Tribe on SCOTUS and the PPACA

Predicting (after a fashion) what the SCOTUS will do with the PPACA and a return to the Commerce Clause and the activity/inactivity disucssion.

Harvard Law Professor Lawrence Tribe does a little prognosticating about the likely behavior of the Justices of the Supreme Court regarding the seemingly inevitable collision between the Nine Robed Ones and the PPACA (aka “Obamacare”):  On Health Care, Justice Will Prevail.  While he does not provide a actual prediction, he basically suggests an 8-1 ruling (something OTB’s own Alex Knapp has stated on multiple occasions).

In regards to Scalia in particular:

Justice Antonin Scalia, whom some count as a certain vote against the law, upheld in 2005 Congress’s power to punish those growing marijuana for their own medical use; a ban on homegrown marijuana, he reasoned, might be deemed “necessary and proper” to effectively enforce broader federal regulation of nationwide drug markets. To imagine Justice Scalia would abandon that fundamental understanding of the Constitution’s necessary and proper clause because he was appointed by a Republican president is to insult both his intellect and his integrity.

The one against is likely to be Thomas:

If Justice Clarence Thomas can be counted a nearly sure vote against the health care law, the only reason is that he alone has publicly and repeatedly stressed his principled disagreement with the whole line of post-1937 cases that interpret Congress’s commerce power broadly.

These evaluations seem extremely reasonable, as do his assessments of Kennedy, Roberts and Alito (the piece seems to assume it likely, as do I , that Breyer, Sotomayor, Ginsburg and Kagan will vote to uphold).

The more I have thought and read about this entire situation I find myself more and more convinced that the following is true:  Congress has the Constitutional power to regulate health insurance and that the activity/inactivity argument is simply incorrect.

In regards to the commerce clause and health insurance, let me quote the Constitution:

Section. 8.

The Congress shall have Power…

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

Now, if we just take the words on the page, we have Congress having the power to regulate commerce among the several states.  Health care and health insurance are both in the category of “commerce” and it is commerce that crosses state boundaries.  I am left with no other logical conclusion* that, therefore, Congress has the power to regulate heath care and health insurance regardless of whether I like the PPACA or not.

In regards to the activity/inactivity issue, as I noted the other day, it seems to me that the decision to forgo the acquisition of health insurance is not a null act without consequences but, rather, is a type of activity because it is a choice within a broader,existing system.

Tribe’s description of this is better than the one I wrote the other day, so I will provide it here:

This distinction is illusory. Individuals who don’t purchase insurance they can afford have made a choice to take a free ride on the health care system. They know that if they need emergency-room care that they can’t pay for, the public will pick up the tab. This conscious choice carries serious economic consequences for the national health care market, which makes it a proper subject for federal regulation.

Again, setting aside one’s policy preference for the PPACA, it is unclear to me what the argument is that Congress does not have the constitutional power to establish the rules regulating a system of commerce that we are all part of by dint of the fact that we live in the boundaries of the United States.  One cannot opt out of the health care system, insofar as doctors have ethical responsibilities to treat any injured person that shows up at a hospital.  Even if I was intending never to avail myself of emergency room services on moral ground, if I am knocked unconscious in a care accident, I am going to get treatment and someone else is going to pay for it if I have no insurance and lack funds in the bank to cover the bill.

Like former Reagan Solicitor General Charles Fried, I find it impossible to read John Marshall’s opinions in McCulloch v. Maryland (1819) and Gibbons v. Ogden (1824) and not come away with the same conclusion:  “I am quite sure that the health care mandate is constitutional.” And, again, it strikes me that such a conclusion comes from a simple and plain reading of the Commerce Clause itself.  Indeed, to come to another conclusion requires reading more in to the words than is on the page.

I am not a passionate supporter of the bill (although I confess to some lukewarm endorsement at this stage of the game) and I can fully understand policy preferences in opposition to it.  What I cannot figure out, however, is an argument against the bill that is strictly constitutional in its basis.  And, for that reason, I am with Tribe:  it is difficult seeing the Court overturning the bill.

Still, we shall see.

Ultimately this whole discussion strikes me as properly a political one,** and it was one that was settled (after many decades of political debate) by a constellation of political circumstances and that any real reversal has to also come via the political process/

*No doubt, some commenters will disagree.  I am sincerely curious how one can take the plain  language and reach a different conclusion.

