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  • Guest Blogger: Dr. Eric Novack on Mandatory Insanity

    The debate over health care reform has been a theoretical affair, full of abstractions that contradict one another. Amid all the ambiguity, one fact is unequivocal and unprecedented.

    Under the Patient Protection and Affordable Care Act, every American will be compelled to purchase health insurance, or else – the “or else” being a fine collected by the Internal Revenue Service should you fail to ante up.

    “The mandate,” as it’s known, has its origins in the Commerce Clause of the Constitution, which grants Congress the authority to regulate interstate commerce. And yet it doesn’t take an Elena Kagan-level legal scholar (or even a fan of “Boston Legal” reruns) to see that the mandate, rather than regulating commerce, is this time being used to regulate the absence of commerce.

    Why does that distinction matter? Well, at the risk of sounding alarmist, if Congress can compel the purchase of a product – health insurance – under its authority to regulate the interstate market for health care, then, using the same legal theory, what transaction can’t it compel?

    Is it any wonder that likely voters reject the mandate by better than a 2-to-1 margin in most recent polling?

    As just one example of the mandate’s potentially slippery slope, consider the interstate market for transportation. As we’ve seen with the $13 billion bailout of General Motors, stabilizing the automotive industry is clearly a Congressional concern. So why not compel Americans earning, say, more than $35,000 a year to buy GM cars? Or, better still, in a kill-two-birds tactic, why not compel them to buy Chevy Volts, thus ensuring the stability of the auto industry and the interstate market for clean energy?

    As the federal government’s lawyers explained in a May motion in the Virginia Attorney General’s case against ObamaCare, “Foregoing health insurance … is not the same as foregoing health care. When accidents or illnesses inevitably occur, the uninsured still receive medical assistance, even if they cannot pay.”

    Play out that logic: Those who get sick need care. People who need care drive up costs in the medical sector. Congress has the authority and the need to control medical costs. Thus, Congress can legally compel Americans to pay for health insurance.

    If that’s a valid reading of the law justifying a mandate, then why not compel Americans to buy 24-Hour Fitness memberships or Nikes? The absence of exercise lowers your fitness level. That increases the likelihood you’ll need health care. Lather, rinse, repeat.

    The government’s theory makes a case broad enough to control virtually all financial transactions – or the lack thereof. If such a mandate doesn’t offend you as a curtailing of liberty, then consider how likely it is to fail at its stated intention: Bringing 45 million Americans who today don’t have private health insurance or Medicaid into the risk pool, spreading out the risk across more payers and bringing down health insurance premiums.

    That theory forms the foundation of Mass-Care, Massachusetts’ universal health care system passed in 2006. Unfortunately, Mass-Care and its mandate haven’t stopped spiraling health care costs. From 2007 to 2009 in the Bay State, the median annual premium for family plans jumped 10% to $14,300 a year. For small business, the increase was 12%. What’s worse is, Massachusetts already had the highest health care costs in the nation before Mass-Care became law.

    Nor does the counter-intuition stop there. The ObamaCare debate often has focused on the $43 billion in uncompensated care bills racked up in 2008 by those without insurance (a number that represents less than 2% of the $2.5 trillion Americans spend on health care annually).

    These costs have been attributed mostly to avoidable ER visits made by the uninsured. Make insurance mandatory, goes the explanation, and the ER onslaught will end. Fast forward to last week’s Boston Globe newspaper.

    “The number of people visiting hospital emergency rooms has climbed in Massachusetts, despite the enactment of nearly universal health insurance that some hoped would reduce expensive emergency department use,” the paper wrote July 4th. “According to state data … emergency room visits rose by 9 percent from 2004 to 2008, to about 3 million visits a year.”

    Mandatory insurance, it turns out, is not the same as access to a primary care physician. So even with the mandate, doctors are still in short supply, ER overcrowding continues and costs keep rising. Call it one more unintended consequence in the world of insurance made mandatory, a world many of us who support the Health Care Freedom acts – which already have become law in five states – are trying to avoid.

