ObamaCare's Defenders Still Aren't Taking Challenges to the Mandate Seriously

When the Patient Protection and Affordable Care Act—a.k.a. ObamaCare—passed two years ago, the law’s defenders dismissed constitutional challenges to its provisions as rubbish. Asked where, specifically, the Constitution granted Congress the ability to enact an individual health mandate, Nancy Pelosi, then the House Majority leader, responded dismissively: “Are you serious?”

But others, including several federal judges, did not dismiss the essential question so quickly. Now, a constitutional challenge to the law has gone all the way to the Supreme Court, which has set aside six hours of its time to hear oral arguments in the case, more than any case decades. And while many and perhaps even most legal experts and Court watchers still believe that the most likely outcome is for the court to uphold the law, there now exists real uncertainty as to how the Supreme Court will rule. The law’s critics, it turns out, were quite serious, even if few took them seriously.

Yet the law’s defenders continue to insist that challengers have no real case. In The New York Times, for example, former legal correspondent Linda Greenhouse explicitly invokes Pelosi’s dismissal, and in the years since the law’s passage, arguments against it have been “gussied up.” The challenge, she writes , is “analytically so weak that it dissolves on close inspection. There’s just no there there.”  So what is there?  She writes, “I want to unpack the challengers’ Commerce Clause argument for what it is: just words.” As opposed to all those constitutional challenges that consist of crayon drawings?

Greenhouse notes that the challengers have repeatedly described the mandate to purchase health insurance as “unprecedented,” does not dispute the description, and asks why it matters that the provision is unprecedented.

So there must be some problem with the Affordable Care Act other than “never before.”

As I said, the rhetoric is powerful: “The Constitution protects and promotes individual liberty, while the mandate’s threat to liberty is obvious.” How so? “It is a revolution in the relationship between the central government and the governed.” In what respect? Beyond regulating commerce, a power explicitly granted to Congress by Article I of the Constitution, the Affordable Care Act gives Congress “the power to compel individuals to enter into commerce” – a “fundamental” distinction with “breathtaking” implications.

This is the argument that persuaded the two members of the three-judge panel of the Atlanta-based United States Court of Appeals for the 11th Circuit who voted to invalidate the mandate. The government argues that, to the contrary, the “uncompensated consumption of health care” by those who are willfully or helplessly uninsured is itself an enormous economic activity. The uninsured don’t exist apart from commerce. To the contrary, their medical care results in some $43 billion of uncovered health care costs annually and, through cost-shifting, adds $1,000 a year to the average cost of a family insurance policy. People who don’t want to buy broccoli or a new car can eat brussels sprouts or take the bus, but those without health insurance are in commerce whether they like it or not.

On the contrary, under the administration’s logic about the interstate effects of the health insurance market, not purchasing broccoli would in fact affect the larger market for the vegetable. Just as most people will utilize some sort of medical care during their lifetimes, nearly everyone will move from place to place, and everyone will consume food of some kind. This necessitates decisions about what kind of food to eat, and how to get from one place to another. Choosing to walk, or use the bus, or buy a Toyota rather than, say, purchase a vehicle made by GM would certainly have some effect on the market for GM’s automobiles. Buying carrots or arugula rather than broccoli would similarly have an effect on the broccoli market.

It is hard, then, to see what limits, if any, would exist on congressional power under the Commerce Clause should the mandate be upheld. This is not an entirely unusual conclusion. Harvard law professor Charles Fried, who believes the mandate is constitutional, told Congress last year that the same constitutional provisions that permit the mandate would also permit Congress to compel the purchase of broccoli or any other vegetable.  “Force you to pay for something? I don’t see why not. It may not be a good idea, but I don’t see why it’s unconstitutional,” he said. To accept this interpretation is to accept that there are no limits on the power granted to Congress on the Commerce Clause. That presents a problem for the mandate’s defenders because the Constitution is a limiting document. The Obama administration, however, has consistently failed to explain what limits would exist under the Commerce Clause if the mandate were upheld. That failure is part of what ultimately led the 11th Circuit Court of Appeals to strike down the mandate. In its ruling, the Court noted that “the government’s struggle to articulate … limiting principles only reiterates the conclusion we reach today: There are none.”

Like many of the law's defenders, the administration's legal team sometimes seem exasperated with the task of defending the law at all. The administration has not entirely failed to answer questions about the limits of power under the Commerce Clause. It has merely failed to answer those questions satisfactorily, generally choosing to sidestep the issue by arguing that the health insurance market has unusual properties that invalidate any potential concerns about mandatory broccoli purchase requirements. One might describe the administration’s insufficient responses as “just words.” Indeed, it would be easy to conclude that “there’s just no there there.”

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  • WTF||

    Okay, which one is the real Joker?

  • WTF||

    Another alt text could have been "Hah haha - Fuck you, that's why."

  • Or ...||

    Pull our fingers!

  • Loki||

    "HAHAHAHA! Limited government, that's a good one!"

  • ||

    To WTF; Or...; and Loki....All of you are what makes this forum unbearable to read...Your juvenile comments and asinine quips, which I'm sure you believe to be quite clever....always fail to address real issues...if you even bothered to read the article or understand its' content...
    You're NOT merry pranksters, you're crashing boors !

  • hk||

    They're fucking hilarious.

    The administration has no case.

  • Almanian||

    "Otis!!! My man!!"

  • Suki||

  • Juice||

    Damn, Nancy Pelosi's Botox treatments make her smiles look especially evil and menacing.

  • ||

    I would love to see this thing go down 7-2 with multiple justices lighting up the US lawyers. (I know, less likely than winning the lottery, but I need some happy in my life here.)

  • ||

    I'd be happy with 5-4, since it accomplishes the same thing as 7-2, or even 9-0. Still, the piercing wail that would emanate from the White House would have an especially sweet ring to it if it was a 7-2 bitch-slapping. I'm not above revelling in gaudy emotional victories.

  • wareagle||

    yeah, but wouldn't something more than 5-4 be more satisfying? It would eliminate, or at least minimize, the whining about politicization.

  • ||

    yeah, but wouldn't something more than 5-4 be more satisfying? It would eliminate, or at least minimize, the whining about politicization.


    What do you mean? I thought an evenly divided court represented the very height of politicization.

