Tom Bevan and others say that those claiming that services like Medicare are more cost-efficient than private insurers are way off the mark.
I’ve long suspected so; I’ve been hearing for years now that government-run health care runs extraordinarily low administrative costs. It makes perfect sense that the reason for that would have more to do with how much money is spent on treatment for your typical Medicare recipient than your average person.
Have no doubt, I am 100% in favor of health care reform and of moving to having every American insured. This is fully in keeping with the Constitution and with the traditions of this country, and it’s both a moral and practical necessity. Period. It’s also just plain a good idea; the burden on private employers is ridiculous and distorts the market in multiple destructive ways.
Nevertheless it would be irresponsible to eliminate private insurers. Consumers should have a choice and government shouldn’t run everything itself–in fact, it’s almost always a bad idea to have the government run everything itself in any area. Besides, it would be a political non-starter to try to destroy the country’s private medical insurers: they’ll fight back, hard, to try to save themselves, and you can bet that most of their employees and many of their customers will join them in that fight. Demonizing them and trying to destroy them does no good at all. Whatever reform we have–and I pray we have real reform soon, because we *do* need it–it would be foolish to try to destroy the private sector.
Although, by the way, has anyone else noticed how, on the other side, we currently have people desperately trying to sell us the notion that, because recent surveys have found that most Americans are satisfied with their health care we have no need for reform? That’s just as much statistical trickery as trying to claim that programs like Medicare are “more efficient.” Just because people are satisified does not mean that they feel secure, that they feel confident that they’ll be able to keep their insurance if something bad happens, that they feel that everyone who’s important to them gets the care they need and is reasonably secure, and so on. It’s statistical dishonesty to say to an individual, “well, you’re reasonably satisfied with what you have at the moment… and therefore I assume you think there is absolutely no need for reform anywhere in any way.”
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The focus on insurance is misleading. Health care costs are too high, and finding a way to pay for too-high costs rather than addressing underlying reasons ensures there is no ceiling for cost. I personally DEPEND on insurance, because I could not afford routine medical care — that’s just plain not right; health care, not health care insurance, needs to be affordable. A catastrophic policy should be the only thing anyone who has a reasonable job should need.
I suspect litigation is a major driver in a couple of ways — malpractice insurance clearly rasies prices, but a culture that requires avoiding malpractice challenges is likely causing unnecessary procedures. There are other issues like equipment costs, how about the Fed Gov supplying new equipment under some kind of grant program?
No.
I have, however, noticed people trying to make the point that because of those survey findings, the arguments that universal medical conscription is desperately needed or even has a significant Citizen mandate are therefore invalid.
It’s possible that there are people going beyond that to what you characterize as “statistical dishonesty”, but I haven’t seen it, so if you’re going to claim that, I’m going to request cites.
What really cheeses me off, though, is how that’s nowhere near as dishonest as the statement that “. . .having every American insured. . .is fully in keeping with the Constitution and with the traditions of this country, and it’s both a moral and practical necessity.”
That’s leftism, Dean, not liberalism, and categorically untrue. Universal medical conscription is diametrically opposed to many traditions of this country, including much of the philosophy upon which (edit) the Constitution rests.
What is a moral and practical necessity is protecting personal liberty, private property, the Bill of Rights, and other aspects of the primacy of the right to self-determination in the usa social contract.
Show us a way to ensure the coverage of every Citizen that necessarily avoids the blatant violation of the right to self-determination for not only patients and practitioners but researchers, investors, and others as well, and then we’ll have something to discuss.
Unless and until you do that, however, people’s unwillingness to be assimilated by Borgcare, and their right to refuse to — which I believe is usually the foundation beneath assertions about people’s satisfaction with their current insurance — remains a valid counterpoint to and invalidation of the statist totalitarian desires and goals of the leftists among us pushing for this naked anti-liberal collectivism.
Update: I believe I read
the WT article you referenced in your pulled comment. Sorry, but that doesn’t count as a cite, because reform =/= nationalization. In fact, they even make that point themselves: “Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied.”
I didn’t even spend 30 seconds looking. Quote:
See, most Americans are happy with the care they get from their doctors and nurses! So anyone who says insurance reform is badly needed is a big fat stinky liar!!!
No statistical sleight-of-hand there, no sirree! So even if I’m desperately afraid of losing my coverage, even if I’m trapped in a job I hate and want to leave but can’t because I can’t afford to lose my insurance or pre-existing conditions will make it impossible for me to be insured elsewhere, there’s no problem!
Even if my business is losing its shirt, or goes under from being unable to compete with bigger companies for quality employees because they can offer cheaper insurance than I can (because they have a bigger pool of employees so their costs are automatically lower), or my business has to compete with companies that don’t even have to pay insurance for most of their employees because they’re in other countries, there’s no problem here!
Sure, I may have lost my house and all my savings and had to declare bankruptcy due to medical bills, but my actual medical care was good, so I had no problem! Sure, nearly half of all bankruptcies, which massively hurt the credit markets, are caused by medical bills, but there’s no problem here! The people like the services they get from the doctors, after all, so that proves none of these other problems matter!
Oh, and sure, tens upon tens of millions of people are very happy with their medical care which they get through the Veteran’s Administration (which is nowadays one of the best systems in the world by the way), through the Armed Forces (because Mom and/or Dad is in the service), or because they already receive Medicare or Medicaid–but hey, that’s just proof that our private insurance system works great and doesn’t need reform anyway! Those tens of millions of families already getting government-assisted care who are happy as clams with it just proves we don’t need it!
Borgcare? I’ve already had it. That’s when my family had some of the best private medical insurance available–Blue Cross–and I was stuck in the worst job of my life and couldn’t leave because we couldn’t afford to lose the insurance. Thank you for “helping” me be “free” to stay assimilated in the system you advocate, Borg Unit Ack!
