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Success! Kansas voters overwhelmingly approved Constitutional Amendment Question No. 2 yesterday!
Mental illness is no longer equated with crime in the state constitution!
Article 5, section 2 of the Kansas Constitution now reads:
Disqualification to vote. The legislature may, by law, exclude persons from voting because of mental illness or commitment to a jail or penal institution. No person convicted of a felony under the laws of any state or of the United States, unless pardoned or restored to his civil rights, shall be qualified to vote.
The state constitution thus obviously authorizes the state legislature to disenfranchise anyone who is being treated for any mental illness diagnosed by a properly licensed medical provider--even common depression or "religious psychosis" (a daignosis some would apply to anyone who is serious about religion). But just as disturbing is the fact that this constitutional provision also includes all mental illnesses in the same class as crimes. That is, it treats all mental illnesses as ongoing crimes, punishable, should the legislature so choose, by the loss of the right to vote.
The mischief that might be possible under the current langauge in only a slightly more toxic political climate is also noteworthy. The same legislature that could deny psychiatric patients the vote because they are diagnosed (for legitimate therapeutic reasons) with schizophrenia or common depression could also deny the vote to citizens who are diagnosed by properly-qualified medical personnel for political reasons with such contrived maladies as "religious psychosis," "pathological socialist thought disorder" (remember the McCarthy era?) or "homosexual behavior disorder." I consider leaving this invitation in the state constitution dangerous.
However, Constitutional Amendment Question No. 2 will give Kansas voters the opportunity to remove the words "mental illness or" from this section of the Kansas Constitution, and so to remove mental illness from the same constitutional class as crime.
It's about time. Vote yes on Ballot Question No. 2.
Further information about the ballot question can be found in this Ballotpedia article.
It's not hard to answer the question the press has been raising in recent weeks about why the Obama coalition collapsed. It collapsed because it abandoned its foundation of actually trying to collaborate WITH the public.
During the campaign and the transition, the emphasis was on networks of small, local groups that asked for input on major public issues and gave the appearance (false, as it turned out) of actually tring to listen to public input. The form of the campaign and transition got large nmbers of people to work for the President by giving the foot soldiers an effective illusion of real influence. It appeared the candidate, later the President-elect, was actually listening.
But something went wrong shortly after the inauguration. The President stopped listening, even to the public input he had appeared to receive so well before the inauguration. On issue after issue, once Congress was in session, he preferred politics as usual--though with a Democratic majority that hasn't been seen in some years--over the real change in the very way of doing things in Washington he had previously seemed to promise. Admittedly, he was aided in reneging on his apparent promise by a Senate which could not do ANYTHING without 60 votes, where the President's party only had 59. Nevertheless, he stopped listening.
This is not to say that the local groups were disbanded. No, they were preserved, to the extent they could be held together, and the individuals who had enrolled in them to this day continue to receive several e-mails per week urging them to contribute money or contact members of Congress to implement the President's program. (I know. I receive these e-mails!) But the President has quit listening to the small groups, and now focuses on his party's corporate benefactors.
One result of this has been an economic recovery program that very quickly stopped trying to help distressed individuals in favor of an application of the Democratic version of trickle-down economics. The underlying theory of the Democratic version of trickle-down is the same as the Republican version--if we give enough money to our big corporate friends, eventually they will let some of it trickle down to create some jobs. Only the list of big corporate friends and the preferred means of making the gift differ, a little bit, between the two parties. (Republicans tend to favor relieving their friends of taxes others pay, whereas Democrats tend to favor taxing everyone and giving the money back to their friends directly). The problem with trickle-down, in either partisan form, is that the bigh corporate friends of those in power are only too happy to use the money to create jobs in other countries, where labor is cheaper. So the effort to build employment through trickle-down is doomed to failure until American labor "catches down" with labor in the Third World. This is not what the President's supporters wanted, if he had really been listening two years ago.
