[barmar]

cherdanno, on Sep 17 2009, 09:45 AM, said:

Do you really find this number so hard to believe? There are 45 million without health insurance. Is it so hard to believe that not having health insurance increase your risk of dying by 0.05% per year? That would roughly correlate to health insurance increasing your life expectancy by 1 year.
Sounds like a pretty reasonable estimate to me.

Correlation does not imply causation.

Most of the people without health insurance are presumably poor. They probably eat poorly and live in crime-infested neighborhoods (if they're not completely homeless). Their life expectancy is almost certainly much lower than the general population, and lack of health care is just one cause of this.

It sucks to be poor.

[kenrexford]

barmar, on Sep 17 2009, 11:23 AM, said:

cherdanno, on Sep 17 2009, 09:45 AM, said:

Do you really find this number so hard to believe? There are 45 million without health insurance. Is it so hard to believe that not having health insurance increase your risk of dying by 0.05% per year? That would roughly correlate to health insurance increasing your life expectancy by 1 year.
Sounds like a pretty reasonable estimate to me.

Correlation does not imply causation.

Most of the people without health insurance are presumably poor. They probably eat poorly and live in crime-infested neighborhoods (if they're not completely homeless). Their life expectancy is almost certainly much lower than the general population, and lack of health care is just one cause of this.

It sucks to be poor.

That was my thought, as well.

Add to this that I don't know that this assessment makes any sense in the first place. If we assume that these 26,000 are all citizens, and thus entitled to benefits under this new plan, will the new plan cure this alleged problem anyway? Some gap of people will still not have insurance, which means that they will die. Some people with insurance will have delays in treatment, which means they will die because of rationing, the other side says.

So, you end up with one side saying 26,000 die because of no insurance and the other side "estimating" that, say, 12,000 will still die because of no insurance but 24,000 will die because of government-caused rationing and maybe another 12,000,000 because the economy is hit so bad that people cannot afford good food, work too hard to pay taxes and therefore shorten their life expectancy, and are killed with a shank by fellow inmates when they go to jail for refusing to buy insurance.

[helene_t]

barmar, on Sep 17 2009, 05:23 PM, said:

Most of the people without health insurance are presumably poor.

Is that true?

I thought there was already a federal solution for people with very low income, and people without insurance would typically have below-median, but above-poverty-line income.

[barmar]

kenrexford, on Sep 17 2009, 12:57 PM, said:

Add to this that I don't know that this assessment makes any sense in the first place. If we assume that these 26,000 are all citizens, and thus entitled to benefits under this new plan, will the new plan cure this alleged problem anyway? Some gap of people will still not have insurance, which means that they will die. Some people with insurance will have delays in treatment, which means they will die because of rationing, the other side says.

Of course it won't be perfect, nothing is. We already have welfare, food stamps, homeless shelters, etc. to assist poor people, but people fall through the cracks.

But when you know there's a huge gap in the system, it makes sense to try to shrink it. If we can look at other countries and see that they do better, then it's obviously not an impossible goal. But getting there from here may be a rocky road.

[Lobowolf]

Winstonm, on Sep 16 2009, 10:10 PM, said:

What exactly is the choice of most Americans - not the 5% but the 95%? I can hope this chest pain goes away or I can kiss off any increase in my living standards for the next 10 years while I pay off the medical bills?

How about, "I can give Time Warner Cable $75 a month" or "I can buy 2 packs of cigarettes a day" or "I can go to Olive Garden twice a month" vs. "I can pay $50 a month for health insurance."

[kenrexford]

Lobowolf, on Sep 17 2009, 12:31 PM, said:

Winstonm, on Sep 16 2009, 10:10 PM, said:

What exactly is the choice of most Americans - not the 5% but the 95%?  I can hope this chest pain goes away or I can kiss off any increase in my living standards for the next 10 years while I pay off the medical bills?

How about, "I can give Time Warner Cable $75 a month" or "I can buy 2 packs of cigarettes a day" or "I can go to Olive Garden twice a month" vs. "I can pay $50 a month for health insurance."

Good points. Add in several other factors, like people not having seven kids, people not having the best cell phones, people not having the big-screen TV.

Sure, not all folks make these bad decisions, but a LOT do.

[kenrexford]

barmar, on Sep 17 2009, 12:12 PM, said:

kenrexford, on Sep 17 2009, 12:57 PM, said:

Add to this that I don't know that this assessment makes any sense in the first place.  If we assume that these 26,000 are all citizens, and thus entitled to benefits under this new plan, will the new plan cure this alleged problem anyway?  Some gap of people will still not have insurance, which means that they will die.  Some people with insurance will have delays in treatment, which means they will die because of rationing, the other side says.

