The FCC has voted to impose so-called "Net Neutrality" rules on the internet [1]. The vote was 3-2, strictly along party lines, with the three Democrats voting in favor. Democrats have also expressed concern that the proposed Net Neutrality rules were too weak and needed to be strengthened [2]. Elsewhere in the media you will undoubtedly find stories proclaiming the goodness of the decision, suggesting that the new regulations will guarantee consumers the "right to view content," prohibit providers from blocking content such as Bittorrent, streaming video, and other high-bandwidth activities [3].
Unfortunately, these proclamations ignore the fundamental problem with Net Neutrality:
The federal government (FCC) has now gifted itself by regulatory fiat the power to regulate the internet without approval from Congress and seemingly in violation of a decision by the 2nd Circuit Court of Appeals earlier this year [4].
The major concern here is that the FCC is imposing regulations to solve a nonexistent problem. Now that the FCC has its foot in the door, what regulations are next? An internet Fairness Doctrine to ensure that all points of view are heard [5]?
When was the last time federal regulations lead to more freedom?
21 December 2010
Individual Responsibility is Doubleplusungood
The Hill has reported that HHS Secretary Kathleen Sebelius and Attorney General Eric Holder penned an op-ed [1] entitled, “Health reform will survive its legal fight,” in response to Judge Hudson’s ruling [2] that the so-called ‘individual mandate’ to purchase private health insurance is unconstitutional, as the activity of not purchasing insurance is not an economic activity that affects interstate commerce. Not surprisingly, Progressives disagree.
In the usual and customary Progressive play to emotion rather than logic, the op-ed opens with a heart-wrenching story about a New Hampshire preschool teacher who, unable to obtain insurance through her employer, put off treating her Lymphoma since the cost of chemotherapy was $16,000 per round. Now, thanks to the PPACA signed by the President in March of this year, the teacher is on an affordable, temporary coverage program that apparently can be used to treat her cancer. I am very sincerely happy that she is receiving treatment, and it is a shame that it had to be delayed due to prohibitive cost and insurance coverage problems.
However, in their attempt to offer the playbook emotional reasoning to wholeheartedly support the PPACA (and any number of other Progressive causes), Sebelius and Holder willfully gloss over a few important details:
1. Not all health insurance must be provided or purchased through an employer. There is (or was) a plethora of individual plans, both temporary and long-term, available for purchase from a range of providers – just check out ehealthinsurance.com if you don’t believe me. Now, before Progressives scream and moan about prohibitively high cost, I will mention that high deductible plans can be purchased for as low as ~ $50. In fact, several plans are available for under $100 a month that offer 20% coinsurance above a yearly deductible of a few thousand dollars, as well as access to in-network rates if you choose a PPO- or network-type plan. Sure, it's not "free," but it would limit the damage considerably in a catastrophe such as this.
On a side note, in consideration of the oft-lauded UK National Insurance (NI) program, the average UK citizen under age 65 and making a salary equivalent to the 'average' American salary of $50,000 per year (32,165 GBP as of 2010) would be expected to pay approximately $4,522 (2,909 GBP) per year towards NI. The employer-covered share would be approximately an additional $5,262 (3,385 GBP) per year for a grand total of $9,784 (6,294 GBP) per year, per employee, for coverage under the UK NI program. This isn't terribly different from the value of a typical American health insurance plan that covers himself plus a spouse at a price of, say ~$12,000. The average American employee pays approximately 28% of such a plan's premium [3],which works out to $3,360 per year, or about $1,100 less than what the UK employee pays for his insurance. (Note that this does not include co-pays, co-insurance, etc. which will be discussed in a future post.)
For all of the noise Progressives make about how wonderful the UK National Insurance program is, one might be lead to think that the British are living in a sort of socialist health care utopia enshrined with golden bed pans and surgeons waiting on every corner. Unfortunately, this isn't true, especially if you're a male with cancer [4] - your chance of survival in the United States is nearly 67%. In England, your survival rate is 45% [5], not to mention you might find yourself neglected by the NI hospital staff and having to find your own source of the rare and difficult to produce pharmaceutical product known as water in the potted plant in the corner of your hospital room [6] [7] [8] [9].