    Still, when it comes to something this important, I'll take what I can get. And if 5-4 gets me what I want (a despondent Obama), then I'll take 5-4.

  • wareagle||

    I'm just saying a wider majority would be the smackdown this thing deserves. Yes, a majority is a majority but the losing side has little to whine about over 6-3 or 7-2 margins.

  • ||

    What Tonio said at 2:58.

    The pain, degradation, and humilation experienced by the Democrats following such a lopsided loss would be sweet and yummy. There's not enough water in the DC municipal water supply to keep up with all the rape showers that would be taken that night.

  • joshua||

    i completely agree. now you got me excited about the possibility, however remote. it would make a great ad...nancy pelosi being smug and then a blurb about the 9-0 decision. this is what dreams are made of i suppose. sigh....i'm not a republican or even that conservative either, but i can read the constitution, and i know it was meant to LIMIT power.

  • Tonio||

    Never underestimate the value of demoralizing your opponents, KH.

    Plus, depending on which justices voted with the majority, it could be a very long time before there's enough turnover in the court for this to be revisited. Again with the demoralization.

  • ||

    9-0 would be the ultimate "You've gone too far." Won't happen, but that's the pinnacle of bitch slaps.

  • Auric Demonocles||

    Maybe the judges will get pissed off at her cause Pelosi asks if they are serious during oral arguments and then go 9-0.

  • ||

    That's right--"That's our prerogative, bitch. 9-0!"

  • Auric Demonocles||

    "Also, in a rare double-whammy decision the court finds polygamy constitutional."

  • ||

    Might as well get it over with, because it's coming.

  • Auric Demonocles||

    My fellow Earthicans, we enjoy so much freedom, it's almost sickening.

  • ||

    "Wait 'til I tell my husband!"

  • Sean Flynn||

    I would love to see the uninsured people in this country who want affordable insurance GET THE INSURANCE THEY NEED.

  • ||

    I would love to see the uninsured people in this country who want affordable insurance GET THE INSURANCE THEY NEED.

    Indeed, that would be chock full of awesomeness. And I'm glad you realize that government is not the entity to provide such a thing!

  • ||

    Brett...I'm in your camp as well.
    It's a nasty feeling to know that nine robed Jurists hold the economic and personal Liberty of millions upon millions of Americans and businesses in their too often political grasp.
    I rather think it will go the way Karl Hungus (below my post) suggests (5-4 split).
    You "nailed it" when you said, "I need some happy in my life....".
    We ALL could use the "happy".
    Like Karl (below), I would LOVE to see a Supreme Court "bitch-slapping" of the Obama administration...and I also would take great delight in reveling....It would be like the heady glee experienced after World War Two.

  • Phat Indian||

    The Broccoli is sporting an afro.....and we all know what that means....wink, wink...nudge, nudge!

  • Ska||

    Take it a step further - it's sporting a fucking tiger striped pimp suit and an afro.

    I'm personally only prejudiced against magenta colored vegetables, so I'll just deal with it.

  • Barney||

    And beautiful pearly whites!

  • ||

    It is just a big green dog whistle.

  • Almanian||

    The Broccoli is clean and articulate, too.

    /Jess Sayen

  • ||

    Hey, at least it's not an eggplant.

  • De La Soul||

    Hey Paulie, I got a job for ya. Ya know that guy Rufus, that muli? Freakin' lick 'im.

    *laughter*

  • ||

    If Obama didn't know best, God wouldn't have put him on the throne. It is too bad his courtiers like the New York Times have to waste time explaining why we have to do what the king says and why those 18th century pieces of paper written on by white slave-owners shouldn't shackle the wrists of the king.

  • Loki||

    18th century pieces of paper written on by white slave-owners shouldn't shackle the wrists of the king

    I see what you did there.

  • ||

    And while many and perhaps even most legal experts and Court watchers still believe that the most likely outcome is for the court to uphold the law,

    WTF? I don't think this is accurate.

  • ||

    Yes, the mandate's constitutionality has been questioned all along by plenty of legal scholars.

  • Joe M||

    Asked where, specifically, the Constitution granted Congress the ability to enact an individual health mandate, Nancy Pelosi, then the House Majority leader, responded dismissively: “Are you serious?”

    Aw, Peter, now some handle spoofer is going to be really sad.

    We need a term similar to Godwinning for when this Pelosi quote is used.

  • ||

    Wrong. Mocking those that think they are our betters is always appropriate. Fuck that wrinkled bag of steaming hot retard and her buddy Barry too.

  • Ska||

    We need a term similar to Godwinning for when this Pelosi quote is used.

    Skeletoring? Cryptkeeping? I'm sure someone can do better.

  • ||

    Queefing.

  • Dan||

    +1

  • Loki||

    Squirting

  • Joe M||

    I don't want to know about your childhoods.

  • Almanian||

    Way to Pelosi the thread, Joe.

    "This thread's been Pelosied."

    "Dude Pelosied the thread right out the gate."

    That'll work.

  • Joe M||

    Hm, that might apply to any time you ignore another's legitimate concerns about a topic.

  • Almanian||

    Way to Pelosi my comment, Joe

  • ||

    "Pelosi" already has a board specific definition: It is the act of vomiting into your own nasal passages.

  • Fluffy||

    People who don’t want to buy broccoli or a new car can eat brussels sprouts or take the bus, but those without health insurance are in commerce whether they like it or not.

    This is completely idiotic and easily debunked.

    I had no health insurance from 1990 to 1997.

    I consumed no health care during that time period. None.

    The total amount of uncompensated care I pushed onto the system: $0.

  • Huffy||

    And you call yourself an "American".

  • shrike||

    You're technically right but let me object on behalf of others for a moment.

    In 1990-1997 many other uninsureds still added billions in cost on to the system due a must-care federal mandate enacted in 1986 (EMTALA).

    Here is where "both parties equally suck" claims are right on. Has anyone talked about repealing that mandate? Has anyone challenged that mandate in court?

  • ||

    But making people buy insurance doesn't reduce those costs. The costs are the same they are just paid for by a different mechanism.

  • A Serious Man||

    How the Federal government manages to assume more and more power:
    1. Declare to the people that there is a serious problem in some section of society.
    2. Use the moral outrage that follows to pass an economically outrageous law (ie EMTALA)
    3. When economically outrageous law causes more and more problems, insist that only Congress has the authority to fix it by assuming more regulatory power.
    4. Profit.

