Some Questions On ObamaCare's Compassion For Dahlia Lithwick and Other Bleeding-Heart Liberals

Slate’s Dahlia Lithwick, usually a solid advocate of civil liberties against government intrusions, can’t for the life of her understand what all the fuss about the loss of economic liberties due to ObamaCare is all about. Shell shocked by the shellacking that the Solicitor General Donald Verrilli received at the hearing Tuesday, she went into a deep sulk and threw the intellectual equivalent of a hissy fit.

How dare the conservatives on the bench ask Verilli if he recognized any limiting principles on the government’s powers under the Commerce Clause to coerce activity? By simply posing this question, the conservative justices had revealed just how dark, primitive and – above all – uncompassionate their conception of freedom was. She wrote:

Until today, I couldn’t really understand why this case was framed as a discussion of “liberty.” This case isn’t so much about freedom from government-mandated broccoli or gyms. It’s about freedom from our obligations to one another, freedom from the modern world in which we live. It’s about the freedom to ignore the injured, walk away from those in peril, to never pick up the phone or eat food that’s been inspected. It’s about the freedom to be left alone. And now we know the court is worried about freedom: the freedom to live like it’s 1804.

(She had no freedom from acid reflux as she wrote this, I’m sure.)

But if she’s having trouble understanding the conservative conception of freedom, I’m having difficulty understanding her conception of compassion. So here are some questions that might help clear the cobwebs off my Neanderthal brain.

One: Liberals insist that the individual mandate forcing everyone to buy coverage is necessary to prevent freeloaders from saddling everyone else with the cost of their emergency care. One can defend this provision by appealing to individual responsibility (as the awful Mitt Romney did) or the need for a more rational health care system, or, if liberals were honest, putting in place a funding mechanism for universal coverage.  But why is forcing someone to buy a product against their wishes on the threat of fines or jail compassionate?

Liberals might say that the individual mandate is not compassionate, but the system in whose service it’s being deployed – universal coverage – is because everyone will get better care. But that only raises more questions: one conceptual and one empirical:

Conceptually, if we subtract the cruelty of the means from the alleged compassion of the ends, will there be a net increase in compassion?

Empirically, if people don’t experience significant health gains under universal coverage, as there is scientific evidence to believe they won’t, does the mere intention of compassion matter?

Two:  The individual mandate shows that it does not matter to Lithwick and her fellow progressives that they have to resort to conscription to enact their grand compassionate designs. But does who they are conscripting matter? In the bad old days of the draft, the fact that politically powerless minorities ended up serving disproportionally more than rich, powerful white kids made the system even more immoral.

Shouldn't that doom ObamaCare too?

In our current health care system, a mix of taxpayers; (rich) hospitals/providers and (even richer) private insurers are stuck with the tab for uncompensated care. There are many problems with this. But isn’t it at least more compassionate than ObamaCare that would force asset-poor young people – trying to pay off their college debt and hang on to some beer money – to subsidize the coverage of relatively wealthier prospective geezers? If maximizing compassion is the issue, shouldn't we stick with what we've got?

Three:  In the Manichean worldview of Lithwick & Co., one can have compassion or freedom but not both. That would be news to Aristotle who, for a dead, white, male, wrote some rather lovely stuff in the Nichomachean Ethics about how freedom is a pre-requisite for genuine compassion.

If anything, the evidence that compulsion leads to more compassion is slim at best. Despite the fact that doctors and hospitals have a legal obligation to treat emergency cases, the total amount of uncompensated care provided in America adds up to only $40.7 billion annually or about 3 percent of our total health care spending (hardly the kind of problem that justifies a draconian 2,500-plus page government power grab). This is comparable to the 3 to 5 percent of billable hours in pro bono services that big law firms, that have no equivalent compulsion, aim to offer. 

Why is it obvious that, absent a legal requirement, doctors would offer any less free care than lawyers? Is it at all plausible that people who have chosen healing the sick as their vocation would simply walk away as poor people “bleed out on the curb,” as Lithwick worries?

Four: Related to the above point, have liberals ever considered that freedom and compassion are not enemies, but friends? That incentivizing, rather than forcing, compassion might be a better way to go? For example, how about offering, say, Bill and Melinda Gates Foundation tax breaks to buy coverage for the uninsured?

I can already hear derisive laughter. But does that show that opponents of ObamaCare are indifferent to compassion – or that liberals have contempt for freedom?

No doubt it’s my naivety that is causing me to ask such simple-minded questions. But perhaps liberals can enlighten me – in the name of compassion, you know.

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  • Righty Rew||

    It’s about the freedom to be left alone.

    You're starting to get it.

  • ||

    I was about the write the exact same thing. I admit, I sometimes feel out of place when, in response to someone's most evilest strawman (from their perspective) I can say, "Exactly - or maybe go even further".

  • Paul||

    Lithwick: "would agree that this debate is all about freedom—the freedom to never be one medical emergency away from economic ruin."

    Freedom from, freedom from Ms. Lithwick, I don't think freedom to you means the same thing it means to the rest of us.

  • ||

    This reminds me of the stupid little park in my neighborhood that has a stupid little obelisk with Cocksucker FDR's Four Freedoms carved in it. I never fail to get pissed off when I see it.

  • Red Rocks Rockin||

    You could always let your dog piss ON it whenever you pass it.

  • ||

    why are you trying to get his dog shot?

  • ||

    *mumbles about joke handle*

    should've read: "Are you Seriously trying to get his dog shot?!"

  • ||

    Are you saying that you let that stay? No midnight trips to the park with a sledge hammer or gallon of muriatic acid?

  • ||

    Thank you Paul. What Lithwick calls freedom is what we call security. It seems like there is an old saying involving those two.....

  • ||

    WAR is PEACE
    FREEDOM is ENSLAVEMENT
    SLATE is INTELLIGENT DISCOURSE

  • ||

    Lithwhick confuses freedom with security. Both good things. But different things. And generally, you have to give up some of one to get some of the other.

    "Freedom from ..." Reminds me of the ditz in one of my law school classes who asked shouldn't we have freedom from contract?

  • ||

    "You keep using that word. I do not think it means what you think it means." Classic.

  • notalentassclown||

    1.
    2.
    3.
    3.

  • ||

    I was going to point that out, and I'm sorry you beat me to the punch, since you decided to be a complete ass about a typo. A typo that has since been corrected.

  • Paul||

    Until today, I couldn’t really understand why this case was framed as a discussion of “liberty.” This case isn’t so much about freedom from government-mandated broccoli or gyms.

    Last night on Amy Goodman's show someone referred to these conjectural congressional flights of fancy as "absurd".

    The next liberal that dares say this to my face will get me screaming: "They told us during the tobacco fight in the 90s that 'it's not like we're trying to regulate fatty foods'" based on the same 'absurdities'.

  • MJGreen||

    Of course, they're reductio ad absurdum.

    The point is that if you can't even explain why the absurd scenario would not occur, you're the one missing something, not the person dreaming up the absurdity. So many pro-mandate people simply change the question, from "Would it be constitutional to mandate broccoli?" to "Would Congress actually mandate broccoli?"

  • ||

    Yep. As Paul points out, they always get around to it. Every single fucking time, if you open a door they will go through it.

  • Paul||

    What drives me batshit nuts about these arguments is that the modern liberal just doesn't get the 'levers to power' argument. It never occurs to them that two, five, ten, fifteen years down the road, someone they don't like will now have this same lever to power and use it in horrifying ways they never expected.

    It makes them such political opportunists. I wouldn't give the most purity-tested libertarian president the powers that liberals want to give to our current leadership. They just don't get it.

  • ||

    One of my most favorite things in the world is, when one of the status quoers start bitching about something that the gubmint did, or plans to do is to ask them, "Why are you complaining? This is all your fault anyway. You voted for these clowns."

    I usually get a cocker spaniel look back.

  • ||

    exactly. two things driving progressives batty right now.
    Government becoming involved in medical choices. (state govt. and conctraception/abortion)
    Government prevented from becoming even more involved in medical choices (fed govt.)
    Rachel Maddow had a piece on the hypocrisy of the republicans on these issues. The whole time I am yelling at the screen "if you hate what the govt. is doing where it has power, why are you fighting to give the govt. more power?"

  • ||

    Please explain how government is involved in contraceptive choices.

    Abortion isn't a medical freedom issue any more than laws against having your kid's spleen removed while you watch are restrictions on medical freedom.

  • Paul||

    Please explain how government is involved in contraceptive choices

    Tangental:

    http://latimesblogs.latimes.co.....-inte.html

    The public interest group Center for Genetics and Society is calling on Congress to hold hearings on oversight of the largely unregulated $3-billion fertility industry.

    Spurred by the octuplets controversy that resulted after a Beverly Hills fertility doctor transferred at least six embryos into 33-year-old Nadya Suleman, and by advertisements for "designer babies," the group said the United States needed to establish regulations similar to what exists in other industrialized countries.

    You know better Tulpa. The government (and its boosters) wants to be involved in every reproductive choice you make about your body.

  • ||

    Kinda like W. when he invented Homeland Security. I saw that comin' a mile away. Just look to Nixon's invention of the EPA.
    Always such good intentions, never thinking of how liberals will use them when they become 'ready to rule from day one'.

  • Jeffersonian||

    For the records, DHS was opposed by Bush at the outset. It's a donk creation.

  • ||

    I didn't know that.
    Too bad NCLB and Med part D wasn't opposed by him as well.
    As much as I loved the man, he did do a few stupid things.

  • Paul||

    It's a donk creation.

    Hillary Clinton: Millions of dues paying members...

  • ||

    Historical Example: Article 48 of the Weimar German Constitution permitting emergency presidential decrees without Reichstag consent. Guess who used that to their advantage in 1933?

    Dahlia Lithwick probably doesn't know a damn thing about Article 48...and Obama probably wishes he had it.

  • MJB Wolf||

    No liberal writer this week has been able to connect the broccoli comment by Scalia to the answer Sotomayor gave at her Senate confirmation. Lithwick, like others I've read, act like Scalia just made that ridiculous broccoli example up out of whole cloth.

  • ||

    I don't know which answer you are referring to. Could you clarify?

  • Max||

    Jesus Christ, it's true. Libertarianism does make you stupid.

  • Jesus Christ||

    Hi Max, not sure why you are addressing me, but if you can hear me, seek counseling pronto because I don't exist.

  • ||

    But Max, you're NOT a libertarian! Silly boy.

