February 3, 2011

"There's a misimpression out there that... federal agents arrive in black helicopters dressed in fully equipped armed ninja costumes, kick down your bedroom door and drag you off at the point of bayonets to an insurance agency."

... hyperbolized lawprof Walter Dellinger at yesterday's Senate Judiciary Committee hearing on the constitutionality of the Affordable Care Act. (Video here.)
In fact, what -- all that happens is that for those who are not otherwise exempted and -- when they're filling out their federal income tax return, if you're not maintaining minimum coverage, you have to pay an additional 2.5 percent, much less than Social Security. That's all that happened.

So in that sense, this great intrusion on liberty doesn't approach any slippery slopes or exceed any understood limits in our legal culture. 
I thought the point of worrying about approaching slippery slopes is that we would otherwise accept one incremental intrusion after another and never see fit to draw the line and, thus lulled, we would lose our liberty.

103 comments:

Scott M said...

The biggest problem with that statement is that the United States can't afford to send black choppers any more. They have to be outsourced to Chinese ninja collection agencies...at taxpayer expense, of course.

Pogo said...

"In fact, ...all that happens is...So in that sense, this great intrusion on liberty doesn't approach any slippery slopes..."

Last time I heard that pitch, I was signed up for 50 dance lessons.

Treacle said...

because i choose not to buy a product from a private company, this dillinger character thinks that the government should have the right to stick its bureaucratic dick in my ass and economically rape and fuck a monetary penalty right out of me? and that doesn't exceed an "understood limit in our legal culture"?

how would walter dillinger feel if the government stuck its ginormous dick in him and fucked a penalty right out of him for not engaging in economic commerce? i bet he would be pretty sore about all that.

AllenS said...

Dellinger = tool.

And him, a law professor!

Triangle Man said...

Think of all the trouble they could have saved themselves if they had just been up-front and said that there would be an additional 2.5% tax on all income, subject to an offsetting credit/deduction if you have a qualifying health insurance plan.

Pogo said...

"...this great intrusion on liberty doesn't approach..."

To me, it is this mockery of those who regard as un-American being forced to buy something (for my own good) that is the most maddening thing.

"Oh, you cute little thing. It's just an ounce of flesh. Don't whine so much. It's not like we're taking a pound."

It moves me to thoughts destructive.

Paul Snively said...

What a bizarre argument. "It's not unconstitutional because it's cheap." How do people that stupid get law degrees?

Lincolntf said...

Pray tell, Mr Dellinger, what happens if you DON'T pay that tax? Armed men from the Government arrest you or seize your families assets. No helicopters or hysterical hyperbole required.

Original Mike said...

This is a little tangential, but I am struck with the ineffectiveness of the fine. It's small enough that if you do the cost/benefit analysis you pay the fine rather than get insurance.

I believe this is an trait of liberal thought. It's all about appearance rather than effectiveness. In so many things, it doesn't matter if their prescriptions don't work, only that they show "correct" intent.

joated said...

Camel. Nose. Tent.

What part of that does Mr. Dellinger not understand?

Seemingly, all of it.

bgates said...

Where would anyone ever get the idea that armed federal agents would kick down your bedroom door and drag you off at gunpoint just because your family wanted nothing to do with socialized medicine?

cokaygne said...

Obamacare is not going to control health care costs unless Congress makes cuts. If Congress does so, eventually Obamacare will look like your state Medicaid program. Health care costs rise faster than incomes. That is a fact. The reason why is because the patient and provider have no incentive, none, to spend wisely. The Act allegedly sets up all kinds of studies of promising new methods of provider reimbursement that will bring down health care cost increases. Proponents act like this has never been done before. That is rubbish!

At least since Nixon, that's right Republican president Nixon, imposed wage and price controls on health care in the 1970s, government has tried and failed to control health care costs. Surely some of these people are old enough to remember managed care in the 1990s. That was the magic elixir, the silver bullet (sorry about the violent rhetoric), that would contain health care costs. It did not take long before patients and providers ganged up on frightened politicians to rein in managed care and render it toothless.

So, when the Judge Vinson's of this world are no longer able to pay out of pocket for routine medical care. Medical providers will answer only to the government. Oh yes, we'll still have a choice of "private" insurance plans, but if any one of them makes a serious move to rein in provider costs or deny unnecessary patient care, patients and providers will go over their heads to Congress.

Health care costs will continue to rise faster than incomes. The only ways out will be either higher taxes (don't call them "mandates" or "penalties") or deficits.

Mark O said...

Classic Dellinger. You cannot really believe he will give an objective view of this.

Florida said...

Nobody has this stupid fucking misconception.

Here's the conception we have: Jackbooted union thugs silenced critics at town hall meetings to get this passed using threats, intimidation and actual violence.

The IRS, with the full force of the law, is the collection agency for these corrupt insurance companies.

Those same unions have been exempted from the requirements of the law but the IRS will take your home if you don't pay their health insurance.

Fuck this corrupt system. It is not sustainable and it destroys the fabric of America. Some get waivers, others get fucked over.

I'm not playing this shit any more.

