Universal health care bill passes U.S. Congress

[Presentiment]

Yesh, It toke you guys that long to get a better health care system. Canada has a free health care system and we have been doing just fine. then again, their are no socailists patries in America. God Bless Tommy Douglas and the NDP (only this one time though).

With America socializing health care, where will Canadians go?


Pretty much everyone agrees that the Health Care System needs Reform, but making "any" change won't make it better.  The Democrats praised Medicare and Social Security, but Social Security is bankrupted and Medicare is losing money to this loathsome bill.  Bureaucracies are inefficient and shouldn't be running one-sixth of the US economy.  The cuts in medicare shows that Obama prefers to help the guy-who-will-not-buy-health-insurance-because-he-wants-to-have-a-bigger-house rather then your and my grandparents.

The health care system isn't going to be much more 'socialized' than it already is, considering SS (Social Security, not Schutzstaffel) and Medicare are government run, and many insurance companies owe the government money.
You also don’t cite any facts, which I find rather disturbing, because it shows to what extent the media at the right can influence people from reason.
Isn’t extending health insurance to more Americans the point? Nobody except perhaps you family cares about your specific circumstance, seeing as you can already afford insurance. The bill extends Medicare to 150% of the poverty line, provides subsidies for those between 150 and 400% of the poverty line, and will reimburse doctors and hospitals for providing subsidies/free care to the poorer.

Since the governement decides what and who gets covered, they can decide that certain heart surgeries are too expense and will not be covered.

Have you read the bill? Can you point to a particular provision that says this?

Nobody has read the whole thing, I hope. Also,

Personally I'm against government influence in many parts of economy, people, etc. So I'm against universal health care, as long as there are so many other government policies and commissions using up federal reserves. So, as I am a little biased as I have read none of the health care bill and only barely understand it, I'm pretty much against it on general principle in that the U.S. government is so stretched and so much in debt with a floundering economy.

So while health care does sound good, But right now? I don't think its the time.

The health care bill should actually save money, seeing as it cuts federal spending for certain programs, and provides for taxation of businesses not offering health insurance, as well as uninsured individuals.
I don’t see what you mean by ‘stretched’ either, seeing as none of the provisions require much more supervision than Medicare and SS need now. 
---
There are some important details you need to understand about the bill:
-You are allowed to keep your current health care plan as long as the insurer does not change it.
-The bill does not restrict health care, neither does it call for ‘snooping’ on individuals.
-You will be able to choose your benefits, as before.
-Health care will not be denied depending on personal characteristics
-And other such myths are likely untrue…there is a fact-check I’m pulling these from. It is here.

[SmartyPants]

The health care system isn't going to be much more 'socialized' than it already is, considering SS (Social Security, not Schutzstaffel) and Medicare are government run, and many insurance companies owe the government money.
You also don’t cite any facts, which I find rather disturbing, because it shows to what extent the media at the right can influence people from reason.
Isn’t extending health insurance to more Americans the point? Nobody except perhaps you family cares about your specific circumstance, seeing as you can already afford insurance. The bill extends Medicare to 150% of the poverty line, provides subsidies for those between 150 and 400% of the poverty line, and will reimburse doctors and hospitals for providing subsidies/free care to the poorer.

Do you know what 'socialized' means?  Instead of trying to lower the price of medicare coverage so more people can afford to pay for it themselves, the government taxes the middle to upper class to pay for the others insurrance.  This is a form of redistributing the wealth aka socialism.  There are many ways to lower prices without the governement paying for people's insurrance including: investing in preventive medicine, reduction of abuse and fraud in the Medicare program, malpractice reform, allowing issurance commpanies to trade over state lines, immigration reform, est.

The health care bill should actually save money, seeing as it cuts federal spending for certain programs, and provides for taxation of businesses not offering health insurance, as well as uninsured individuals.

Explain to me why it is a good idea to tax small business(the greatest source of job creation) when the economy is bad.  The "cuts federal spending for certain programs" is cuts in Medicare.


Why is this bill a good idea?
*There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?
*"Free" health care isn't really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.
*Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.
*Government-controlled health care would lead to a decrease in patient flexibility.
*The health-care industry likely will become infused with the same kind of corruption, back-room dealing, and special-interest-dominated sleeze that is already prevalent in other areas of government.
*Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.
*Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.
*Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.
*Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.
*A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.
*Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.
*Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
*Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.
*Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.
*Health care equipment, drugs, and services may end up being rationed by the government. In other words, politics, lifestyle of patients, and philosophical differences of those in power, could determine who gets what.
Patients may be subjected to extremely long waits for treatment.