  • shrike||

    Exactly.

    See Medicare Part D also.

  • ||

    You bitch about that but you love Obamacare. You really are insane.

  • shrike||

    also, christfag

  • shrike||

    I have never said I like Obamacare. I like parts of it though.

    The idiot GOP House voted to kill the cost containment piece today (IPAB).

  • A Serious Man||

    How the Federal government manages to assume more and more power:
    1. Declare to the people that there is a serious problem in some section of society.
    2. Use the moral outrage that follows to pass an economically outrageous law (ie EMTALA)
    3. When economically outrageous law causes more and more problems, insist that only Congress has the authority to fix it by assuming more regulatory power.
    4. Profit.

  • ¢||

    Your not sharing any "So I went to the doctor..." anecdotes for seven years reduced public awareness of available health care options and killed a bunch of babies.

  • Joe M||

    And just think of the millions of 20-somethings in identical circumstances as you. Thanks to this law, they will be forced to either buy health insurance they don't need, or subsidize grandma and grandpa.

    Leftists always claim flyover country idiots are voting against their own interests, when this law is a clear example of something that's not in the interests of all the hipster doofi that support it.

    Of course, it's just a step on the road to single payer.

  • Auric Demonocles||

    23. Have mandatory health insurance through work (MA). Have only used it once in the year I've had it (bought a new pair of glasses and contacts with my FSA).

  • Joe M||

    I didn't have insurance until I was 32 and got a day job. I worked at a bar through my 20s, and never had any health problems. The only problem I ever had was when a beer bottle exploded in my hand, and my employer paid for the ER visit.

  • fish||

    The only problem I ever had was when a beer bottle exploded in my hand

    Well I hope you changed the ice!

  • Joe M||

    Ha! We had separate ice bins for the bottled beer and the mixed drinks.

  • Auric Demonocles||

    Also look at this:

    People who don’t want to buy health insurance can pay for healthcare themselves or not use any, but those who want to buy brussel sprouts in place of broccoli are in commerce whether they like it or not.

    Did that change the argument at all? And isn't it actually more accurate since buying brussel sprouts actually is commerce (compared to not using healthcare)?

  • Joe M||

    Didn't you hear? Brussel sprouts are free.

  • Pelosi||

    I had no health insurance from 1990 to 1997.

    I consumed no health care during that time period. None.

    The total amount of uncompensated care I pushed onto the system: $0.

    Ah, but by NOT buying insurance while healthy, you drove up the cost-per-person in the risk pool that you would have been a part of. That means that anyone who couldn't afford insurance at that time and died without coverage is directly attributable to YOUR selfish action!

  • ||

    So because he didn't subsidize someone else, he is evil?

  • joshua||

    yes. isn't that easily understood?

  • ||

    What childish drivel! Not buying a car and therefore not buying car insurance doesn't mean some one is responsible for auto accident deaths.

    You throw up straw dogs to distract from the real issue, being forced to by a product and the loss of freedom.

    You must worship those great freedom fighters - Stalin, Mao, Hitler and soon to be Obama.

  • Devil's Advocate||

    Not sure if serious.

    You may be new here, but if you notice that Obama or Pelosi is commenting on an article, you might want to consider the distinct possibility that you are responding to someone that is spoofing someone else.

  • pottfullofpith||

    If you think broccoli is expensive now, just wait until it's free.

  • Matrix||

    I know I'm not the only person who wishes there was such a thing as eyebleach, so I can use it every time that see that horrible woman.

  • Maria Shriver||

    Amen to that!

  • Joan Rivers||

    Can I borrow some? I really hate mirrors!

  • Afazia||

    Afazia este o tulburare a vorbirii care afectează exprimarea sau înțelegerea limbajului vorbit sau scris în absența oricărei modificări senzoriale sau a unui deficit al aparatului fonator, rezultând în urma unor leziuni dobândite ale creierului. Elementul fundamental al unei afazii îl constituie tulburarea codificării lingvistice și nu a articulării sau perceperii verbale. Pacientul afazic nu mai este capabil să folosească limbajul ca simbol pentru obiecte sau pentru procesele gândirii. Există mai multe tipuri de afazie, în care diversele proprietăți ale limbajului pot fi mai mult sau mai puțin afectate. Disciplina medicală care se ocupă cu studiul afaziilor este denumită afaziologie.

  • Brandon||

    Is this the new troll? What's spanish for "Gambol?"

  • Night Elf Mohawk||

    Eso no es el español.

  • Almanian||

    u mad bro?

    I don't speak Spanish. Or whatever language that is. Racist, I know...

  • ||

    French?

  • What does language||

    have to do with race?

  • Chupacabra||

    It ain't no Spanish. I think it's Trollish.

  • ||

    Romanian

  • ||

    Thanks. I was thinking Italian, but it didn't seem quite right.

  • Applederry||

    Asked where, specifically, the Constitution granted Congress the ability to enact an individual health mandate, Nancy Pelosi, then the House Majority leader, responded dismissively: “Are you serious?”

    To be fair, she did answer the question. It was just a more polite way of saying "Up my ass, you fucking pleb."

  • Tonio||

    If SCOTUS overturns this, she's going to avoid the press like the plague. But someone with a mic or cam will eventually catch her in a position where she can't avoid the question. Tears...yummy...sweet.

  • ||

    She'll blame George Bush. It worked well after the 2010 debacle: she created the worst epic fail in electoral politics in 70 years, and was voted back into leadership. Now that is a woman who is "too big to fail." So to speak. Or put another way, if you're going to lie, make it big and tell it often.

  • joshua||

    actually, i have no confidence in the media to pose such an obvious and important question. or if it happens, it'll be a softball, and she'll say, "well, that's why we have courts", even though i think we can all agree that a representitives ability to interpret the constitution is critical to their job description.

  • Number 2||

    Maybe she was just calling Ken Goffman?

  • ||

    i think she was actually saying 'Duhhhhhh.....'

  • ||

    I know I'm not the only person who wishes there was such a thing as eyebleach, so I can use it every time that see that horrible woman.

    You know you'd hit it. Don't even lie.

  • ||

    Paging SugarFree ....

  • Matrix||

    You know you'd hit it. Don't even lie.

    With a baseball bat? Sure. With a bus? Sure. With a 50,000 lb boulder? Sure.