I will not participate in it and if federal agents arrive in black helicopters to kick down my bedroom door, they better fucking come with bayonets because they're going to meet in immovable force that is unafraid to punch them back twice as hard.

If Barack Obmaa thinks he can take my money for his insurance and union crony pensions, he will have to pry it from my cold dead fingers.

Fuck him.

Roger J. said...

Nope--The tactics described by Dellinger are only used to abduct Elian Gonzalez. Except they dont use bayonets any more.

garaji mahal said...

The individual mandate is a Republican idea. Naturally, people hate it. And because Democrats implemented it, it's worse than Nazis marching through Europe.

Quayle said...

All the government wants you to do is follow the laws.

Slipery slopes just don't apply in such situations.

Tibore said...

"There's a misimpression out there that... federal agents arrive in black helicopters dressed in fully equipped armed ninja costumes, kick down your bedroom door and drag you off at the point of bayonets to an insurance agency."

Great argument! Because it's subtle, done on paper and not at gunpoint, there's no actual assault on liberty!

(*rolls eyes*)

J.R. said...

I think Original Mike is correct.

Suppose I'm a 29 year old male, and so I don't want to buy health insurance because it is unlikely I will even pay for one doctor visit in a year (say $200.) An insurance policy, one that fits the mandated coverages, costs me $300/month.

My AGI is $50,000. So my penalty, tax, whatever the word of the day for it is, is $1,250. Why would I opt into the insurance system and pay $3,600 per year?

The law is supposed to mitigate against adverse selection, but the penalty is not high enough to do so.

bgates said...

I am struck with the ineffectiveness of the fine

It's ineffective only if the intended effect is to keep the insurance companies solvent.

If the goal is to get everyone who does the cost/benefit analysis to pay a small amount to the government, then sign up for "insurance" in the event medical care is needed, thus guaranteeing the collapse of the health insurance industry and provoking a crisis which could lead to the single-payer system every Democrat in DC wants, the fine is set up perfectly.

Florida said...

"What a bizarre argument. "It's not unconstitutional because it's cheap." How do people that stupid get law degrees?"

He's not stupid. They know it's a bullshit argument.

They don't care.

YOu see, they believe the fix is in. Once you understand that, their actions make more sense. They believe it's fixed and that they just need to "sell" it better. So they throw up every argument to see which ones will stick to the wall.

And you know, they may be right.

It may be fixed.

traditionalguy said...

The "Obama Health Bill" has always been one gigantic slippery slope. It was designed and sold among the Progressives as a trap door dropping the USA into a Nationalized Health Plan (a/k/a Single Payer) which would be all that was left standing once private plans are priced out of existence by the new government subsidized Plan. That subsidy cost factor is immense at first, so the trick accounting and faux tax raising parts of the bill were inserted just to hide it. But once the private plans are Dead, then the big cost reductions can start, that's right,by the denial of services Panels spotted early on by the intelligent Sarah Palin. Doofus Law Professors have not 1/2 of the intelligence and none of the integrity of Sarah and the Tea Partiers who see exactly the nature of the firing squad the Marxists are marching them out to. No wonder they are angry.

Original Mike said...

@cokaygne: Yep, ObamaCare could be Exhibit A for appearance trumping effectiveness. It will fail to rein in costs without rationing. We know this because, a) it's as obvious as the nose on your face, and b) we've gone down this road before (in fact, we're on this road now. ObamaCare is merely doubling down on our current, failed model). Yet, we do it anyway because it appears to be the equitable.

Paddy O said...

I believe this is an trait of liberal thought. It's all about appearance rather than effectiveness. In so many things, it doesn't matter if their prescriptions don't work, only that they show "correct" intent.

Yes! This is a core reason why I'm conservative, but share a lot of affinity with liberal ideals. I'm conservative, partly for some very liberal reasons.

I want approaches that work. Just talking about intent means, to me, that you care more about your self (having the right intent) rather than actually helping other people.

This is why liberalism tends to be very egocentric (in charitable clothes) and paternalistic. They want to help, but they more want the power of feeling like they help, which sometimes means creating systems where the poor are helped, but also stay in their poverty so they always need help.

Henry said...

Tibore wrote: Great argument! Because it's subtle, done on paper and not at gunpoint, there's no actual assault on liberty!

Yes, as through this world I've wandered
I've seen lots of funny men;
Some will rob you with a six-gun,
And some with a fountain pen.

And as through your life you travel,
Yes, as through your life you roam,
You won't never see an outlaw
Drive a family from their home.

Florida said...

"... thus lulled, we would lose our liberty."

What do yo mean "would?"

We have already lost our liberty.

It is gone.

Kelo v. City of New London.

ObamaCare.

Raich.

The question isn't when we lost our liberty, the quesiton is when we're going to fucking start the fight to take it back.

Egyptians are fighting to get theirs back. The Tunisians fought, and now they have theirs back. Just like the Poles did with Lech Walensa. And the East Germans tearing down that wall. Isn't it a wonder to see people actually stand up and say enough is enough!

They have courage. It is in them ... it is in us.