[Presentiment]

The health care system isn't going to be much more 'socialized' than it already is, considering SS (Social Security, not Schutzstaffel) and Medicare are government run, and many insurance companies owe the government money.
You also don’t cite any facts, which I find rather disturbing, because it shows to what extent the media at the right can influence people from reason.
Isn’t extending health insurance to more Americans the point? Nobody except perhaps you family cares about your specific circumstance, seeing as you can already afford insurance. The bill extends Medicare to 150% of the poverty line, provides subsidies for those between 150 and 400% of the poverty line, and will reimburse doctors and hospitals for providing subsidies/free care to the poorer.

Do you know what 'socialized' means?  Instead of trying to lower the price of medicare coverage so more people can afford to pay for it themselves, the government taxes the middle to upper class to pay for the others insurrance.  This is a form of redistributing the wealth aka socialism.  There are many ways to lower prices without the governement paying for people's insurrance including: investing in preventive medicine, reduction of abuse and fraud in the Medicare program, malpractice reform, allowing issurance commpanies to trade over state lines, immigration reform, est.

And how the hell do you think you're going to implement your said solutions? Anyways, I don't see what is wrong with wealth redistribution, and its already being done, seeing as the income tax is variable depending on your income, between 0 and 33%.

I also don't see how your solutions are actually solutions. Investing in preventive medicine is a vague idea, and I can't see how this can be implemented as to produce tangible results, which is the problem with essentially all those solutions. How would you reduce abuse/fraud? How would you deal with malpractice? Are those two really issues that are important on a large scale? What about legal issues arising out of insurance companies trading over state lines?

If we had magical bullets to solve every problem we'd be living in a utopia.

The health care bill should actually save money, seeing as it cuts federal spending for certain programs, and provides for taxation of businesses not offering health insurance, as well as uninsured individuals.

Explain to me why it is a good idea to tax small business(the greatest source of job creation) when the economy is bad.  The "cuts federal spending for certain programs" is cuts in Medicare.

Small businesses get subsidies for providing employees with health care, so your point is moot.

Why is this bill a good idea?
1. There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?
2. "Free" health care isn't really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.
3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.
4. Government-controlled health care would lead to a decrease in patient flexibility.
5. The health-care industry likely will become infused with the same kind of corruption, back-room dealing, and special-interest-dominated sleeze that is already prevalent in other areas of government.
6. Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.
7. Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.
8. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.
9. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.
10. A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.
11. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.
12. Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
13. Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.
14. Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.
15. Health care equipment, drugs, and services may end up being rationed by the government. In other words, politics, lifestyle of patients, and philosophical differences of those in power, could determine who gets what.
16. Patients may be subjected to extremely long waits for treatment.

Few of these concerns are legitimate, I'll tackle them in order. I’ve numbered them for clarity. 
1. The government is designed to be inefficient, as to make sure it works as fairly as possible. If you wanted efficiency you can take a time machine and go to Italy during World War II. However, your point is irrelevant anyways as it is based under the assumption the government is going to ‘taking control of’ health care, which is isn’t.
2. Wealthier families can pay more, and even if they didn’t have to, the benefits have to be weighed. Someone will have to look up where the cuts are being made/what taxes are being implemented before we can fairly argue this point.
3. That’s your opinion, and it doesn’t conflict with the health care bill anyways. You’re stuck with a viewpoint of a vague, messy hive mind that is the government enveloping everything, which severely limits your viewpoint.
4. No it wouldn’t. Fact-check that please. You are allowed to stay with your current insurer as long as they don’t change the plan, and the government does not dictate your new insurer/doctor, merely recommends them.
5. That’s a hypothetical, so I ask you for proof.
6. That is again a hypothetical, so I ask you for proof.
7. Yes, and they’ll have to pay. The new health-care bill subsidizes insurance for the poor, and offers a plethora of new ways to get it.
8. Nope. You have to fact-check these, this is a myth that is blatantly untrue.
9. Where did you get that idea? Rush Limbaugh, Sarah Palin, or Glenn Beck?
10. That won’t happen, seeing as no companies are going to be dismantled…
11. Again, an idea based on an untrue myth.
12. Malpractice makes up for a tiny fraction of a fraction of health care costs, and you’re basing this on a hypothetical.
13. Where did you get that idea?
14. --16. Hypotheticals…
In the end, although your list seems impressive, it is based mostly on personal assumptions and no facts.

