Friday, April 6, 2012
Comment on NEJM Article on Constitutionality of ACA
Fortunately in the United States we remain a society of
laws rather than of men. The power of the federal government over the states and
individual citizens is limited by our written law even if the men in the
temporary majority feel that they have a wonderful idea that will be good for
all. The Supreme Court, for better or for worse, is the mechanism in our written
law for deciding where those limitations lie. The members of the Supreme Court
are individuals of varying temperment, unelected but selected by a political
process. This is our system.
The Obama administration and the Democrat party could have carried out their idea by levying a tax and purchasing "insurance" for those who did not have it. That clearly would have been constitutional and from the economic standpoint would have given the same result as the ACA. I believe this approach would have been their preference but was not considered politically feasable. The constitutionality question was a calculated risk which they took as the best available option politically.
On the payment issue: medical insurance is not insurance - it is a pre-payment scheme. It is the worst of all ways to pay for medical care.
The Obama administration and the Democrat party could have carried out their idea by levying a tax and purchasing "insurance" for those who did not have it. That clearly would have been constitutional and from the economic standpoint would have given the same result as the ACA. I believe this approach would have been their preference but was not considered politically feasable. The constitutionality question was a calculated risk which they took as the best available option politically.
On the payment issue: medical insurance is not insurance - it is a pre-payment scheme. It is the worst of all ways to pay for medical care.
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