  • Matrix||

    You know you'd hit it. Don't even lie.

    With a baseball bat? Sure. With a bus? Sure. With a 25 ton boulder? Sure.

  • Night Elf Mohawk||

    With a two-ton heavy thing.

  • sarcasmic||

    John would. There's no pussy he wouldn't stick it into.

  • Loki||

    I doubt that Nancy Pelosi even has a pussy at this point. Probably just a dried out dusty old hole.

  • ||

    filled with spiders

  • ||

    John would. There's no pussy he wouldn't stick it into.

    John casually stated in another thread a few weeks back that when it comes to women's grooming, he prefers "the grizzly" over "the bald eagle." So yeah, there might be some merit to your statement.

  • ||

    Some girls have feathers down there? Ew.

  • ||

    from the feather boas?

  • ||

    Even if you pluck them, they're all loose and bumpy like raw turkey skin.

  • ||

    Not feathers, teeth.

    Haven't you ever heard of a pussy troll?

  • Almanian||

    Better than the girls with Lee Press-On Nails™ surrounding their cooter.

  • ||

    I'll be glad when we finally have nanites that live in our follicles and eat the hair as it grows for the energy to power themselves. I just crawls long it and clips it to the precise length.

  • Almanian||

    See, this right here is why I come to H&R on a regular basis...

  • ||

    OK, this is beyond shitty typing. I might be having some sort of neurological event. Any one else smell oranges? azfb[]aERH]Jtp]p]adbfm['''''mamamamamamamamamamamamamamamama

  • ||

    I might be having some sort of neurological event.

    Quick - crunch up an aspirin!

  • ||

    I'm fine now. It turns out I'm just stupid and type too fast.

  • Lurker ||

    "I just crawls along and clips it to the precise length."

    When I was a kid, I just wanted to be a firefighter.

  • ||

    Raptor claws.

    Just imagine your dick ripped from your flesh and majestically carried away like an unfortunate salmon.

  • ||

    I would expect it to wiggle free and find it's way back to me.

  • ||

    Or, get married. Six of one . . . .

  • sarcasmic||

    I'm not sure that I want to know how you know of her grooming habits.

  • ||

    You are just so angry sarcasmic. Why do you hate men who like women?

    And as Loki pointed out, the spiders that live there would prevent me from engaging in such activity.

  • Almanian||

    HAHAHAHAHAHA! JOHN'S AFRAID OF SPIDERS!! HAHAHAHAHAHAHAHA!

  • sarcasmic||

    He definitely ain't ever coming into my house then. My wife's latest hobby is pet tarantulas, and one got loose the other day.

  • Almanian||

    Really?

    ALMANIAN'S AFRAID OF TARANTULAS! HAHAHAHAHAHAHA!

  • sarcasmic||

    Nothing to be afraid of. It's only a baby. Not much bigger than the average wolf spider. Hell, it's probably cat food by now.

  • Joe M||

    He's afraid of spiders. He's afraid of horror movies. He's not afraid to speak up.

    IF YOU SEE SOMETHING, SAY SOMETHING.

  • ||

    The spiders were run off years ago by the scorpions. And even they are loosing ground the carnivorous nematodes.

  • ||

    stupid extra o

  • ||

    It is a regular Jurassic park down there.

  • Almanian||

    Well, it's approximately the same age as dinosaurs would be, so...

  • ||

    Worst job in America has to be Pelosi's GYN.

  • ||

    I assume it's all done with waldos, like handling spent fuel rods and VX gas shells.

    Hell, it might be how we developed VX gas in the first place.

  • ||

    True story about Pelosi. She came and spoke at the high school where my wife used to work. A very high end private girls' school. So all of these good little liberal girls and their parents showed up one night to hear some inspiration from a feminist hero. Her whole presentation was a big infomercial for the book she was hawking. She didn't say a single thing that applied to the girls. Not so much as a "you go gettem out there". Nothing. Total fucking bitch.

  • ||

    She came and spoke at the high school

    So much for the Eighth Amendment.

  • Ska||

    Nice tie-in back to the queefing meme.

  • ||

    Remember the Snook? If we go with multiple warheads, Nan would definitely be in the running. Like planting ICBMs in the Montana high plains: no one will even notice.

  • Double D||

    Snuke

  • wareagle||

    of course, defenders don't take the challenges seriously. Look at all the other stuff this administration has gotten away with that no one says a word about. Besides, it's all about expanding govt control by whatever means, and the defenders and their media acolytes are quite willing to justify any means toward that end.

  • ||

    My favorite part of that photo is the obvious pain Pelosi is in while attempting to get her hideous stretched, stapled, and Botoxed face to warp itself into something resembling a smile.

  • ||

    You know at this point that smiling causes her physical pain.

  • ||

    I hope everything causes her physical pain. She's taken an apple corer to the tender collective asshole of this country and I hope she has to feel it like we have to to. She's a vile and evil creature.

  • Underpants Gnome||

    I am going to be haunted by that image for no less than 5-10 minutes.

  • School Kid||

    Someone should just slap her on the back so it stays that way.

  • Brandon||

    Why would Broccoli want me to eat broccoli? Seems kinda sadistic.

  • Broccoli||

    Eat YOUR broccoli. Duh.

  • Phat Indian||

    Masochistic Brandon. That's obviously a "self loathing" broccoli....perhaps Broccoli Tony is his name.

    He wrestles with his "issues" daily.

  • Brandon||

    That reminds me, did anyone else read the webcomic "Goats?"

  • sarcasmic||

    I hate the term unconstitutional because it implies that the government has the power to do anything that is not explicitly forbidden by the Constitution.

    When it's supposed to be the other way around, that the government has no powers other than those explicitly granted to it by the dusty old document.

  • ||

    Who can possibly read that old thing anyway?

  • Almanian||

    Man - what country are YOU living in.

    Living document, commerce clause, can do anything "necessary and proper" to "ensure domestic tranquility" and....Executive Privilege®.

    DUH!

  • ||

    That's the most rudimentary, foundational, basic principle of the United States -- it's a constitutional republic. Not that the progressives give a flying fuck.

  • ||

    And fuck Ezra Klein with a barbed cane.