  • Old Mexican||

    Re: Maxipad,

    Liberals always blame someone or something besides themselves for their failures.

    By the way, those stains your left in your mommy's basement carpet do not clean themselves... go, git!

  • Night Elf Mohawk||

    Liberals insist that the individual mandate forcing everyone to buy coverage is necessary to prevent freeloaders from saddling everyone else with the cost of their emergency care.

    If there has been a more disingenuous argument in the history of the world than liberals arguing for the mandate on the basis of preventing freeloaders and fostering personal responsibility, I haven't seen it. And I don't think I want to see it.

  • Tman||

    If there has been a more disingenuous argument in the history of the world than liberals arguing for the mandate on the basis of preventing freeloaders and fostering personal responsibility, I haven't seen it. And I don't think I want to see it.

    The funniest part of that argument is that whether or not they actually think that we believe that they want to prevent freeloaders and foster personal responsibility (we don't) nothing in Obamacare will do anything to prevent this. All the evidence from Romneycare have shown precisely the exact opposite results. Insurance costs have skyrocketed for everyone in MA, even worse than what they were before the state mandate passed, emergency room visits went up and the costs to the state to run the services are ballooning beyond any previous cost projections.

    They can't even argue their lies with any evidence.

    This is fun to watch.

  • Typical Obama supporter||

    We don't want health insurance premiums to increase, because of uncompensated care. We would rather see them increase, because the government forced insurance providers to expand services, and subsidize the cost of insurance for the poor.

  • Tman||

    "Well, as long as you don't want costs to increase I guess that's ok th-HEY WAAAAIIITT A MINUTE!!!"

  • ||

    subsidize the cost of insurance for the poor = taxpayers on the hook for the uninsured

    Aside from the complete loss of liberty we will all suffer and the plummeting quality of care we will receive under obamacare, I cant tell the difference between conditions now and those under obamacare. Gosh, you dont think that is by design?

  • Libtard||

    Why can't you heartless people understand that we wish to make individuals more responsible by using the power of government force to absolve them of the burdens of personal responsibility?

  • ||

    Why can't you heartless people understand that we wish to make individuals more responsible by using the power of government force to absolve them of the burdens of personal responsibility porn?

    See, it's not just a liberal thing.

  • P B||

    And yet it OK that I'm saddled with other peoples' rent, food, retirement, and non-emergency care?

  • free2booze||

    In order to prevent freeloaders from saddling everyone else with the cost of emergency care, we need to create a system that will allow freeloaders to saddle everyone else with the cost of health care.

    I love that the left has such a big issue with freeloaders in the health care system, yet they promote freeloaders in every other aspect of society.

  • ||

    I love that the left has such a big issue with freeloaders in the health care system, yet they promote freeloaders in every other aspect of society.

    Very profound. That's going on my FB status.

  • wef||

    So? She is a power-worshiping fascist who doesn't mind using violence to make herself feel better, and she slathers on the compassion shtick to cover her coercive buttinskism. Ignore these power suckups.

  • ||

    Even for fans of government, compulsion should be a last resort, not a casual, daily event.

  • Paul||

    Apparently the EPA is kind of upset that compulsion went from a casual, daily event, to one that's subject to due process.

  • Eric Holder||

    What the hell are you on about? You had plenty of due process through the bureaucracy, there was never any need to bother the courts with your whiny bullshit.

  • Also sprach Liberal Psyche ||

    Doing it the easy way by covering the 40 billion tab with a simple expansion of SCHIP is not feasible. We are driven by a sublimated religious guilt that we cannot shake. Any other way than grand gestures of communal sacrifice is out of the question.

  • adam||

    There is, and has been for a long time, a program called theM edicaid Disproportionate Share Hospital (DSH), which paid states, who then paid hospitals, for this "uncompensated care." Hospitals didn't get paid at their full rates, but they got something. If it wasn't enough, it would have been pretty easy to find a couple extra bil in the federal budget to up the payments.

  • np||

    You are only free to do what you ought to do!

    Methinks she'd think Good Samaritan laws are a great idea...

  • free2booze||

    Those on the left fail to understand why people are so concerned about the mandate. As someone who's always had health insurance, the mandate to purchase health insurance doesn't have a big impact on my life. The mandate concerns me, because of what this power will lead to, beyond the compulsion to purchase health insurance.

    The left just sees a problem that needs fixing, and believes that a mandate will solve the problem. What they are not thinking about, is the next big problem on society, and what type of mandate will be forced upon us, as a supposed solution.

    I'd like to see what the reaction would be on the left, if there was a mandate for every citizen to own a firearm. After all, people need protection.

  • Killazontherun ||

    I'd like to see what the reaction would be on the left, if there was a mandate for every citizen to own a firearm.

    Given that it would save lives, by golly, why don't we push for it. Hopefully, we would lose, but progressives might finally get the message that it is stupid to assume concentrated power will always be in your hands.

  • ||

    I used to live just down the road from Kennesaw Georgia, which has such a mandate. I can tell you without hesitation that the reaction would be to completely blow every neuron in their brain.

  • free2booze||

    I can tell you without hesitation that the reaction would be to completely blow every neuron in their brain.

    That's all I needed to hear. Bring on the gun mandate!

  • From your lips... ||

    Yes, it does seem to be a great argument to throw back at the left, but it worries me. While I already comply with the "mandate," it would only further the power of gov't....oh fuck it! Go ahead with the mandate! I live in Marin County, CA and would love to see so many heads explode!

  • cynical||

    I sort of hope we would win, actually. Maybe the state would learn to fear its citizens again. I think it would even be pretty easy, Constitutionally -- just expand the Selective Service Act to make firearm ownership an requirement for draft eligibility and thus voting (and cover women as well as men).

    Hell, I would even drop the Heller decision for that. Let Chicago and New York disenfranchise every one of their citizens. Not my problem.

  • Juice||

    This has been done before: Second Militia Act of 1792.

  • For Farm, for City, for State||

    A telling point. Liberals really, honestly, genuinely believe that the Great Progressive Utopia will one day catch on and there will be no more pesky opposition to their oh so beautiful ideas. I mean, they're so obviously beautiful ideas, how can people keep opposing them forever, right?

  • ||

    My first problem with the mandate is that they choose to ignore the limits on their power imposed by the constitution. If they want a mandate there is a pretty straightforward process for obtaining that power.

    Actually, the idea that everyone should be required to carry some form of major medical (catastrophic care) coverage isn't all that far-fetched. It is a pretty sensible public policy decision when compared to the current mandate on healthcare providers to provide urgent care when needed regardless of ability to pay. But if you reach that decision you can't just declare yourself to have more power because of the mere existence of a problem that needs solving.

  • ||

    Contrast this with drug prohibition which has some of the same constitutional problems (at least with regard to intrastate drug sales and use). The public policy argument is much weaker for prohibition - you are not imposing costs on others by growing and smoking pot in your own back yard. Of course they did go ahead and declare themselves to magically have new powers to regulate drugs.

    Listening to the arguments the last few days, it is apparent that "what are the policy implications?" has been completely swapped in for "what does the constitution say?" for everyone on the court - or at least those who spoke.

  • Zeb||

    This is a good observation. The defenders of the ACA seem to have given up on making any constitutional argument at all. Even if it were the best idea in the world and would solve all of our health care related problems, it still needs to be within the constitutional powers of the government.

  • ||

    Actually they could have gotten around this whole issue by

    (a) attaching a severability clause

    (b) calling the mandate a tax.

    Choice (a) is especially delicious since it was a pure legislative screw-up; it wouldn't have cost them any votes they needed. And if the mandate was struck down alone we would have wound up with single payer in a couple of years as every private insurance company went bankrupt.

    Choice (b) of course might have lost some votes. But probably not many.

  • Juice||

    Lack of severability was intentional. I forget the reason why, but it was political.

  • ||

    Don't forget that the insurance companies had a very heavy hand in crafting the bill. If they couldn't get the mandate to bring in all the young, healthy, profitable policyholders, they didn't want to be stuck holding the bag the way they would if ACA was upheld sans mandate.

  • ||

    What they are not thinking about, is the next big problem on society, and what type of mandate will be forced upon us, as a supposed solution.

    Actually, I believe that they see this not as a problem but as a feature. If we can get the line moved this far this time, just think how much farther we can move it next time!

  • ||

    Here's what we're being set up for by the Individual Mandate.

    Soon, no one is going to want to purchase US debt. Lack of buyers will force debt prices down, driving rates up. We will be unable to roll over our debt without letting rates rise. But if rates rise, we'll need to borrow even more to pay the additional interest--a vicious cycle.

    The progressive solution: Pass legislation to force Americans to buy US debt. This will drive up demand, increasing prices and driving down rates. With the Mandate in place, Congress can do this because all Americans eventually participate in the debt market.

    Congress can't do this now, but it can with the Individual Mandate as precedent. The government can then borrow forever and keep rates low. For progressives, the individual mandate is a gift that promises to keep on giving... IF it passes muster.

  • cynical||

    Or, you know, they could raise taxes. They don't even have to pretend that they'll pay those back.

  • ||

    This would be on top of raising taxes.

  • ||

    "The left just sees a problem that needs fixing..."

    Yeah, kind of like Stalin seeing kulaks as a 'problem that needs fixing'.

  • Suki||

    Despite the fact that doctors and hospitals have a legal obligation to treat emergency cases . . .
    Is one of those legal requirements found in Medicare laws? I know that some states require hospitals that receive state money provide emergency room services to anybody who shows up, where are some of the other laws requiring this?

  • adam||

    It's a federal law called EMTALA.

  • Suki||

    So, the reason why there are "so many people gaming the system" (the Leftie complaint) is because the feds ordered it to be that way. Now the same lefties want another law, same result, with the added feature of more regulation and higher taxes?

  • ||

    Yes.

  • dave||

    That's how the ratchet works.

  • Rackets too!||

    .

  • ||

    Yes.

    EMTALA.

  • ||

    You completely misunderstand the progressive conception of freedom. For them the word connotes a state of security and equality. To be free from want, free from danger, free from greed, free from insult to one's personhood (in the form of race, gender or sexuality)...

    Under this conception, poverty is the opposite of freedom. Rich people having more than the rest of us is the enemy of freedom. It is the center of their ethos. You cannot be free as long as Bill Gates has F.U. money. You cannot be free while Joe Sixpack owns guns and goes hunting on the weekends after watching NASCAR. Mr. Bergeron is a threat to us all.

