Sunday, June 20, 2010

Anti-Obama care proposition would be on August ballot.

According to subtitle F, Part I, section 1501 of the Patient Protection and Affordable Care Act, the new health care reform law that was signed into law by Barak Obama, everyone is required to have health insurance or face a $750 fine. On August 3rd, Missouri voters will have the opportunity to voice opposition to this section by voting on Proposition C. The initiative reads:

Shall the Missouri Statutes be amended to:

* Deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services?
* Modify laws regarding the liquidation of certain domestic insurance companies?

It is estimated this proposal will have no immediate costs or savings to state or local governmental entities. However, because of the uncertain interaction of the proposal with implementation of the federal Patient Protection and Affordable Care Act, future costs to state governmental entities are unknown.

Recently, I interviewed to experts on opposing side of this issue. John Payne is a research assistant at the Show-Me Institute. The Show-Me Institute is a research and educational institute dedicated to improving the quality of life for all citizens of Missouri by advancing sensible, well-researched solutions to state and local policy issues. He is oppose to the new law.
Gaylard Williams, is an experience attorney and actively involved in politics. He is in support of he new law. I interviewed John First.

Damien: Why should the voters oppose individual mandates?

John: Well I think you should look at this and ask why should the votes oppose more government involvement in health care because if you are going if your going to have a system where you are going to tell insurance companies that you must cover everyone regardless of preexisting conditions, the only way your going to make the work is with an individual mandate. But that care a whole host of other problems. For one, it’s a significant expansion in federal power. It’s unprecedented for the government to say; in order to live you must buy this product. People use this analogy and say, “Well, it’s like car insurance.” Well that is not entirely true. For one, that states require care insurance. Another, you don’t drive. Driving is a privilege, not a right. You don’t have to drive. I think we should oppose the whole package, not just the individual mandate. But that is certainly one of the worst aspects of the health care bill.

Damien: We’ll only be voting on the individual mandate.

John: True, but I think it will be beneficial in the since that it might cause the whole law to be repealed. I think that got to be the ultimate goal. Maybe not every single part of it. There are some beneficial parts, but the must insure parts, we got to take them out.

Damien: Couldn’t we have the rest of the part of the bill with out the individual mandate or vice versa?

John: I don’t think without the individual mandate, you could have a system where the insurers have to insure everybody. Now if we want to cover everybody, I think that is the goal of the law, you could just give the poor or people who do have catastrophic, preexisting conditions from birth, you could give them some type of government assistance, a voucher. But to impose a law that says the insurance have to cover, will be a lost on the insurance companies and ultimately, the insurance companies costumers. If we want to that, I think it should be straight form the government. Which essentially what Medicaid was design for. If we do that better, we could avoid a system where the insurance companies commanded to do all these things.
Damien: How would we go about doing that better?
John: Basically, we need to get government out of health care aside from the small parts where it’s just about helping out the poor and someone with catastrophic, preexisting conditions. So I think we need to retrench Medicare because as a group, seniors are actually the richest part of the population. Not to say that some of the seniors don’t need help, but there is no reason automatically at 65, you automatically go on the government payroll. So I think we need to start thinking about how we can roll that back. And there is a lot of good evidence that suggest that Medicare have not been successful at getting more health care to seniors but it had it successful at driving up cost and diverting more income towards doctors. So if we do that, we can save more money and put more money in to people who really need it.

Damien: If we all were covered, would insurance be cheaper?

John: No, I don’t think so. Because there is a limit on supply. If every one is buying insurance, at some point the price has to go up. Demand goes up and supply stay constant. You might get less coverage, less hospital beds, doctor visit or the price would have to go up. So you would have to reduce the amount of actual care or raise the price.

Damien: People without health insurance shows up to the emergency rooms and get care on the backs of the people with health insurance. Without a mandate, support argue, people with insurance will continue to pay. How do you respond to that point and what is your alternative?

John: regardless of people mandate there or not, people are going to continue to pay for people without health insurance anyway. I don’t think people without health insurance are going to get health insurance even with a mandate. The fact is, the penalty for the mandate is not that it’s is not as steep as for people who have to pay car insurance. So most people are going to just pay the penalty and move on. So you might be getting some tax money to offset some cost through penalty but there is still going to be a drain on the system that is covered by everyone else. Even if they do by health insurance they, would probably be heavily subsidized for it so everyone is paying the cost for it anyway. So one way or another, you’re still paying the cost. So it might encourage to get preventative care. The best system for that, it has been shown is high deductable plans combined with a health savings account. This bill seems to go in the opposite direction. High deductable plans only covers catastrophic things. It’s there when you need it. It encourages people to stay healthy because you get sick, you’ll have to pay more out of pocket. So that it provides an incentive to stay healthy. So it’s one of my alternatives to the health care plan we have going now. So encourage people to get health insurance that doesn’t cover everything. The idea that insurance company should cover regular checkups is can of insane. If something is regular and predictable, it should not be insured. Insurance are for things you can’t predict; something that comes out of now where it not sure that something is going to happen. You may have a incentive to avoid high health care cost by paying more out of pocket.

Damien: What if paying out of pocket is a strain on the individuals? A lot of people take advantage of Medicaid or Blue Cross/ Blue Shield so they can show up to the dentist, the emergency room, or regular checkups without paying out of pocket.

