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Cato Institute scholar Gene Healy makes a good argument that the health-care reform bills now before Congress are unconstitutional. Forcing citizens to buy a product—health insurance—certainly sounds like it might require powers not granted by the constitution.
Speaker Nancy Pelosi has pooh-poohed this notion as “nonsensical,” because “the power of Congress to regulate health care is essentially unlimited.” Essentially unlimited—that has a scary ring, doesn’t it? Healy argues that such an act is “flagrantly unconstitutional.”
But this may make little practical difference:
In answer to the question “by what authority?” Reid’s bill offers the Commerce Clause — the go-to provision for friends of federal power. That clause gives Congress the power “to regulate Commerce … among the several states.”
It was a modest measure designed to regularize cross-border commerce and prevent interstate trade wars — so modest, in fact, that Madison described it in the Federalist as a clause that “few oppose, and from which no apprehensions are entertained.”
The Founders would have worried more had they known that the Commerce Clause would eventually become a bottomless fount of federal power. In 1942′s Wickard v. Filburn, the court held that the Commerce Power was broad enough to penalize a farmer growing wheat for his own consumption on his own farm.
So do we think that, if passed, Obamacare will be overturned by the courts?
Don’t count on it. Wickard v. Filburn was just the beginning of a federal power grab via the constitution.
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More dispiriting poll numbers for true believers in Obamacare, as ABC News reports these brand-new figures:
“Despite the considerable efforts of Congress and the president to pass health insurance reform, the public remains reluctant to endorse that goal,” Gallup says.
The poll shows that 49% of respondents say or lean towards saying that they would advise their member of Congress to vote against a bill, while 44% say or lean towards advocating in favor of the bill. Support among Rs, Ds, and Is has dropped since last month, having dropped 12 points among Republicans, 6 points among Democrats and 8 points among Independents since early October. By 53-40, most Americans disapprove of the President’s handling of health care policy—”his worst review to date on this issue.”
The good news for Obamacare pushers is that Vice President Joe Biden has gone on the video warpath to persuade fence-sitters:
In a video posted to the White House’s website today, Vice President Biden asks whether people should trust “the people who say you’d be better off if you just left things the way they are” or “the folks who actually know something about what’s happening in our health care system.”
The bad news is that it’s the same Joe Biden who posed for this photo just the other night.
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Remember President Obama’s promise that his healthcare overhaul would never, never, never extend coverage to illegal immigrants? And remember Rep. Joe Wilson’s “You lie!” when Obama reiterated his promise to Congress in September?
Let’s see who was right–and yup, it was Joe Wilson! Turns out, according to the Center for Immigration Studies, that, thanks to mandates or near-mandates in both congressional health bills, about 1 million illegal immigrants will be able to obtain health coverage through their employers if some version of either bill passes.
The Washington Times reports:
The House bill mandates, and the Senate bill strongly encourages, businesses to extend health care coverage to all employees. But the bills do not have exemptions to screen out illegal immigrants, who usually obtain jobs by using false identities and are indistinguishable from legal workers.
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Democrats who wrote the House bill said that employer coverage for illegal immigrants is not intentional, but rather the outcome of people breaking the law.
Oh. That makes me feel a whole lot better. I dunno about you.
Finder’s fee: Drudge
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You know those “eat more to lose weight” diets? Funny, but that’s sort of how projected health-care reforms are being sold. But, as Matthew Continetti points out, only magical thinking allows Democrats in Congress to believe that their health-care program will save money:
Next time you run into a group of Democrats, offer to splash water on their faces. They’ve spent 2009 in a dream state, and it’s time they wake up. They’re convinced that they can subsidize health insurance for millions of people while also “bending the cost curve” of health care spending. They want to sign us up for the political equivalent of one of those three-step “eat more to lose weight” diets. Step one: Pile on the expenditures, regulations, taxes, and fees. Step two: Close your eyes. Step three: Pray it all works out in the end….
The idea that expanding coverage will save the country money has always been a fantasy. True, the Congressional Budget Office found that, under certain assumptions that the authors of the legislation in effect required the CBO to make, the House and Senate health bills might not blow up the deficit over the next decade. But that won’t happen in the real world. For one thing, doctors’ reimbursements just aren’t going to be cut 20 percent.
Here’s an idea: When estimating costs for projected programs, use real figures, not budget tricks, and come up with real projections. Otherwise, the United States will go broke. THAT is the real concern behind the health-care debate.
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Congressional Democrats bargain basement cost of “only” $1 trillion for their health-care reform may be significantly off—like $5 trillion below the actual cost. Michael Cannon of the Cato Institute writes that the Democrats are using “budget gimmicks” to conceal the real costs. There are several interesting ways to conceal the cost:
Another gimmick pushes much of the legislation’s costs off the federal budget and onto the private sector by requiring individuals and employers to purchase health insurance. When the bills force somebody to pay $10,000 to the government, the Congressional Budget Office treats that as a tax. When the government then hands that $10,000 to private insurers, the CBO counts that as government spending. But when the bills achieve the exact same outcome by forcing somebody to pay $10,000 directly to a private insurance company, it appears nowhere in the official CBO cost estimates — neither as federal revenues nor federal spending. That’s a sharp departure from how the CBO treated similar mandates in the Clinton health plan. And it hides maybe 60 percent of the legislation’s total costs. When I correct for that gimmick, it brings total costs to roughly $2.5 trillion (i.e., $1 trillion/0.4).
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Are you beginning to think that, when it comes to health care, the Democrats don’t care how high they have to raise your taxes? Michael Barone has an interesting observation:
[Health-care reform costs] suggests that, at least for some Democrats, huge looming budget deficits are not a bug but a feature. Just as Ronald Reagan hoped that cutting taxes would force politicians to cut spending, these Democrats hope that increasing spending will force politicians to increase taxes to levels common in Western Europe. Never mind that those economies have proved more sluggish and less creative than ours over the long haul.
