Off-Topic

Ok, cool, so you're fine with it. Well, what politician or political party is working to make that a reality? Democrats, Republicans? Your statement is akin to saying "I'm fine with legalizing slavery, so I refuse the way you have the decision structured". Its nonsense. There is no way that modern society will accept hospitals turning emergency patients away because they cant pay for themselves.

Guess what, I dont have a solution either. So if neither of us has a solution, I guess we have to get behind one of the options on the table, because the problem isnt going to go away. People will always get sick and someone will always have to pay for their care. I would prefer for that someone to not be taxpayers, despite the fact that I'm not crazy about the idea of "forcing" people to buy health insurance......

It's politicians' favorite syllogism: Something must be done. This is something. Therefore, it must be done.

1thegame, even though I would be against it on principle, I'd have less of a problem of an individual mandate at the state level. States have far more general "police" powers than the federal government by design. So for instance, Massachusetts can constitutionally mandate that its citizens by healthcare. The federal government cannot.

ORLY?

Uh, yes, RLY. The federal government is one of enumerated powers (i.e. it can only do something if the Constitution specifically authorizes it). The 10th Amendment states that those powers not granted to the federal government by the Constitution are reserved to the states and the people. The Massachusetts constitution does not structure the state government as one of enumerated powers. Therefore, it can pretty much do anything unless their constitution specifically forbids it.

I assume you mean tax payers are footing the bill for uninsured that CAN pay for their own care. Because tax payers are probably always going to foot the bill for those who CANT pay for their own care. The mandate is trying to get that hypothetical 25 year old who is making enough to afford healthcare but chooses to spend that money elsewhere into the system. Like tent says, those are the people the insurance company wants signed up because for most of them the money they pay in premiums will be much greater than the amount the insurance company has to spend on their care. The insurance company can stomach covering high risk people (people with preexisting conditions) if the government forces healthy, low risk people into the pool as well.

It's one method to (hypothetically) drive costs down, or at least keep them from rising so quickly. But it doesn't mean it is the best. And even if it IS the best, it doesn't mean it passes constitutional muster. The constitution doesn't ask what is most convenient or expedient, it asks what is the government allowed to do.

Translation: fuck personal responsibility, let taxpayers keep paying the medical bills for the uninsured, even as medical costs rise and the ranks of the unemployed/uninsured grow.

Cool, sounds like you have it all figured out.

If you don't like what the Constitution says, there's a process by which it can be amended.

Torts you are "fine" with denying people health care if they do not have insurance. That makes you unrealistic since it is not going to happen. Federal law-as you know or should know-requires medical providers to provide emergency health care to patients and to stabilize them without asking for proof of insurance. Poor people use emergency rooms at hospitals all the time as their dr.'s office for the flu etc. hospital cannot just turn them away because they have to 1st make sure it is "just the flu" and even if it is, sometimes the flu kills.

so you have to operate in a real world:

1. people without health insurance will get treated regardless of whether they have it or not.

2. treating people in emergency room settings for non medical emergencies is inefficient and creates waste.

Now, onto the legal argument. There is no doubt a state could require you to buy health insurance. A state requires you to buy car insurance, and it could require you to do a lot of things under its police power.

Basic constitutional law though is the federal govt is one of LIMITED enumerated powers-unlike the states that have a police power. Federal power has expanded, however, over the decades through liberal interpretation of the commerce clause. Child labor laws(a good thing) are federal regulation of a traditional state area(labor)
under the commerce clause. Conservatives have always thought the 10th amendment should limit the commerce clause more than it does.

There is no doubt that under an expanded view of the commerce clause, the regulation of Health care affects interstate commerce and would give Congress the power to act. The issue is what right, if any, comes into play that should curtail the application of the commerce clause when congress acts to force people to buy health insurance?

Congress has the obvious power to tax its citizens. And that also forces people to part with money for the "general welfare." Congress could tax(there is no question about this) people and use the money to provide health coverage. So can it do directly what it can most assuredly do indirectly? Is there a substantive difference between a new tax(health insurance tax) and requiring people to buy health insurance?

Hard to say what the current court will do. If it follows precedent i think the law is const. But the majority of the Court does not particularly like Obama, and you could see them saying the tenth amendment prevents the use of the commerce clause in this situation, and that statute before it does not use a "tax mechanism" that would be permissible under congress' taxing power, so that issue is not before the Court. In other words, the Court would say that the states have the power to force its citizens
to buy health insurance under its inherent police power, but the federal govt does not under the commerce clause. That the federal govt by design is one of limited- not all encompassing powers.

Would the idea be that they would have to use the $250 for and only for health insurance? You'd have to use a debit card model, ala new food stamps. You'd also have to insure somehow--perhaps using similar language to the Obama healthcare bill--that people couldn't be turned down buying insurance because of preexisting conditions.

Or else the $250 per month is worthless.

The $250 per month would be a good enough subsidy for younger, healthier people, but for older people/those more prone to sickness, I'm not sure that would cover your premium. It would subsidize it decently, though. I'd be interested in looking at the numbers for average monthly premium costs for an older American vs. lower monthly premiums + high deductibles.

Interesting idea, though.

One point that I think is being missed here is that a majority of our unisured citizens are not homeless or incapable of covering their own medical expense/health insurance premiums. They actually make other decisions with their money, be it cars/vacation/social activities, house/rent payments, etc. Those people making such a decision do so knowing full well that they are exposed to potential costs if something catatrophic happens. My feeling is they need to deal with the consequences if it does and not rely on other Americans as a backstop. I guess that means personal responsibility.

Right. And even those people who would choose to decline HC and do make a decent middle class wage still will NEVER be able to afford open heart surgery or a devastating car wreck. My father is a middle class regular Joe and had an accident this summer that thankfully was covered by workmans comp. He shattered his spine and suffered a stroke in the process. So far the bills are somewhere around 250K. If he didn't have insurance then there would be no way a retired guy like him could ever pay these bills even if he sold his house, cashed in his minimal saving and sold his possessions. I mean we're not talking about COULD he pay for it here...we're talking about NEVER being able to pay for it until the day he dies.

So what happens to those people who are healthy one day and have a horrible accident the next while they CHOOSE to not have HC? We pay for it...we all do. Why is that fair? My Dad has insurance as did his company and I'm thankful he/they did not only because if he ever gets back to 100% he won't have to live out of his car...but also because he was responsible enough to not lump those unpaid bills on me and my kids.

Characterizing this healthcare bill as promoting "personal responsibility" instead of putting it on the government and tax payers is a pretty big stretch. Yes, it compels individuals to buy health insurance. But most will have their employers paying 2/3 of their premiums, shielding them from the true cost. And everyone will be buying insurance in a heavily subsidized market, also shielding people from the true costs. I get the point you are trying to make, but let's not act like this is some huge welfare reform telling people to get off their lazy asses, dig deep into their pockets, and lift themselves up by their bootstraps. The individual mandate is just saying "you're now forced to enter the heavily [taxpayer] subsidized and gerrymandered market we have created. Bring in your employer if you can."