John: If they are below the poverty line, I don’t have problem with the government subsidizing them. I would say, it would be a better idea is to instead of having the government having an insurance plan, is to give out vouchers for people to buy insurance which would bring competition to the market. I do think there must be some out of pocket cost if you are going to be on government assistance even if it comes in the form of government money because you need that incentive to use to prevent people from over using the system.

The following is from Gaylard. Please be advised that he did not take a position on how much the fine should because he haven't seeing enough details of the law. But he did provide valuable information relating to the constitutionality of both the Patient Protection and Affordable Care Act and Prop. C.

Damien: Where do the federal government get its authority to mandate someone to buy health insurance?

Gaylard: Commerce Clause, that is the basis of regulating a lot of business. Actually, People don’t realize is, the Commerce clause is the backbone of the 1964 Civil Rights Act. Through the Civil Right Act, congress was able to outlaw discrimination of private and as well as public facilities. Whenever there is an issue, state have been using the 10th understates rights. Congress have used the Commerce Clause many times to try to address social problems; problems that are to big for any one state to handle. Whether the mandate is constitutional or not is best addressing the issue by sending the matter to the Supreme Court. If the Supreme Court would find the law is unconstitutional, it would strict down the law. So, this seems like a road block, a legal roadblock, that this state and other state would prevent enforcement of the mandate. It’s interesting that one of he paragraphs here say, “It is estimated this proposal will have no immediate costs or savings to state or local governmental entities. However, because of the uncertain interaction of the proposal with implementation of the federal Patient Protection and Affordable Care Act, future costs to state governmental entities are unknown.” It seems like this is jumping the gun. Why don’t we wait till we see what to outcome is before we pass a law to outlaw it. We don’t know what to cost is going to be. To me this is more of a political reaction. Lets pass a law supposedly banning or deny the government authority to penalize. I would be concerned about any law that penalize citizens. Obvious to force people to have insurance is no different then the state forcing people you got to have auto insurance. We’re required by law to have insurance and if we don’t have auto insurance we are penalize for it. The concept is the same. The cost of health care is borne by everyone. Just like in automobile accident, if I go out and have and accident and I don’t have insurance, the public end up paying the cost of that accident. If this law is unconstitutional, the Supreme Court will strike it down and the Court has been known to do that. Rosseveltt tried to use the Commerce Clauses to ease the suffering of depression. With congress, he passed a lot of social programs. But the Supreme Court, rightfully or wrongfully, ruled that he overreached his authority to deal with the issue. I will defer to the Supreme Court. Having said that, I just want to say this current Supreme Court would strike it down. This Current Court seems to be less proactive. If it’s not in the enumerated in constitution we’re not going to allow it to happen. So I think the proponents have a better chance at getting this strike down in the Supreme Court. It seems this gives opponents of health care another issue to raise in court because if it doesn’t violate federal law, it violate state law and they can say we have a law on the books that says you can’t do this. If the Supreme Court ruled that is this (the federal mandate) stood the test of the Commerce clause, then this (the prop. C) would be unconstitutional. This is like when the federal government passed the Civil Rights Act and states passed laws saying the federal government can’t force restaurants to let blacks in. When the Supreme Court ruled that that the federal government has that authority, that state laws was preempted. So I think this could be preempted. How could the state prevent the federal government form tax? If the federal government is relaying on the state to enforce the law, you could deny the state from enforcing the law. But the state can’t deny the federal government form enforcing the law.

Damien: You studied federal Nullification in school?

Gaylard: think about what you’re saying here. A state cannot nullify federal law. That’s the whole premise of succession. The whole idea the states left the union was the state can defy federal law. That whole issue was put to rest with the Civil War. The states that came back into the Union said we are gong to follow federal law.

Damien: When you mention this is comparable to auto insurance, the opponents argue that is different then auto insurance because a) the states are doing it and b) you don’t have to drive.

Gaylard: One the states are doing it. Lets say I move and travel somewhere, my insurance should be the same it should be portable. The other question was you don’t have to drive. Well that is true you don’t have to drive. There is never a perfect analogy. Brown v. Board of Education was decided on the fact education if a federal issue. It involved the equal protection clause.

Monday, June 14, 2010

Changes to Miranda rights

Sherry Colb blogs about the recent Supreme Court ruling on Miranda rights. In the Case of Warden v. Thompkins, the Court ruled that when a suspect is being interrogated and wants to insert the right to remain silent, the suspect have to tell the interrogators. In spite of staying silent for most of the time, the police interrogated the suspect for 3 hours until he confessed. Colbs explain the two different views on the right to remain silent. On one view, it’s only the right not to respond, even if the suspect is sitting in the interrogation room for hours. The other view is the right not to respond. The Court believe it’s only the right not to respond. It the suspect wants to remain silent, the suspect have to tell the interrogators that.
I’m diagnosed with autism and I’m concerned what effect this would have on people how are diagnosed with mental disease. Growing up in special needs school, I met a lot of people who could be pressured to talk. In spite of the ruling, I believe every police department should recognize the right not to be interrogated.
In other News, Missouri voters would have the chance to express how they feel about a portion of Obamacare, the mandate to get health insurance. On August 3rd, the would have a chance to vote for Prop. C, stating the federal government does not have the authority force people to get health insurance.