They are not about to allow a petty tyrant to control their lives any longer.

They set a fine example.

A fine example.

Original Mike said...

"The individual mandate is a Republican idea."

Not that I accept your assertion, but even if you're right, I don't care. I don't genuflect to the Republicans.

I'm not even that exercised about the Individual Mandate. I think it's clearly unconstitutional, and I think that matters. But I am more interested in its use to take down this disasterous monstrosity that is ObamaCare.

AllenS said...

It might start out at 2.5%, but within a few years and if the tax doesn't come even close to the cost, that tax will then be 5%, and then 10%...

WV: mazoo

Then you will be taking it right up the mazoo.

Henry said...

I've always found that song annoying, since farmers need banks and contract law more than anyone, but in this case it seems to apply.

The left loves the Man.

Scott M said...

The individual mandate is a Republican idea. Naturally, people hate it. And because Democrats implemented it, it's worse than Nazis marching through Europe.

First of all, GM, Obama actively campaigned against the individual mandate for all the reasons most people are still against it today...except something changed his mind. What is that, do you suppose? Has he been on the record as to why he flip-flopped so violently on this?

Secondly, Obama is on the record as stating his goal is a single-payer system and that we can't get there all in one go. Occam's Razor says this abortion of a health insurance bill (because it has little to do with reforming actual health care) is the President's stepping stone to single-payer...his stated goal.

Sloanasaurus said...

All we are doing is making Jews wear a yellow star. What's the big deal?

Original Mike said...

"It's ineffective only if the intended effect is to keep the insurance companies solvent."

Yeah, I know. Whether or not that's by intent (i.e. it's ddesigned to fail) depends how smart these guys are. And I don't think most of them are that smart.

Henry said...

The Ballad of Pretty Boy Floyd by Woodie Guthrie.

Bob Ellison said...

Darn. I came to the comments just to find out who would jump to the "slippery slope is a logical fallacy" silliness.

Also, it's a metaphor! Release the hounds!

Florida said...

"All we are doing is making Jews wear a yellow star. What's the big deal?"

It's a very small star and they can take it off at night. It's not like we are tattoing them.

No, that comes much, much later - once Mew York Mayor Mike Bloomberg completes his undercover investigation in Arizona.

traditionalguy said...

I for one am greatful to Professor Dellinger for pointing out the part of Obama Care that abolished the IRS collection powers. Wheh, that's a relief. And here I was under a misimpression, that's all.

Sloanasaurus said...

If Obamacare passes constitutional muster, Congress would be able to draft citizens via the commerce clause.

For example, under Congress' war powers, it has the right to draft citizens into the army. However, Congress does not have the power to draft citizens into a civilian work-force, say to force people to work in digging ditches, or setting up the green economy).

However, if Obamacare is constitutional, Congress would have that power under the commerce clause since people not working in such a force would have economic effect in the same way people not buying insurance has that effect.

Paddy O said...

Is that the misimpression? Who says anything about helicopters? It's a misimpression of the impression that people have. Or a mischaracterization that seems to assert that a great many people in this country are conspiracy theorists. Anyone who believes this is, I think, inherently unable to comment on what anyone does or should believe.

And that's part of the real impression. These are the sorts of people who will be making the kinds of decisions that affect real, actual people. They don't like the people, but aren't really ninjas. They're intellectual and bureaucrats.

The real impression out there is that you have to pay for this, or your wage will be garnished, both for the costs and for the fines. Repeated increasing fines would lead to government bureaucrats stamping a form that takes your house or otherwise robs you of assets.

Such bureaucrats are impersonal except in the case of people they know, so the impression is that corruption will be immensely increased as knowing the right people will get you more benefits or less costs.

In America we don't get furious at ninjas. That's what the second amendment is for. In America we get furious at stamps, and signatures, and taxes which we have no control over. We get furious at supposedly neutral bureaucrats who steal and rob and encourage corruption, all while "just doing their job".

The impression is that it's that's it's not ninjas or helicopters, but slightly paunchy men and women of middling intelligence who will control lives because of bureaucratic insistence. It's the point of a pen, not a bayonet that we worry about. Because that's the weapon bureaucrats and their propagandists like Dellinger wield, with a paternalistic affect hiding a perfidious intent.

garaji mahal said...

Not that I accept your assertion, but even if you're right, I don't care. I don't genuflect to the Republicans.

If/when the time comes around, you'll vote for Romney(Care) in 2012.

Original Mike said...

"Yes! This is a core reason why I'm conservative, but share a lot of affinity with liberal ideals. I'm conservative, partly for some very liberal reasons.

I want approaches that work. Just talking about intent means, to me, that you care more about your self (having the right intent) rather than actually helping other people.

This is why liberalism tends to be very egocentric (in charitable clothes) and paternalistic. They want to help, but they more want the power of feeling like they help, ..."


Yep.

Henry said...

Paddy O: In America we don't get furious at ninjas.

I'm quoting that.

One more way America is exceptional.

Sloanasaurus said...

