Supreme court debate Affodable Care Act

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Re: Supreme court debate Affodable Care Act

Postby bentheimmigrant » Thu Mar 29, 2012 10:04 am UTC

sardia wrote:
bentheimmigrant wrote:
lutzj wrote:
PossibleSloth wrote:
CorruptUser wrote:The people who are uninsured and can pay actually subsidize you, as they tend to have to pay higher rates since the insurance company didn't negotiate the price down on their behalf.


The majority of uninsured persons are unable to pay their hospital bills. This study found not only that, on average, uninsured patients were only able to pay for 12% of hospital stays, but also that even those in the top 10% of uninsured in terms of personal assets were only able to pay for half of potential hospital visits.


Again, as CorruptUser said, the correlation between not having insurance and not being able to pay bills has more to do with the fact that insurance and hospital visits both cost money, and therefore aren't affordable to many people. Being uninsured doesn't inherently prevent people from paying for healthcare.

Furthermore, if we attribute all the costs imposed by the uninsured to freeloaders in emergency rooms, then the non-freeloading uninsured are paying just as much in extra costs as the insured, because they also pay to use hospitals.

You seem to be ignoring the facts presented - including the part about people in the top 10%. No, being uninsured does not preclude people paying, but only 12% of people manage it. I think you're severely underestimating a few things, namely how much a lengthy hospital stay would cost and how difficult it would be to get a loan if you did fall ill. If you got leukemia and were unable to work for a year or more, who is going to give you a loan? That's great if you know some people who might be able to cobble together a good amount of money, but that pales in comparison to the amount you'd need for some treatments. And if you die then you've basically taken away their savings for when they get sick.


On another note, I don't know why everyone is immediately jumping on the hostility in the court to some of the government's arguments as confirmation that it will be overturned. I was following it yesterday on WSJ's live blog and basically got the impression that at least Kennedy, and maybe Roberts are willing to consider it in terms of market regulation, and the case that this is indeed a unique market that everyone is involved in whether voluntarily or not.

It's been statistically correlated that justices that question one side more or extra harshly are more likely to vote against them. Meaning if you get a rough interrogation, chances are you're gonna lose.

Has anyone actually produced a measure of the amount or harshness of Kennedy and Roberts' questioning of the two sides?
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Re: Supreme court debate Affodable Care Act

Postby Telchar » Thu Mar 29, 2012 1:54 pm UTC

An interesting interview with Reagan's former solicitor general here.
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Re: Supreme court debate Affodable Care Act

Postby bentheimmigrant » Thu Mar 29, 2012 3:30 pm UTC

Yeah, the mandate is a long established conservative principle.
The Heritage Foundation wrote:There is an implicit contract between households in society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and does not have the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. Healthcare is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services – even if that means more prudent citizens end up paying the tab … A mandate on individuals recognizes this implicit contract.
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Re: Supreme court debate Affodable Care Act

Postby sardia » Thu Mar 29, 2012 4:28 pm UTC

http://www.nytimes.com/2010/07/25/us/25 ... urt&st=cse
Spoiler:
Court Under Roberts Is Most Conservative in Decades
By ADAM LIPTAK

WASHINGTON — When Chief Justice John G. Roberts Jr. and his colleagues on the Supreme Court left for their summer break at the end of June, they marked a milestone: the Roberts court had just completed its fifth term.

In those five years, the court not only moved to the right but also became the most conservative one in living memory, based on an analysis of four sets of political science data.

And for all the public debate about the confirmation of Elena Kagan or the addition last year of Justice Sonia Sotomayor, there is no reason to think they will make a difference in the court’s ideological balance. Indeed, the data show that only one recent replacement altered its direction, that of Justice Samuel A. Alito Jr. for Justice Sandra Day O’Connor in 2006, pulling the court to the right.

There is no similar switch on the horizon. That means that Chief Justice Roberts, 55, is settling in for what is likely to be a very long tenure at the head of a court that seems to be entering a period of stability.

If the Roberts court continues on the course suggested by its first five years, it is likely to allow a greater role for religion in public life, to permit more participation by unions and corporations in elections and to elaborate further on the scope of the Second Amendment’s right to bear arms. Abortion rights are likely to be curtailed, as are affirmative action and protections for people accused of crimes.

The recent shift to the right is modest. And the court’s decisions have hardly been uniformly conservative. The justices have, for instance, limited the use of the death penalty and rejected broad claims of executive power in the government’s efforts to combat terrorism.

But scholars who look at overall trends rather than individual decisions say that widely accepted political science data tell an unmistakable story about a notably conservative court.

Almost all judicial decisions, they say, can be assigned an ideological value. Those favoring, say, prosecutors and employers are said to be conservative, while those favoring criminal defendants and people claiming discrimination are said to be liberal.

Analyses of databases coding Supreme Court decisions and justices’ votes along these lines, one going back to 1953 and another to 1937, show that the Roberts court has staked out territory to the right of the two conservative courts that immediately preceded it by four distinct measures:

¶In its first five years, the Roberts court issued conservative decisions 58 percent of the time. And in the term ending a year ago, the rate rose to 65 percent, the highest number in any year since at least 1953.

The courts led by Chief Justices Warren E. Burger, from 1969 to 1986, and William H. Rehnquist, from 1986 to 2005, issued conservative decisions at an almost indistinguishable rate — 55 percent of the time.

That was a sharp break from the court led by Chief Justice Earl Warren, from 1953 to 1969, in what liberals consider the Supreme Court’s golden age and conservatives portray as the height of inappropriate judicial meddling. That court issued conservative decisions 34 percent of the time.