**By which I mean campaigns, elections, and the resultant partisan control at sufficient levels in the House, Senate and White House.

FILED UNDER: Health Care, Law and the Courts, US Politics
Steven L. Taylor
About Steven L. Taylor
Steven L. Taylor is a Professor of Political Science and a College of Arts and Sciences Dean. His main areas of expertise include parties, elections, and the institutional design of democracies. His most recent book is the co-authored A Different Democracy: American Government in a 31-Country Perspective. He earned his Ph.D. from the University of Texas and his BA from the University of California, Irvine. He has been blogging since 2003 (originally at the now defunct Poliblog). Follow Steven on Twitter

Comments

  1. steve says:

    The option of opting out is one that I would support. People could register to not be part of the health care system. We could still initiate emergency care if they are brought in unconscious, but once we find that they have opted out, we could just immediately terminate care (and I could go back to bed).

    Steve

  2. sam says:

    “You need to understand what the term regulate meant in the time the constitution was written. For a good reference check out what is meant by the term “a well regulated militia”. At the time the 2nd amendment was written it meant a well practiced militia”

    So, you’re saying that the words, “shall have to power to regulate commerce” means Congress shall have to power to bring about a well practiced commerce? What the hell does that mean? Do the merchants have to show up for close order drill on Saturday mornings on the common?

  3. Speaking of plain language and how it might be interpreted differently, you might want to check out Ann Althouse’s three (three!) scathing indictments of Professor Tribe’s attempt to be not quite so plain as you imagine with his language.

    Here’s the third with links to the other two: http://althouse.blogspot.com/2011/02/i-have-to-take-3rd-shot-at-larry-tribes.html

  4. Also Dr. Taylor, if Congress can impose a health care mandate through the Commerce Clause thereby regulating inactivity, is there anything, and I do mean anything, that they cannot do? That is a serious question. Are federalism, limited government and enumerated powers dead letters? I am interested in seeing how you or Alex can square the demise of each of these with the founders’ intentions.

  5. sam says:

    Actually, not, Charles. She writes:

    “In fact, the cases refer to “commercial activities,” and a switch from “activity” to “choice” is immensely important in the health care litigation, in which opponents stress that the failure to buy insurance is inactivity, not activity, and therefore beyond even the broadest interpretations the Supreme Court has ever given to the Commerce Clause.”

    This is false. The government does reach inactivity via the commerce clause. For instance, if you purchase a home via a mortgage backed by a federal agency (VA, FHA, etc), and the house is on a flood plain, the government mandates that you purchase flood insurance. In the early years of the farm price support program, the government mandated that you purchase crop insurance.

    Now, the argument here, for those who oppose the health insurance mandate, is that while the government did reach out to inactivity in the above cases, there was a nexus to some business established (farming, home ownership). In the case of health insurance, the argument is that there is no nexus to the health care system. Or, as they colorfully put it, you’re simply breathing.

    The counterargument for the health care mandate, insofar as the activity/inactivity distinction is pursued, is that we all will use the healthcare system sooner or later, so there is a nexus.

    But this, I think, is all misplaced. The activity/inactivity distinction need never be entertained, since the mandate will stand or fall, I believe, as a consequence of how the Court views it vis-a-vis the Necessary and Proper Clause. Nobody, but nobody, thinks the regulation of the health care market is beyond the reach of the Commerce Clause. The question will, I think, be: Is the individual mandate a necessary and proper means in the furtherance of that regulation?

  6. sam says:

    Zels

    “Yes Sam that is what it means. Not. WTF is wrong with your thinking?”

    You’re the one who pointed to the use of the word ‘regulate’ in the 2d as illustrative of what the word meant way back then. You said it meant ‘well practiced’. If that’s not what it means in the Commerce Clause, then your pointing to the word’s use in the 2d is nugatory.

  7. sam says:

    I don’t even know why I bother, but:

    ” The commerce clause was designed to prevent the sale of goods and services to people of another state at a rate higher than that charged to the states residents.”

    Go read Gibbons v. Ogden.

  8. Herb says:

    “Steven go read what Althouse has to say about what Tribe wrote.”

    Um…..no. If you ever saw what Althouse wrote about the metal band GWAR, you’d find yourself never uttering the words, “Go read what Althouse has to say.”