There is a way to make people pay for their insurance. That is when someone actually shows up to use health care services and has not not previously purchased insurance, make them pay for the for the services... at least up to the amount of prior insurance they did not previously pay. Since, as the Democrats argue, that everyone will eventually use the health care system, then you will eventually collect the insurance premiums anyway, thus the mandate is not needed.

(oh wait.... maybe not everyone will actaully use the health care system - at least to the extent of their insurance premiums, thats why they have the mandate - to collect cash from people who don't need health care services.....)

AJ Lynch said...

The govt should make it a priority to examine why there were rolling blackouts in Texas hospitals. And try to prevent future blackouts.

Instead, they are doing all kinds of other less important stuff like Obamacare, cap & tax, net neutrality, DADT, etc

Original Mike said...

If/when the time comes around, you'll vote for Romney(Care) in 2012."

You could not be more wrong. I will not even consider voting for Romney in the primary unless he states clearly and without equivocation that his Mass. plan is a failure and he has seen the error of his ways.

The Concrete Dog said...

in olden times
when i was a god
worshiprs paid me annual tribute
wheat n goats n such

the flowrs wer pretty

one day
a vainglorios young man
toppled me ovr
and sed he was a god
to be paid tributs

just 2.5 percnt is all
but then it was 5 and ten
and thn he took the mony first
and doled out wot was
leftover
to his subjects

being made of cncrete
i watched
soon
he was topled
his grave as forgottn as his name

but this lesson is nevr learnt
each new man thnks he knows
how to get ths tribut thing
done right

Lincolntf said...

If/when the time comes around, you'll vote for Romney(Care) in 2012."



You understand the vast difference between a State Legislature passing health care reform and the Federal Government taking over the entire health industry, right?


Wv: preach

garaji mahal said...

You could not be more wrong. I will not even consider voting for Romney in the primary unless he states clearly and without equivocation that his Mass. plan is a failure and he has seen the error of his ways.

And if Mittens does win the primary? I will go out on a limb and say almost all conservatives will suddenly stop talking about RomneyCare. I mean ObamaCare.

Original Mike said...

"And if Mittens does win the primary? I will go out on a limb and say almost all conservatives will suddenly stop talking about RomneyCare. I mean ObamaCare."

If Mittens win the primary, I will be in the same fucking boat I am always in. Two bad choices. And just like I don't care what "Republicans" say, I don't care what "almost all conservatives" say. I will denounce RomneyCare at the top of my voice.

Roger J. said...

Seems to me the hearings were nothing more than attempt by the senate dems to control the debate--they control the senate (at least until 2012)--they control the process and hearings are a kabuki dance to attempt to appear even handed--and better yet, what is said in hearings is consedquential because the official record is the written record in which the congress critters have the right to "revise and extend" their remarks--ie, get rid of the dumb shit stuff they said and have their staffers write the stuff they wish they would have said.

Roger J. said...

sorry: what they say is "inconsequential...."

Scott M said...

I prefer consedquential, Roger.

WV - "dindfuz" = lint that collects in your dind

Maguro said...

According to garage, anything that is originally proposed by a Republican is automatically constitutional. Good to know.

bagoh20 said...

No, No, No, You don't lose your liberty, just some money. That should only bother the greedy and selfish. Don't you want to share?

Mark O said...

Wally admids the central failure of the bill as it relates to the Commerce Clause:


“In this instance, Congress is dealing with a dysfunction in the market,” said Duke University law professor Walter Dellinger. “In order to make the market work efficiently, [Congress] needs to encourage people to enter the market.”

bagoh20 said...

How much of that 2.5% will end up paying for actual care, or is that to come later. I mean this IS a government program, and we all know the starting figures don't even cover administration costs for cronies and such, so where is the real figure? Is there an example where this has not been true, and if not why do some believe this will be different from what has always happened in innumerable previous experiments. How many rabbits have to die before you meet the parents.

Christopher said...

"I will go out on a limb and say almost all conservatives will stop talking about RomneyCare. I mean ObamaCare."

Care to put real money with thjat flapping maw of yours, Garbage? Because I will.

If Romney gets the nomination, RINOs and colaborationist Beltway scum - the crawling insects who'd whore out their mothers for a nice word from the NYT - yes. Yes, they will shut up, like good little apparatchicks.

Conservatives? No.

Hell, Garbage, if Mittens does get the nomination I'll pull the lever for Little Black Jesus - and believe me, I think that Marxist, terrorist-fellating empty suit ought to be busting rocks in federal PMITA prison right now.

edutcher said...

Considering this is the only product where, if I choose not to buy it, I get a tax surcharge; yeah, I'd say there's a slippery slope (Oh, we see you're not registered Democrat; well, that's going to cost you...).

Lincolntf said...

Pray tell, Mr Dellinger, what happens if you DON'T pay that tax? Armed men from the Government arrest you or seize your families assets. No helicopters or hysterical hyperbole required.

At the very least, you get your wages garnished and go to jail.

Original Mike said...

...

I believe this is an trait of liberal thought. It's all about appearance rather than effectiveness. In so many things, it doesn't matter if their prescriptions don't work, only that they show "correct" intent.

"Symbolism over substance".