¶Four of the six most conservative justices of the 44 who have sat on the court since 1937 are serving now: Chief Justice Roberts and Justices Alito, Antonin Scalia and, most conservative of all, Clarence Thomas. (The other two were Chief Justices Burger and Rehnquist.) Justice Anthony M. Kennedy, the swing justice on the current court, is in the top 10.

¶The Roberts court is finding laws unconstitutional and reversing precedent — two measures of activism — no more often than earlier courts. But the ideological direction of the court’s activism has undergone a marked change toward conservative results.

¶Until she retired in 2006, Justice O’Connor was very often the court’s swing vote, and in her later years she had drifted to the center-left. These days, Justice Kennedy has assumed that crucial role at the court’s center, moving the court to the right.

Justice John Paul Stevens, who retired in June, had his own way of tallying the court’s direction. In an interview in his chambers in April, he said that every one of the 11 justices who had joined the court since 1975, including himself, was more conservative than his or her predecessor, with the possible exceptions of Justices Sotomayor and Ruth Bader Ginsburg.

The numbers largely bear this out, though Chief Justice Roberts is slightly more liberal than his predecessor, Chief Justice Rehnquist, at least if all of Chief Justice Rehnquist’s 33 years on the court, 14 of them as an associate justice, are considered. (In later years, some of his views softened.)

But Justice Stevens did not consider the question difficult. Asked if the replacement of Chief Justice Rehnquist by Chief Justice Roberts had moved the court to the right, he did not hesitate.

“Oh, yes,” Justice Stevens said.

The Most Significant Change

“Gosh,” Justice Sandra Day O’Connor said at a law school forum in January a few days after the Supreme Court undid one of her major achievements by reversing a decision on campaign spending limits. “I step away for a couple of years and there’s no telling what’s going to happen.”

When Justice O’Connor announced her retirement in 2005, the membership of the Rehnquist court had been stable for 11 years, the second-longest stretch without a new justice in American history.

Since then, the pace of change has been dizzying, and several justices have said they found it disorienting. But in an analysis of the court’s direction, some changes matter much more than others. Chief Justice Rehnquist died soon after Justice O’Connor announced that she was stepping down. He was replaced by Chief Justice Roberts, his former law clerk. Justice David H. Souter retired in 2009 and was succeeded by Justice Sotomayor. Justice Stevens followed Justice Souter this year, and he is likely to be succeeded by Elena Kagan.

But not one of those three replacements seems likely to affect the fundamental ideological alignment of the court. Chief Justice Rehnquist, a conservative, was replaced by a conservative. Justices Souter and Stevens, both liberals, have been or are likely to be succeeded by liberals.

Justices’ views can shift over time. Even if they do not, a justice’s place in the court’s ideological spectrum can move as new justices arrive. And chief justices may be able to affect the overall direction of the court, notably by using the power to determine who writes the opinion for the court when they are in the majority. Chief Justice Roberts is certainly widely viewed as a canny tactician.

But only one change — Justice Alito’s replacement of Justice O’Connor — really mattered. That move defines the Roberts court. “That’s a real switch in terms of ideology and a switch in terms of outlook,” said Lee Epstein, who teaches law and political science at Northwestern University and is a leading curator and analyst of empirical data about the Supreme Court.

The point is not that Justice Alito has turned out to be exceptionally conservative, though he has: he is the third-most conservative justice to serve on the court since 1937, behind only Justice Thomas and Chief Justice Rehnquist. It is that he replaced the more liberal justice who was at the ideological center of the court.

Though Chief Justice Roberts gets all the attention, Justice Alito may thus be the lasting triumph of the administration of President George W. Bush. He thrust Justice Kennedy to the court’s center and has reshaped the future of American law.

It is easy to forget that Justice Alito was Mr. Bush’s second choice. Had his first nominee, the apparently less conservative Harriet E. Miers, not withdrawn after a rebellion from Mr. Bush’s conservative base, the nature of the Roberts court might have been entirely different.

By the end of her almost quarter-century on the court, Justice O’Connor was without question the justice who controlled the result in ideologically divided cases.

“On virtually all conceptual and empirical definitions, O’Connor is the court’s center — the median, the key, the critical and the swing justice,” Andrew D. Martin and two colleagues wrote in a study published in 2005 in The North Carolina Law Review shortly before Justice O’Connor’s retirement.

With Justice Alito joining the court’s more conservative wing, Justice Kennedy has now unambiguously taken on the role of the justice at the center of the court, and the ideological daylight between him and Justice O’Connor is a measure of the Roberts court’s shift to the right.

Justice O’Connor, for her part, does not name names but has expressed misgivings about the direction of the court.

“If you think you’ve been helpful, and then it’s dismantled, you think, ‘Oh, dear,’ ” she said at William & Mary Law School in October in her usual crisp and no-nonsense fashion. “But life goes on. It’s not always positive.”

Justice O’Connor was one of the authors of McConnell v. Federal Election Commission, a 2003 decision that, among other things, upheld restrictions on campaign spending by businesses and unions. It was reversed on that point in the Citizens United decision.

Asked at the law school forum in January how she felt about the later decision, she responded obliquely. But there was no mistaking her meaning.

“If you want my legal opinion” about Citizens United, Justice O’Connor said, “you can go read” McConnell.

The Court Without O’Connor

The shift resulting from Justice O’Connor’s departure was more than ideological. She brought with her qualities that are no longer represented on the court. She was raised and educated in the West, and she served in all three branches of Arizona’s government, including as a government lawyer, majority leader of the State Senate, an elected trial judge and an appeals court judge.

