Category Archives: Healthcare

Co-Equal, Or Colluding, Branches of Government?

Constitution, Federalism, Government, Healthcare, Law, States' Rights, The Courts

The problem with the Commonwealth of Virgina’s pleasing legal victory in challenging the constitutionality of Obama’s “healthscare” is this: The individual mandate and much of the health care bill may be manifestly violative, but most of the limits the Constitution placed on the federales (and the courts themselves) are no longer upheld by the courts (or by Congress, that other co-equal branch of government), starting with the Tenth Amendment.

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

So, as PBS’s News Hour reported, once again so well (appending as it always does a PDF document of the Decision), “Federal judge Henry Hudson ruled Monday afternoon that a major provision of the health care reform law is unconstitutional. In his decision, the judge sided with Virginia Attorney General Ken Cuccinelli, who argued that the Congress does not have the authority to require Americans to purchase health insurance. ‘The Minimum Essential Coverage Provision is neither within the letter nor the spirit of the Constitution,’ Judge Hudson wrote.”

But along could come the Supreme Court Justices and nullify the health-care preferences of the people of Virginia. That’s because the framers’ constitutional dispensation is now nothing but a sad joke. The Appellate Court could beat the SCOTUS to it.

The Real Porker Programs (Yes To A State Shut-Down)

Debt, Democrats, Economy, Healthcare, John McCain, Military, Republicans, The State, Welfare

If the Republicans’ ideas on budget slashing is anything like McMoron’s, then, the months ahead will be filled with threats to cut National Public Radio loose, and to do away with earmarks—minuscule amounts which don’t cover a day’s interest payment on the national debt.

Even the Harvard Political Review, which now departs from the King of Keynesians, Paul Krugman, knows as much. The editors of the HPR-produced “Annual Report of the USA” include a Democrat and a Republican. The one writes:

“Despite public criticism of ‘pork barrel’ spending and foreign aid, these items constitute a minuscule portion of the federal budget. Instead, the area of greatest concern is spending on the major entitlements: Social Security, Medicare, and Medicaid. Spending on these programs is expected to skyrocket in the coming decades due to an aging population and the increasing cost of medical care. The long-term Social Security solvency problem can be avoided if Congress can muster the political will, but there is no obvious solution as to how to limit the growth of public health care spending. One of the major goals of the recent health care reform legislation was to reduce health spending over the long term, but achieving this will require a discerning and disciplined Congress in the years to come.”

“While the military budget is not growing nearly as rapidly as spending on entitlements, it represents nearly a fifth of total federal spending and is a perennial target of deficit hawks. While there is some waste in defense spending that could be eliminated without much consequence, more fundamental cuts will entail a sacrifice of military capabilities.”

[SNIP]

The deceptive issue of earmarks was raised by Rep. Eric Cantor, of Virginia. From Chris Wallace’s interview with Cantor, the “Presumptive House majority leader,” it transpires, moreover, that Republicans intend to demand “sizable” spending cuts (presumably other than earmarks or NPR) from Obama in return for agreeing to raise the debt-ceiling.

The debt ceiling should not be raised. Better that the government be forced into default. In that case, a government shut-down, as in 1995, would be most welcome.

To his credit, Cantor did not rule out such eventualities. Should they occur, he contended, Obama would be the one to blame for the fiscal crisis that brought about a default on the debt and a subsequent government shut-down.

If government shuts-down for long enough, we may find ourselves thanking Obama for delivering us from evil, indirectly, at least.

UPDATED: Healthcare Under The Hammer

Government, Healthcare, Law, Regulation, The State

The judicial, legislative, and executive are in an unholy alliance that has long since sundered the 10th Amendment, namely constitutional individual and states’ rights. As we wait on the tyrannical federal trinity to issue decrees in response to the challenge to Obamacare launched by “20 different lawsuits with 21 different states as plaintiffs,” TIMES-DISPATCH COLUMNIST A. BARTON HINKLE provides valuable background analysis.

How Will the Court Rule in Mandate Case?
By A. BARTON HINKLE

Predicting how the Supreme Court will rule in a given case is often a sketchy business. The court doesn’t break down neatly along liberal/conservative, or big-government/small-government, lines. For every Heller or Citizens United infuriating the left, there’s a Kelo or Raich to send steam billowing out of conservatives’ ears.

So there’s no telling how the Supremes might come down on the question of whether Obamacare’s individual mandate is constitutional. Now that a federal judge has refused to dismiss Attorney General Ken Cuccinelli’s suit against it, proponents of the Patient Protection and Affordable Care Act will have to argue the case on the merits.
That might not be as easy as some have assumed. This becomes clear from an amicus brief submitted by Ilya Somin — a law professor at George Mason — along with the Washington Legal Foundation and assorted other law profs from around the country.

