Experts predict ObamaCare wil lbe overturned

[Kaa]

What does happen?

Typically the hospital sends you a bill at full-rate prices (which are rather ridiculous and, by the way, which almost no one, certainly not insurance, pays). At this point you can ignore it or negotiate. If you negotiate, the results obviously vary but typically the hospital will cut the charges in half or more. If you ignore it, the account receivable eventually gets sold to a collection agency which will try to get some money out of you. Their success rather depends on how easily can they find you and what kind of assets you have. Eventually they'll write the debt off and forget about you.

Kaa

[Cuyahoga Chuck]

Its not a very good law. I'm not gonna say we 'deserve' better, but I will definitely say that we as a nation need better.

Democracy isn't brain surgury. It's a system where you get what is possible and that might be a damned long way from perfect. With the Republicans engaged in the biggest wrecking operation in our history passing Affordable Health Care was a master stroke and judicial destruction of it will, no doubt, destroy the lives of some of those the law tried to up lift.
I say, sanctification to all who helped pass it and damnation to those , especially the catholics, that would destroy it.

[Cuyahoga Chuck]

Exactly!

Never has it been hard for this age group to get insurance anyway. This is one of the more ridiculous arguments liberals like ljb5 and John Smith make in support of the Affordable Health Care Act, that children will be able to stay on their parents insurance, but in reality its this demographic that insurance companies want the most to offset older health care consumers.

It wasn't mandated because young people faced some structural cause that made health insurance hard to get. It was the recognition that millions of the young don't have a job, can't afford the cost and are reduced to living with their parents. Or they are students whose education involves long years of schooling and there isn't any money for the niceties of life .

[S.V. Airlie]

Aren't you making an assumption that the ENTIRE bill in your eyes will be over turned and not just one provision in it? Nice scare tactic Norman.

[Cuyahoga Chuck]

That is certainly a possibility... :-D



Norman, you're a white upper-middle-class Massachussets liberal who wouldn't know what a fringe of sustainability is if it bit you on the ass.

And ideals and principles do NOT fade into irrelevance when you are facing hard choices. In fact, they become more important. They are what makes humans humans. The observation that you do not understand this is part of the reason why I am asking the question.



I've seen you make the argument ("if only you stood to lose from this, you'd change your mind") many, many times. With respect to taxes, with respect to elections, with respect to health care, with respect to everything under the sun. That's why I called this a deep conviction -- it's a recurring, consistent theme in your postings.

Kaa

The above comes pretty close to an ad hominem attack. Stuff like this destroys the intellectual chain of the thread. Mouthing only what your guts tell you may work in the local beer joint but we deserve better.
Remember," Scott is watching you"!

[Kaa]

Democracy isn't brain surgury.

ROFL... That's worth saving as a quote :-D

Kaa

[Osborne Russell]

Experts predict that the abolitionists' loss on the Compromise of 1854 will prevent civil war and protect slavery indefinitely.

[Cuyahoga Chuck]

Typically the hospital sends you a bill at full-rate prices (which are rather ridiculous and, by the way, which almost no one, certainly not insurance, pays). At this point you can ignore it or negotiate. If you negotiate, the results obviously vary but typically the hospital will cut the charges in half or more. If you ignore it, the account receivable eventually gets sold to a collection agency which will try to get some money out of you. Their success rather depends on how easily can they find you and what kind of assets you have. Eventually they'll write the debt off and forget about you.

Kaa

That world is long gone.
Bad debts can be sold over and over again to folks who are more and more likely to use threats and abuse to get something out of their investment.

[Cuyahoga Chuck]

ROFL... That's worth saving as a quote :-D

Kaa

Don't bother. I aimed that at Pless. It wouldn't mean anything in your world.

[ccmanuals]

Good news and bad news, On average, 5,102 Americans filed for bankruptcy each day that court was in session over the first four months of this year — and that’s the good news. Bankruptcy filings are down 13 percent so far in 2012, according to the American Bankruptcy Institute

Here are the top 5 reasons for bankruptcy. Guess what's number 1.