Those experiences informed Justice O’Connor’s sensitivity to states’ rights and her frequent deference to political judgments. Her rulings were often pragmatic and narrow, and her critics said she engaged in split-the-difference jurisprudence.

Justice Alito’s background is more limited than Justice O’Connor’s — he worked in the Justice Department and then as a federal appeals court judge — and his rulings are often more muscular.

Since they never sat on the court together, trying to say how Justice O’Connor would have voted in the cases heard by Justice Alito generally involves extrapolation and speculation. In some, though, it seems plain that she would have voted differently from him.

Just weeks before she left the court, for instance, Justice O’Connor heard arguments in Hudson v. Michigan, a case about whether evidence should be suppressed because it was found after Detroit police officers stormed a home without announcing themselves.

“Is there no policy protecting the homeowner a little bit and the sanctity of the home from this immediate entry?” Justice O’Connor asked a government lawyer. David A. Moran, a lawyer for the defendant, Booker T. Hudson, said the questioning left him confident that he had Justice O’Connor’s crucial vote.

Three months later, the court called for reargument, signaling a 4-to-4 deadlock after Justice O’Connor’s departure. When the 5-to-4 decision was announced in June, the court not only ruled that violations of the knock-and-announce rule do not require the suppression of evidence, but also called into question the exclusionary rule itself.

The shift had taken place. Justice Alito was in the majority.

“My 5-4 loss in Hudson v. Michigan,” Mr. Moran wrote in 2006 in Cato Supreme Court Review, “signals the end of the Fourth Amendment” — protecting against unreasonable searches — “as we know it.”

The departure of Justice O’Connor very likely affected the outcomes in two other contentious areas: abortion and race.

In 2000, the court struck down a Nebraska law banning an abortion procedure by a vote of 5 to 4, with Justice O’Connor in the majority. Seven years later, the court upheld a similar federal law, the Partial-Birth Abortion Act, by the same vote.

“The key to the case was not in the difference in wording between the federal law and the Nebraska act,” Erwin Chemerinsky wrote in 2007 in The Green Bag, a law journal. “It was Justice Alito having replaced Justice O’Connor.”

In 2003, Justice O’Connor wrote the majority opinion in a 5-to-4 decision allowing public universities to take account of race in admissions decisions. And a month before her retirement in 2006, the court refused to hear a case challenging the use of race to achieve integration in public schools.

Almost as soon as she left, the court reversed course. A 2007 decision limited the use of race for such a purpose, also on a 5-to-4 vote.

There were, to be sure, issues on which Justice Kennedy was to the left of Justice O’Connor. In a 5-to-4 decision in 2005 overturning the juvenile death penalty, Justice Kennedy was in the majority and Justice O’Connor was not.

But changing swing justices in 2006 had an unmistakable effect across a broad range of cases. “O’Connor at the end was quite a bit more liberal than Kennedy is now,” Professor Epstein said.

The numbers bear this out.

The Rehnquist court had trended left in its later years, issuing conservative rulings less than half the time in its last two years in divided cases, a phenomenon not seen since 1981. The first term of the Roberts court was a sharp jolt to the right. It issued conservative rulings in 71 percent of divided cases, the highest rate in any year since the beginning of the Warren court in 1953.

Judging by the Numbers

Chief Justice Roberts has not served nearly as long as his three most recent predecessors. The court he leads has been in flux. But five years of data are now available, and they point almost uniformly in one direction: to the right.

Scholars quarrel about some of the methodological choices made by political scientists who assign a conservative or liberal label to Supreme Court decisions and the votes of individual justices. But most of those arguments are at the margins, and the measures are generally accepted in the political science literature.

The leading database, created by Harold J. Spaeth with the support of the National Science Foundation about 20 years ago, has served as the basis for a great deal of empirical research on the contemporary Supreme Court and its members. In the database, votes favoring criminal defendants, unions, people claiming discrimination or violation of their civil rights are, for instance, said to be liberal. Decisions striking down economic regulations and favoring prosecutors, employers and the government are said to be conservative.

About 1 percent of cases have no ideological valence, as in a boundary dispute between two states. And some concern multiple issues or contain ideological cross-currents.

But while it is easy to identify the occasional case for which ideological coding makes no sense, the vast majority fit pretty well. They also tend to align with the votes of the justices usually said to be liberal or conservative.

Still, such coding is a blunt instrument. It does not take account of the precedential and other constraints that are in play or how much a decision moves the law in a conservative or liberal direction. The mix of cases has changed over time. And the database treats every decision, monumental or trivial, as a single unit.

“It’s crazy to count each case as one,” said Frank B. Cross, a law and business professor at the University of Texas. “But the problem of counting each case as one is reduced by the fact that the less-important ones tend to be unanimous.”

Some judges find the entire enterprise offensive.

“Supreme Court justices do not acknowledge that any of their decisions are influenced by ideology rather than by neutral legal analysis,” William M. Landes, an economist at the University of Chicago, and Richard A. Posner, a federal appeals court judge, wrote last year in The Journal of Legal Analysis. But if that were true, they continued, knowing the political party of the president who appointed a given justice would tell you nothing about how the justice was likely to vote in ideologically charged cases.

In fact, the correlation between the political party of appointing presidents and the ideological direction of the rulings of the judges they appoint is quite strong.

Here, too, there are exceptions. Justices Stevens and Souter were appointed by Republican presidents and ended up voting with the court’s liberal wing. But they are gone. If Ms. Kagan wins Senate confirmation, all of the justices on the court may be expected to align themselves across the ideological spectrum in sync with the party of the president who appointed them.

The proposition that the Roberts court is to the right of even the quite conservative courts that preceded it thus seems fairly well established. But it is subject to qualifications.

