Freedom for the uninsured!
Is it an "assault on liberty" to require us to carry health insurance?
Freedom for the uninsured!
Dick Polman, Inquirer National Political Columnist
I’m traveling for the rest of the week, so postings will be light or non-existent. But not quite yet. This is an expanded version of my latest Sunday print column:
Perhaps you’ve long believed that extremist Islamic terrorism poses the greatest danger to America. Well, the Republicans wish to disabuse you of that notion.
House leader John Boehner declared the other day that health care reform is actually “the greatest threat to freedom that I’ve seen in the 19 years I’ve been in Washington” - an enlightening assertion, since I’d foolishly assumed that al Qaeda scored higher on the fright meter than the prospect of Americans getting the same health protections that are common everywhere else in the democratized world.
Worse yet, real health reform hinges on a proposal that Republicans call “a stunning assault on liberty.” They’re incensed about the so-called “individual mandate,” the idea that virtually all Americans should be required to carry health insurance. Republicans see this mandate as an unconstitutional curb on personal freedom, arguing in essence that Americans have the inalienable right to be uninsured; in the words of Senator Charles Grassley, “Individuals should maintain their freedom to choose heath care coverage, or not.”
Republicans often have been quite successful in political disputes when they invoke words like freedom and liberty, which pack an emotional wallop. But there is also something called the social compact, the notion that the American community is strengthened if everybody pitches in. That’s where the health care mandate comes in.
It’s simple, really: An effective, affordable insurance program spreads the risks. If only sick and high-risk people sign up for health insurance, coverage will be too costly for many purchasers. But if virtually all healthy people are compelled to sign up, premiums will be cheaper across the board and there will be more money in the till for the sick folks who truly need costly care.
What’s ironic is that many Republicans in the past have agreed with this inescapable logic. They were for the mandate before they were against it.
Earlier this year, Grassley told Fox News that there wasn’t “anything wrong” with a mandate. Just as motorists are required to carry auto insurance, he said, “the principle then ought to lie the same way for health insurance.” At least seven other Republican senators have spoken favorably of such a requirement (South Dakota’s John Thune: “There are good arguments on behalf of getting everybody into the pool”), and 2012 presidential candidate Mitt Romney made it a centerpiece of his health insurance overhaul in Massachussetts (the ex-Bay State governor wrote in Newsweek that when the uninsured show up for treatment at hospitals, “require them to either pay for their own care, or buy insurance”).
But Republicans, mindful of the need to placate the tea-baggers and right-wingers who equate health reform with various forms of totalitarianism, can ill afford to echo their previous statements. Nor they can afford to agree with their former Senate leader, Dr. Bill Frist, who has endorsed the mandate concept, arguing recently on the Fox Business Network that it’s “about the only way” to achieve reform, that Americans “should be responsible to paying for it” - and face federal penalties if they don’t.
The Democrats continue to tweak the proposed penalties, much to Boehner's chagrin. Last weekend, shortly before the House passed a health reform plan (thus becoming the first chamber to do so in the 60 years since Harry Truman put it on the agenda), the GOP leader delivered this statement on the floor:
“We have an individual mandate in this bill in front of us, that says every American is going to buy health insurance – whether you want to or not. And if you don’t want it, you’re going to pay a tax….Now, this is the most unconstitutional thing I’ve ever seen in my life!”
Translation: Even if President Obama ultimately signs a health reform law, the fight may well continue. The opposition could hire lawyers and ask the courts to throw it out.
Whether they would succeed is highly debatable. It’s true that the Congressional Research Service has looked at the constitutionality of a mandate and come up empty, saying only that “it is a novel issue whether Congress may…require an individual to purchase a good or service,” and calling it a “challenging question.” But Supreme Court rulings since the 1930s put the reformers on fairly solid ground.
When Boehner declared the mandate to be the most unconstitutional thing in his whole life, he was presumably referring to the Constitution’s commerce clause, which says that Congress has the power “to regulate commerce…among the several states” – in other words, economic issues – but certainly says nothing about requiring Americans to buy health insurance or any other product.
The problem for Republicans, however, is that the high court has long given the commerce clause an expansive reading, and allowed the feds to regulate all kinds of behavior.
To cite the most famous example, the landmark ’64 Civil Rights Act invoked the commerce clause in order to bar whites from discriminating against blacks, even though the core issue was not economic. The court was fine with that. The court has overturned only two commerce-clause laws since 1935, as even mandate opponents grudgingly acknowledge, which is why Obama spokesman Robert Gibbs was correct on Oct. 28 when he said, “I don’t believe there’s a lot of case law that would demonstrate the veracity” of the GOP’s position. (The high court nixed a federal law that curbed gun possession near schools, and a federal law making it easier for women to file gender-related claims. The court said that neither law had the remotest connection to national economic issues covered by the commerce clause.)
