Obamacare Is On the Line

Obamacare remains deeply unpopular among Americans. According to a recent New York Times / CBS News poll, two-thirds of Americans want the Supreme Court to overturn at least some part of the healthcare law.

Today, arguments opened at the Supreme Court regarding the Affordable Care Act. In six hours of hearings over three days (the longest in forty-five years), the Court will hear oral arguments on four separate issues with the Act. Ezra Klein does an excellent job of outlining the four issues and what each side is likely to argue. Most importantly, the Court will hear arguments on the least popular aspect of the bill, the individual mandate requiring Americans to purchase healthcare insurance, tomorrow.

In my opinion, this provision of the law has the highest probability of actually lowering costs. It does so by expanding the overall insurance risk pool. Without it, the insurance industry would have to contend with the classic economics problem of adverse selection, in which only the unhealthiest people sign up for healthcare coverage. Without the individual mandate, the law is dead on arrival.

The only wrinkle is that a law mandating that Americans purchase a product may stand on dubious constitutionality. In my view, I think pragmatism ought to prevail in this case. In other words, the problem of bringing down the spiraling costs of healthcare justifies the individual mandate.

Either way, the Court will decide the law’s constitutionality in the near future. It should be interesting to watch.

About Sean Patrick Hazlett

Finance executive, engineer, former military officer, and science fiction and horror writer. Editor of the Weird World War III anthology.
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14 Responses to Obamacare Is On the Line

  1. pino says:

    In my opinion, this provision of the law has the highest probability of actually lowering costs.

    Does this include the options of:

    1. Allowing insurance to be purchased across state lines?
    2. Separating corporate funded insurance from tax deducted compensation?
    3. Increasing the number of people who can perform medical procedures? Either growing more doctors or allowing non-doctors to perform commoditized procedures?

      • pino says:

        Yes.

        I think you’re wrong on two levels:

        1. A more fundamental need than medical care is food. And we allow the food market to function more appropriately than we allow the medical care delivery market to function. And food is cheap.

        2. Juts because it’s convenient doesn’t mean we just pitch liberty.

        • (From original post) “In my view, I think pragmatism ought to prevail in this case. In other words, the problem of bringing down the spiraling costs of healthcare justifies the individual mandate.”

          I’m with Pino. Obamacare is an offense to liberty, unjustifiable, whether it reduces costs or not.

          Apropos, have you heard the latest? Apparently it won’t reduce costs, either. Like so many big-government schemes, it was offered with lots of promises and (presumably) the best of intentions, but it ends up costing more than projected, and still not accomplishing the stated goals that were (presumably) the whole reason for enacting it in the first place.

  2. If there’s any product that this kind of law makes sense for, it’s health th insurance. We pay more than 2x the OECD average for health care, without notably better results. In some measure because we have far more uninsured. A large, large part of our long term debt problem is continuing health care cost growth.

    What’s more: Congress has the power to pass a law taxing all income earned over $1000 at 91%. But we have a representative government. So. they didn’t do that. The whole “law to force feed you broccoli” thing is designed to make people angry & fearful, to run away from the existing question.

    • pino says:

      The whole “law to force feed you broccoli” thing is designed to make people angry & fearful, to run away from the existing question.

      But until just recently, like tonight, I haven’t heard the PYM guys admit that the government COULD mandate broccoli. You know it. And I know it. And the whole nation knows it. That the United States government Ought not be able to mandate the purchase of broccoli.

      But by allowing this law, the government could if it wanted.

      • Scott Erb says:

        The government could decide to mint dollar bills that are pink with pictures of Pee Wee Herman on them. The government could decide to make Interstate speed limits 5 MPH. The government could decide that the drinking age should be 50 if you want to get highway funds. See why that line of argument is so off base – it doesn’t deal with reality, just with fantasy. I don’t see any reason to say the government ought not be able to do those things above — being able to make laws makes those things possible. Yet in a democracy, it’s not going to happen.

