Debate over health care
The editorial "Health mandate's day in court" (Dec. 27) demonstrates knowledge of the Constitution, but also reveals some holes in logic.
Refusing to buy a movie ticket would be "not engaging in a private commercial activity." Refusing to buy health insurance? Not so much. If the health-care system were truly and completely a private commercial activity, providers would have the right to refuse treatment based on inability to pay. We haven't granted them that right because we've determined health care to be a public concern.
Nonparticipation in the health-care system is simply not an option. We're all born participants, whether we like it or not. The bottom line is, if someone receives treatment, someone will pay.
The new law would enable me to pay either with the insurance of my choice or by a constitutionally authorized "tax in order to fund these social needs."
That doesn't sound coercive to me. Besides, government has long been exercising its right to push people into action. Good Samaritan laws and mandatory schooling for minors are two examples.
This editorial may well be correct; the individual mandate to buy health insurance could be struck down by the Supreme Court.
It is the biggest flaw in the health-care legislation, which I generally support.
But I believe it reflects a flawed legislative process. Partisan blockades may well have robbed the nation of ideas that could have produced a better bill. We elect senators and representatives, not Democrats and Republicans.
An individual mandate is actually central to fixing how the health-insurance market works. Insurance companies are not willing (and should not be forced) to offer insurance coverage to anyone who applies, unless all or virtually all are covered.
This is the "deal" President Obama cut with the insurance companies. They had originally complained about the Senate version of the bill because it covered a smaller number of the currently uninsured and so exposed them to a higher likelihood of adverse selection.
With everyone covered and coverage provided at community-determined rates (rather than individual experience rates) insurance companies will compete on the basis of quality of service.
Without the individual mandate, insurance companies will compete against their peers for the lowest risk individuals, leaving many people uninsured, as at present.
David J. Weinschrott
Prodev Associates Ltd.