- Rush Limbaugh

garaji mahal said...

Not that I accept your assertion, but even if you're right, I don't care. I don't genuflect to the Republicans.

If/when the time comes around, you'll vote for Romney(Care) in 2012.


Good he included the 'if'. Last I looked, Romney came in second behind None of the Above in NH.

garaji mahal said...

Hell, Garbage, if Mittens does get the nomination I'll pull the lever for Little Black Jesus

No you won't.

bagoh20 said...

"According to a 1936 pamphlet on the Social Security website, the federal government promised the following maximum level of taxation for Social Security, "... beginning in 1949, twelve years from now, you and your employer will each pay 3 cents on each dollar you earn, up to $3,000 a year. That is the most you will ever pay."

However, according to the Social Security website, by the year 2008, the tax rate was 6.2% each for the employer and employee"
~Wikipedia

And this program is broke beyond repair, so we got that going for us.

knox said...

when they're filling out their federal income tax return, if you're not maintaining minimum coverage, you have to pay an additional 2.5 percent

It's so sneaky, I'm actually surprised he'll openly admit that this is how the mandate will function.

traditionalguy said...

It does sound un-Constitutional for the Regime to say, "send in all of your money, and we will give you back a small living allowance ...maybe". But that is the mind set of all Harvard trained social Engineers. To them CONTROL is the purpose of government they offer to "Serve Us With". So forget your misimpressions and lay back and enjoy it.

DADvocate said...

Delinger uses the "reduce to the ridiculous" argument, i.e. if you can somehow make the monetary amount seem small and inconsequential, then all is OK. Look for this the next time you buy a car, other big ticket item or someone is wanting to raise your taxes.

It's an argument that it is absurd that you won't give up such a small amount of money for, in this case, your freedom. Yet, remember, their not willing to forgo taking that amount.

Hoosier Daddy said...

when they're filling out their federal income tax return, if you're not maintaining minimum coverage, you have to pay an additional 2.5 percent

Which of course is the fatal flaw in the argument that this penalty will discourage adverse selection. Assume a healthy annual wage of $100K a year, said surcharge/penalty/whatever comes out to $2500, far less than what a comprehensive health care plan will cost annually. So how many will pay the lesser 'fine' and then simply sign up for health insurance when its needed (since they can't be turned away).

Sloanasaurus said...

and then simply sign up for health insurance when its needed (since they can't be turned away).

This potential outcome of Obamacare has always troubled me. Yeah, there will be lots opf people waiting to just sign up for insurance the moment they are hurt, but what insuarnce company would want this.

Which unlucky insurance company gets the guy who is already sick or injured?

Wouldn't insurance companies go out of their way not to be selected -- i.e. find another way to turn people down? Or be crappy, so such people select some other insruance company? Or make it really hard to sign up? etc...

For example, Insurance companies could end the practice of offering insurance directly to individuals and instead only offer to "reinsure" business or other organizations. In that way the businesses or other organizations can then reject the person with the pre-condition rather than the insurance for some other reason (such as I don't want to hire you).

Will the liberals then push a law saying you cant discriminate hiring sick people?

Sigivald said...

If you don't do X, you must pay $Y in fines/taxes.

Refuse to do that?

The IRS takes your money - and you can't really stop them.

If you manage to avoid garnishment somehow, say by getting paid only in cash, they'll put a lien on your house or other property, last I checked.

And if you won't pay, they'll take it.

By force (if you resist, armed men will take you to jail - which they might anyway simply for tax evasion).

Eventually, all taxation and fines are at gunpoint.

Grownups have to admit this and defend the fines as worth the coercion. It's not like this is actually difficult - so it's odd that so many people refuse to even admit that there's coercion involved.

(Hell, I'm a libertarian, and following Nozick and Hayek I'm perfectly fine with some coercion as simply necessary and unavoidable.

But I won't pretend it's not being done at the point of a gun.)

Meade said...

CNN headline: Senate Democrats block GOP bid to repeal[unconstitutional ]health care law

garaji mahal says the individual mandate is a Republican idea. Even if that were true, it was Democrats and Democrats only who voted for and signed it into law. Before they even read and understood something that we're told wasn't even their own idea! Is it really any wonder that a libertarian/conservative grassroots movement grew, in just one short year, to sweep 25% of those Democrats out of office?

Hoosier Daddy said...

Which unlucky insurance company gets the guy who is already sick or injured?
Well if I was tasked with solving the uninsured/un-insurable, I would begin by creating an association of insurers from across the country. Those insurers would provide a health insurance plan that would provide full coverage for catastrophic care. A slate of preventative care measures could also be included (mammograms, prostate testing, well baby). Basic physician office visits would remain the financial responsibility of the insured. Yes this means those folks would not receive a ‘comprehensive health plan’ where you pay your $10 copay and that’s it.

Those who qualify as uninsured or un-insurable would be assigned to those insurers within the pool. This could be done on a premium income percentage basis. The higher premium income; the more individuals assigned to that company. Premiums would be set based upon a wage income formula. A co-pay/deductible option could be implemented that would reduce the initial premium outlay with the understanding that your initial out of pocket costs would be higher.