  • Kwanzaa Cake||

    You completely misunderstand the progressive conception of freedom. For them the word connotes a state of security and equality.
    ________________________

    Security and equality for some. Others are to be forced at the point of a sword to pay for all that "equality and security." All that coercion is somehow irrelevant to the leftist's conception of freedom. Not to mention the obvious contradiction between liberty and dependence. Liberals can bring us plenty of the matter, very little of the former.

  • ||

    That's just the point, isn't it? To them there is no coercion inherent in taking from some to give to others. It is part of the "social contract", to use their parlance. Failing to give to the common pot is a violation of the social contract.

    Therefore, trying to keep that which you earned is doing violence to the society at large. It is the wealthy that are initiating violence by having so much more than others. This is their fundamental view of the world, and explains why libertarians are the embodiment of evil to them. To them the "social contract" is a fundamental principal of humanity, just as individual liberties are foundational to Libertarians.

  • Kwanzaa Cake||

    I agree with you. Of course, their "social contract" comes with infinite fine print that they don't disclose to the payees -- i.e., in exchange for all this largesse bestowed upon you, we (the liberal grantors) get to control your lives. Eat what we tell you to eat. Do what we tell you to do. What a deal.

  • Loki||

    To be free from want, free from danger, free from greed, free from insult to one's personhood (in the form of race, gender or sexuality)

    In other words, what they really want is to be free from all the uncertainties that existence in this imperfect world implies (to be free from life IOW).

    Maybe they should just go ahead and off themselves because that's pretty much the only way to be free in that sense.

  • ||

    Having taught us all Darwin in public school (no other theory allowed!) they now want us to all be free from Darwin's world.

    They want the zebra to be free from the lion.

    So why is the left so anti-progress and anti-improvement?

    Don't they know (and didn't they teach us) that the zebras get faster when the lions eat the slow ones!

  • Zeb||

    I'm pretty sure I learned about theories other than Darwin's in public school biology class. He didn't even know about DNA, for heaven's sake.

  • ||

    What are these "other" theories of evolution of which you write? I'm "pretty sure" that Darwin's was the only one taught, in public schools anyway.

  • Another Phil||

    Don't they know (and didn't they teach us) that the zebras get faster when the lions eat the slow ones!

    No surprise, but public school did a lousy job of teaching you about natural selection.

  • Ring||

    The liberal dishonesty is that while the mandate would eliminate freeloaders with no health insurance, it would merely shift the freeloading onto the taxpayer since they will no doubt be on the hook for those deemed too poor to pay for health insurance or the tax/penalty.

    This is just another avenue to get more people dependent on government to subsidize their lives.

    Since when has the left ever cared about freeloaders?

  • Zeb||

    And who says that the uninsured are freeloaders? Is it impossible or illegal to pay for medical care out of pocket? Or to set up a payment plan or get a loan if you don't have the cash?

  • ||

    I think in some states it IS illegal to pay for medical care out of pocket.

  • Zeb||

    Some countries, but I'm pretty sure no US states do that. Some (MA, VT) seem like they are working on it, though.

  • Ring||

    I'm talking about the people deemed too poor to pay for health insurance or pay the penalty for whom the taxpayer will ultimately pick up the tab.

    Unless of course you are suggesting that the poor who cannot pay for insurance or the penality will suddenly pay for their own medical care, in which case you are crazy. Giving you the benefit of the doubt, I have no qualms about the uninsured who pay for their health care. My argument is that the liberals are suggesting everyone will suddenly pay their own way, when we know that half the country will have their hand out to the feds looking for money.

  • Zeb||

    Oh, I agree. I'm responding more to the suggestion by proponents of Obamacare who suggest that all uninsured are freeloaders who need to "pay their way". Which is bullshit.

  • ||

    Forget it Shikha, it's Obama-town.
    http://www.youtube.com/watch?v=1v_BVNGAfYM

  • ||

    I think we can get the reference without the link.

  • adam||

    Frankly the entire development of our medical system indicates that people are compassionate on their own, without the need for government compulsion. Ever wondered why so many hospitals are St. XX's, or Beth XX, or XX Presbyterian, or XX Methodist, etc? It's because they were set up to give charitable care at low or no cost!!!!!

  • Killazontherun ||

    People still get sick and injured so obviously a system based on voluntary charity doesn't work. Market failure, don'tcha know?

  • Fluffy||

    Uncompensated care is in fact a problem.

    But it's only a problem because the federal government forces medical practitioners to accept patients without regard to ability to pay through EMTALA.

    I remember EMTALA passing. And you know what issue was being addressed? Not a lack of available care. The issue being addressed was a relative handful of emergency cases where people were shuttled from a hospital that didn't take charity cases to a hospital that did take them. People were getting emergency care; the length of their ambulance ride was sometimes changing. That's it.

    And sometimes an extra 20 minutes would be a bad thing. Absolutely true. But let's remember that we have essentially destroyed our health care system for the sake of a handful of anecdotal cases where people had long transfer times from a hospital that wouldn't take them to a hospital that would.

  • adam||

    How big a problem is it really though?

    We hear the $40B figure, which seems quite large in absolute numbers. But does that figure subtract payments to hospitals under Medicare DSH (about $18B a year) and amounts that are budgeted for charity care? Hospitals go out and fund-raise for charity care, so if it's budgeted as such, I'm certainly not crying for the hospital.

    Lastly, $40B is small in comparison to health care industry. Every industry has to deal with customers that don't pay their bills and/or go bankrupt. That's a cost of business. If the $40B minus the two factors above/the total revenues the affected hospitals is roughly equal to the loss ratio suffered in other industries, then it's certainly not that big a deal.

  • ||

    I remember EMTALA passing. And you know what issue was being addressed? Not a lack of available care...People were getting emergency care

    Kinda shoots a very large hole in the use of that nebulous, all-encompassing term currently being abused known as "access".

    The cost shifting that you are referencing Fluffster, is primarily not transferred to insured patients, as insurance contracts with a given facility prevents this as per both state and federal laws. There was a peer-reviewed study published in 2007 showing rates and premiums raised around $80 on average nationally.

    Costs are shifted primarily to the state (and they either raise taxes or demand Fed lucre to cover shortfalls) and self-pay patients.

  • ||

    Seems to me that SCOTUS, while they're in a "striking down" mood, should toss EMTALA while they're at it.

  • Hobie Hanson||

    And why don't we just "toss" Medicaid and Medicare and Social Security and the Indian Trust Funds while you're at it? Somalia here we come.

  • ROOOOADDZZZZ!!||

    ....WE AIN'T GOT NONE!!

  • ||

    I like the cut of your jib Hobbie.

  • Double D||

    Please excuse me while I jeer.

    Honestly, I am still only cautiously optimistic about recent developments. t is hard to be honest with oneself when honest conclusions oppose your goals, but methinks any honest Justice has to conclude that there is something wrong with mandates to purchase X, Y, or Z. This kind of compulsion simply cannot be equated with any kind of freedom, regardless of its ultimate purpose.The fact that this is even a question for the Supreme Court leaves me badly shaken.

  • Killazontherun ||

    And now we know the court is worried about freedom: the freedom to live like it’s 1804.

    Libertarians are so behind the times, dragging us down, when progressives are trying to move us forward to the vision of 1824, windmills, trains, the cronyism of Henry Clay and the technocratic vision of Augustus Comte. Can't we just see that there is a Brave New World just waiting for us to embrace?

  • Killazontherun ||

    Auguste

  • ||

    CANALZZ!

  • Killazontherun ||

    Major ++1

    Wished I thought of that.

  • Double D||

    "I can already hear derisive laughter. But does that show that opponents of ObamaCare are indifferent to compassion – or that liberals have contempt for freedom?"

    No, no Shikha...liberals AND conservatives have contempt for freedom.

  • Killazontherun ||

    But if she’s having trouble understanding the conservative conception of freedom, I’m having difficulty understanding her conception of compassion.

    I had a wee problem with the above wording as well. There are too many dominate strains of conservatism that have no problem with an expansive definition of the commerce clause if it serves their purpose for this to be considered THE conservative position. Santorum, for one, would like to abuse the commerce clause to dick slap the porn industry, and Reagan and the Bush's used it to justify an expansion of federal policing of drug trafficking. It is THE libertarian position, best articulated in Friedman's Free To Choose as a coherent approach to defining freedom in terms of the absence of coercion, but wholly consistent with all major strains of libertarian thought.

  • Killazontherun ||

    Otherwise, a very well reasoned post, Shikha.

  • Gilbert Martin||

    Compassion extends to the limits of one's own resources volutarioy contributed and no further.

    Advocating SOME ELSE be forced to do something or pay for something has nothing to do with compassion.

  • ||

    That's because you see yourself as an individual. Progressives would assert that you are not. You are a member of society. You have certain responsibilities as a member of society.

    It is not the individual who is compassionate, it is society. (What kind of society do you want to live in, anyway?) Failing to live up to your social contract and provide for others is a criminal violation of the rights of the community.

    Your individuality is expressed in other ways, which cannot be violated or even judged by other members of society. Like your choice of hairstyle, or sexuality. Those are sacrosanct. Not your labor or your wealth.

  • Gilbert Martin||

    "Progressives would assert that you are not. You are a member of society. You have certain responsibilities as a member of society."

    Yeah - responsibilites that for some unexplained reason, only liberal individuals are capable of defining - for everyone else.

  • ||

    The logic is thus:

    1. The government is us. (After all, "we the people", "government of the people, by the people, and for the people", etc.)
    2. The singular of "us" is "me".
    3. Therefore, if the government provides a service, I'm providing it.
    4. Since the service is "compassionate", I am.

    This is why lefties are fanatic about democracy, and often freak out if you refer to the government as anything other than "us" or "we".

  • West Texas||

    I have yet to meet someone who has a convincing constitutional argument for this beyond, "because Congress just can!"

    But I have met a LOT of people - doctors even - who think the ends justify the means, so fuck the constitution. The world if full of meanies and we just can trust them to be nice to each other.

  • American||

    "In the bad old days of the draft, the fact that politically powerless minorities ended up serving disproportionally more than rich, powerful white kids made the system even more immoral." This is a falsehood. You really need to do some research instead of mouthing lies.

  • ||

    Prove it wrong.

  • GILMORE||

    "Black antiwar groups opposed the war for the same reason as white groups but often protested in separate events and did not cooperate with the ideas of white antiwar leadership.[61] They harshly criticized the draft because poor and minority men were usually most affected by conscription.[62]

    [Gerald Gills (1992). Barbara Tischler. ed. Sights on the Sixties. Rutgers, the State University of New Jersey. pp. 177–195.]