  9. @Charles:

    Also Dr. Taylor, if Congress can impose a health care mandate through the Commerce Clause thereby regulating inactivity, is there anything, and I do mean anything, that they cannot do? That is a serious question. Are federalism, limited government and enumerated powers dead letters? I am interested in seeing how you or Alex can square the demise of each of these with the founders’ intentions

    But, the power to regulate commerce is an enumerated power. As such, what’s the problem? Is health care/insurance not “commerce”? Does it not cross state lines? And I am not being sarcastic when I ask the question. Do you not see this to be the case?

    So, the issue becomes whether, as noted above, the IM is, as someone else noted above, “necessary and proper” in the execution of that enumerated power.

    The honest answer to your main question is, by the way, is that Congress has substantial powers to regulate commerce under the Constitution (again, an enumerated power). It is constrained by various amendments and other restrictions that can be found in the document. They are further constrained by the political process. So while they cannot do anything, they can do quite a bit.

    I will endeavor to give Althouse a look.

  10. Alex Knapp says:

    Why did the tea partiers dump the British tea in the sea?

    Because the price of tea had been lowered so much by the East India Tea Company that several people who’d made a profit smuggling tea on the black market (like John Hancock) had their profits threatened….

  11. Sam, what you write is a decision by the Supreme court, not what the Constitution intended.

    Yes, a legally binding interpretation of the meaning of the Constitution in a given situation written by John Marshall, who was part of that class of Americans known as “The Founders” (see also McCulloch v. Maryland same author and same conclusions, as a general matter, as Gibbons.).

  12. I do not have time to make a formal response, but just so people know I tried: I read Althouse’s post and I am a tad underwhelmed, to be kind. The first, long response is rather snarky and the one on choice in unpersuasive (as I note above, I don’t buy the notion that failure to buy insurance is inactivity).

    I will say this about the long, original post: she is correct that some people cannot afford insurance, but that is why the law increased access to Medicaid and why it creates the exchanges and provides subsidies. I will be more than happy to note the imperfections with all of that, but she seems to ignore the facts so as to have an excuse to call Tribe “The Old Man.”

    And perhaps she’s right that Tribe is trying to “sweet talk” Scalia, but what she doesn’t do is explain how Scalia’s logic from Raich is going to be transformed for this case.

  13. Since congress has decided not to allow Health Care Insurance providers from doing business across state lines, there is no interstate commerce to regulate and since each state has its own regulatory body dealing with health care insurance, the commerce clause does not and cannot be applied.

    Except, of course, there are other elements of health care and health insurance that do rather regularly cross state lines.

    Heck, for years my prescription benefits came from Denver and now they come from Texas. And while you can’t sell insurance across state lines, the companies themselves are hardly contained only within states (amongst other elements).

    You really are making fundamental errors in your argument.

  14. sam says:

    “Since congress has decided not to allow Health Care Insurance providers from doing business across state lines, there is no interstate commerce to regulate ”

    See, Gonzalez v. Raich, esp.Scalia concurrence.

  15. Dr. Taylor, interestingly enough, health insurance cannot be sold today across state lines, so I’m not at all sure what the answer to your question is. Maybe a little competition would be the better solution. BUt who am I kidding, this legislation is actively hostile to idea of competition in favor of government regulation of not just health care, but the purchasing, availability, and by inference, eventual unavailability of health care, as it gets rationed by our betters.

    IMHO, if all commerce, or indeed, non-commerce, is considered interstate commerce then the term has no real meaning but is the epitome of a penumbra to mean “whatever we want to do.” I understand Wickard, Raich, et al, are the law of the land, but that doesn’t mean it’s right.

  16. Neil Hudelson says:

    You really are making fundamental errors in your argument.

    Color me shocked.

  17. Dr. Taylor, and sam, you must distinguish between health care and related products and services, i.e., prescriptions, and health care insurance, which is a mechanism FREELY ENTERED INTO BY BOTH PARTIES for obtaining said services at an agreed upon price based upon an assessment of relative risk.

    Sorry, for the shouting, but the fundamental difference is kind of important. It’s the loss of that whole “freely” part, the attendant loss of competition and ultimately rationing by something other than price that worries the bejeezus out of some of us.

  18. @Charles:

    Health care and health insurance are already within the realm of the commerce clause, regardless of the issue of selling specific policies across state lines. That is why the activity/inactivity argument has been raised in regards to the individual mandate. This is why the whole enumerated powers argument is a nonstarter.

