OPINION & EDITORIAL
Health care not in Constitution
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Also by Ryan Masse:
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by Ryan Masse
Thursday, March 27, 2008
The allocation of health care raises several issues. Economic issues, for instance. Moral issues as well.
And, would you believe it, even constitutional issues are at play.
At least that’s what U.S. Rep. Steve Kagen, D-Wis., author of the “No Discrimination in Health Insurance Act,” suggests.
In making this claim, Mr. Kagen does not argue (thankfully) that the U.S. Constitution grants anyone the right to health care. It doesn’t. Rather, the issue — as the first-term congressman explains it — is that health insurance companies “discriminate” on the basis of a person’s health. They do this when deciding whether to insure a person or not and when choosing how large of a premium to charge.
This, Mr. Kagen says, doesn’t jibe with the spirit of the Constitution. “Our Constitution protects all citizens — even those who are ill — against discrimination, and it is time to establish this fundamental principle in health care,” Mr. Kagen said in a statement when introducing his legislation. He has repeated the constitutional theme ever since.
The connection here is silly. Presumably, the prohibition on discrimination the congressman refers to is the Equal Protection Clause of the 14th Amendment. But this provision, like much of the Constitution, enjoins the government from engaging in certain behavior. It doesn’t bind the actions of private parties. While a private actor may be statutorily barred from engaging in certain forms of discrimination, the Constitution itself does nothing to prevent you or me (or insurance companies) from excluding and discriminating to our hearts’ content.
Invoking the Constitution here, then, in is nothing but a rhetorical device.
And perhaps one could excuse such flourishes if the underlying legislation were sound. Unfortunately, Mr. Kagen’s is not.
Mr. Kagen’s bill would prohibit insurance companies from denying coverage to people due to pre-existing medical conditions. It would also force insurers to “charge the same premium price for the same coverage.” Hence, there would be no “discrimination.” You want insurance? You’ve got it, and at the same price as everyone else.
The result would be more competition and lower prices for everybody, according to Mr. Kagen.
Uh-huh.
Insurance companies don’t deny coverage or charge different premiums to different customers because they get a kick out of it. They do it because of economic reality. My grandparents’ health expenses are much higher than mine. Therefore, if an insurance company is to indemnify them in an economically feasible manner, it needs to charge them more.
Health insurers obviously own no monopoly on such a scheme. Auto insurers “discriminate” against teenage drivers because of their proclivity for reckless driving. Home insurers “discriminate” against people who live in mansions and not shacks. “Discrimination” here is nothing more than an insurer’s ability to factor cost into its pricing structure.
By not being able to charge more for more medically risky customers, an insurance company is faced with two options: write off huge losses on many policies, or raise premiums for everybody. Needless to say, insurers will opt for the latter course of action.
Moreover, the idea of not letting an insurance company deny coverage due to a pre-existing condition undermines the entire concept of insurance. A person would be free to go without insurance, and as soon as a problem occurs, quickly buy a policy. Think Homer Simpson’s strategy when he needed a triple-bypass operation.
Mr. Kagen anticipates this in his legislation, which would allow the federal agency responsible for oversight to create rules preventing people “from enrolling in individual health insurance coverage only after they develop an illness or injury for which such coverage applies.”
Perhaps such rules could be established. Nonetheless, any insurance company that denied coverage would risk lawsuits from the would-be insured disputing the insurer’s grounds for denial. The cost of defending this litigation would add more to everybody’s premiums. Creative plaintiffs could even take a cue from Mr. Kagen and try to argue their constitutional rights have somehow been infringed.
None of this is to say health care reform is not needed. Mr. Kagen’s proposal would also aim to increase pricing disclosure in the health care market. This is laudable and absolutely essential if health care is ever to be subject to the market forces that work for every other product in this country.
Alas, this can’t be divorced from the rest of Mr. Kagen’s “No Discrimination in Health Insurance Act.” Health care raises many tough questions. Raising everybody’s premiums on a phony constitutional premise is not an answer.
Ryan Masse (rmasse@badgerherald.com) is a first-year law student.
Anonymous (March 27, 2008 @ 7:19am):
I run 30 miles a week, eat right, get enough sleep, and am a nonsmoker. Why should I be forced to pay for the health care of people who sit on the couch, drink, smoke, and watch television all day?
Anonymous (March 27, 2008 @ 7:29am):
Your arguments and writing style are weak and tired, friend.
"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."
Affordable health insurance seems to fit in with domestic tranquility, general welfare, and the blessings of liberty. Too bad our blessings of liberty have been spent in Iraq, rather than on the general welfare of OUR homeland and OUR citizens.
Anonymous (March 27, 2008 @ 7:58am):
Let's debate the TRUE intentions of the second amendment and the current obliteration of the fourth amendment while we're at it. After all, it's only rhetoric.
Anonymous (March 27, 2008 @ 8:10am):
While you may consider his writing style "weak and tired", he did hit the nail right on the head with the discussion of the 14th ammendment. The biggest counter-arguement to the premise of leaving the insurance companies to running their businessis still the ethical question of genetic pre-screening, where insurance companies could deny coverage for certain genetic markers which increase risk. And please, keep the conversation on the arguement for/against this bill regarding insurance premiums. Iraq has no place in this discussion.
