Two Years On: Obamacare

Bob Cook sums it up very well. Talk about a nightmare scenario.

 

That's a valiant attempt to try to prove that there's still a line, but it just doesn't hold up to me. It's not a self-evident idea, it's an ad hoc scramble to try to create a distinction because admitting that there is no limit might mean legal defeat.

First, the health-care industry certainly isn't unique in that regard. The argument, as I understand it, is that this sort of compulsion to activity is allowable because inactivity isn't a true option. "Everyone will need health care eventually," had been the government's argument in the oral arguments. "We aren't forcing them to use it, we're forcing to pay in advance for something they are going to use eventually regardless."

There are plenty of industries besides health care where we know that everyone will, at some point in their lives, have economic activity. The questioning led in that direction today with the questions about "burial insurance" and "brocolli." We're all going to eat (food), we're all going to move from one place to another (transportation), we're all going to have some contact with other human beings (communication).

The possibilities for deciding that inactivity is actually activity are endless, and they all come from this same place.

People who choose not to watch TV make it less profitable and thus fewer unique shows are created, thus everyone must now own a TV and watch a minimum number of hours.

People who hold on to used cars for a long time make it harder to maintain a national auto industry, which stifles economic growth. Thus, everyone must buy a new car every four years.

People who cook their own food at home may cause local restaurants to go under, and thus make it impossible for others to engage in economic activity with them. Therefore, everyone must eat out at least three times per week.

Once you've decided that "inactivity with an effect" is "activity," everything is fair game.

On a less Constitutional issue, I find it a bit unsettling that the argument here is that government action created a unique industry that has unintended, unforeseen problems, and thus the only solution available to us is one that is fraught with potentially unintended problems.

 

But all your scenarios are built on bankshots, where the argument the government -- and possibly Kennedy -- are making is a direct step.

You might not eat broccoli, but you might eat asparagus, or you might eat a cheeseburger and do two hours on the treadmill.

You might be buried, but you might be cremated, too.

But it's a central truth that you will die, and chances are, you will get sick or injured before you do -- and then you'll require medical treatment.

It seems to me that insurance IS a unique industry in this regard, given that it's based on actuarial tables and pooling risk. The only thing I can think of that might be comparable is, well... Growing crops. And that's already been decided, and not the way you're arguing.

 

It's also a central truth that you will consume food, interact with other human beings, move from one place to another, and do a whole lot of other things.

What makes health care different from them?

 

See my above post.

You might eat broccoli, you might asparagus, you might eat no vegetables at all.

You're insured or you aren't, and the costs of that binary distinction are priced directly into the market.

 

You might need surgery, you might need drugs, you might be completely healthy. I'm still not seeing the distinction.

The price of X is determined by how many people do or don't use X? That's not exactly unique to health insurance.

 

You won't be completely healthy. That's why you're missing the distinction. Man is mortal.

Why is insurance unique? Well, for one thing, if we all buy insurance, the cost to all of us will go down.

If we all buy broccoli, the price will go up.

 

You don't need health insurance to pay for ordinary health care. That's the way many people use their health insurance these days, but it's certainly not a universal need.

It's a little bit of a semantic bait-and-switch.

There's ordinary health care and there's extraordinary health care. You only need insurance to pay for the latter, but everyone will need the former.

The "everyone needs it" argument hinges on trying to conflate the two.

The majority of people could afford every cent of health care they will use in their lives, with room to spare, in the cost of the premiums they pay. They don't need insurance. A few people will rack up catastrophic costs, and they do need insurance. Everyone buys insurance because we don't know which of us will be in the latter category, but that doesn't meant that everyone will eventually use it.

Not exactly.

Yes, demand pushes up price, if supply is static. But supply isn't static. When demand increases, economies of scale also kick in, and make the product cheaper. That's universal as well. If everyone in the country started buying 3-D TVs tomorrow, the price would drop significantly.

 

Everyone will die.

That means those not lucky enough to get shot or hit by a bus and die instantly will need extraordinary health care -- more than just immunization and the occasional antibiotic scrip.

You seem to be deliberately "not getting" that.

 

Because it's false.

Not everyone will rack up the kind of extraordinary health costs that only insurance can pay for. Not even the majority will.

 

Well, you're just wrong on the facts.

It's damned expensive to die. It's a nightmare to be chronically ill before you go. But it's still more than most Americans could afford out of pocket to simply die.

I suspect you know this.

 

Went back and did some research. It appears that Obama drug plan really builds on Bush plan and essentially closes the doughnut hole.

I am surprised that the health care proponents would not push this fact.