Taking personal responsibility for yourself is a fundamentally Conservative principle. The question about whether or not we have a mandate at the federal level is a different question as it is unconstitutional and it pre-emps state level reforms which is the way to go if you are interested a process of continually making progress on health care policy. Romney did not back a federal mandate in 2008 when it was a non-issue, he isn't now. Gingrich supported a federal mandate as early as 1993 and only stopped supporting one when it became politically inconvenient to do so.
>>Lowry's posting is most interesting.
***
Yes it is. Rich has been pretty hostile to Romney for a while having concluded that he does not have the temperament for the kind of Churchillian/Thatcherite/Reaganesque aggressiveness that we need to sharply turn the ship of state away from the ice field of statism and socialism that is dead ahead. Fair enough...it is a judgment that reasonable people may reach (although it seems to me to violate that fundamental principle of conservative thinking that requires that alternatives be measured against other, real-world alternatives rather than against fantasy candidates who are dead, not running, or otherwise unavailable).
But however you add it up, this post looks like something a political hack would put up...like an out-of-context "gotcha." No what I come to NR for.
Freshly scrolling The Corner, I see Rich's post with different eyes: Perhaps he is simply calling attention to significant moments in the policy arguments.
Can't wait for Liberal congressmen/women, Senators, and the President run that ad against conservatives. Thanks Republican party for bringing us Mitt Romney.
Yes, I could see this clip used in ads by Democrat candidates.
However, I think it will be useful for moderate/blue dog Democrat representatives.
Liberals expressed this same sentiment when they became bitterly discouraged by Obama's pivot away from the single-payer plan. I suspect liberals will be quiet, in regards to their disappointments with Obama, during election season.
Moving away from the health care reform issue, liberals could use this to argue the "Republicans as obstructionists" theory. But that is a difficult idea to sell.
What kills me about this mandate mishigas, is the fact that the absolute only reason there is a mandate as opposed to the tax is because Obama couldn't sell a new "tax"; he thought "mandate" would be more palatable to American voters, particularly conservatives. Like so many things, boy, did he get that wrong.
The irony is if Obama and his minions just would have passed a new "health care tax" and then allowed a credit for any company and/or employee that paid for health insurance, all of this would be a moot point. People who had insurance would have been largely exempted (or credited), and the people who didn't and weren't "poor" (however that's defined today) would have had a new tax liability. There wouldn't have been any constitutional infirmity because of the broad reading of the taxing & spending clause, and Obamacare would have been as permanent as Medicare and Social Security.
In this regard (and quite accidentally), the Heritage Foundation's original concept for the "individual mandate" will still (maybe) be the foil to actual socialized medicine, although not in the way that it was intended. Politics are weird.
Well, when Newt was confronted about his support for the Federal Level Mandate, he tried to explain it's "history" amongst Conservatives, saying the exact same thing in one of the Iowa Debates.
Gingrich told everyone on that stage, Conservatives embraced the Mandate in response to try to avoid the push for the Democratic Partisans nationalization efforts.
Romney was not only endorsed and supported by numerous Conservatives at the time of the MASS Reform (like Gingrich), we all know the Heritage Foundation was a major contributor to this State Level effort.
I am not certain why Mr. Lowry would post this video at this time?
Ironically, Romney comes across very well in this offering.
Ann Coulter is absolutely right, Romney is the best offering, without a doubt.
It is the very misguided Erick Erickson trying to make an issue with Romney's statement.
Erickson is so lost, a terrible record of very poor offerings, so stuck on superficial image/identity games. Erickson is a symbol for the misguided fashion sinking all.
Mr. Erickson's credibility tanked long ago, even further with those predictable flops from the 2010 Midterms.
Saaaalute...rational friends Old Fan, Scott, and Richard.
If people think that emergency rooms should turn away uninsured patients, then they ought to make that argument rather than arguing against a mechanism that seeks to apply the fundamental conservative principle that there should be no free riders....everyone is going to receive essential health care -- the law requires it -- and therefore everyone should help to pay for it.
Constitutionally speaking, I am a cynic: We are in a war against the Left and whenever lawyers are involved -- civilly, criminally, or constitutionally -- we have departed the search for higher truth and entered that arena of warfare. I am more than happy to use any constitutional argument that will fly in order to bring down ObamaCare.