5. Unexpected disaster
It could be a hurricane, a death in the family or another nasty surprise – unexpected disasters underlie 7 percent of U.S. bankruptcies, and can especially cause problems for people with inadequate insurance.
4. Divorce
Splitting up is spendy, and when former partners have to get by without each other’s financial support while paying legal fees, going from one household to two, and sometimes taking on other costs, it’s little wonder that divorce contributes to 8 percent of bankruptcy filings.
3. Out-of-control spending
Some say shoppers who rack up huge credit card bills before heading to bankruptcy court are guilty of reckless spending and shouldn’t be able to wipe the slate clean, but Rose said he does not buy the frequent claim that irresponsible choices are at fault. More often, people with very tight budgets use plastic to pay for basics, like food, or to handle unexpected expenses, like car repair. When interest rates are high and incomes are low, the debt climbs fast. About 15 percent of bankruptcies fall into this category.
2. Job loss
When the housing market crashed, many people employed in related sectors lost their jobs. Rose said he saw a surge in filings from construction workers and real estate industry employees. Those people are no longer filing for bankruptcy in such high numbers, Rose said. The labor market is improving, but unemployment in the U.S. still remains abnormally high. About 22 percent of bankruptcy filings are linked to a job loss.
1. Medical expenses.
As many as 62 percent of bankruptcies were caused by medical costs, according to a Harvard study.
Close to three out of four health-cost related bankruptcies are filed by people who had insurance – just not good enough insurance enough to cover the high costs of modern medical care. “I may see a $100,000 bill covered by insurance – but it comes with a $20,000 co-pay,” Rose said.
Rose said he was once optimistic that the Affordable Care Act, sometimes nicknamed “ObamaCare,” would help already-insured families to get better policies and avoid medical-emergency bankruptcies. “Now I think the Supreme Court is going to overturn the law’s insurance mandate,” he said. “The Afordable Care Act would have prevented a lot of bankruptcies, but we’re not going to get there.”

[ljb5]

You are mistaken. I am asserting that EMTALA requires doctors to provide care (and so, presumably, implies that patients accept it) without considering the ability to pay. This has nothing to do with what happens to the medical bills afterwards.

Yes. That is my point exactly. EMTALA does not provide for freeloaders. It does not destroy the relationship between services provided and payment rendered. (Some people consider this relationship to be the foundation of Capitalism and the American way of life.)

EMTALA does, perhaps, put a little bit of a blip in the payee-payer relationship, but that is only temporal, temporary and frankly, logical, given the emergent nature of emergencies.

When services are rendered under the EMTALA, there is still an expectation of payment and consequences for non payment.

No responsible or principled person would turn their back on that fundamental relationship.

LOL. So *that* is the great advantage of single-payer with respect to free-loading? :-D

Why, yes.

Under either a Single-Payer sytem or the Individual Mandate, there are allowances made for freeloaders. The benefit is that they are means-tested and provided in a rational way that balances responsibility to pay with the age-old adage that you cannot squeeze blood out of a turnip. This is known as "Pragmatism."

The drawback of the Kent Snyder-Ron Paul-Tea Bagger system is that freeloaders are allowed to self-designate. Even people of ample means are permitted to freeload and leach off others, as Kent Snyder did. This is not principled and generallly not beneficial either to the freeloader (who may be forced into bankruptcy, suffering long-term damage), nor to the other members of society who get stuck with the bill.

[Kaa]

That world is long gone.
Bad debts can be sold over and over again to folks who are more and more likely to use threats and abuse to get something out of their investment.

Based on my experience I will disagree :-P

Kaa

[Kaa]

Yes. That is my point exactly. EMTALA does not provide for freeloaders. It does not destroy the relationship between services provided and payment rendered.

Right. So I'm a homeless guy or maybe I rent a room and have occasional jobs which pay for the rent and the food. I get into a car accident and after I'm discharged from the hospital in a couple of weeks, there is a variety of bills totaling a few hundred thousand dollars. And the relationship between services provided and payment rendered is... where?

(Some people consider this relationship to be the foundation of Capitalism and the American way of life.)

Do you?

No responsible or principled person would turn their back on that fundamental relationship.

Heh. You sound like a moneylender preaching :-D

Kaa

[Andrew Craig-Bennett]

We've been here before. FDR vs the Supremes.

