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Obamacare

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Anenome replied on Thu, Jun 28 2012 1:09 PM
 
 

Dissapointing.

Makes the need for an alternative libertarian nation to escape to much more urgent.

Means we may very well see the crash of the dollar in our lifetime after all, as the US will now probably not be able to avoid regular trillion dollar deficits.

Lastly, the US Constitution is swiss cheese at this point. It's a document of unlimited federal power. I suppose we shouldn't have expected any other outcome :\

Roberts has shown his strips.

 
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Wheylous replied on Thu, Jun 28 2012 1:09 PM

Hahaha! I was just about to say "My God, F4M has made an on-topic remark!" When I realized that it is a new user "Double Eagle" with the same avatar.

Cracked me up.

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Anenome replied on Thu, Jun 28 2012 1:14 PM

There is one class of people who can escape the law: religious dissenters who won't buy healthcare as a point of religion... the Amish won't be forced to buy, for instance.

Also, I'm thinking of becoming Amish :P

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Here is Ron Paul's statement: http://paul.house.gov/index.php?option=com_content&task=view&id=1987&Itemid=28

" The issue is not whether Congress can compel commerce by forcing you to buy insurance, or simply compel you to pay a tax if you don’t.  The issue is that this compulsion implies the use of government force against those who refuse.  The fundamental hallmark of a free society should be the rejection of force.  In a free society, therefore, individuals could opt out of “Obamacare” without paying a government tribute."

Adds credibility to the idea that he is, in fact, at heart, a voluntarist.

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Anenome replied on Thu, Jun 28 2012 1:18 PM

I think there's something about being the swing justice on a case that screws with a person's brain. Put yourself in Roberts's shoes. He knows and ruminates on the fact for weeks that his decision means he decides for 300 million people.

There's got to be some unique psychology going on there, the intermix of a sense of responsibility for the outcome. And it seems like this swing vote psychology tends people towards statism somehow... Kennedy and Roberts. Gah.

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Cortes replied on Thu, Jun 28 2012 1:22 PM

But we need Republican presidents to appoint conservative justices who will respect the law of the land!!!

 

 

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A very worthy and interesting inquiry, Anenome.

Maybe the tendency towards statism somehow makes one think they are actually no longer responsible, ie by ceding power to the state, any ill effects are the result of the state. Which may explain why he reiterates, in his opinion, that it's not his job to decide whether it is good or bad, but rather simply whether the state can do it.

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Fephisto replied on Thu, Jun 28 2012 1:30 PM

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bloomj31 replied on Thu, Jun 28 2012 1:39 PM

Here's the full opinion if anyone wants to read it.

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Greg replied on Thu, Jun 28 2012 2:04 PM

I really don't understand the court opinion. No I didn't read the whole damn thing lol perhaps this was rebutted.

They make mention of the Anti-Injunction Act recognizing that taxes can only be challenged after they have been paid. Roberts considered the mandate not as an actual mandate, but as a tax akin to having people without children pay more taxes. (They even clearly note the laws language stating "penalty.") It's as if the judges just re-wrote the law, not just interpreted it differently. (I think the dissenting judges even shared that opinion.)

I was pleasantly surprised reading the opinion about the commerce clause and the mandate being unconstitutional under that clause. I thought the mandate was goin' for the smackdown. This case also clearly would have never made it to court if the language in the bill described the mandate as a tax, considering the Anti-Injunction Act. This to me seems to be a contradiction. Perhaps I'm wrong but I figured what allowed this case to make it to the supreme court was the dispute over the commerce clause, and it was clearly struck down on that account. Then all of a sudden the law passes on account of after-the-fact being considered a tax. Seems awful shady. (Yes, I know, this is the government we're talking about.)

Not so good at this law stuff, there's just too much information (or crap) to run through for me to be able to understand it at all. 

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bloomj31 replied on Thu, Jun 28 2012 2:39 PM

The government advanced two basic lines of reasoning for why the individual mandate should be upheld.

1. That it was a justifiable use of the Congress' power to regulate interstate commerce under the combined enumerated powers given to the Congress under the Commerce Clause and the Necessary and Proper Clause.

2.  That even if it wasn't justified under the Congress' power to regulate interstate commerce it was certainly justified under the Congress' power to lay and collect taxes.

