Let's say I decide not to buy a car. That doesn't make my transportation needs disappear.
I might walk a lot, using sidewalks and streets built with tax dollars, the same byways I'd pound if I rode a bicycle.
I might use city buses or trains, which are subsidized by public dollars.
I might bum rides from friends.
It might look like I'm not participating in our great automobile-driven society. But I'm simply making other choices, which someone is underwriting, not always me.
Or say I do buy a car -- but don't, for whatever reason, purchase required insurance.
If I cause a wreck, I might pay the other driver's expenses out of pocket. But if I can't afford it, the other driver's insurer gets the bill. And someone's premium probably goes up. Though not mine, ha, ha, because I've refused to participate in the government directive.
It's a fallacy to think that individuals who don't pay to play in a major economic activities have no impact and thus shouldn't be forced to get in the game.
Opponents of the new health care law argue that it's an unheard-of expansion of congressional power, an unconstitutional coercion.
Have they never heard of Social Security, which the Supreme Court upheld in 1937?
Health insurance isn't like chewing gum. If I don't buy gum, so what? If I don't buy health insurance, I've made an economic decision with costs and ramifications.
If I'm healthy, I risk that I won't need a doctor, but if I do, I'll be able to pay the bill myself. If I can't pay, maybe I can borrow money. Or maybe I can use the emergency room, and the costs will be absorbed by the hospital, passed on to paying patients or covered by government compensation to the hospital for charitable care.
Of course, if many healthy people take this route, sick people make up a larger proportion of those insured, which drives up everyone's premium to share the risk.
If I'm not so healthy and don't get insurance, chances are greater that I'll wait until I'm sicker to see a doctor, which will make my care more expensive. Or I might rely on a public clinic or ER, where tax dollars will end up paying for some or all of my treatment.
I'm not under the delusion that the new law will magically reduce my healthcare expenses. But it's easy to forget how much the system as it's been costs all of us.
The federal lawsuit that 13 state attorneys general filed Tuesday to challenge the Patient Protection and Affordable Care Act cites several grounds. The one Texas Attorney General Greg Abbott focused on in a recorded interview posted online by Texas Tribune was the "individual mandate."
The new law requires Americans who don't already have health insurance to get it if it's available and affordable -- or pay a tax. The insurance companies wanted this provision if they also were going to have to cover those, including children, with pre-existing conditions.
The Constitution, through the Commerce Clause and tax-and-spend power, allows Congress to require certain behavior, including paying taxes, to promote the general welfare.
But Abbott told the Texas Tribune that it is "unprecedented in American history" for Congress to regulate the activity of people who refuse to buy goods or services.
He's overreaching -- not to mention wasting Texas' taxpayers' money by taking part in this suit when the state faces an $11 billion budget deficit next year.
Seems as though only individuals, not state AGs, have legal standing to object, anyway. Even so, it's hard to argue that people who've redistributed costs, usually to the rest of us, haven't affected the commerce system.
Do we protect their "liberty" in order to maintain a system whose freedoms are hard to see? Where's the freedom in watching premiums soar every year as coverage shrinks?
Where's the freedom in having benefits capped when you face a debilitating disease requiring expensive treatment?
Yale law professor Jack Balkin wrote in the New England Journal of Medicine that to strike down the individual mandate the Supreme Court "would have to reject decades of precedents."
Or maybe the justices could find a new right to opt out of health insurance right there in the Constitution's privacy protections, or in its penumbras and emanations. Wouldn't that be ironic.
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