  • ||

    It started with FDR. He figured out that the constitution gave him the power to appoint SCOTUS justices, but didn't say how many. So he used that power to force the court to undo the entire philosophical foundation of the republic and replace it with a self-contradictory mishmash of left wing crapola which allowed him to do what he wanted despite obvious and egregious violations of basic constitutional principles ... and now, leftist constitutional scholars all over the country point to that as SCOTUS precedent for the takeover of pretty much everything.

  • ||

    "To the contrary, their medical care results in some $43 billion of uncovered health care costs annually and, through cost-shifting, adds $1,000 a year to the average cost of a family insurance policy."

    And having insurance doesn't reduce those costs. The costs are still there. They just get paid for by an insurance company now rather than eaten by the provider. The only thing that changes is that people who were not buying insurance before and welshing on their medical debts are now being forced to contribute by buying insurance.

    Two points. First, there would seem to be very few people who fit that description. And those people would be almost entirely poor. Is really the case that the point of Obamacare is to make poor people bear more of their health care costs? If so that is quite a departure from the usual NYT editorial line.

  • ||

    Second, if the solution is for the government to help poor people pay for their insurance, why not get rid of the mandate and just pay the providers for their lost costs.

    The whole point of this seems to be the idea that people having insurance somehow magically causes their medical care costs to go down. I would like to hear exactly how that works.

  • ||

    Especially since once everyone has "insurance," everyone can be charged the wildly inflated insurance rates that are supposedly to recoup money for indigent/uninsured care.

    Do these idiots really think that hospitals are going to voluntarily jump off that gravy train?

  • ||

    No. It really is just a scheme to get people to pay more of their medical costs. But what is sad is that idiot liberals like those at the NYT honestly think the point is to cut costs.

  • sarcasmic||

    Much of what is supposedly "eaten by the provider" is actually paid for by Medicaid.

  • Tonio||

    Medicare supplies broccoli now?

  • ||

    Yes, but it costs 6 times what it does at the store, is certified organic, picked with union labor that has lavish pay, pension and benefits and it rotted while sitting in a warehouse waiting for light rail to be built all the way to your doorstep after meandering through 382 Congressional districts.

  • The other 53||

    What about me?

  • ||

    Much of what is supposedly "eaten by the provider" is actually paid for by Medicaid.

    Err, not really, at least for hospitals. Medicaid typically pays around 20% of the actual cost of services provided to Medicaid patients.

  • sarcasmic||

    Even services to people who aren't officially Medicaid patients are often submitted to Medicaid anyway. And while yes Medicaid doesn't pay as much, it's still better than eating the entire thing.

  • adam||

    You work at a hospital, no? I've always been curious about how a hospital figures out what it "costs" to treat someone. Do they have rigorous cost accounting, or the "costs" generally allocated to the areas where they have the ability to bill more?

  • ||

    Do they have rigorous cost accounting,

    Yes, they do. As part of Medicare, we have to keep fanatically detailed cost accounting records, which are submitted and audited.

  • Joe||

    On a unit cost basis right? But utilization is really audited by Medicare. Hence the issue with Fee for Service.

  • adam||

    "The only thing that changes is that people who were not buying insurance before and welshing on their medical debts are now being forced to contribute by buying insurance."
    Well that assumes that those people are actually paying for their own insurance. However, nearly everyone in this pool of people won't be paying for much or any of their own insurance because they will get picked up by the medicaid expansion or through the subsidized health care exchanges. So, just like before, other people pay. The other people may change a bit, because now other people = those who pay income taxes and other new obamacare taxes whereas before other people=those who had private health insurance.

  • ||

    Exactly! Saving me from having to pay for people's unpaid medical bills by making me pay for their medical bills does not help me! What do I care if I pay via the cost shift from an unisured person or via taxes to Medicaid? The problem is people who are unwilling to pay for their medical bills- Obamacare makes more of those not less.

  • ||

    Read the capitation clause.

  • sarcasmic||

    ObamaCare's Defenders Still Aren't Taking Challenges to the Mandate Seriously

    Of course not. Then they'd have to actually address the substance of their arguments. It's much easier to dismiss the challengers out of hand and ignore their arguments.

  • ||

    LALALALALALLALALALA, I can't hear you!

    HAHAHAH!

    LALALALALA!

    GO BACK TO ALABAMA AND FUCK THE SHEEP WITH THE REST OF YOUR NEO-CONFEDERATE KKK FRIENDS!

    /Harvard law professor.

  • Fist of Etiquette||

    Pelosi was Speaker, not Majority Leader. She worked really hard for that title.

  • Barbara B||

    I worked harder!

  • Liberty||

    For the most part, the complaints about Obamacare aren't taken seriously because a strong majority of the people making them said mandates were fine just a few years ago, until a member of the other team used them. Moreover, a lot of those same people were part of the wildly embarrassing "Obamacare Is a Government Take Over of Healthcare" argument that made a lot of people look tremendously bad. If they didn't have a good argument then, why would they have one now?

  • Almanian||

    because a strong majority of the people making them said mandates were fine just a few years ago

    Citations, needing, etc.

  • ||

    Does a majority of the voices in his head count?

  • Joe M||

    a strong majority of the people making them said mandates were fine just a few years ago

    I guess you mean three out of four GOP presidential candidates?

  • Gilbert Martin||

    "Moreover, a lot of those same people were part of the wildly embarrassing "Obamacare Is a Government Take Over of Healthcare" argument that made a lot of people look tremendously bad"

    The only one looking tremendously bad is you.

    Or perhaps you'd care to explain exactly how legislation that mandates everyone buy health insurance and mandates exactly what kind of health insurance is to be offered and purchased and mandates that the insurance companies cannot charge risk based premiums or refuse to insure people with pre-existing conditions ISN'T a government takeover of healthcare.

  • Hyphenated American||

    And Obama is not taken seriously about the mandate because he spoke against him in 2008.
    Right?

  • ||

    Well, Obama opposed a mandate when Hillary offered it in the campaign, so why do we take his support for the mandate seriously when he opposed it "just a few years ago?" Do you truly claim that "government takeover" made people look worse than "You have to pass it to see what's in it," "It will get more popular with time" and "If you like your current insurance you can keep it?" The position of Obamacare in the polls shows that all the politicians who ended up looking "tremendously bad" had a (D) in front of their name.

  • ||

    In its ruling, the Court noted that “the government’s struggle to articulate … limiting principles only reiterates the conclusion we reach today: There are none.”