It’s not nirvana but it’s a far better concept than the 2000 page abomination that was forced on the populace.

Phil 3:14 said...

My AGI is $50,000. So my penalty, tax, whatever the word of the day for it is, is $1,250. Why would I opt into the insurance system and pay $3,600 per year?

The law is supposed to mitigate against adverse selection, but the penalty is not high enough to do so.


Bingo. This is the nub of the issue. When asked, American's biggest concern with healthcare is their individual costs. A penalty that would, in a meaningful way, approximate the cost of the likely premium would be equally unacceptable. And so to have a mandate and an acceptable penalty will lead to sick individuals signing up for insurance at a point in time when they would be guaranteed to consume more health care dollars than would have previously been "put in the system". That's not financially feasible. Or to put it another way, as bgates says:

thus guaranteeing the collapse of the health insurance industry and provoking a crisis which could lead to the single-payer system

Furthermore, even if the penalties are "high enough" the program still doesn't address the overall costs of the system. Getting universal coverage is easy. Paying for it is the tough part. If you follow Mass Care you can see its slowly falling apart as costs rise, insurance companies can't raise premiums to meet the increased costs and in the meantime patients demands exceed resources and thus the ER are overwhelmed with "insured" patients.

Phil 3:14 said...

If Romney gets the nomination, RINOs and colaborationist Beltway scum - the crawling insects who'd whore out their mothers for a nice word from the NYT - yes. Yes, they will shut up, like good little apparatchicks.

Conservatives? No.


Gosh, this tent is getting smaller all the time!

Lucien said...

Don't look now, but slippery slope arguments are more and more being validated by courts and legislatures.

"Allow gay people the right to do X and eventually, they will want to get married, some folks warned -- and people laughed. "Allow this or that law or lawsuit against tobacco companies and eventually slomeone will sue McDonalds or Coca Cola because hambugers and sodas made them fat" they warned --and people laughed.

No matter where you now stand on gay marriage or transfats, you sure can't afford to be disparaging of slippery slope arguments, can you?

BJM said...

It's not just healthy younger folks who would benefit from paying the fine, but healthy seniors would as well.

There are a lot of Boomers who are still quite healthy and yet we're paying onerous health insurance premiums based on age risk assessment. We also pay Medicare Part B or carry alternate and/or supplemental policies.

Since I already absorb a high deductible and pay for my basic & preventative care (it's impossible to find a competent doctor that accepts Medicare in my area now), I'd dump my coverage and sign up when I needed it and save a considerable sum annually.

btw- Medicare Part B doesn't provide 100% coverage, will seniors be required to buy supplemental insurance under the mandate? Even a small cost increase would force more low income seniors on to Medicaid. Which runs counter to bending the cost curve down...unless there are mechanisms to manage their numbers, and I'm not refering to subsidies or waivers.

Obamacare will have so many unintended consequences and costs that they alone will make it untenable.

Obamacare is designed to fail.

Phil 3:14 said...

Garage;
You seem to suggest that Republicans reflexively vote for Republicans regardless of the candidate's position on a particular issue. That doesn't seem to square with the last election. (or 1996 or the last midterm for that matter)

On the flip side, I would ask that if healthcare trumps all other issues I will assume that a significant number of Dems WILL vote for Mitt if he gets the Republican nomination?

JAL said...

So in that sense, this great intrusion on liberty doesn't approach any slippery slopes or exceed any understood limits in our legal culture.

Uhm.

It sure does.

(And I would assume he was being snide ... Did he gesture quotatiuon marks around the "great intrusion"? He might have closed with a /s, ya think?)

wv gropit
Hysterical. If we can't slip it, slide it or rahm it, we'll gropit.

Hoosier Daddy said...

Furthermore, even if the penalties are "high enough" the program still doesn't address the overall costs of the system. Getting universal coverage is easy. Paying for it is the tough part.

Which is what Europe is dealing with right now. Increasing health care costs are not unique to the US. Several European countries, despite an emasculated military, are facing national bankruptcy because they can no longer sustain a social welfare system that provides cradle to grave care for everyone. There can’t be a greater vindication for Thatcher’s ‘other people’s money’ quote than to look at Greece, Ireland, Spain, etc.

I think we can provide catastrophic coverage for the uninsured/un-insurable thereby eliminating the specter of financial ruin for someone who is unfortunate enough to become ill without breaking the national piggy bank. I emphasize catastrophic care in that the individual simply has to assume a greater individual responsibility for routine care and not expect the taxpayer to foot every doctor visit he or she deems is necessary.
The compromise for the liberals and conservatives when it comes to social welfare should be an acknowledgment that government involvement is best when it provides a helping hand rather than a hand-out.

Hoosier Daddy said...

Medicare Part B doesn't provide 100% coverage, will seniors be required to buy supplemental insurance under the mandate? Even a small cost increase would force more low income seniors on to Medicaid.

Does the mandate require 100% coverage? Part B covers physician office visits and out patient care on a 80-20 basis. This isn't all that out of line with many individual/group health plans so I don't see where the mandate requires 100% coverage.

