Although there are solid arguments and precedents that an individual mandate in the Patient Protection and Affordable Health Care Act (PPCA) is well within the four corners of the Constitution, it is also worth noting that the supposed demonic imperative that a person must actually purchase an insurance plan from a private company does not even exist.
If a person prefers not to purchase health insurance, he pays a fine. The choice is purely voluntary. That fine does not require any purchase of any private product. In no case is anyone compelled to have any medical care at all.
All it does is provide a pool of money to pay for uninsured peoples' medical care, rather than the mandate that currently exists in law and in fact that the rest of us who pay premiums or pay directly for our health care pick up their tab in the form of higher prices. It does what a tax does, but it differs because it offers people the alternative of purchasing health insurance.
In 1986 Congress passed the Federal Emergency Medical Treatment and Labor Act (EMTALA), which guarantees people who need emergency care or are in labor the medical care they need before they can be transferred or discharged. Cases under the act have gone to the Supreme Court, which has interpreted its provisions (e.g., what is the minimum care required?), but never suggested that it was unconstitutional. That law in effect imposes a mandate on emergency rooms that is passed along to others in the form of higher premiums or higher direct costs.
Thus, what the PPCA actually does is eliminate the current mandate that the insured assume those costs in favor of a choice between a fine and purchasing insurance.
Conceptually, under the PPCA everyone pays for our health-care system in the form of a fine. They can avoid paying that fine by purchasing insurance, which also pays for our health-care system. Each person can choose for himself.
It is two sides of the same coin, but it looks at the fine-side first.
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But, your confusion raises a good point. Strictly speaking, kuntil the law is actually in force, it is difficult to know how it will be administered. Thus, the Supreme Court should really decide that the case is not ripe for review, and put it off until the law goes into effect. "Ripeness" is a Supreme Court consideration that is applied to make sure the issues are clear and sharply drawn.
I think there is about a 20% chance that the Court will decide that the case isn't ripe for review. The 2 Justices that might do that are Kennedy and Roberts. If they go there, then I suspect all the Justices except Thomas, Scalia and Alito--who really are politicians appointed to the bench, and not jurists--would likely join them. But, as indicated, I suspect it is only a one-in-five chance that that will occur.
Making a big deal of this is all political and SCOTUS should not be involved in politics. What a great job they did with George Bush in 2000...NOT!
But, I also am cognizant that healthcare for all has been attempted for a century, and never passed. Johnson got medicare passed in the wake of JFK's assassination, and two-thirds majorities in both Houses.
I'm willing to give this a chance, it is better than the current system.
"Conceptually, under the PPCA everyone pays for our health-care system in the form of a fine. They can avoid paying that fine by purchasing insurance, which also pays for our health-care system.... It is two sides of the same coin, but it looks at the fine-side first."
Noooo...
In REALITY, the ACA defines the REQUIREMENT (INDIVIDUAL Health Insurance) ... and THEN defines the PENALTY (the FINE, i.e. CONSEQUENCE) which is imposed AFTER an individual has failed to comply with the REQUIREMENT.
Straight from the PPACA:
SEC. 5000A. REQUIREMENT TO MAINTAIN MINIMUM ESSENTIAL COVERAGE.
`(a) Requirement To Maintain Minimum Essential Coverage-
An applicable individual shall for each month beginning after 2013 ensure that the individual, and any dependent of the individual who is an applicable individual, is covered under minimum essential coverage for such month..
`(b) Shared Responsibility Payment-
`(1) IN GENERAL- If an applicable individual fails to meet the requirement of subsection (a) for 1 or more months during any calendar year beginning after 2013, then, except as provided in subsection (d), there is hereby imposed a PENALTY with respect to the individual in the amount determined under subsection (c).
The constitutional question raised by the plaintiffs is whether a person can be compelled to purchase a product, or service, from a private company. I think he can, and there is very good precedent for it.