Health care, by contrast, is indisputably an economic issue. It would be tough for the Republicans’ lawyers to argue in court that an insurance mandate falls outside the commerce clause – given the reality that health care costs have a major impact on economic commerce. In fact, the Republicans themselves have repeatedly made that link, by complaining about how the Democrats are seeking to restructure “one sixth of the economy.”
The Republicans have also asserted that the proposed federal non-compliance penalty, which would target anybody who refuses to buy health insurance, is tantamount to a brand new tax. Maybe that’s a good political argument – a new Associated Press poll reports that 64 percent of Americans oppose an insurance mandate if a non-compliance penalty is attached – but it’s a lousy constitutional argument, because the high court has repeatedly upheld Congress’ broad taxing powers.
Nevertheless, this is potentially fertile rhetorical turf for the Republicans. If health reform is enacted and signed, they can stoke conservative base turnout for the ’10 congressional races by inveighing against the Democrats’ “unconstitutional” attempt to require health insurance and thus infringe on freedom and liberty. And even if reform fails, they can recount how the Democrats tried to pull an unconstitutional fast one. The mandate is hardly a threat akin to al Qaeda, and I doubt that even the tea-baggers think so. But there’s ample red meat in the argument that Americans resent being told what to do. Social compact notwithstanding.
Excellent article. The funny thing about Republicans flip-flopping on the mandate is that they WERE in support of it.... back when the public option was considered dead and a mandate would just mean the insurance companies would have a new roll of 45 million+ potential enrollees to abuse, lie to, and wring every last penny of profit out of them as possible. For the life of me I can't figure out why this country lags so far behind the rest of the developed world when it comes to fundamention social rights such as access to health care. Here's an idea for all of you BUDGET DEFICIT wolf-criers out there: Perhaps if the US stopped spending trillions upon trillions of dollars to equip and maintain a vastly superior military to anyone else in the world and send them (and lots of taxpayer money) to other countries to wage war, we could afford to do the decent thing. As someone who is uninsured at the moment, my biggest fear isn't Al Qaeda or the shackles of government slavery. It's that tomorrow, by some freak accident I could require medical intervention and be pushed over an already precarious ledge into utter financial ruin. Such a scenario would also negatively affect the hospital that faced the prospect of never recouping that cost, except maybe for some GOVERNMENT MONEY to keep it open and serving the community..— kami
Comment removed.- Lagx- My criticism of Bush's free spending ways is well chronicled. In Bush's case the creation of the office of Homeland Security and the prescription drug beneft cost trillions. Liberals come in many forms. Mostly Democrats but about 85% of Republicans are free spending liberals who savor the opportunity to spend money, not of the own, on the liberal causes they support. It is unsustainable and has to stop. In my view government isn't the solution, it's the problem. Whatever they stick their nose in, they " eff " up. Just allow people to keep their paychecks and we'll all be better off.
- Talvenada- You said "You're either a Conse 'Pub or you're a wrong sub-humanoid."....... You are one confused lad! There is a big difference in a Conservative and a Republican. While I don't disagree with you that most conservatives vote Republican but 9 times out of 10 the elected leader quickly abandons the constituents and turns into a flaming liberal.
- The CBO scored Reid's bill at $849 Billion. Of course this does not count the Medicar Doc Fix, and CBO underlined the fact that this was a preliminary cost estimate. Of course, Reid never mentioned that fact. Harry also said his bill reduces the deficit by $777 Billion during the second 10 years. Anybody not drinking Jack Daniels for the past 12 hours believe that?— tom - wilmington, de
- Tom , I'm not sure of the how/why but here in the People's Republic of PA, car insurance can be be instituted for those in your household who have a driver's license regardless of wheter they actually drive a car, have a car available to drive, or live less that 50 miles away (college student) They seem to be allowed to tack on a driver, assign a car to them, and add the premiums to the bill. There is an assumption of cheating, so insurance is mandatory.— JimR
- swmike, interesting read from the NYT you posted. Of particular interest was when the author wrote "More than half of all the jobs claimed — 325,000 — were those of educators that states said they were able to keep on the job thanks to stimulus aid. But some school districts said that they might not have actually laid off teachers without the stimulus money. Many Head Start programs reported saving the jobs of employees who in fact had simply been given raises with stimulus money — putting their claims of 8,000 jobs under review. Many states and private companies seem to have used different criteria when estimating whether stimulus aid had saved jobs or not, and when calculating full-time positions. The reports, for all their shortcomings, do provide the first check of how the stimulus bill is working so far. They suggest that more than half the jobs claimed so far are in the public sector — despite the fact that President Obama has said that he expects only 10 percent of stimulus jobs to be in the public sector."— tom - wilmington, de
- how is it that The Right keeps telling us that it will take "decades" for history to judge the Bush administration (so convenient for Them) yet they know already that the Obama administration is a failure (again, so so convenient for Them)? how is that? do they have exotic herbal tea leaves that email them historical results realtime? or is it a Magic-8 ball that empowers their science fiction visions? i want that Partisan Crystal Ball so i can go to Vegas or Wall Street and make me some Palin money? i want that Special Magic-8 ball. if only we could conveniently microwave the here-and-now and distill its Tomorrow like Yesterday. life would be grand .... and very predictable ... and very unrealistic. like the song says about Tomorrow: "The sun'll come out . Tomorrow . Bet your bottom dollar . That tomorrow There'll be sun! ... Just thinkin' about Tomorrow . Clears away the cobwebs, and the sorrow . 'Til there's none! ... The sun'll come out Tomorrow . So ya gotta hang on 'til tomorrow . Come what may ... Tomorrow! Tomorrow! I love ya Tomorrow! . You're always A day A way!" ~~~ The End ~~~— jimy_max
- JimR, just one question. By assigning a car to them, are they making that person the primary driver, or are they saying only that person is insured to drive that car? Seems to me that is how it worked in NJ when I lived there as well. They would "assign" the youngest driver to the newer car to get the higher rates, but still any driver could drive any car and still be insured, right?— tom - wilmington, de
- Comment removed.