  • GILMORE||


    ""Going to college, as an undergraduate or a grad student, greatly increased the chances of getting an exemption, as did marrying and having kids. Thousands also used connections to win deferments from their draft boards. Minorities and the poor, however, often found it harder to avoid being called up. By one estimate, 76 percent of the soldiers in Vietnam were from working-class or lower-income families.""

    [Monica Davey is Chicago bureau chief of The New York Times]

    http://www.thefreelibrary.com/.....0207323951

  • GILMORE||

    What is hilarious is that 'antiwar liberals' of today LOVE the idea of the draft.

    There should be a book by some modern progressive baby boomer called, "How I learned to stop fighting The State and suck its dick"

  • ||

    That would require them to realize that they do, in fact, have the state's dick in their mouth. I'm not so sure that modern progressives are smart enough to realize it.

  • ||

    The Left believes in freedom to think and say lefty things. They do not believe in property rights. If the government is going to do anything to further "social justice" (as far as I can determine, anything which makes a society more "just" as the Left sees it) then what the government proposes to do is good, and good=constitutional. The Constitution exists only to make sure the left prevails and "social justice" is achieved.

    The great PR success of the left is the use of the terms "progressive" and "social justice". Who can be against justice or progress???

  • Tony||

    This is totally incoherent, but that's not your fault, except insofar as you choose to believe in an economics that disallows for basic medical rights.

    Subsidize the Gates foundation to provide charity? Ok. Don't see how that's different from subsidizing anything else. Libertarians seem to prefer that the poor receive handouts rather than be a part of a social contract. I don't get it.

    The mandate to buy insurance is not the best healthcare delivery option there is. It is the "free market" alternative to other options. Or rather it was until it was proposed by a Democrat, at which point it became freedom killing socialism. Would you be any happier if we had managed to pass single payer? Doubtful. It's hard to argue that Medicare is freedom killing when it's ubiquitous, long-standing, and well liked.

  • Tman||

    "basic medical rights."

    Does that include gym memberships?

  • Scruffy Nerfherder||

    It obviously includes rubbers and birth control pills.

  • ||

    Give me a few minutes with a flashlight. I'm sure it can found somewhere in this penumbra.

  • ||

    basic medical rights

    Define and codify these "basic medical rights" of which you claim, please. As opposed to pulling them out of ass when convenient, that is.

    Furthermore, if I determine, as your physician (and agent of the state, as you propose to indenture me in this Platonic scheme) that you are not complying with a given TX regimen, I can then withhold such services at anytime, under the rubric that "what the state giveth, the state can taketh?"

  • ||

    pulling them out of ass

    What's the medical term for that?

  • Ben the Duck||

    What's the medical term for that?

    Liberalism.

  • ||

    ""Furthermore, if I determine, as your physician (and agent of the state, as you propose to indenture me in this Platonic scheme) that you are not complying with a given TX regimen,""

    And the gubmint is already involved with looking at outcomes and feeding that data back to providers. Incentives today, penalties tomorrow.

  • Night Elf Mohawk||

    basic medical rights

    Rights as against whom? The right to force the doctor to provide your care or the right to force someone else to pay for your care?

    What if I don't want to insure against chemical dependency? Do I have a right not to be forced to do so?

  • Tony||

    Basic medical rights are what people have in the modern civilized world.

    The right not to be taxed has never existed anywhere, not even in some imaginary golden age of freedom libertarians daydream about.

  • Old Mexican||

    Re: Tiny,

    Basic medical rights are what people have in the modern civilized world.


    How quaint: A meaningless Tautology.

    The right not to be taxed has never existed anywhere


    Yes it has - it's "Thou Shall Not Steal."

  • Gilbert Martin||

    "Subsidize the Gates foundation to provide charity? Ok"

    Exactly how is the Gates foundation being subsidized?

  • ||

    Because it is a government-ordained charitable non-profit. The government grants it freedom from having its assets seized by the government.

    Duh...

  • Gilbert Martin||

    Ah yes, the liberal definintion of a "subsidy" - when the state refrains from taking something away from you that was yours to begin with.

  • Red Rocks Rockin||

    It's hard to argue that Medicare is freedom killing when it's ubiquitous, long-standing, and well liked.

    Federal spending on medical expenses, 1980: $55 billion

    2011: $800 billion

    At a continued 9% annual increase in that time frame, costs will rise to $1.6 trillion in eight years and $3.2 trillion in 16 years.

    Short of massive inflation, medical costs that take up nearly the entire current federal budget are far from freedom-promoting.

    Basic Math > Tony

  • MJGreen||

    In the old Greco-Roman times, it was hard to argue that slavery was freedom killing since it was ubiquitous, long-standing and well liked.

  • Citizen||

    I like bread and circuses

  • West Texas||

    basic medical rights.

    You guys need to be nice to Tony. He understands what he means, even if you don't.

    It's like smut and Tony is a modern Potter Stewart.

  • Old Mexican||

    Re: Tiny,

    This is totally incoherent,


    You are right: What you write is totally incoherent.

    but that's not your fault, except [sic] insofar as you choose to believe in an economics that disallows for basic medical rights.


    Yep, you proved your point: Your text is incoherent.

    Economics does not allow or disallow anything; economics is the science of human action. Also, there is no such thing as "basic medical rights."

  • Ring||

    What happens with people who can't afford health insurance and can't afford the penalty/tax?

    Do they then get to freeload from the taxpayer?

  • Tony||

    That's why Medicaid was expanded.

    The presumption everyone is overlooking is that having people covered, even if it is tax subsidized, actually lessens costs, since uninsured people only show up for care when their costs will be the highest.

  • Charlotte Corday||

    That is a complete fantasy. If that were true, preventative care would be shown to reduce costs. And it hasn't shown any such thing.

  • Scruffy Nerfherder||

    That is most definitely a presumption.

  • Old Mexican||

    Re: Tiny,

    The presumption everyone is overlooking is that having people covered, even if it is tax subsidized, actually lessens costs, since uninsured people only show up for care when their costs will be the highest.


    Somehow Tiny here seems to be inmune to irony like Sheldon Cooper.

    If I have a runny nose, I would not wait until my cost is higher to address it - I would go and get myself checked and have a prescription. That is how *I* keep my costs down. Instead if care is for free or subsidized, then I would go only when I really feel like shit, because my cost would be nearly ZERO (as the TRUE cost is shared by many individuals.) So in reality the cost of healthcare will go UP in the aggregate, not down.

  • dave||

    Ring: "Do they then get to freeload from the taxpayer?"

    Tony: "That's why Medicaid was expanded."

    translation of answer: YES

  • Jeffersonian||

    So we have to address these people who are freeloading on the taxpayer dime when they get medical care. We will do that to make sure they get health insurance on that same taxpayer dime.

    Do I get you right?

  • Eric Holder||

    Uh...Ring, if you remember Pelosi and maybe Obama were pushing for jail time. I am not sure that it has been put into law, but you can bet the series of bureaucratic actions that would be set in motion would eventually land you in the pokey.

  • ||

    Uh...Ring, if you remember Pelosi and maybe Obama were pushing for jail time. I am not sure that it has been put into law, but you can bet the series of bureaucratic actions that would be set in motion would eventually land you in the pokey.

  • ||

    The only thing that makes me not be embarrassed about that little faux pas is that Tony embarrasses himself so thoroughly every time he posts that no one could ever sink to that level of self-deprecation.

  • ||

    SOCIAL CONTRACTZZ!

  • ||

    "basic medical rights"

    HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA

    Wait you're serious?

    HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA

  • Jeffersonian||

    Wait you're serious?

    You just can't make this stuff up.

  • Joe M||

    In our current health care system, a mix of taxpayers; (rich) hospitals/providers and (even richer) private insurers are stuck with the tab for uncompensated care. There are many problems with this. But isn’t it at least more compassionate than ObamaCare that would force asset-poor young people – trying to pay off their college debt and hang on to some beer money – to subsidize the coverage of relatively wealthier prospective geezers?

    That's kind of the dirty little secret of this whole deal. It's just another sneaky way to transfer wealth away from the relatively poorer and younger to the relatively richer and older.

  • Scruffy Nerfherder||

    The AARP approves.

  • Loki||

    does the mere intention of compassion matter?

    Intentions are all that matter to dipshits progressives.

  • BelowTheRim||

    Shikha, you get better to read every time.

    I love the written bitch slap when you call out Lithwick for having an intellectual hissy fit.

    Keep it up. I love your surly attitude towards liberals. They all deserve it, even the ones who 'try' to be respectful in arguments.

  • Kwanzaa Cake||

    Obamacare is not intended to actually solve any problems. It has one purpose: to royally fuck up health care and the federal fisc to an even greater degree, thereby causing the "crisis" that can only be "solved" by single payer. The liberals will claim, we've tried everything else, it does not work, single payer is all that is left. Obamacare is just another body shot setting up the knockout punch in the 12th round.

    You have to admire the left in that they just do not quit. Their incremental tinkering in health care is the very cause of many of today's problems. Their last two attempts to move us further down the line to single payer -- Hillarycare and Obamacare -- are pretty thoroughly despised. Now, as to Obamacare, the left has actually taken on a constituntional showdown over a law the public hates! It's unbelievable. And their contempt for the public really has no end.

  • Charlotte Corday||

    They never quite and they never learn. No matter how many times their policies fail, it is always because we just didn't try hard enough.

  • ||

    **the total amount of uncompensated care provided in America currently adds up to only $40.7 billion annually or about 3 percent of our total health care spending**

    Bingo. The (claimed) 17% of uninsured Americans are responsible for only 3% of system costs. And if only the government and the insurers can get those 17% under their financial thumbs, they get a whole new pot of money to play with.

    To look at it another way -- the 83% that generate 97% of our medical care costs get another major subsidy.

  • Charlotte Corday||

    The whole point was to rob the young and healthy to pay for the old.

  • Jeffersonian||

    If you look closely enough at the "it's for the children" meme deployed by the Left, you will discover it's really all about plundering said children.

  • sci78||

    The reality is:

    Lenny, you will have saved the lives of millions of registered voters.

  • sci78||

    left the quotes off - so its
    "Lenny, you will have saved the lives of millions of registered voters."

  • ||

    If the mandate is upheld I predict the precedent it creates will be used within a decade if not less: Forced loans to the Federal Government. "Want to keep your 403(b)? Fine. Invest 15% of it into treasuries."

