Conservatives, under what conditions would you allow universal coverage?

Newtons Bit said:
Why? Can't an insurer be localized to one state and that one state only? How does interstate commerce have anything to do with that?
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It's possible that an insurer could behave that way, there just aren't any. If they just regulated those that engage in interstate business, that would be enough.

I would like to hear an explanation of how insurers that do business all over the country aren't part of interstate commerce.

Newtons Bit said:
It bugs me with the Interstate Commerce clause is thought to be an all-inclusive clause dealing with any and all business. It's not supposed to be that way. The original intent, and the older definition of the word, was exclusively about goods and services travelling from state to other states. It's been so thoroughly abused, such as with the Gun Free School Zone Act that it doesn't mean anything anymore. It's just carte blanche for the government to do whatever the hell it wants to.
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The gun act was ruled unconstitutional on commerce clause grounds. IT was then re-written to be in accordance with the law and has yet to be challenged.

These are all just battles against modernity. The Founders simply did not contemplate the degree to which commerce would ignore borders. The Commerce Clause has been increasingly broadly interpreted because commerce has become increasingly interstate, hell, it's international, now.
 
Here's the plain language of the taxing and spending clause:

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;
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http://en.wikipedia.org/wiki/Taxing_and_Spending_Clause

They lay out types of taxes and explain what they can be used for: pay debts, provide defense and general welfare.

It's broadly written and has been broadly interpreted since the 1930's (and Hamilton argued for this interpretation). You can disagree on a substantive level, but there is a long Constitutional tradition of interpreting the clause that way.

This means that the argument needs to be made on the merits. People can't just hide behind some inchoate notion of "Constitutionality."
 
TraneWreck said:
It's possible that an insurer could behave that way, there just aren't any. If they just regulated those that engage in interstate business, that would be enough.
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New Mexico has at least one New-Mexico-Only insurance/hospital service. They're non-profit, but the founders still manage to make a ton of money.

I would like to hear an explanation of how insurers that do business all over the country aren't part of interstate commerce.
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Their products don't cross boundaries. They're sold to people living in a state. They're never put on a wagon, boat, truck or boat. Unless you count the paper they're printed on anyways.

The gun act was ruled unconstitutional on commerce clause grounds. IT was then re-written to be in accordance with the law and has yet to be challenged.
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Yes, but it was re-written in such a way that it's now on the criminal court to determine if interstate commerce was interfered with. It's an even more ludicrous law.

These are all just battles against modernity.
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Careful now, you'll add fuel to the fires burning in the south-west with that straw.

The Founders simply did not contemplate the degree to which commerce would ignore borders.
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Uhh, what? People sold goods back and forth between the States in the 1790's. The commerce clause was but in the Constitution to prevent things like a state putting tariff on goods from another state. It had nothing to do with OSHA or medical care or any activity that actually took place inside of a state.

The Commerce Clause has been increasingly broadly interpreted because commerce has become increasingly interstate, hell, it's international, now.
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The Constitution specifically gives the power to regulate international commerce:

Article I, Section 8, Clause 3:
To regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes;
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That doesn't mean the Constitution grants Congress the power to enforce OSHA standards worldwide just because international commerce is prevalent. It was written so that the United States would have a singular foreign trade policy (that may or may not include tariffs).
 
Newtons Bit said:
New Mexico has at least one New-Mexico-Only insurance/hospital service. They're non-profit, but the founders still manage to make a ton of money.
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These are small insurers. As I said, if that rule didn't apply to local insurers, it would still create universal insurance. Finding a handful of insurers that stay within a state boundary doesn't mean those that cross the border can't be regulated.


Newtons Bit said:
Their products don't cross boundaries. They're sold to people living in a state. They're never put on a wagon, boat, truck or boat. Unless you count the paper they're printed on anyways.
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Really? This is the 21st century. We should realize that "commerce" involves more than just physical products.

When a Wall Street Trader buys stock in a California corporation with a computer, is that an interstate transaction?


Newtons Bit said:
Yes, but it was re-written in such a way that it's now on the criminal court to determine if interstate commerce was interfered with. It's an even more ludicrous law.
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Maybe, but it hasn't been challenged. The Constitutionality is up in the air. If you're that upset by it and think we need to get some guns closer to schools, go ahead and file a lawsuit. I'm sure the NRA will jump on board.