Another result of this was the health care reform package that was actually enacted. While it has many good aspects, fundamentally it is designed not to provide affordable health care to normal people but to guarantee the profits of the health insurance industry. Its centerpiece is its requirement that everyone buy the health insurance industry's product after 2013. The industry, meanwhile, is to be left free to collusively set the price of that product. (The indutry kept its anitrust law exemption). This also is not exactly what most of the President's supporters expected two years ago.
These are only two examples of politics as usual winning out, and the President not listening to the people who elected him. It is not hard to see why his defunct coalition is not helping him keep control of Congress this year.
This posting is in response to the Yahoo Finance article entitled "The Middle Class in America is Radically Shrinking. Here are the Stats to Prove it." The problem identified is that the American middle class is disappearing, resulting in a polarization of the US population into the very rich 1 or 2 percent and the 99 percent poor service sector servants. The Yahoo commentator, it seems to me, has a part of the cause right, but has not completely identified the causes. The prmary cause, as I see it, is the transition from the historic situation in which the economy was run by rich people to the current situtation in which the economy is run by rich corporations.
There was a reason the framers of the Constitution, and nearly everyone in the Federal and various state governments in the U.S. until about 1870, deeply distrusted corporations. In the early days of our republic, corporations could be created only by a special act of Congress or a state legislature, and were created only for carefully limited purposes for a set period of years. The framers distrusted corporations because they are not human. Individual wealthy people, like the framers of the Constitution themselves (all of whom were wealthy and influential men) have consciences and normal human ties to their community and nation. Corporations are artificial people that have no conscience, no ties to the community, and no motives except their own continued existence, expanding power, and, above all, profit. We are seeing the fruit of going completely and unreservedly corporate in the destruction of our middle class and the impoverishment of almost all of us for the benefit of immortal corporations.
See my Warning Concerning Idolatry, first posted October 8, 2000, for a related warning about trust in corporations. I've been saying this for some time!
sadMy constitutional question is this: Is it within the enumerated powers of Congress to delegate to a group of private corporations the power to lay and collect a Federal tax for their own benefit?
Now that all proposals for real health care reform are officially dead, I will raise a constitutional question that I would not have dared to raise while there was still any chance of real reform. I support real reform, and would not wish my constitutional question to prevent it from occurring.
It seems to me that all of the proposals that were on the table after the death of the public option, by requiring almost everyone to purchase health insurance from private corporations, created taxes for the benefit of those private corporations--the health insurance companies. That the payment of premiums was to have been, in effect, a tax for the benefit of the insurance companies is demonstrated by the fact that, under all proposals, nonpayment of premiums was to be subject to punishment by the federal government, starting with administrative monetary penalties (collected by the IRS!) and progressing to the threat of criminal prosecution and imprisonment. The political rhetoric often likened the tax to the requirement to maintain proof of insurance to be licensed to drive. However, that analogy breaks down because no one is actually REQUIRED to maintain auto liability insurance on threat of criminal penalty. One only need maintain auto insurance if one chooses to drive--and it is possible to live without driving (many people do it). The health insurance tax was to be made a condition of simply living. The choice not to drive is not at all analogous to the choice to commit suicide.
I will grant that such a tax for the benefit of the insurance companies by itself would clearly have been within the powers of Congress under its taxing power (Art. I, sec. 8, cl. 1) and the "necessary and proper" clause (Art. I, sec. 8, cl. 18) IF the proposal had been for the Federal government to collect a tax, in an amount set by Congress, and pay the proceeds over to the health insurance companies to provide coverage.
However, none of the proposals that died after the Senatorial election in Massachussetts did this. Instead, all of them merely required individuals to pay the insurance companies directly, in an amount to be determined by the insurance companies themselves. Moreover, the insurance companies and their premium-setting processes would remain regulated by state law, rendering the amount of this tax geographically non-uniform. But the most potent objection to this arrangement is simply that it would have given the insurance companies, private entities, the power to determine the amount of the tax without any further action on the part of Congress, that is, the power to lay and collect a tax enforced by the federal government.
