ObamaCare Back & Forth, Part One

About a week ago, I noticed that my good friend, Josh Bails, had posted a facebook status supporting the Supreme Court's decision that largely upheld the controversial health care law known as ObamaCare. I indicated that I was not quite as thrilled about the Court's decision. He then asked me to explain why I opposed the bill. This was what sparked what has been an intense and thoroughly enjoyable thread of emails between the two of us. I recently asked him if he would mind me posting them here and he was kind enough to encourage it.

It's pretty long, so I think I'll post it in 2 installments. The second one will be up as quickly as I can get it ready.

Let me give you a little background. "Me:" means I am writing and "Josh:" means Josh is writing. The first email in this thread is me responding to Josh's request on facebook for a well thought-out argument against ObamaCare. The subject like of my email simply said "Freedom."


Me:

That's mainly why I oppose the individual mandate. I don't want the government making me do things, even if they're making me do things that are good for my health. If I own a company, I don't want the government telling me how to run it. If I don't want healthcare, I shouldn't have to buy it.

Simple as that. Let me get my own healthcare if I want it. Let me not get healthcare if I don't want it. Let me be free.

I understand that it helps alot of people get insurance and that it attempts to stop insurance companies from "bad" policies. Those are all good and nice things, but the price is too high. Freedom is more important.

Thoughts?


Josh:

I understand the argument, but I feel a lot of it is refuted in the Supreme Court's own explanation - the individual mandate is legal *as a tax*.

Which makes perfect sense to me - it might be something you disagree with, but if it's something we've decided to provide the country with then so it goes. We get taxed for all kinds of things not just what we agree with. If it worked that way, I'd happily ask to get the part of my paycheck back that went towards making our military larger than the next 14 largest militaries combined.

When it comes to things like the government telling people how to run companies and whatnot, the majority of that is things that protect the population like health and pollution regulations, which I'm very happy are in place. I don't think any of these things are compromising our freedoms. I just see this as society finally deciding to cover the ambulance along with the cop car and the fire truck (overly simplified, but you get what i mean).


Me:

Well first, it's not a tax. A tax applies to everyone who buys a certain good. I buy a fridge, I pay a tax. I buy a sandwich, I pay a tax. Say I don't want to pay the tax on the sandwich then I am free to not buy it and not pay the tax.

This is a fine. I commit an offense, I pay a fine. Too long at the parking meter, I pay a fine. Drunk and urinate in the street (which kinda does sound like me), I pay a fine. Now it is an offense for me to not buy health care and now I must pay a fine. This bill defines not having healthcare as an offense (or crime or misbehavior or whatever word sounds better there) which incurs a fine.

You could ask here, "Well, you agree that people who stay too long at the meter deserve a fine. You agree that if you get drunk and urinate in the street you deserve a fine. Don't you think that you should be fined for not having health care?"
No. With the parking meter, I made a type of 'agreement' with the meter to stay only as long as I paid for. If I go over that time, I should be fined. With the peeing in the street, I most likely disturbed some passerby and affected them negatively and I should be fined. In the health care case, I have done nothing wrong. I simply don't want health insurance for some irrelevant reason. Now the government can fine me for choosing to not have healthcare? This is why I oppose the individual mandate.

The way in which the government spends its money is the subject a different and much lengthier email. I generally endorse military spending; makes me feel safe.

There are certain regulations that I support the government in enforcing, specifically those regarding pollution. A company should not be allowed to pollute the air or the water because that adversely affects nearby citizens. I as well am happy that those regulations are in place. With regard to health regulations, I'm not sure I know specifically what you're talking about. I most likely would not endorse them. I like my government small, with as little interaction in the market as possible.

tl:dr With regard to the individual mandate: it's not a tax, it's a fine on an offense that they create in the bill. It infringes on the freedom of US citizens.
I endorse some government regulations (pollution) but like to keep it as small and uninvolved as possible.

Make sense?


Josh:

While you can debate the semantics of it, the Supreme Court ruling is that it is a tax. That is therefore the new definition, so it is a tax. The reason it is there in the first place is so that no one can decide to just not have health insurance until right when they get sick, since the health care law doesn't let health insurance companies deny coverage to those with preexisting conditions. There are very few people that would seriously want to intentionally not have health insurance in the first place, and I doubt you are one of them.

By health regulations I meant things like what the FDA is there for, I doubt you want things to return to how they're described in The Jungle by Upton Sinclair.


Me:

What?! That is incorrect. The Supreme Court has no legislative power. It cannot say that something is a tax or is not a tax. Its only power lies in determining if laws are constitutional or not. In this case, they ruled the individual mandate constitutional because they think that the fines imposed on individuals without health insurance can be "construed" as taxes. But it does not make these fines taxes because the Supreme Court said so. Not at all. Here is Roberts' statement:

"It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance.  Such legislation is within Congress’ power to tax."

So the Supreme Court says it's a tax thus making it constitutional, but not making it a tax by simply calling it one. They cannot define it to be a tax.