In the majority opinion the court found that Congress did not have the power to compel commercial activity either through its powers to regulate interstate commerce and/or through the powers its understood to have through the Necessary and Proper clause.

But the court did uphold the mandate on taxing power grounds because to not acquire insurance was to essentially accept an increased tax burden in the form of a "shared responsibility payment" that would be collected by the IRS like all other taxes.  This, the majority finds, is evidence enough that the mandate is indeed a tax and that the Congress' power to lay and collect taxes is sufficient to create the mandate.

Their view is that the individual mandate is to be legally viewed not as an order to buy health insurance but instead as a tax for those who choose not buy health insurance from here on out.

"The Federal Government does not have the power to order people to buy health insurance. Section 5000A would therefore be unconstitutional if read as a command. The Federal Government does have the power to impose a tax on those without health insurance. Section 5000A is therefore constitutional, because it can reasonably be read as a tax."

In reading the opinion one finds that to avoid the Anti-Injunction problem that the court used the Congress' actual language from the bill to conclude that Congress did not originally intend the mandate to be considered as a tax but rather as a "penalty."  Through this reasoning, the court found that it did have grounds to consider the constitutionality of the individual mandate before it was enacted.  The court then finds in subsequent consideration that the mandate is indeed a tax after all.

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You have heard about Amish farms being raided by armed 'agents' for selling unpasteurized milk to those who wanted to buy it, haven't you ?

There is no protection for anyone from these criminals - - - except a citizenry that is informed, engaged, and has courage.

Its amusing (though sad) that people will dig into and argue all the tiny details of this 'ruling' - - - and miss the big picture.

Today, I think I'll go back and read Murray Rothbard on the criminal nature of government. He did a great deal of work on power 'elite' analysis and the so-called 'conspiracy theory of history'.

Murray would have seen this coming . . . easily.

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At the risk of looking stupid, I'm not quite sure why a government mandate for everyone to purchase health care insurance will raise prices. The SD curve is not an argument. If there is competition among health care insurance companies for business, then won't that lead to lower prices for health care insurance? The business still has to compete for customers. It's not guaranteed if the guy down the street has a lower insurance price. Let's assume that the businesses can accept whomever they want and however many customers are necessary for profitable risk pooling. Further, if everyone has insurance this will lead to an increase in demand for health care service providers. This will attract more health care service providers and will allow for more competition through the increased supply.

For the record, I'm thoroughly opposed to Obamacare. I just want to really understand this issue. I remember seeing similar arguments for a mandate, but I wasn't quite sure how to refute them. Feel free to refer me to a thread. I did a search but didn't immediately find anything.

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xahrx replied on Thu, Jun 28 2012 3:18 PM

 

"I think there's something about being the swing justice on a case that screws with a person's brain. Put yourself in Roberts's shoes. He knows and ruminates on the fact for weeks that his decision means he decides for 300 million people.

There's got to be some unique psychology going on there, the intermix of a sense of responsibility for the outcome. And it seems like this swing vote psychology tends people towards statism somehow... Kennedy and Roberts. Gah." - Anenome

Only an issue if you're arrogant enough to think you can affect the outcome you want for that 300 million people.  That's the central planner mindset; just make a law and everything will fall into place.  It's the arrogance that comes from thinking your will dictates how the universe works, that you are above the system that is the world and not a part of it.  I mean, would the venerable justices have to struggle with the decision if congress passed a bill outlawing death and it ended up on their docket for some reason?  I mean if they support the law as constitutional then no one dies, but if they strike it down as unconstitutional, they're damning 300 million people to death...

The pressure would be enormous.  Know what I mean?

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bloomj31 replied on Thu, Jun 28 2012 3:22 PM

They actually do collect taxes on people when they die.  Estate taxes for example.

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xahrx replied on Thu, Jun 28 2012 3:26 PM

"If there is competition among health care insurance companies for business, then won't that lead to lower prices for health care insurance?"

Prices will be higher than they otherwise would be is the point.  Yes, there may still be some competitive forces at work driving prices relatively downward from where they would be under a fully nationalized system.  There will be higher demand for the same supply and less incentive to produce more supply because the people who don't buy will still pay via a third party extortion (taxes) anyway.  

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xahrx:

"If there is competition among health care insurance companies for business, then won't that lead to lower prices for health care insurance?"