Of course it won't be perfect, nothing is. We already have welfare, food stamps, homeless shelters, etc. to assist poor people, but people fall through the cracks.

But when you know there's a huge gap in the system, it makes sense to try to shrink it. If we can look at other countries and see that they do better, then it's obviously not an impossible goal. But getting there from here may be a rocky road.

Many disagree, and probably legitimately, that "other countries * * * do better."

Furthermore, not all of us agree that we "know" there to be a big gap in the system. The "gap" is presumably the uninsured and the underinsured. However, the "system" does not necessarily have a "gap" simply because people do not have insurance, any more than the system has a "gap" because people cannot find jobs because no one wants to hire a person with 18 felony conviction or any more than the systemn has a "gap" because the single mom with her seventh child on the way cannot afford to raise her children. Any system assumes people, and people are idiots, and life sucks at times.

This dsame logic would justify radical changes to transportation, because there is a "gap" in effective delivery of people from one place to another safely, as several thousand (26,000?) die in cars each year. Do we then reduce the speed limit to 5 MPH, build cars with two inches of rubber on everything, and tax people to pay for all of this rubber?

[luke warm]

hrothgar, on Sep 17 2009, 05:38 AM, said:

Comment 1:  From the sounds of things you are confusing "Public Option" and "Single Payer".  The plan that you are describing here is single payer.

Comment 2:  Please show me where anyone is arguing in favor of complete (or even relative) equality in health care.  A lot of people, myself included, argue that there should be a right to receive a certain minimum standard of care.  I haven't seen anyone argue that people shouldn't be allowed to pay for their own private health care if they have the means to afford it.

Personally, I think that a parallel private health care system would have a great deal of value, if only to measure the relative efficiency of the single payer system.

perhaps i have confused the two... in any case, if there is to be universal care it should be completely gov't run and it should be the same plan for everyone... iow, it should be absolutely (relatively?) equal... there should be no private option unless the cost is at least triple, in which case the excess goes to help fund the public option

the absense of that will lead to a system that is confusing and will not work as it is intended... just expand medicare to include everyone... the present premium for meda/medb/medd is about $525/mo. (for those who don't receive "free" meda)... the funding for those premiums can be increased taxation... providers will receive whatever medicare pays, and that's all

[Lobowolf]

Winstonm, on Sep 16 2009, 06:59 PM, said:

If health care is a right, then the government should provide it at no charge

I think the "desirable" cart, with respect to this notion, is put far in front of the "remotely possible even in principle" horse.

[mike777]

interesting posts...but

BACK to OP


Do you think it is constitutional to force everyone to buy Health Insurance and if so by what legal logic?

[luke warm]

mike777, on Sep 17 2009, 02:20 PM, said:

interesting posts...but

BACK to OP


Do you think it is constitutional to force everyone to buy Health Insurance and if so by what legal logic?

no, but the constitution is a pesky document at best

[DrTodd13]

nigel_k, on Sep 16 2009, 06:21 PM, said:

Let's go back to basics here. There are two (non-violent) ways to apportion scare resources: pricing and rationing.

I don't think you are right here. There's only one non-violent way to apportion scarce resources and that is pricing. There is no way to prevent a rationing situation from transitioning to pricing without the threat of violence. The sellers certainly don't have much if any reason to prefer rationing to pricing.

[hrothgar]

DrTodd13, on Sep 18 2009, 01:40 AM, said:

nigel_k, on Sep 16 2009, 06:21 PM, said:

Let's go back to basics here. There are two (non-violent) ways to apportion scare resources: pricing and rationing.

I don't think you are right here. There's only one non-violent way to apportion scarce resources and that is pricing. There is no way to prevent a rationing situation from transitioning to pricing without the threat of violence. The sellers certainly don't have much if any reason to prefer rationing to pricing.

I remember hearing how many people got shot back during the rationing riots during the World War II....

[Winstonm]

Quote

Political power corrupts more severely than money,

Don't you realize that political power IS money?

Quote

It is the socialists who fail to account for human nature as has been tragically seen all around the world.

I agree that socialists also fail miserably - but it has nothing to do with politics or the ideology of socialists and/or capitalists. It has only to do with basic human nature. The proof has been around as long as our ancestors the monkeys climbed in trees, and it has been proven ever since civilization tried its hand at governance.

Give a monkey a toy and then try to take it back - it is a great way to lose a hand; give a government power and then try to take it back - same result.

[mike777]

By Shirley S. Wang
A requirement that all Americans buy insurance is common to all of the major health-overhaul bills — but it’s not constitutional, write two lawyers in an op-ed in the WSJ.