First, the rightward shift is modest.

Second, the data do not take popular attitudes into account. While the court is quite conservative by historical standards, it is less so by contemporary ones. Public opinion polls suggest that about 30 percent of Americans think the current court is too liberal, and almost half think it is about right.

On given legal issues, too, the court’s decisions are often closely aligned with or more liberal than public opinion, according to studies collected in 2008 in “Public Opinion and Constitutional Controversy” (Oxford University Press).

The public is largely in sync with the court, for instance, in its attitude toward abortion — in favor of a right to abortion but sympathetic to many restrictions on that right.

“Solid majorities want the court to uphold Roe v. Wade and are in favor of abortion rights in the abstract,” one of the studies concluded. “However, equally substantial majorities favor procedural and other restrictions, including waiting periods, parental consent, spousal notification and bans on ‘partial birth’ abortion.”

Similarly, the public is roughly aligned with the court in questioning affirmative action plans that use numerical standards or preferences while approving those that allow race to be considered in less definitive ways.

The Roberts court has not yet decided a major religion case, but the public has not always approved of earlier rulings in this area. For instance, another study in the 2008 book found that “public opinion has remained solidly against the court’s landmark decisions declaring school prayer unconstitutional.”

In some ways, the Roberts court is more cautious than earlier ones. The Rehnquist court struck down about 120 laws, or about six a year, according to an analysis by Professor Epstein. The Roberts court, which on average hears fewer cases than the Rehnquist court did, has struck down fewer laws — 15 in its first five years, or three a year.

It is the ideological direction of the decisions that has changed. When the Rehnquist court struck down laws, it reached a liberal result more than 70 percent of the time. The Roberts court has tilted strongly in the opposite direction, reaching a conservative result 60 percent of the time.

The Rehnquist court overruled 45 precedents over 19 years. Sixty percent of those decisions reached a conservative result. The Roberts court overruled eight precedents in its first five years, a slightly lower annual rate. All but one reached a conservative result.

That should give you an idea as to their conservative/liberalness score.
http://www.nytimes.com/2010/07/25/us/25 ... nted=print
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Re: Supreme court debate Affodable Care Act

Postby Arrian » Thu Mar 29, 2012 7:38 pm UTC

Diadem wrote:What the heck is a lemon (I know, I know, Life is, but I assume we're not talking about that here).


The Market for "Lemons": Quality Uncertainty and the Market Mechanism by George Akerlof is the key economic paper laying out the fundamentals of what happens to markets when one party knows more information than another party. It's very accessible and well worth reading, I highly suggest reading it.
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Re: Supreme court debate Affodable Care Act

Postby CorruptUser » Thu Mar 29, 2012 8:07 pm UTC

That assumes that you know a lot more about your health than the insurance company does. A used car dealer knows more about a car than an ordinary person, but a mechanic can inspect the car and know as much as the dealer. Or at least, enough to know which car is a lemon. Same with insurance companies; they can and will investigate people prior to agreeing to an insurance policy.
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Re: Supreme court debate Affodable Care Act

Postby Arrian » Thu Mar 29, 2012 8:20 pm UTC

CorruptUser wrote:That assumes that you know a lot more about your health than the insurance company does. A used car dealer knows more about a car than an ordinary person, but a mechanic can inspect the car and know as much as the dealer. Or at least, enough to know which car is a lemon. Same with insurance companies; they can and will investigate people prior to agreeing to an insurance policy.


Yeah, I don't remember who brought up the idea that young people who previously turned down health insurance are lemons, and am not sure I agree. I can see the idea that previously uninsured people suddenly wanting to enter the health insurance market might be seen as lemons, but that was handled by not covering pre-existing conditions before the ACA passed. But figured it was a teachable moment, and hey, why pass up a chance to reference Akerlof? (At least his non-behavioral stuff. >.> )

On an unrelated note, back closer to topic, Intrade gives the ACA getting ruled unconstitutional a 63.3% chance as of 15:15 CDT today. That's fallen from 64.5% at the start of the day, but is still a huge spike over the 35-40% it was predicting prior to the oral arguments this week.
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Re: Supreme court debate Affodable Care Act

Postby Save Point » Fri Mar 30, 2012 12:40 am UTC

I thought the opponents to the ACA had done a fantastic job. The RNC decided to throw that away to remind the world that it has no class.
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Re: Supreme court debate Affodable Care Act

Postby Garm » Fri Mar 30, 2012 6:17 pm UTC

So here's why I said that the case wasn't going to be decided on it's legal merits:
First, we've got Scalia quoting rightwing blogs (or whatever part of the misinformation-sphere this comes from) about shit that doesn't even exist: http://www.esquire.com/blogs/politics/tony-scalia-ann-althouse-7723075

Second, you've got Paul Ryan's "budget" encapsulating the same concept as the mandate but as a tax "credit" (how much of a credit is it really if everyone gets it unless they pay for healthcare?): http://www.washingtonmonthly.com/ten-miles-square/2012/03/individual_mandate_is_ryan_tax036376.php

If they overturn the individual mandate it won't be on the constitutionality, really. It'll be on the merits of a semantic argument. I'd really like it if SCOTUS could adhere to a level of debate somewhat higher than that of N&A.
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 6:23 pm UTC

In law, especially with precedence, semantics matter.

And the administration spent a long time saying it wasn't a tax, it was not a tax credit, so on and so forth, and put stuff into the bill indicating it was definitely unrelated to taxes and totally a mandate.

The screwed themselves, essentially, solely to appease people who wouldn't vote for it anyway.