You bring up the example of a person not having insurance and then purchasing health insurance right when they get sick. If this were a free country, health insurers could refuse coverage to whoever they wanted, preexisting conditions or not. People would also be free to buy health insurance or not. If I choose to buy health insurance and then subsequently get sick, I'm covered. If I don't choose to buy health insurance and subsequently get sick, I'm fucked, but it was my choice to not buy health care and I'm a grown up and must deal with the consequences of my decisions. There's no need for government here. This way, if someone gets sick and then immediately tries to get health care, no care provider will take them. In regard to people with preexisting conditions, what happened to their previous health care provider? Or are they just an example of people who didn't get health insurance, got sick, and subsequently want it?

I want and have health insurance because I like having that security. If I get sick, my provider will be paying my medical bills. But who am I to mandate that everyone gets it?

I've never read The Jungle but I imagine I'm behind most of what the FDA does (I'd have to do a little research to make a definitive statement).


Josh:

So I was perhaps a bit hasty in my explanation of how it is a tax, but as you said it falls under congressional taxing power in their decision which is what I was getting at. I don't see letting someone not have health insurance and then getting fucked when they get sick as a very good example of freedom, if we've decided that everyone should be provided with basic care I really don't see how that constitutes a major infringement of freedom. That's like debating whether or not someone should be forced to pay for the fire department, and if they decide not to and get fucked when their house burns down then that's them exercising their freedom.

I'm not saying I'm the biggest fan of the principle behind the individual mandate, but i see its necessity in provided much needed care and services to the rest of the population. I'm sorry, but I really think calling that a threat to any freedom as pretty blatant hyperbole.


Me:

From your last email:

"I don't see letting someone not have health insurance and then getting fucked when they get sick as a very good example of freedom..."

It might not be a pretty example of freedom because one person gets sick and then gets fucked, but it is nonetheless an example of freedom. It is an example of a freedom that this law would take away. Later in your last message, you say

"...I really think calling that a threat to any freedom as pretty blatant hyperbole."

when you are referring to the individual mandate. But by making it a crime to be uninsured, the government has not just threatened the individual's freedom, it has taken it away. I don't think calling a law out on what it does (takes away my right to be uninsured under penalty of a fine) is hyperbole at all.

You make a good point in the analogy with the fire department. However, there is a key difference between the two cases. It comes down to one being a federal law and one being a local law. I should be able to choose whether or not to pay for the fire department and, like you said, reap the consequences of my decision if my house burns down. But I am forced by my city (or state) to pay taxes to fund the fire department, potentially against my will. By my logic this is an infringement of freedom. But nothing is stopping me from moving to another state if I find this infringement unbearable. This is the beauty of the US. Our system of federalism allows for different state governments with different rules, laws, and taxes. If I find one not to my liking, I can move to another that I like more. The problem with imposing laws that infringe on citizens rights at the federal level is that I can no longer move to a different state. My ability to find a free state is gone.

See the difference? Understand the logic? Still reading? Wanna punch the obnoxious, capitalist, insensitive, uncaring ginger in the nose yet? Haha. I appreciate the conversation man.


Josh:

Well the first thing I see is no matter what state you move to you're still paying for a fire department, I didn't exactly get the reasoning there. And if you consider that an infringement of freedom and the individual mandate an infringement on a similar level then that's kind of unrealistic given how this country has been set up for quite some time.

And it's not a crime to not have health care, just if you don't you'll get taxed one percent and receive the most base care possible. Just as the police station paid for in your taxes is the base level of that service the country allows while you can choose to pay for a private security company as well.

Haha I get the logic, I'm just not sure how well informed it is :P


Me:

Ok, so if all the states make me pay for a fire department and it's that big of a deal to me, I call my state legislature and voice my opinions or I run for office myself on the platform of "No Public Fire Departments." Another beauty of our system is allowing anyone to run for office to change the issues that are important to them. I feel like the fire department tax is a significant infringement on my freedom (I don't in actuality, but for the sake of the argument) then I can run for office, convince people that I am right, and eventually change it. The only difference between the individual mandate and the fire department tax is that there are already prominent politicians in Washington declaring it's infringement of freedom, so I just support them. See the reasoning now?

Do I consider infringement of freedom in the form of a fire department tax to be on a similar level as infringement of freedom in the form of the individual mandate? Of course not. I support the fire department tax. Maybe I wouldn't have if it were just beginning right now, but its been long established and is relatively inexpensive. But you know how I feel about the individual mandate. So no, I don't think these two examples of freedom infringement are on the same analytical level.

The federal government is mandating that I get health care. If I don't, I have to give them money. It is NOT similar to a situation in which I'm funding a local police station and also paying for private security.

I think that should clear up some of the logic. I tried to keep it simple, well-informed.


Josh:

It isn't mandating any more than it is mandated that you get fire department service and police service. The money you have to give them if you don't is just a tax for which you will receive the base level of care. In any case yeah you can support people who think something is an infringement of a freedom, and where does that argument ultimately end up? In the Supreme Court. Who just made the ruling, and set the precedent, despite being empirically very conservative in most of its decisions in the past few years so the argument of rigged court doesn't hold much water either. http://fivethirtyeight.blogs.nytimes.com/2012/03/29/supreme-court-may-be-most-conservative-in-modern-history/


Me:

You keep calling it a tax. Did you understand my paragraph explaining how it's not a tax? It's a penalty, a fine, a punishment. I'm not doing what the government says, and I'm being punished.

