17- Let’s start with the already famous exchange in which Justice Antonin Scalia compared the purchase of health insurance to the purchase of broccoli, with the implication that if the government can compel you to do the former, it can also compel you to do the latter. That comparison horrified health care experts all across America because health insurance is nothing like broccoli.
- Why? When people choose not to buy broccoli, they don’t make broccoli unavailable to those who want it. But when people don’t buy health insurance until they get sick — which is what happens in the absence of a mandate — the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain. As a result, unregulated health insurance basically doesn’t work, and never has.
That said, I'm an optimist with respect to my feeling about how the court will rule. I think the conservative justices asked tough questions that betrayed their conservative bent, because they're philosophically opposed to health coverage and didn't want to be seen to be openly defending it. However, there is a much larger issue that the Court is deciding that goes well beyond health care and the particulars of this law. That is, what is Congress' role in regulating this type of commerce?
Its been pointed out by several people that The Broccoli Man himself may be the deciding vote in favor of the mandate. This is based on the fact that he has tended to side with Congress often in his career. He may despise universal health care, but he needs to make a choice between the ability of the government to regulate the commerce between states, and one singular issue that he might find distasteful. Until I see otherwise, I'm putting my money on the former.
There is one more interesting caveat in the politics of the Court itself. The Chief Justice reportedly has an extreme dislike of 5-4 decisions. There was a story on NPR (that I can't find right now) about how his court, although farther to the right than any court in history, has a remarkable number of unanimous or 8-1 decisions (with Thomas usually dissenting). It just happens to be that they almost always rule 5-4 in very controversial (politically charged) cases, so that is what the majority of us hear about. But, he must be aware of the abuse he took in the media and with the public at large over Citizens United. Even the President called him out in the State of the Union, which was unprecedented. So I think he has a legacy to consider. I think we can safely assume that the four liberal justices will vote in favor, and that Thomas probably slept through the proceedings, but that his activist wife already told him everything he needs to know to rule against it. Alito is extremely conservative, so lets out him as a "Nay". If Scalia is on the fence, or is in favor of upholding, my guess is Roberts will vote to uphold, as well. That will leave a very surprising 7-2 or 8-1 victory in favor of ACA. This Court is viewed with such contempt and such skepticism by so many Americans, that I don't think Roberts wants to fuel the fire anymore. It might be wishful, but I can see it happening.
- This Court is viewed with such contempt and such skepticism by so many Americans, that I don't think Roberts wants to fuel the fire anymore. It might be wishful, but I can see it happening.
I'm curious what you think citizens could do about it? Judges are elected for life, so the only thing they have to lose is their reputation, certainly not their job.
I can see this court ruling either way, and can think of reasonable explanations for both scenarios. However, in the end, I think that the US will eventually end up with universal coverage one way or another.
If the mandate is struck down, I can see the Dems doing better in November, as it will take the wind out of the sails of the GOP (Without Obamacare to rail against, and an improving economy, Romney won't have a strong rallying cry). Whenever the Dems get a house majority again, they will probably create a version of a public option in order to fight the continuous rise in costs. I could see this coming at a State level option, maybe as an extension of Medicaid. Alternately, if the mandate isn't struck down, I see some states figuring out effective coverage solutions within the new scheme, and these spreading to other states that want to emulate their success.
At any rate, conservative intellectualism seems homeless in this country.
- At any rate, conservative intellectualism seems homeless in this country.
I disagree. It is alive and well in the Democratic Party. Let's not forget that the mandate was the brain child of Republicans back in the early 90s when the Clintons were trying to adopt universal health care.
I forget if it was discussed on here or somewhere else, but the reason the costs of pills are lower in other countries is that the single-payer gives the government a lot of leverage in bargaining with pharmaceutical companies to decide their prices. Medicare has a similar power, too a lesser extent, too, but the increased fragmentation of the insured population in the US lowers each's bargaining power.
- At any rate, conservative intellectualism seems homeless in this country.
I disagree. It is alive and well in the Democratic Party. Let's not forget that the mandate was the brain child of Republicans back in the early 90s when the Clintons were trying to adopt universal health care.
- Here’s what Charles Fried — who was Ronald Reagan’s solicitor general — said in a recent interview with The Washington Post: “I’ve never understood why regulating by making people go buy something is somehow more intrusive than regulating by making them pay taxes and then giving it to them.”