Obamacare Going Down?

[rvg]

So this is an issue of federal power rather than about the individual freedom vs general government interference? It's fine for Massachuetts to mandate you to buy brocoli but not for the federal government? (That's not a rhetorical question.)

Legally there is nothing preventing the individual states from following the example of Massachusetts. Still this measure has little more than a snowball's chance in hell of passing in any red state and most blue states for that matter.

[Lemur]

So this is an issue of federal power rather than about the individual freedom vs general government interference? It's fine for Massachuetts to mandate you to buy brocoli but not for the federal government? (That's not a rhetorical question.)

Your example is silly, but not incorrect. The Federal Guvmint has certain powers reserved for it in the constitution (power to declare war, power to sign treaties, etc.), and the tenth amendment says that any powers not specifically ascribed to the Feds are reserved for the states and the people. There are no boundaries or limits put on state power, except that it cannot usurp or replace Federal powers (and "people" power is supposed to be just as potent, although we tend to overlook that clause).

So there are all sorts of things a state can legally do which the Feds cannot. Claro?

-edit-

More thoughts on the implications:

I think conservatives have an idea that, if they fight hard enough on this issue, liberals will get tired and move on to something else. You see that in knocks against the president for spending so much time on health care in 2009 and 2010. But liberals see universal health coverage as the crown jewel in a completed social safety net, one that was well worth spending time and political capital on. This isn’t an issue they’re likely to go quietly on—which is why they’ve gotten some sort of universal coverage enacted in every other wealthy country.

Conservatives also often say they favor universal coverage. But the only ways to achieve universal coverage are to give coverage to everyone, which costs money, or induce everyone to buy it, which also costs money. Republicans haven’t been able to coalesce behind a workable and enactable plan for universal coverage, probably because any such plan would cost a lot of money.

Strike down Obamacare, and only the Left will have a viable plan for universal coverage, and it will be one even less palatable to conservatives than the one that was enacted in 2010. Absent another viable proposal, they will eventually get their way, and Medicare For All will become a reality.

And furthermore:

What we have here is an attempt at a middle way on healthcare: universal coverage within a private system that bars discrimination based on pre-existing conditions. If that cannot be done constitutionally with a private-public partnership, and cannot be done at all with an entirely private market, then ... we logically end up with single payer.

Which would be quite a resolution, wouldn't it?

[HoreTore]

The declaration of human rights is all fine and dandy, but who voted for it? I'd prefer it was democratic before it trumps any and all constitutions.

Who voted for it? Assuming you are over 18, you did.

Membership in the UN means accepting that the human rights trumps any of your own laws. Any country is of course free to leave the UN, and since the US is a democracy, you are of course free to start a "leave the UN"-party.

[rvg]

Membership in the UN means accepting that the human rights trumps any of your own laws.

Says who?

[gaelic cowboy]

Says who?

America does every time they use UN rules to invade a place or pressure say the government of Myanmar or put sanctions on Iran the list goes on and on.

[rvg]

America does every time they use UN rules to invade a place.

Your statement begs the question. Give me an example.

[gaelic cowboy]

Your statement begs the question. Give me an example.

Do I really need to google every resolution for proof or can we just leave it at Iraq 2003

[rvg]

Do I really need to google every resolution for proof or can we just leave it at Iraq 2003

And how exactly is the invasion of Iraq tied to the U.N. declaration of human rights?

[Lemur]

Oh you two, get a room! gaelic is suggesting that by requesting, voting for and acting on UN resolutions we are implicitly accepting UN supra-national authority, a debatable point. rvg is saying "nuh-uh."

[HoreTore]

Says who?

Not sure which part you ask about, so I'll answer both:

Who decides that being a member in the UN means accepting he UNHCR? The UN does. If you don't sccept, you can't be a member.

Who decides that the UNHCR is above any other law? The UNHCR does. The preamble, article 2 and article 30 says where, when and to whom it applies.

[HoreTore]

Oh you two, get a room! gaelic is suggesting that by requesting, voting for and acting on UN resolutions we are implicitly accepting UN supra-national authority, a debatable point. rvg is saying "nuh-uh."

No, you accepted UN supra-national authority when you decided to become a member.

[Lemur]

No, you accepted UN supra-national authority when you decided to become a member.

As I said, that's a highly debatable perspective. Deserves its own thread, really.

[HoreTore]

As I said, that's a highly debatable perspective. Deserves its own thread, really.

It most certainly is not. And its not a perspective, those are the rules for being admitted to the UN.

[rvg]

Not sure which part you ask about, so I'll answer both:

Who decides that being a member in the UN means accepting he UNHCR? The UN does. If you don't sccept, you can't be a member.

Who decides that the UNHCR is above any other law? The UNHCR does. The preamble, article 2 and article 30 says where, when and to whom it applies.

