I don’t think we will have examples of individuals suffering as a result of the mandate until it is enforced (and to criticize the plaintiffs for failing to publicize individual stories of people suffering under the mandate is unfair; it isn’t in place yet). Until then, there are people who are suffering under other provisions in Obamacare and it would make sense to find a way to put their stories forward to the public. Yesterday I attended a panel discussion at Cato’s new facility in DC (most excellent in all respects). Michael Cannon was able to point to at least two cases where people have been caught in attempts by their insurance companies to unload them as a result of the price controls. (You can watch the discussion online at CSPAN.)

Second, if you prefer to anchor the mandate as being essential to
putting into effect the guaranteed issue regulation, then you must argue that
it does not put into effect the regulation but it corrects an unwanted side effect:
insurance companies can no longer be profitable. So the principle that falls
out is that if there is ever a regulation that causes an unwanted side effect,
including that business is not as profitable, an economic mandate is then a
proper remedy. But all regulations have compliance costs, so most regulation can
be “corrected” by adding a mandate. There is no limit on how long ago the scheme
was put into place or how much cost-shifting occurs, Congress need only have a
rational basis for trying to correct some perceived problem (consider was the
cost-shifting that was part of EMTALA a bug or a feature?). Again, this is a
broad power over the consumer and represents an extra-Constitutional means to
leverage an individual’s income, in essence a sixth type of tax implemented
through the Commerce Clause.

Many will argue that SDP will kick in to save the day or that the
political process will naturally limit this power as it does to a degree with
income taxes and unwanted wars, but this still implies that Congress has the
ability to mandate the purchase of any product or service without a true
conditioning link to interstate commerce and without being necessary to enforce
a commercial regulation. This affords the majority unacceptable power and sets
the Court in the uncomfortable position of trying to weigh the cumulative
impact of just-one-more mandate. The Court needs to rework the Commerce Clause
test to require an explicit act of production, consumption, or distribution to
authorize a mandate.

That said, I have to wonder how many “fair weather libertarians” oppose the ACA on personal liberty grounds (as opposed to the federalism issue) yet nod approvingly at the Virginia statute.

I labelled the link to these comments “link”, and the Giant Electronic Brain changed “link” to “161 comments”, though now it says “link” again as I edit…

I really liked the health reporter they had on as well.  I think it’s easy to get lost in the academic debate without actually thinking through the real world nuts and bolts of the law.  That was a good idea on their part to address both.

1) I’m an anti-mandate person, I am somewhere, and in particular Virginia (although at this particular moment I’m in North Carolina), and I think the proposed vaginal ultra-sounds were a horrible idea. Although I do have the intellectual capacity to recognize a difference between regulation of an industry, its participants, and the practices and procedures within that industry whose players have voluntarily entered into it compared to forcing people into the industry regardless of their actual will. 

2) No problem, how about we also ensure we allow insurance companies to rate groups of people based on relative risk? A few states have gone against this idea since it seems to make some people feel like it’s unfair. For example, men tend to pay higher vehicle insurance rates based on as a gender they having higher costs. But when the exact same rational is applied to women and health insurance it’s unfair. But that is really an insurance problem, not a care problem.

So what are the health care problems? Access to drugs, not enough doctors, lack of medical schools? Okay well I guess a State that wants more doctors could always go about funding more residency positions since at present we graduate more doctors than can be matched. But that would be a State by State thing now wouldn’t it.

Feel better now?

Perhaps it does, but then, again, many veteran claims for care are either denied or inadequately addressed.  This is the reality of American government regulated health.  Perhaps a few other industrialized countries do socialized medicine better than we– perhaps–  but those countries can scarcely afford nanny statism these days for a number of reasons, chief among them the demographic seismic shifts they’re experiencing with aging “native” populations, an increase in underemployed and “entitled” working age citizens and the influx of differently cultured guest workers, new citizens and dependent wards of the State.  

I don’t see how the U.S. and Democratic Party can forestall the ultimate failure of Ponzi-like medical and Social Security safety nets while simultaneously discouraging independent business and increasing entitlement mentality (hey, Free! contraception for the women folks with so many more goodies/ “rights” to come.)