Is Universal Health Care Constitutional?

[bascule]

In another thread jackson33 raised the topic of whether National Healthcare is Constitutional. I'll go ahead an bump it up a notch and ask whether Universal Healthcare is Constitutional.

 

I see something like Universal Healthcare as an embodiment of the idea that the government should "promote the general Welfare" as spelled out in the Constitution. I assume this is the same part of the preamble that "Welfare" itself derives its Constitutionality from.

 

"http://usconstitution.net" (don't know anything about them, but...) describes the "promote the general Welfare" part of the Preamble in this way:

 

http://www.usconstitution.net/consttop_pre.html

 

promote the general Welfare

 

This, and the next part of the Preamble, are the culmination of everything that came before it — the whole point of having tranquility, justice, and defense was to promote the general welfare — to allow every state and every citizen of those states to benefit from what the government could provide. The framers looked forward to the expansion of land holdings, industry, and investment, and they knew that a strong national government would be the beginning of that.

 

Is there same way I am missing in which providing healthcare to every citizen of every state would not count as promoting the general Welfare?

[padren]

Is there same way I am missing in which providing healthcare to every citizen of every state would not count as promoting the general Welfare?

 

It boils down to the subjectivity inherent in promoting general welfare. Many people (perhaps the majority even) would probably believe the general welfare of the nation would be improved if every citizen was given a Bible, and had state funded Sunday school for all children.

 

Thankfully, there's a separation of church and state so that can't even be attempted but in short it's the idea of forcing people to pay for enhancing their "general welfare" by means they may feel do not help their general welfare. Granted the caveat is in using the term "their" general welfare versus "the" general welfare, but by forcing everyone to have health insurance, you remove their freedom to choose not having any health care provider.

 

Should it be mandatory by law that every household have a fire extinguisher, federally subsidized if need be? Should the government really spend that much time and energy trying to fine tune people's general welfare? Where is the fine line between helping people, and doing their job of securing themselves in the world for them?

 

 

The "Libertarian purist" in me doesn't like national healthcare for that reason - but the realist in me thinks it's the best possible solution to the problem. I may be very careful not to set my house on fire, but I still have to support the fire department all the same. When people don't have health care by choice, they end up needing it later and have never caught up to what they'd have paid in, and it's a large enough issue to justify the mandate. In addition to that, it's the only way to really guarantee universal coverage for those who do desire it and many can't get it through no fault of their own - as such the choice of whether to have health care or not is a freedom I'm willing to sacrifice.

 

I may be in favor of it, but I can understand why some people are apprehensive. I don't think the "improving the general welfare" argument alone suffices for it's justification - it's the sheer amount of damage done to people's welfare when they fall through the insurance cracks that warrants it.

 

In general, I find arguments like "improving the general welfare" for government intervention very unsettling, and hints at the kind of social engineering I find reprehensible. I can accept my efforts going towards the benefit of society in general as much as is warranted to avoid calamities, but stop short of funding some social architect's wet dream for a perfect society. That's not to say I think welfare programs are over-funded or anything - I think they are woefully underfunded in general and that government programs could do a lot more to help people in crisis.

[iNow]

No, it is not unconstitutional any more than social security, veterans benefits, or public roads and libraries are unconstitutional. It's just part of the idiotic narrative that keeps getting propagated through our nation by these hate-filled half-witted windbags with large microphones... which is then just further repeated by those with too little sense to realize how stupid it is.

 

As you mentioned, Article 1, Section 8 of the constitution has the provision to provide for the general welfare of the public, and this was expounded upon by Alexander Hamilton in the Federalist Papers where he put forth that spending is an enumerated power which congress may exercise independently to benefit the general welfare, such as to assist national needs in agriculture or education. He also put forth that this spending by congress is entirely constitutional provided that the spending is "general in nature" and "does not favor any specific section of the country over any other."

 

http://press-pubs.uchicago.edu/founders/documents/a1_8_1s21.html

 

 

Additionally... as shown in the general welfare clause, the congress may "enact laws as it sees fit to promote the well-being of the people governed thereunder." That really demolishes the "it's unconstitutional for the government to offer healthcare coverage" argument/assertion right there. Game over. Do not pass go. Do not collect two hundred dollars.