[CraigStern]

1. There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?

It's one thing to be philosophically opposed to government involvement in health care. That's a personal belief, not susceptible to proof. But you can't just walk up and say "government is always inefficient, therefore this program will be poorly managed and wasteful." That's a factual assertion, and you need to have a factual basis for making it.

I can make the same argument on the other side, and you'll quickly see why it's flawed: Private industry is more wasteful than government. Just last year, our entire private banking industry practically threw itself off of a proverbial cliff. Would you trust private industry people to handle your medical insurance? I wouldn't.

The problem with making broad-brush arguments like this is that some organizations are well-run, and some aren't, regardless of whether they are private or public. You have to look at the particular organization. The evidence suggests that Medicare, the largest part of our national public health insurance system, is actually somewhat better at controlling costs than the private insurance industry has been for the past quarter-century or so. This, even with private insurers systematically kicking sick people off of their rolls. So there is good reason to believe that this bill will actually be an improvement, efficiency-wise.

Like I said earlier, everyone agrees to health care reform.  Just because a few of the reforms are good, doesn't mean the bill as a whole is good.  Both Republicans and Democrats agreed that people can't cancel coverage based on pre existing condition.  If Obama did what he promised and what the American people want, then we would have a moderate, partisan bill that doesn't give the government bureaucracy control of one-sixth of the economy.

I'm a little suspicious about where you're getting some of these ideas: "what the American people want," for instance. That's pretty much verbatim a Republican Party talking point. Most people support establishing a public health insurance option, which is actually a good deal more socialist than what we got in this bill. (Here's a second poll saying the same thing, and a couple more for good measure.)

It's fine to not like this bill--it certainly isn't perfect, and I personally have some misgivings about the thing. (I am, for example, not particularly enthusiastic about being fined unless I buy health insurance from private insurers.) But nonetheless, it behooves us to investigate the claims we hear about a proposal before we decide whether to support it or not.

[SmartyPants]

The health care system isn't going to be much more 'socialized' than it already is, considering SS (Social Security, not Schutzstaffel) and Medicare are government run, and many insurance companies owe the government money.
You also don’t cite any facts, which I find rather disturbing, because it shows to what extent the media at the right can influence people from reason.
Isn’t extending health insurance to more Americans the point? Nobody except perhaps you family cares about your specific circumstance, seeing as you can already afford insurance. The bill extends Medicare to 150% of the poverty line, provides subsidies for those between 150 and 400% of the poverty line, and will reimburse doctors and hospitals for providing subsidies/free care to the poorer.

Do you know what 'socialized' means?  Instead of trying to lower the price of medicare coverage so more people can afford to pay for it themselves, the government taxes the middle to upper class to pay for the others insurrance.  This is a form of redistributing the wealth aka socialism.  There are many ways to lower prices without the governement paying for people's insurrance including: investing in preventive medicine, reduction of abuse and fraud in the Medicare program, malpractice reform, allowing issurance commpanies to trade over state lines, immigration reform, est.

I also don't see how your solutions are actually solutions. Investing in preventive medicine is a vague idea, and I can't see how this can be implemented as to produce tangible results, which is the problem with essentially all those solutions. How would you reduce abuse/fraud? How would you deal with malpractice? Are those two really issues that are important on a large scale? What about legal issues arising out of insurance companies trading over state lines?

I don't have time to write a thousand page bill to go into detail about preventive medicine and fraud reduction.  Malpractice reform is needed, because hospitals charge more for health care to pay for many frivolous lawsuits. It is easy for a jury to give away someone else's money, so money given for pain and suffering needs to max out.  This would greatly reduce health care costs, because doctors wouldn't need to spend so much money on malpratice insurance.  Because of lawyers, doctors have to due many useless tests, so they are not sued for missing anything.  A bill needs to adress legal issues about trading over state lines.  With more companies trading in a state, there is more competition and prices will lower. Simple supply and demand.

Why is this bill a good idea?
1. There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?
3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.

