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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Thursday, November 17, 2011

PPACA & Civic Duty etc.



A law review citation dump led me to another defense of the PPACA that is helpful given it briefly goes over a lot of ground.  Again, a reminder of the many things some want to toss out:

The Act contains many other provisions whose constitutionality has not been questioned. For example, the ACA prohibits insurers from establishing “lifetime limits on the dollar value of benefits” or “unreasonable annual limits” on benefits and claims, id. § 300gg–11(a)(1)-(2); prohibits the rescission of insurance contracts, id. § 300gg–12; requires insurers to provide a simple, straightforward summary of coverage, id. § 300gg–15(b); requires insurers to include provisions for preventive care, such as immunizations, breast-cancer screening, and screenings for infants, children, and adolescents, id. § 300gg–13; and requires insurers to provide coverage for dependents to a specified age, id. § 300gg–14(a).
Jack Balkin (who defended the law in various venues)  is cited a few times, including respecting the "misleading" nature of the term "individual mandate," since many groups are not penalized for non-purchase. He also puts forth a "civil republicanism" defense that need not be the only one, but it does provide (for me and many others) a principle moral basis for the law. Racial equality was not enforced merely because the Constitution required it.  Popular acceptance of the immorality of the alternative was necessary.  Do we see the "mandated association" with blacks in supermarkets a problem?  The matter was seriously debated in the 1960s and even now Rand Paul just couldn't answer a question Rachel Maddow put to him on the question, but today it is not publicly proper to suggest something like that.  Public morality opposes it.

In the words of Jack Balkin:
This is a very modest request that individuals not be entirely selfish and that they contribute to the public good in a small way by helping to make health care accessible and affordable for all Americans. Indeed, under the terms of the Affordable Care Act, one doesn't even have to purchase insurance; one can simply pay a small tax instead. And one doesn't have to pay at all if one is too poor to do so or has a religious objection.

The notion that being asked to either buy health insurance and make health care accessible for one's fellow citizens--or to pay a small tax-- is a form of tyranny akin to George III's regime is simply bizarre: it shows how perverted and twisted public discourse has become in the United States. The assault on the individual mandate is really an assault on the public duty to assist other Americans in need, and in particular, an assault on the legal obligation to pay taxes to contribute to the general welfare. The assault on the health care bill is not a defense of liberty. It is a defense of selfishness.
The fact something is right doesn't mean Congress has the power to put it in place, but this re-enforces other arguments that show that they do have the power to enact the PPACA.  It provides a reason why, one that answers concerns that the measure will threaten individual liberty and limited government.  Quite true, and annoying to me as well, that the arguments put forth against it turn out to rest on sand.  We as a society tend to talk out of two sides of our mouths at times though and are known to be inconsistent.  "What have you done for me lately" is a standard approach for sports teams as much as anyone out. 

So be it.  The need to answer the overall message of the opponents is clear and involves various facets, including the good aspects of the law, the reasonable constitutional arguments, the limits in place and overall why this is right.  For me, at least, the bottom line is that I think the reasoning put forth here is particularly specious and yes, downright selfish. This brings some anger and disgust along with other things when I read about and debate people on this issue.  Such emotions come with the program when defending against bad things like discrimination and here deprivation of health care and stopping an attempt, however flawed, to deal with a core aspect to a good society in eminently reasonable ways.