 

 

Now... If you want to broaden your argument (it's a bit weaker than the above, but still supplemental) you can suggest that... as a general rule... the framers of our constitution had enough foresight to leave "wiggle room" in their language, and that they fully intended to let the document evolve.

 

More specific to my point... The constitutionality of government healthcare coverage is further supported by reviewing sections such as the 9th amendment, whereby the following is put forth:

 

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

 

In essence, they were saying, "Just because we didn't write it explicitly here does not mean we intended for it to be prohibited." This applies, as well, to the healthcare coverage argument.

 

As I said... it's not as strong as the general welfare argument, but it certainly offers more ammunition when attacking those who are so misguided as to suggest that the government "does not have the power to offer universal healthcare." Quite the contrary, it's power is pretty explicit in this regard... As has been proven by government involvement with social security, medicare, veterans benefits, public roadways, libraries, and universities.

[DJBruce]

In essence, they were saying, "Just because we didn't write it explicitly here does not mean we intended for it to be prohibited." This applies, as well, to the healthcare coverage argument.

 

The ninth amendment applies to restrict the government from infringing upon the unenmurared rights of the people. As Supreme Court Justice Arthur Goldberg stated, "The Framers did not intend that the first eight amendments be construed to exhaust the basic and fundamental rights.... I do not mean to imply that the .... Ninth Amendment constitutes an independent source of rights protected from infringement by either the States or the Federal Government....While the Ninth Amendment - and indeed the entire Bill of Rights - originally concerned restrictions upon federal power." How can an amendment created to restrict the power of the federal government be used to justify the expansion of the government?

 

The issue of constitutionality is not one of that is based upon hard founded fact. It is one that is based upon the opinion in interpretation of people. That said one who views the constitution very rigidly would most definitely find the healthcare legislation -as well as much other legislation- unconstitutional. For this argument I will quote one of my previous posts on this matter,

 

That said when I consider the constitutionality of Congress creating a national healthcare program I find the two parts of the Constitution that might be used to justify the program to be found in Article 1, Section 8; more specifically:

 

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

 

To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.

 

With regards to the first quote it seems that the crux of the issue comes down to the term “general welfare.” When I consider what term the meant to the founders I find that Thomas Jefferson said it best when he said, “Congress has not unlimited powers to provide for the general welfare, but only those specifically enumerated.” Then since I do not see the power to provide healthcare enumerated anywhere in the Constitution I would hold that Congress does not have the power or the duty to provide health care.

 

When I consider the “elastic clause”, I believe that the key words of the clause to be, “carrying into Execution the foregoing Powers.” To me the clause can only be used to create legislation to carry out Congress’ existing power. Since as stated above that Congress does not have the power to create a healthcare system I do not see how this clause could be used to justify the creation of a national healthcare system.

[ecoli]

I'm pretty sure that dying is not in the interest in one's "general welfare" should we also say that "not dying" is a constitutional right as well?

 

In that case, instead of trying to pretend we can afford to give everyone health care, why don't we just start up the cryonics and start freezing dead people?

 

(PS - I'm not being totally facetious, I actually think this idea has some merit)

[bascule]

I'm pretty sure that dying is not in the interest in one's "general welfare" should we also say that "not dying" is a constitutional right as well?

 

In that case, instead of trying to pretend we can afford to give everyone health care, why don't we just start up the cryonics and start freezing dead people?

 

(PS - I'm not being totally facetious, I actually think this idea has some merit)

 

At the very least, I would say such a program is Constitutional. Write your Senator and see if he'll create a bill for you

[npts2020]

It boils down to the subjectivity inherent in promoting general welfare. Many people (perhaps the majority even) would probably believe the general welfare of the nation would be improved if every citizen was given a Bible, and had state funded Sunday school for all children.

 

Thankfully, there's a separation of church and state so that can't even be attempted but in short it's the idea of forcing people to pay for enhancing their "general welfare" by means they may feel do not help their general welfare. Granted the caveat is in using the term "their" general welfare versus "the" general welfare, but by forcing everyone to have health insurance, you remove their freedom to choose not having any health care provider.