    A government with unlimited powers is the statist wet dream, so of course they can't imagine a government of limited powers let alone articulate limiting principles.

  • ||

    We could probably ruin Obama's future career chances by pointing out that he went to a school with exactly 0% Americans.

  • ||

    The real point about it being unprecedented is that this means, literally, there are no precedents. So all that stuff following Wickard v Filburn doesn't hold water. This would be very frightening to Greenhiuse were she paying attention...

  • ||

    Bahahahaha "As opposed to all those constitutional challenges that consist of crayon drawings?" is the best line in ages.

  • ||

    ...in the years since the law’s passage, arguments against it have been “gussied up.”

    Isn't gussying up your arguments what a lawyer is supposed to spend his time doing while waiting to argue before a court?

  • ||

    On the contrary, under the administration’s logic about the interstate effects of the health insurance market,...

    It would be easier to buy the logic of the argument, if an interstate market in health insurance actually existed.

  • ||

    The argument that we can be compelled to buy health insurance is weak, but it's even weaker when you realize they're also telling us what kind of health insurance to buy. If I decided to buy a health insurance plan that only costs a dollar a year has a billion dollar deductible and only covers me in case of bengal tiger attacks, the feds would say that doesn't qualify as buying health insurance (even though it is). No, the health insurance plan has to cover a laundry list of conditions and have a sufficiently low deductible based on some arbitrary criteria the administration made up. So, how exactly is that justified by the constitution?

  • ||

    Because Susan Fluke needs her free birth control pills. That is how.

  • Auric Demonocles||

    Also, I (as a male), need those birth control pills too.

  • ||

    If you were a "T" in the "BLTG" menage, you might. Hey, WTF.

  • Auric Demonocles||

    I have no idea what you are attempting to say.

  • ||

    I kid around a lot, but I serious about this...

    I don't want to pay for Sandra Fluke's birth control, but I'd gladly kick in if she wanted to get her tubes tied.

  • ||

    I'd pay for the procedure, but not for the anesthetic. If she gets anesthesia, the deal's off.

  • ||

    i want that kind of health insurance!

  • ||

    Sorry, this is a valued benefits policy, not a health policy. See my post way below and tell me what you think about what I have to say.

  • Sean Flynn||

    Because people get sick and they need treatment. People are suffering in this country and they need health insurance to ease their suffering at an affordable cost.

  • ||

    When I see some of these 70+ year old fucks that can't drive worth a shit or even be aware that they are passing urine or stool in their pants, it scares me to think they are running our country.

  • Alex Scipio||

    Yeah, well, when I read some of these younger folks who can't have a reasoned discussion without profanity - I guess their education and training in manners and common courtesy was as lacking as their vocabulary - It scares me to think that you vote.

    That the same mouth you kiss your mom with?

  • ||

    I forgot to add "inb4 butthurt"

  • ||

    Not to mention, the infirm people he is talking about usually are way over 80. Very few 70-year-olds are like that. Just a wounded guy who can't quite locate his humanity. I sincerely hope he has no influence over the political system. But he has one. Maybe two or three if he lives in California, New York or Chicago. A living argument for the EC, if you ask me.

  • Number 2||

    On the other hand, many of us still aren't taking Linda Greenhouse seriously.

    The difference is that we're right.

  • JWS||

    I'm quite certain that shills like Greenhouse are fully aware of the real arguments against Obamacare. What they're doing is creating a strawman to both easily dismiss and reframe the meme in public discussions. It's their oh so nice way of redefining your thoughts so that they're always right and you're always an ignorant (and usually racist) boob.

  • Alex Scipio||

    So how about an analogy for those who don't seem to understand the issue?

    Suppose that we one day elect a GOP president again. And suppose that, as all current research has shown, she or he acccepts the fact that the more guns carried by law-abiding citizens, the lower the rate of violent crime (a fact, whether or not you like it). And suppose that this president, in conjunciton with a GOP House and Senate, in order to "promote the general welfare" orders ALL citizens over age 21 to buy a handgun.

    What, exactly, will be your challenge to this action, the federal government forcing you to buy what that president and congress think you must buy in order to lower crime costs?

    ... tell them they can't make you buy something, right?

    .. and you want to ensure this future GOP president HAS this power.. why?

  • ||

    Or, just order every woman of child-bearing age to buy the pill.

    She doesn't have to take it, of course . . . .

  • ||

    And the President appoints the Sec. of Health and appoints some of the committee that makes decisions about the coverage. Maybe Democrats should take into consideration what changes the GOP would make in their healthcare

  • Sean Flynn||

    Mandating that people buy Health Insurance isn't absurd. It's a way to get everyone something that's essential to their wellbeing. THEY WILL NEED TO USE THE INSURANCE AT SOME POINT IN THEIR LIFE. Or they will die. Government mandates you buy a gun? That's absurd and would just create more crimes. Health Insurance doesn't create more sickness.

  • shrike||

    All power to the Soviets

  • NRO||

    Is the Romney campaign like an Etch A Sketch?

  • ||

    The constitutions grants the federal government the power to tax and to grant public benefits. But the power to order a private individual to do something because their existence imputedly impacts interstate commerce?

    Then there is the capitation clause of the constitution.

    The federal government has the power to regulate the health and insurance industries. It has the power to establish a universal health system, but only if it does it the old-fashioned way, tax and spend.

    Just so you know, I can explain in three sentence how to establish a universal health system and raise the money to pay for it. Establish a payroll tax of, say, seven or eight percent to pay for health care. Give employers who purchase this benefit a credit against the tax. Use the money you raise, along with some general revenue, to buy everyone who is uninsured a health and medical policy.

    Is that so hard?

  • Gilbert Martin||

    "The constitutions grants the federal government the power to tax and to grant public benefits"

    Not exactly.

    The federal government has the power to tax but it doesn't have any power to spend any of those taxes collected on any activities that are not enumerated powers as required by the 10th Amendment.

    That's why the federal government cannot spend tax revenue to establish a federal speech police agency that goes around gagging people who say things the government doesn't like.

    Oh and there is no enumerated power delegated to the federal government in the text of the Constitution "to grant public benefits".