Newtons Bit said:
Careful now, you'll add fuel to the fires burning in the south-west with that straw.
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I don't think you understand what a straw man is.

This is the basis of a great deal of right wing consternation over the Constitution. Why would we expect a bunch of 18th century people to write laws that could deal with the internet or cars or new medical technology? It's ridiculous.

And, I might add, when it serves the interest of the right, you never see these originalist arguments. Are you upset that the Contract Clause applies contract law from 2011, not 1787?



Newtons Bit said:
Uhh, what? People sold goods back and forth between the States in the 1790's. The commerce clause was but in the Constitution to prevent things like a state putting tariff on goods from another state. It had nothing to do with OSHA or medical care or any activity that actually took place inside of a state.
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So the law didn't have to with things that wouldn't exist for a century? What a bold analysis.

The Commerce Clause was written in a world where the states had a great deal more autonomy and a great deal less interaction than they do today. These relationships were fundamentally altered after the Civil War. We tried operating a country the way you're suggesting and it failed miserably.

Newtons Bit said:
The Constitution specifically gives the power to regulate international commerce:
That doesn't mean the Constitution grants Congress the power to enforce OSHA standards worldwide just because international commerce is prevalent. It was written so that the United States would have a singular foreign trade policy (that may or may not include tariffs).
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Cause you say so? Unfortunately for you the Supreme Court thinks you're wrong. Sorry.
 
Grizzly Adams said:
I can't state there are any laws of the Universe/economics that state any such scheme must be bad. I could imagine some variety where everyone must pay something, a capitation tax of sorts, and each visit is accompanied by a co-pay or each procedure is paid in part by the patient (a percentage of the cost, capped at a certain dollar amount adjusted annually for inflation, maybe).

I guess I'd have to see the specifics.
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Well what specifics? Do you have any idea what you'd want to see in a universal system that would make you want it? Could such a thing exist?

I don't think you've answered the question.


I do, however, have an exceedingly difficult time accepting the proposition that the simple fact that I exist obligates you to donate to me your labor, especially if I am an able-bodied adult. Should you choose to voluntarily contribute to my well-being that should be your choice.
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But you have that already. The Simple fact that they exist means that your taxes contribute to their welfare, to the roads they drive on, the water they drink, the pavements they walk on. All paid for by you solely because they exist. You do it already, why do you baulk at this point?


Note that this is not the same as wanting to see people die in the streets. Note that this is not the same as simply being selfish and saying "screw you" to everyone else. It's a logical result of a rational belief that a person owns his labor and no one else is entitled to it for their own personal gain.
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This one's fairly straightforward if there's no UHC:


Either

a) You pay emergency rates for the very, very ill to stop them dying for lack of medical care. This is either paid for by taxes or the medical providers just have to write it off as a bad loss (possibly against tax)

or

b) You have people dying for lack of widely available medical care, possibly literally in the streets.


That's it. They are the options. The only way to ensure that people bear at least part of the risk we all run of getting ill is universal health care of some sort.
 
RecoveringYuppy said:
Did any conservatives actually show up and answer? Sorry, if my contribution turned in to a derail. I should have been posting in "Liberals, under what conditions would you oppose universal care?"
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I consider myself to be a conservative, and I have expressed the opinion that the real problem, high health care costs, is not addressed by universal health care. I'm not opposed to universal health care in principle, nor to the idea that everyone must participate (it wouldn't work, otherwise).

I still have a hospital bill from the early seventies when I had an in-patient procedure to remove splinters from my leg. I was in the hospital for three days, and the total bill was one hundred twenty-five dollars. Insurance paid a hundred of that.

The skills and equipment required to perform such an operation have hardly changed since then, but now the $125 wouldn't even cover the x-ray. Ridiculous.
 
aggle-rithm said:
I consider myself to be a conservative, and I have expressed the opinion that the real problem, high health care costs, is not addressed by universal health care. I'm not opposed to universal health care in principle, nor to the idea that everyone must participate (it wouldn't work, otherwise).