1. The government is designed to be inefficient, as to make sure it works as fairly as possible. If you wanted efficiency you can take a time machine and go to Italy during World War II. However, your point is irrelevant anyways as it is based under the assumption the government is going to ‘taking control of’ health care, which is isn’t.
3. That’s your opinion, and it doesn’t conflict with the health care bill anyways. You’re stuck with a viewpoint of a vague, messy hive mind that is the government enveloping everything, which severely limits your viewpoint.

First you say "government is designed to be inefficient" and then you say it is my opinion that the private sector is more efficient.  Apparently you have a "a vague, messy hive mind" too.

Why is this bill a good idea?
5. The health-care industry likely will become infused with the same kind of corruption, back-room dealing, and special-interest-dominated sleeze that is already prevalent in other areas of government.

5. That’s a hypothetical, so I ask you for proof.

I sure you are right.  Noble politicians like Obama wouldn't use his control over the bureaucracy to further his leftist political agenda. This is the same guy who had to tell the world that the underwear bomber is talking for only political reasons.  If he is willing to warn terroist in Yemen that their guy is talking to increase his approval rating, then he willing to use his control of the health care system to further other political goals.

6. Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.

6. That is again a hypothetical, so I ask you for proof.

You probably failed economy in school by answering "thats hypothetical".  This is simple logic.  When it cost money to go to the doctor, people will only go when they really need to.  When the government pays for it, people will go for minor illnesses.  With more people going to the doctor and purchasing drugs, the demand goes up.  When the demand goes up, so does prices.

8. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.

8. Nope. You have to fact-check these, this is a myth that is blatantly untrue.

If you want proof, then read about any country with socialized health care.

9. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.

9. Where did you get that idea? Rush Limbaugh, Sarah Palin, or Glenn Beck?

Smoking and obesity are pre existing conditions that the new bill forces the issurance companies to cover.  To cover these unhealthy people, the price of insurance will go up.
Glenn Back is funny, because he make stuff up as he goes and most of the time it is total bull $hit. Even if she is smarter then people portray her, Sarah Palin doesn't know half about what she is talking about.  Never listened to Rush Limbaugh. 

11. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.

11. Again, an idea based on an untrue myth.

I am sure many people want to go four years of collage, then four years of medical school, work as an intern, work as a resident, pay back huge loans, and then get payed less money after the government tries to lower doctor wages.

14. Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.
15. Health care equipment, drugs, and services may end up being rationed by the government. In other words, politics, lifestyle of patients, and philosophical differences of those in power, could determine who gets what.
16. Patients may be subjected to extremely long waits for treatment.

14. --16. Hypotheticals…

Let me guess. You knew I was right, so you called it "hypothetical" as a last resort.

[Presentiment]

No, none of your inferences are based on fact.

It sounds like you're quoting from Sarah Palin.

[SmartyPants]

1. There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?

It's one thing to be philosophically opposed to government involvement in health care. That's a personal belief, not susceptible to proof. But you can't just walk up and say "government is always inefficient, therefore this program will be poorly managed and wasteful." That's a factual assertion, and you need to have a factual basis for making it.

I can make the same argument on the other side, and you'll quickly see why it's flawed: Private industry is more wasteful than government. Just last year, our entire private banking industry practically threw itself off of a proverbial cliff. Would you trust private industry people to handle your medical insurance? I wouldn't.

The problem with making broad-brush arguments like this is that some organizations are well-run, and some aren't, regardless of whether they are private or public. You have to look at the particular organization. The evidence suggests that Medicare, the largest part of our national public health insurance system, is actually somewhat better at controlling costs than the private insurance industry has been for the past quarter-century or so. This, even with private insurers systematically kicking sick people off of their rolls. So there is good reason to believe that this bill will actually be an improvement, efficiency-wise.

In private industry, ineffcient businesses are put out business by the competitors.  When the government bureaucracies are ineffcient,  the taxes payers keep giving them money to flush down the drain.  Medicare is a good idea, but Medicare needs to be fixed.  The government should have fixed Medicare before spreading government inefficiency in the health care system.

My article is written by a doctor, while yours is written by a liberal writer.  Who know better?