FDR won, iirc.

I assume the Supremes are as interested in precedent as any other common lawyers?

[ljb5]

Right. So I'm a homeless guy or maybe I rent a room and have occasional jobs which pay for the rent and the food. I get into a car accident and after I'm discharged from the hospital in a couple of weeks, there is a variety of bills totaling a few hundred thousand dollars. And the relationship between services provided and payment rendered is... where?

In that case, the relationship is rendered rather imperfectly. There will probably be a few rounds of back-and-forth before the debt is written off as a loss.

The homeless guy may be permanently impaired by the debt or by bankruptcy. If he does manage to land a decent job, it's likely that the debt would haunt him the rest of his life.

A less extreme example is someone who makes a decent, but not extravagant salary. Perhaps $60k per year... just enough to put something away for his kids' college savings. If he were to incur a sudden medical expense, it's likely to consume all of his assets, push him into bankruptcy, and have a permanent, negative effect on his children's future.

Don't kid yourself -- that happens all the time.

Another example is where the medical treatment is not considered emergent. The patient may simply be denied treatment altogether and either sent home to suffer, or must wait until the condition becomes an emergency and therefore he cannot be turned away. (At which point, he will be billed and then a fight ensues over ability to pay.)

A common example of this is a poor person with diabetes who does not recieve treatment until it becomes necessary to amputate a foot. This is an unfortunate and avoidable outcome and may ultimately prove to be more expensive and more detrimental for everyone involved.

Do you?

Yes, I consider respect for property rights, the payee-payer relationship and the sanctity of contracts or transactions to be very important to the American way of life. Don't you?

Heh. You sound like a moneylender preaching :-D

Nah. I just consider that 'responsibility.'

Don't you?

[Kaa]

The homeless guy may be permanently impaired by the debt or by bankruptcy. If he does manage to land a decent job, it's likely that the debt would haunt him the rest of his life.

The purpose of bankruptcy is *precisely* to make it sure some debt does not haunt you for the rest of your life. There is no such thing as being "permanently impaired" by debt, unless that debt is not dischargeable in bankruptcy (like, for example, student debt).

Yes, I consider respect for property rights, the payee-payer relationship and the sanctity of contracts or transactions to be very important to the American way of life. Don't you?

Property rights have nothing to do with what we're discussing and I don't believe the US legal system holds contracts sacrosanct (even if you could show the existence of a contract between a hospital and a bleeding body being wheeled into ER...). The payer-payee relationship I certainly do not consider to be central to capitalism or to the American way of life, whatever it may be (I am not quite sure ;-) )

Kaa

[ljb5]

The purpose of bankruptcy is *precisely* to make it sure some debt does not haunt you for the rest of your life. There is no such thing as being "permanently impaired" by debt, unless that debt is not dischargeable in bankruptcy (like, for example, student debt).

Depending on if it's Chapter 7 or 13, bankruptcy may stay on your credit report for 7 to 10 years. The debt goes away (along with a huge part of your assets, I suspect), but the impairment is lasting.

Considering the difficulties and opportunities lost in that time, the impairment may be permanent. Can a person get a small business loan immediately after bankruptcy? I'm guessing it would be quite difficult. In the seven years it takes for the credit to clear, the opportunity is lost forever.


I feel like you have conceded all my points. You're now just arguing for the sake of argument, which I find boring.

If you have nothing interesting to say, don't feel the need to say anything at all.

[Paul Pless]

I feel like you have conceded all my points. You're now just arguing for the sake of argument, which I find boring.

Did you steal this line from SamF?

[PeterSibley]

This is as usual illustrates the difference between those who see their country as a group of disconnected competing individuals and those who see themselves as part of a mutually supporting society.

[Paul Pless]

This is as usual illustrates the difference between those who see their country as a group of disconnected competing individuals and those who see themselves as part of a mutually supporting society.