I still have a hospital bill from the early seventies when I had an in-patient procedure to remove splinters from my leg. I was in the hospital for three days, and the total bill was one hundred twenty-five dollars. Insurance paid a hundred of that.

The skills and equipment required to perform such an operation have hardly changed since then, but now the $125 wouldn't even cover the x-ray. Ridiculous.
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So now the dollars are worth less, largely because the US Gov has been printing dollars to pay for free stuff like in patient procedures such as yours but for people who get it for free.

And with today's dollars worth less, you need more of them to buy the same medical procedure as in the 1970s.

DUHHH!!!!!!!
 
mhaze said:
So now the dollars are worth less, largely because the US Gov has been printing dollars to pay for free stuff like in patient procedures such as yours but for people who get it for free.

And with today's dollars worth less, you need more of them to buy the same medical procedure as in the 1970s.

DUHHH!!!!!!!
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Yes, I know there's such a thing as inflation...

but if the value of the dollar were the only determining factor, then milk would be $50 a gallon.
 
aggle-rithm said:
I consider myself to be a conservative, and I have expressed the opinion that the real problem, high health care costs, is not addressed by universal health care. I'm not opposed to universal health care in principle, nor to the idea that everyone must participate (it wouldn't work, otherwise).

I still have a hospital bill from the early seventies when I had an in-patient procedure to remove splinters from my leg. I was in the hospital for three days, and the total bill was one hundred twenty-five dollars. Insurance paid a hundred of that.

The skills and equipment required to perform such an operation have hardly changed since then, but now the $125 wouldn't even cover the x-ray. Ridiculous.
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Just curious, why don't you think UHC will address costs? The US already has the most expensive health care in the world. In every country with UHC, people pay much less, and with a couple exception, less taxes to healthcare.
 
rustypouch said:
Just curious, why don't you think UHC will address costs? The US already has the most expensive health care in the world. In every country with UHC, people pay much less, and with a couple exception, less taxes to healthcare.
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I think the bolded bit is wrong. I think, per capita, the US pays more than the UK for public health. The difference is that the average US taxpayer can't access the healthcare their taxes have paid for.
 
rustypouch said:
Just curious, why don't you think UHC will address costs?
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Because absolutely nothing is being done to address costs. There are a few token measures in the health care bill, but none of them are any more than a symbolic pilot program.

I urge you to pick up a copy of this month's Scientific American, and read the article called "The Best Medicine" by Sharon Begley. There's a very brief teaser online here: http://www.scientificamerican.com/article.cfm?id=the-best-medicine-july-11

Basically, we spend lots of money on expensive treatments that are no better and sometimes worse than far cheaper alternatives.

The results, announced in December 2002, were stunning: the oldest and cheap­est of the drugs, known as thiazide-type diuretics, were more effective at reducing hypertension than the newer, more expensive ones. Furthermore, the diuretics, which work by ridding the body of excess fluid, were better at reducing the risk of developing heart failure, of being hospitalized and of having a stroke. ALLHAT was well worth its premium cost, argued the National Heart, Lung, and Blood Institute (nhlbi), which ran the trial. If patients were prescribed diuretics for hypertension rather than the more expensive medications, the nation would save $3.1 billion every decade in prescription drug costs alone—and hundreds of millions of dollars more by avoiding stroke treatment, coronary artery bypass surgery and other consequences of high blood pressure.
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3point14 said:
I think the bolded bit is wrong. I think, per capita, the US pays more than the UK for public health. The difference is that the average US taxpayer can't access the healthcare their taxes have paid for.
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Indeed. I did not phrase it well. I blame Monday morning.
 
Newtons Bit said:
Wait, what? Congress does have the authority to enforce OSHA regulations worldwide? I'm a bit confused.
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Misread your post, my apologies. I thought you were talking about interstate, not international regulation.

Of course, that analogy breaks down because the United States doesn't have regulatory control over other countries. If they wanted to enforce OSHA standards through the provisional authority in Iraq, I certainly think they could, hell, they could even assert the ability to do so in France, but France would say, "uh, no thanks."

Recall that this sort of "nullification" led to a conflict that made clear how the federal-state relationship was supposed to work.
 
Well I know the first thing I think of when I think of UHC is slavery.
 
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