Regarding morality: I’m just not interested in debating morality with anyone who thinks the market is the only morality that matters. Been there, done that, bought the t-shirt–I even used to be a true believer as it happens! Now I just see it as Marxism’s conjoined mirror twin. Both are equally silly.
Ditto arguing over whether it’s “leftism” or “liberalism” to advocate for reform that would give people and businesses more freedom, more choices, and less government hassle.
And I’m DEFINITELY not going to waste time arguing with someone who obviously doesn’t know that Strict Constructionism was a dead doctrine before the ink was even dry on the Constitution, and that we have never lived under this doctrine in the entire history of this nation. Alexander Hamilton won, Ack, not Jefferson, and despite all Jefferson’s rhetoric (and whatever twaddle comes out of Glenn Beck’s mouth), when Jefferson won office he too discovered that Strict Constructionism was impossible, and most of his biggest achievements flew right in its face.
We work under the Doctrine of Implied Powers, and we have since the Constitution was ratified. It’s served us very well. There is no Constitutional impediment, PERIOD.
It wasn’t today’s politicians who rejected Strict Constructionism. It was THE FOUNDERS.
That’s the facts, Jack. Do with ‘em what you will.
Oh, and P.S.: do I really have to show you all the places where most any proposal is referred to as “nationalized health care?” You know the President isn’t advocating nationalized health care, don’t you? Because he isn’t. So what’s your point?
When the government “competes” with private industry, the government will always win. Why? Because the government can regulate the competition out of existence. Maybe not today. Maybe not tomorrow. But it will happen. All we have to do is look at the abysmal situations in Europe and Canada.
Also, “in keeping with the Constitution?” Exsqueeze me? Baking powder?
Please, please, PLEASE show me where government run health care is a power granted the Federal government by the Constitution.
And you want to talk traditions? How about the traditions of state primacy? If a state wants to setup a health system, more power to ‘em! The Federal government has no such power.
See, most Americans are happy with the care they get from their doctors and nurses! So anyone who says insurance reform is badly needed is a big fat stinky liar!!!
Except, of course, for how reform =/= nationalization, and how the WT editors said: “Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied.”
No statistical sleight-of-hand there, no sirree!
Yes, just your own gross misrepresentation.
So even if I’m desperately afraid of losing my coverage, even if I’m trapped in a job I hate and want to leave but can’t because I can’t afford to lose my insurance or pre-existing conditions will make it impossible for me to be insured elsewhere, there’s no problem!
Except, of course, for how reform =/= nationalization, and how the WT editors said: “Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied.”
Even if my business is losing its shirt, or goes under from being unable to compete with bigger companies for quality employees because they can offer cheaper insurance than I can (because they have a bigger pool of employees so their costs are automatically lower), or my business has to compete with companies that don’t even have to pay insurance for most of their employees because they’re in other countries, there’s no problem here!
Except, of course, for how reform =/= nationalization, and how the WT editors said: “Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied.”
Sure, I may have lost my house and all my savings and had to declare bankruptcy due to medical bills, but my actual medical care was good, so I had no problem!
Except, of course, for how REFORM =/= NATIONALIZATION, and how the WT editors said: “Instead of NATIONALIZED health care, a more targeted and much cheaper REFORM could take care of just those who are dissatisfied.”
Sure, nearly half of all bankruptcies, which massively hurt the credit markets, are caused by medical bills, but there’s no problem here!
Except, of course, for how that particular figure has been credibly accused of. . .statistical-sleight-of-hand. . .and is still being heavily debated across the internet. Sorry, but that’s not a valid cite either.
The people like the services they get from the doctors, after all, so that proves none of these other problems exist!
Except, of course, for how REFORM =/= NATIONALIZATION, and how the WT editors said: “Instead of NATIONALIZED health care, a more targeted and much cheaper REFORM could take care of just those who are dissatisfied.”
Oh, and sure, tens upon tens of millions of people are very happy with their medical care which they get through the Veteran’s Administration (which is nowadays one of the best systems in the world by the way), through the Armed Forces (because Mom and/or Dad is in the service), or because they already receive Medicare or Medicaid–but hey, that’s just proof that our private insurance system works great and doesn’t need reform anyway!
Except, of course, for how REFORM =/= NATIONALIZATION, and how the WT editors said: “Instead of NATIONALIZED health care, a more targeted and much cheaper REFORM could take care of just those who are dissatisfied.”
To say nothing of the numerous and widespread criticisms of the VA, Medicare, and Medicaid, and calls for reform therein.
Those tens of millions of families already getting government-run health care all just prove it!
Except, of course, for how REFORM =/= NATIONALIZATION, and how the WT editors said: “Instead of NATIONALIZED health care, a more targeted and much cheaper REFORM could take care of just those who are dissatisfied.”
Borgcare? I’ve already had it.
Not without the threat of State force being applied to you for refusing to participate in it, you haven’t. Because that’s the critical element that makes it Borgcare: the threat of force for refusing to participate.
Because of how, y’know, the Borg used force to forcibly assimilate by force virtually every individual they forced to join them.
With force.
To be fair, though, that might be just a misunderstanding on your part rather than a deliberate misrepresentation.
Might be, considering your behavior in this response otherwise.
Also: FORCE
That’s when my family had some of the best private medical insurance available–Blue Cross–and I was stuck in the worst job of my life and couldn’t leave because we couldn’t afford to lose the insurance. Thank you for “helping” me be “free” to stay assimilated in the system you advocate, Borg Unit Ack!
Except, of course, for how nobody from the State threatened you or yours with force for refusing to participate.
