This is a sad week in the history of the United States, as both the President and the United States Congress passed a bill that is both unconstitutional, and does not represent the will of the people. While the President's disdain for the will of sixty percent (more or less, depending on who you ask) of the American people is not new, I was surprised that the holdout Democrats were bought off so easily. My hope is that the electorate will keep this in mind in November, and send the incumbents packing. But while I am unhappy with the Government ignoring the will of the people, my largest concern is that much like some of the other legislation within the past decade, this legislation appears to not be constitutional. It appears that Congress no longer cares about the Constitutionality of what they produce. Since when can the government require an individual to enter into a contract with another entity, merely because the individual happens to be alive? Worse, the contract must be made with an insurance company that has been
approved by the government to be on the insurance exchange. So much for freedom of association.
And then there is the taxation issue. There will be a tax imposed by the Internal Revenue Service if an individual does not purchase insurance. It is not a tax on income, a duty, a direct tax based on the census, and it is not uniform throughout the United States. I seem to have missed the section of the Constitution that permits this sort of tax. And unlike a fine for a criminal or civil act, this is imposed by the Executive Branch and not the Judicial Branch. Congress could have gotten the same effect legally by raising tax rates across the board, and then giving a deduction if one had insurance. But as it stands, the bill does not appear to be consistent with the Constitution.
Then there is the issue of the perks for individual states. Section 8 of the Constitution permits Congress the ability to provide for the common defense and general welfare. But specifically saying that the states have to pay for specific states (e.g. Louisiana and Nebraska) hardly seems to be the general welfare.
As much as I hate the concept of "single payer" health insurance, I think that expanding Medicare to everyone would have been more consistent with the Constitution than the abomination that Congress just passed. At least there could be a claim that the Congress was exercising its right to provide for the general welfare. Telling individuals, "you must do business with one of these five companies" is so ridiculous.
As a small business owner, I am extremely upset with this legislation. I have a decent health care policy right now that I pay for as an individual. However, if the government deems policy renewals to be "new policies", I will be forced to purchase a government approved policy (a "qualified plan" according to Section 1301) on the government exchanges. The Health and Human Services Secretary gets to define what goes into a "qualified plan", and who knows how much these qualified plans will cost. And that small business tax credit in Section 1421? Totally useless to most of the small businesses in my field.
Plus, you can't add "thirty million" people to the health care rolls while at the same time reducing payments to Doctors. If supply does not go up, and prices can't go up, then quality either goes down or becomes non-existent.
November is a little over five months away. I will be voting against anyone who voted for this bill, which includes Rep. Dingell, Sen. Levin, and Sen. Stabenow. Here are the Michigan representatives who voted yes for this bill:
- John Conyers
- John Dingell
- Dale Kildee
- Carolyn Kilpatrick
- Sander Levin
- Gary Peters
- Mark Schauer
- Bart Stupak
In case anyone wants to peruse this bill, here is a link to the Congressional Research Service
summary on Thomas.
Also, one random provision in the bill that I found interesting was a prohibition (with some exceptions) for new physician-owned hospitals to participate in Medicare. Apparently, this has been controversial since 2003, since these hospitals tend to specialize in specific areas (such as orthopedics or rehab), and then standard community hospitals end up with a higher percentage of routine care cases. The American Hospital Association (which represents the big hospital chains) sees this as a threat, and with 73% of their contributions going to the Democrats, the Democrats decided to give them a gift.