But at the end of the day, wanting to be sure that emergency room free riders are not exploiting their neighbors on health care is not remotely the same thing as broadly empowering the government to reshape and control American medicine. The politics on our side is hopelessly degraded if most of us prefer to use this issue to bludgeon each other rather than be honest and realistic about it. Let's save our bludgeoning for the b'tards on the other side and insist that the issue be handled on the state level.
You write, "wanting to be sure that emergency room free riders are not exploiting their neighbors on health care is not remotely the same thing as broadly empowering the government to reshape and control American medicine."
You're comparing a goal and a means, and it is certainly feasible that the goal of ending free-riding can end up enabling the means of empowering the government to control the industry. The individual mandate accomplishes precisely that, because it not only dictates that individuals buy insurance, it defines what qualifies -- and, thanks to lobbyists and rent-seeking, that definition will almost certainly grow far beyond a minimum definition needed to cover emergency-room costs.
I find very credible the argument that healthcare costs are high precisely because of government interference, and the assumption that ER care is cost-prohibitive buys into the statist status quo that feeds into a ratcheting effect: costs are high, which justifies government interference, but costs predictably rise, justifying more interference.
Remember that cost control was a big justification for Romneycare. It hasn't worked.
Ultimately you're presenting a false dilemma: either we support the individual mandate or we must turn people away from emergency rooms.
There's at least one other option: treat them, but charge them for the costs. If they pay, they're not free-loading; if they don't, then the penalties would make them an example that would encourage everyone to get adequate insurance.
That's a far less intrusive and more market-oriented solution. It treats the ER-treatment market like any other: the law already rightfully empowers sellers to prosecute shoplifters and others who would seek to enjoy the product they sell without paying for it.
--
But let's suppose that you're right that the individual mandate is the only quote-unquote conservative solution to the problem of higher heatlhcare costs resulting from freeloading, given the assumption that we must not turn people away. ("The law requires it.")
What's the argument for repealing Obamacare again? It seems to me that the only conservative argument left is a Tenth Amendment argument -- that Washington forcing you to buy private-sector goods and services isn't an encroachment on the individual's rights, it's only an encroachment on Boston and Austin's right to force you to buy private-sector goods and services.
Considering every other Tenth-Amendment violation the federal government has engaged in for 40 and even 70 years, is that really an overwhelming reason to repeal Obamacare immediately? Can we really trust Romney to repeal it rather than decide to reform it?
"If they pay, they're not free-loading; if they don't, then the penalties would make them an example that would encourage everyone to get adequate insurance."
Good Lord, where to start. First, it's not a "false dilemma". It's quite a real dilemma. Second, there is absolutely no appetite to change The Emergency Medical Treatment and Active Labor Act. Politicians in America aren't not going to force poor, expectant mothers to give birth on the curb. It ain't hapennin'.
With respect to your "penalty", the only penalty someone pays in this country for not paying a bill is a bad credit score. Here's a newsflash, the VAST majority of people who use the emergency room as their primary care physician already have horrible credit. They don't care. And, just like EMTALA is never going to be amended, much less repealed, no politician is going to vote for a Bill that turns a sick person seeking medical attention into a (your word) shoplifter.
So long as the law says hospitals have to treat women in labor and emergency room patients that have life or limb-threatening injuries (and with trial attorneys today, that virtually EVERY patient) irrespective of the patients inability to pay, hospitals (particularly in urban areas) are going to see increasingly unrecovered costs (and more cost-shifting), which will (eventually) drive more of them out of business which will then raise everyone's costs because of the simple laws of supply and demand.
Some conservatives are living on a different planet when it comes to addressing the problems of non-paying patients. EMTALA is not going anywhere. That's the political reality.
If you tell Harris-Teeter or Piggly-Wiggly that they have to give food to anyone who walks through their doors irrespective of that person's ability to pay for that food, Harris-Teeter or Piggly-Wiggly would go bankrupt in fairly short order. That's EXACTLY what Ronald Reagan did to private hospitals when he signed EMTALA in 1986.
"Can we really trust Romney to repeal it rather than decide to reform it?"
Lawrence, you seem like a reasonably bright guy. Doesn't this question answer itself?
Do you think that a President Mitt Romney - in his first term no less - is going to VETO the repeal of Obamacare passed by a reliably conservative House and a reasonably conservative Senate? Really?