 

Should it be mandatory by law that every household have a fire extinguisher, federally subsidized if need be? Should the government really spend that much time and energy trying to fine tune people's general welfare? Where is the fine line between helping people, and doing their job of securing themselves in the world for them?

 

 

The "Libertarian purist" in me doesn't like national healthcare for that reason - but the realist in me thinks it's the best possible solution to the problem. I may be very careful not to set my house on fire, but I still have to support the fire department all the same. When people don't have health care by choice, they end up needing it later and have never caught up to what they'd have paid in, and it's a large enough issue to justify the mandate. In addition to that, it's the only way to really guarantee universal coverage for those who do desire it and many can't get it through no fault of their own - as such the choice of whether to have health care or not is a freedom I'm willing to sacrifice.

 

I may be in favor of it, but I can understand why some people are apprehensive. I don't think the "improving the general welfare" argument alone suffices for it's justification - it's the sheer amount of damage done to people's welfare when they fall through the insurance cracks that warrants it.

 

In general, I find arguments like "improving the general welfare" for government intervention very unsettling, and hints at the kind of social engineering I find reprehensible. I can accept my efforts going towards the benefit of society in general as much as is warranted to avoid calamities, but stop short of funding some social architect's wet dream for a perfect society. That's not to say I think welfare programs are over-funded or anything - I think they are woefully underfunded in general and that government programs could do a lot more to help people in crisis.

 

Why does universal health care = forcing everyone to buy health insurance?

[ecoli]

Why does universal health care = forcing everyone to buy health insurance?

 

I think he's confusing current proposals with the concept of universal health care, in general.

 

Of course, if universal health care exists and you choose not to us it, then good riddance to you, I say.

---

Merged post follows:

Consecutive posts merged

At the very least, I would say such a program is Constitutional. Write your Senator and see if he'll create a bill for you

 

It would be way cheaper than trying to insure everyone and can postpone our treatments until after we get friendly AI in a post-disease world. Win-win I say.

 

I'll draft that letter now.

[Phi for All]

I think providing universal healthcare is a perfect way to promote the general welfare. Providing health insurance, however, promotes mostly insurance companies.

 

In that case, instead of trying to pretend we can afford to give everyone health care, why don't we just start up the cryonics and start freezing dead people?

I object to the premise that we can't afford universal healthcare when there are other nations that can. Remove some of the obvious obstacles and we can stop pretending.

 

Why does universal health care = forcing everyone to buy health insurance?

I'll second that. Insurance is a good thing when you're insuring an object like a car or a home, but putting a profit-oriented company between humans and their health is just stupid imo.

[ecoli]

I object to the premise that we can't afford universal healthcare when there are other nations that can. Remove some of the obvious obstacles and we can stop pretending.

 

I should amend that then. We certainly can't afford it with our economy in its current state (current proposals for funding are based on non-existent "savings"). More expensive, true universal plans are just impossible right now.

 

I'm skeptical about the economic soundness of providing a universal service. If you follow supply and demand curves, and make the realistic assumption that supply will never be able to keep up with demand, we should get shortages and/or prices should rise.

[Phi for All]

I should amend that then. We certainly can't afford it with our economy in its current state (current proposals for funding are based on non-existent "savings"). More expensive, true universal plans are just impossible right now.

Not without a major restructuring of the healthcare market, I agree.

 

I'm skeptical about the economic soundness of providing a universal service. If you follow supply and demand curves, and make the realistic assumption that supply will never be able to keep up with demand, we should get shortages and/or prices should rise.

I'm convinced that nothing will ever be a complete solution. Has there ever been a complete economic solution to anything? That's not the nature of Life, especially one that we keep prolonging with medical advancements. But surely there has to be a better way than placing an industry between us and our doctors that's heavily invested in making sure we get the least care possible.

 

Let's face it, as long as we live long enough to have children and maintain a viable customer base, insurance companies fare better if we don't live long enough to require more expensive treatments. A representative government option whose aim is to cure me no matter what seems to have a better chance of representing my wishes, and is at least a step in a better direction. So yeah, universal healthcare seems totally constitutional to me.