And for how I am not in the least bit meaningfully responsible for your life choices, let alone the consequences.
And for how I am not advocating the current employment-linked primary coverage system.
Casually yet ruthlessly destroying your silly little overwrought misrepresentations, yes.
Advocating the existing employment-linked primary coverage system? No.
So, you know, no. Wrong. . .Misrepresentatory Unit Dean.
Regarding morality: I’m just not interested in debating morality with anyone who thinks the market is the only morality that matters.
And when one of them shows up in this thread, that will become meaningfully relevant.
However, since I’m pretty sure that neither P Mike nor Kevin D thinks that, and I know for a fact that I don’t, it isn’t.
Been there, done that, bought the t-shirt–used to be a true believer as it happens! Now I just see it as Marxism’s conjoined mirror twin. Both are equally silly.
And again, when someone who thinks that shows up in this thread, that will become meaningfully relevant.
However, since I’m still pretty sure that still neither P Mike nor Kevin D thinks that, and I still know for a fact that I still don’t, it still isn’t.
Ditto arguing with you over whether it’s “leftism” or “liberalism” to advocate for reform that would give people more freedom, more choices, and help more businesses than what we have now.
Except, of course, for how
REFORM
=/=
NATIONALIZATION,
and how the WT editors said: “Instead of
NATIONALIZED
health care, a more targeted and much cheaper
REFORM
could take care of just those who are dissatisfied.”
And for how the distinction between nationalization and reform is a debate over leftism versus liberalism, respectively.
But yeah, I can definitely see you refusing to debate the issue of the leftism versus the liberalism of your position. It’s my first time trying that observed distinction out, and I have to say the rageaholism it apparently inspires has exceeded my anticipations.
And I’m DEFINITELY not going to waste time arguing with someone who obviously doesn’t know that Strict Constructionism was a dead doctrine before the ink was even dry on the Constitution, and that we have never lived under this doctrine in the entire history of this nation.
And, yet again, when someone who obviously doesn’t know it shows up in this thread, that will become meaningfully relevant.
However, since I’m pretty sure that both P Mike and Kevin D do, and I know for a fact that I do, it isn’t.
Alexander Hamilton won, Ack, not Jefferson,
“May have been the losing side. Still not convinced it was the wrong one.”
and despite all Jefferson’s rhetoric (and whatever twaddle comes out of Glenn Beck’s mouth),
LOLWHUT?
when Jefferson won office when he won office he too discovered that Strict Constructionism was impossible, and most of his biggest achievements flew right in its face.
And if universal medical conscription was objectionable solely on the grounds of Strict Constructionism, that would be meaningfully relevant.
However, since it isn’t, it ain’t.
We work under the Doctrine of Implied Powers, we have since the Constitution was ratified. It’s served us very well. There is no Constitutional impediment, PERIOD.
Except, of course, for how there very well may be.
It wasn’t today’s politicians who rejected Strict Constructionism. It was THE FOUNDERS.
And again, if universal medical conscription was objectionable solely on the grounds of Strict Constructionism, that would be meaningfully relevant.
However, since it still isn’t, it still ain’t.
That’s the facts, Jack. Do with ‘em what you will.
Except, of course, for how they’re not the only, let alone meaningfully relevant facts involved.
Such as, for example, the fact that I said “much of the philosophy upon which the Constitution rests,” not just “the Constitution.” Deliberately so, because I’ve learned over the years to avoid the thickets of Constitutional arguments; they’re almost always irreducible and inconcludable.
And the fact that your refusal to address my points about how universal medical conscription is diametrically opposed to many traditions of this country, and the real necessity of protecting personal liberty, private property, the Bill of Rights, and other aspects of the primacy of the right to self-determination in the usa social contract, and the need to avoid violating that for those who wish to exert their right to refuse to participate, means that they continue to invalidate the statist totalitarian desires and goals of the leftists among us pushing for this naked anti-liberal collectivism.
And the facts that nationalization =/= reform, but nationalization DOES = leftism.
And the fact that the WT editors said: “Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied.”
And the fact that you therefore haven’t provided a valid cite yet.
Oh, and P.S.: do I really have to show you where you yourself said having every American insured was both a moral and practical necessity? You know trying to pass that off onto Obama’s shoulders is a cheap, sleazy, dishonest rhetorical gimmick, don’t you? Because it is. So where’s your integrity?
I do not have medical insurance. I have the cash on had to pay for it, yet I choose not to. Instead, I pay for medical treatment out of pocket, and keep the savings.
I understand that I am trading risk to my life for money. This is my choice, for my own reasons. As it turns out, that extra money has been the margin of my survival more than once.
When someone else says to me “You need to do X for your own good, and I intend to use force to compel you to do it”, I find that completely unwelcome.
In effect, that’s what you’re saying here, Dean.
I’d like to pass, please.
Ack: Another great bit of rhetorical dishonesty being employed by many on the Right, and which apparently you’ve been fooled by as well (I wouldn’t want to accuse you of knowingly taking part in the dishonesty) is to blur the distinction between reform and nationalization as if they’re both the same thing. Now you, amusingly, take me to task for not knowing the difference, even while you trumpet the evils of “Borgcare” and “medical conscription” even though it is in fact reform, not nationalization, that’s being proposed in Washington right now?
Since the government in Washington is not currently considering nationalizing the health care system, and only a tiny minority are advocating any such thing–and certainly the President and the current majority leadership in the Congress are not among them–then all this ink spilled on the evils of nationalization is exactly the sort of rhetorical dishonesty we’re talking about.