We can solve the health-care crisis with incremental changes. But we can transform our economy into a sluggish bucket of molasses by enacting the current health-care bill.
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Charles Krauthammer isn’t the only one in the public arena who can put M.D. after his name who is urging defeat of Obamacare (see below). Now, none other than Dr. Howard Dean, former chairman of the Democratic National Committee, is doing so. For different reasons, of course, but Dean is still saying it’s a disaster. Here are some highlights of his remarks (finder’s fee: Hot Air):
DEAN: There is something worse than passing no bill. This bill isn’t very strong. In fact, the only piece of reform left in it is the public option. The insurance reform is gone, essentially, because what they did is they have guaranteed issue — they have to, er, the insurance company has to ensure you — the problem is they don’t have community rating any more. They, they, they, the Senate bill, I think, charges three or four times as much for sick people as they do for healthy people, and the House bill is twice as much. …
DEAN: You know, we did this ten or fifteen years ago in Vermont, and you can charge 20% more for your most expensive clients as you can for your cheapest clients, and that’s it. Now if you can afford to buy health insurance if it’s 20% above the bottom price, but you can’t afford to buy health insurance if it’s twice as much or three times as much, so guaranteed issue doesn’t do you any good unless you have real community rating. Real community rating doesn’t exist in either the House or the Senate bill, so the old argument, which I used to make, was that we ought to pass this thing just to get the insurance reform. There isn’t any insurance reform left in this bill to speak of. …
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Dr. Charles Krauthammer, a physician before he became a pundit, has the best summary of what is wrong with the health-care legislation before Congress: everything. Krauthammer writes:
The United States has the best health care in the world — but because of its inefficiencies, also the most expensive. The fundamental problem with the 2,074-page Senate health-care bill (as with its 2,014-page House counterpart) is that it wildly compounds the complexity by adding hundreds of new provisions, regulations, mandates, committees and other arbitrary bureaucratic inventions.
Worse, they are packed into a monstrous package without any regard to each other. The only thing linking these changes — such as the 118 new boards, commissions and programs — is political expediency. Each must be able to garner just enough votes to pass. There is not even a pretense of a unifying vision or conceptual harmony.
The result is an overregulated, overbureaucratized system of surpassing arbitrariness and inefficiency….
The better choice is targeted measures that attack the inefficiencies of the current system one by one — tort reform, interstate purchasing and taxing employee benefits. It would take 20 pages to write such a bill, not 2,000 — and provide the funds to cover the uninsured without wrecking both U.S. health care and the U.S. Treasury.
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Charlotte Hays yesterday linked to a lovely editorial in the Seattle Times pointing out that we Americans have the best healthcare system in the world (not that there aren’t flaws that ought to be fixed), and that’s something we can be thankful for on this uniquely American holiday.
Here’s another list of health things to be grateful for today, from Melinda Beck at the Wall Street Journal:
• Fewer Americans died in traffic fatalities in 2008 than in any year since 1961, and fewer were injured than in any year since 1988, when the National Highway Traffic Safety Administration began collecting injury data. One possible reason: Seat-belt use hit a record high of 84% nationally.
• Life expectancy in the U.S. reached an all-time high of 77.9 years in 2007, the latest year for which statistics are available, continuing a long upward trend. (That’s 75.3 years for men and 80.4 years for women.)
• Death rates dropped significantly for eight of the 15 leading causes of death in the U.S., including cancer, heart disease, stroke, hypertension, accidents, diabetes, homicides and pneumonia, from 2006 to 2007. (Of the top 15, only deaths from chronic lower respiratory disease increased significantly.) The overall age-adjusted death rate dropped to a new low of 760.3 deaths per 100,000 people—half of what it was 60 years ago….
• Around the world, 27% fewer children died before their fifth birthday in 2007 than in 1990, due to greater use of insecticide-treated mosquito nets, better rehydration for diarrhea, and better access to clean water, sanitation and vaccines.…
• Twenty-seven countries reported a reduction of up to 50% in the number of malaria cases between 1990 and 2006.
And here’s a study by the Cato Institute’s Glen Whitman and Raymond Raad explaining why America leads the world in medical innovation (finder’s fee: Cato’s David Boaz).
So, please: Eat all the turkey you want (it’s a holiday!), and as you’re offering thanks, pray that Congress won’t take our wonderful American system away from us. Happy Thanksgiving!
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Here’s something to be thankful for: the best health-care system on the planet. It’s imperiled and so you might have fewer medical blessings to count in coming years.
This doesn’t mean there’s no room for improvement. We must bring down costs and make sure that the benefits of the system are available to all citizens. The bills before Congress now won’t do the former. They may well be less effective with the latter than we are led to believe. So now a few good words about American health care:
We have deciphered the genome and developed dialysis, bone-marrow transplantation and catheter-based cardiac interventions. Our population can get advanced imaging studies or virtually any laboratory test performed promptly and reliably. A simple call to 911 provides instant access to a remarkable countrywide system of emergency care. We have many reasons to be proud, and I am disappointed in my colleagues who are too modest to defend vociferously what is good in our system.
The 2002 Institute of Medicine report (which actually estimated not 90,000, but between 44,000 and 98,000 deaths per year attributable to medical error) is old hat. We have long since internalized its message and taken it to the floors of hospitals to improve care at the bedside. We work hard to surpass standards and reach error rates below 1 in 100,000.
Our medicine is not static. But amid all the turbulence, let us pause and give thanks for the bedrock of American medicine that is the envy of all the world.