[ecoli]

Let's face it, as long as we live long enough to have children and maintain a viable customer base, insurance companies fare better if we don't live long enough to require more expensive treatments.

No... they're better off if you live long and healthy. That way you keep paying into the system but not using it. As long as many more people are healthy than unhealthy, insurance companies will be profitable.

 

I think anti-discrimination legislation and removal of competitive barriers would help take care of the denial of coverage problems.

 

A representative government option whose aim is to cure me no matter what seems to have a better chance of representing my wishes, and is at least a step in a better direction.

 

That largely depends on what other systems are in place. If we follow your logic through though, then it seems that the most powerful group of healthcare users are the ones who are the sickest. The result is lots of sick people demanding treatment that they may not need (its not like they're paying for it) driving up costs. Since its a representative government, these people are powerful politically.

 

It will be politically untenable to deny money to really sick people, even if we're wasting a lot of that money.

 

This is pretty much what driving up the cost of Medicare/medicaid.

 

I don't think its a solvable problem in a universal system (without massively increasing bureaucracy - but that could backfire anyway).

 

 

So yeah, universal healthcare seems totally constitutional to me.

The question of its constitutionality is independent of whether or not its a good idea.

 

Certainly, if access to health care is deemed a constitutional right, surely more basic needs, such as food, shelter and clothing be considered a right. And if its a right, does that mean the government has to pay for it? Does that mean non-government options should be prohibited? If you take this to its logical conclusions, all I see are soviet-style shortages and mass starvation.

[iNow]

Certainly, if access to health care is deemed a constitutional right, surely more basic needs, such as food, shelter and clothing be considered a right. And if its a right, does that mean the government has to pay for it?

Where has anyone argued that healthcare is a constitutional right? Is not the question whether the constitution permits the government to spend on healthcare? I'm pretty sure this is an important distinction.

[bascule]

Certainly, if access to health care is deemed a constitutional right

 

To reiterate iNow, nobody said it was a "constitutional right". However, the "promote the general Welfare" part of the preamble outlays the idea that the government should provide services, especially of the sort that are applicable to every American. It's up to Congress to decide what those services should be.

 

surely more basic needs, such as food, shelter and clothing be considered a right. And if its a right, does that mean the government has to pay for it?

 

Psst, 1 in 8 Americans is living off food stamps at the moment

[Mr Skeptic]

Yes, providing universal health care is Constitutionally allowed, via promoting the general welfare -- which is why we already have universal health care. However, the universal health care we have now is a really dumb system where only emergency treatments are covered, rather than the much cheaper preventative measures, and can result in bankruptcy. This is what we have because we decided we will not allow people to die in the streets due to not being able to pay for emergency care.

 

Now, we decided to wise up a bit and include non-emergency treatments as well, and that they shouldn't result in bankruptcy.

[iNow]

The ninth amendment applies to restrict the government from infringing upon the unenmurared rights of the people.

<...>

How can an amendment created to restrict the power of the federal government be used to justify the expansion of the government?

 

I believe you are profoundly misframing the issue. The 9th amendment, contrary to your suggestion, is not really about "restricting the power of the federal government," as much as it is about protecting the rights of the people governed thereunder.

 

The 9th is about protecting the rights of the people, and ensuring that the federal government does not trample the rights of the governed. It has more to do with protecting the populace than it has to do with limiting the government (although I concede the tremendous overlap in those two points). For the argument put forth by you above to have worth, you'd have to be suggesting an equivalence between the provision of healthcare to all citizens and the trampling and/or removal of their guaranteed rights.

 

I am unable to accept that assertion as valid, as if it were, then public roadways, water treatment plants, public libraries, veterans benefits, medicare, the police force, fire departments, public universities, and all of the other services from which we benefit must (by your logic) also be unconstitutional.

[toastywombel]

I love how someone sites something as constitutional or not.

 

1. The constitution is a document that is nearly over 200 years old, times change.

 

2. According to the one guy's interpretation of the 9th amendment: interstates, schools, FBI, military, medicare, medicaid, social security, FDA, and essentially any federal government program would be unconstitutional.