Like I said earlier, everyone agrees to health care reform.  Just because a few of the reforms are good, doesn't mean the bill as a whole is good.  Both Republicans and Democrats agreed that people can't cancel coverage based on pre existing condition.  If Obama did what he promised and what the American people want, then we would have a moderate, partisan bill that doesn't give the government bureaucracy control of one-sixth of the economy.

I'm a little suspicious about where you're getting some of these ideas: "what the American people want," for instance. That's pretty much verbatim a Republican Party talking point. Most people support establishing a public health insurance option, which is actually a good deal more socialist than what we got in this bill. (Here's a second poll saying the same thing, and a couple more for good measure.)

All the sites you gave me are sites I use to quote liberals.  Use a non-baised site like Gallup. If the people didn't disagree with the bill, then why did the Democrats reject the voice vote.  The reason why is because they will lose re-election if they are on video voting for the bill.

No, none of your inferences are based on fact.

It sounds like you're quoting from Sarah Palin.

Unable to argue with my logic, you have to attack my credibility.  That just shows how weak your arguement really is.  You're kinda pathetic.

[Presentiment]

Simply because the logic isn't there, because you come out with random inferences, such as 'centralized health information likely to be maintained by the government', 'may end up'. You provide no reasoning for why you would come up with these ideas.

I'd also like to point out that voice votes are not recorded unless there is major disagreement on what people said, in fact, voice votes are in fact used to cover up voting, as there is no formal record of the proceedings. Because the Senate allows unlimited debate, the Democrats need 60 to overcome a Republican filibuster, and it is harder to determine whether that majority was met with a voice vote.

It also doesn't matter who wrote the article as long as it makes sense. 

[CraigStern]

My article is written by a doctor, while yours is written by a liberal writer.  Who know better?

First of all, this is an appeal to authority. You should weigh the arguments based on how sound each of them is, not based on who made them.

Second, a doctor is trained to treat patients, not to analyze financial data. I can't think of any reason why I should give greater weight to an industry cost analysis made by a doctor than I would to an analysis by someone who works regularly on the policy end.

Third, Health Affairs is a peer-reviewed journal, not some liberal blog. And the writer, Joseph White, is not just "a liberal writer." Here is his bio:

Joe White is Luxenberg Family Professor of Public Policy, Chair of the Department of Political Science, Professor of Epidemiology and Biostatistics, and Director of the Center for Policy Studies at Case Western Reserve University. He earned his AB in Political Science from the University of Chicago and his MA and PhD in Political Science from the University of California, Berkeley. His research has focused on federal budget policy and politics, international health care systems, entitlements, and health care cost control. His research on health care policy and politics includes two books: False Alarm: Why the Greatest Threat to Social Security and Medicare is the Campaign to “Save” Them (Baltimore: Johns Hopkins University Press, 2001; paperback with new afterword, 2003), and Competing Solutions: American Health Care Proposals and International Experience (Washington, DC: Brookings, 1995). Among his articles are “Markets and Medical Care: The United States, 1993-2005.” The Milbank Quarterly 85:3 (September 2007), and “The Obama Administration’s Options for Health Care Cost Control: Hope vs. Reality,” with Theodore R. Marmor and Jonathan Oberlander. Annals of Internal Medicine 150, No. 7 (7 April 2009).

I'm a little suspicious about where you're getting some of these ideas: "what the American people want," for instance. That's pretty much verbatim a Republican Party talking point. Most people support establishing a public health insurance option, which is actually a good deal more socialist than what we got in this bill. (Here's a second poll saying the same thing, and a couple more for good measure.)

All the sites you gave me are sites I use to quote liberals.  Use a non-baised site like Gallup. If the people didn't disagree with the bill, then why did the Democrats reject the voice vote.  The reason why is because they will lose re-election if they are on video voting for the bill.

Reuters is a non-partisan news wire, like McClatchey or the Associated Press. The Washington Post has left-leaning editors, but it is nonetheless a credible paper with accurate reporting. The Huffington Post is a bit of a liberal rag, I'll admit that.

As for Gallup, their latest poll shows that Americans support the health care bill 49-40: http://www.gallup.com/poll/126929/Slim-Margin-Americans-Support-Healthcare-Bill-Passage.aspx

[SmartyPants]

Simply because the logic isn't there, because you come out with random inferences, such as 'centralized health information likely to be maintained by the government', 'may end up'. You provide no reasoning for why you would come up with these ideas.