The UK isn't alone in having such deplorable conditions present themselves in local hospital facilities. In 2007, the Washington Post reported on a series of incidents involving rats, feces, and mold [10] infesting a portion of Walter Reed Army Medical Center in Washington, D.C. Unfortunately, this facility is also government operated and doesn't help Progressives' promotion of national public health care. But, then again, I guess it's just not fair that the nonprofit Mayo Clinic, which is routinely ranked among the top 3 health care facilities in the US [11] and is known for providing top quality care for low cost [12], takes all the glory. Anyway, back to the original story...
2. A condition is not considered ‘pre-existing’ so long as the person had some form of health insurance coverage for the six months prior to changing plans, or attempting to buy into an employer-sponsored plan. When you leave a health insurance policy, you will be sent a Certificate of Creditable Coverage – a certification that your health was insured for at least six months prior to your date of departure. You can provide this certificate to your new health insurance provider, who must then accept you in whatever condition you arrive, even with pre-existing conditions. This certificate effectively removes the pre-existing conditions clearing period found at the beginning of most health insurance plans. Since the teacher in this story was unable to obtain employer-sponsored health insurance due to a pre-existing condition, this suggests that she was uninsured at the time that the condition began (and lymphoma is not a life-long condition). Presumably, she was otherwise healthy prior to her diagnosis, and had made the decision to not purchase any form of health insurance. After all, even a $50 a month plan would have severely limited her financial liability for chemotherapy after say a $5000 deductible and 20% coinsurance had been paid – her first round would have cost approximately $7,200, and all subsequent rounds wound have cost $3,200, assuming the provider was approved by her insurance company and did not have a contract for a cheaper rate with the provider. In this scenario, a $50 a month policy could have potentially saved her $36,400 over the cash cost of three chemotherapy rounds.
3. The federal government is not the sole source of funding or treatment for serious medical conditions. The story makes no mention of the woman’s appeals to her local community, her church, family, potential negotiations with local doctors and/or drug companies to provide reduced service costs (which I know first-hand is available for cancer treatment [13]), or other organizations in her state which deal with cancer and/or low-income medical treatment. Had she thought of contacting the Huntsman Cancer Institute? John Huntsman is a self-made billionaire and a seemingly reasonable, caring, and motivated individual. After all, he has donated most of his wealth to charitable causes. Instead, the story describes how this teacher’s life was saved when the federal government rode in on a white horse, with the name “taxpayer” written on its thigh.
To take this even further, the story continues by expressing how the right’s attack on the “individual responsibility [to purchase basic health insurance]” is ill-fated because we each have a responsibility to each other, by way of shared medical expenses (expressed as an additional $1,000 that each insured pays per year to support the uninsured). Call me crazy, but what part of being forced to purchase a private insurance policy under threat of a fine is “individual responsibility”? Wouldn’t “individual responsibility” be when the individual takes responsibility for their own individual health and chooses whether or not to spend the money to insure it? Certainly not! The term "individual responsibility" in this article is simply Progressive-speak (similar to Newspeak [14]) for collective responsibility, or in other words, socialism. I would venture that Madison, Franklin, and the like would find this new responsibility doubleplusungood.
The article goes on to say,
In the usual and customary Progressive play to emotion rather than logic, the op-ed opens with a heart-wrenching story about a New Hampshire preschool teacher who, unable to obtain insurance through her employer, put off treating her Lymphoma since the cost of chemotherapy was $16,000 per round. Now, thanks to the PPACA signed by the President in March of this year, the teacher is on an affordable, temporary coverage program that apparently can be used to treat her cancer. I am very sincerely happy that she is receiving treatment, and it is a shame that it had to be delayed due to prohibitive cost and insurance coverage problems.