 

Even if this was an accurate interpretation of the 9th amendment, it would be rather ridiculous. And I just noticed that I essentially reiterated iNow's point.

[jackson33]

The US Constitution, for all practical purposes in a format to Govern in the interest of many States. The major difference today and when written are, 13 States v 50 States and 3.5 Million people v 307 Million. Even today, much of what goes on, is either Federal Support of the States or a cooperative program, between States and the Federal are controlled by the States. Education for instance is strictly a State issue, where as States, by compliance have agreed to do testing and/or other projects with Federal Aid.

Sovereignty of the original States and as of today, is and was the essence of the Constitution, the generations that have followed and has been the objective of the Supreme Court to support. This feeling was so strong, into the 20th Century State Officials referred to their State as a NATION.

 

We've had this debate before when Federalist supporters (those actually wanting one nation) clashed ideologically with Anti-Federalists (those wanting recognition of states as sovereign nations). Would it surprise you to learn states, in the language of the day, were considered nations rather than a sub-category within a nation? In the Treaty of Paris King George III did not recognize one independent nation but 13 sovereign nations. [/Quote]

 

http://www.nolanchart.com/article5968.html

 

If those founders and/or the representatives from the 13 Colonies had wanted to provide the General Welfare, the simple word AND would have followed defense, not promote which had a very different meaning than the accepted today definition. As for the meaning of Welfare, what was then was nothing like that of today, or redistribution, which was a 20th Century US political concept, taken from some rather diabolical world history....

 

Preamble

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.[/Quote]

 

http://www.usconstitution.net/const.html

 

Provide for the Common Defense

The new nation was fearful of attack from all sides — and no one state was really capable of fending off an attack from land or sea by itself. With a wary eye on Britain and Spain, and ever-watchful for Indian attack, no one of the United States could go it alone. They needed each other to survive in the harsh world of international politics of the 18th century.[/Quote]

 

promote the general Welfare

This, and the next part of the Preamble, are the culmination of everything that came before it — the whole point of having tranquility, justice, and defense was to promote the general welfare — to allow every state and every citizen of those states to benefit from what the government could provide. The framers looked forward to the expansion of land holdings, industry, and investment, and they knew that a strong national government would be the beginning of that.[/Quote]

 

http://www.usconstitution.net/consttop_pre.html

 

Welfare

welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD

 

Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.[/Quote]

 

http://www.usconstitution.net/glossary.html#WELFARE

 

inow;

The 9th is about protecting the rights of the people, and ensuring that the federal government does not trample the rights of the governed. It has more to do with protecting the populace than it has to do with limiting the government (although I concede the tremendous overlap in those two points).[/Quote]

 

Amendment 9 - Construction of Constitution. Ratified 12/15/1791.

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

 

Amendment 10 - Powers of the States and People. Ratified 12/15/1791. Note

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.[/Quote]

 

inow/toasty;

Briefly; Anything not listed as duties of Congress, falls to the tenth Amendment. By people, the intent is to allow State Jurisdiction (if necessary)in these or other issues, separate from the Federal. For the record, mentioned issues, The Federal Highway System - excluding the Interstate- planned and began constructed for National Security- only Military usage, the various Library Systems, Fire Departments, Education, Welfare and Medicaid are ALL State operated and under the authority of the States. I might add so are the National Guards in each State as are many other, felt National Issues.

 

If you want to classify Health Care a "RIGHT", which some do, then by precedence long set in Constitutional Law, you would need an Amendment to the Constitution.

 

The constitution is a document that is nearly over 200 years old, times change. [/Quote]

 

toasty; You might be interested in where much of that Constitution came from. In addition to the several Colonial Constitutions, Articles of the Confederation (Our first Federal Government), much came from the British Magna Carta (1551), which is now over 500 years old. The rights and privileges we have in the US, are no minor things and what it has taken to achieve and maintain these things, has a long history, in addition to many that died in there protection (near 3 million).

