On Obamacare

This is the third in a series on healthcare in America. For context, see the first and the second posts in the series.

After the Supreme Court ruling last week, the world has been abuzz with commentary on the ruling. Here are my thoughts.

The Ruling

I’m glad to read the the Supreme Court did not strike down another law. It seems to me like a shortcut for the non-ruling party to get what they want. It’s a get-out-of-jail-free card used too often.

That being said, the logic behind the ruling is bizarre to me:

  • The law is not a tax, therefore the Supreme Court has jurisdiction to listen to the case.
  • But the law was ruled a tax and is a Constitutionally permissible. It is not regulating commerce, per se, but imposing taxes on a certain group.

Go figure. Does this mean someone could challenge the law in 2014 as an unconstitutional tax?

“I just remind conservative commentators that for years we’ve heard that the biggest problem is judicial activism or a lack of judicial restraint. That a group of people would somehow overturn a duly constituted and passed law. Well, this is a good example. And I’m pretty confident that this court will recognize that and not take that step.” [Source]
— President Obama, April 2, 2012

Last week, the Court ruled on several issues:

  • National Federation of Independent Business v. Sebelius (Obamacare). Verdict – Constitutional.
  • Stolen Valor Act. Verdict – Unconstitutional. [Source]

In both cases a “duly constituted and passed law” was contested before the court. One was upheld, and one was not. Clearly there’s some sort bias here. It doesn’t matter how a law us passed (seems to me like all follow the same basic path), but what you believe about the philosophy of law.

Could you imagine is the rulings were reversed? I sure can, and the President who is both happy/unhappy with the Court would be unhappy. But he’s happy because one was upheld and the other wasn’t. Go figure.

Disclosure: I don’t tend to think the Stole Valor Act was needed. All it takes is an internet connection to prove someone’s a fraud. Shame the perpetrator and move on.

On Idealogy

For the last time, yes, Supreme Court Justices make decisions based on their judicial philosophy. Is anyone shocked to read this? John Roberts performed legal limbo to declare the law Constitutional (see above) because of a prevailing philosophy. Perhaps it was in this line that explains his thinking the most:

“Members of this Court are vested with the authority to interpret the law; we possess neither the expertise nor the prerogative to make policy judgments. Those decisions are entrusted to our Nation’s elected leaders, who can be thrown out of office if the people disagree with them. It is not our job to protect the people from the consequences of their political choices.”
— John Roberts, Chief Justice, U.S. Supreme Court

And there you have it from the Chief: don’t blame me, elect new people. I agree–this should be the way democracies work. Sending laws before the Supreme Court to have them overturned isn’t ideal. And lastly, did anyone expect the four liberal judges to strike the law down? Uh, no.

The Good

Obamacare has a number of beneficial regulations (here’s a truncated list):

  • No lifetime maximums for coverage amounts (how can you put a value on human life?).
  • Minors are covered under their parents plan through age 26 (this will be good for us in about 20 years or so).
  • Pre-Existing conditions won’t preclude an individual from coverage (the same as above, how do we value human life?).
  • Lapse in coverage won’t hinder your future coverage (once again, a moral question).

The Bad

New taxes and many government guidelines are bad–the tax burden on our nation is already tremendous.

  • Taxes
    • Medical Equipment Excise Tax
    • Non-payer “feetax” (I should trademark this word!)
    • Capital gains (investment) surtax.
  • Regulations
    • Conscience violating provisions (abortifacients and birth control, mainly).
    • Perhaps other conscience violating guidelines to be issued by HHS later: sex change operations, abortions, etc.

Note: I’m not making an argument for- or against- these specific regulations. What am I saying is that government should not be a position of forcing people to violate their faith. The issue is compulsion.

The Sophistry (or the really bad)

My heavens: is this a fee, a tax, or a feetax? I don’t know. Democrats say one. Republicans another. The Court has its opinion, and since they decided the law is legal, it’s officially a tax. Let’s be honest and call it a tax. If you’re happy with the ruling, just be honest.

I don’t know how adding 50 million plus people to the insurance roles is going to provide us with better, lower-cost healthcare. If demand increases, so does the price. Someone has to pay for this (see taxes above).

I think the moral argument for the necessity of universal health insurance is crazy. The goal isn’t for people to have health insurance, the goal is to create an excellent health care system. All of the insurance in the world won’t due you any good if you still can’t afford a $2,000 surgery (after insurance). Someone still eats that figure.

The insurance market is so regulated and filled with intricate laws that it prevents the market from working properly. Have you ever gotten a doctor’s bill for a non-covered procedure? I have. It’s expensive. If the insurance company chose to cover it, the amount paid to the doctor would plummet. That’s right, if I pay out of pocket, it’s one number, but if the insurance company pays, it’s lower. Something smells rotten in the state of healthcare.

The other bizarre part of health insurance is the lack of natural penalties for bad behavior. Take car insurance, for example. If I have a wreck, my premiums will increase. I have become riskier to insure. If I were a smoker or obese, should my insurance rates be higher? These are voluntary behaviors that adversely affect my health.

It’ll be interesting to watch this unfold between now and November.

Chime in. What do you think?