Prices will be higher than they otherwise would be is the point.  Yes, there may still be some competitive forces at work driving prices relatively downward from where they would be under a fully nationalized system.  There will be higher demand for the same supply and less incentive to produce more supply because the people who don't buy will still pay via a third party extortion (taxes) anyway.  

I'm not so sure they would be higher otherwise. I'm assuming that businesses can charge whatever prices are appropriate to be profitable, e.g. more for pre-existing conditions, poor lifestyles, etc. I'm assuming virtually everyone is buying. I don't understand why the supply of health care providers would not increase. There would essentially be universal demand if everyone has insurance.

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xahrx replied on Thu, Jun 28 2012 3:48 PM

Businesses can't charge whatever prices are appropriate, that's one of the problems.  If you want, do a Google search and look up what happened to car insurance in states where it's required, I think the prices universally went up.  Same thing here; you have a captive consumer base that has to buy, and even if the find a way not to buy, you get to charge them anyway via another means.  And how do you start another company with all the regs and compliance issues?  Barriers to entry, captive consumer base, extorted payment.  If those are the standards for getting lower prices the mafia would offer the lowest interest rates in town.

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 I'm assuming that businesses can charge whatever prices are appropriate to be profitable, e.g. more for pre-existing conditions, poor lifestyles, etc.

In theory this is true. But consider that many, if not most, Americans with health insurance get it through their employer (usually because of government mandates to provide health insurance). This makes the employer the customer, not the individual employees. This results in employees only being offered one or two choices for the policy they wish to take part in. The policy covers sometimes hundreds or thousands of other employees working for the same company. This means that, unless all these employees somehow have exactly the same level of risk (level of health, fitness, and similar lifestyle habits), the employees with lower levels of risk subsidize the cost of employees with higher risk. That is, if they could keep the money their employer spend on this insurance and spend it on their own private insurance, the people with lower risk could get a policy with lower premiums, greater coverage, or some combination of these. 

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Sorry, guys. I forgot include this important detail in my thought experiment.

What if we also assume there are no employer-based health insurance plans? Everyone contracts directly with insurance providers. What I'm basically doing is taking out all other government mandates on employers, health care insurance companies, medical care providers, and so forth, and only analyzing the effect of a government mandate to buy a product in an otherwise price-coordinated, competitive, free economy. I want to understand demonstrate why a government mandate by itself is also a bad idea even if all other conditions are favorable for the best costs and prices.

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Well, besides the fact that it is a restriction of liberty...

And beyond the reasoning that, since government has demonstrated its ability to control commerce in this, insurance companies, medical schools, pharmaceutical companies, etc. would lobby government to enact regulations, mandates, and other interventions that would restrict competition...

The only other major flaw I can think of off the top of my head is the nature of what is referred to as health insurance. It's actually not so much insurance as it is pre-payment. If everyone has it, everyone will constantly demand more and more services, ie they will go to the doctor for every little tickle in their throat. They would do this out of the natural idea of maximizing gain/minimizing loss. They will want to get the most for what they pay for. Ultimately, supply may not be able to meet demand. Which would lead to some form of rationing. Rationing would make the good or service more valued, thus leading to higher prices, right?

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Health care costs have gone up stupendously since govt got involved with health care. No surprise. Is there anything govt does that is effective and cost efficient ?   In the past, as recently as the 1950s people could paid for heatlh care out-of-pocket. Doctors could afford to give care to those who couldnt afford it; and it was expected that they do so. People were able to keep enough of their own earnings - - though in dollars worth less each year - - to also contribute to charities that would help people.

Healthcare inflation is due to productivity differentials (labor intensive sectors see cost increases on top of wage growth) and was just was fast before the government healthcare programs. Problem is, inequality has increased a lot and middle class families (or what's left of the middle class after manufacturing was outsourced) can't afford the same standard of living.

Excess inflation in healthcare:

http://research.stlouisfed.org/fredgraph.png?g=8kg

But anyway, ignore these facts, back to the thread.

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Phi est aureum:

Well, besides the fact that it is a restriction of liberty...

And beyond the reasoning that, since government has demonstrated its ability to control commerce in this, insurance companies, medical schools, pharmaceutical companies, etc. would lobby government to enact regulations, mandates, and other interventions that would restrict competition...