But the Supreme Court isn't just ruling on this law - what they rule and how they rule will determine how "mandates" can be used by the government in the future. And while they may overlap with taxes here, it won't always be so - they need to be careful about the ever incessant power creep.
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Re: Supreme court debate Affodable Care Act

Postby Chen » Fri Mar 30, 2012 6:36 pm UTC

President: My fellow Americans and voting illegal aliens, I will not mince words. Your country needs you. That's why today I'm proposing a temporary refund adjustment.

Citizen 1:Refund adjustment? Hey, sounds good to me.

Citizen 2:Sure beats a tax.

Citizen 3:We love you, President SimpsonObama


Its always what I'm thinking when I hear all this tax/mandate talk.
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Re: Supreme court debate Affodable Care Act

Postby Falling » Fri Mar 30, 2012 7:01 pm UTC

Griffin wrote:In law, especially with precedence, semantics matter.

And the administration spent a long time saying it wasn't a tax, it was not a tax credit, so on and so forth, and put stuff into the bill indicating it was definitely unrelated to taxes and totally a mandate.

The screwed themselves, essentially, solely to appease people who wouldn't vote for it anyway.

But the Supreme Court isn't just ruling on this law - what they rule and how they rule will determine how "mandates" can be used by the government in the future. And while they may overlap with taxes here, it won't always be so - they need to be careful about the ever incessant power creep.


The reasoning that I heard for why it was not phrased as a tax/rebate combo was Obama promised no new taxes on the middle class and didn't want to go back on that.
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 7:06 pm UTC

"I promised I wouldn't buy anything, so I stole it instead! I even told the police I stole it!

(I also left the money on the counter, you know, just in case. And made sure the lady behind it new I did. And winked at her.)"

Does not an honest position make, and seriously only seems like a way to get yourself in trouble.
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Re: Supreme court debate Affodable Care Act

Postby bentheimmigrant » Fri Mar 30, 2012 7:40 pm UTC

The status of it as a tax (or not) does not alter the fact that health insurance is interstate commerce, which congress had the right to regulate.
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Re: Supreme court debate Affodable Care Act

Postby lutzj » Fri Mar 30, 2012 7:45 pm UTC

Falling wrote:Obama promised no new taxes on the middle class and didn't want to go back on that.


He should have looked to George H. W. Bush's experience, thought really hard, and then not made such a straitjacket of a promise.
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 7:48 pm UTC

Except of course that its not regulating interstate commerce, its mandating it - AND its mandating something thats not even necessarily interstate.

It's a bit of, to put it bluntly, complete and utter bullshit. It's not regulating interstate commerce, its regulating refusal to participate in interstate commerce.

You can't get any more not interstate commerce than regulating what is explicitly described as the decision to not engage in interstate commerce. :/
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Re: Supreme court debate Affodable Care Act

Postby Silknor » Fri Mar 30, 2012 8:00 pm UTC

We can disagree about whether it's regulating and/or mandating it, and many do. But as a matter of Supreme Court precedent, it is most certainly both interstate and commerce.

See Wickard v. Filburn and Gonzalez v. Raich, both of which allowed the government to regulate an individual's decision to grow (wheat and marijuana respectively) for personal consumption (well, the farmer's cow's personal consumption in one case) on the principle that such production for personal use, in aggregate, has substantial impacts on interstate commerce because if they were not growing it, they would be forced to buy it on the interstate market (be it illegal or not).
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 8:08 pm UTC

And, again, I would be fine with the feds /regulating/ the purchase and terms of insurance for that reason, even if the insurance companies were local. But they very specifically AREN'T with the bit under debate.

The bit under debate is specifically regulating the behavior of those who are not involved in interstate commerce or any sort of commerce at all, even personal commerce. What's being regulated is inaction.

The decision's in both cases were intentionally narrow, by the way.

I guess we'll see if the precedent applies here as well.
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Re: Supreme court debate Affodable Care Act

Postby bentheimmigrant » Fri Mar 30, 2012 8:13 pm UTC

If you're refusing to take part in the healthcare market (and by extension insurance), then sure. But consider that the court appeared to agree that forcing people to pay for their care at the door (I can find links of you need, but I'm on a mobile at the moment, so it's not so easy) would be constitutional, how much of a jump is it to forcing people to have insurance?
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 8:18 pm UTC

I don't see how they are related. A law forcing people to pay for their care at the door would, in fact, be regulating interstate commerce, similar to a law saying insurance has to be paid in a certain way.

I don't see what that has to do with a mandate, so I'd say a pretty enormous jump.
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Re: Supreme court debate Affodable Care Act

Postby bentheimmigrant » Fri Mar 30, 2012 8:27 pm UTC

Can the majority of people pay at the door? No, unless they have insurance.
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Re: Supreme court debate Affodable Care Act

Postby Ghostbear » Fri Mar 30, 2012 8:28 pm UTC

That has to do with the "special market" conditions of health care. Healthcare is interstate commerce. Requiring people to have insurance for it is a regulation. This gets muddled a bit during discussion because health insurance is almost a synonym for healthcare in the vernacular these days. That large intertwining of the two also helps the argument some, as well.
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 8:29 pm UTC

Yes... and? I'm still not seeing the connection here.

Don't get me wrong, I think it would be a bad law - you'd get a bunch of people who wouldn't get treated at all. But I don't see how its unconstitutional or hows its related to the insurance mandate.
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Re: Supreme court debate Affodable Care Act

Postby Silknor » Fri Mar 30, 2012 8:29 pm UTC

While it's been a while since I read either, I've never before heard Wickard v. Filburn be described as narrow, be it by supporters or opponents.