  • ||

    Those would be the 'Freedom Bonds'

  • Kwanzaa Cake||

    Indeed, I agree. Soon enough they will raid tax-deferred savings accounts in one way or another. Like all things they do, it will be incremental and rest on class warfare. Start with 401(k)s worth a million and up -- those folks surely can survive if we force 20% of their accounts into Trasuries, right? Then the threshhold keeps ratcheting downward. Then, at some point, comes the direct tax, say, a tax of 35% of all 401(k)s woth more than $2 million. The particulars may differ, but in the end, no way the pols keep their mitts off these pots of money.

  • GILMORE||

    Kwanzaa Cake|3.29.12 @ 2:33PM|#
    Indeed, I agree. Soon enough they will raid tax-deferred savings accounts in one way or another.

    KWANZAA-SHAZAAM!!! I reveal to you, *THE FUTURE* =

    http://moneyland.time.com/2012.....01k-gains/

    A Senate Finance Committee proposal slipped into a highway-funding bill would have forced those who inherit an IRA or 401(k) to empty the accounts within five years—almost certainly triggering income-tax payments. Let the encroachment games begin
    ...

    Uhm. By 'future' I mean the past.

    I'm sure a progressive liberal could discover some reason why this kind of thing is "compassionate"

    Probably because some people are inheritin' moneys, and it aint US! WE WANTS IT@@!!

  • Sean Healy||

    Bingo! Explicit financial repression is already happening in Europe, where all the best liberal ideas come from.

  • ||

    How compassionate is it to spend money now that will have to be repaid by people who have no vote? I am referring, of course, to our children, grandchildren, great-grandchildren,...

  • Charlotte Corday||

    Couldn't they have just passed a $40 billion appropriation for uncompensated care and called it a day?

  • Old Mexican||

    Remember, boys and girls: March 31 is the fundraising deadline for the Elizabeth Warren campaign!

    So, lock yourselves inside your homes, place your wallets on your security box lest you suddenly become nuts and do a happening with your money.

  • Abdul||

    All I can think is that Lithwick must be a big damn idiot if the only motive that she can possibly discern from legal or policy objections to Obamacare is because the opposition enjoys hearing the cries of the suffering, and enjoy watching orphans starve in the streets.

  • Charlotte Corday||

    She is really that stupid. She is not being dishonest. Remember she lives in a bubble. Everyone she knows and interacts with thinks exactly the way she does.

  • ||

    There is also racism.

  • The Amazing Racist||

    Bingo!

  • Killazontherun ||

  • ||

    the mandate will force you to buy more insurance than you need to cover your possible future medical needs ...
    It is all about cost shifting not compassion ...

    a tax of .0033 (3 tenths of a percent) would pay for the 43 billion of "uncompensated care" ...

    that amounts to $165 a year for someone making $50,000 or $662 for the magical rich person ($200k) ...

    seems like that would have been a much shorter bill, would have been Constitutional but most importantly would have worked ...

  • Charlotte Corday||

    For one year. But once you start paying people's medical bills for free, that figure would go up.

  • ||

    For one year. But once you start paying people's medical bills for free, that figure would go up.

    Are you paying people's medical bills or are you compensating hospitals and doctors for losses due to lack of payment?

    The incentives move around depending on who the government gives the money to.

  • Zeb||

    Yeah, if the hospitals can still try to collect on unpaid bills as they do now, you could pretty well get rid of the incentive to seek out free care.

  • Charlotte Corday||

    If hospitals know that they are going to collect any unpaid bills from the government, they won't have much incentive to keep down costs or collect bills will they?

    Paying the hospitals would create the same moral hazard. It would just take a bit longer for it to manifest itself as hospitals slowly caught onto the idea that they could charge anything they wanted because the government would make up the difference between what the patients and the insurance companies actually could pay.

  • ||

    One assumes the hospitals would have to jump through a hoop or two to prove that the person cannot pay for the health care.

    Paying the hospitals would create the same moral hazard.

    Qualitatively sure quantitatively no.

    Anyway I was only making the argument that their is a cheaper more effective left wing method of solving this problem then Obamacare.

    Obamacare has the same kind but more moral hazard then the above described solution. People will not face the costs of their own health care so they will consume as much as they want. Obamacare tries to solve this through price controls...which we all know will create scarcity.

  • Old Mexican||

    Re: JeffC,

    a tax of .0033 (3 tenths of a percent) would pay for the 43 billion of "uncompensated care"


    I don't see why $43 billion out of a trillion dollar a year industry would require a 2000 page law to address it, or even require making people buy something. Seems like the returns do not justify the effort.

    The fact is that the $43 billion of uncompensated care stems from the unintended consequence of a contract-violating law that requires emergency rooms to treat patients no matter their ability to pay, instead of leaving such decisions to their discretion. The fact that this fills emergency rooms with people with the sniffles instead of people with true emergencies does not seem to interest those that want to play Santa Claus with other people's money.

  • ||

    contract-violating law

    Not so sure about that.

    Doctors have to treat but they still send a bill...even if it is unlikely to ever be payed....of course with 3% of it not being payed it would appear that it is in fact likely to be payed.

    Seriously with only 3% in losses how is this a problem at all?!?!

    What business cannot take 3% in losses? Hell what business does not take far more then that from other government bullcrap?

  • we||

    If you truly need some edification on these matters and aren't just playing stupid for rhetorical effect, read the latest frontpiece by your fellow contributor Sheldon Richman.

    If there has ever been a more fetid, stinking, sloppy, reductionist, smug, glib, self-satisfied piece of filthy Social-Darwinist claptrap in the annals of Libertardium, I have yet to encounter it.

    So, we don't need the mandate because -we have the option of closing our emergency rooms to uninsured people who are bleeding out? In my world, people who think like that are good for exactly one thing: paying taxes at the point of a gun, and nothing else.

    If you're so dissatified with a world in which human beings act like social animals with organizational capabilities, then go set up your own little Libertopia in some Artic ice station or moonbase or undersea city. The real world belongs to the rest of us.

  • Charlotte Corday||

    We don't need the mandate because before we have charity hospitals who cover such needs for free.

    If ever there was a more fetid piece of deliberate misunderstanding and stupidity in a single post than yours, I have yet to see it.

    If you are dissatisfied in the world in which human beings operate charity hospitals and work things out for themselves, rather than at the point of a gun, why don't you go set up your own little stupidtopia in the Arctic somewhere. The real world belongs to the rest of us.

  • we||

    Where does the U.S. Constitution say that Congress, in regulating interstate commerce, has to rely exclusively on the unenforceable promise of private charity, and cannot make public provision for human necessities?

  • dave||

    You're hopelessy confused. The Constitution limits Congress to a specific few powers, and making "public provision for human necessities" is not one of them.

  • we||

    sez you.

    The language of "regulate commerce ... among the several states" has proven infinitely malleable, and the ACA is no more of a stretch than various other federal laws predicated on interstate commerce.

  • Charlotte Corday||

    The language has been misread to the point of absurdity. To believe that it means what you think it does is to believe that the framers spent months in Philadelphia crafting a delicately balanced federal system only to completely render it moot by writing a limitless commerce clause. In other words, to believe as you do is to believe ahistorical nonsense.

  • we||

    To paraphrase Spooner, the constitution has either authorized the government we have, or it has failed to prevent it. Either way, it is unfit to exist.

    Our current constitutional regime -- the Constitution as interpreted by Supreme Court precedent and as acted upon by our political branches of government -- offers no barrier to the ACA.

  • Charlotte Corday||

    So your argument boils down to "scoreboard". And of course that is just more nonsense. By your logic, the Court was wrong in deciding Brown v. Board of Education. as interpreted by Supreme Court precedent and as acted upon by our political branches of government -- offers no barrier to Segregation.

    Stop and think about what you are saying.

  • Charlotte Corday||

    And if elections are so important, then why doesn't the 2010 election, an enormous defeat for the bill's supporters count?

  • Zeb||

    "Our current constitutional regime -- the Constitution as interpreted by Supreme Court precedent and as acted upon by our political branches of government -- offers no barrier to the ACA."

    I don't think that we will know that until the court rules on this case, will we? Isn't that sort of the point of this whole exercise?

  • Zeb||

    So, in other words, the constitution can be safely ignored.

  • Charlotte Corday||

    So, in other words, the constitution can be safely ignored.

    When it supports our view.

    don't forget that Zeb. We's argument boils down to "fuck you that is why".

  • GILMORE||

    we|3.29.12 @ 2:49PM|#
    sez you.

    The language of "regulate commerce ... among the several states" has proven infinitely malleable...

    "...and therefore there is no such thing as limited government, despite the entire rest of the constitution *specifically detailing its limits*"

    See, they put in *one little clause* that invalidated the rest...

    Nice! QED!!!

  • Jeffersonian||

    The language of "regulate commerce ... among the several states" has proven infinitely malleable...

    It's only that way because of a deliberate misconstruction of that passage from 70 years ago, in direct opposition to the intent and writings of even the "big government" types who wrote the document.

    At any rate, if it's a "living document," maybe it's growing in a way you don't like.

  • ||

    "proven infinitely malleable..."

    That was never "proven."

    There have indeed been several Supreme Court rulings that greatly expanded the power of the Commerce Clause. But even so, there were also a few Supreme Court rulings that established situations when the Commerce Clause was inapplicable.

    Wikipedia has a good summary of these various cases in its article on the Commerce Clause.

    IOW, the malleability (or lack thereof) of the Commerce Clause is in Supreme Court case law. It's not like it's some kind of iron law of history or something.

    The Supremes typically defer to precedent.

    But not always--and not forever.

    You can't cite the alleged malleability of the Commerce Clause like it's some law of nature. It's just what certain groups of Supreme Court justices ruled at certain points in time.

    But as you know, the composition of the Supreme Court changes over time.

  • Charlotte Corday||

    I take that back. I now have seen a bigger fetid piece of misunderstanding and stupidity than your first post, your second one.

    The Constitution is not concerned with providing for human necessities beyond a stable government and the common defense. The Constitution was not written so you could get free health care.

    Try harder.

  • we||

    The constitution is a bundle of linguistic compromises and aambiguities stretched and twisted to serve a multitude of agendas over more than two centuries. It no more enshrines your Libertard dreamland than it enshrines my vision of social democracy. The battle is won and lost at the ballot box, and nothing elevates your preferences over anyone else's as a matter of "constitutional truth."