    Not that everything is uncertain with this new law: America, you can rest assured, is badly in need of a new cliché. Now the only things certain in life are death and taxes – and the need to buy an insurance policy.

    Dr. Eric Novack, a Phoenix orthopedic surgeon, is the chairman of the Arizona Health Care Freedom Act and the U.S. Health Care Freedom Coalition.

    The views expressed by guest bloggers on the Foundry do not necessarily reflect the views of the Heritage Foundation.

    Posted in Obamacare [slideshow_deploy]

    9 Responses to Guest Blogger: Dr. Eric Novack on Mandatory Insanity

    1. Brad, Chicago says:

      Unfortunately, having insurance won't compel anyone who doesn't like going to the doctor to make preventive care visits. An emergency is still an emergency and people aren't going to become less stubborn about seeing their primary care physicians before their condition becomes an emergecy.

    2. DM, Los Angeles says:

      I agree with Dr. Novack but probably not for the exact same reason. I do not like having to pay 30% to a 'for profit' administrative middleman to shuffle a payment. It's ridiculous, expensive and adds no value to care.

    3. Billie says:

      This is not what the American people EVER wanted. it doesn't make sense. Before this ugliness was introduced as "THIS IS What the American people WANT," private insurance was bought by choice of responsible people who took care of themselves. Chose to do so at a cost of a privilege called insurance. The ones who don't take care of themselves will continue to get it for free. Why the costly paper work? I can't imagine those getting it for free now, where, how and why they'll gain the dignity to pay for themselves insurance? This is nothing but fraud, corruption, etc, for one government insurance take-over under many names.

    4. Peter Asher Oregon c says:

      This article does not address the (freedom of) choice of self insuring by maintaining the ability to pay for one’s care while simultaneously maintaining a life style that avoids the need for much of it.

      If there must be universal health care than it is pure “Vulcan” logic that it be paid for by taxing all products and activities that contribute to poor health. This would be positive feedback loop as the lessening of the illness causing activities and consumption would lower the gross national health care cost while simultaneously raising the funds for the expense.

      As to the mandate, when government enacts what the majority wants, it is a democracy. When the government enacts what the majority does not want, it is a dictatorship.

    5. Ted Sharp; Fort Laud says:

      The mandatory purchase of health care insurance is not the underlying problem in and of itself. Of course it can not possibly be Constitutional to require a purchase of Anything. The States, or the People, might try, under the Tenth Amendment, but could never accomplish such a concentrated enforcement with such a difuse mechanism. The real root of this travesty is the misreading, now of long standing, of the "Commerce Clause", Article I, Section 3, ( 3 ). To "Regulate" was at the time meant as to promote regular, smooth, and unhampered, commerce, which was a dire concern due to the disruptions in commerce between the States under the Articles of Confederation. It did not mean to the Founders "to control" commerce. To control commerce requires a drastic reduction in Individual Liberty and State sovereignty, neither something the Founders held close to their hearts, nor anything they would have intended as their Countyman's future. The States would not have ratified the Constitution in the first place had "to control" been the understood meaning of "regulate". Precedent has been set by terribly awful Supreme Court Decisions on the matter, and, with numerous prior travesties, has finaly led us to the imposition of a preposterous mandatory purchase. The remedy can only be a basic revisit and reversion of the meaning of the "Commerce Clause". Much mischief could be averted, and perhaps much more be aleviated.

    6. Mark Knopf, Millinoc says:

      I'm at a loss to understand. I can't prove my former employer forced me out of my job due to my medical liablities, but here I am after 30 years of service with no health insurance and pre-existing conditions that no insurance company will touch. Neither will the state programs, I make $100 a month too much on my pension. So I guess I am an untouchable-class citizen. And now this nightmare of "reforms"…. I don't trust the feds, either. I don't want charity, just a chance to get my meds refilled. So what is there for a guy at the end of his productive years. I guess a bitter pill is a bitter pill.

    7. Pingback: Is The Individual Mandate A Tax? – Blog Watch

    8. MaxMusic says:

      Best guest book!

    9. Pingback: Is The Individual Mandate A Tax? | Go HealthReform

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