According to Article I, Section 8, Clause 1 of the Constitution:
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...
The Constitution gives the power to lay and collect taxes to Congress--and only to Congress. The Sixteenth Amendment gave Congress the power (formerly denied it by Art. I, sec. 9, cl. 4) to impose proportional income taxes on individuals, but it did not change the fundamental principle that only Congress may lay and collect Federal taxes. Neither did it change in any way the requirement of Art. I, sec. 7, cl. 1, that all bills for raising revenue must originate in the House of Representatives and be concurred in by the Senate. So bills setting tax rates are to originate in the House, also pass the Senate, and be signed by the President or enacted by Congress over his veto. (Art. I, sec. 7, Cl. 3).
Congress has in the past on several occasions attempted to delegate some of its Constitutional powers to the Executive Branch, and been rebuked by the Supreme Court for attempting to do so. Perhaps most relevant to this discussion is the Supreme Court's opinion in Clinton v. City of New York, 524 U.S. 417 (1998), in which the Court invalidated the Line Item Veto Act--which directly involved Congress' powers to raise and spend money--as impermissibly delegating Congressional powers to the President.
If Congress may not delegate a part of its power to spend tax revenues to the President, it seems inconceivable that the courts would permit it to delegate a part of both its taxing and spending power to private corporations that are not subject to the will of the electorate at all. (Remember the great slogan of the Revolution: "Taxation without representation is tyranny!")
These constitutional objections would be competely eliminated by going to a Federal single-payer system (which I have supported). Under a single-payer system, Congress would both levy the taxes to support health care and determine how to appropriate the resulting revenues.
These constitutional objections would also probably be overcome by a system in which individuals could choose either private insurance or a public option. Such a system could be analogized to a uniform tax, from which individuals could exempt themselves by taking the appropriate actions (purchasing private insurance). Much of our present income tax law already operates in this way.
But if I were a gambler, I would wager money that the only, or nearly the only, part of health care reform that WILL survive the Massachussetts election will be the requirement that nearly everyone buy health insurance--at whatever rates the insurance companies want to demand. The companies will gladly let this part of the proposal pass, because they really WANT the subsidy!
OK. I confess that I really know what is wrong with the picture I painted in the last post. The problem is that many of the wealthy and powerful (note that I said "many," not "all") worship wealth and power, live for it, and are willing to sacrifice anyone ELSE, besides themselves and their friends, to get it. Wealthy oppressors have been around as long as man, as, for instance, the Apostle James wrote
Now listen, you rich people, weep and wail because of the misery that is coming upon you. Your wealth has rotted and moths have eaten your clothes. Your gold and silver are corroded. Their corrosion will testify against you and eat your flesh like fire. You have hoarded wealth in the last days. Look! The wages you failed to pay the workmen who mowed your fields are crying out against you. The cries of the harvesters have reached the ears of the Lord Almighty. You have lived on earth in luxury and self-indulgence. You have fattened yourselves in the day of slaughter. You have condemned and murdered innocent men, who were not opposing you.
James 5:1-5 (NIV).
Those who really believe they are "pulling the strings" that run the world (because God is presently leaving them in that delusion) worship power, and those they have set up as public figurehead leaders in government, the economy, the media, the arts, and the other areas of life, worship wealth (material "progress") and sensual pleasure and urge us to do likewise. But all such worship is idolatry. (Ephesians 5:5). They also, incidentally, urge us to view other human beings as expendable for our own collective purposes, and the visible Church itself has largely adopted this view. (See, The Human Expendability Fallacy ). I saw more than nine years ago that the end of this would be an economic collapse that would ultimately be so deep that the Church will be absolutely forced to rely on God rather than on the means of this world, and those who refuse to do so will perish. See my
first posted October 8, 2000. The collapse started only a few months after I issued my warning, and is now visibly approaching its climax. The solution is still what I said nine years ago: the Church must repent!