Which side are you on? Do you not see the difference between a true single payer health care plan and what the AHCA is? Do you trust future politicians with the precedent that this case will set if the Supreme Court decides to let it stand? Every country with universal health care basically had four institutions standing in the way of universal health - hospitals, doctors, big pharma, and insurance companies. One or more of them was going to have to be bought out to establish universal coverage. Obama chose another way that no other country has chosen, he decided to side with the most unethical and unscrupulous institution of the four; and he chose not to buy them out but to get right in bed with them. Without confronting the other institutions where is the cost containment? Without subsidizing the other institutions how can we end up with anything but a further rationing of health care? Its a really poor plan, that was pushed through for reasons of expediency. Hope he's happy with his legacy, I was hoping for more than just superficial change. . .

[ljb5]

Which side are you on? Do you not see the difference between a true single payer health care plan and what the AHCA is?

It might be worth mentioning that Republicans pushed the idea of using "market forces" to help solve the problem of delivering care.

Depending on which side of their face they are talking out of on any given day, Republicans may refer to insurance companies as "free-market, capitalist, innovative, competitive, and good".... or they may refer to them as "unethical and unscrupulous."

If Obama had advanced a plan that actually did away with insurance companies, Republicans would have moaned and screamed about "government take-over of business." Instead, he partnered with them to keep the free-market operations intact... in which case, Republicans moan and scream about "government take-over of business."

It might also be worth noting that Obama did not just "get in bed with them." He did create significant new requirements for the services they must provide. He got something in exchange for their cooperation.

Republicans, who never liked single-payer were in favor of the individual mandate precisely because it left insurance companies intact, which they considered to be good capitalism.

Now, they complain about that.

[RonW]

LBJ -

If Obama had advanced a plan that actually did away with insurance companies,

Hail to the great leader ..............

[PeterSibley]

Which side are you on? Do you not see the difference between a true single payer health care plan and what the AHCA is? Do you trust future politicians with the precedent that this case will set if the Supreme Court decides to let it stand? Every country with universal health care basically had four institutions standing in the way of universal health - hospitals, doctors, big pharma, and insurance companies. One or more of them was going to have to be bought out to establish universal coverage. Obama chose another way that no other country has chosen, he decided to side with the most unethical and unscrupulous institution of the four; and he chose not to buy them out but to get right in bed with them. Without confronting the other institutions where is the cost containment? Without subsidizing the other institutions how can we end up with anything but a further rationing of health care? Its a really poor plan, that was pushed through for reasons of expediency. Hope he's happy with his legacy, I was hoping for more than just superficial change. . .

More a comment on how the rest of the world sees the US Paul. The Machiavellian twists of your politics on this one are quite beyond me.

[Shang]

I've been self employed for twenty years. I did go onto my wife's plan last year. I continue to administer the health insurance plan for my employees, which I have done so for nineteen of the twenty years that I have been in business.

What impelled you to go onto your wife's plan last year instead of continuing on the plan for your employees?

[Paul Pless]

What impelled you to go onto your wife's plan last year instead of continuing on the plan for your employees?

$26.00 a month versus $350.00 a month. The coverage is about the same. What would you have done?

[wardd]

It might be worth mentioning that Republicans pushed the idea of using "market forces" to help solve the problem of delivering care.

Depending on which side of their face they are talking out of on any given day, Republicans may refer to insurance companies as "free-market, capitalist, innovative, competitive, and good".... or they may refer to them as "unethical and unscrupulous."

If Obama had advanced a plan that actually did away with insurance companies, Republicans would have moaned and screamed about "government take-over of business." Instead, he partnered with them to keep the free-market operations intact... in which case, Republicans moan and scream about "government take-over of business."

It might also be worth noting that Obama did not just "get in bed with them." He did create significant new requirements for the services they must provide. He got something in exchange for their cooperation.

Republicans, who never liked single-payer were in favor of the individual mandate precisely because it left insurance companies intact, which they considered to be good capitalism.

Now, they complain about that.

the market forces as much money as possible out of you while giving as little service as possible

[Shang]

$26.00 a month versus $350.00 a month. The coverage is about the same. What would you have done?

Jumpin' Jeezus, Paul, you can get health coverage for twenty-six bucks a month!
I'm paying way more than that amount.

Would you consider adopting me?

[wardd]

i've yet to see the business model that provides health care on for everybody the private market from cradle to grave that would be profitable

[Shang]

$26.00 a month versus $350.00 a month. The coverage is about the same. What would you have done?