Interesting... Let's take a look at the point #7 of the Article 2, Chapter 1:

Nothing contained in the present Charter shall authorize the United Nations to intervene in matters which are essentially within the domestic jurisdiction of any state or shall require the Members to submit such matters to settlement under the present Charter; but this principle shall not prejudice the application of enforcement measures under Chapter Vll.[1]

i.e. it's none of the UN's damn business.

[HoreTore]

Interesting... Let's take a look at the point #7 of the Article 2, Chapter 1:



i.e. it's none of the UN's damn business.

I see little future for you as a lawyer.

Edit: nor do I see a future for myself as alanguage teacher, but I already knew that. Where the abbreviation "unhcr" came from, I will never know. I was, of course, referring to the declaration of human rights, UDHR. I may have been thinking "un human rights commission" or something, but I blame it on the coke.

[rvg]

I see little future for you as a lawyer.

Rest easy, I'm not a lawyer. Nonetheless, my point stands.

[HoreTore]

Rest easy, I'm not a lawyer. Nonetheless, my point stands.

If your point stands, I suggest you visit China's embassy. I'm quite sure they're interested in knowing how to argue that the human rights does not apply to them. Should earn a living on that.

[drone]

Some way up, someone claimed that health care is not a right. I direct you to the declaration of human rights, article 25:

http://www.un.org/en/documents/udhr/index.shtml#a25

Healthcare IS a right. And the declaration of human rights stands above any and all constitutions, period.

Looks at entire list of universal human rights. Looks at membership list of UN. Goes into full Tribesman mode.

[rvg]

If your point stands, I suggest you visit China's embassy. I'm quite sure they're interested in knowing how to argue that the human rights does not apply to them. Should earn a living on that.

Would you be so kind as to point to any U.N. resolution condemning China's human rights record?

[Productivity]

I think that's a bit of a stretch to apply it so.... Actually, I think the founding fathers would be spinning in their graves if they knew how the clause was being abused.

I agree, that it's a stretch. It's an interstate commerce clause to regulate general commerce, not a specific tool to surgically enforce bits of policy. However, if it couldn't be used in the way it is, the founding fathers would probably be equally spinning in their grave that a rich, developed and democratic nation doesn't have the policy framework to address real issues (be it healthcare or others).

[HoreTore]

Would you be so kind as to point to any U.N. resolution condemning China's human rights record?

Why would that matter?

Does speed limits only apply when I'm caught and punished?

And China is, of course, a veto-member. But they're always on the look-out for ways to improve their propaganda.

Edit: the policy towards african-americans in the 50's was of course a gross violation of their human rights. And of course the human rights applied even though there was no condemnation from the UN about it.

[rvg]

Why would that matter?

Because there are rules and rules matter. If one rule doesn't matter, then why follow any of them?

[HoreTore]

Because there are rules and rules matter. If one rule doesn't matter, then why follow any of them?

Enforcement of the human rights is of course a sketchy matter, and in the case of the non-eu veto-members, next to impossible.

[rvg]

Enforcement of the human rights is of course a sketchy matter, and in the case of the non-eu veto-members, next to impossible.

Which leaves persuasion by individual countries on one-to-one basis, which is what the U.S. does. Not in any official U.N. capacity of course. Anyhow, the point being, we can use the U.N. Human Rights Declaration as toilet paper and still be compliant with the UN regulations. The declaration doesn't say anything specific about healthcare either, but that's beside the point and largely irrelevant even if there was something in it.

[Lemur]

As I stated earlier in the thread, I think talk of "rights" serves only to confuse the issue. Much more logical to approach this from a "common good" or "common harm" perspective. Here's a very good essay on why this is the case:

In my previous column, I briefly discussed John Stuart Mill and the harm principle as a way for Democrats and liberals to justify the idea of the individual mandate. [...] [I]n Mill’s words: “The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.” Get that. The only purpose. That is, our natural wills guide us toward being left alone, not being part of community. And that’s just fine—until our actions harm others. Then, governmental power is justified. [...]

Millions of people in this system don’t pay insurance premiums. They are bringing direct and obvious harm to the many more millions who do pay premiums. They make our premiums higher. When they get in a car wreck or have a stroke, they’re amassing medical bills that they can’t possibly pay. The rest of us pay for them.

And that is why the harm principle applies here. The government, under Mill’s definition, has the right and duty to step in to prevent harm to others—by making the free-riders pay. It’s exactly a Millian case of harm to others. And just as it explains why the mandate is valid in this case, it also explains why this kind of government action is limited to health care and can’t be extended to the purchase of broccoli or Chevy Volts or funeral plans or whatever else the conservative justices came up with Tuesday. If you don’t eat broccoli, you cause me no harm. Some would say, well, you increase your odds of colon cancer if you don’t eat broccoli, you might harm me if you don’t have insurance, but that’s speculative and very indirect and frankly pedantic. I can’t seriously claim injury based on your diet. Or whether you drive a Chevy or a Volvo. Or whether you are buried or cremated. These are not systems in which we’re all participants, either paying or nonpaying. Following Mill’s harm principle ensures that this kind of governmental activity is limited to cases in which person or Group A’s action directly harms person or Group B. That limits this to health care, answers the broccoli question, and shuts down that entire line of attack.