What I didn't see nine years ago, however, was that the "elite," the small group of very wealthy people whom God permits to labor under the delusion that they are in control, are orchestrating the final disaster DELIBERATELY and WITH CAREFUL CALCULATION, believing that sacrificing the rest of the world will gain them even more wealth and power. I picked up this piece of the puzzle from a quite lengthy video presentation
The World Elite, Testimony of Lindsay Williams.
Pastor Williams claims to have inside information, from a member of the world's real ruling elite, to the effect that the United States will be put through an economic collapse from which it can never recover, in approximately two years' time (i.e., about 2011). He also predicts that a great war that will start in the Middle East, likely with Iran (and a few others) and Israel, that will precipitate the entire world into war, at about the same time. The real, hidden objectives of this economic disaster and great war will be 1) the complete impoverishment of the U.S.A. and the enslavement of its citizens; and 2) the great increase in the wealth of the elite. Some whole nations of people-notably Israel and Iran-will likely be sacrificed tomake the enslavement of the rest of us possible.
I do not know Pastor Williams, and it is possible that he has misunderstood his sources or been deliberately misinformed about the details. But, regardless of the accuracy of the details of Pastor Williams' predictions, the MECHANISM he believes will lead to the great disaster is entirely cosistent with what the Bible says about the behavior of the wealthy and powerful, behavior which will become increasingly prominent as the end times approach. But the "joke" will be on the powerful, as God will bring them violently out of their delusion:
Why do the nations conspire, and the peoples plot in vain?
The kings of the earth take their stand, and the rulers gather together, against the Lord and against his Anointed.
"Let us break their chains," they say, "and throw off their fetters."
The one enthroned in heaven laughs; the Lord scoffs at them.
Then he rebukes them in his anger, and terrifies them in his wrath, saying,
"I have installed my King on Zion, my holy hill."
Psalms 2:1-6
About the health insurance reform bill now before the Senate, I have a question I'd like someone to answer:
How is the continuation of the insurance industry's antitrust exemption necessary to the preservation of a free market in insurance?
I thought the purpose of antitrust law was the preservation of a free market.
I suspect the answer is that, when politicians use the term "free market," they lie. The code words "free market" are a smokescreen; they do not mean what they say. What they really mean is not "free market," but "status quo."
The truth is that the health insurance market as it presently exists is not a free market at all. Entry to the market is carefully regulated by state insurance departments that are wholly-owned subsidiaries of the regulated industry, that are enforcing state laws written largely by the industry. The terms that will be offered to insureds are agreed upon in a formal oligopolistic fashion by the major insurance companies and their trade associations, then written into state laws and regulations. Risk rating practices and premiums are similarly a matter of open agreement within the industry. Real competition in these matters is strictly prohibited.
Therefore, it is clear that Senator Reid's version of health care reform is trying to give the industry the best of both worlds--and the consumer the worst of both worlds. We are all going to be required to buy health insurance, on whatever terms and at whatever premiums the industry itself decides together to give us. In the end, there will be no "public option" competing with ythe industry's offerings, and the existing "public options" for certain vulnerable groups (Medicare, Medicaid and VA) are all having their funding reduced to raise funds to support the insurance industry option.
Moreover, because the industry will retain its complete exemption from the antitrust laws, its decisions about what coverage it will offer in exchnge for its large new subsidy and at what price will be made entirely by the industry itself, behind closed doors, with ABSOLUTELY NO PUBLIC SCRUTINY. We can be sure that these decisions will be made in favor of maximizing short-term profits, not in favor of better or less expensive health care. The consumer will pay, not profit.
Of course, the consumer is an ordinary person with real needs, quite insignificant in comparison to a faceless corporate stockholder!