- jimy_max, nobody is saying the Obama administration is a failure, yet. What is being said is that what Obama has tried so far has failed. Surely you cannot be in the Biden camp and say the stimulus is working in creating jobs, which is how Axelrod and Obama said the stimulus should be judged, when unemployment has risen more than 2 points since its enactment. And what people said would take a decade to judge Bush on was Iraq, not his entire presidency. Just as the healthcare bill will not be proven to be a success or failure if enacted during the first few years, but over a span of 10-20 years to see if it really lowered costs, provided coverage, and did not lead to rationing of care.— tom - wilmington, de
- Sen. Hatch says the debate on the Senate HCR bill will be a "holy war". I suppose it's so, since the Repubs let the Catholic Bishops dictate legislation to them ...— PicassoArt
- the reason that Palin is the IT-Republican-of-the-moment is precisely why the GOP is in trouble (she replaced Beck, who replaced Rushbo, yada-yada). you have an obscure Alaskan governor who was prematurely swept down to the lower 48 to juice up a lame, gimmicky Prez ticket that fizzled. she returns home and then abruptly quits on her Real Alaskan constituency. she "writes" a book that paints her like a constant whiner and perpetual victim. did i mention that she's also a serial lier (eg, claims that Couric sandbagged her on the simple grade school question "What do you read?" really???) and again in her "tome" she still makes no sense whatsoever talking about why she quit being governor of Alaska. and at this Twitter moment, Palin is the face of the Republicans. What is wrong with this picture? you have a non-elected "writer" trying to lead a Political party. What is wrong with this picture? Sarah Palin is not a politician .... she's more like a new breed of non-office-holding politico-Celebrity. There's that Ly-to-the-Ug Obama word: C-e-l-e-b-r-i-t-y . oh my! Why is Palin the IT-Girl for this GOP at this moment? because they have nothing else -- where are the elected leaders of the GOP ... The Real Leaders of the Party? basically The Right ain't got squat: no message, no leadership, no real national identity, no real national support, no fresh ideas, no real solutions .... just an echo chamber of incoherent babbling. they are quickly becoming the party of NO, ZILCH, NADA, NYET. the right wing(nuts) are slowly reducing the GOP to an irrelevant regional loose confederation of partisan politicians. the conservative tradition of Goldwater and Reagan is headed for extinction by the NO-nothings. a real sad legacy. Memo to the GOP: is it time to bring back Joe the Plumber?— jimy_max
- jimy...seems to me you just wrote a lot of words about something you deem is irrelevant. Now, how could you do with something that is relevant? Here is some news, first time unemployment filings last week totaled 505,000. So, nine months after the stimulus jobs bill we still have more than 500,000 people a week filing for unemployment. Any thoughts?— tom - wilmington, de
- Odd that nobody has commented on Eric Holder's testimony before the Judiciary committee yesterday. He really told some whoppers yesterday.— tom - wilmington, de
Cited by the Columbia Journalism Review as one of the nation's top political reporters, and lauded by the ABC News political website as "one of the finest political journalists of his generation," Dick Polman is a national political columnist at the Philadelphia Inquirer. He is on the full-time faculty at the University of Pennsylvania, as "writer in residence." Dick has been a frequent guest on C-Span, MSNBC, CNN, NPR and the BBC. He covered the 1992, 1996, 2000, and 2004 presidential campaigns.
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