Part A is the 'free' part (you're automatically enrolled in it and don't pay a premium). This covers in-patient hospital care, skilled nursing, hospice. The kind of care that typically is out of reach financially for most people, the elderly nothwithstanding.

Quaestor said...

Sondercommando Dellinger's reassurances remind one of another national heath program in another country.

"Tie your shoe laces together, hang your clothes on the numbered peg. Remember the number. You wouldn't want to loose your clothes after your shower."

Florida said...

"garaji mahal says the individual mandate is a Republican idea."

Garaji Mahal (not to be confused with Garage Mahal) is correct.

The idea for forced insurance purchases was Mitt Romney's. (Hey, Romney doesn't own any stock in health insurance companies, does he?)

RomneyCare (which the Republican? proudly helped design and signed into law while he was governor of Massachusetts) also requires either forced insurance purchases, or a $2,000 fine.

They take your money either way. It's indentured servitude to the Democrat Party (hey, Mitt isn't a closet Democrat is he? He worked very closely with them when they created RomneyCare and he was surrounded by them when he signed it.)

The only people who do not have to pay of course are Muslims (no Amish in Massachusetts to speak of, but we have lots of Muslims).

So, Mitt has done Muslims a great service. He's instituted a Jew Tax that Muslims don't have to pay!

Jew = Must Pay The Romney Tax
Christian = Must Pay The Romney Tax
Muslim = Don't have to pay Romney Tax.

Florida said...

"I'll pull the lever for Little Black Jesus

Garaji Mahal: No you won't."


I will.

I'd never vote for Romney. Obama would be better.

I'd rather have my enemies in the Democrat Party than in my own party.

Obama in a second term would be a great Republican president.

Romney would be a Democrat president always signing their bills and creating bi-partisan solutions with them that fuck over America.

Romney guarantees an Obama re-election.

Phil 3:14 said...

Which is what Europe is dealing with right now. Increasing health care costs are not unique to the US.

Exacty Hoosier. Unfortunately we start so far ahead of the Europeans regarding per capita healthcare spending. But its useful to point out when certain folks say
"Well look at Europe"

I'd refer them to this)(see exhibit 3) Medical inflation from 1990 - 2003 in the US is about "the middle of the pack" when compared to European countries.

And as someone who firmly believes in not paying for those things that don't make a difference this graph is additionally disheartening. Given all of the negative publicity in the US (among conservatives ) regarding NICE, it looks like it hasn't had the impact of cost that it maybe was intended to.

Hoosier Daddy said...

Unfortunately we start so far ahead of the Europeans regarding per capita healthcare spending

True, largely in part because we will spend more on procedures that aren't typically paid for by our Euro counterparts.

bgates said...

How much of that 2.5% will end up paying for actual care

None of it, I think. Health care is to be paid for by "insurance" companies. If you're old-fashioned, you pay some number - somebody upthread said $3600, I'll use that - each year to the company, and if you should end up needing half a million in medical expenses you have a claim. The new way of doing things will be to wait until you need the half million, pay the company $3600 to get "insurance", and write a check to the government to cover the penalty. The "insurance" company doesn't see any of that penalty money.

Phil 3:14 said...

FYI;
Assuming my back of the envelope math is correct using these OECD tables. The medical inflation rate for Canada year over year 2008 to 2009 was over 8%.

OUCH!!

wv: montain. Yes we have a high one to climb.

Hoosier Daddy said...

The medical inflation rate for Canada year over year 2008 to 2009 was over 8%.

OUCH!!


I'm not surprised. In fact, consider that while we may be living longer, that doesn't necessarily correspond to livng healthier. Advances in medical technology and pharmaceuticals can allow people who live an unhealthy lifestyle chugging along well past thier sell date.

Brian said...

Many individuals - including innocent individuals - have been the victims of homicide by federal agents in drug raids that only happened because of wrong, self-serving interpretations of Commerce and Necessary & Proper Clauses, which made mere possession of banned substances a federal crime.

We're already at the bottom of the slippery slope in several areas, and post-2010 elections we're trying to hike back up, but we keep running into willfully stupid professors such as Dellinger trying to kick us back down.

garaji mahal said...

Before they even read and understood something that we're told wasn't even their own idea!

The entire health care legislation started in the Senate Finance Cmtee. The whole bipartisanship thingy that Obama foolishly thought would be a good idea. People like Baucus and Grassely were in charge of it. So there were never ever going to be genuine liberal or progressive ideas incorporated in any of it. Things like the public option that liberals were for, that were extremeley popular with both Dems and even Repubs, were stripped.

So in the end, it looked a lot like Bob Dole's health care plan, or Mitt Romney's. No wonder it's unpopular.

Original Mike said...

"Things like the public option that liberals were for, that were extremeley popular with both Dems and even Repubs, were stripped.

So in the end, it looked a lot like Bob Dole's health care plan, or Mitt Romney's. No wonder it's unpopular."


You're delusional.

garaji mahal said...

Delusional about what?

Scott M said...

The proper spelling of garage?

Original Mike said...

