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Statism Goes to Court

Health care should not be a federal concern at all.


By Andrew C. McCarthy
http://www.nationalreview.com
March 30, 2012

Well, I can’t imagine that that — that the Commerce Clause would — would forbid Congress from taking into account this deeply embedded social norm.”

This was Solicitor General Donald Verrilli on Day Two of the great Obamacare case. At issue was Affordable Care Act’s most controversial aspect: the “individual mandate” — the requirement that Americans purchase health insurance as a condition of living in their country. The SG was being pummeled by Justice Antonin Scalia.

Pummeling was the order of the day for Verrilli. From the moment he rose to deliver the most important argument of his professional life, he seemed tongue-tied; he could barely get through “May it please the Court” without sputtering. It is hard, even for a lawyer as fine as Verrilli, to defend the indefensible. Yet, as he argued with Scalia, the SG grabbed on to a hidden truth: He and his fellow progressives are already way, way ahead. They may not win this skirmish over the individual mandate. But there is the battle, and then there is the war. For statism, the war is still going very well.

The “deeply embedded social norm” to which the SG referred was another government mandate: The 1986 law demanding that hospitals, without compensation, treat emergency patients who lack insurance or the capacity to pay. It was a telling moment: The hullaballoo over the individual mandate is a case of noticing the barn door open about a quarter-century after the horse has galloped away.

So who are “the uninsured”? They sort into two categories, alternatively emphasized, depending on what the Left is trying to accomplish that day. If the aim is to achieve “social justice” (i.e., the redistribution of wealth from the producers to the takers), they are “the poor.” If the aim is to manufacture social injustice, they are the “free riders” — “free,” once our coveted condition, is now an epithet. The “free riders” rationally choose not to insure themselves, figuring that they are young, healthy, not likely to need much medical attention, and able to get treatment in the event of an emergency.

There are no free lunches, though. The central planners want to co-opt the aged and the poor, but they cannot afford to seduce them with “free” health care unless they soak the free riders. Meantime, hospitals cannot afford to treat and bear the malpractice risks of non-paying patients unless they recoup by over-charging the paying customers. Since people generally pay by insurance, this drives up the private insurers’ costs. That, in turn, drives up the costs of premiums, which responsible people choose to pay in order to insure themselves against the skyrocketing prices bred by this vicious cycle of coercion.

Thus, Verrilli contended, Congress can force free riders either to buy government-approved insurance or to pony up a government-dictated fine. As he put it, you must “pay for what you get” because you are “getting the health care service anyway as a result of the social norms . . . to which we’ve obligated ourselves so that people get health care.”

Well, no, Justice Scalia countered. There’s a much easier answer: “Don’t obligate yourself” in the first place. After all, if you didn’t coerce the hospitals and the insurers, you wouldn’t need to coerce the citizens.

Heaven forefend! Why, government coercion is the beating heart of our “free” society. It is — all together now — a “deeply embedded social norm.”

In the abstract, Verrilli’s case on the individual mandate is specious. The Commerce Clause empowers Congress to regulate interstate commerce that free people choose to engage in. It does not authorize Congress to create commerce by compulsion, to coerce Americans into engaging in individual commercial transactions that — thanks to New Deal alchemy — are feverishly imagined to jolt interstate markets, activating the hair-trigger of federal regulation. This is why the SG labored mightily to claim that the mandate does not so much fabricate new commerce as regulate ongoing commerce. Bootstrapping mandates to mandates, Verrilli theorized that we are all in the health-care market already, whether we realize it or not, because accident or disease could strike at any moment — and when it does the “free” emergency room is here for us.

Still, we don’t live in abstractions. Ours is a landscape of statist excess, enabled by 80 years of Supreme Court jurisprudence. Verrilli was thus at his strongest talking not about the Commerce Clause per se but about its unrecognizable remains. Just look at the “reforms” already enacted, the SG urged: not just the mandate that hospitals must treat ER patients but mandates that force insurers to cover people despite “preexisting conditions” and mandates that “require ‘guaranteed issue’ and ‘community rating’” — euphemisms for prohibitions that bar insurers, when setting premiums, from accounting for factors, such as age, sex, and health status, that common sense says are highly significant to the risk being assumed.