You think that legislation is going to show up on his desk and he's going to say, "Hey, lets' not be hasty. Let's send this back to Congress so they can work on reforming Obamacare rather than repealing it". Does that sound likely?
It seems to me that if you're really worried about Obamacare not being repealed, then your concerns lie with Congress, not the Executive. Presidents don't repeal or enact anything: Congresses do.
However, I would also point out that while Obamacare in its entirety is pretty unpopular, there are elements of Obamacare that are WILDLY popular (and are really what drove health care reform to begin with). One of those elements is the preexisting condition provision. Americans, by a margin of 8:1 favor the prohibition of insurers on declining preexisting conditions. If Republicans throw that away along with everything else, they'll be voted out in 2014 in tremendous numbers.
Here's the problem: When you tell an insurance company that they have to cover someone's illness who isn't an existing customer, that stops being "insurance" and it starts being something else - a medical treatment credit plan, or something.
What does this mean? Well, among other things, it means that a GREAT majority of Americans want the federal government involved in health care to some degree. So, that argument is already lost. The only argument to settle now is to what degree the FedGov is going to be involved.
Actually, there is some question as to whether or not a repeal bill can be filibustered given the way it was passed into law. If it can be, I don't think Romney or any president can get enough Dems to go along with a repeal bill if their are not already 60 votes.
Taking personal responsibility for yourself is a fundamentally Conservative principle. The question about whether or not we have a mandate at the federal level is a different question as it is unconstitutional and it pre-emps state level reforms which is the way to go if you are interested a process of continually making progress on health care policy. Romney did not back a federal mandate in 2008 when it was a non-issue, he isn't now. Gingrich supported a federal mandate as early as 1993 and only stopped supporting one when it became politically inconvenient to do so.
Reply to this commentLinkReport AbuseIndeed...
Even on a recent Beck interview, Gingrich admitted his support for a version of a Federal Mandate.
Perry clearly has his own Mandate offering in Texas.
Lowry's posting is most interesting.
Reply to this commentLinkReport AbuseI thinking he is working overtime to try and prove the recent DC Caller article inaccurate.
Reply to this commentLinkReport Abuse>>Lowry's posting is most interesting.
***
Yes it is. Rich has been pretty hostile to Romney for a while having concluded that he does not have the temperament for the kind of Churchillian/Thatcherite/Reaganesque aggressiveness that we need to sharply turn the ship of state away from the ice field of statism and socialism that is dead ahead. Fair enough...it is a judgment that reasonable people may reach (although it seems to me to violate that fundamental principle of conservative thinking that requires that alternatives be measured against other, real-world alternatives rather than against fantasy candidates who are dead, not running, or otherwise unavailable).
But however you add it up, this post looks like something a political hack would put up...like an out-of-context "gotcha." No what I come to NR for.
Reply to this commentLinkReport AbuseFreshly scrolling The Corner, I see Rich's post with different eyes: Perhaps he is simply calling attention to significant moments in the policy arguments.
Reply to this commentLinkReport AbuseCan't wait for Liberal congressmen/women, Senators, and the President run that ad against conservatives. Thanks Republican party for bringing us Mitt Romney.
Reply to this commentLinkReport AbuseYes, I could see this clip used in ads by Democrat candidates.
However, I think it will be useful for moderate/blue dog Democrat representatives.
Liberals expressed this same sentiment when they became bitterly discouraged by Obama's pivot away from the single-payer plan. I suspect liberals will be quiet, in regards to their disappointments with Obama, during election season.
Moving away from the health care reform issue, liberals could use this to argue the "Republicans as obstructionists" theory. But that is a difficult idea to sell.
Reply to this commentLinkReport AbuseWhat kills me about this mandate mishigas, is the fact that the absolute only reason there is a mandate as opposed to the tax is because Obama couldn't sell a new "tax"; he thought "mandate" would be more palatable to American voters, particularly conservatives. Like so many things, boy, did he get that wrong.
The irony is if Obama and his minions just would have passed a new "health care tax" and then allowed a credit for any company and/or employee that paid for health insurance, all of this would be a moot point. People who had insurance would have been largely exempted (or credited), and the people who didn't and weren't "poor" (however that's defined today) would have had a new tax liability. There wouldn't have been any constitutional infirmity because of the broad reading of the taxing & spending clause, and Obamacare would have been as permanent as Medicare and Social Security.