    In regards to your second comment (the shouty one 🙂 ): the problem remains that people cannot fully opt-out of the current health care system (the whole ER/bankruptcy bit). And., indeed, the healthy youngster who don’t want insurance NOW, and going to want ti LATER (hence the free rider problem).

    Your argument only works if health care is something that some people really don’t want and never will seek to get. This is not the case. There is no one alive who is likely to never need or seek medical attention.

  19. steve says:

    “Dr. Taylor, interestingly enough, health insurance cannot be sold today across state lines”

    Insurance companies can sell across state lines if they get licensed to sell in each state. If you wish to remove the states’ rights to regulate their insurance products, then you need to pass a law that removes that state based regulation.

    Steve

  20. sam says:

    “Dr. Taylor, and sam, you must distinguish between health care and related products and services, i.e., prescriptions, and health care insurance, ”

    Charles, what makes you think Steve and I do not so distinguish? Heath care insurance is part of the health care system.

    “health care insurance, which is a mechanism FREELY ENTERED INTO BY BOTH PARTIES for obtaining said services at an agreed upon price based upon an assessment of relative risk.”

    Well, it’s not national, of course, but how does the ‘freely’ figure into state-mandated purchase of auto insurance?

    “It’s the loss of that whole “freely” part, the attendant loss of competition and ultimately rationing by something other than price that worries the bejeezus out of some of us.”

    The problem, Charles, is that we’ve got lots and lots of people in our country who don’t have the freedom to purchase health insurance at all, e.g, they either can’t afford it or the companies will not ensure them. Invoking the free market if fine and dandy if you can get into the market, if not, tough luck. That’s rationing by price with a vengeance.

  21. sam says:

    What, no gun threats?

  22. @Zels:

    The probability of your condom bill garnering the requisite votes in the House and then winning a super-majority in the Senate and then being signed by the President is precisely 0.00%. Indeed, the likelihood of such a bill being proposed, let alone making onto committee’s calendar and then out of committee are 0.00%. As such, the whole notion is utter nonsense and therefore discussing its constitutionality is pointless.

    The fact that you have to go to absurdities to attempt to make an argument underscores your lack of an argument.

  23. sam, the comparison to auto insurance is really, really stupid and you should stop trying to compare the two because they aren’t even close to the same thing. You don’t have to drive a car on the roads. which are a perfect example of a natural monopoly, but if you choose to do so the state has every right to insist that you carry liability for the damage you might cause in an accident. Please note that you generally not required to insure yourself or your vehicle. Of course, this gets muddled a bit in no fault states, but that’s not really your point now, is it?

    Oh, and “don’t have the freedom to purchase health insurance” is utter bullshit. Forcing a radical equivalency in everyone’s access to health care is not the solution you are looking for, no matter who is paying for it, to mitigate the fact that outcomes can never be made equal. Then again, maybe you are looking for it, but I just as radically oppose such measures on moral and ethical grounds

    Dr. Taylor, an inherent assumption in your argument is that health care is somehow materially different than all other goods and services. I do not think this is true and I sure don’t think the government is obligated to force us all to act in a manner that makes, say, your health care, more affordable at my short term and long term expense. You have no obligation to seek treatment before or after an injury or trauma, but I wouldn’t discourage anyone from doing so for fear of bankruptcy. I certainly don’t consider bankruptcy court as part of the health care system, but I understand with the fines the administration built into their projections to be levied to provide the necessary funding.

    We may have to agree to disagree, but being a health care plan administrator, I will continue to maintain that health care and insurance are not the same thing. We effectively have an insurance problem for a small percentage of the population, not a health care problem. If the administration would try to address the former while leaving the last one alone, perhaps I wouldn’ be so damn obstinate about it.

    Any thoughts on what the loss of competition is going to do to the health care industry, the insurance industry, and all us poor old sods who can forget about as many new drugs or medical procedures being developed once we have the state directing us all under a Five Year Plan?

  24. Dr. Taylor, an inherent assumption in your argument is that health care is somehow materially different than all other goods and services. I do not think this is true

    Health care is ultimately radically different than other goods and services. To wit: when your 9 year old falls off his bike you cannot price shop for the best market-based deal to fix his broken arm or to make sure that he has done no damage to his brain. You cannot even decide not to get treatment–rather you rush to the hospital and worry about the cost later. Likewise when your mother had cancer or your wife contracts swine flu, or your father has colon cancer, etc.