However, in their attempt to offer the playbook emotional reasoning to wholeheartedly support the PPACA (and any number of other Progressive causes), Sebelius and Holder willfully gloss over a few important details:
1. Not all health insurance must be provided or purchased through an employer. There is (or was) a plethora of individual plans, both temporary and long-term, available for purchase from a range of providers – just check out ehealthinsurance.com if you don’t believe me. Now, before Progressives scream and moan about prohibitively high cost, I will mention that high deductible plans can be purchased for as low as ~ $50. In fact, several plans are available for under $100 a month that offer 20% coinsurance above a yearly deductible of a few thousand dollars, as well as access to in-network rates if you choose a PPO- or network-type plan. Sure, it's not "free," but it would limit the damage considerably in a catastrophe such as this.
On a side note, in consideration of the oft-lauded UK National Insurance (NI) program, the average UK citizen under age 65 and making a salary equivalent to the 'average' American salary of $50,000 per year (32,165 GBP as of 2010) would be expected to pay approximately $4,522 (2,909 GBP) per year towards NI. The employer-covered share would be approximately an additional $5,262 (3,385 GBP) per year for a grand total of $9,784 (6,294 GBP) per year, per employee, for coverage under the UK NI program. This isn't terribly different from the value of a typical American health insurance plan that covers himself plus a spouse at a price of, say ~$12,000. The average American employee pays approximately 28% of such a plan's premium [3],which works out to $3,360 per year, or about $1,100 less than what the UK employee pays for his insurance. (Note that this does not include co-pays, co-insurance, etc. which will be discussed in a future post.)
For all of the noise Progressives make about how wonderful the UK National Insurance program is, one might be lead to think that the British are living in a sort of socialist health care utopia enshrined with golden bed pans and surgeons waiting on every corner. Unfortunately, this isn't true, especially if you're a male with cancer [4] - your chance of survival in the United States is nearly 67%. In England, your survival rate is 45% [5], not to mention you might find yourself neglected by the NI hospital staff and having to find your own source of the rare and difficult to produce pharmaceutical product known as water in the potted plant in the corner of your hospital room [6] [7] [8] [9].
The UK isn't alone in having such deplorable conditions present themselves in local hospital facilities. In 2007, the Washington Post reported on a series of incidents involving rats, feces, and mold [10] infesting a portion of Walter Reed Army Medical Center in Washington, D.C. Unfortunately, this facility is also government operated and doesn't help Progressives' promotion of national public health care. But, then again, I guess it's just not fair that the nonprofit Mayo Clinic, which is routinely ranked among the top 3 health care facilities in the US [11] and is known for providing top quality care for low cost [12], takes all the glory. Anyway, back to the original story...
2. A condition is not considered ‘pre-existing’ so long as the person had some form of health insurance coverage for the six months prior to changing plans, or attempting to buy into an employer-sponsored plan. When you leave a health insurance policy, you will be sent a Certificate of Creditable Coverage – a certification that your health was insured for at least six months prior to your date of departure. You can provide this certificate to your new health insurance provider, who must then accept you in whatever condition you arrive, even with pre-existing conditions. This certificate effectively removes the pre-existing conditions clearing period found at the beginning of most health insurance plans. Since the teacher in this story was unable to obtain employer-sponsored health insurance due to a pre-existing condition, this suggests that she was uninsured at the time that the condition began (and lymphoma is not a life-long condition). Presumably, she was otherwise healthy prior to her diagnosis, and had made the decision to not purchase any form of health insurance. After all, even a $50 a month plan would have severely limited her financial liability for chemotherapy after say a $5000 deductible and 20% coinsurance had been paid – her first round would have cost approximately $7,200, and all subsequent rounds wound have cost $3,200, assuming the provider was approved by her insurance company and did not have a contract for a cheaper rate with the provider. In this scenario, a $50 a month policy could have potentially saved her $36,400 over the cash cost of three chemotherapy rounds.