Anonymous (March 27, 2008 @ 8:28am):
I work 60 hours a week, work hard, save enough for retirement, and am a nonsmoker. Why should I be forced to pay for the monitary care of people who sit on the couch, drink, smoke, and watch television all day?
Anonymous (March 27, 2008 @ 8:30am):
"the market forces that work for every other product in this country."
Except for corn (and by extension, pretty much all foodstuffs), pharmaceuticals, munitions, housing, banking. You know, nothing important.
Anonymous (March 27, 2008 @ 8:34am):
I wish I could wait until after I had an accident to buy auto insurance. And don't you go looking at my driving record to price the policy either!
Anonymous (March 27, 2008 @ 10:31am):
The problem with the health care debate thus far is that we forget we're talking about people's health. You know, your parents, your neighbors, your classmates, your teachers, etc. It's not just nifty graphs or statistics, nor is it cars or houses or other property we're insuring. It's human life. Why does the pro-life rhetoric stop at the hospital door?
And should it have to be in the Constitution for it to be considered important? There's a lot of things this country does and spends money on that's not in there, that most people would argue are necessary. That's why this country also has laws.
Anonymous (March 27, 2008 @ 12:04pm):
7:19, 8:28, You may do all those things, but you can still get sick. If you happen to be working for Wal-mart or McDonalds, you could still have to pay for your own health insurance; since you work for McDonalds, your paycheck is probably already stretched thin. If you're running 30 miles a week, you'll probably need new knees or hips eventually, too.
Anonymous (March 27, 2008 @ 1:19pm):
I run 30 miles a week, eat right, get enough sleep, and am a nonsmoker. Why should I be forced to pay for the health care of people who sit on the couch, drink, smoke, and watch television all day?
Yes...because every sick person in this country fits this exact definition. You might want to go back to middle school, where you first discovered that argument, and refine it a little. Lance Armstrong was smoking those cigarrettes, eating bags of potato chips, and watching tons of SportsCenter when he had to be treated for cancer.
Anonymous (March 27, 2008 @ 3:47pm):
12:04 & 1:19: You're both missing the point that the other posters were making. Why should we have to pay for someone else's misfortune? Why should I have to pay twice-over for health care? If I was in their situation, would I expect someone else to give me a handout? No. Sure, it would be nice but there's no reason why I should expect someone else to pay for my bills. Believe it or not, but there are other jobs someone could work at besides McDonald's or Wal-Mart. There is always another option instead of just throwing up your hands and saying "woe is me," while resorting to sucking off the collective teat of society. I am really sick of this attitude from some of society that goes crying to the government to cater to their every whim and need, just because someone else might have things a little bit better than they do---just so they can have the same luxuries without putting forth the effort to EARN THEM from the merits of their own hard work. I went to school on my own, sought out a good job that has its benefits. Why shouldn't someone else be expected to do the same? You shouldn't be rewarded for making your own wrong decisions. It's a little thing called personal accountability.
Does this mean that we shouldn't help one another from time to time? No. What it means is that one person should not have to be supporting themselves along with another random person (or two or three). It doesn't work in the animal kingdom (natural selection anyone?), so why should it work with humankind. Help the person get a hand up, not just a hand-out.
Anonymous (March 27, 2008 @ 3:58pm):
"I run 30 miles a week..."
Are you saving up to pay for those artificial knees and hips you'll need when you get old, are you? Or are you planning to stick Medicare with the bill?
Anonymous (March 27, 2008 @ 4:09pm):
1:18,
It's not that healthy people don't get sick; it's just that they get sick less often and should enjoy lower health care premiums than those who don't take care of themselves.
Anonymous (March 27, 2008 @ 5:44pm):
There are other jobs than McDonald's or Wal-Mart... but there are people who work here too, and there always will be.
Unemployment is near record lows, but you still think there is some sort of slacker contingent that needs your rath.
Screw everyone else so that your tax dollars don't go to some ghetto resident. Or screw GM, Ford and Chrysler, because you have an agenda with unions.
Anonymous (March 27, 2008 @ 6:11pm):
"It doesn't work in the animal kingdom (natural selection anyone?)"
It actually does sometimes. While Darwin was partially right that animals evolve, other biologists have found that the species that are most successful are those that cooperated within the species. Can you imagine if ants competed against each other, rather than working together? Or if there was no such thing as herds?
Unfortunately, in this age, being able to take care of yourself is a privilege, something that is difficult for many of the same people who don't have health insurance now. In many households, both parents work tirelessly, and don't have the time or energy to run 30 miles a week. They may make bad decisions, like smoking or drinking, for whatever reasons, often to cope with stress. When it comes time to eat, they often don't have the time, money or aptitude to fix gourmet, healthy meals, and instead rely on fast food or microwaveable meals to feed the family.
Anonymous (March 27, 2008 @ 9:22pm):
"it's just that they get sick less often and should enjoy lower health care premiums than those who don't take care of themselves."
