Trejbal: A more fundamental question about the individual mandate
The individual mandate is the wrong debate
Christian Trejbal
Trejbal is a Roanoke Times editorial writer based in the New River Valley.
Reason has departed the national health care reform debate. Two sides wage a vacuous shouting match over the constitutionality of the individual mandate to purchase health insurance. Everything else falls aside.
Partisans tout every law professor’s analysis or judge’s opinion with which they agree. They hold each up as the definitive, irrefutable proof that confirms they were right all along.
They keep score, too, as if the number of judges were more important than quality analysis and sound logic.
The tally stands at three judges in favor of the individual mandate to two opposed. At best, these early decisions are the minor leagues, almost irrelevant to who will win the eventual World Series in the Supreme Court. Only nine judges are really in play, and maybe only one will matter — Justice Anthony Kennedy.
Lost in the constitutional dispute is a much more interesting and important question: Whether the individual mandate is even a good idea.
It is not.
March 6, 2011 - 2:02 PM
Clever piece, sir. Back door maneuver to a public, socialized, universal health care system.
At least it would be Constitutional (a legislated public policy funded by taxes). But is it a “good idea”?
It is not.
#1 Why not a front door maneuver to health care and make sure our rights as Americans to have a decent health care and not have to always go broke paying those bills at hospitals were the cards are stacked up against you.
Oh yeah, this Affordable Care Act is set up for the insurance companies to prosper. You can’t turn anybody down. No tort or defensive medicine reforms and between 80-85% of premium MUST be paid out in claims. Why it’s like shooting fish in a barrel.
#1: You are correct that it is not a good idea, but I want to demonstrate why.
#2: You incorrectly assume that healthcare is a right. It is not.
I applaud Trejbal for going beyond the legal aspect of this debate because that is precisely where the decisions should be made. Unfortunately, Trejbal completely drops the ball after this point and enters into both a political and anti-corporate harangue instead of offering valid solutions based on complex but necessary information. In particular, the choice should be determined by cost/benefit analysis.
The issues are how to provide healthcare to citizens in the most affordable manner. The private market provides healthcare more cheaply than the government but not in sufficient quantities for everyone. The public market can provide it for all but at significantly higher cost than the private market. If we can quantify, even roughly, what the costs and benefits are, then we have the information to decide whether we want to provide healthcare publicly, privately or both and whether we want to pay enough to cover everyone.
“The Affordable Care Act and the individual mandate in particular are predicated on the notion that insurance companies are part of the solution to the nation’s health care crisis. They are, in fact, part of the problem. If they need an individual mandate in order to survive without their worst abuses, perhaps they should be allowed to die. Call it a death panel for corporate welfare.” – Trejbal
The above quote looks like Christian did not do his homework nor does it make him objective. If we provide healthcare publicly, the existing literature has shown that the losses resulting from raising taxes to pay for it far exceed the cost of premiums insurance companies charge to provide it. Yes, businesses require a profit, but even after this required return, they still deliver insurance more cheaply than the government can.
The public option or the ACA covers most everyone; however, government already pays for some level of care for everyone by law. After all, that is what the latest Federal judge ruling stated. So, we already pay for some coverage through taxes. Is it ideal coverage? Probably not, but it is care nonetheless. But the real decision we must make is do we want to pay significantly more and be burdened with the mandate to give an improved level of care to everyone?
Possible Alternatives:
1. Provide subsidies or vouchers to the uncovered/insufficiently covered, and therefore achieve coverage without implementing either more costly public option or ACA while avoiding the mandate issue. This is more efficient than full public option because it shares the cost between user and taxpayer rather than making taxpayer fund full cost.
2. Institute full national private insurer competition to control medical costs. For some reason, this idea gets avoided by Christian, the media, politicians, etc., but it is THE most important detail since the private market can provide insurance much more cost efficiently than government.
3. Keep medical usage honest by making the user pay more out-of-pocket expense. This will eliminate over-using insurance just because the government has subsidized it beyond what you would use if you had to pay for it.
“You incorrectly assume that health care is a right. It is not.” I was reading the writings of the Founders over the weekend and one of the reasons that some objected to the Bill of Rights being added to the Constitution was that when only some rights had been enumerated thusly it would appear they there were no other rights to be considered. Since the writer literally considered all rights to be natural and Divinely given, it was a logical position. You appear to base your idea that health care, in a very capable nation, is not a right, not because it is the moral, decent and society enriching thing to do, but because it is not enumerated. Seems like poppycock to me, given that since the story of “The Good Samaritan” we have been admonished to care for the needy, sick, old and disabled.
We COULD have done myriad things differently and maybap better, perhaps even would have done so if ALL of the Congress has been willing to work on the solutions we need, but the ACA remains a good foundation on which to build to achieve the goals we want and still maintain private business as our health care system. I am all for throwing that model out and starting over, if that is what most people want.
Christian T, “reason” never gets the votes that lies and hyperbole do. Shame on us.
Gone. Have fun.