3. The federal government is not the sole source of funding or treatment for serious medical conditions. The story makes no mention of the woman’s appeals to her local community, her church, family, potential negotiations with local doctors and/or drug companies to provide reduced service costs (which I know first-hand is available for cancer treatment [13]), or other organizations in her state which deal with cancer and/or low-income medical treatment. Had she thought of contacting the Huntsman Cancer Institute? John Huntsman is a self-made billionaire and a seemingly reasonable, caring, and motivated individual. After all, he has donated most of his wealth to charitable causes. Instead, the story describes how this teacher’s life was saved when the federal government rode in on a white horse, with the name “taxpayer” written on its thigh.
To take this even further, the story continues by expressing how the right’s attack on the “individual responsibility [to purchase basic health insurance]” is ill-fated because we each have a responsibility to each other, by way of shared medical expenses (expressed as an additional $1,000 that each insured pays per year to support the uninsured). Call me crazy, but what part of being forced to purchase a private insurance policy under threat of a fine is “individual responsibility”? Wouldn’t “individual responsibility” be when the individual takes responsibility for their own individual health and chooses whether or not to spend the money to insure it? Certainly not! The term "individual responsibility" in this article is simply Progressive-speak (similar to Newspeak [14]) for collective responsibility, or in other words, socialism. I would venture that Madison, Franklin, and the like would find this new responsibility doubleplusungood.
The article goes on to say,
Opponents claim the individual responsibility provision is unlawful because it 'regulates inactivity.' But none of us is a bystander when it comes to health care. All of us need health care eventually. Do we pay in advance, by getting insurance, or do we try to pay later, when we need medical care?
Excuse me, but what business is it of the federal government's to decide whether or not I am a 'bystander' when it comes to health care? Are we to assume that Holder and Sebelius are correct in asserting that the only two possible options are either to "pay in advance, by getting insurance," or "try" to pay for our medical care later, when we need it? Who the hell are they to assume that it's only an insurance policy that pays the bill and that the individual can't be responsible enough to plan ahead and negotiate with our doctors for reasonable fees in advance? Of course, reduced flat rates offered by private doctors geared to the uninsured have already been attempted in New York, but were shut down by state bureaucrats who claimed the business was attempting to operate as an insurance company - and insurance regulatory law simply won't allow it [15] [16].
The article continues,
The article continues,
The individual responsibility provision says that as participants in the health-care market, Americans should pay for insurance if they can afford it. That's important because when people who don't have insurance show up at emergency rooms, we don't deny them care. The costs of this uncompensated care - $43 billion in 2008 - are then passed on to doctors, hospitals, small businesses and Americans who have insurance.
As two federal courts have already held, this unfair cost-shifting harms the marketplace. For decades, Supreme Court decisions have made clear that the Constitution allows Congress to adopt rules to deal with such harmful economic effects, which is what the law does - it regulates how we pay for health care by ensuring that those who have insurance don't continue to pay for those who don't.
Holder and Sebelius are correct in stating that emergency rooms don't deny care to anyone who enters - the federal government made sure of that in the Emergency Medical Treatment and Active Labor Act of 1986 [17], when the Congress mandated that emergency rooms treat everyone regardless of ability to pay. Have you ever wondered why being treated for uncontrollable nausea and vomiting at 2:00 am cost you $1,800? Why it's because the ten year old child with an ear infection was brought in by his parents (who are quite possibly in the United States illegally [18] [19] [20]) rather than to a regular doctor or urgent care clinic the following morning because they know they won't be forced to pay for the service, thanks to federal legislation.
A more shining example of the federal government riding to the rescue to solve a problem that it created is hard to come by. Fortunately, rather than allowing hospitals as private businesses to decide which medical conditions to treat on an emergency basis and which to deny and send elsewhere for treatment, Holder and Sebelius have proposed the ultimate bureaucratic solution to the problem - you must buy health insurance. How, you ask, will this prevent runaway health care costs due to unpaid emergency room visits? Nobody knows, including the government, but is sure sounds good, doesn't it?