As for if the individual mandate targets economic activity or inactivity, the debate is long and complex, but I"ll just point out that:
1. This is a distinction that I do not believe has ever been endorsed by the Supreme Court (obviously, if they rule against it, that will probably soon change).
2. The supposed inactivity has an substantial impact on interstate commerce because of externalities (costs imposed on others by your decision) in the form of both uncompensated care and higher premiums because it's the healthier people that would tend to avoid insurance if you forbid insurers from denying coverage or raising prices based on an individual's pre-existing conditions.
3. The relevant market to analyze is the market for health care, not health insurance. Not buying insurance is an active decision to push the costs of the care you are very likely to require onto the general population.
4. Regulations which are necessary and proper to a legitimate end of Congress are constitutional if they do not violate an explicit prohibition (e.g. the Bill of Rights). It is not in dispute in this case that preventing insurance companies from discriminating on the basis of pre-existing conditions (referred to in the case as guaranteed issue and community rating) is constitutional. And the individual mandate is necessary for these regulations to function without significant unintended consequences.
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Re: Supreme court debate Affodable Care Act

Postby Garm » Fri Mar 30, 2012 9:27 pm UTC

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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 9:34 pm UTC

Guy in the first link may know what he's talking about, but he's demonstrating a couple fallacies here. States are, in fact, allowed to do things the Feds can't do.
Amar wrote:if they violate the Bill of Rights, for instance. This doesn’t. If it did, states couldn’t do it. Romneycare would be improper.

Bill of Rights wrote:The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively


is the biggest problem here.

But really its full of big ol' bullshit arguments, and while he makes some good points...
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Re: Supreme court debate Affodable Care Act

Postby Garm » Fri Mar 30, 2012 9:51 pm UTC

Sigh. His point is that if Romneycare violated the Bill of Rights it would have been struck down. Saying that health care is a states rights issue is to ignore the interstate nature of health insurance. So, to put the onus of regulation and payment on the states is stupid. In absence of Federal regulation a state CAN create legislation but any Federal law will trump that.
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Re: Supreme court debate Affodable Care Act

Postby Griffin » Fri Mar 30, 2012 10:12 pm UTC

And I'm saying that is bullshit. The federal government can do things that end up violating the bill of rights, which the states can then do without any problem whatsoever.
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Re: Supreme court debate Affodable Care Act

Postby Ghostbear » Fri Mar 30, 2012 10:20 pm UTC

Griffin wrote:And I'm saying that is bullshit. The federal government can do things that end up violating the bill of rights, which the states can then do without any problem whatsoever.

That's not true for ~99% of situations. As per the incorporation doctrine of the 14th amendment.
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Re: Supreme court debate Affodable Care Act

Postby Silknor » Fri Mar 30, 2012 10:23 pm UTC

I'm sure the guy knows very well that states can do more than the federal government can (outside of a few specific areas). It's clear from context he's using violates the Bill of Rights as shorthand for violating one of the first 8 Amendments. After all, the 9th and 10th amendments by themselves don't tell you anything about if the federal government has power in an area, only how you should interpret things that aren't mentioned.

His point is very clear: the limits on the power given to the federal government by the Commerce Clause are the limits written into the clause itself (it must be interstate, and it must be commerce), and the limits on all federal powers which are primarily in the first 8 Amendments.

And Ghostbear is right: the limits in the first 8 amendments apply to the states*.

*There may be some provisions that have not yet been incorporated (applied to the states), eg. the 2nd amendment wasn't until 2008. But I'm not aware of any provisions which were held not to apply to the states, so AFAIK each provision either applies to the states or the question simply hasn't come up yet.
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Re: Supreme court debate Affodable Care Act

Postby Ghostbear » Fri Mar 30, 2012 10:33 pm UTC

Silknor wrote:*There may be some provisions that have not yet been incorporated (applied to the states), eg. the 2nd amendment wasn't until 2008. But I'm not aware of any provisions which were held not to apply to the states, so AFAIK each provision either applies to the states or the question simply hasn't come up yet.

I actually found this really interesting in the wiki article. It gives the following provisions as not yet being 100% incorporated:
The 3rd amendment: the right to not quarter soldiers. This has only been incorporated in the court of appeals for the 2nd Circuit. Based on this, it probably hasn't come up in other circuits/SCOTUS to be found to apply to them.
The 5th amendment: the right to an indictment by a grand jury. As wiki notes, most states have this right already, so it's unlikely to be brought to trial, just because of how things are setup.
The 6th amendment: the right to a jury selected from residents of the state and district where the crime occurred. It lists several cases from the 1980s, so it looks like this is one that will likely remain to not be incorporated.
The 8th amendment: protection from excessive fines. No text is provided here for further details.

Unless I missed something, every other provision of the first eight amendments to the bill of rights has been incorporated.
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Re: Supreme court debate Affodable Care Act

Postby Save Point » Sat Mar 31, 2012 2:35 am UTC

Silknor wrote:4. Regulations which are necessary and proper to a legitimate end of Congress are constitutional if they do not violate an explicit prohibition (e.g. the Bill of Rights). It is not in dispute in this case that preventing insurance companies from discriminating on the basis of pre-existing conditions (referred to in the case as guaranteed issue and community rating) is constitutional. And the individual mandate is necessary for these regulations to function without significant unintended consequences.

It has certainly been debated in amicus briefs and Scalia was sympathetic to the argument in oral arguments.

