he or she is as healthy as a horse and puts off buying insurance for a couple more years. Your demeanor is more a reflection of your attraction towards authoritarianism than any real concern for people's lives.

    Again with the idiot thing. In two ways this time. 1) not recognizing the denial thing. Just because I am healthy, does not mean I will not have a significant health care cost in the near future...to assume so means you are in denial. Simple fact. Almost a tautology 2) You, again, make assertions about my opinions on a topic without any basis. You are arguing with some authoritarian bogey man in your head. As I have already stated a few times on this thread...I am in the "undecided" column on the mandate. I do think the overall approach taken with the health care bill, however, was basically misguided.

  • Dick Fitzwell||

    1) not recognizing the denial thing.

    Assume much? I have been paying for insurance through my employer for the last 10 years. I have not been to a doctor for any reason for almost 17 years. Just because I have lived a relatively healthy life up to now does not mean that I am due for some bad shit to happen to me in the future. To believe so is asinine. Yet you think we're foolish for not agreeing with the assumption that you have taken on. This is like debating with my brother's kids.

  • Neu Mejican||

    Just because I have lived a relatively healthy life up to now does not mean that I am due for some bad shit to happen to me in the future.

    But you are due for some bad shit in the future. It happens to everyone to some degree at some point. Just because you have been healthy doesn't mean you will always remain that way for the rest of your life. To believe that bad shit can only happen to others requires a child like naiveté...

    Now, the truth is that for the vast majority of people these bad things happen during the last few years of their life, but that is just a group level finding. There is no way to predict whether or not those bad things will happen to you earlier. Yet you act like I am making this basic fact of life up whole cloth.

  • Neu Mejican||

    Yet you think we're foolish for not agreeing with the assumption that you have taken on.

    The assumption is the basis for the entire insurance industry. On a group level, they are betting that more people will remain healthy (as you have recently), while still paying for insurance against the unexpected high-cost year, than will have a high-cost year. And for the most part they are profitable with that assumption, because most health care costs in a year are incurred by a small percentage of people. An individual who recognizes that there chances IN ANY YEAR are low for having to cover those costs is making a good short term bet to not buy insurance. But insurance is a long-term game. Eventually those making short term bets will lose and will have a high-cost year that is likely to take them beyond their financial means. Insurance companies recognize that most people recognize this danger, and offer a hedge against this risk. Those that recognize the risk, but game the system by waiting, because they know that they'll get taken care of anyway, are the problem being addressed. Those that think they don't need insurance because, so far, they have been healthy are in denial as to their future risk.

    Do you seriously believe that because you've been healthy for the last 17 years this somehow makes you immune to future health problems?

  • ||

    So, if you know for 100% sure that your medical costs are going to increase, then you should be saving up for it. Not buying insurance.

  • waffles||

    PUSH THE FUCKING BUTTON ALREADY I'M GOING TO DIE!

  • Obama's Juggalo||

    Magic is everywhere in this bitch.

  • Nancy Pelosi||

    Allowing the mandate to stand would allow the government to do virtually anything under the Commerce Clause.

    Bonus!

  • Julie Kinnear||

    The judge who said that the health care bill is unconstitutional should be aware of the fact that its repeal can have detrimental consequences for people diagnosed with serious medical conditions.

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  • Progressive Puritans: From e-cigs to sex classifieds, the once transgressive left wants to criminalize fun.
  • Port Authoritarians: Chris Christie’s Bridgegate scandal
  • The Menace of Secret Government: Obama’s proposed intelligence reforms don’t safeguard civil liberties

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