Didn't Clear My Head

I went skiing with Tabula Rasa yesterday. It was a perfectly wonderful day, but then this morning the headline in three papers is the individual mandate to buy health insurance looks to be in serious jeopardy. Even the most perfect days can only last 24 hours.

My thoughts have been a little heavy this morning. I sent the following message to Mike, an attorney, to try and make a little more sense of things. Maybe you have some opinions too:


I have wondered for some time now if the everyone-buy-insurance thing would undermine this health care law. I am not sure that it sits all that well with me, however much it seems the only way forward. What I am wondering is, if the affordable care act clause about universal purchasing is struck down, how will this affect the Massachusetts law? Isn't the provision there nearly identical? in a New Yorker article from last June, the author found this statement from somebody close to Romney at the time they were debating the Massachusettes legislation:

According to Murphy, Lischko, and Gruber, Romney believed that the logic in favor of a mandate was impeccable. Federal law requires emergency rooms to treat patients regardless of their ability to pay. “This is not Calcutta,” Murphy said. “We don’t let people go and die in the street. And then the question is, Who bears that cost? Those costs get paid by increased premiums for the people who do buy insurance, or they get paid for through socialized costs and claim our tax revenues and come at the expense of other things that people might want to do, like building roads and bridges. And in the Republican Party that I grew up in—go back to the welfare debate, it’s about personal responsibility—that seems pretty reasonable.”

Read more http://www.newyorker.com/reporting/2011/06/06/110606fa_fact_lizza#ixzz1qR5Iky17

In other words, requiring health insurance demonstrates more personal responsibility (making it more Republican) than eventually and effectively becoming a ward of the state anyway.

The whole article is wonderful. It made me hope that the Constitutionality might not be such an issue, but now the whole thing appears to be hanging by a thread. 

Also, if the personal mandate provision is struck down, the next step is to rule on whether or not the rest of the law can stand without it. I think there is one possibility. Another provision in the law requires that insurance companies spent 80% on health care. I read a commentary that said the provision will basically drive the for-profit groups out of business, leading to overall cheaper health care, allowing more and more people to buy it. This editorialist (democrat) was hopeful that it was a first step toward universal health care. . . . and I say not unless Obama gets a chance to replace another justice or two.

And one last thing. Rick Perry's campaign had an idea to amend the Constitution to allow each sitting president to replace a Justice every 2 years. The oldest justice would retire. This would mean that each Justice could only serve 18 years and have less long term effect on the court. It would also mean that the make up of the Court would shift, but not too rapidly and lag behind the political process by a few years. It would make the appointment process less contentious, and probably allow presidents to appoint justices with a little more time on the bench. No doubt you've noticed that appointees keep getting younger and younger so they can have influence longer and longer. Anyway, I just wanted your take on the idea.