They are mandating that I have insurance. This is an infringement of freedom similar to being forced to pay for a fire department. In my opinion, a fire department tax is necessary and does not substantially infringe on my freedom (see also the paragraph describing the difference between local law and federal law). Again, in my opinion, a mandate to buy health care does substantially infringe on my freedom. This is why I believe it to be unconstitutional and should be struck down. Now do you see the difference between funding the fire department and being forced to buy insurance? I've beat it to death at this point.

Considering our tax/fine discussion, maybe this argument will be more comprehensible for you. A tax stems from some sort of action. I actively buy a loaf of bread, I pay the tax. I own a property, I pay a tax. But what you refer to as the individual mandate "tax" stems from inaction (not having actively bought health insurance). This is an extreme example, but say I do nothing with my life. I've somehow managed to never buy things, not need food, not need property, clothes, etc. In all senses of the word, I am inactive. Thus I pay no tax, right? Not anymore. Obama wants to make me pay a fine for being inactive, not having health insurance. I would have lived happily ever after in my make believe world being inactive all the time, but now I'm being punished. This is unconstitutional.

Basically, a tax is a portion of my income or a portion of the price of a good/service that I pay for. I'm active in both endeavors. But now I'm being "taxed" for being passive, not buying a certain service. I consider this not a tax at all but a penalty, a fine. If I had decided to buy the health insurance and was forced to pay extra money to the government when I bought it, then you could call that a tax. But this is a penalty for being passive, not a tax at all.

I can see how you think of it as a tax. Can you see how I think of it as a fine?

So this is why ObamaCare ended up in the Supreme Court; some people thought it was an infringement of freedom that was unconstitutional and made an appeal. The Supreme Court, despite being quite conservative, ruled that the law was constitutional. Fair enough. This is the way in which our government works; I might not have agreed with the decision but I'm mature enough to realize the legitimacy of the process by which it was created, passed, and recently analyzed. However, just because the Supreme Court ruled the law as constitutional does not mean that I immediately take them at their word and implicitly believe them. Yes, they get to make the decision, but I am not obligated to adopt the same one. I don't really understand why you bring up the political leaning of the court. It's informative, but is not relevant if we're discussing the legitimacy of the individual mandate.

I think this is a pretty strong and well-explained argument. You understand my thinking now? Agree that it is a fine? Unconstitutional? Put all the benefits of the law aside for a moment and ask yourself if you think it's constitutional. You will find that it is not.

Please be open-minded, for the sake of a naive, aspiring, sincere youngster.


Me again:

Relevant:

http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/#.T-xn4HB_L9U.twitter


Josh:

So I get your and Obama's points of it not being a tax in the traditional sense, but you also have to realize the last thing a politician wants to admit to is levying a new tax so of course he's going to do everything he can to talk it out of that definition. But honestly, Obama presents a much better argument than I do. If you have a car you're already required to get car insurance, and of course you have a body so now you're required to have health insurance too.

As to your hypothetical situation where you don't do anything to require any taxes whatsoever, then it that case you would most likely be broke, putting you under 133% of the poverty line, which waives the mandate for you, and most likely qualifies you for some sort of free health care through your state's Human and Health Services Department. And for anyone between 133% and 400% of the poverty line, they qualify for government subsidies be it on the mandated base care or a plan they choose. The only people being "forced" into anything are those that can afford health care but don't want to buy it until they need it. My personal opinion is that this is a very small price to pay for a very small amount of the population (that is kind of doing them a favor anyways) to expand health care coverage to millions who couldn't afford or didn't qualify for it before. This was no one's first choice as to how to make health care reform work, but it's a compromise that is worth it for what society gains in return. Also, if you have a certain part of the Constitution this violates when you call it unconstitutional I'd be interested to hear it.

Now please don't take this as me being someone who doesn't worry about the government overreaching their bounds and infringing on freedoms, I just think there are much more significant battles to be fought that present much worse threats than "forcing" everyone to have health care. For instance, bills like SOPA that want to put significant controls, restrictions, and possible censorship on the open web continue to show up in Congress and would cause much more troubling infringements on our freedoms. Things like this scare me much more than the individual mandate, and personally I find the mandate a lot lighter compromise for security over freedom than, say, what the TSA puts you through to get on an airplane when that system hasn't been very effective at achieving its goal.

There will always be an argument that this or any other law is in someway an infringement on your freedoms and involves putting one value over another to some degree (such as security/health over freedom/autonomy or vice versa when it comes to laws allowing certain levels or unrestricted levels of industrial pollution), and the individual mandate seems to be a rather insignificant one that provides a great service to be provided to even more of our population and I would find kind of a stretch to consider it a slippery slope towards more "fines" or even more socialistic policies, as this is still far from universal health care.


End of this installment.

So I'm not sure how links work in blogger. Maybe they still work? Comment below if you have problems. Installment 2 is coming soon so stay tuned!