So I’m with you. There is a firm difference between the two. And since nationalization isn’t on the table (and shouldn’t be), then presumably we can agree that it’s a waste of time, not to mention dishonest, to start railing about the evils of “Borgcare” when no one’s proposing any such thing. And we should both be wondering why the Washington Times and others are blathering about such nonsense–to me it’s pretty obviously a tactic to scare people and change the subject from the issue at hand.
The combination of private and public health care works very well in Germany. If we’re seeking to improve our system, we should use Germany, not Britain or Canada, as a model.
Kevin:
When the government “competes” with private industry, the government will always win.
Nonsense. Private industry out-competes the government here in the United States all the time. Examples are numerous. A couple off the top of my head: the government competes all the time at job faires to get High School and/or College kids to join the armed forces or other government jobs. Guess what? Most kids don’t take the government jobs.
Federal employees are generally offered a range of health insurance options, one of which is an insurance program that is run entirely by the government itself. Most Federal employees, however, wind up opting for Blue Cross or one of the other list of private insurers they’re allowed to choose from. Why? They like it better.
There’s tons of other examples. This bogeyman so many on the Right have made of government as an evil spectre that’s going to consume us all is really out of control, Kev, and you ought to be smart enough to clear your head of this nonsense.
All we have to do is look at the abysmal situations in Europe and Canada.
Uh, well, like us, their systems all have problems, because there is no perfect system. Not on this Earth, anyway. Those systems all have major advantages and disadvantages. Our current system can easily be described as abysmal, because it is in a lot of ways. But on the whole Canadians get decent health care, and so do most Europeans, and Europe isn’t falling into tatters and neither is Canada. Indeed, on the whole, economically and otherwise, the Canadians are doing a lot better than us these days, and not just in health care. You hadn’t noticed?
Please, please, PLEASE show me where government run health care is a power granted the Federal government by the Constitution.
M-heh. Please, please, PLEASE show me where immigration regulation and enforcement is a power granted the Federal government by the Constitution.
Ditto, show me where the Federal government is empowered to set standards for who is or isn’t a citizen.
Ditto, show me where they’re empowered to DEMAND that states enforce those laws for them.
Ditto, where they’re granted any power to set any sort of policy on drug use.
Can you please also cite for me where the Federal government gets its right to maintain a standing Army?
Can you show me where they get a right to build or maintain an Interstate Highway System?
Why do we even have a Veteran’s Administration offering health care by the way? I mean, you can’t show me where it specifically says they can create such a thing in the Constitution, can you? I really don’t think you can.
I suspect that the problem here is that you and a few others have been fooled by twaddle about “strict constructionism.” Strict Constructionism is a doctrine of Constitutional interpretation that’s been rejected since this country was founded.
To emphasize: it is a doctrine that has NEVER, EVER, AT ANY TIME been the means by which the Constitution is used to govern. If you have a beef with that, you’ve got a beef with George Washington, John Adams, Thomas Jefferson, and almost every one of the men who wrote and ratified the Constitution.
Under proper Constitutional interpretation–under the doctrines that have been in place SINCE THE FOUNDERS–there’s no problem with the Federal government collecting taxes and using those funds for the necessary and useful purposes of the nation as a whole. Through its powers to regulate interstate commerce, the Federal government is also fully able to set national policies on things like how the insurance industry operates. And it’s certainly empowered to set up agencies to manage such functions.
There’s simply no Constitutional impediment, Kevin, and whoever is trying to teach you these false doctrines is selling you snake oil.
And you want to talk traditions? How about the traditions of state primacy? If a state wants to setup a health system, more power to ‘em! The Federal government has no such power.
I didn’t particularly want to talk about traditions, as I don’t see where traditions are relevant here. Sure, the states would absolutely be within their powers to create their own state-run health insurance systems. Some already have. But the Federal government is perfectly well empowered to do the same if it wants to. The Constitutional arguments against are without merit.
Indeed, Constitutional arguments in this setting are a red herring, pretty much exactly like all the blatherings about “nationalization”: they’re a red herring designed to distract from the real issue. They have nothing to do with anything being discussed, they just distract people and get them worked into a froth over bullshit.
Mary, I’m pretty much with you. Except Britain’s not all that bad an example these days either; they long ago found that their National Health Service, which used to run pretty much ALL medical care (and would be an example of the sort of “nationalization” that no one is proposing here in the United States), was just not able to do all they’d hoped it would be able to, and had serious shortcomings. The Brits these days have a range of options to choose from, and private health insurance is among those options for those who can afford it.
I personally would hate to see Single Payer like they have in Canada. Although it’s definitely got its advantages, it’s got serious weaknesses. Of course all systems have serious weaknesses, but I don’t think it’s in keeping with how we like to do things in the U.S. to do it the way they do it.
We’re going to continue having private health insurance and private health practice. It’s foolish for those on the far left to try to abolish those things–and on a practical, pragmatic level that will never happen anyway because the private insurance companies will fight tooth and nail to prevent themselves from being destroyed, and they’ve got plenty of resources to make sure the government doesn’t do that to them. Some few on the left keep calling for that, and as I argued in the front page article that started this, that’s just not wise.
Wow, Dean, talk about saying mostly nothing. You are in favor of improving health care and access ? Way to stick your neck out on a subject.
Yeah, government run health care would be a calamity.
And while you may be able to find people that point to the “satisfied” stat to claim nothing is needed, that is not the point. The point is, when 77% of people are satisfied with their health care, you need to TWEAK, not smash the existing system and spend a trillion dollars to remake it in Cuba’s image.
You might also point to the poll results that show over 80% of people recognize that the current proposals will 1) cost them more and 2) their health care quality will decrease. How in the hell are we continuing to pursue what the vast majority of America knows is a disaster ?
