American Elephants

Mandate? Mandate? What Mandate? by The Elephant's Child

Peter Suderman of the Reason Foundation remarks on the ObamaCare mandate:

The Obama administration has repeatedly and somewhat counterintuitively argued that the individual mandate to purchase health insurance is not, in fact, a requirement that compels anyone to purchase health insurance. Arguing the case in front of an appeals court in Atlanta, Neal Kumar Katyal, the Obama administration’s former acting solicitor general,told judges that the government is “not asking people to buy something they otherwise might not buy.”

Eventually, Katyal argued, everyone will need health care. Requiring individuals to purchase health insurance merely regulates how that care will be financed.

Katyal and other defenders of the mandate have used this idea that the provision merely regulates financing as a response to the concerns about the mandate’s novelty and the scope of congressional action it might allow. Congress already regulates the financing of health care, the argument goes; this would simply be a new way to regulate that financing. By minimizing the provision’s novelty, the law’s defenders can sidestep concerns about the breadth of power granted to Congress under the Commerce Clause should the mandate be ruled constitutional.

There’s a big difference between regulating commerce in which an individual has chosen to participate, and compelling someone to participate in a specific form of commerce in which they have chosen not to participate. The protestations that the pig in the poke is not a pig are getting increasingly weird.

The mandate doesn’t regulate commerce, it requires commerce. Unwanted commerce.


A Warning Voice from Across the Water: by The Elephant's Child

As the Supreme Court hears arguments about the fate of ObamaCare, it is useful to once again take a look at the country with the longest experience with socialized medicine. Britain adopted their National Health Service just after World War II.

When we read the accounts of NHS care in the British papers, we are told that they are only “scare stories.” They would never happen here, we are told. Yet, we were told, Obama’s health care advisers — Dr. Ezekiel Emanuel, Peter Orzag, Tom Daschle, and Dr, Donald Berwick — were all extravagant admirers of the National Health Service.  They talked a lot, we were told,  about the fact that the highest costs of medicine came in a person’s final years.

That’s where the ideas for the Independent Pay Advisory Board (IPAB) that Congress is trying to repeal right now, came from.  That’s where “comparative effectiveness research” came from. Obama even referred to it when confronted with a woman in one of his campaign events, who wanted to know what value ObamaCare would place on ‘zest for life’ when deciding on a procedure for an older person (in this case, her mother who needed a pacemaker at age 100 — got it— and has enjoyed 5 more years and is still going strong). Obama mumbled a little and said something about there was a time when radical expense maybe wasn’t worth it, and pain pills were more in order.

Monday, March 25, 2012, The Telegraph reports: Elderly Dying due to Despicable Age Discrimination in NHS.

A lack of treatment or insufficient treatment is contributing to 14,000 deaths a year in people over the age of 75, Macmillan Cancer Support has found, in what it called an ‘unacceptable act of discrimination’.

Deaths from cancer are reducing in most age groups but at a slower rate in those aged 74 to 84 and are increasing in people aged 85 and over, the report said.

Professor Riccardo Audisio, Consultant Surgical Oncologist at St Helens Hospital, said: “It is despicable to neglect, not to offer, not to even go near to the best treatment option only on the simple basis of the patient’s age. “This has been a horrible mistake that, particularly in the UK, we have suffered from.”

According to research published in the journal Cancer Epidemiology, there would be 14,000 fewer deaths from cancer in those aged over 75 per year if mortality rates from cancer matched those in America.

Keep in mind that this is just, we are told, a “scare story” from England, and has nothing to do with ObamaCare.

Free market medicine is based on competition, which helps to keep the costs down, and rewards excellence. Socialized medicine, which offers all things pretending to be “free,” encourages overuse, because nobody really knows what anything costs. It’s just that the taxes keep going up. And both the providers and the administrators focus becomes reducing the cost. Providers try to receive adequate recompense for their efforts; administrators make more rules to slash expenses. The incentives have changed, and excellence goes by the wayside. It’s just the way of the world.

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