Also, Romneycare arguably falls under the state's police powers, which the government does not have. One of the implicit issues in this case is that, were the individual mandate ruled constitutional, it effectively turns the commerce clause into a police power for the federal government. Such a thing makes sense for the states, which have residual powers, but the federal government is supposed to be limited to its enumerated powers. This creates an even more difficult hurdle in that the mandate arguably runs a muck of our constitutional order.
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Re: Supreme court debate Affodable Care Act

Postby omgryebread » Sat Mar 31, 2012 4:21 am UTC

Themis wrote:the states, which have residual powers, but the federal government is supposed to be limited to its enumerated powers.
There shouldn't be much discussion past this point about whether or not states can do it. He's right.

Any federal law will trump state law, because of the Supremacy Clause.

The federal government is constitutionally bound by two requirements. First, it cannot be explicitly disallowed by the constitution. So no quartering troops, whatever. The Bill of Rights. Trickier and more interesting is the requirement that whatever the federal government does must be positively allowed by it's enumerated powers. It's why the FBI can't investigate crimes that don't move interstate (or involve the whole host of things the federal government has claimed jurisdiction on for various reasons.)

The states are not bound by that second requirement. They are bound, thanks to the fourteenth amendment, to the restrictions in the Constitution, namely the Bill of Rights, but they can make any law they want, not needing any enumerated powers. This is called the police power.

That being said,

Griffin wrote:Guy in the first link may know what he's talking about, but he's demonstrating a couple fallacies here. States are, in fact, allowed to do things the Feds can't do.
Amar wrote:if they violate the Bill of Rights, for instance. This doesn’t. If it did, states couldn’t do it. Romneycare would be improper.

Bill of Rights wrote:The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively


is the biggest problem here.

But really its full of big ol' bullshit arguments, and while he makes some good points...
He's not making any such fallacies, you're taking that quote out of context. He's saying the mandate does not violate the Bill of Rights, and therefore is "proper" under the Necessary and Proper Clause. If it violated the bill of rights, it wouldn't have been proper, and also would have been unconstitutional for the states. Also, the Tenth Amendment is pretty much never a problem. The Supreme Court barely ever refers to it, and in fact, it has said in rulings that the Tenth added nothing. The only times I can think of (I'm not exactly a walking case law book, of course) that the Tenth is cited in an opinion is when the Federal government tries to make the states enforce federal laws.
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Re: Supreme court debate Affodable Care Act

Postby Save Point » Sat Mar 31, 2012 4:34 am UTC

omgryebread wrote:Any federal law will trump state law, because of the Supremacy Clause.

I'm pointing out that the justifications for Romneycare cannot necessarily justify the individual mandate in The Affordable Care Act, not that mandates similar to The Affordable Care Act would remain untouched by the outcome of this case. I probably should have quoted the post to which I was referring, but it was peppered throughout this discussion.

EDIT: Huh, does "m-andate" automatically become "ACA"...?
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Re: Supreme court debate Affodable Care Act

Postby Garm » Sat Mar 31, 2012 4:38 am UTC

I think it's a stretch to say that state regulation of the health care and health insurance markets is justifiable under police powers.
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Re: Supreme court debate Affodable Care Act

Postby Silknor » Sat Mar 31, 2012 1:13 pm UTC

@Themis: I didn't look at the brief, but what Scalia didn't say anything in the portion quoted that contradicts my claim, which is that the constitutionality of the guaranteed issue and community rating provisions is not at question. I didn't say that it was undisputed that the individual mandate is proper, only that I believe it is necessary and proper.
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Re: Supreme court debate Affodable Care Act

Postby Steroid » Sat Mar 31, 2012 4:35 pm UTC



"ARA: The most important limit, the one we fought the Revolutionary War for, is that the people doing this to you are the people you elect. That’s the main check. The broccoli argument is like something they said when we were debating the income tax: If they can tax me, they can tax me at 100 percent! And yes, they can. But they won’t. Because you could vote them out of office. They have the power to do all sorts of ridiculous things that they won’t do because you’d vote them out of office. If they can prevent me from growing pot, can they prevent me from buying broccoli? Perhaps, but why would they if they want to be reelected?"

Then why have any constitutional limits at all? In fact, all limits prescribed by the constitution can be overturned by amendment, so it's really just a higher electoral standard. As much as I'd like a standard of "even if everyone in the country wants it, you can't do it," that's not practical. Practically speaking, the limits are in place because voting someone else in to change the law is a slow and unsure process. Laws have momentum. If congress did pass a 100% tax, they'd be voted out, but if they did it in their first session, they'd have two years of the entire country's income in the treasury before any change could come about, and six years before the entire government could be turned over.



"That comparison horrified health care experts all across America because health insurance is nothing like broccoli.

Why? When people choose not to buy broccoli, they don’t make broccoli unavailable to those who want it. But when people don’t buy health insurance until they get sick — which is what happens in the absence of a mandate — the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain."

A) I don't see how that holds. If 99% of the people in a town don't buy broccoli, none of the grocery stores would stock it, and if they did it would have to be ridiculously expensive to make up for its cost. More of a product demanded lowers prices. If the logic is that less of a product demanded raises prices, and that raise is an economic act against those who still want it, and that that's equivalent to taking money away from them, then I think it's stretching the terms out of usefulness. B) That might work if it were spoken ex cathedra or was self-evident. If there was such a clear line between a mandate for insurance and a mandate for broccoli that everyone could see where the line is and not have to argue about it, it might work, but others to come with less scruples than Paul Krugman (as hard as that is to believe) might not see it so. Everyone having insurance is good, they would say, so we can mandate it. Everyone eating their broccoli is good, so we can mandate that too.

Silknor wrote:3. The relevant market to analyze is the market for health care, not health insurance. Not buying insurance is an active decision to push the costs of the care you are very likely to require onto the general population.

