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Tuesday, March 27, 2012

The RAW DEAL- Insurance Regulation Market

Isn't the Health Care Market. This isn't the New Deal, its the Raw Deal. That was a main point of those arguing against the Health Care mandate. While everyone may need health care, they may not all need insurance. Further the catastrophic policies are not what is being mandated- a minimum coverage package is. Also, if you are hit by a bus in a car your car state mandated insurance might already cover that. So the government is telling you to get something you may never need- forcing you to do it. The guy from West Virginia who runs a sole proprietorship flooring company in a town of 300 people says this will bankrupt him personally. It's like Social Security argued Ginsburg. Except it isn't. Because social security is something paid for over time in a means tested way in percentage proportion to your income from your income/paycheck and gives back to people in a manner proportionate to their giving into the pool after they hit a certain age including the person who paid into it. Chief Justice Roberts made the point that in fact some of what the mandate requires is something that some people will never ever use, like pregnancy or pediatric care. Health insurance buyers may never need the breadth of the insurance or the insurance at all. Some people do die peacefully in their old age- and have little doctors bills up until their death or none that are not already covered under their medicare or medicaid. Further, the health care statute is not saying that the health care mandate costs must be some minor percentage of income. They are imposing an affirmative purchase obligation without a cost cap or definition, and if you don't buy a package of what they say you must minimally have, you are going to be fined and subject to criminal IRS prosecution. Crazy. Justice Breyer sounded like there was no restriction on anything the government wanted to regulate ever given the right circumstances in something that sounded too 'big brotherish' even for the usually liberal allies. The government, he argued, could tell you that you had to buy a cell phone for emergency purposes, or tell you that you had to get a vaccine, or tell you that you had to buy anything if they said it regulated interstate commerce. Buying anything always has a tangential affect on commerce, even interstate, but that is not what the innumerated powers sought to define. I love Justice Breyer usually but here he seems way over the top. The fact that the government was allowed to create a government bank didn't mandate that people had to put so much of their own money into it. There is a huge difference between regulation of contractual relations of people already in a market and making people get into a market. The government can decide that it can regulate for public health the pasturization of milk but can it force everyone to buy a gallon a week to support interstate commerce? That notion, I venture to guess shocks people. That would indeed, as Justice Kennedy suggested at the outset fundamentally alter the relationship between Americans and their federal government in a way that does not bode well for what people call 'liberty', 'freedom' or things Americans love about being Americans. Rationing has been in past justified in war time, to limit purchases of people in a market of things they already purchase. But the government cannot tell people who like Pepsi that they must now all buy gallons of Kefir instead. The question of the limiting principle was asked over and over again. No one has a problem with creating a national health care system where people are taxed for revenues to support a public health system it seems. But forcing people to purchase private products that they don't want or need (and cannot afford) to underwrite a service others do use strikes people as basically really unfair. The argument that we all need health care of some kind at some point is irrelevant to the forced buying of private insurance argument and is a false premise anyway. The argument that everyone who doesn't buy insurance is a deadbeat is wrong. Some people use services that they can afford to pay for as they go along and are covered for catestrophic in part by car insurance. What the statute didn't ever do was challenge the excess and in some cases obscene costs of health care to coddle the providers and drug manufacturers. It is ridiculous that it costs for example $1,000 to get a basic set of chest x-rays- and a huge profit is built into it by way of just one example. Huge profits are built into most health care that the government does not challenge- it just wants to make more people pay for underwriting the exhorbitant services without regulation of any cost structures or even minimal investigation into the excessive nature of these costs. Small business people are going to be put unfairly out of business by this if it is passed. It strikes one as just violative of a basic right to order ones finances and assess ones risks as free agents in a free society. It's not Social Security at all.

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