  • Charlotte Corday||

    The battle is won and lost at the ballot box, and nothing elevates your preferences over anyone else's as a matter of "constitutional truth."

    No. The Constitution is composed of words that have meanings. And those meanings don't change because the ballot box. If that were true, we would not need an amendment process. And the ballot box could decide that say, you had no 4th Amendment Rights, or the Senate was no longer elected by popular election.

    Again, you are preaching nonsense.

  • we||

    Funny how all of your political preferences are enshrined in the "correct" reading of the Constitution, and all of your political distates are banned by the Constitution.

    You think you should get your way without ever having to win an argument or an election. The "correct" Supreme Court would just dictate your political desires as a matter of constitutional law.

    Talk about a rampant sense of entitlement springing from a moral hazard...

  • Charlotte Corday||

    You are projecting again. The document says what it says. And when you consider the context of its writing, it is impossible to believe the drafters could have wanted it to mean that.

    I don't like the income tax. But I am not going to pretend the Constitution doesn't authorize it.

    You have yet to present one single argument why the clause should mean what you say it does beyond "I want it that way".

    Sorry, you have to do better than that. And the fact that no one on your side seems to be able to is going to spell the doom of the bill.

  • we||

    The justification has been stated ad nauseum and is irrefutable:

    - Congress has chosen to regulate the national medical insurance market as per the Bismarck model, and this fits easily under current conceptions of the Commerce Clause.

    - The Bismarck model requires an individual mandate. It is thus "necessary."

    - The individual mandate is sound under the Bill of Rights and other liberty-conserving provisions of the Constitution. It is thus "proper."

    - The individual mandate is thus "necessary and proper" to the Congress's Bismarck-type comprehensive regulation of the national medical insurance system.

    - That which is "necessary and proper" to a comprehensive regulation of a sector of interstate commerce is constitutionally valid. It does not have to have a separate, freestanding commerce-clause "jurisdictional hook" like some ersatz broccoli hypothetical.

    QED

  • Charlotte Corday||

    All of those assertions beg the question. None of them answer the underlying question of whether the Bismark model is itself a proper power under the commerce clause.

    The fact is that "regulating commerce among the states" does not mean and was not meant to mean "compel people to enter into a certain form of commerce". If it does, then there is no limit to federal power.

  • we||

    Ah, yes. "Restoring the Lost Constitution." One 5-4 vote at the SCOTUS and "POOF!" the Great Society and the New Deal are relegated to the proverbial Dustbin of History. Zombie Lochner bestrides the nation.

    Like I've said before: anything is possible.

  • Jeffersonian||

    Ah, yes. "Restoring the Lost Constitution." One 5-4 vote at the SCOTUS and "POOF!" the Great Society and the New Deal are relegated to the proverbial Dustbin of History.

    From your lips to Anthony Kennedy's ear.

  • NeonCat||

    If only that were true. If only that were true.

  • Red Rocks Rockin||

    The justification has been stated ad nauseum and is irrefutable:

    The justification is pointless if there's no way to pay for it.

    Show how this law cranks back the 9% annual cost of healthcare, and you might have an actual basis in reality to justify it from an economic perspective, if not a Constitutional one.

    Constitutionally speaking, there's no justification unless you honestly believe the Constitution allows the federal government to make you buy whatever market product it wants you to buy, irrespective of whether you want to buy it.

    Keep that in mind the next time Team Red passes a similar proposal. We'll see at that time if you end up making the same arguments.

  • we||

    Fiscal balance questions are for Congress, not SCOTUS. Period.

  • Red Rocks Rockin||

    Fiscal balance questions are for Congress, not SCOTUS. Period.

    The money to pay for the bill still has to be found. Period.

    And your Constitutional argument still has no standing. Period.

  • Zeb||

    "Funny how all of your political preferences are enshrined in the "correct" reading of the Constitution, and all of your political distates are banned by the Constitution."

    Bullshit. I can't speak for everyone, but there are plenty of things that the government has the power to do under the constitution that I don't think the government of libertopia should do. No one is claiming that the constitution is a libertarian document. It is a limited government document, so it sometimes aligns with libertarian goals, but not always.

  • ||

    It no more enshrines your Libertard dreamland than it enshrines my vision of social democracy. The battle is won and lost at the ballot box

    Gotta love the base-stealing.

  • Night Elf Mohawk||

    Where does it say that going from one part of a city to another part of a city for medical treatment is interstate commerce?

  • Old Mexican||

    Re: There is no "we",

    In my world, people who think like that


    That is, people who think based on moral principles and not expediency...

    are good for exactly one thing: paying taxes at the point of a gun, and nothing else.


    That is, only good as slaves.

    Liberal thought, in a nutshell.

  • Charlotte Corday||

    Funny how quickly the mask slips.

  • we||

    There is no mask. My contempt for you is a matter of pride that I wear on my sleeve for all to see.

  • I am we's taxpaying slave ...||

    ... who wears his pride from the shirt he ripped off my back.

  • we||

    deal with it

  • Zeb||

    Well then you are just a bad person. You think that people who disagree with you should be enslaved. I, on the other hand, think you are entitled to all the freedoms that you disdain even though you are a spiteful little prick.

  • we||

    If losing elections repeatedly and being politically marginalized is "slavery" then, yeah, I'm a regular Simon Legree.

  • Jeffersonian||

    There is no mask. My contempt for you is a matter of pride that I wear on my sleeve for all to see.

    Your contempt isn't for us, we, it's for the idea of individual liberty and personal autonomy. You see society as your own personal little hive, with you as the queen bee. It's not.

  • we||

    For better or worse, even the most confoundedly stupid retain the equal franchise, so there is no "slavery" under the American regime.

    But, in my estimate, they contribute less than nothing to the public discourse, actually subtracting from the sum of useful information by introducing white noise, and the more elections they lose, the better.

  • NeonCat||

    Yes, you still have the franchise, God help us, and God help the United States. And if you aren't Tony, he's going to be upset with you for stealing his schtick.

  • dave||

    If there has ever been a better admission that you are a despotic authoritarian autocratic thuggish tyrant, I have yet to encounter it.

    Oh, and you're "we don't need the mandate because -we have the option of closing our emergency rooms to uninsured people who are bleeding out" proves that you're stupid as well.

  • we||

    Tyranny of the majority blah blah blah...

  • Kwanzaa Cake||

    So, we don't need the mandate because -we have the option of closing our emergency rooms to uninsured people who are bleeding out?

    _____________________

    For every 1 person bleeding out in an ER, there are at least 50 there for treatment of a headache or similar routine malady. Have you actually been to an ER lately? Shockingly, once you open the door to free care, it gets abused.

    I was in the ER a year ago for a serious injury (and have insurance). While waiting I saw an obviously poor woman with absolutely no discernable injury or illness complain that other patients were being called even though she got to the ER before them. Talk about blinded by entitlement -- I'm here, I want my free shit right now. A nurse had to explain to this creature of your compassionate welfare state brainwashing the common sense of triage.

  • we||

    Mildly interesting anecdote, with exactly zero significance to the merits of the ACA.

  • Charlotte Corday||

    It has every significance. If you give people free stuff, they will take it and abuse the privilege. It is called moral hazard. The little concept liberals have been forgetting since 1789.

  • we||

    The Constitution does not ban "moral hazards," and it certainly doesn't ban government regulation of health insurance based on the Bismarck model because some dopey old hag bitches out ER personnel to the unending chagrin of Kwanzaa Cake.

  • Charlotte Corday||

    At the state level sure. But not at the federal level. The Constitution does prevent the creation of a Bismark model at the federal level.
    It is called enumerated powers.

    And beyond that, even if it was authorized, it doesn't make the idea any less stupid.

  • we||

    Zombie Lochner. "The constitution in exile." The Holy Grail of Libertard mouth-breathers.

    http://en.wikipedia.org/wiki/Constitution_in_Exile

    We'll see. After Bush v. Gore, anything is possible.

  • Charlotte Corday||

    You don't have to bring Lochner back to life to kill the mandate. You are only screaming Lochner because you have lost the argument and have nothing else to say.

    Sorry performance. Almost Mary Stack level bad.

  • we||

    I said "Zombie Lochner," not Lochner. The walking corpse of Lochner. (What we used to call the "Ghost of Lochner" before zombies were so cool with the kids.)

    Lochner was a state-law case, duh. This is federal, obviously. But your approach still requires going back to the "Lochner Era," a Gilded-Age system under which the Commerce Clause couldn't support a comprehensive regulatory regime of a sector of the national economy, and a constitutional amendment would be separately required to, say, prohibit alcohol sales.

  • Charlotte Corday||

    No it doesn't. This case doesn't even require overturning Wickard. In Wickard the guy chose to enter into commerce by growing wheat. He could have avoided the injunction by growing corn or some other crop not covered by the law. Here, everyone, even those who have enough money to self insure or for religious reasons refuse medical care are being compelled to enter commerce.

    The two cases are equally distinguishable. And overturning the mandate does not require any modification of existing law.

  • we||

    Maybe if they overturn the individual mandate and nothing else. But if they overturn the mandate and the provisions it supports, or the whole law, then they are saying Congress can't regulate interstate commerce in a way that would require an individual mandate on any purchase, however necessary or proper the mandate is in the context of the larger regulation, however vital and universal the item in question.

    That would be Lochner on steriods.

  • Charlotte Corday||

    You overturn the entire law because Congress specifically removed the severability clause as a political compromise. It is not that the other sections are unconstitutional. It is that the unconstitutional parts cannot be severed from the constitutional one.

    You don't need Lockner on steroids.

  • we||

    "Congress specifically removed the severability clause as a political compromise."

    ****

    Too bad Scalia doesn't believe in looking at legislative history...

  • Gilbert Martin||

    I don't know you waste your time on "we".

    He/she is a pseudointellectual bluffer with nothing to back it up.

  • Jeffersonian||

    It only permits federal regulation (and even the definition of that word has been perverted by the Left) of commerce "among the several states," not within states or at the personal level.

    Since the power was conferred in the same breath as that to regulate commerce with foreign powers, logically Congress can thereby micromanage the internal economic affairs of Thailand, Zaire or India, no?

  • Red Rocks Rockin||

    If you're so dissatified with a world in which human beings act like social animals with organizational capabilities, then go set up your own little Libertopia in some Artic ice station or moonbase or undersea city. The real world belongs to the rest of us.