Also, Dean, you have yet to offer an example where the government competes on an even playing field and doesn’t win. Army jobs ? Really ? The point there is that if the government decided the Army was important enough, they absolutely have to power to raise salaries to the point that kids will flock to the military and private employers WILL lose. And considering that you yourself admit the left WANTs a single payer system, the government can easily undercut private insurance in exactly the same way and private insurance WILL lose.
I would also point that your “bogeyman” about medical bankruptcy is misleading. According the statistics I could find with a simple google, 50% involve a medical crisis. But 67% involve losing a job, and another 24% involve divorce. The real underlying problem is debt, not health care.
For the most recent year I could find, the average household owed 50% more in debt than their annual income. Statistics available up to 2007 show a very stable climb in personal debt payments as a percentage of disposible income.
Meaning that health care is not the problem. Unless you are similarly advocating a massive government program to provide continuous unemployment benefits or some other government program to subsidize divorce. No, the real problem is debt spending, which I’m pretty sure you already knew.
I am not all that sympathetic to people who end up bankrupt because they were massively in debt and then had a medical emergency that prevented them from continuing to live their unsustainable lifestyle. I don’t begrudge anyone the medical care they need, and as I pointed out in a previous comment, they will never be turned away from the ER. But getting that care and then paying for it instead of your massive credit card debt, those are two very different issues.
And finally, the idea you were stuck in some deadend job, oppressed and held hostage for health care, that is complete BS. You CHOSE that job and then CHOSE not to leave it. Few, if any, responsible adults, especially those with dependents can just quit their job. I certainly couldn’t. But the options available for ANOTHER job with comparable insurance are effectively infinite. In my career, spanning 18 years now, I’ve always had insurance – with the exception of about 6 months when I opted for cash in lieu of insurance – I’ve worked for 5 different companies in 4 different states.
Don’t tell me some tale of woe that assigns responsibility for your life to someone else. During that time you were better off than a sizeable portion of this country and probably 90% of the rest of the world. And yet you describe as if you were oppressed and subjugated. Ridiculous. The amount of luxury we take for granted in this country is amazing.
I saw a bumper sticker the other day that sounded like you on the “moral” aspect of this debate – “Health Care is a Human Right”. Really ? Then why am I and my employer paying for it ? Seems to me that something that is a right, should be free. It isn’t. I’d be curious to see some statistics about health care over the last 200 years. Seems to me that health care is improving exponentially. How we expect the cost an exponentially improving entity to somehow decrease is baffling.
“…the government competes all the time at job fairs to get High School and/or College kids to join the armed forces …”
Are you serious?
You do know, Dean, that all it takes is one simple act of congress, and all of those young men who are – right now – COMPELLED by our government to register at age 18 for the selective service system, can then be called up and be drafted against their will – that is, *FORCED* at the point of a gun – to take one of those lucrative Army jobs you describe. It doesn’t matter what the pay is or what better civilian job might be available, or even what the draftees wishes might be. If you don’t believe me, just talk to one of the thousands of Vietnam veterans who had that exact scenario forced on them 40 years ago. Or any WWII vet who went through it 65 years ago.
“Please, please, PLEASE show me where immigration regulation and enforcement is a power granted the Federal government by the Constitution.”
We’ve been here before, but you ignore the plain language -
Article 1, Section 8, which describes the scope of legislative power, in paragraph 4 states very simply and to the point:
To establish a uniform rule of naturalization,…
“Ditto, show me where the Federal government is empowered to set standards for who is or isn’t a citizen.”
See above, plus:
Fourteenth amendment, Section 1:
All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States…
“Can you please also cite for me where the Federal government gets its right to maintain a standing Army? ”
How about Article 1, Section 8, paragraphs 12:
To raise and support armies, but no appropriation of money to that use shall be for a longer term than two years;
(The defense budget gets re-appropriated by congress every two years – like clockwork.)
“Can you show me where they get a right to build or maintain an Interstate Highway System?”
This one is open to interpretation, but how about:
Article 1, section 8, paragraph 7:
To establish post offices and post roads;
Look, there are a lot of things that the Federal government does today that some conservatives and most libertarians consider extra-constitutional. Some, like the war on drugs, are even on your list.
But that’s the whole point, isn’t it.
And you can pooh-pooh other folks fears about this administrations’ plans for our health care system all you want. That’s still not going to change the fact that this administration and it’s majority congress – in just 6 months in power – has shown itself to be supremely untrustworthy. The president,repeatedly has said one thing, and then done another.
And then there is the past history of this issue. We’ve been here before. You may not remember, but I sure do – Hillary-care. It was touted as mere reform, but was really a smash-and-grab. The act had more penalties for going outside of the government system than it did services inside the system. And it went down in flames, and could arguably have been the major cause of the Democrats losing a 40-year majority in congress back in 94. Do we really need a repeat of that?
The fact is – whether you believe it or not – is that a lot of people don’t trust this president and this congress to simply “reform” the health care system in this country. And I don’t blame them. We have history on our side.
Ditto, show me where they’re empowered to DEMAND that states enforce those laws for them.
Article VI, Paragraph 2:
and Article I, Section 8, Paragraph 18:
Deadroady: Casual dismissal of the very pervasive reality of people being trapped in jobs due solely to medical insurance concerns merely indicates to me a lack of knowledge on the subject. It appears to amount to “this hasn’t happened to me, therefore it doesn’t happen.” In fact it does happen, and the options for those so trapped are most definitely NOT “infinite” because so many employers cannot offer insurance at all, those who would choose to be self-employed really often can’t get the insurance if they have pre-existing conditions that would effectively leave them or family members bankrupt or dead if they tried self-insuring, and this is fricking REAL. Screaming that it doesn’t happen just because you don’t want to believe it happens doesn’t add anything to the discussion. But then again, neither does overheated rhetoric about “Borgcare” and “medical conscription.”