[gaelic cowboy]

So this would mean Obamacare stays


So no ANHS then for you.

[rvg]

As I stated earlier in the thread, I think talk of "rights" serves only to confuse the issue. Much more logical to approach this from a "common good" or "common harm" perspective. Here's a very good essay on why this is the case:

In my previous column, I briefly discussed John Stuart Mill and the harm principle as a way for Democrats and liberals to justify the idea of the individual mandate. [...] [I]n Mill’s words: “The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.” Get that. The only purpose. That is, our natural wills guide us toward being left alone, not being part of community. And that’s just fine—until our actions harm others. Then, governmental power is justified. [...]

Millions of people in this system don’t pay insurance premiums. They are bringing direct and obvious harm to the many more millions who do pay premiums. They make our premiums higher. When they get in a car wreck or have a stroke, they’re amassing medical bills that they can’t possibly pay. The rest of us pay for them.

And that is why the harm principle applies here. The government, under Mill’s definition, has the right and duty to step in to prevent harm to others—by making the free-riders pay. It’s exactly a Millian case of harm to others. And just as it explains why the mandate is valid in this case, it also explains why this kind of government action is limited to health care and can’t be extended to the purchase of broccoli or Chevy Volts or funeral plans or whatever else the conservative justices came up with Tuesday. If you don’t eat broccoli, you cause me no harm. Some would say, well, you increase your odds of colon cancer if you don’t eat broccoli, you might harm me if you don’t have insurance, but that’s speculative and very indirect and frankly pedantic. I can’t seriously claim injury based on your diet. Or whether you drive a Chevy or a Volvo. Or whether you are buried or cremated. These are not systems in which we’re all participants, either paying or nonpaying. Following Mill’s harm principle ensures that this kind of governmental activity is limited to cases in which person or Group A’s action directly harms person or Group B. That limits this to health care, answers the broccoli question, and shuts down that entire line of attack.

If the author were to Mill's logic, then the obvious solution would be to turn away the uninsured at the ER, rather than buying into the mandate mumbo-jumbo.

[Lemur]

So this would mean Obamacare stays

So no ANHS then for you.

Not necessarily. If the individual mandate is ruled unconstitutional, we will have a situation very similar to New Jersey, which tried to implement universal coverage without a mandate, and is in the quick and predictable process of imploding. This is a concept referred to as "adverse selection" and/or "the death spiral."

The New Jersey effort began in the late 1980s, when rising health care costs were getting the attention of business and political leaders across the country. And a big worry then, as now, was what to do about people who couldn't get insurance from a large employer. When those people tried to get coverage in the individual or small-group market, they underwent scrutiny from insurers, who were wary of taking on big medical risks. "Insurance companies make their money not by being efficient, or managing care, but by weeding out the sick and insuring only the healthy," a frustrated Jim Florio, then governor of New Jersey, said in 1992. [...]

The plan went into effect in late 1993, not long before President Bill Clinton's efforts to reform health insurance nationally started foundering. And, for a while, it looked like Florio and his advisers had done what Clinton and his advisors could not. Nobody believed New Jersey's plan would bring universal coverage to the state. But "people thought this would have a significant impact," says Bruce Siegel, who was the state health commissioner and is now president of the National Association of Public Hospitals. "They thought it would … change the situation for the uninsured."

An early assessment of the program, by researchers at Harvard and sponsored by the Robert Wood Johnson Foundation, declared the experiment a success. But, by 1996, enrollment in the regulated plans started to slide after peaking at about 186,000. By 2001, it was down to about 85,000. Not coincidentally, the mix of people left in the program changed dramatically. According to a study published in Health Affairs, the median age for enrollees jumped from 41.9 years to 48.4 years in just five years, and premiums rose by between 48 percent and 155 percent, depending on the plan.

These were the tell-tale signs of adverse-selection death spiral: An exodus of healthy people from the insurance pool, leaving behind a population of ever-sicker people whose high health costs keep driving up prices. [...]

New Jersey's experience hardly seems unusual. Kentucky, New York and Vermont all tried to reform their insurance markets without a mandate. All ended up with higher premiums, lower enrollment in insurance or some combination of the two.

If the author were to Mill's logic, then the obvious solution would be to turn away the uninsured at the ER, rather than buying into the mandate mumbo-jumbo.

Raise your hand if you think the public really has the stomach and fortitude to watch people die in the streets. Ain't gonna happen. Two or three well-publicized cases of sweet little girls and innocent grandmas keeling over from preventable causes and we'd be in some form of NHS faster than you can say social darwinism.

[gaelic cowboy]

If the author were to Mill's logic, then the obvious solution would be to turn away the uninsured at the ER, rather than buying into the mandate mumbo-jumbo.

No because that would harm society by allowing tens of thousands to die for want of treatment.

[rvg]

No because that would harm society by allowing tens of thousands to die for want of treatment.

People die every day. It doesn't harm the society one bit.