    Repeated for your edification:

    Federal spending on medical expenses, 1980: $55 billion

    2011: $800 billion

    At a continued 9% annual increase in that time frame, costs will rise to $1.6 trillion in eight years and $3.2 trillion in 16 years.

    Basic math > we

  • we||

    Fiscal balance is for Congress, not the SCOTUS.

  • Red Rocks Rockin||

    Fiscal balance is for Congress, not the SCOTUS.

    And it was passed by Congress without taking that fiscal balance into account.

    I realize this whole issue of "money" intrudes on your little Smurf-village fantasy, but in the real world, these things do have actual consequences.

  • ||

    You do understand that the solicitor general's argument is essentially "we can break the constitution because we think it balance the budget" right?

  • ||

    There's this place called Europe where they live the way you would like. Why don't you move there instead of trying to turn us into them?

  • we||

    Because I'm just as much an American as anybody else and I can vote the way I want.

  • Red Rocks Rockin||

    Because I'm just as much an American as anybody else and I can vote the way I want.

    A stance that invalidates your entire "the federal government can make me buy whatever it wants me to buy" line of reasoning.

  • ||

    But it is illogical to fight against people like us when there is a system already set up that caters to your very belief system.

  • Ben the Duck||

    In my world

    i.e., "basement."

  • ||

    the total amount of uncompensated care provided in America currently adds up to only $40.7 billion annually or about 3 percent of our total health care spending

    WTF?!?!

    So the US could just charge a 3% tax on health care spending to cover this crap??

    How does having a brain = having no compassion?

  • ||

    The question answers itself.

    Like any other good or service, provided for "free" demand always outstrips supply.

    No amount of Federal tax on healthcare is going to alter this one iota. It would just drive up costs of existing healthcare,

  • Zeb||

    That's only true if the money goes to "free" care rather than reimbursing hospitals for people who don't pay their bills. As long as hospitals can still bill people for what they owe, I don't see how this would create an extra incentive for people to drop insurance coverage. The people who can't afford their bills are not the ones who woudl receive the payments.

  • ||

    No amount of Federal tax on healthcare is going to alter this one iota. It would just drive up costs of existing healthcare,

    Obamacare has the same problem..ie the moral hazard of free health care. It then adds-in price controls which will create scarcity...which in turn will amplify the problem even further.

    My devils advocate solution has less of the same problem that Obamacare has...ie it "solves" more cheaply.

    Anyway the real solution is to remove the problem created by the government in the first place and get poeple to pay for their own health care costs so as to bring prices down.

    My 3% tax solution was obviously a WTF juxtaposition with Obamacare.

    They wrote 2700 pages of bullshit instead of using a more straight forward leftwing solution. ie make a tax then spend it on the service they want to provide.

  • ||

    "But why is forcing someone to buy a product against their wishes on the threat of fines or jail compassionate?"

    Because their compassion is limited to those who need something and not extended to those who are forced to provide it.

  • ||

    >>Why is it obvious that, absent a legal requirement, doctors would offer any less free care than lawyers?

    Begging the question of why highly trained professionals should be compelled to to offer ANY of their services "for free" (IE why not plumbers or pilots?), in fact, back in the "good old days" before the Federal gov't left its slime all over healthcare, physicians routinely provided a certain proportion of their work to free clinics and other unpaid charity care.

    Not only was this the norm for MDs, but memberships in various physician organizations required this service.

    Incidentally, as it stands now, except for the smallest number of pure "fee for service" physicians like plastic surgeons, I find it hard to believe that any physicians anywhere are getting "only" 3% of their billing not reimbursed.

    In my practice, the "actual" number is probably closer to 30%.

  • ||

    In my practice, the "actual" number is probably closer to 30%.

    If you are guessing 30% and not knowing the exact number I am guessing either you do not have a practice or you are a terrible manager of it.

  • ||

    IE why not plumbers or pilots?

    I don't know about pilots but I am sure plumbers and other contract workers easily loose 3% in unpayed work every year.

  • Angel Network||

    Does charity flights.

  • ||

    I'm looking forward to the Left bleating about judicial activism after this case goes down, and the Right trying to pretend that this is somehow different from all the times they bleated "judicial activism" when the Court struck down some unconstitutional law they liked.

  • Night Elf Mohawk||

    Yes, finding new things for the government to control in a document meant to limit that government is exactly the same as striking down something that goes beyond those limits.

  • ||

    Not what I was referring to. I'm saying the right wing likewise find plenty of things for government to control not found in that document, and also write many laws completely contradictory to the rights protected in the Constitution. Then when the court knocks those laws down, they cry about "judicial activism".

    For instance, Rasul v. Bush, which knocked down the conservatives' claims that Guantanamo detainees have no right to habeas corpus. And undoubtedly, the day the SC knocks down drug prohibition laws as unconstitutional (haha, yeah right), the Conservatives will claim fake constitutional rights for government they won't claim when talking about, say, broccoli or lightbulbs.

  • ||

    I think he was referring to things like the Drug War, which is patently unconstitutional.

  • ||

    You missed the 5th point:

    The supreme court cannot base its decisions on compassion. It has to base its decisions on the rule of law.

    Perhaps Lithwick wishes the supreme court to be a court of compassion rather then a court of law.

  • Ghost of Leo Buscaglia||

    I'm still hoping for that SCOTUS appointment!

  • Tom||

    Really disappointed in the article and the comments. Got a point to make? How about rising above petty sarcasm for a minute? Stop competing with Rush and Glenn and start making your arguments respectably and respectfully. (And before you say "they started it" -- no one is saying they didn't. We can all grow up together.)

  • Charlotte Corday||

    I am really disappointed that you apparently are not intelligent enough to understand the points made in this comment thread.

    But, if you are so stupid or deliberately misinformed that you think the people on this board listen to Rush and Glenn, whoever they are, you probably lack the basic intelligence necessary to understand the arguments anyway.

  • Tom||

    I never said I didn't understand the points. I said I was disappointed in the tone.

    I have a political science background and am quite capable of processing multiple points of view. And it's worth noting that I never claimed to disagree with the points made.

    I'm also not saying you listen to Rush and Glenn. I'm sure you don't. But the tone -- the smug, self-satisfied, "I'm right and everyone else is an idiot" tone -- in this article and its comments is very similar to what you hear on talk radio.

    So if I'm looking for a rational and reasonable exchange of opinions, does that make me "stupid or misinformed"?

    Boy I hope not.

  • Charlotte Corday||

    I think there were plenty of reasonable exchanges above. A lot of snark. But no more than any other internet board.

  • ||

    I wasn't aware they debated Aristotlean ethics and negative liberties on talk radio.

    Moreover, she was responding to claims that were either woefully inaccurate interpretations of (at least one segment of) Obamacare opposition - which she should have no excuse for if she is as smart as she thinks she is, or willfully fallacious strawman arguments misrepresenting her political opponents.

    The "libertarians and conservatives want the poor to die in the streets" meme is virtually impossible to answer respectfully, as she was obviously intending to provoke an emotional flamewar.

  • ||

    The "libertarians and conservatives want the poor to die in the streets" meme is virtually impossible to answer respectfully, as she was obviously intending to provoke an emotional flamewar.

    +100

  • ||

    I said I was disappointed in the tone.

    lol

    Tom meet the internet, internet meet Tom.

    I am kind of surprised you two have not met already.

  • ||

    I have a political science background

    Translation: "I have no marketable skills, and so I spend my copious free time concern-trolling libertarian websites."

  • Ed Schultz||

    Fuck you, Tom!

  • ||

    ???

    I don't really see anything Shikha posted that stooped to Rush level disrespect. She made our valid argument that negative freedom and compassion are not contradictory, that Obamacare's means are not as compassionate as its (intended) outcomes, and that the pre-Obamacare system, as bad as it was, was likely more "progressive" than Obamacare, by putting costs for the uninsured on the wealthy insurance and health providers.

    And frankly, responding to someone hyperbolically claiming Obamacare opponents would rather let poor people "bleed out on the curb," sorry - you can't expect a completely cordial reaction.

    And if you don't expect dripping sarcasm from both the writers and commentariat at Reason, you obviously don't know this place very well.

  • Tom||

    I hate hyperbole regardless of origin and think sarcasm limits thoughtful interaction.

    But to each their own. Your point is taken, this is Reason's style and it attracts an audience for a reason. I enjoy some of the pieces but others just seem a bit over the top.

    Just bemoaning the tone of politics today, I suppose.

  • ||

    If I levy unsubstantiated charges that you are a Nazi sympathizer and want to gas all Jews, how can I expect you to respond with a calm/collected and/or serious demeanor? You'd probably either scream back at us calling us names, or you'd laugh it off with sarcasm. Why waste our time laying out every possible intellectual and personal argument about how we DON'T want the poor to die out on the streets - for someone who obviously doesn't care what we really think?

    I actually thought Shikha responded fairly substantially. To many non-libertarian pundits, we're automatically stupid, cruel, out of touch with reality, or all of the above because we don't support technocratic government programs.

    I thing "regardless of origin" is your problem. Target the person levying the initial volley of hyperbole before blaming us for responding in kind.

  • ||

    Dude, no offense, but get off your high horse.

    The tone of politics today is exactly the same way it's been for at least the last 200+ years (probably all of human history, but that's besides the point).

    http://reason.com/blog/2010/10.....circa-1800

  • Jeffersonian||

    He's lost the game, so he's working the refs.

  • ||

    probably all of human history, but that's besides the point

    I think I prefer the metaphorical jabs of today's political debate then i would the real tip of the spear jabs of past political debate.

  • ||

    Hmmm. Good point.

  • ||

    I hate hyperbole regardless of origin and think sarcasm limits thoughtful interaction.

    As a huge fan of hyperbole and sarcasm I say, without hyperbole or sarcasm and complete sincerity, that you are an asshole.

  • The not-pompous Tom||

    There's nothing petty about my sarcasm you patronizing snob!

  • GILMORE||

    Tom|3.29.12 @ 2:41PM|#
    Really disappointed in the article and the comments.

    Dissapoint /= Legality of Obamacare

    Have a nice day! (smooch)

  • Ben the Duck||

    Really disappointed in the article and the comments.

    Clutch those pearls just a little bit harder, next time out, and you won't have to fret over being "disappointed" about anything, ever again.

    Hint, hint.

  • Rick San Francisco||

    Really, you don't have to even qualify your critique of Lithwick's poor reasoning, faulty logic, appeal to sentiment and navel gazing with a nod to her usually "pro-civil liberties stance."