Obama himself wants to make it where any doctor can look up health information about anyone.  If a doctor is willing to give Michael Jackson a lethal amount of drugs, then what will stop a doctor from selling personal medical information.  Your lack of logic and false accusations make you seem even more pathetic.

As for Gallup, their latest poll shows that Americans support the health care bill 49-40: http://www.gallup.com/poll/126929/Slim-Margin-Americans-Support-Healthcare-Bill-Passage.aspx

At least this a non-baised poll.  It wierd that there were so little people who answered "no opinon", since the bill passed less than two days ago.  I surprised that so many actually know what is in the bill to like it or not like it.

I find it interesting that so many people oppose this bill on national debt grounds. You might be interested to know that the Congressional Budget Office has estimated that the bill will actually reduce the federal deficit by roughly $143 billion over the next ten years, and up to $1.2 trillion over the ten after that.

The reason for that is because the bill forces the states to pay for the bill.  Instead of the federal govenment having deficit spending, the bill will force the states into deficit spending.  That is why 10 states are sueing for violating the 10th Amendment.

It is 11 states now.  Does no one else think it is wrong that the federal government is forcing its problems onto the states?

[CraigStern]

I don't see any basis for the argument that the Patient Protection and Affordable Care Act* violates the 10th Amendment. The new health care law requires individuals to secure insurance, and in some instances, business owners will have to provide health insurance to their employees. It doesn't require the states to buy insurance for anyone.

The 10th Amendment has only ever been applied in cases where the federal government forces the states to either adopt or enforce federal rules. The only thing at all like this in the bill is the state insurance exchange mandate, but the bill provides no penalties for states that do not set one up. Instead, it just empowers the Secretary of Health and Human Services to set one up in their stead. (See Section 1321(c) of the law.)


*I'd link to thomas.loc.gov, the official Library of Congress website, but links to that site expire after a while. If you want to find it on thomas.loc.gov, look under H.R. 3590.

[Presentiment]

Federal law takes precedent over state law.

[SmartyPants]

I don't see any basis for the argument that the Patient Protection and Affordable Care Act* violates the 10th Amendment.

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

Health care isn't in the Constitution and being alive isn't considered interstate commerce, so the government can't mandate health issurance.  Since health care isn't in the Constitution, it is "reserved to the States respectively, or to the people".

[CraigStern]

The 10th Amendment isn't considered an affirmative limit on Congressional power, though: as interpreted by the courts, it only really applies to keep Congress from hijacking state governmental functions, as mentioned above. It's actually Article I of the Constitution that limits Congressional powers to those enumerated. (Trust me on this one: I used to be a research assistant for one of the country's foremost Constitutional scholars. )

Personally, I think those 11 states are going to have a very hard time arguing that the commerce clause doesn't support this bill. Ever since Wickard v. Filburn, there's been a rule in commerce clause jurisprudence called the aggregation principle. Basically, what it means is that even personal conduct that never crosses state lines can be reached through legislation via the commerce clause if that behavior, taken in the aggregate, has a substantial affect on interstate commerce.

So in Wickard, agricultural laws passed in response to free-falling food prices during the Great Depression limited the amount of wheat farmers were allowed to grow. The guy suing was a farmer who had produced about 240 bushels of wheat above the amount allowed. The excess wheat was for his own personal consumption, and wasn't ever going into commerce anywhere, so he claimed that the agricultural act reached beyond Congress's constitutional powers. Not so, said the court: "That appellee's own contribution to the demand for wheat may be trivial by itself is not enough to remove him from the scope of federal regulation where, as here, his contribution, taken together with that of many others similarly situated, is far from trivial."

The situation is similar here: you have an industry spanning every state, and Congress is trying to control prices by regulating individual behavior. While someone's individual choice to not buy health insurance will have only an infinitesimal effect on interstate commerce on its own, taken in the aggregate, that kind of decision would have a huge effect, raising the cost of covering really sick people. I think the chances of the Supreme Court striking this law down are about 1 in 1,000. It could happen, but I'd be really surprised.

[SmartyPants]

How is it considered interstate commerce when the system is built to where you can't buy insurrance over state lines?  It is one thing to regulate the amount of a good, so inflation doesn't happen, but to mandate someone to buy health insurance for being an American citizen is another.  Where does it stop?  Is the government going to mandate citizens to buy cars to save inefficient automotive companies?