Those who don’t buy insurance would be required to pay a penalty, according to the various health proposals. But this mandate isn’t so much a regulation as a “tax,” and Congress shouldn’t be allowed to tax people just because they are uninsured, argue David Rivkin and Lee Casey, who served in the Justice Department during two Republican administrations. Otherwise, Congress could institute similar “taxes” on anyone who doesn’t follow other orders, such as joining a health club or exercising regularly, they point out.

“This type of congressional trickery is bad for our democracy and has implications far beyond the health-care debate,” they write, noting that the division of power among the three branches of government are “the most reliable means of protecting individual liberty—more important even than the Bill of Rights.”


"A tax that is so clearly a penalty for failing to comply with requirements otherwise beyond Congress’s constitutional power will present the question whether there are any limits on Congress’s power to regulate individual Americans,” write Rivkin and Casey."


http://blogs.wsj.com/health/2009/09/18/man...ax-lawyers-say/

[barmar]

Some states, such as Massachusetts, have mandatory health insurance. Have any of them been challenged in court yet?

[Winstonm]

mike777, on Sep 18 2009, 06:46 PM, said:

By Shirley S. Wang
A requirement that all Americans buy insurance is common to all of the major health-overhaul bills — but it’s not constitutional, write two lawyers in an op-ed in the WSJ.

Those who don’t buy insurance would be required to pay a penalty, according to the various health proposals. But this mandate isn’t so much a regulation as a “tax,” and Congress shouldn’t be allowed to tax people just because they are uninsured, argue David Rivkin and Lee Casey, who served in the Justice Department during two Republican administrations. Otherwise, Congress could institute similar “taxes” on anyone who doesn’t follow other orders, such as joining a health club or exercising regularly, they point out.

“This type of congressional trickery is bad for our democracy and has implications far beyond the health-care debate,” they write, noting that the division of power among the three branches of government are “the most reliable means of protecting individual liberty—more important even than the Bill of Rights.”


"A tax that is so clearly a penalty for failing to comply with requirements otherwise beyond Congress’s constitutional power will present the question whether there are any limits on Congress’s power to regulate individual Americans,” write Rivkin and Casey."


http://blogs.wsj.com/health/2009/09/18/man...ax-lawyers-say/

I don't want to get into a big debate about the quality of quotations, as we all tend to find something of interest and use those quotes. However, I will point out two oddities about this WSJ Op-Ed quote: first, the WSJ Op-Ed may as well be bylined as by Rupert Murdoch, and secondly I happen to agree with this conclusion that mandatory health insurance is outside the scope of Constitutional powers granted to governments, either federal or state. It is a power reserved "for the people".

Having said that, I also find that using the argument of an unconstitutional law made by the same people who support things like domestic spying, rendition, and no penalty for executive wrongdoing to be a complete mockery - it is more Alice in Wonderland exception that the constitution is only valid when I want it to be valid and not at any other time.

And it also shows that there is only one legal recourse and that is universal coverage provided to all by the government.

[luke warm]

barmar, on Sep 18 2009, 06:49 PM, said:

Some states, such as Massachusetts, have mandatory health insurance. Have any of them been challenged in court yet?

i'm not sure a state law mandating health insurance is the same as a federal law, iow i doubt the state law is unconstitutional

[blackshoe]

Hm. I'm no Constitutional Law expert, but it seems to me that "powers" fall into three categories: those delegated to the Federal Government, those delegated to the States, and those not delegated at all. If a power has been delegated to the Feds, then it is not a power available to the States. Equally, if a power has not been delegated, it's not available to the States. So if the power to mandate buying health insurance has been delegated specifically to one or more states (either in the US Constitution or in the state's constitution) then that is a power the states have, and not unconstitutional. It would be unconstitutional for the federal government to exercise this power if it has not been delegated to that government in the US Constitution. It would unconstitutional for a State to exercise this power if it has not been delegated to that State in its own Constitution, or to the States generally in the US Constitution. It would also be unconstitutional for a State to exercise the power if it has been delegated to the Federal Government. Or so it seems to me.

[Winstonm]

luke warm, on Sep 19 2009, 08:15 AM, said:

barmar, on Sep 18 2009, 06:49 PM, said:

Some states, such as Massachusetts, have mandatory health insurance.  Have any of them been challenged in court yet?

i'm not sure a state law mandating health insurance is the same as a federal law, iow i doubt the state law is unconstitutional

It would also require what "mandatory" means. Whether it is mandatory to offer it, purchase it, or to provide it would make considerable difference to the lawfulness I should think.