    She wasn't that great of a legal reasoner anyways, and now she's been promoted at Slate to Queen of progressive partisan hackery.

    It's only worth your time in that she wields cultural power given the current political landscape. Hopefully, she'll be forgotten soon.

  • Charlotte Corday||

    She was hired to be a hack. She has no legal background beyond going to Stanford and working for her father's law firm for a couple of years. When you think of all of the hundreds of Con Law professors and burned out lawyers who practice before the court who would love to have a gig as a reporter covering the court, you have to conclude she was hired for one reason, to be a complete dishonest partisan hack.

  • submandave||

    "freedom from our obligations to one another"

    Ummm, in which article of the Constitution is that "obligation" specified? Hey, I'm all for assisting those who need it, and helping to take care of those in trouble, but this is America, and everyone has a right to be a skinflint a-hole, if they want.

  • hmm...||

    minor point, but i find it irksome when libertarians offer tax incentives as a better policy alternative to penalties. the use of tax policy to shape behavior implies the need for a very thorough and comprehensive tax system. and as wednesday's medicaid argument demonstrated, sometimes people complain that incentives if too effective are themselves coercive.

  • GILMORE||

    hmm...|3.29.12 @ 3:14PM|#
    minor point, but i find it irksome when libertarians offer tax incentives as a better policy alternative to penalties.

    Is it OK to also say, "Better is Not *Good*", but just Better?

    There's nothing wrong with pointing out that one is superior to the other despite both being unsatisfactory in essence. Arguing otherwize is sort of assuming, "utopia, or nothing!"

    Then again, that's exactly what this @#*(&$ Litwick argues 'conservaties' think =

    “There is government compulsion in almost every economic decision because the government regulates so much. It's a condition of life.” But one gets the sense that not everyone acknowledges the reality of that life, much less approves of it

    i.e.

    "We have government! Governments DO stuff!! Get over it!!"

  • hmm...||

    you pose your objection in practical terms, but creating an effective system of incentives as an alternative the existing one would seem like a lot of effort for only a slightly less turdy crap sandwich.

    and then of course there will be problems if the incentives ever become too incentivizing.

  • GILMORE||

    Comment #1 from the piece =

    larry_author

    The essence of civilized society is that we give up certain freedoms to obtain the protections and benfits of government. ...

    Ahh, the wonderful, wonderful 'Benfits'. [snif]

    I think the key point is that progressive liberals don't really care what exactly the "Certain" means. "We said 'certain'!! Which means whatever!! You don't like it, you are uncompassionate!!"

  • hmm...||

    also wanted to make a point about comparing big law firm probono time to medical volunteerism. i suspect big law firms would tell you that the value of the services they are providing pro bono is equivalent to the value of their billable rate. yet a lawyer who would ordinarily provide low end services for a fee would charge far, far less than what, say, a securities lawyer charges for that sort of work. this leads to a vast overstatement of the aggregate value of these pro bono services.

    the point is that because people want to appear more charitable than they actually are, self-reported estimates are not very provative of whether charity is a viable way to effectively provide necessary services.

  • shrike||

    Behindertsein ist schön

  • ||

    "Liberals insist that the individual mandate forcing everyone to buy coverage is necessary to prevent freeloaders from saddling everyone else with the cost of their emergency care."

    Actually, I think it's: Liberals insist that the individual mandate forcing everyone to buy coverage is necessary to ALLOW freeloaders to saddle everyone else with the cost of their health care.

    Isn't the whole point of the mandate to make healthy people pay for the health care of unhealthy people?

  • GILMORE||

    Progressive liberals, whenever getting *owned* in a straightforward, logical argument, invariably accuse their opponent of being, "smug, juvenile, sarcastic, biased, *racist*, mean, unsympathetic, 'resorting to 'unfair' tactics, of puerile use of insults, and basically unfit for further 'reasoned' (DRINK) debate, because the other person is simply "in denial of REALITY(tm)*"

    [*"REALITY" = the fantasy world in which all progressive arguments hold water]

    Meaning, they immediately go ad hominem, then stomp off and refuse to carry on, all the while pretending its their "opponent" who caused it... not their ridiculous "hissy fit"

    Sound familiar(anyone who's ever had a girlfriend)?...

    (OMG!SEXIST!!!)!!!!!

    And this, this from people who spent most of the last few years calling people who want lower taxes and limited government, "Teabagging racists"

    Yeah, *we're* the juvenile ones

  • Charlotte Corday||

    The live in a cocoon where every right thinking person agrees with them. And only the defective do not agree. To make an argument you have to understand the counter argument.

  • Clara Madison||

    Great post.

    I'm only surprised she didn't bring up "the children."

    She makes me wish I was living in 1804.

  • Charlotte Corday||

    Clara,

    Your blog is really good. I wish you had come here before. And I hope you come here often.

  • GILMORE||

    Clara Madison|3.29.12 @ 4:13PM|#
    Great post.

    I'm only surprised she didn't bring up "the children."

    I thought she said that evil conservatives want them all to die of smallpox because no one will pay for their vaccines.

  • Libertarian Toff||

    But if all the little moppets die of smallpox, who will mop my floors and prepare my truffles?

  • NeonCat||

    You forgot to add monocle-polishing. You can't be a real Hit n Runner until you put in the monocle-polishing part.

  • ||

    Everybody seems to have missed this little tidbit from Lithwick's article:

    The analogy of taxing carriages probably makes perfect sense to the court’s conservatives, who likened GPS devices to tiny constables in this year’s GPS case. We seem to be talking across the centuries once again in this room, and the days of leeches are looking pretty darn dreamy for some.

    WTF? She didn't like the decision forbidding GPS tracking without a warrant either? She epitomizes the new breed of authoritarian liberal I've spoken about before.

  • ||

    And yes, she is talking about the majority opinion which Scalia wrote and which Kagan, Breyer, and Ginsburg opposed.

  • ||

    I'm sure I will have the freedom to buy Health Insurance from Solyndra if the mandate is upheld.

  • ||

    Once we are mandated to enter a contract, it won't be long before the vendor is mandated as well.

  • ||

    You have a good point. Many critics of the British NHS accuse it being a middle class welfare... when you peal away the talkingpoints.

    Also; they don’t really care about medical care here. It is about power and control. I have a chronic disease and when I bring up that my special pacemaker (that has helped me lead a more normal life) is typically not covered by ‘public’ European health care systems I’ve never had a ‘liberal’ bat an eye lash before saying something like ‘if the science doesn’t support using them’ and moving on. Science can’t dictate morality btw… that aside, health studies for some medical devices and drugs tend to always have poor results because the people chosen to be included with them are almost all over 60.

  • ||

    So what would the libertarian approach (it seems like most commenters here would identify as libertarian) to health care look like? And please don't interpret this as a snarky "Oh yeah?? Well what would YOU do, Mr. smarty-pants!?" question. I'm just curious what the ideal libertarian health care system looks like.

  • Double D||

    Ummmm...that's a dumb question. There is no "ideal libertarian health care system."
    There is however, a market. In it, goods such as health care or insurance can be paid for by individuals. They may make poor choices or decide not to purchase at all. The consequences of that are theirs' to suffer, just as they get to reap the benefits when their choices are good.
    For those to poor to participate in this newfangled "market" there could be charities and free clinics.

  • ||

    I kind of like Singapore's solution (this isn't entirely libertarian...) where they basically have a forced withdrawal from your income directly into a health savings account which we could operate like social security except instead of the pyramid-scheme-like pay-as-you-go the money actually goes into bank accounts that individuals OWN.

    One of the main reasons that the health care markets in the United States are so fucked up is because we insure for EVERYTHING, even routine care (hence the retarded debate about "insuring" for inexpensive birth control medicines). No one gives a shit how much anything costs and health care providers just play a game with insurance companies to try and get as much reimbursement as possible (costs which are then just passed on to employers, who pass it on the employees).

  • ||

    The thing I find infuriating about the $40.7B number is that it is LESS than what the government spends in fraudulent medicare payments every year. So if we wanted to reduce the amount of money we spend on "medical care" we would have been better off figuring out a way to reduce the FRAUD inherent in government provided care.

  • lightbulb thoughtbubble||

    maybe we could give medicare fraudsters tax incentives for not defrauding medicare!

    and maybe you're completely right here, but you're saying that outright fraud, i.e. intentionally deceiving the federal government for the purpose of stealing money, is directly responsible for over three percent of the total costs of healthcare?

  • ||

    This, in my opinion isn't about liberal or conservative - it's about resort to state coercion versus free market and charity.

    Much of the debate over at slate appears to be ad hominems against anyone who doesn't believe that the commerce clause, {in light of the 9th, 10th and the government our Constitution actually arranged, etc.} necessarily, let alone 'properly' contains a power to compel private purchases.

  • ||

    The mandate isn't the regulation of commerce - it's a mandate on private action designed to assist in the regulation of commerce.

    The truth is, you can cobble together an argument for why it "is" Constititional, and the tension is between a default to giving more and more power to the federal government, and an increasing pushback against Wickard's progeny.

    From what I can see, there's been no serious worry on the left about what limiting principle there is. They say, the broccolli example is silly - but then, so, I would think is the idea that their Dem president would expand warrantless wiretapping and indefinite detention and execution without trial... and most of them are not in the streets marching like they'd be if it were a "right winger."

  • ||

    And of course, it's one thing to disagree with X which doesn't involve forcing others to do as you like, and wanting it, which forces those who disagree to go along. Progressives care less and less about anything but their morally solipsistic cryptofascist desire to order the world as they think best - your control over your life, liberty and property be damned.

    As to morals... Aristotle might also have noted, in this vein, that Progressives, through their statism, engage in a kind of morality by proxy {let's start saying "proxy moralism" maybe} -- - - they don't actually have to love their neighbor, perform charity, or the like... all they have to do to be better than those awful "right wingers" is favor government coercion of everyone.

  • ||

    It's a neat trick - they are morally superior beings not for the assistance they provide the less fortunate, but for feeling strongly about using government to force everyone to follow their scheme.

    Progressives and Neo-Conservatives vary mainly in which set of my rights and privileges they'd like to expunge via judicial fiat.

  • ||

    I want the government to force kagan to buy clothes at victoria's secret

  • Clara Madison||

    Liberals have a very hard time understanding the concept of freedom that this country was founded upon.

    The more power one gives to the government, the worse the people will be off.

    I grew up in a socialist country, and I know from experience what it's like!

    Today's "progressives" seem to have a very short historical memory...

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