In truth our current system of laws created this situation that’s trapped so many Americans exactly as I was trapped. The whole system, which government was instrumental in creating by the way, effectively removes the option for self-employment, for starting your own business, or taking jobs with companies that can’t offer you insurance for pre-existing medical conditions because they can’t afford it, for many millions of American families.
The law created these situations, and the law can undo it. In fact, the law will be necessary to undo it. If you want a system that’s not so hostile to the self-employed and to small businesses, you want reform as badly as I do.
As for the relationship between bankruptcy and medical bills, recent studies back me up and peg the number as high as 60%. While it’s almost certainly true that in most cases factors in addition to medical bills caused those financial capsizing, it’s a case of clapping your hands over your ears and yelling “lalalallaa, I can’t hear you!!” to deny the relevance here–or the very real impact to the credit markets.
I’m starting to find this exhausting. If there’s something important I haven’t addressed, can someone put it in bullet points for me? It would help.
Greenwell: Argh, it’s rather weird to have so many things thrown at me in so many directions at once. But it’s rather amusing to have someone say I haven’t given an example of government competing with private industry unsuccessfully, and to point to how government competes constantly to get people to take government jobs and/or join the military, and have someone rant and rave to me about how this example doesn’t matter because in theory we could start drafting people again. Whatever, dude. We haven’t drafted anyone in close to 40 years, we have been competing for them. And no one gets drafted to get a job for the CIA or the FBI or the Department of Justice or the EPA–those agencies compete in the open market for employees just like everyone else.
This is getting exhausting, but I’ll try to address the Constitutional arguments in one more comment, then if I’ve missed something let’s try to get it in a format that won’t have me spending all day picking through multiple contents looking for whatever I’ve supposedly intentionally ignored or whatever.
Greenwell & Eric point out some examples of the Constitution allowing things that aren’t in its strictly enumerated powers. By their examples, they have already proven that the doctrine of Strict Constructionism is false, because most of these examples show where the Constitution empowers the Federal government to do things NOT spelled out in the enumerated powers. They are in fact mostly interpretations that endorse the doctrine of Implied Powers, which is what this country has actually been running under since the First Congress and the Presidency of George Washington. Let’s have a look:
1) If you take a “strict constructionist” view, there is no power of the Federal government to set immigration policies. Article I, section 8 of the Constitution does say that the Federal government is empowered “To establish a uniform rule of naturalization, and uniform laws on the subject of bankruptcies throughout the United States;” therefore, clearly, it does say they can set rules for how you become a naturalized citizen.
So, one part of my challenge is met; the Constitution does say they can set citizenship rules. But it does NOT say they can set rules for immigration. There’s nothing in there about setting rules about who’s allowed to come into the country or stay or live in the country, and my challenge there remains active. Where do they get the right to say who can or cannot move into this country?
To be clear, I fully believe they are empowered to set rules for immigration. But I endorse the doctrine of Implied Powers and reject Strict Constructionism. I just don’t know how “Strict Constructionists” can say with a straight face that they support any laws by the Feds which attempt to regulate immigration, since the Constitution doesn’t say the Feds can do that, it only says they can set rules for citizenship.
2) The standing Armies: the Constitution states, clearly, that they are empowered “To raise and support armies, but no appropriation of money to that use shall be for a longer term than two years;” which was indicative of the understanding of the time that the Founders DID NOT WANT us to have standing armies. Historically, the idea was anathema to them. Which is why, like clockwork, every two years the President of the United States issues a statement to Congress that we are in a state of national emergency and must maintain the armed forces. Every President has done this every two years for a long time now; historically, the practice was to muster out and send the vast bulk of the armed forces home after whatever recent war we’d had. We’ve been maintaining a state of “national emergency” to keep large standing armies for a while now strictly in order to maintain a Constitutional standing for the armed forces.
I suppose you could go back and forth on whether this is a “strict constructionist” argument or not. Clearly, the Founders intended us to avoid large standing armies, and clearly we’re keeping them anyway.
I suppose if you ignore the intent of the Founders, you can say that “Strict Constructionism” allows this state of affairs. But in my experience, most Strict Constructionists talk at length about the importance of the intent of the Founders. Perhaps my experience is limited, and most Strict Constructionists don’t give a whit about the stated intent of the Constitution’s authors?
3) Interestate Highways. This one always amuses me. The ONLY power listed ANYWHERE in the Constitution for the Federal government to have ANY funding for roads of any kind is in article 1, section 8, which empowers them to “Establish post offices and post roads.” In other words, to create a mail system and roads useful for mail carriers.
You have to take a very broad reading to spin that into authority to create general-purpose highways for the nation as a whole. You have to reject Strict Constructionism and endorse the doctrine of Implied Powers to accept the existence of an Interstate Highway system. You just do.
——
In a related vein, Eric Rall points to the sections used by the government to fund and regulate all sorts of things: yes indeed, Article VI, Paragraph 2 and Article I, Section 8, Paragraph 18, (and other sections besides) make it clear that the Federal government is indeed empowered with vast ability to demand enforcement of its laws, making the Constitution the Supreme Law of the Land and making Federal law trump state law in most cases.
So yes indeed, the Federal government CAN demand enforcement of its laws. Therefore, if the Federal government decides to set rules for immigration, or drug policy, or medical insurance, or sales and manufacture of automobiles, or pollution standards, they can demand that state governments respect those rules. And yes, the Federal government can (depending on circumstances) trample all over state laws or throw them out entirely. The Constitution clearly says that, and if the states didn’t want that then they shouldn’t have ratified the Constitution or even petitioned for statehood in the first place.
