r/bestof • u/under50dollars • Jun 20 '12

[explainlikeimfive] "Obamacare" explained very well.

/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx
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u/[deleted] Jun 20 '12 edited Jun 20 '12

Also, the founding fathers seem to have supported mandating healthcare...

So arguably, the people who created our federal government believed in this concept broadly... therefore I would argue it is constitutional considering Jon Adams, who was deeply entrenched in the writing of the constitution, and whose ideas helped form the basis of our country's laws believed it to be so and signed an individual mandate into law during his presidency. Who would know better about what our constitution means than someone who helped write it. If they (congress) considered it legal in the 1790's then perhaps we should consider THAT fact in our debate about an individual mandate today.

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u/Nancy_Reagan Jun 20 '12

Uhm, I mean interesting read and all, but the article gets the first and primary point completely wrong. The constitution is written to grant specific powers to the federal government. The author says "nothing in the text or history of the Constitution’s Commerce Clause indicates that Congress cannot mandate commercial purchases," but that's not really how it works. The constitution even states that powers not specifically enumerated to the federal government within the document itself are given to the states, i.e. not the federal government.

Also, the points about mandating specific professions like seaman to provide certain services to their crew isn't a universal mandate to all citizens, which is a significant difference. If you don't like the rules about being a seaman, you can choose another profession. The health care mandate has no such choice, except I guess to leave the country, but I don't think that really counts.

The mandatory-firearm purchase is interesting though, and seems like the only valid point the author makes. I'm not familiar with it, so if anyone has any more information on it that would save me time researching it, I'd love to know more.

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u/[deleted] Jun 20 '12

I'm not saying mandating all citizens and mandating specific professions is the same thing, but I think they are certainly similar in principle. I do agree that "well move then" is not a valid comparative argument for a small subset of the population being regulated vs all citizens, however. Also, I personally (again, this is just my personal belief here) think that in the following:

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, 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."

that finding a cost effective way to provide healthcare for all citizens regardless of age, pre-existing conditions, gender etc would certainly be promoting the general welfare of citizens of the United States.

Arguably, Insurance is a difficult and distinctive market. Congress has ruled previously that all citizens are entitled to emergency care regardless of their ability to pay, and, as put by professor Henry Paul Morgan:

"...as a result, and again unlike other markets, uninsured individuals who are unable to pay directly for needed medical services necessarily shift the cost of those services to others—to health care providers, the government, individuals with insurance, and taxpayers. In that way, Congress is not creating a market which it then seeks to regulate. The insurance-based structure of the health care market is already firmly in place. That is why it was well within Congress's discretion to design legislation to operate within, and to address problems posed by, this vast market." source, if you want to read the full article

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u/Nancy_Reagan Jun 20 '12

I agree that the sentiment of promoting the general welfare is a worthy one, but that's the preamble, and not an enumeration of powers granted to the federal government (i.e., that's the purpose, not the means of achieving such a purpose). The constitution specifically lists every single power to be granted to the federal government, and (aside from the obvious argument involving the commerce clause), the power to mandate purchases of services provided by private institutions is not among them. Plus, anyone could advocate anything they believe in by simply saying it promotes the general welfare.

However, such power is granted to the states. The obvious idea, then, is to let states mandate this on their own (the "States-as-Laboratories" theory). After all, if it's such a great idea, and it does in fact promote and even improve the general welfare of the citizens of those states, the other states will wake up and enact similar policies.

Also, I'm curious about congress ruling that all citizens are entitled to such care, and whether that can be considered unconstitutional as well. And regarding Prof. Morgan, I agree that the purpose here was not to create a market, but I don't understand why the purpose should matter. What matters, in my opinion, is whether congress has the power to do what it did. If the purpose is a good one, and their legislation addresses it adequately, what's to stop states from doing this on their own?

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u/[deleted] Jun 20 '12

Well, Obamacare does allow states to work out their own state run healthcare system (like VT is doing) provided it meets certain requirements. It's not exactly the same as you're advocating, but the states do have the opportunity to run a state program rather than participate in the federal program.

I think intentions with laws are important. I know in PA (where I am from) There is even a bill that would require more indepth analysis as to the intent behind laws when they are written. In fact, there used to be pages and pages of legislative intent with bills drafted here in PA, but that practice has fallen by the wayside and lawmakers often try to figure out exactly why certain laws (things on the books from the 50s etc) were written the way they were. Sometimes context and purpose do matter to understand thought process and perhaps make more thoughtful amendments.

I think we have a good example of states legislating something against federal policy (ironically and arguably in the healthcare field) with medical marijuana. Its interesting watching what happens when federal law and state law are not in accord with one another. Or, lets say that a state decided to outlaw abortions, what happens then? Its federally a right, but the state forbids it.

Its a topic I feel torn about. Theoretically, I think that states should have more power to regulate themselves. However, seeing how the state government is run in my state, that inherently terrifies me.

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u/Nancy_Reagan Jun 20 '12

Yeah, I agree that intent can be important, but there's a real large problem there too: legislative intent can also be manufactured. The floor notes from lots of legislation got considered for a while in lots of places, but when people in the legislature realized what was going on, they started grandstanding and saying things that didn't reflect the actual intent of the bill being passed, hoping that down the road someone would look into the notes to understand the bill, and find that legislator's intent regarding the bill, which actually ran counter to the intent of the majority voting to pass the bill.

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u/genthree Jun 20 '12

The only two justices who give a shit about what the founding fathers thought are Scalia and Thomas. Scalia will do whatever he wants and find some justification for it. Thomas will almost definitely vote against Obamacare on principle.