 

bascule; While I believe an Amendment should be required or be Constitutional acceptable under law, the House/Senate/Executive are proceeding under the proper procedure. Whatever passes, will be subject to Constitutionality and I believe the Administration is counting on some losses. For instance, if the fining of individuals for not buying a product or Mandating an Insurance Company (private business) to accept or not accept certain customers ARE unconstitutional acts IMO and will be ruled as such. I feel, the desired objective is to take those rulings or maybe one of another 20 that will be taken to court and adjust the bill into back into the original intent, the single payer. In this case, or possibly before, the Insurance Industry will have standing (been hurt by government) and allowed recourse. Aside from the some 30 States have or are in the process of invoking A9, by having Sovereignty in there Constitutions. If nothing else, the process being used [secrecy/midnight voting/intimidation and bribery) are being seen by millions of people and will have their say in 2010 and 2012.

 

My original comments were to the Constitutionality of the Obama Administration in general compared to Bush. I find it hard to believe anyone, believes the actions, practices and policies of this Administration are in fact ALL Constitutional, but then I did live through the FDR and Johnson periods, which were no less contested.

[Mr Skeptic]

Welfare

welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD

 

Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.

 

Well yes, the purpose of wellfare programs is to promote wellfare. The concept of decreasing marginal utility means that transferring from those with excess to those lacking increases utility (welfare). As always, this will interfere to some extent with another right (right to private property), but we have decided to do this anyways. It seems to have been a good choice.

 

Amendment 9 - Construction of Constitution. Ratified 12/15/1791.

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

 

Amendment 10 - Powers of the States and People. Ratified 12/15/1791. Note

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.

 

Briefly; Anything not listed as duties of Congress, falls to the tenth Amendment. By people, the intent is to allow State Jurisdiction (if necessary)in these or other issues, separate from the Federal. For the record, mentioned issues, The Federal Highway System - excluding the Interstate- planned and began constructed for National Security- only Military usage, the various Library Systems, Fire Departments, Education, Welfare and Medicaid are ALL State operated and under the authority of the States. I might add so are the National Guards in each State as are many other, felt National Issues.

 

If you want to classify Health Care a "RIGHT", which some do, then by precedence long set in Constitutional Law, you would need an Amendment to the Constitution.

 

It seems to me that the Constitution allows us to maintain unspecified rights not mentioned in the Constitution. Even if this were not the case, it could be considered an extension of the right to life which is specifically mentioned.

[JohnB]

I should amend that then. We certainly can't afford it with our economy in its current state (current proposals for funding are based on non-existent "savings"). More expensive, true universal plans are just impossible right now.

I have to challenge this. It was shown in this thread

http://www.scienceforums.net/forum/showthread.php?t=39659

that not only do a number of Universal systems provide better health outcomes than the US system, they do so for far less money than you are currently spending.

 

(Shamelessly quoting myself)

Let's look at some other figures' date=' shall we? A report quoted in the LA Times in 2005 found that when comparing the US to the average of other developed nations there were:

* 2.9 hospital beds per 1,000 Americans, compared with a median of 3.7 per 1,000 residents in the other countries;

 

* 2.4 physicians per 1,000 Americans (in 2001), compared with 3.1 per 1,000 elsewhere in 2002;

 

* 7.9 nurses per 1,000 Americans (in 2001), compared with 8.9 nurses per 1,000 elsewhere in 2002;

 

* 12.8 CT scanners per million Americans (in 2001), compared with 13.3 per million elsewhere in 2002.

 

Nationmaster has some figures for spending per capita as of 2002.

US: 4,271

Denmark: 2,785

Sweden: 2,145

Austria: 2,121

Australia: 1,714

United Kingdom: 1,675

 

As to "Unconstitutionality". How anybody could possibly argue that reasonably priced access to healthcare for all citizens would not "Promote the general welfare" of those citizens is absolutely beyond me.

[Pangloss]

They're not questioning the constitutionality of reasonably-priced healthcare, they're questioning the constitutionality of forcing people to buy insurance when their lack of taking it is not a risk to others.

 

Don't you Ozonians have a right-to-die law?

[iNow]

They're not questioning the constitutionality of reasonably-priced healthcare, they're questioning the constitutionality of forcing people to buy insurance when their lack of taking it is not a risk to others.