But the Constitution doesn’t explicitly state that the Federal government can set rules for immigration or residency requirements or the right to hold a job in this country or whether or not you can use marijuana. It doesn’t. Therefore, if you believe in “Strict Constructionism” (which I do not), you should be opposing any Federal laws on those matters. And if you believe in “Strict Constructionism” (which I don’t) you should agree that our Federal anti-drug laws are unConstitutional (which I don’t, even though I think they’re immoral and ghastly).
If you believe in the importance of the Founders’ intent as having any relevance, you should be massively uncomfortable with the size of our armed forces as they clearly intended for us not to maintain large standing military forces, and the only way we manage it is to declare every 2 years that we’re in a state of national emergency. To me this is mildly troubling, but only mildly, as it satisfies a legal nicety to continue a necessary state of affairs.
Those who invoke the founders, on the other hand, seem to be ignoring an elephant in the room, since those who wrote and ratified the Constitution were pretty unanimous that they didn’t want this state of affairs and felt that permanent standing armed forces were a direct threat to the liberty and well-being of the nation (which I don’t believe myself, but I’m not a Strict Constructionist and I don’t think invoking the Founders and their intent is the most important way to deal with Constitutional interpretation; their views are an interesting and potentially useful data point, and no more).
Finally, to the matter of people “not trusting” those currently in government in Washington: I don’t find trust or lack thereof to be particularly relevant to the discussion. I do not believe there has ever been a time in this country where “a lot of people don’t trust this president and this congress.” This has been true of every President and every Congress since the First Congress and since George Washington first took the oath of office.
Yes, even George Washington, about whom it is remarkably difficult to find much bad to say about, had people who didn’t like him and didn’t trust him. So when I’m confronted with people who angrily tell me that there are people who “just don’t trust this President” and “just don’t trust this Congress,” I can only chuckle. I have been able to find people who feel that way pretty much my entire life, and I expect to be finding people who feel that way until the day I die.
The fact is that the President and the Congress were legitimately elected to govern. And to get back to where this started: the current President and Congress, just like previous Presidents and Congresses, are perfectly empowered Constitutionally to set national regulations on health care and to collect taxes for the useful and necessary purposes of the nation as a whole. There is no Constitutional impediment–NONE–to them changing the regulations on the already heavily regulated medical insurance system, and none to seeing to it that all Americans have medical insurance. The Constitutional arguments against this are without merit, a red herring to detract from the real issues at hand.
We already have three very large government-run medical systems–the massive VA medical system, the Medicare program, and the Medicaid program. None of them are unConstitutional unless you believe phony Constitutional arguments that have been rejected since the founding of the country. Of the three we have, Medicare and the VA medical system actually work exceedingly well and are very popular.
Reform is badly needed because while most Americans are satisfied with their actual care, the current set of government regulations creates all sorts of problems, and the current set of government rules we operate under is causing massive bankruptcies and trapping people in jobs and harming businesses, especially small ones but also many large ones.
Furthermore, if you irresponsibly choose not to be insured, you’re creating a substantial burden on your fellow citizens. Because the reality is that if you become seriously injured or extremely ill, you are going to be imposing a massive burden on the nation (unless, I suppose, you do something like kill yourself). You’re likely to default on your debts, AND, in reality, you’re going to get medical care that the rest of us will pay for one way or the other.
I think it’s a moral imperative to fix this situation, and the market alone cannot be counted on to miraculously fix it by itself. Indeed, we don’t even have a “free market” in health care, and we haven’t in my lifetime or the lifetime of anyone reading this.
Constitutionally, the government is fully empowered to deal with this situation, and Constitutional arguments against reform are weak tea at best.
What I would suggest that those who oppose the current proposals concentrate on is what alternative proposals they’d like to see enacted instead, rather than wasting time with phony Constitutional arguments.
So yes indeed, the Federal government CAN demand enforcement of its laws. Therefore, if the Federal government decides to set rules for immigration, or drug policy, or medical insurance, or sales and manufacture of automobiles, or pollution standards, they can demand that state governments respect those rules. And yes, the Federal government can (depending on circumstances) trample all over state laws or throw them out entirely. The Constitution clearly says that, and if the states didn’t want that then they shouldn’t have ratified the Constitution or even petitioned for statehood in the first place.
The sections I pointed out give Congress the power to demand enforcement of constitutional laws, those which have some reasonable relation to the powers the constitution grants the federal government. The Necessary and Proper clause gives some stretch to what the government can do, but there’s a limit to how far you can stretch it.
If the federal government were intended to have the power to do anything it wanted to do (except perhaps for violating a constitutionally protected freedom), then why were the enumerated powers listed at all? Why didn’t Article I, Section 8 just say something like “Congress shall have the power to make such laws as are necessary and proper to provide for the well-being of the United States and their citizens”? And why was the 10th amendment included in the Bill of Rights:
What I would suggest that those who oppose the current proposals concentrate on is what alternative proposals they’d like to see enacted instead, rather than wasting time with phony Constitutional arguments.
Expect a post from me on that in the next few days. I’ve been joining in the constitutional argument first because the constitutional arguments are easier to make, and because you brought it up.
Well, to quibble, I’m not the one who ultimately brought up the Constitutional arguments, since I see them all the time in other forums, and Kevin D. has been doing quite a lot of work on the front page making Constitutional challenges demanding that we be shown where the Constitution says the Feds have the power to do this, that, or the other thing.