In closing, Holder and Sebelius make the statement,
A more shining example of the federal government riding to the rescue to solve a problem that it created is hard to come by. Fortunately, rather than allowing hospitals as private businesses to decide which medical conditions to treat on an emergency basis and which to deny and send elsewhere for treatment, Holder and Sebelius have proposed the ultimate bureaucratic solution to the problem - you must buy health insurance. How, you ask, will this prevent runaway health care costs due to unpaid emergency room visits? Nobody knows, including the government, but is sure sounds good, doesn't it?
In closing, Holder and Sebelius make the statement,
It's not surprising that opponents, having lost in Congress, have taken to the courts. We saw similar challenges to laws that created Social Security and established new civil rights protections. Those challenges ultimately failed, and so will this one.Yes, similar challenges were brought against the Social Security Act of 1935, a part of the New Deal brought by FDR, one of America's most Progressive presidents. Several pieces of New Deal legislation were determined to be unconstitutional by the Supreme Court, only to be rewritten and eventually found to be constitutional in the same year that FDR threatened to stack the court [21].
Since the Progressive Era of the 1920's and up through FDR's death, Progressives have long held that the Congress has the authority and the moral responsibility to legislate social programs such as Social Security, Medicare, and Medicaid. This marked a stark change of course in jurisprudence prior to ~1920 and it is clear that the Constitution was never intended to provide the Congress with such broad social authority - during James Madison's tenure as the fourth President of the United States, he vetoed a bill which the Congress had sent to him entitled, "An act to set apart and pledge certain funds for internal improvements." The bill had intended to construct roads and waterways to promote and secure commerce within the states and to improve the cost effectiveness of 'the common defense.'
In Madison's rejection of the bill on March 3, 1817, he, as the former principle author of the Constitution, opined,
The legislative powers vested in Congress are specified and enumerated in the eighth section of the first article of the Constitution, and it does not appear that the power proposed to be exercised by the bill is among the enumerated powers, or that it falls by any just interpretation with the power to make laws necessary and proper for carrying into execution those or other powers vested by the Constitution in the Government of the United States.
"The power to regulate commerce among the several States" can not include a power to construct roads and canals, and to improve the navigation of water courses in order to facilitate, promote, and secure such commerce without a latitude of construction departing from the ordinary import of the terms strengthened by the known inconveniences which doubtless led to the grant of this remedial power to Congress.
To refer the power in question to the clause "to provide for common defense and general welfare" would be contrary to the established and consistent rules of interpretation, as rendering the special and careful enumeration of powers which follow the clause nugatory and improper. Such a view of the Constitution would have the effect of giving to Congress a general power of legislation instead of the defined and limited one hitherto understood to belong to them, the terms "common defense and general welfare" embracing every object and act within the purview of a legislative trust. It would have the effect of subjecting both the Constitution and laws of the several States in all cases not specifically exempted to be superseded by laws of Congress... [emphasis mine] [23]Could the "Father of the Constitution" have been any more clear? The passage of such a social works program, he found, would have the effect of "giving to Congress a general power of legislation instead of the defined and limited one hitherto understood to belong to them." Evidently, Madison simply didn't understand just how important and morally obligated the federal government's public works program would be to the People of the United States.
In light of such a profound opinion clearly defining the Constitution's provision of Congressional powers, by none other than the author of the Constitution himself, it should be unequivocally insulting that the Congress has passed legislation creating Social Security, Medicare, and any other of the thousands of public and social works legislative disasters we live under today.
Who then, Progressives might ask, will come riding to the rescue of the poor, down-trodden American citizen who needs these social programs? In Madison's day, as it should be in ours, the answer would have been wholly embodied in two simple words: individual responsibility.
In love of liberty,
The Bulletproof Patriot
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