That's what the "free market" is all about, isn't it!
Those who follow this blog know that I originally supported single-payer national health care, and still think it would be the best approach (though it has no chance of passage now). I later said that I supported the President's public outline for health care reform as the best realistic chance for reform, so long as it contained a "realistic" public option. However, the "bipartisan" plan that is slowly emerging is far from the President's outline.
While few details of the "bipartisan" health care reform package have been settled clearly enough to be fed to the public in written form, the comments of those involved in the process reveal both that few large changes may be expected and that some of the changes that will occur will be good for the insurance industry and bad for a lot of people. Some of these important details may be inferred from single comments that have been repeated, in one form or another, by people on both sides of the process. Other details must be inferred from pairs of apparently contradictory statements that can only be reconciled with each other by assuming certain plan details.
The first and most obvious problem with Congress' bipartsan approach to the issue is that, in counting the "cost" of the program, they are counting only the relatively short-term costs to be borne by the Federal Government through new taxes. To evaluate the REAL COST to the ENTIRE ECONOMY of health care reform would require a balancing of the new taxes required against the savings to individuals, employers, and state and local governments that will result from the reform. But Congress is not even attempting this. What the responsible members of Congress are publicly saying is that a reform that "costs" $1.6 trillion, or even $1 trillion, in new taxes over the next 10 years costs too much. This debate simply ASSUMES that the new taxes to pay for the government's end of the reform will simply be ADDED to the cost of the present system to its participants (individuals, employers and the government), and that none of the other costs will change. However, the immediate cost to the government is NOT the whole picture. It is, in fact, generally agreed that, if this country had a well-functioning health care financing and delivery system, this would ultimately save all of the participants in the system a great deal of money. It may well be that individuals and employers would end up saving more from the existence of a well-functioning system than they would pay in taxes to maintain it. But we will never know.
Second, we know now that, because of the expense, the public plan is off the table. There is still some talk of permitting nonprofit cooperatives into the market, but even that looks a little unlikely. Note that the very fact that a statute would be needed to merely permit nonprofits to offer health insurance amply proves the point I made in an earlier blog post that health insurance is NOT in any way a free market, but rather a market carefully regulated to insure consistent profits for oligopolistic for-profit insurance companies. This is absolutely not going to change. Nonprofit cooperatives, if permited at all, will have to play by the for-profits' coverage, pricing and premium-rating rules.
Third, we know that something at least similar to the current premium rating system, which only pools risks over employment-related groups and not over the whole population, is going to continue. We know this from the comments of some leading Democrats to the effect that the reform must be limited as requested by big labor, so as not to interfere with multi-employer group plans under collective bargaining agreements. But because both coverage for everyone and employer contributions for full-time employees are to be mandatory under the new system, the reform would not in any way interfere with union members' ability to get coverage at their employers' expense. Thus, what these Congressional Democrats are actually telling us is that the rating system that gives many union employees preferential premium rates is not going to change. This, in turn, implies that the current policy rating system is not going to change very much.
This rating system is the source of the largest inequities in the present system. Those who are fortunate enough to be employed by large employers that have large group plans, or by nationwide union-administered multi-employer groups under collective bargaining agreements will still get the best rates--though it's really hard to say whether those rates will go up or down as a result of the reform. Young, healthy people purchasing individual policies, and small employer groups wherein all of the covered employees are young and healthy will still get decent rates, though not as good as those eligible for large group plans. Small employer groups in which some of the covered employees are older or have health conditions will still pay very high premium rates. Individual premiums for older people and people who have ever had any serious health problems will remain often prohibitively high (though the insurance companies will no longer be permitted to exclude coverage altogether).