The only other major flaw I can think of off the top of my head is the nature of what is referred to as health insurance. It's actually not so much insurance as it is pre-payment. If everyone has it, everyone will constantly demand more and more services, ie they will go to the doctor for every little tickle in their throat. They would do this out of the natural idea of maximizing gain/minimizing loss. They will want to get the most for what they pay for. Ultimately, supply may not be able to meet demand. Which would lead to some form of rationing. Rationing would make the good or service more valued, thus leading to higher prices, right?

Well, of course, that's the worst part.

Now, we're getting into other political variables. It's likely the companies would try to setup an oligopoly. However, let's assume there was free access for suppliers, no shenanigans.

Isn't the care already rationed by the price of the insurance plan? The demand for medical service is also further limited by the maximum yearly disbursement from the insurance company. Certainly, it's not unlimited, and the customers would have to be judicious in using the insurance.

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shackleford:
At the risk of looking stupid, I'm not quite sure why a government mandate for everyone to purchase health care insurance will raise prices.

See today's Mises Daily:

Why ObamaCare Will Fail: A Reading List

(and the health care list here)

 

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F4M hasn't been here for a while. Perhaps he really left?

If I had a cake and ate it, it can be concluded that I do not have it anymore. HHH

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I cannot seem to understand how forcing everyone to buy a service, let alone one with the issues that health insurance as a form of pre-pay has, won't lead to an ever increasing demand, which ultimately leads to a supply that perpetual fails to have the ability to match or overcome demand could lead to a reduction in prices. I might not be seeing it from all angles though.

However, another issue is, brought up by Bastiat, that which is seen and that which is not seen. While its easy to see that everyone would have health insurance, it is not seen what some of that capital may have gone on to flow if individuals were left to only voluntary exchange. This is why the restriction of liberty is much more than a political issue. At its core, it's an economic issue. Less choice on what one can spend one's money on in the free markets ultimately leads to a reduction in production and efficiency, which equals a lower standard of living.

Consider, under the mandate, a man who will go on to never need any sort of medical treatment or advice except the occasional aspirin or antacid, is forced to pay for a service that he does not need or want. Maybe, if left up to his judgement, he would have taken the risk of forgoing health insurance, not knowing he would be fortunate enough to never need it, and instead used his saved capital for anything else. You would never see the growth possible because he would not have been given the choice to use his capital as he pleased. Liberty is very important to economic prosperity.

@blablanine

What is "Healthcare inflation?" I know that inflation is an increase in the supply of money, but can't seem to wrap my head around what you are referring to. Thanks in advance!

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Is that a prediction? Will you bet bitcoins on it?

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Greg replied on Thu, Jun 28 2012 8:03 PM

bloom:
 In reading the opinion one finds that to avoid the Anti-Injunction problem that the court used the Congress' actual language from the bill to conclude that Congress did not originally intend the mandate to be considered as a tax but rather as a "penalty."  Through this reasoning, the court found that it did have grounds to consider the constitutionality of the individual mandate before it was enacted.  The court then finds in subsequent consideration that the mandate is indeed a tax after all.

I take it you were responding to me, thanks. There that seems to be the exact contradiction - how can these people think that makes any sense?

I quote: "The most straightforward reading of the individual mandate is that it commands individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not give Congress that power. It is therefore necessary to turn to the Government’s alternative argument: that the mandate may be upheld as within Congress’s power to “lay and collect Taxes.”

I'm pretty sure they even say the words "shall" and "penalty" were deliberate on the part of congress to set it apart from a tax. Since the SCOTUS doesn't have the power to change that wording, the alternative argument is exactly what would make the whole individual mandate part unable to be considered in the first place. Isn't the fact that the mandate could be considered by the court what made the tax argument null from the beginning? I think so.

 

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Michael Cannon highlights an important point:

"States — because they don't have to expand their Medicaid programs — can block half of Obamacare's new entitlement spending that way.  If states refuse to create a health insurance exchange, then they can block the other half of Obamacare new entitlement spending.  So states are really in the driver seat here.  They can effectively stop the new spending under this law just by refusing to create an exchange and refusing to expand their Medicaid programs."