    Further: most of us don’t even pay the “market value” of a doctor’s visit or for our prescriptions. Price is not fully set by the market. It simply isn’t and to pretend otherwise is simply that: pretending.

    I am extremely favorable to the power of markets. I am, however, quite convinced that we currently do not live (nor have we–this is not a ref to PPACA) truly market-driven health care system and I am not convinced (based on the examples above) that it is even possible to do so.

    And in all honesty: the nature of the PPACA is an attack on the health insurance problem you note. It is not a major restructuring of health care in the US nor is it a “governement takeover”–it is the deepening of the insurance-based system we currently have.

  25. And there is no “Five Year Plan”. There is no centralized planning of the entire health care system. This is simply not the case.

  26. Yet. Once the insurance companies have been forced out of business, or just to act as zimindars for the state, and we have been forced into a single payer plan to address the revenue shortfalls, well, let’s revisit the Five Year Plan thing around 2020 unless this is repealed. So what are those 54 new committees for anyway? And the unmitigated power of the HHS secretary to make a remarkable number of decisions for reasons he or she sees fit?

    Yes, I realize I am dealing in hypotheticals at this point, but where does the unending faith that the government will do health care for all of us coming from, considering the way they handle Medicare, Medicaid, and US veterans?

    As to the other points, responding to trauma is necessarily a little different, but that gets handled now, although not terribly efficiently, but again, that’s kind of a different problem. Why not propose some catastrophic care system for everyone instead if that is the only concern. As for all the other types of care, I have my choice of doctors and hospitals now that I fully expect to eventually lose once health care becomes like, say, public education in its administration. Or worse, Social Security.

  27. Charles: The thing is, we are not arguing hypotheticals–we are (allegedly) arguing about a real piece of legislation.

    I continue to find it odd/amusing/perplexing/any number of things that the basic architecture of this plan is exactly what conservatives once said was needed to fix the insurance problems that we have (and that you acknowledge above). Now it is the Health Care Apocalypse (with Five Year Plans and Death Panels, no less).

    On the other issue:

    And not just trauma: kids with ear aches and hacking coughs (do you have kids? I ask simply out of curiosity, not as an accusation–but if you do, you know what I am talking about–it is not like other economic decisions).

    And not just kids but as we get older. I know my parents and grandparents have a host of medical issues (and they are all quite healthy for their ages). It is coming for all of us and we all want to live longer and more active lives all the time.

    And not just as we get older but if one has chronic issues–even relatively simply ones like asthma, allergies, migraines, the list is long: we do not (and sometimes cannot) treat these the way we treat other economic decisions.

  28. And speaking of old age + your nightmare scenario. We have evidence that things do not turn out as you fear: we have had “government run health care” (more specifically: a single payer system) for people over 65 for decades and decades and none of the nightmares of which you are worried about has happened.

    And I know from my almost 90 year-old Grandmother (who can be a bit of hypochondriac at times) that they hardly ration care.

  29. steve says:

    “Any thoughts on what the loss of competition is going to do to the health care industry, the insurance industry, ”

    Most states are dominated by one or two large insurance companies. AFAICT, there is little difference in health insurance costs depending upon the number of insurance companies in a state. If you understand the concept of market power, you would expect that lots of insurance companies would make costs rise.

    Steve

  30. @Charles:

    One more thing about the nightmare scenario: it was extremely difficult, for a political point of view, to get the PPACA passed. What makes you think that there is any realistic chance of sufficient political capital existing at any time in the foreseeable future for more radical health care reform?

  31. Who said I wanted more radical reform? I would much rather this be handled at the state level where many different things can be tried and the best will win out over time, but barring that, how about more incremental approaches to specific problems that are smaller and easier to approve and implement? If the Democrats had been willing to compromise at all they would have got a few Republican votes, but it was a damned the torpedoes, we’re going to push a game-changing solution through. I guess I’m just increasingly skeptical about the efficacy of a too tightly regulated market over the invisible hand when it comes to health care, not to mention that the estimated costs are complete BS, IMHO.