In this regard (and quite accidentally), the Heritage Foundation's original concept for the "individual mandate" will still (maybe) be the foil to actual socialized medicine, although not in the way that it was intended. Politics are weird.
Reply to this commentLinkReport AbuseWell said...
Reply to this commentLinkReport AbuseWell, when Newt was confronted about his support for the Federal Level Mandate, he tried to explain it's "history" amongst Conservatives, saying the exact same thing in one of the Iowa Debates.
Gingrich told everyone on that stage, Conservatives embraced the Mandate in response to try to avoid the push for the Democratic Partisans nationalization efforts.
Romney was not only endorsed and supported by numerous Conservatives at the time of the MASS Reform (like Gingrich), we all know the Heritage Foundation was a major contributor to this State Level effort.
I am not certain why Mr. Lowry would post this video at this time?
Ironically, Romney comes across very well in this offering.
Ann Coulter is absolutely right, Romney is the best offering, without a doubt.
Reply to this commentLinkReport AbuseI get it, or feel I do...
It is the very misguided Erick Erickson trying to make an issue with Romney's statement.
Erickson is so lost, a terrible record of very poor offerings, so stuck on superficial image/identity games. Erickson is a symbol for the misguided fashion sinking all.
Mr. Erickson's credibility tanked long ago, even further with those predictable flops from the 2010 Midterms.
Reply to this commentLinkReport AbuseYou've used the word "offering" 4 times in 3 comments, are you trying to use up the 2011 supply before New Years?
Reply to this commentLinkReport AbuseSaaaalute...rational friends Old Fan, Scott, and Richard.
If people think that emergency rooms should turn away uninsured patients, then they ought to make that argument rather than arguing against a mechanism that seeks to apply the fundamental conservative principle that there should be no free riders....everyone is going to receive essential health care -- the law requires it -- and therefore everyone should help to pay for it.
Constitutionally speaking, I am a cynic: We are in a war against the Left and whenever lawyers are involved -- civilly, criminally, or constitutionally -- we have departed the search for higher truth and entered that arena of warfare. I am more than happy to use any constitutional argument that will fly in order to bring down ObamaCare.
But at the end of the day, wanting to be sure that emergency room free riders are not exploiting their neighbors on health care is not remotely the same thing as broadly empowering the government to reshape and control American medicine. The politics on our side is hopelessly degraded if most of us prefer to use this issue to bludgeon each other rather than be honest and realistic about it. Let's save our bludgeoning for the b'tards on the other side and insist that the issue be handled on the state level.
Reply to this commentLinkReport AbuseEd:
You write, "wanting to be sure that emergency room free riders are not exploiting their neighbors on health care is not remotely the same thing as broadly empowering the government to reshape and control American medicine."
You're comparing a goal and a means, and it is certainly feasible that the goal of ending free-riding can end up enabling the means of empowering the government to control the industry. The individual mandate accomplishes precisely that, because it not only dictates that individuals buy insurance, it defines what qualifies -- and, thanks to lobbyists and rent-seeking, that definition will almost certainly grow far beyond a minimum definition needed to cover emergency-room costs.
I find very credible the argument that healthcare costs are high precisely because of government interference, and the assumption that ER care is cost-prohibitive buys into the statist status quo that feeds into a ratcheting effect: costs are high, which justifies government interference, but costs predictably rise, justifying more interference.
Remember that cost control was a big justification for Romneycare. It hasn't worked.
External Link
Ultimately you're presenting a false dilemma: either we support the individual mandate or we must turn people away from emergency rooms.
There's at least one other option: treat them, but charge them for the costs. If they pay, they're not free-loading; if they don't, then the penalties would make them an example that would encourage everyone to get adequate insurance.
That's a far less intrusive and more market-oriented solution. It treats the ER-treatment market like any other: the law already rightfully empowers sellers to prosecute shoplifters and others who would seek to enjoy the product they sell without paying for it.
--
But let's suppose that you're right that the individual mandate is the only quote-unquote conservative solution to the problem of higher heatlhcare costs resulting from freeloading, given the assumption that we must not turn people away. ("The law requires it.")