Jumpin' Jeezus, Paul, you can get health coverage for twenty-six bucks a month!
I'm paying way more than that amount.

Would you consider adopting me?

[Norman Bernstein]

$26.00 a month versus $350.00 a month. The coverage is about the same. What would you have done?

That is an eminently sensible decision, on your part.

There is only one problem: the actual costs of your medical care are precisely the same. You simply found a different sucker to pay for it all.

[Paul Pless]

There is only one problem: the actual costs of your medical care are precisely the same. You simply found a different sucker to pay for it all.

That's not quite true, its a rate that is afforded as part of Katherine's compensation. And, she had options to choose from which would have made my cost more or less, as well as my benefit eligibility to be more or less. One very interesting difference between my previous plan and this one is incentives for good health or at least educating myself on good health. My previous plan it didn't matter even if I had the 'free' physical each year. Her plan assigns a penalty if I don't get a physical. Her plan extends a credit if I take a class on healthy diet and exercise. Other than that they are both administered by the same company and are very similar. Here's something else that you might find interesting, I've had employees turn down my insurance, in favor of additional pay, and they did so without having other avenues to get employer subsidized insurance. Put that in your mandate pipe and smoke it. . .

[George Jung]

Did you steal this line from SamF?

That was a good one - and struck just the right tone. Bravo!

AFA the 'debts' argument, the liklihood is they'll go after any/all assets you may have, and from my experience, they're generally merciless. #1 cause of bankruptcies in this country, folks.

AFA single payer vs what we have - for those who have forgotten - that was the compromise Obama went with to get the basic, initial HCR bill passed. Republicans wouldn't have gone for single payer anyway/anyhow. But the latest news has insurance companies saying, even if the SC pulls the bill, they'll continue some of it's provisions - including no pre-existing conditions exclusions, and coverage to age 26 for kids. BTW, that's big. I have four kids, and if all had to have individual policies (in school, not making enough), it'd be a back-breaker. Back in the day, I didn't have insurance - but a clinic visit wasn't $100, a broken arm wasn't $5,000. It's a different world.

And yes, I think Normans pegged kaa exactly - his accent gives him away!

[Norman Bernstein]

That's not quite true, its a rate that is afforded as part of Katherine's compensation. And, she had options to choose from which would have made my cost more or less, as well as my benefit eligibility to be more or less. One very interesting difference between my previous plan and this one is incentives for good health or at least educating myself on good health. My previous plan it didn't matter even if I had the 'free' physical each year. Her plan assigns a penalty if I don't get a physical. Her plan extends a credit if I take a class on healthy diet and exercise. Other than that they are both administered by the same company and are very similar. Here's something else that you might find interesting, I've had employees turn down my insurance, in favor of additional pay, and they did so without having other avenues to get employer subsidized insurance. Put that in your mandate pipe and smoke it. . .

Actually, I think you have proven my point. The difference in dollars simply represents Katherine's employers decision to build in health care as part of her compensation... Money which might otherwise be paid in salary. The cost of delivering the health care IS no different.

As for your employees who choose to take the cash, rather than the health care, it represents their irresponsibility (because their inevitable healthcare will be paid by taxpayers, making them intentional leeches on society), as well as YOUR possible irresponsibility in letting them go uncovered... Which implies either a callous disregard for their health, or a rather poor appreciation for their contributions to your company.

[ljb5]

More and more, I find it difficulty to recognize George Jung.

It's almost as if he's been paying attention for the last eight years.

[Paul Pless]

Actually, I think you have proven my point. The difference in dollars simply represents Katherine's employers decision to build in health care as part of her compensation... Money which might otherwise be paid in salary.

Not at all Norman, its just as likely that Katherine might have chosen to go on my plan as a spouse and given up her employer's coverage, accepting cash in lieu of benefits. The fact of the matter is that large employers can offer insurance for less than they would have to offer traditional cash compensation. Its a win win for both the employer and for the employee.