This article, however, shows that the PPCA does not even do what plaintiffs allege. That is, it does NOT compel someone to purchase insurance. It says that you either purchase insurance from a private company OR pay a fine. If one elects the fine, there is no compulsion, but rather a choice.
The complaint about the individual mandate was not the mandate part of it, it was that the law told people they had to purchase a product from a private company. The law provides an alternative--pay a fine. The point of the article is not that there is no compulsion at all, but that there is an alternative to purchasing a product from a private company, if that is what one is hung up about.
The law mandates things and behaviors all the time. That is nothing new.
The point of your article was to make a ridiculous statement in an effort to rouse the rabble on this site. Don't pretend it was anything more than that.
As to the "general welfare"...
Thomas Jefferson said:
"Our tenet ever was…that Congress had not unlimited powers to provide for the general welfare, but were restrained to those specifically enumerated, and that, as it was never meant that they should provide for that welfare but by the exercise of the enumerated powers, so it could not have been meant they should raise money for purposes which the enumeration did not place under their action; consequently, that the specification of powers is a limitation of the purposes for which they may raise money."
(Letter to Albert Gallatin, 1817)
What you mean to say is that 40% don't pay income tax.
Some of these people who don't pay income tax still have a percentage of their paycheck withheld every week until it is refunded after every April 15th. In these cases the government is using their money interest free for up to a year.
What's your point?
And, like it or not, we all relinquished some of our freedom when we agreed to live together in a society. The Constitution itself says that two of its purposes are: i) Establish justice; and ii) preserve the blessings of liberty. "Justice" and "liberty" are opposites--e.g., the liberty of your fist ends at the tip of my nose.
The law was not only the first time the United States created a socialized medical program but was the first to require that privately employed citizens be legally mandated to pay for health care services. Upon passage of the law, ships were no longer permitted to sail in and out of our ports if the health care payments had not been collected by the ship owners and paid over to the government.
So I think the "founding fathers" made their intentions quite apparent with regard to healthcare.
IF that 1798 law you refer to actually required those citizens to directly engage in transactions with private companies.
It did not.
It was paid for with a tax.
Mary Brown, a 56-year-old owner of an automobile repair shop in Panama City, Florida, volunteered to lend her name to the lawsuit. Brown was outspoken in her belief that Congress had gone beyond what the U.S. Constitution allows when it included in the reform law a requirement that, beginning in 2014, most Americans will have to obtain health insurance or pay a fine to the IRS. She said she was uninsured and was that way by choice.
Last year Brown shuttered her business and filed for personal bankruptcy. Among her debts: nearly $4,500 in medical bills. More than $2,000 of that was owed to the Bay Medical Center in Panama City. The rest was to doctors in Florida, Alabama and Mississippi.
It is people who have decided not to buy coverage -- but who nevertheless get sick or injured and seek medical care when they do, even if they don't have the money to pay for it -- that make health insurance so expensive for the rest of us.
But to rally against a system designed to insure Americans while at the same time limiting their exposure to bad debt, then default on both your own insurance and health related bad debt, is kind of hypocritical.
Yeah.... go and vote Mutt, the very builder of the model for the ACA.
Your premise is without any logical or historical force. When you drive your car onto the public streets, you have a choice: Obey the traffic laws or pay fines (and possibly face jail time) when you break them. When you walk into a store, you have a choice: Pay for what you want or pay fines (and possibly face jail time) when you steal things. When you own a home, you have a choice: Keep your yard at least minimally maintained or pay fines when you let it go all to hell.
All all levels of US government (local, state, federal), people put into place systems of laws that have consequences for their infringement, usually fines and sometimes imprisonment. Without these consequences, the rule of law ceases. You may with some tenuous validity argue that fining people for failing to insure themselves against disease and accident ought not be a law on the books, but you can't do so with any logical force by asserting that the entire basis of law has no validity. *All* laws are mandates to make people do things that they not want to do because the consequences of not doing them (fines, imprisonment) are unpleasant.
Lune