The argument that the Constitution does not list medical insurance among its “enumerated powers,” therefore, it has no authority over the issue is without merit. The government does–has always done–many things that are not within the strictly enumerated powers. In my experience, most people expounding the “strict constructionist” philosophy are eager to defend and demand those things anyway. You’d think the fact that the only section that says they can build roads at all only references postal roads would give these folks pause, but I’ve been seeing them try to make that argument for years–not just here, not just in this thread, but everywhere. If you take a “strict constructionist” line, while expounding on the massive incompetency and all-encompassing danger of the Devouring Beast of Government, those interstate highways should be pretty high on your hit list and not some sort of “okay, well, yeah, sorta but…” aside.
Flat out, the Constitution simply does not authorize the Federal government to set immigration rules. It doesn’t. Me? Since I reject the notion that the enumerated powers must be read in strict and absolute fashion, I don’t find that troubling. I think the doctrine of implied powers—the doctrine we’ve actually been working under since Washington was President–covers it perfectly.
Ditto the issue of drug interdiction. I may find drug interdiction ghastly (and I do), morally repugnant (and I do), horrendously destructive (and I do), and a genuine threat to individual liberty (and I do). But unConstitutional? Nope, I think the interstate commerce clause and other sections of the Constitution clearly mean the Feds can do this even if I think it’s awful and they should stop. I don’t couch my arguments against the Drug War in soaring rhetoric about the Founders and how we have to “get back to” Constitutional government–a form of Constitutional government that never existed in the first place, especially.
Immigration laws? We should have ‘em. Does the Constitution say we can have ‘em? Not explicitly. Since I don’t expect the Constitution to explicitly detail everything like that, I’m untroubled by it. But how people who claim they’re all about the strictly enumerated powers can defend immigration laws–and how they can even talk about state sovereignty, then unironically demand that the States enforce those immigration laws for the Federal government–is something that makes my head spin.
I simply don’t believe the Strict Constructionists ARE Strict Constructionists, and I don’t believe their Constitutional arguments are genuine. They want Strict Constructionism when it suits their purpose, but when it doesn’t suit them and they want the Feds to do something the Constitution doesn’t clearly say they can have, they’re all about the Implied Powers after all.
The truth is that there is a certain tension between state sovereignty and Federal authority that’s been there since the Constitution was first ratified. Arguments about where Federal authority begins an ends are as old as the Republic, and no one can come up with a definitive answer. Those who say that states’ rights ended with Lincoln are wrong; the states DO have sovereignty and the Feds can’t just step all over it any time they feel like it. There are many circumstances where they can’t, and don’t or won’t. Deferral to state laws happens all the time at the Federal level–but as you note, Eric, in many areas, state law just loses, and if the states don’t like it they shouldn’t have become states in the first place.
In my view, however, this is already settled law: because medical insurance is a nationwide issue, the interstate commerce clause is clearly in play. So is the “necessary and useful” clause. So is the fact that we already have broad Federal laws and regulations on health care and health insurance, and we already have massive Federal programs dealing out health care and health insurance.
If the Constitutional arguments are really central here, then we need to be talking about abolishing the VA Medical system, we need to be talking about abolishing Medicare and Medicaid, and so on. We’re not, and we’re not going to. Otherwise, we have to go by the precedents set by these programs, which have already passed muster in the courts Constitutionally. And the reality is that the Feds already HAVE a role and we already ARE working under a system where the Feds are involved at just about every level of the medical insurance industry and the health care industry. A lot of the problems we have now were arguably caused by bad decisions–bad decisions at the state AND Federal level, and also at the corporate level.
The Feds have a role in fixing some of the very serious problems–and those problems do exist, they are severe, and they are worsening. It’s harming not just your average person with health issues, it’s harming businesses as well. And yes, most Americans are satisfied with the CARE they get, but that does not mean most Americans are content with the status quo, that they aren’t scared and that they don’t want something better.
As I say, it’s clearly not supportable by the facts that, as a percentage of expenditures Medicare has lower administrative costs; that’s a bit of trickery that depends on the fact that most of their patients have huge expenditures and thus the administrative costs are proportionally lower. That doesn’t mean, it almost certainly isn’t the case, that if everyone was on Medicare those administrative costs would stay so low percentage-wise. They almost certainly won’t.
But it’s just as disingenous to say “Well you like your doctor, right? So there’s no problem!”
That’s really all I’m saying.
By the way, another example for me is conscription:
I have *huge* moral issues with conscription. I’m glad we got rid of it. I think that a state which cannot muster enough volunteer troops for its defense is probably a state that shouldn’t exist.
But do I think there’s a Constitutional impediment to conscription? No. I just don’t. There’s definitely a Constitutional tension there, but clearly they *can* do it, even if the Constitution doesn’t explicitly say so. I think it’s settled Constitutional laws, and reasonably within the implied powers the Constitution grants the Feds. They *can* do it. I don’t think they *should* in most circumstances (maybe under any circumstances, I really can’t decide how I feel about that), but I don’t deny that they *can*. My arguments against conscription are practical and moral, not Constitutional because I don’t think the Constitutional arguments hold much water.
Reading through what’s been written so far, health care and medical insurance are being used interchangably. Medical insurance is not health care. The cost of medical insurance is rising and more difficult BECAUSE health care costs are rising; until actual health care costs are controlled, medical insurance costs cannot be controlled. No one is even talking abiout or tackling rising health care costs, only the cost & availability of insurance.
FWIW: References to Army above, it just occurred to me; I was in the military (USN) from ’74-’80, my son has been in the Air Force for about a year. It’s a different world; a large fraction of services that used to be provided by the military has been farmed out to commerical entities. Pizza Hut, Taco Bell, McDonalds, etc. has replaced base-cafterias, PX’s/BX’s are run by contractors. (An army runs on its stomach.) Contractors played a notorius role in Iraq that once was stricitly a military role.
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