 

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LOLBAMACARE

i actually like that it passed. now when everyone sees how shitty things will get, they will look at the government a second time and pause to think what its doing.

cant live in normality for long now can we?

the government always uses and abuses the courts to rule constitutional what is supposed to be unconstitutional.

“Since people are concerned that ‘X’ will not be provided, ‘X’ will naturally be provided by those who are concerned by its absence."
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I like the comment by Roger Pilon in the video JJ posted. If this is a tax, what kind tax is it? Not an income tax, nor a duty, nor and excise, nor an impost... Nor is this "tax" going to be levied uniformly throughout the union.

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DD5:

Don't be angry.  You were led to believe that there are or were "barriers" to government power.  But there aren't any such barriers and there never were.  Nothing broke down.  The fact that you have a few selected group of people dressed in silly robes always deciding arbitrarily what government can or cannot do proves that there are and never were any barriers.

This needs to be told to Constitutionalists and Minarchists everywhere. Great response DD5

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Cortes replied on Thu, Jun 28 2012 9:11 PM

@ Andrew Cain:

Yup, and to add more:

http://mises.org/Community/forums/t/29376.aspx

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Prime replied on Thu, Jun 28 2012 9:59 PM

Phi est aureum,

"Further, if everyone has insurance this will lead to an increase in demand for health care service providers. This will attract more health care service providers and will allow for more competition through the increased supply."

That sentence is the flaw in your reasoning. I can tell you from experience that insurance companies do not reimburse based on the supply and demand of healthcare providers. There is a reason physicians don't take Medicare and Medicaid. There is a reason Walgreens parted ways with Express Scripts, the 2nd largest PBM in the country. There will in fact be an increase in demand for healthcare sevices, there just will not be any incentive for an increase in  the supply of providers.

In fact, there is incentive to leave the health care profession. There is the paperwork, audits, regulations, etc... that comes from this monster. Electronic medical records are very expensive. Refusal to reimburse hospitals if patients are admitted for a second time, even if they refuse to take their prescribed medications. The list goes on and on.

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NEPHiLiX replied on Thu, Jun 28 2012 10:02 PM

i actually like that it passed. now when everyone sees how shitty things will get, they will look at the government a second time and pause to think what its doing.

"Democracy is the theory that the common people know what they want, and deserve to get it good and hard".

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@Prime

That quote was from shackleford, not me. In several of my responses to him, I mentioned that it would lead to an ever-increasing demand that would not likely be met by supply. That is, I am in agreement with you.

I apologize if I somehow gave the impression that I believe ObamaCare (or anything besides free markets) could provide lower costs, higher quality, or greater availability. I do not.

For the record, I am a believer in truly free markets and reject the initiation of force.

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John James replied on Thu, Jun 28 2012 11:08 PM

A nice overview for people who don't feel like reading an article or (god forbid) the actual opinion...

 

And as usual, Ben Swann offers an interesting twist:

 

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bloomj31 replied on Thu, Jun 28 2012 11:50 PM

Doren makes some good points, I'd been thinking some of the same things since I read the opinion this morning.

Swann also makes an interesting point, it would be interesting to see a challenge brought on those grounds.

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Neodoxy replied on Thu, Jun 28 2012 11:59 PM

The whole issue is sad. Obama care is doomed to failure. The fact that it prevents any ability to deny for preexisting conditions while still putting private funds on the line in the health insurance industry means that either the cost is going to go through the roof in order to cover costs, or the entire insurance industry isn't going to be able to pay out its liabilities and it will fail as people switch from the lowest possible coverage to the highest available package the moment that they become ill. One or the other must happen so long as the federal government doesn't directly pay for the healthcare of the average person in some way, be it by outright nationalization or through a radical expansion of medcaid/care or the pre-existing conditions aspect is torn down. 

The really sad part about it is that no one was even made happy by the law. The democrats wanted more, particularly the public option, while the republicans wanted less. At any rate, at least it might bring us back on track to the possibility of real reform if it finally is enacted.

At last those coming came and they never looked back With blinding stars in their eyes but all they saw was black...
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Seraiah replied on Fri, Jun 29 2012 9:42 AM

I don't know how to embed (Looks like I'm not allowed), but peter schiff also did an excellent video.

http://www.youtube.com/watch?v=NNCyEC9r_mk&list=UUIjuLiLHdFxYtFmWlbTGQRQ&index=1&feature=plcp

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