As for your employees who choose to take the cash, rather than the health care, it represents their irresponsibility (because their inevitable healthcare will be paid by taxpayers, making them intentional leeches on society), as well as YOUR possible irresponsibility in letting them go uncovered... Which implies either a callous disregard for their health, or a rather poor appreciation for their contributions to your company.

A twenty four year old, under our current system, is not an 'inevitable' consumer of health care. I'm not sure its even legal for me to require someone to accept health insurance. What would you have had me do, require the employee to bring me proof of some other insurance coverage before paying them an alternate salary?

There's some kind of real disconnect going on here. We've traditionally been a nation (since WWII) where the largest employers provided health insurance but due to market structures smaller employers very generally did not. And here I am trying to be proactive and do the right thing and I'm being castigated for it.

[Paul Pless]

George always pays attention and misses very little, IMO!

To be fair, he did notably misplace the 'attack SamF thread'. Not quite sure what that says about George, but I'm sure it says something. . .

[PeterSibley]

George always pays attention and misses very little, IMO!

Agreed

[ljb5]

George always pays attention and misses very little, IMO!

I don't know if you noticed, but his post #82 just agreed with and reinforced everything I've been saying.

So I would have to agree... he does seem to be paying attention!

[Keith Wilson]

Do you not see the difference between a true single payer health care plan and what the AHCA is?

We do not have a choice between single payer and the ACA. We have the choice at this point between the ACA (or parts of it) and nothing at all. The Republicans, you may have noticed, have abandoned the pretense of coming up with any kind of heath care reform on their own. Without the current reform, of course, we'll eventually be forced to take action by the rising cost of healthcare (both Medicare and private insurance); since it's already twice as expensive in the US as the rest of the developed world, but the damage done in the meantime will be enormous.

I assume the Supremes are as interested in precedent as any other common lawyers?

Andrew, in a rational world and normal times no one would have the slightest doubt about the ACA being upheld; the constitutional arguments were regarded as utterly bogus by almost everybody two years ago. There is a long list of applicable precedents. With the recent radical turn of the right wing in this country, I'm not betting either way. There are several members of the Supreme Court who appear to be quite willing to ignore 75 years of commerce clause precedents.

[Paul Pless]

Andrew, regarding precedent, in a rational world and normal times no one would have the slightest doubt about the ACA being upheld; the constitutional arguments were regarded as utterly bogus by almost everybody two years ago. There is a long list of applicable precedents. With the recent radical turn of the right wing in this country, I'm not betting wither way. There are several members of the Supreme Court who appear to be quite willing to ignore 75 years of commerce clause precedents.

Its quite rare to see Keith engaging in spin and hyperbole.

[Paul Pless]

You make it sound like George is SamF's Chuck Norris.

[Keith Wilson]

Paul, that's neither spin nor hyperbole, even if you disagree. The idea that a heath insurance mandate might be unconstitutional certainly didn't occur to those flaming socialists at the Heritage Foundation 15 years ago when they were advocating it..

[Paul Pless]

Paul, that's neither spin nor hyperbole, even if you disagree. The idea that a heath insurance mandate might be unconstitutional certainly didn't occur to those flaming socialists at the Heritage Foundation 15 years ago when they were advocating it..

You guys sure do bring up that Heritage Foundation a lot, and often seem to imply that it speaks for all conservatives and even writes legislation and policy and pushes such through Congress; when in reality its just another Washington think tank.

[ljb5]

The idea that a heath insurance mandate might be unconstitutional certainly didn't occur to those flaming socialists at the Heritage Foundation 15 years ago when they were advocating it..

From the mid-90s to 2009, Newt Gingrich was openly calling for an individual mandate.

Mitt Romney wrote an article in USA Today in 2009 calling for a federal individual mandate, not just the one he implemented in Massachusetts.

This actually happened.

[Keith Wilson]

The Heritage Foundation isn't the point. Yes, they're just a think tank, although a very influential one. My point is that the supposed unconstitutionality of the individual mandate was a mere argument of convenience that nobody took seriously until very recently. See ljb's examples above. It's become respectable on the right by constant repetition, and it does indeed go against 70 years of commerce clause precedent.

[Paul Pless]

The Heritage Foundation isn't the point.

You're the one who brought them up.