Somin notes that, as Madison said, the Constitution does not grant Congress “an indefinite supremacy over all persons and things.” Rather, it lists a finite set of federal powers — and forcing people to buy consumer goods is not one of them.

True, the federal government does many other things the Constitution does not explicitly mention, and the power to do them is taken to be implied. So proponents of the individual mandate hang their hat on a couple of different hooks.

One is the Commerce Clause, granting a congressional power to regulate interstate commerce. The Supreme Court has broken down the Commerce Clause into three parts: regulating the channels of interstate commerce, the instrumentalities of commerce, and the “activities” that “substantially affect” interstate commerce. But, Somin writes, “an individual’s mere status as uninsured is neither an instrumentality of interstate commerce, such as a road or airport, nor . . . is being uninsured a person or thing that travels in interstate commerce.” And it is absurd to claim that inactivity constitutes activity.

To see why, Somin goes back to the decision in Gonzales v. Raich, in which the court ruled that growing marijuana for personal medical use — an activity that is neither commerce nor interstate — could be forbidden under the Interstate Commerce Clause. The Supreme Court ruled that Congress had broad authority under the clause to regulate even “noneconomic activity.”

But unlike growing marijuana, not purchasing health insurance is not even an activity, and it is fatuous to pretend otherwise. The Commerce Clause gives Congress the power to regulate transactions between Jim and Bob. It doesn’t give Congress the power to force Fred, who had been resting under a tree, to join Jim and Bob’s exchange.

If Congress has the power to do that, Somin writes, then “the federal government would have the power to force citizens to engage in any activity that might conceivably affect commerce is some way.” Big-government liberals might be perfectly fine with that. But, Somin says, “this is precisely the kind of unconstrained power that the court has expressly rejected.”

At this point, Obamacare advocates usually interrupt with the emergency-room argument. It goes like this: “Well, people who don’t have insurance end up needing medical care, and hospitals are required by law to treat them, and that imposes costs on everybody else. What are you going to do — let hospitals throw patients into the street?”

This is a fine rhetorical device and an interesting ethical question, despite some factual weaknesses (not everybody requires medical care they can’t pay for out of pocket; millions of healthy young adults don’t need insurance). But it is not a constitutional argument. A hospital’s legal obligations don’t confer powers on Congress. Banks have lending obligations. That doesn’t mean Congress can force you to open a checking account.

On Thursday, a federal judge in Michigan tested another argument: The failure to buy insurance qualifies activity because “by choosing to forgo insurance plaintiffs are making an economic decision to try to pay for health care services later.” The same reasoning, however, would deny conscientious objectors the right to avoid military service, because by choosing to forgo participation in a war, they are forcing someone else to go in their place.

The amicus brief makes quick work of the notion that the penalty for not buying insurance is a tax. It’s not an income tax, it’s not an excise tax, so it must be a direct tax — which must be apportioned among the states — or, as seems patently obvious, it’s a penalty. But Congress can’t impose a penalty to enforce regulation of something it has no authority to regulate in the first place.
Finally, the mandate’s proponents say it’s authorized by the Necessary and Proper Clause, because it’s necessary to impose the requirement that insurance companies accept all comers regardless of pre-existing conditions. (Why? Because without the mandate, people wouldn’t buy insurance until they got sick.) This might be the strongest argument for the mandate. But it still faces a couple of problems.

First, the individual mandate tries to achieve something by taking an extremely broad step when a more narrowly tailored one would suffice. As Paul Starr wrote in the liberal American Prospect last year, Congress could address the adverse-selection problem by giving individuals “a right to opt out of the mandate if they signed a form agreeing that they could not opt in for the following five years . . . .For five years they would become ineligible for federal subsidies for health insurance and, if they did buy coverage, no insurer would have to cover a pre-existing condition of theirs.” Strictly speaking, the mandate is not necessary.

Second, if the court concludes that the mandate is justified because it is, after all, “rationally related” to insurancee regulation, then the justices would open the door (as they did in Kelo) to governmental sophistry: As long as legislators claim a new power being sought has some tenuous connection to an existing power, then the courts can never say no. This would allow lawmakers to assume an indefinite supremacy over persons and things, by stacking new powers one atop the other.

Liberals are in love with granting Washington indefinite supremacy right now, with a Democratic Congress and president at the helm. They might not like it so much should a Republican Congress start working hand-in-glove with a President Sarah Palin.

UPDATE: Good news. A “Federal Judge Allows Multi-State Suit Against Health Care Law to Proceed.”