 

I don't believe that is accurate, Pangloss. As linked in the OP, you can see that we were, in fact, discussing UHC as provided by the government and/or a public healthcare option, not a mandate to purchase from the private sector as we've wound up with during this last 2 weeks of congressional activity. In that other thread (linked in the OP) the claim was made that a government offering UHC or a public option is acting in a manner counter to the US Constitution.

 

That claim has been flatly disproven, and yet the conservative meme continues its propagation.

 

 

Finally, you've made an inaccurate claim about the "lack of risk to others" when an individual fails to secure coverage for themselves. That claim is easily rebutted on two primary fronts, which I will summarize here. One - Others will have to pick up their tab when the uninsured inevitably get sick and land in the ER, hence all of our premiums increase due to their lack of personal responsibility (supporting data below). Two - A failure to have coverage implies that they would avoid seeking treatment early due to costs, and would attempt to "ride out" the illness, thus increasing contagion across the population (due to their failure to seek treatment resulting from their lack of coverage) which would negatively impact the herd immunity of the population (supporting data below for this, as well).

 

That's two primary facts which negate your assertion that "lack of taking [healthcare coverage] is not a risk to others," and I can easily present a few others if needed. The point being that a lack of coverage in members of our population does present a risk to others, both economically AND biologically.

 

 

 

 

 

http://www.bloomberg.com/apps/news?pid=10000103&sid=aj6M8rPP1GHM&refer=us

American families with employer- sponsored health insurance will pay an average of $922 in added premiums this year because of costs doctors and hospitals incur in treating patients who don't have insurance, according to a report today by consumer advocacy group Families USA.

 

The extra cost, about $1 out of every $12 spent on health insurance premiums, will rise to an average of $1,502 within five years, the report said.

 

<...>

 

About 45 million Americans lacked health-care coverage in 2003, according to the U.S. Census Bureau. Washington-based Families USA said people without insurance pay about a third of their health-care costs, leaving doctors and hospitals this year with more than $43 billion in unpaid bills. Health providers raise prices to other patients to make up the difference, according to the report.

 

``The large and increasing number of uninsured Americans is no longer simply an altruistic concern on behalf of those without health coverage but a matter of self-interest for everyone,'' said Families USA Executive Director Ron Pollack in a statement.

 

NOTE: The Bloomberg article from above is from 2005, and costs have risen dramatically in the past five years, making the numbers shown above under representative of the actual costs today.

 

 

http://www.joepaduda.com/archives/000207.html

Providers who treat the uninsured only receive about 1/3 the cost of their care from the uninsureds, leaving others to pick up the tab for the rest.

 

According to the report, about 8% of insurance premiums goes to cover costs associated with caring for the uninsured. And, the cost will rise to over $1500 within five years.

 

The report notes:

"Insured families in six states - New Mexico, West Virginia, Oklahoma, Montana, Texas and Arkansas - will pay more than $1,500 in additional premiums this year to cover the costs of patients who lack medical insurance, the report found. By 2010, the list will include five more states: Florida, Alaska, Idaho, Washington and Arizona."

 

Here's the impact in real world terms. On an individual basis, your family premiums would be $900 less if the uninsured had coverage. On an employer-specific basis, General Motors is paying about $480 million a year in "excess costs" to cover the uninsured. And nationally, considering the Federal and state governments' expenditures on health care, our taxes are paying more than $50 billion a year to "insure the uninsured".

 

I have been saying for several years that the "uninsured" are actually "insured" through a mix of taxation, cost-shifting, and self-insurance. This is the first study that quantifies the cost of that "insurance".

 

 

Here is a more recent one:

 

http://www.americanprogressaction.org/issues/2009/03/cost_shift.html

Some mistakenly believe that the plight of the uninsured, and America’s failure to provide continuous quality health insurance for everyone, only affects those who are unable to find health insurance. But this is wrong.

 

The uninsured pay more for care—and get less—than those with insurance. But when the uninsured cannot pay, health care providers shift those costs to those who can pay—those who have insurance coverage. This leads to higher premiums for those who buy their insurance on the individual market, as well as workers who get insurance for themselves and their families through their job.