  • ||

    The point is, whether the power is enumerated in the constitution or not, the federal government's authority to create public benefits has been established. Social Security and many other programs. This is not a coffeehouse argument. People like you have to get off your hobbyhorse and take a walk around the real world. Winning isn't everything, it's the only thing" Vince Lombardi never actually said that, but it is still true. Pick what you can win, please.

  • Mike Field, 1850||

    The point is, it is a well established fact that blacks are not people, which is why they can be owned as property. This has been held to be true since our ancestors first settled this land. This is not a coffeehouse argument. People like you have to get off your hobbyhorse and take a walk around the real world. Winning isn't everything, it's the only thing" Vince Lombardi never actually said that, but it is still true. Pick what you can win, please.

  • ||

    The mandate is an illegal tax called a capitation. The fact that the terminology is rearranged does not change that fact.

    I actually have been poor and have kept my "homie" card all my life. I support universal health insurance, but paid for by a payroll levy and general revenue. I support many "universals", particularly universal higher education, but I am not interested in ravaging those with high incomes. They can keep their boutique medicine for all I care.

    Seems to me you are reiterating Roger Brooke Taney, an idiot in a robe who thought he was solving all the world's problems. Instead he killed and maimed hundreds of thousands. Strangely, he doubted slavery and freed his own slaves. Some of these judges wouldn't pass muster as a newspaper columnist.

    Unless your born name is Mike Field, just quit usurping my name. You can speak as yourself or under an avatar and still be heard.

  • Gilbert Martin||

    "The point is, whether the power is enumerated in the constitution or not, the federal government's authority to create public benefits has been established. Social Security and many other programs."

    And every one of them is unconstitutional.

  • ||

    You're not going to prevail. Just sign on to the idea that "mandate" is a capitation, and you might be on the winning side for once I hope it's the winning side.

  • Gilbert Martin||

    "The federal government has the power to regulate the health and insurance industries"

    No. It only has the power to regulate discrete interstate commerce transactions only and absolutely nothing else.

    And that means nothing other than shipments of goods across state lines wherein title to the property transfers from seller to buyer as part of the explicitly contractual terms of the transaction.

  • ||

    This is your reading of the orignal document. But not what is. What we are in is a battle to limit the commerce clause at least to actual business entities or commercial transactions. Not to including allowing the regulation of individuals simply because their mere existence might be deemed to affect interstate commerce.

    If you have to have a universal health system, and I think we do, universal insurance financed by a payroll levy is a better way to go than Obamacare or the Hillarycare proposal of the early 1990s.

    Tax and spend. At least it's constitutional! If you have better idea, let's hear it. Or what do you want?

  • Gilbert Martin||

    "This is your reading of the orignal document. But not what is"

    It most certainly is what it is.

  • ||

    Hope I am not being confusing. Your reading of the document is something that is, meaning a real opinion about what the constitution is.. But it not what is, on the ground. The federal government has operated beyond these boundaries probably almost from the beginning of the republic. Sorry.

  • Gilbert Martin||

    "Tax and spend. At least it's constitutional! "

    No, it isn't Constitutional

    "If you have better idea, let's hear it. Or what do you want?"

    I want the federal government to abide by the actual Constitution. And that getting out of the healthcare business altogether. Leave everything up to a pure free market.

  • ||

    Sorry again. By tax and spend, I mean as opposed to the "mandate". The mandate is a disguised capitation, which if forbidden by the constitution. It orders the payment of a specific amount which the person gets a credit against if they possess a purchased insurance. That is exactly a capitation.

    I opposed that to what I call "tax and spend", which means raise money by a tax which is legal and spend it on a public benefit. What I think you are arguing with the idea that the federal government has the authority to provide public benefits to individuals. But that horse left the barn long, long ago.

  • ||

    Those billions in uninsured cost would drop by billions if our Corrupt Government would abide by our Constitution against invasion, enforce our immigration laws and honor their Oath of Office!

  • John Thompson||

    You are confusing the Absence of There with the Being of There.

  • ||

    And now you raise the issue of our Chauncey president?

  • ||

    Unless we turn away the uninsured at Emergency Rooms, others must pay to cover those costs. People should be free to do anything that doesn't negatively impact others, but this does, and a mandate fixes that.

    That said, it is unconstitutional, but the Founders knew the Constitution might need to be changed and created a way to do so: Constitutional Amendments. Abortion is the same. The precedent in order, in the Declaration of Independence was for "life, liberty, and the pursuit of happiness." Absent clarity about when life begins, it's prudent to assume conception. As the first freedom, the unborn's right to life is protected. For many other reasons I'm pro-choice, but it should also require an Amendment.

    The truth is most people who agree with me about mandates and abortion simply twist the Constitution to their liking, but even if right that doesn't make it Constitutional.

  • ||

    Wasn't it the supreme court that said it was ok for the gubment to take your property and give it to someone else who will pay more taxes?

  • ||

    Yes, and it was the Supreme Court who ruled in Wickard that the Federal Govt coult bar a farmer from growing food to feed his family. That kind of insanity shows just how far we've strayed from being "the land of the free and the home of the brave", and how long we've been wandering down the path of darkness.

  • ||

    The reasoning that still baffles me is the argument that choosing to go uninsured is commerce because it must result in a cost shift. Most people who choose to go uninsured only do so for a certain period (for example between jobs) and many millions go uninsured for a period every year without cost shifting- they either don't go to the doctor or they pay cash. I have gone uninsured a couple of times in my life, and never once did I go to the emergency room and not pay- was that commerce? The idea that everyone who is uninsured is cost shifting is ludicrous. This is not at all an example of something that must be commerce- it is something that might be commerce. It seems to me that an action or inaction that might or might not affect commerce is an awful stretch for the commerce clause.

  • ||

    Or because they just plain can't afford to. Or are chronically unemployed or underemployed. Well, good thing I brought that up. How much of these excess costs are accounted for by people who are not even working? A lot, I am sure.

  • ||

    So many view ObabaCare’s federal mandate simply as that the government has the power to compel you to purchase health insurance. But the reality is that the government can compel you to purchase anything, at any price, from whoever it designates.

    The government can compel you to purchase food, cloths, and shelter from a single supplier and compel you to be employed by that individual/organization.

    And we once called a person who worked in this situation a slave.
    Anyone, compelled to act against his or her own interest for merely existing, is in a manor, the subject of involuntary servitude.

    Clearly, ObamaCare is in violation of the 13th Amendment: “Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.”