    Hey. I’d like to be proven wrong, but the several briefings I’ve attended by lawyers and insurance brokers has them all shaking their heads and rolling their eyes. No one can completely figure the damn thing out. Did I mention that my company can’t be grandfathered because of decisions we made on June 1 due to regulations issued in September that were backdated to be effective in April? This is nuts and a perfect illustration of the uncertainty that we exploitative biznessmen are facing all the time with our government right now. If the whole 1099 fiasco is illustrative of how well this was thought through, then we all have plenty to be concerned about. But I digress.

    FWIW, I have two children, now 20 and 14. Been there done that. As I have mentioned before, I lived in the UK for a while and have minor horror stories related to the sick child problems you mentioned. And sometimes if not most times, it is absolutely an economic decision, though I’m not sure we are disagreeing much. My kids got better health care than I did, no doubt about that, but I don’t know that I suffered to much more because my parents didn’t take us to the doctor unless it was serious — in my case a ruptured appendix, but that’s another story for another day.

    Personally, I’m not looking forward to Medicare, but I realize their are other opinions and perspectives. Thanks for your thoughtful replies.

  32. Here’s an excerpt from an article on Reason by Matt Welch talking about something else, but I think you can see how it is applicable here:

    That sort of anti-corporate policy nullifies the hard-won insights that many left-leaning policy analysts arrived at in the 1970s. December saw the passing of a great American: the academic and bureaucrat Alfred E. Kahn, father of airline deregulation. Kahn was a liberal Democrat who, after applying rigorous study to the impact of federal regulation on industry, came to the conclusion that in many cases regulation served to raise prices, blunt innovation, form government-sanctioned industrial cartels, and discriminate against new businesses. The market, not the government, was the most effective tool to discipline big business, because corporations that punished their customers were doomed to failure. In short, Kahn understood that misguided regulation produced exactly what Robert F. Kennedy Jr. claims to despise: big business and government entwined in unholy corporatism.

    Liberals and Democrats in the 1970s —a decade that should have proved once and for all the folly of letting “the best and the brightest” try to build a technocratic nirvana—understood that loosening government control helped consumers at the expense of big corporations. The senator most responsible for pushing through airline deregulation was Kennedy’s uncle Ted. The staffer who did the most important legwork on the Kennedy-led Senate hearings was a guy who would later become a liberal Supreme Court Justice, Stephen Breyer. The most famous consumer advocate in favor of decontrol was Ralph Nader. And above them all stood a liberal president.

    What happened?

    http://reason.com/archives/2011/02/07/the-c-word

  33. Charles,

    In regards to a more radical change, I wasn’t sayng that you wanted it, but rather that you seemed to be claiming that it was coming.

  34. wr says:

    Shorter Charles Austin — Since airline deregulation worked, we should do away with all laws.

  35. wr says:

    If Democrats had compromised? They adopted and passed the Republican plan from the 1990s. At which point the Republicans called it Fascism.

  36. G.A.Phillips says:

    ***Because the price of tea had been lowered so much by the East India Tea Company that several people who’d made a profit smuggling tea on the black market (like John Hancock) had their profits threatened….****lol,,,,,,,

    http://wallbuilders.com/LIBissuesArticles.asp?id=69934

  37. sam says:

    @Charles

    The state auto insurance mandate was simply a response to this:

    “health care insurance, which is a mechanism FREELY ENTERED INTO BY BOTH PARTIES for obtaining said services at an agreed upon price based upon an assessment of relative risk.

    I only asked where was the freely entered into part.

    “Oh, and “don’t have the freedom to purchase health insurance” is utter bullshit.”

    You being simple-minded. My point was, that a lot of folks will not be able to obtain health insurance on the open market because of preexisting conditions or because of poverty, that lack of freedom.

    As for this:

    “Forcing a radical equivalency in everyone’s access to health care is not the solution you are looking for, no matter who is paying for it, to mitigate the fact that outcomes can never be made equal. Then again, maybe you are looking for it, but I just as radically oppose such measures on moral and ethical grounds.”

    I guess that across that divide there can be no meeting of the minds. You and I have fundamentally different ideas about the obligations we have by virtue of our living in a community. Your “virtue of selfishness” ethic is repugnant to me on moral and ethical grounds.

  38. sam says:
  39. sam, My co-religionists? You clearly have no idea what you are talking about. Can’t even get your pathetic ad hominems correct. You take Jonathon Chait seriously? Really? I used to read TNR regularly, then the progressive kiddies took over.

    wr, it’s all one way or the other, is that it? I guess it does make it easier to imagine me, my arguments, or, dare I say it, my co-religionists, as not worthy of any cosideration at all. The sooner we bow to your greater wisdom and plans for us the better off we will all be. Seriously, if that’s the lesson you draw from Matt Welch’s snippet then maybe you’d benefit from reading it again.