[Paul Pless]

and it does indeed go against 70 years of commerce clause precedent.

Has the commerce clause ever been used to force someone to buy something from a private company?

[ljb5]

Has the commerce clause ever been used to force someone to buy something from a private company?

You're drawing a couple of artificial distinctions there.

First, we all know quite well that as early as 1792, Congress enacted laws that required people to purchase specific goods on the open market. These included, specifically a belt, a knapsack, a valise, a horse, boots, etc.

This has never been disputed.

Some people will point out that this falls under the "Militia Clause" not the "Commerce Clause".... but I will point out that these are two clauses of the same sentence.

Indeed, there is nothing in the Constitution that says that powers of Congress under the Commerce clause are different or more limited than they are under the Militia Clause.

It is an artificial distinction to say that the Commerce Clause does not impart the same authority as the Militia Clause. There is nothing written in the Constitution that says that the early words in the sentence are less meaningful than the latter.

The second artificial distinction is between being forced to buy something vs. being prevented from buying it. Both affect commerce. The Supreme Court has long held that the Commerce Clause gives Congress the authority to regulate not just inter-state commerce, but anything that affects inter-state commerce. This includes, believe it or not, things you do on the privacy of your own property such as growing marijuana or even wheat.

As recently as 2005, Justice Scalia wrote: "where Congress has authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective."

Please note: he said every power... he did not break it out into (1) power to regulate, (2) power to prevent someone from purchasing and (3) power to require someone to purchase. He simply wrote every power.

There is nothing in the Constitution that creates a distinction between those three different types of power to regulate. It simply says Congress has the power to regulate.. it does not say regulation in a restrictive way is different than regulation in a prescriptive way. If you see that distinction written anywhere, please let me know.

In Gibbons (1824), the Supreme Court ruled:

the power to regulate; that is, to prescribe the rule by which commerce is to be governed. This power, like all others vested in Congress, is complete in itself, may be exercised to its utmost extent, and acknowledges no limitations, other than are prescribed in the Constitution.

Finally, I have to say I'm kinda disgusted by this new libertarian philosophy which takes an "opt-in" approach to citizenship. Their idea is that people are only subject to rules if they actively engage in specific activities. If they don't "opt-in", they think they are impervious to laws. People think they can pick and choose which parts of the law they want to apply to them by simply avoiding any activity.

That is in conflict with the traditional view that citizenship comes with both rights and responsibilities. It has long been established that Congress does have the power to require people to do stuff, regardless of whether they participate in a specific activity. The obvious examples of this are (1) the Draft and (2) the Uniform Militia.

In these examples, it is obvious that Congress has (and always has had) the power to compel people to do something, regardless of whether or not the person engages in any particular activity. It is a responsibility of citizenship, not a transaction.

I think we all recognize that a specific company cannot make you buy their product. You can walk out of any store or restaurant if you don't like the service. But the government, our nation, is not a company. Our loyalty to our nation and our obligation to it is not as flimsy as selecting products off a shelf in a store. We don't get to choose how much of a citizen we want to be. If you're a citizen, you're subject to its laws regardless of if you choose to be.

[Paul Pless]

You're drawing a couple of artificial distinctions there.

Keith drew that distinction, not me.

[Paul Pless]

Finally, I have to say I'm kinda disgusted by this new libertarian philosophy which takes an "opt-in" approach to citizenship. Their idea is that people are only subject to rules if they actively engage in specific activities. If they don't "opt-in", they think they are impervious to laws. People think they can pick and choose which parts of the law they want to apply to them by simply avoiding any activity.

That is in conflict with the traditional view that citizenship comes with both rights and responsibilities. It has long been established that Congress does have the power to require people to do stuff, regardless of whether they participate in a specific activity. The obvious examples of this are (1) the Draft and (2) the Uniform Militia.

It may have been more appropriate to use the example of of taxation as we've always recognized the legitimacy (on some level) of being a conscientious objector to refrain from military service. But there is no relief from taxation. Did you ignore being compelled to pay taxes so as to not raise the issue of whether failure to abide by the mandate to purchase health insurance would result in a penalty? or is it a tax? I'm confused, the Obama Administration has argued it both ways. . .