Obamacare

It’s kind of astonishing, even as it is entirely to be expected, that the SCOTUS upheld the Affordable Care Act and its “individual mandate”.

You can read the whole hot mess here.

At this point it might be accurate to characterize the concept of federalism (Note wicki’s phrase:  it’s an “evolving relationship”.  That’s putting it mildly, after today’s ruling.), which really is central to the original constitutional scheme, as largely vestigial.  If Congress’ power to “lay and collect taxes” is as unlimited as the SCOTUS’ decision today indicates, then Washington is the seat of a central government, not a federal one, with plenary authority over every person it chooses, so long as the exercise of that authority can be characterized as a “tax”.

But here’s a guess:  federalism will continue to be harshly invoked and scrupulously observed in other contexts, when the SCOTUS feels like it, such as in federal habeas corpus cases.  Federalism may have been reduced to a quaint vestige, but it will continue to depend on whose ox is being gored.

Unless I missed it in my somewhat breezy reading of the opinion, Chief Justice Roberts did not explain why, if Congress’ power to lay and collect taxes can encompass this “individual mandate” thing, the constitution had to be amended to give Congress the power to impose an income tax.

But never mind.

The idea that the government should provide health care for everyone, while  profoundly un-American in a traditional sense, has had an air of inevitability about it for a long time.  I may have noted elsewhere that socialism, or maybe socialism-lite, has at this point a claim to a significant slice of the nation’s history (Ed. noteI sure did!  Pretty different context, though.).  It’s been operative in the way our government has functioned since at least the 1930’s; arguably longer than that, since both the Federal Reserve Act and the 16th amendment date from the 1910’s.  That would be nearly 100 years out of a little more than 200 that the US has been at least dabbling in socialism.

I would really prefer that if the central government is going to get into the health care business it should just do so directly, build hospitals and clinics that anyone can go to for free, and leave everyone else alone.  It would be far less expensive, far less intrusive in the personal autonomy sense, and the mobilization of resources for highly standardized mass undertakings is a more traditional government function that governments can actually pull off well sometimes.  That’s how they field armies and dispatch navies.

But again, never mind.  I remember proposing that as an alternative, years ago, in conversations with various liberal types who wanted to see “government guaranteed” health care.  To a man, they objected that the proposal would result in a terrible disparity of health care:  the direct-delivery government health care would suck, they said.

I didn’t and don’t see any reason why that would be so; or why, even if it were true, “government guaranteed” health care would be any better than “government run” health care.

This is one of those areas where many people just want what they want, and they expect reality to bend to their wants, and no amount of reasoning gets through or changes anyone’s mind.

There are times I not only don’t envy “powerful” politicians, I am positively sympathetic to them.  People can behave like spoiled children sometimes.

Nothing is free.  Every product or service costs somebody something, and the demand for something for nothing is at bottom a demand to oppress others.

We have too much of that as it is.

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3 Comments

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3 responses to “Obamacare

  1. Zarepheth

    I have to agree that for the government to be directly involved in delivery health care would be more efficient than setting up a system that adds multiple layers of private middle-men to suck a profit from the system.

    Personally, I think government should directly run every monopoly and in situations of near monopoly, the government should run a directly competing business. In both cases, the public option should be run as a self-funded non-profit operating for the benefit of everyone. Sort of like the postal system is theoretically supposed to work.

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    • Z that’s an interesting thought. The way we decided, over a century ago, to deal with the problem of monopolies was various “anti-trust” acts that obviously haven’t done the job very well.

      I’d say Microsoft is a near-monopoly. So you think the government should operate a competing company? You see this as a check on the drive for profit that for every private company is pretty much infinite by design, is that right?

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      • Zarepheth

        The first thing we should do, is determine the source of their monopoly power. I’d say the source is their proprietary software interfaces. They dictate what the interfaces will be – and have their products meeting the interface standards at the same time the interface becomes the de-facto standard. Microsoft also played a number of anti-competitive games to get to their position – games which ought to be illegal (if they aren’t already).

        Anyway, I think the best solution is to take the monopoly power and hand it over to the government. The government should then operate it in the best interests of the community. In this case, the government should put together a team of skilled software architects to define appropriate interfaces between the various layers of software, between the software and the documents, and so on. Then the company and its large competitors should be broken into hundreds (or even thousands) of tiny, competing companies. The would cut the cost of operating systems and office productivity software by approximately 75%.

        A second best option, if the above does not seem practical, is for the government to run a competing business on a net-zero profit/loss basis. Still, part of Microsoft’s monopoly power comes from patents and copyrights. And the value of those patents and copyrights comes from the community – because it is our laws and government which enforce, or enable Microsoft to enforce the patents and copyrights. I realize that there’s a purpose for our patent and copyright laws, but still, I think a few people use them to make out like bandits while everyone else either goes without or has to pay monopoly prices to enjoy the product. I think those patents and copyrights need to be seriously narrowed in scope, more limited in duration, and the a significant portion of the monopoly profits should be taxed back to the government.

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