Fourth, it is obvious that there are going to be no realistic subsidies to support coverage for those who can't afford it. The test for subsidy eligibility is quite obviously going to be a straight household gross income "needs test," fixed as a percentage of the federal poverty line in the reform statute itself. It will make no distinction, for example, between a young healthy couple with healthy children that is eligible for coverage under a union contract and pays 20% of its household income for health insurance, and a couple a few years older with a sick child who must pay 70% of their identical household income in health insurance premiums. If the subsidy threshhold is set at 200% of the poverty line, as seems quite possible right now, and the household gross income of both of these hypothetical families is 199% of the poverty level, both families will receive identical subsidies, probably based on the average premiums for young healthy people. If the household income of both of these families is 201% of the poverty level, neither family will receive any subsidy.
Fourth, it appears that Congress is really intent upon enacting a measure that will make all of us who have been pressuring it for reform sorry that we ever asked, because it will make a large proportion of the population into involuntary lawbreakers. This can be seen by reconciling 1) the repated assertions by lawmakers on both sides of the aisle that the reform will mandate that all persons, or their employers, must purchase health insurance and 2) the apparently contradictory admission, by lawmakers again on both sides, that the packages they are presently considering would leave millions of Americans uninsured. Wait, if it's mandatory, that means everyone is going to be covered, right? Well, no. It means that everyone who can afford coverage is going to be covered. Many will still not be able to afford coverage, though required to purchase it. This group would include the millions of unemployed. Moreover, since eligibility for employer-sponsored group coverage would remain restricted BY LAW (as it is today) to "full-time," permanent employees, most of the millions who work one or more part-time jobs, or can only find temporary work, would also remain uninsured. The comments made by our members of Congress recognize this. These uninsured would not be covered under the new law, but would simply become involuntary LAWBREAKERS, criminals whose only crime was being too poor and/or employed by the wrong employer.
This leads to my final point. In an earlier posting in the "pure satire" channel on this blog, I asked how a law that would make mandatory individual purchase of health insurance would be enforced. In that posting, I facetiously compared compulsory automobile liability insurance laws to the proposal for compulsory health insurance. I suggested, by analogy to taking away the drivers' licenses of uninsured drivers, that the only logical penalty for failure to maintain compulsory health insurance would be to take away the lawbreaker's "breathing license." Unfortunately, Congress appears likely to take my satirical suggestion seriously. Several members of Congress have publicly suggested that the package they are now working out will include provisions that would remove from all health care providers (including emergency rooms, which now bear this burden) any obligation to provide treatment to any uninsured individual unless that individual immediately, at the time of service, pays for enrollment in a health insurance plan. This can only mean one thing for those who are really unable to afford the premiums the health insurance industry demands of them--for their crime they will be sentenced to death, at a random and unpredictable time, by untreated medical emergency. If the statuory income-based subsidy formula says you OUGHT to be able to afford insurance, but in fact you can't afford the rates imposed, we are going to take away your breathing license for your crime!
This will be a blog post--possibly the first in a related series of posts--that will get me in trouble with both sides of a highly polarized issue as to which both sides insist vehemently that "whoever is not fully for us is against us." In it, I will raise the question whether the political and judgmental tone, single-issue emphasis, and methods and tactics of the pro-life movement may actually encourage abortions.
Before I go any farther, let me declare this: I believe that unborn babies are humans and have rights. Therefore, I believe that abortion is a wrong, not a right.
However, I suspect that the highly polarized and judgmental political atmosphere surronding the issue may actualy encourage abortions for several reasons. The first and simplest is simply that people naturally want to do anything that is forbidden. This is not a new observation, by any means. In fact, the Apostle Paul discussed this matter at length in the seventh chapter of his letter to the Romans. Applying the principle to the sin of coveting, Paul explained that he would not have known what coveting was if God's Law had not forbidden it, but when he was told of that Law, "sin, seizing the opportunity afforded by the commandment, produced in me every kind of covetous desire." Romans 7:7-8. So by insisting on the prohibition of abortion as a motivation, we may actually be perversely increasing the attractiveness of abortion as a viable alternative.