  • ||

    Guns, not broccoli.. with the argument that unarmed Citizens are consuming excess police services without compensation. Or, they fine you.

    Would that be legal too?

  • ||

    Don't like the mandate,don't like the idea of not having choice. Would like to be the one to determine what & how much coverage I need. Like my medical records kept private.
    I have fortunately never been without insurance or on any kind of assistance. Yet I lost my job & my husband's pay has been cut by more than half. We still have insurance yet with Obamacare we would qualify for a subsidy. How many people fall into this situation? Is that not putting a needless expense on the back of others? The notion that Medicare, a program Trillions in the red, will be cut by $500 Billion to pay for Obamacare not just for people that don't have insurance but to subsidize those that have always had it? Not right! I like being beholden to none.How many would jump on it because it's there?

  • Sean Flynn||

    If a person doesn't want health insurance then they are stupid. Really stupid. Can't afford it? The government will give you the money to buy it. There's no logical argument against not having health insurance other than "I'm stupid and I don't want it" So, why is it that the intelligent people who want insurance but can't afford it on their own need to appease the unintelligent people at the cost of their own health and finance? We have 30 million people we need to get insured. Most of them WANT to be insured. LET'S GET THEM INSURED. No more wasting time. Let's do it. Don't like the mandate? Don't like a government option? Okay. What ideas DO YOU HAVE to get these people the insurance they need. Not 10 years from now. I'm talking by 2014. Let's hear it. GO.

  • Appalachian Australian||

    The Amish have strong religious objections to insurance, and I wouldn't call them "stupid". They're healthier, on average, than the average (insured) American.

    If someone is a billionaire, having health insurance is also a stupid decision that makes no financial sense.

    But, hey, nice to see you consider 50 million Americans "stupid". Obviously they need your enlightenment to run their lives for them.

  • Sean Flynn||

    Seriously, the Supreme Court will rule on the mandate whichever way it decides to. Let's start talking about how to get people insured. What are you ideas? What can we do to get the people in this country affordable health insurance outside of an employer?

  • ||

    Payroll levy. A percent tax a la social security. The money raised along with some general revenue would be used to buy everyone who is uninsured a health policy. Employers who provided a health policy would get a credit against the payroll levy. It ain't brain surgery. It's just good old fashioned tax and spend.

  • Appalachian Australian||

    Maybe people who want employer-provided health insurance should go get a job.

    Myself, I choose to buy private, individual insurance. And I always have. Often had to go without things like cable T.V. or a fancy cell phone plan, but my health premiums were always paid as my #1 priority.

    Other people chose to be sick so that they could watch 500 channels of cable. They deserve to stay sick.

  • Sean Flynn||

    What's been lost in this ENTIRE argument is how to get the uninsured the health insurance THEY NEED. So, Conservatives, HOW DO WE DO THAT? We are closer to that than EVER before. Someone has cancer RIGHT NOW and they need treatment but don't have the money because they DON'T HAVE THE INSURANCE. This is your fellow countryman. HE/SHE NEEDS INSURANCE AND THEY NEED IT NOW. How do we get it to them at a price they can afford? Their lives are more important than an INTERPRETATION of the constitution. So, let's forget the petty politics and figure our OUR solution. Because if Peter Suderman has yet to hear a real case for the mandate, I have yet to hear from Peter Suderman a real case for GETTING PEOPLE AFFORDABLE HEALTH INSURANCE. So, how do we do that? Don't ignore the people who need health insurance. Don't throw them under the bus of petty politics. Please.

  • Mike Field, 1850||

    Have you considered the possibility that healthcare (the bit that matters) might be expensive because of too much insurance (the bit you think is important)?

  • Sean Flynn||

    I am under the impression that the law of supply and demand applies to this. If there is less insurance, it will be more expensive because the demand is greater. If there is more insurance, it will be cheaper because demand will be low. Insurance isn't the "bit" either. Getting people insurance coverage is more important than some argument over the constitutional merit of the mandate. If the ACA is dealt Affordable Care Act is dealt away with in it's entirety I would like to know what the Conservatives have to offer in it's place to get the uninsured healthcare coverage. What is the conservative plan to get affordable coverage to the uninsured who want it?

  • Appalachian Australian||

    If coverage isn't "affordable" then you can't afford it and you need to get some other kind of coverage.

    I can't afford a Lamborghini, but that doesn't mean my human rights have been violated and that everyone else needs to get crackin' on a plane to get me an "affordable" Lamborghini plan.

  • Sean Flynn||

    Let's do better than saying "our fellow Americans who are uninsured will just have to continue going uninsured because even though most want health insurance they can buy on their own, we've decided to take the side of the irresponsible Americans who don't want it because their right to be foolish supercedes the health and well being of others" That's not the side to take. So, again, how do we get the uninsured coverage?

  • Double D||

    No, that is exactly the right side to take. Adults get make decisions that you don't like.

  • Double D||

    The uninsured can get themselves some damn coverage. Or not.

  • Appalachian Australian||

    It's not my responsible to get coverage for other people who choose to be uninsured.

    Why do you feel the need to run other people's lives for them? Do you interrupt their mealtimes and force-feed them broccoli?

  • Double D||

    Let me make this clear: appeals to emotion mean nothing to me. I understand that other may get sick, or lose a job, or make poor economic choices, or just have bad luck. What I fail to understand is exactly why you feel that I or anyone else has the duty to do anything at all about this, especially at my expense.
    I'm not saying I wouldn't sympathize and try to help out (on a case-by-case basis, mind you, and mostly friends and family). I just don't see where i have any obligation whatsoever to anyone but someone I've made a contract or other legally binding agreement with.
    People have problems? You have problems? My own MOTHER has problems?
    I DON'T HAVE TO CARE.

  • ||

    So when you recite the Pledge of Allegiance, you are promising to do what you want, when you want, at your convenience, if it happens to be in your self-interest. Now that is an inspiring commitment that, in the aggregate, is sure to forge a strong nation we can all be proud of.

  • ||

    By this reasoning Heller means that if the Second Amendment precludes banning keeping a Glock in your home it also precludes limiting a private citizen, or a self-appointed citizen watch group, from running around in a fully loaded and operational Bradley Fighting Vehicle. Somehow the Court has managed the "floodgates" argument, and it will again. But you guys should still eat your broccoli.

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