 

This “hidden tax” on health insurance arises from a failure to continuously cover all Americans and accounts for roughly 8 percent of the average health insurance premium. This cost-shift amounts to $1,100 per average family premium in 2009 and $410 per average individual premium. By 2013, assuming the cost shift remains the same percentage of premium costs, the cost shift will be approximately $480 for an individual policy and $1,300 for a family policy.

 

 

 

And now the biological impact (the whole link is very good):

 

http://www.abanet.org/irr/hr/fall07/mayfall07.html

The benefits of addressing the health insurance crisis are significant even for those who already are insured because the impact of the insurance crisis is felt in many areas that affect the health of the entire community, insured and uninsured alike.

 

<...>

 

The high number of uninsured people means that for a very large segment of the population access to the health care system will come only as a last resort, and then much later than those who are insured would enter the health system for similar ills. Numerous studies have shown that the uninsured use significantly fewer early detection services.

 

<...>

 

To the extent that lack of insurance slows access to the health care system and use of early detection resources, the problem of the uninsured will slow the identification of an infectious disease outbreak. This is especially true in urban areas. Urban areas contain a disproportionate percentage of ethnic minorities and the economically disadvantaged, both populations that are significantly less likely to have health insurance. In addition, because urban areas represent a concentration of people, they contain higher absolute numbers of people lacking health insurance coverage. At the same time, urban areas more readily facilitate disease spread. Because people in urban areas tend to live in multiunit housing (sharing air circulation, waste disposal, etc.) and come into contact with greater numbers of people in their daily lives, infectious disease spreads more rapidly. Since the key to slowing disease spread lies in early detection, when large segments of the population lack access to early detection and preventive services (like primary care providers), disease spread within the community at large increases.

 

<...>

 

The lesson of these examples is simple; health is largely a community good, and the effects of an individual’s lack of access to health services extends well beyond that person’s immediate circle of family and friends to the community as a whole. If we are not motivated to address the health insurance crisis for moral reasons, perhaps we can be motivated by self-interest to protect our own health by recognizing the broader community effects of the growing health insurance crisis.

Edited December 23, 2009 by iNow

[Pangloss]

I don't believe that is accurate, Pangloss. As linked in the OP, you can see that we were, in fact, discussing UHC as provided by the government and/or a public healthcare option, not a mandate to purchase from the private sector as we've wound up with during this last 2 weeks of congressional activity. In that other thread (linked in the OP) the claim was made that a government offering UHC or a public option is acting in a manner counter to the US Constitution.

 

Wups, my mistake, thank you.

 

 

Finally, you've made an inaccurate claim about the "lack of risk to others" when an individual fails to secure coverage for themselves.

 

I definitely agree with your point that my stipulation doesn't work when you consider indigent care, and I think that's an excellent answer to bascule's question from the other thread regarding justification for the enforcement of the purchasing of insurance. Nice job on that.

[npts2020]

iNow; IMO the vast majority of people do not have health care because the cost of it is so high and most cannot afford it. By telling everyone they *must* have it and then mandating that private corporations profit from it, you have not solved the problem. All you have done is make it more burdensome for those who are not affording it to begin with. I find it to be an unbelievable proposition that there are substantial numbers of people who could easily afford insurance who do not already have it. Once this kicks in, tell me how much your monthly health insurance bill goes down, I will be very interested to know. IMO it is nothing more than a hand up from the least able to afford it to enhance private profit.

[iNow]

We'll have to see how helpful the tax rebates are. Also, as I mentioned earlier in the thread there are hardship exemptions in place with the legislation. Either way, I'm not exactly pleased with what this bill is, and agree that the lack of public option is a real set-back, but it's still far better than what we have now. 30 million more people covered, exemptions and tax rebates to help people afford it, and it brings down the deficit by $132 billion in the next 10 years, and up to $1.3 trillion in the next 10 after that.

 

 

As for the "vast majority" you cite not having insurance due to cost, while it is a majority, it is certainly not vast (since a majority is 51% or more, and the number is around 53%... I'd reserve the descriptor of "vast" for something over 70-80%, myself).

 

 

http://www.cdc.gov/nchs/data/series/sr_10/sr10_229.pdf

 

---

Merged post follows:

Consecutive posts merged

Nice job on that.

Many thanks.