Second, and somewhat related to this, is the observation that, by making the primary focus of the issue the search for a prohibitory POLITICAL solution, we literally have INVITED the abortion industry, and the political and media allies it finances, to recast the issue in terms of a woman's "right" to her body. Precisely because of the vehemence of the Christian political block that has been trying for almost 40 years to restore the defunct prohibition on abortion, women with unwanted pregnancies--who are already hurting and vulnerable--are being told that Christians are trying to steal their "rights" and the only way they have to defend those rights is to choose abortion. Abortion, instead of being a wrong aganst the baby, becomes a kind of a civic duty.
Third, and probably most important, is the observation that the whole debate over legal prohibition of abortion has been a distraction from the real issues that created the problem. The real issues are spiritual, social and moral, but not mostly political. I'll start with issues that relate to the Church. What are we, as the Body of Christ, doing to encourage responsibility and natural love for children? What are we doing to assist mothers--whether or not in intact families--with their children? Do we approach unwed mothers, and unmarried pregnant women among us, , with real love and support, or as outcasts that we provide some "assistance" somewhere else, where we don't have to be reminded of them? Are we judgmental, attaching mental scarlet letters automatically, or are we showing real Christian love? And what are we doing to turn the hearts of the fathers to their children (even in intact families)? Behind every woman with an unwanted pregnancy is a man. That's just a fact of nature. What are we doing about it?
But because we have chosen to focus on changing the law, we are collectively not asking these questions--at least, not persistently enough to get good answers.
As those who have read much of this blog know, I have long supported national, single-payer health care. Nevertheless, I support the president's proposal for two reasons:
1) I have committed myself to support the President personally, as far as good conscience allows, for the good of the country, as explained in earlier posts on this blog.
2) I remember what happened to Hillary Clinton's health care reform proposal, during Bill Clinton's first term as President. At the beginning of the Clinton administration, there was a fairly strong national consensus in favor of health care reform. Mrs. Clinton proposed, with her husband's support, a plan that would have been a great improvement over the status quo, though it stopped well short of single-payer national health care (although the enemies of the plan accused her of proposing this). But several other proposals also had strong support in Congress. During the year or so that the supporters of reform were arguing among themselves about which plan to follow, the health insurance industry was able to mount a successful public relations campaign that completely derailed any reform. So, because the supporters of health care reform could not agree quickly on the details, we ended up with NOTHING.
I've explained my misgivings about the direction the President plans to take--mandatory private health coverage--in previous blog entries. Greatly summarized, they are:
1) If individual payment of health insurance premiums is to be mandatory, what is to be the penalty for failure to pay? A fine (wholly unrealistic if the problem is self-perceived inability to pay)? Prison time (which appears to be a self-defeating penalty, as it destroys the ability to pay)? Commitment to a mental institution? Seizure of property to pay past-due premiums? Random capitol punishment by death in a medical emergency?
2) Are insurers to be left free to rate policies as they do now? Do self-employed individuals and individuals whose employers escape the requirement to provide coverage still get the highest premium rates--only now compulsory rather than discretionary? Will individuals with pre-existing medical problems now simply be required by law to pay whatever premiums the industry demands of them? Do small employer groups remain small employer groups? Or are we to move toward community or national rating (which seems much more fair if payment of premiums is to be required by law)?
3) Will the formulas for premium subsidies be realistic? Government income formulas never are. Will the formulas take into account other types of debt that the law highly favors for payment, such as child support and student loans (both of which have strong enforcement mechanisms and virtual nondischargeability in bankruptcy), mortgages, and credit card debt. I recognize that, if a person cannot simultaneously make all legally favored payments and eat, he or she must stop eating and make the payments. But if a person truly cannot simultaneously make all of his or her legally-protected debt payments and the mandatory health insurance premium payment, which debt must yield?
I trust that Congress will be able to address these problems before the final markup of the bill, and that it will act quickly to make the reform a reality.
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