I'm also not sure if this is true, because I tend to think that not buying insurance is a passive decision based on having other things to spend your money on, but even so, where is it written that pushing costs on others is something that can or should be regulated? Especially since they can choose to not pay the costs.

Which is of course the bottom of this debate. It's a dilemma between the two inviable alternatives of, "I'm at the emergency room but I can't pay. You're just going to let me die?" and "All these people are at the emergency room and can't pay. You're going to make us work for free?"
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Re: Supreme court debate Affodable Care Act

Postby Garm » Sat Mar 31, 2012 4:43 pm UTC

Steroid wrote:A) I don't see how that holds. If 99% of the people in a town don't buy broccoli, none of the grocery stores would stock it, and if they did it would have to be ridiculously expensive to make up for its cost. More of a product demanded lowers prices. If the logic is that less of a product demanded raises prices, and that raise is an economic act against those who still want it, and that that's equivalent to taking money away from them, then I think it's stretching the terms out of usefulness.


This hypothetical is worth about the same as the broccoli argument, which is to say... nothing. Try harder.
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Re: Supreme court debate Affodable Care Act

Postby Silknor » Sat Mar 31, 2012 6:38 pm UTC

Steroid wrote:
3. The relevant market to analyze is the market for health care, not health insurance. Not buying insurance is an active decision to push the costs of the care you are very likely to require onto the general population.

I'm also not sure if this is true, because I tend to think that not buying insurance is a passive decision based on having other things to spend your money on, but even so, where is it written that pushing costs on others is something that can or should be regulated? Especially since they can choose to not pay the costs.

Which is of course the bottom of this debate. It's a dilemma between the two inviable alternatives of, "I'm at the emergency room but I can't pay. You're just going to let me die?" and "All these people are at the emergency room and can't pay. You're going to make us work for free?"


Where is it written that externalities can/should be regulated?
Constitutionally speaking, you're not going to find anything that specific for just about any power. Where will you find that inter-generational and inter-temporal wealth transfers (Medicare and Social Security, respectively) are explicitly granted powers to Congress? Well you're not, because the Constitution is not a detailed legal code outlining every possible situation. Rather you'll simply find the general consensus is that both of these are covered by the general spending power, which refers to the 'general Welfare."

Of course, you can, and some do, say that it has to be far more explicit, perhaps even that there are no implied powers. But that's a view that would roll us back not to before the Affordable Care Act, before the Great Society, or before the New Deal, but back to the early 19 century. And, not surprisingly, it's far out of the mainstream.

As for should, the economic case for regulation of externalities is very basic, and it's easily shown that proper regulation boosts economic efficiency and overall societal welfare. Obviously it's a little more complicated than pollution, but the economic case here is similar: the efficiency of the free market is based on people internalizing costs. When there are costs or benefits to society which are not included in an individual's decision making, a deadweight loss is created.

Lastly, you say it's either the ER patient gets no care or the doctors work for free. But this is not only not the totality of options, it doesn't even describe our current system, in which some of that care is paid for by taxes, and some by widespread increases in premiums and other healthcare costs.
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Re: Supreme court debate Affodable Care Act

Postby Steroid » Sat Mar 31, 2012 7:02 pm UTC

Garm wrote:
Steroid wrote:A) I don't see how that holds. If 99% of the people in a town don't buy broccoli, none of the grocery stores would stock it, and if they did it would have to be ridiculously expensive to make up for its cost. More of a product demanded lowers prices. If the logic is that less of a product demanded raises prices, and that raise is an economic act against those who still want it, and that that's equivalent to taking money away from them, then I think it's stretching the terms out of usefulness.


This hypothetical is worth about the same as the broccoli argument, which is to say... nothing. Try harder.

Why is it worth nothing? It's a hypothetical that's showing an economic principle, the demand curve. Or do the concepts of economics cease to exist when they're inconvenient for you?

Silknor wrote:Where is it written that externalities can/should be regulated?
Constitutionally speaking, you're not going to find anything that specific for just about any power. Where will you find that inter-generational and inter-temporal wealth transfers (Medicare and Social Security, respectively) are explicitly granted powers to Congress? Well you're not, because the Constitution is not a detailed legal code outlining every possible situation. Rather you'll simply find the general consensus is that both of these are covered by the general spending power, which refers to the 'general Welfare."

Of course, you can, and some do, say that it has to be far more explicit, perhaps even that there are no implied powers. But that's a view that would roll us back not to before the Affordable Care Act, before the Great Society, or before the New Deal, but back to the early 19 century. And, not surprisingly, it's far out of the mainstream.

But isn't that SCOTUS's job, to take the positions that are out of the mainstream because the constitution says so? If they can't bring the principles into play, who can?

And the constitution being simple shouldn't mean that we find implied powers, it should mean that government itself should be simple.

As for should, the economic case for regulation of externalities is very basic, and it's easily shown that proper regulation boosts economic efficiency and overall societal welfare. Obviously it's a little more complicated than pollution, but the economic case here is similar: the efficiency of the free market is based on people internalizing costs. When there are costs or benefits to society which are not included in an individual's decision making, a deadweight loss is created.

But when those costs are paid (or benefits restored) by government, losses are also created, losses both to freedom and to economic efficiency. Just because the free market can't achieve something at all does not imply that the government can accomplish it efficiently.

Lastly, you say it's either the ER patient gets no care or the doctors work for free. But this is not only not the totality of options, it doesn't even describe our current system, in which some of that care is paid for by taxes, and some by widespread increases in premiums and other healthcare costs.

Right, but it does mark the two endpoints. What the Court is saying in this case is that the endpoint of "government takes care of everything" is unconstitutional, at least as it is written in ACA (not speaking on the issue of single-payer).
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