      • Don’t think that they could, as broccoli is a consumable, unlike health care, and isn’t projected to be responsible for like 95% of federal spending by mid-century.

        Don’t care, though, either, for the reasons Scott Erb points out. We have a representative government. They could tax income earned over 75 cents at 99%, too. But they don’t. The Constitution is a framework with some specifics, not an all-purpose “don’t do things that make me feel mad” backstop.

        The whole “law to force feed you broccoli” thing is designed to make people angry & fearful, to run away from the existing question.

        • pino says:

          Don’t think that they could, as broccoli is a consumable, unlike health care, and isn’t projected to be responsible for like 95% of federal spending by mid-century.

          A consumable? As opposed to the pill? Or blood pressure medication?

          The Constitution is a framework with some specifics, not an all-purpose “don’t do things that make me feel mad” backstop.

          And you remain unable to tell me where the limit of government mandates is.

          The whole “law to force feed you broccoli” thing is designed to make people angry & fearful, to run away from the existing question.

          You are lying to me.

          It was a serious question asked by a sitting Justice of the Supreme Court of the United States of America.

          Rather, people who say that restricting Liberty because they approve of the charity involved are running away from the question.

          • Does broccoli decrease in price through increased market participation by spreading risk? Is there moral hazard associated with the purchase of broccoli? Is broccoli responsible for the bulk of the US’s long-term debt problem?

            Health insurance is distinguishable on many grounds that are obvious to folks who think about it for 45 seconds or so.

            The whole “law to force feed you broccoli” thing is designed to make whites angry & fearful, to run away from the existing question. To wit: does the Commerce Clause power reach the country’s biggest long-term economic problem? If the ACA is unconstitutional, what should be our policy response to our 2x OECD average health care costs?

            Those are policy-related questions, though. So there’s no answer from the Republican Party, which is solely & entirely devoted to the production and sacoring of fear, resentment, and anger.

            • pino says:

              Does broccoli decrease in price through increased market participation by spreading risk?

              Eating more broccoli has a direct and measurable impact on the health of people. Same as blueberries.

              Is there moral hazard associated with the purchase of broccoli?

              Is that the test for constitutionality?

              Is broccoli responsible for the bulk of the US’s long-term debt problem?

              I know that the requirement for constitutionality isn’t:

              I think this law is a really ‘effin good idea.

              The whole “law to force feed you broccoli” thing is designed to make whites angry & fearful,

              I don’t know what you mean by “whites.”

              which is solely & entirely devoted to the production and sacoring of fear, resentment, and anger.

              You’ve jumped the shark on this meme. What started out as a debate that had merit and even required me to reassess some thoughts has devolved into a screech that is better ignored.

            • Scott Erb says:

              Also, it’s misplaced. The issue is not what government can mandate, it’s what the federal government can mandate. No one doubts that states can mandate health insurance, states could constitutionally mandate broccoli consumption.

              But whenever you argue about fantasies of what could happen, it becomes more about emotion than reason. It’s legitimate to question what the limits of the constitutional right to mandate are, but that’s a technical question. To twist it into “fear of tyranny” makes no sense — again, states already have that power!

  3. I’m with you Sean. Very rational indeed.

  4. dugmaze says:

    “the problem of bringing down the spiraling costs of healthcare justifies the individual mandate.”
    Only if you assume insurance is a must. But insurance is not healthcare in most modern countries.

    A + B = C
    Insurance + healthcare costs = total healthcare costs

    Insurance(A) is not total healthcare costs(C).
    Insurance(A) does not provide total healthcare costs(C).
    Insurance(A) is simply a way to pool money to buy healthcare costs(B).
    Insurance(A) cannot lower healthcare costs(B) but it can only lower total healthcare costs(C) through the mandate.
    Why not get rid of the insurance(A) companies to lower total healthcare costs(C)?
    Like they do in the rest of the world.

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