Tuesday, November 10, 2009

Think Twice

This isn't, I hope, a political blog. I didn't really set out with an agenda in mind, other than replacing the hole in my online life that the demise of the "political" message board left. What I wanted to do was to write, at whatever length I thought was warranted, about the ideas and principles that I think ought to underlie the way people live their lives in community with each other. I don't want to write knowingly about what's likely to happen in workaday electoral politics; I have no reason to think I know what's likely to happen, nor do I have much interest in such. I want to write about how things should be, not how things are. I have a grown daughter who's playfully impatient with me about this; she likes to ask me how things are this week in Candyland. Well, so be it; the TV cable, and the remnants of the papers, and the internets are full of clever folks who give the play-by-play in the elephant-donkey trivia contest.

All of which is by way of noting that the "health-care reform" bill that just cleared the House of Representatives seems unlikely to make it through the Senate. And, on balance, that seems like a moderately good thing to me. Apart from the minor matter of being constitutionally impermissible, it represents a gun held to the heads of people who can't afford health insurance, along with a growled command to go and buy some health insurance. And yes, it has a "public option," whereby our notorious drunken-sailor-with-bottomless-pockets government becomes a competitor to the wicked private insurers; however, it seems unlikely to emerge from the Senate so equipped, if it emerges at all. Since the thing passed the House by a skinny margin, you have to wonder if a Senate-acceptable version wouldn't lose enough House support to doom it. As I say, I claim no expertise in these matters, and maybe a bill of some sort will pass. But I'm pretty much thinking not.

Before we go find a tea party at which to celebrate, though, consider: does the current "system" deserve any enthusiasm? Under it, people with good jobs get to go to the doctor, and those who don't, don't; they get to do without, or go to an emergency room and receive not-very-appropriate care at great cost to everyone. Under the current system, routine medical services are covered by insurance. As I read somewhere (don't remember where, just now), if homeowner's insurance worked this way, you wouldn't buy a replacement for a burned-out light bulb -- you'd file a claim. And far from being an exemplar of the glories of the free market, current arrangements seem to be as distorted and crabbed a market, with as high a set of barriers to entry, as one could imagine -- except for what may yet be coming from the people who brought you the Tuskegee syphilis experiments, COINTELPRO, and Abu Ghraib. Still, under current arrangements, we're spending one-seventh of GDP on such matters (actually, we were in 1997 -- it's very likely more now).

What we have now is long-term unsustainable, although it can always be made even worse, and that is why I consider a failure of the House-passed bill to be a moderately good thing. Still, things must, and will, change. Perhaps the situation will resolve itself in the context of a general economic collapse -- which also seems like an inevitability. Instead of playing the red-jerseys-and-blue-jerseys football game, though, maybe we should be thinking about how the poor man's family can get some basic doctoring, without putting a gun to anyone's head and taking a big chunk of their earnings away from them.


Harl Delos said...

We currently hold a gun to the head of people who can't afford auto insurance, and tell them they have to buy.

How is "driving your car into mine" any different than "sneezing on me and giving me a potentially fatal illness"?

Should we be repealing mandatory auto insurance laws as constitutionally impermissible?

Anonymous said...

maybe we should be thinking about how the poor man's family can get some basic doctoring, without putting a gun to anyone's head and taking a big chunk of their earnings away from them.

I think, as Christians, the first step would be to quit looking to the government for answers.

The second might be to look to the church: not to build more buildings or inflate clergy salaries, but to actually tend to the poor - voluntarily.

Jim Wetzel said...

To Harl: I think the two cases are not so parallel as you might think. You're required to buy liability insurance only if you want to register a car. You may be required to buy so-called "health insurance" as a condition of ... well, breathing, I suppose. Existing. Sticking gravitationally to Planet Earth, or at least the U.S. part thereof.

And, in any case, the fact that one wrong thing is done does not seem to me to be a very good justification for doing a second wrong thing. I don't think there is a federal law mandating auto insurance; I suspect those are state laws, and as such, they may or may not be permissible under the constitutions of the several states. However, the feds are contemplating forcing people to buy health insurance, and such action should (SHOULD, I say) have to square with the U.S. constitution, in which I see no text authorizing such activity -- the lack of which renders it constitutionally impermissible.

To akaGaGa: I agree about the first step. I agree about the second step. And I suspect I'll agree about the third, whenever it may be stated.

Anonymous said...

umm ... a third? I thought I was done.

Well, as I have to think about this some more, I'd say let local churches partner up with the local medical community to help local people, and let God be our insurance.

Does this count, or am I missing a big point here?

Harl Delos said...

We mandate the purchase of insurance in the form of Social Security and Medicare. In 1937, the SCOTUS found in Helvering v. Davis that it was constitutionally permissible under the "general welfare" clause, and that Congress gets to decides what is "general" versus "particular" welfare, unless it is plainly arbitrary.

The new law does not mandate the purchase of insurance, however. You can opt out if you are exempt, or you can opt out by paying an income tax (2.5% of MAGI), not to exceed the average cost of insurance.

Those who are already exempt from Social Security and Medicare for religious reasons are exempt from paying that tax. So are those who live in US possessions or outside the US entirely.

And obviously if you don't have enough income to tax, there's no tax to pay.

State laws have to conform to the US Constitution. It's just that state laws need to conform to their own state's constitution as well.

I suggest you google the Helvering v. Davis decision. It's interesting reading, if a bit long.

Anonymous said...

@Harl The new law does not mandate the purchase of insurance

It does, however, mandate that employers pay a large percentage of the insurance to cover their employees or pay the 2% tax.

Ultimately, because the government will be able to undersell private insurance companies, the only option available will be the government-paid-and-controlled insurance.

Read more here: http://tinyurl.com/y9b2lau

And, yes, we should be repealing mandatory auto insurance, which can be more costly than the car itself. The net effect is that people in rural areas - where a car is a necessity to work - simply can't afford to work, and thus wind up on the welfare rolls.

Jim Wetzel said...

Harl: if Medicare and Social Security can be describes as "insurance," so can protection paid to your local mafia family. In fact, it seems to me that the parallels between the gummint and other forms of organized crime are numerous and profound.

And I really don't much care what the Supremes had to say in '37 concerning the "general welfare" clause. The USSR had a judiciary, and a constitution, too, as far as that goes. I doubt they found any problems with Stalin's purges of the '30s. Our modern Supremes certainly haven't inconvenienced our supervisors when they've decided to sort-of-secretly ingest the entire internet, plus any email and phone calls they find interesting. The weasel words of pseudo-justification ... what do they signify? Only that our rulers do what they do -- because they can. No other reason is required.