What's the argument for repealing Obamacare again? It seems to me that the only conservative argument left is a Tenth Amendment argument -- that Washington forcing you to buy private-sector goods and services isn't an encroachment on the individual's rights, it's only an encroachment on Boston and Austin's right to force you to buy private-sector goods and services.
Considering every other Tenth-Amendment violation the federal government has engaged in for 40 and even 70 years, is that really an overwhelming reason to repeal Obamacare immediately? Can we really trust Romney to repeal it rather than decide to reform it?
Reply to this commentLinkReport Abuse"If they pay, they're not free-loading; if they don't, then the penalties would make them an example that would encourage everyone to get adequate insurance."
Good Lord, where to start. First, it's not a "false dilemma". It's quite a real dilemma. Second, there is absolutely no appetite to change The Emergency Medical Treatment and Active Labor Act. Politicians in America aren't not going to force poor, expectant mothers to give birth on the curb. It ain't hapennin'.
With respect to your "penalty", the only penalty someone pays in this country for not paying a bill is a bad credit score. Here's a newsflash, the VAST majority of people who use the emergency room as their primary care physician already have horrible credit. They don't care. And, just like EMTALA is never going to be amended, much less repealed, no politician is going to vote for a Bill that turns a sick person seeking medical attention into a (your word) shoplifter.
So long as the law says hospitals have to treat women in labor and emergency room patients that have life or limb-threatening injuries (and with trial attorneys today, that virtually EVERY patient) irrespective of the patients inability to pay, hospitals (particularly in urban areas) are going to see increasingly unrecovered costs (and more cost-shifting), which will (eventually) drive more of them out of business which will then raise everyone's costs because of the simple laws of supply and demand.
Some conservatives are living on a different planet when it comes to addressing the problems of non-paying patients. EMTALA is not going anywhere. That's the political reality.
If you tell Harris-Teeter or Piggly-Wiggly that they have to give food to anyone who walks through their doors irrespective of that person's ability to pay for that food, Harris-Teeter or Piggly-Wiggly would go bankrupt in fairly short order. That's EXACTLY what Ronald Reagan did to private hospitals when he signed EMTALA in 1986.
Reply to this commentLinkReport Abuse"Can we really trust Romney to repeal it rather than decide to reform it?"
Lawrence, you seem like a reasonably bright guy. Doesn't this question answer itself?
Do you think that a President Mitt Romney - in his first term no less - is going to VETO the repeal of Obamacare passed by a reliably conservative House and a reasonably conservative Senate? Really?
You think that legislation is going to show up on his desk and he's going to say, "Hey, lets' not be hasty. Let's send this back to Congress so they can work on reforming Obamacare rather than repealing it". Does that sound likely?
It seems to me that if you're really worried about Obamacare not being repealed, then your concerns lie with Congress, not the Executive. Presidents don't repeal or enact anything: Congresses do.
However, I would also point out that while Obamacare in its entirety is pretty unpopular, there are elements of Obamacare that are WILDLY popular (and are really what drove health care reform to begin with). One of those elements is the preexisting condition provision. Americans, by a margin of 8:1 favor the prohibition of insurers on declining preexisting conditions. If Republicans throw that away along with everything else, they'll be voted out in 2014 in tremendous numbers.
Here's the problem: When you tell an insurance company that they have to cover someone's illness who isn't an existing customer, that stops being "insurance" and it starts being something else - a medical treatment credit plan, or something.
What does this mean? Well, among other things, it means that a GREAT majority of Americans want the federal government involved in health care to some degree. So, that argument is already lost. The only argument to settle now is to what degree the FedGov is going to be involved.
Reply to this commentLinkReport AbuseRomney won't have to veto it. Without a vigourous effort on the part of the president, repeal will never get passed the filibuster in the Senate.
Romney does not have it in him to fight against something that he basically supports.
Reply to this commentLinkReport AbuseActually, there is some question as to whether or not a repeal bill can be filibustered given the way it was passed into law. If it can be, I don't think Romney or any president can get enough Dems to go along with a repeal bill if their are not already 60 votes.
Reply to this commentLinkReport AbuseI know
"there"
Reply to this commentLinkReport AbuseDo you have a link to this debate, I'm not familiar with it.
Reply to this commentLinkReport AbuseSeems to me that a repeal would be a new bill, and as such the normal rules would apply.