So outlaw employer paid health insurance and force everyone to buy individual health insurance - just like the system for auto insurance for car owners.
If you can't afford heath insurance then it's off to the organ banks for you!
Anonymous (March 28, 2008 @ 12:26am):
"They may make bad decisions, like smoking or drinking, for whatever reasons..."
Again, that was THEIR poor CHOICE; why should I have to pay out of my pocket for their mistake? The same goes for if an uninsured motorist hits me; not only do I have to pay my deductible, but my rates from then on out will go up to cover the person(s) without insurance. Everything can be traced back to a bad decision or two somewhere along their path in life. It used to be that you had to live with the effects of those decisions that YOU made, and YOU would have to find a way to turn your life back around. What happened to having to live with the consequences of your actions/decisions? The same goes in corporate America. It used to be that if a company made bad financial decisions, the place would have make serious changes or close its doors. Now, all they have to do is complain loud enough and they'll almost always get some type of bailout.
If I go out and drink myself to the point of needing detox, will you help pay for my detox bill? After all, it is a health care issue, even though I willingly drank more than I could handle. Someone would feel sorry for me, right? Or can I go whine to the government until someone gives me a handout courtesy of every taxpayer that made the right/responsible choices?
Having to rely on fast food or microwaveable meals? Give me a break. Let me guess, they also probably let their car idle in the drive-thru lane while their waiting for their McDinners. With the time wasted in line, savings from not idling and driving to fast food joints, you could have easily taken that same time to pick up much healthier choices at say Aldi or Woodmans. No, it won't be gourmet nor will it come with a toy, but it will be much healthier and cheaper in the long run. And many times those microwaveable meals are much more expensive than something healthier. 88 cents for a loaf of bread at Woodmans; another buck for a decent sized can of soup; or every college-student's "favorite" Raman noodles. There are plenty of other options than resorting to relying on fast food. Nor does it take much aptitude either...just the right attitude.
I truly feel that the lack of personal accountability and responsibility will continue to erode and eventually be the downfall of our modern society. This problem is already quite evident in our court system, with the backlog of what would have been classified as 'frivolous' lawsuits a decade or so ago.
Anonymous (March 28, 2008 @ 12:38am):
"but you still think there is some sort of slacker contingent that needs your rath.
Screw everyone else so that your tax dollars don't go to some ghetto resident. Or screw GM, Ford and Chrysler, because you have an agenda with unions."
Obviously you didn't read the whole comment. Way to twist the words to fit your own agenda. Continually giving hand-outs is not going to solve anything in the long-run. People should still help one another, but help them make a better life for the other, and those needing the help need to have the attitude and the will to want to make a better life for them self. Throwing money at the problem will do nothing to solve anything, except bring temporary happiness and satisfaction.
Where the hell did the comment come from about unions? That was never even mentioned in that comment. Sounds like you're the one with the agenda. But since you brought it up, why don't you go out and help form the same type of unions at Toyota, Honda, and all the other auto makers? I personally have no problem with unions, and at least then everyone would be closer to a level playing field since you obviously don't want anyone to have any "unfair" advantages over someone else.
Anonymous (March 28, 2008 @ 10:11am):
For those who cry out against paying for the health care of others. Guess what, Corporations in Wisconsin are the biggest hogs at the slop bucket for tax payer funded health care
http://dhfs.wisconsin.gov/badgercare/pdfs/employers0307.pdf
So think of this scenario.. You are enjoying a Big Mac after buying some "cheap" products from Wal-Mart. And you have a discussion about how you are tired of paying for lazy people and their health care and they should get a job. So then write a letter to the CEOs of Big Box Stores and fast food chains and ask them why they get to enjoy millions of dollars in personal profit, yet they can't afford to purchase health insurance for all of their employees?
That truly isn't the "free market" is it? These tycoons thumb their noses at any government involvement when it comes to making their money, yet they beg the states to subsidize their health care. That is not free market, that is corporate socialism!
So moving forward, we can keep fighting each other, or we can unite and fight for a common cause.
Anonymous (March 28, 2008 @ 4:26pm):
"ask them why they get to enjoy millions of dollars in personal profit, yet they can't afford to purchase health insurance for all of their employees?"
Because they earned it.
"These tycoons thumb their noses at any government involvement when it comes to making their money, yet they beg the states to subsidize their health care. That is not free market, that is corporate socialism!
So moving forward, we can keep fighting each other, or we can unite and fight for a common cause."
The common cause should be freedom. Yes, fight not only corporate socialism, but working-class socialism, Medicare and Medicaid socialism, etc.
If some group is demanding government handouts, the solution is to oppose handouts, not start demanding your own handouts.
Anonymous (April 7, 2008 @ 12:52pm):
To Healthy Anonymous:
It is society's benefit to pay for health care. It is better for society to NOT pay for tobacco tax, etc. We are talking about social consciousness here. Think of all the countries who are not socially conscious --- they fall apart. But we do have to manage our social services very very well.
REMEMBER you are a part of a whole group. You are not an island no matter how healthy you are.
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