That the reason this bill is popular is that it's not progressive enough.

Original Mike said...

Make that UNpopular.

garaji mahal said...

That the reason this bill is popular is that it's not progressive enough.

If you believe the polling that says the health care law is unpopular, you also need to believe the overwhelming support for the public option. I can cite dozens of polls.

Original Mike said...

Yes, and free ice cream is "popular" too.

AJ Lynch said...

"Knock knock"
"Who's There?"
"I am Secretary Sebelius of HHS"
"What do you want?"
"To check and see if you took your vitamins and ate your veggies"
"Yeah sure whatever"
"Break the door down Men!"

Clay-ipso Facto said...

Alright, garaji, I'll bite. Please cite some of those polls that show "overwhelming support". Preferably recent and with some consideration of costs. Google didn't lead me to them...

BJM said...

@Hoosier

Part B covers physician office visits and out patient care on a 80-20 basis.

Um...no. Medicare pays schedule, which doesn't even approach 50% for an office visit, the patient is billed the difference or they must try to find a doctor who will accept schedule.

There's a great deal neither Parts A,B or D covers or they cap; the infamous Part D "donut hole" is the perfect example.

The 2011 Medicare booklet is over an inch thick and it's so tediously written in bureaucrat mouse-ese that few, if any lay person, could understand it thoroughly enough to know exactly what their coverage is or is not.

However, you raise a good point about co-pays,deductibles and lifetime caps.

We know tens of millions of Americans are living paycheck-to-paycheck and the young are notorious for risk taking and non-saving. So those same tens of millions with low cost/minimum coverage policies will still turn up in ERs for minor injuries and illnesses and exceed caps for serious illnesses or injuries.

How then would costs be bent down if people access publically financed services instead of paying for fuller coverage?

That's why it didn't matter what was in the bill, in fact the more screwed up it is the better. It was simply a vehicle to take the Dems where they intend to go; a single-payer system.

mariner said...

They already do that based on mere rumors of illegal firearms or illegal drugs.

Why should we believe they won't do that for illegally refusing to buy insurance?

Hoosier Daddy said...

Um...no. Medicare pays schedule, which doesn't even approach 50% for an office visit, the patient is billed the difference or they must try to find a doctor who will accept schedule.

Um...no. If you are a Medicare provider, you accept the Medicare schedule payment, you cannot bill the Medicare beneficiary for the difference you are accepting the Medicare schedule.

Medicare negotiates schedule rates just like every major health insurer does, they just negotiated a lower rate. Providers are not required to accept Medicare patients and can cheerfully turn them away. Like other insurers, Medicare has a population of 45 million beneficiaries so that tends to lend considerable leverage in negotiating rates.

There's a great deal neither Parts A,B or D covers or they cap; the infamous Part D "donut hole" is the perfect example.

Indeed. There is a great deal my private health care coverage does not provide for or has caps.

Hoosier Daddy said...

Alright, garaji, I'll bite. Please cite some of those polls that show "overwhelming support".

There is considerable support for certain individual provisions of the bill, which is understandable.Then again that's like saying I really enjoy the burger, cheddar cheese and onion, but when you spread the dog shit on the bun it kind of ruins the whole thing.

garaji mahal said...

Alright, garaji, I'll bite. Please cite some of those polls that show "overwhelming support". Preferably recent and with some consideration of costs. Google didn't lead me to them...

Just type in "health care polls public option". You'll see them.

Clay-ipso Facto said...

Yeah, I did search before asking. Got all kinds of old and worthlessly worded stuff.

BTW: here are the dates of the results I get using your search suggestion:

Oct 20, 2009
Jun 20, 2009
Dec 3, 2009
Aug 20, 2009
Aug 19, 2009
Sep 1, 2009
Jun 20, 2009
Sep 14, 2009
Nov 17, 2009

Which is why I asked if you were referring to something more recent.

No biggy. I'll just consider your assertion sufficiently addressed by Original Mike's ice cream theory then.

BJM said...

@Hoosier

You're right, I mis-spoke, it's my private insurance that bills the difference.

I opted out of Part B because I don't see any providers who accept Medicare.

Hoosier Daddy said...

You're right, I mis-spoke, it's my private insurance that bills the difference.

I assume you mean a Medicare supplement pays for the costs that Part A doesn't cover.

I opted out of Part B because I don't see any providers who accept Medicare.

Actually this is not something unique to Medicare beneficiaries. Years ago I had to switch providers because my preferred physician no longer would accept my health insurance. Granted I could have continued to go to him but would have paid the full out of pocket costs for services.

traditionalguy said...

If the US Government wants to pay for first quality medical care for its citizens we should accept the gift.

We should ignore Canada and England where their plans have had a terrible experience in getting actual quality or timeliness into the delivery systems that are bankrupting them.

But I am sure that it's just because Americans were not put in charge of running the Nationalized Health Care Monopolies that are such failures.

Why ever did Obama hire that English Administrator to do it for us too?

I am sure that deep down Obama loves us too much to steer us wrong. He only lies to us about everything every day because he is on our side and knows what we need.