    Dr. Taylor, I do believe radical change is coming if we continue down this path. It doesn’t happen overnight. But ten year from now we will be standing like like King Theoden asking, “How did it come to this?”

  40. sam says:

    Tell us, Charles, if you do not agree with what Chait said. Don’t you agree that wealth and poverty are moral categories? That the poor are poor because of some moral failing? The the wealthy are so because of pluck and hard work and a superior moral sense? And the poor fail because they do not work hard enough and that because they suffer from some moral lack? That any attempt to ameliorate the plight of the poor by redistribution is unjust as it is taking from the deserving and giving to the undeserving? Don’t you believe all that?

  41. Dr. Taylor, I do believe radical change is coming if we continue down this path. It doesn’t happen overnight. But ten year from now we will be standing like like King Theoden asking, “How did it come to this?”

    I would point out two things:

    1) A lot of your argument is about what may come, not on what is. In fairness, I think that the argument needs to be about what is unless you can make a specific argument about how “what is” becomes “what will be.”

    2) The notion of trying to create universal health care dates back to the early 20th Century. The last time we even had a real debate on this was 1993. In other words, history (as well as practical politics) dictates that nothing more radical is likely to be coming, especially in only 10 years.

    A simple observation: the filibuster rules in the Senate alone mean that substantial change to the health care system is highly unlikely (unless there is a massive shift in public opinion).

  42. wr says:

    Charles — With all due respect, yes, I believe that you and your co-religionists are not worthy of any consideration at all, and that includes everyone who has ever written for Reason.

    Libertarianism isn’t a philosophy. It’s the glorification of adolescent self-absorption. I’m sorry, but “It’s mine, mine, MINE!!!!” is appropriate coming from a two year old and predictable, if less forgivable, from a fourteen year old. From an adult, it’s appalling.

  43. wr, Thanks for the patronizing lecture. Fortunately, most of us liberatarians (or in my case, libertarian-minded conservative) sleep rather comfortably in our own skin and don’t depend on your approval, and frankly despise your disdain for liberty. I hate to disappoint you, but the moral high ground isn’t where you and the kool kidz are standing.

    sam, sorry, I don’t have the time to waste on Chait’s false dichotomies and misrepresentations of anyone who doesn’t think like him.

    Dr. Taylor, fair enough, but my exposure to the blunt end of PPACA still leads me to feel otherwise.

  44. steve says:

    My experience has been that an awful lot that I am told is being caused by the ACA is not true. When something is blamed on it, I go look it up and send out some emails.

    Steve

  45. sam says:

    @ Charles

    “sam, sorry, I don’t have the time to waste on Chait’s false dichotomies and misrepresentations of anyone who doesn’t think like him.”

    Just answer the questions I asked, Charles, forget Chait. Just answer my questions. Surely you can do that, right? I mean a man of principle such as yourself.

  46. wr says:

    Liberty equals lower taxes and my neighbor dying in the street.

    Oh, wait, not in the street. Because in liberty-land, the streets are all privately owned.

    Of course libertarians sleep well. Sociopaths always do.

  47. sam, sorry. Not sanctioning you patronizing approach.

    wr, So I’m a sociopath? Great. Thanks for helping me realize there is no point in conversing with you further.

  48. sam says:

    “sam, sorry. Not sanctioning you patronizing approach.”

    You know Charles, I think you’re a stone coward. Really.

  49. Dr. Taylor, fair enough, but my exposure to the blunt end of PPACA still leads me to feel otherwise.

    This does, of course, make it rather difficult to have a conversation as it seems that I am being asked to deal with feelings and hypotheticals rather than the actual policy at hand.

    At a minimum it has nothing to do with enumerated powers, the necessary and proper clause, the commerce clause, activity/inactivity or really anything of substance.

    I don’t want to sound rude, but I am not sure what your position really is save that a) you don’t like it and b) you fear that thins will just get worse.

  50. wr says:

    Sociopaths are interested only in their own personal needs and desires, without any concern for the effects of their behavior on others.

    How is that any different from a Libertarian? Except that a sociopath doesnt have to pretend Ayn Rand could write…