Then Verrilli dropped the hammer: For all their caterwauling about the individual mandate, the states that brought the Obamacare suit did not, and do not, dispute Congress’s Commerce Clause power to impose these other long-established health-care “reforms.”

The premise of the states’ challenge to Obamacare is that, in taking direct aim on the whole citizenry, the individual mandate crosses a new threshold. The claim is not without merit, and it seemed to resonate with several of the justices. Addressing Verrilli, Justice Anthony Kennedy, the presumptive swing vote, admonished, “You are changing the relation of the individual to the government in . . . a unique way.”

But how unique, really, is the Obamacare mandate? Assuming we are still a free society, of course it is offensive for government to coerce citizens into buying health insurance. But is it not equally offensive for government to coerce private hospitals to treat patients for free? For government to coerce private insurers regarding whom they must cover and what they must cover them for? To dictate that, in making these determinations and calculating their risks, insurers must ignore palpably pertinent information? In the law, a contract is a voluntary bargain. What we’ve tolerated for a very long time, however, are adhesive arrangements of involuntary servitude. The law’s usual word for that is extortion.

And health-care extortion, by the way, is not Obama’s doing. It is our longstanding, bipartisan, Big Government condition. To take just one example, here is an excerpt from the vaunted “Pledge to America” that House Republican leaders touted during the 2010 campaign:
Ensure Access For Patients With Pre-Existing Conditions: Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans.
No, President Obama did not invent this stuff. He is simply fast-forwarding to the next logical steps.
Health care, like most things, should not be a federal concern at all. If people at the state or local level think everyone should be entitled to emergency medical care, that’s fine — they ought to raise taxes and pay the hospitals to provide it. If they think sick or high-risk patients who can’t get affordable private medical insurance ought to have their treatment paid for nonetheless, they ought to raise taxes to pay for that, too. It is great to be noble, but it’s not noble to throw around other people’s money. Your choices ought to be your costs. And that goes for insurance-company executives, too: If they take premium payments, then fraudulently wriggle out of the consequent obligations, they ought to be prosecuted, sued for damages, and put out of business. The state’s legitimate role is limited, but it is essential.

That is how a sensible, private, cost-effective system would work. To the contrary, the ruling class of both parties embraces a central planning scheme of “deeply imbedded social norms”: Politician A and lobbyist B get together to decide what service-provider C is going to be forced to do for interest group D. Adam Smith, Frederick von Hayek, and Milton Friedman told us why this never works, but by now we should know from our own experience. Coercion begets coercion: If you’re going to force the hospitals, then you have to force the insurers; if you’re going to force the insurers, then you have to force the citizens.

Donald Verrilli had a tough go of it at the high court this week. The individual mandate may be on the ropes, as, perhaps, is the whole 2,700-page Obamacare monstrosity — although I wouldn’t bet on it. But if we were in the wagering business, what do you figure is more likely: The statists regroup and put us on a surer legal path to a “single-payer” system of socialized medicine; or Republicans seize the moment, roll back more noxious federal mandates, and forge a path back to free-market health care? I’m not sure how solicitor general Verrilli will grade out come Judgment Day in early July, but, alas, I like his team’s chances over the long haul.

Andrew C. McCarthy is the author, most recently, of The Grand Jihad: How Islam and the Left Sabotage America.

Just reading Obamacare cruel and unusual punishment

It’s not just that the legislators who legislate it don’t know what’s in it, nor that citizens can ever hope to understand it, but that even the nation’s most eminent judges acknowledge that it is beyond individual human comprehension.


By Mark Steyn
The Orange County Register
http://www.ocregister.com/
March 29, 2012


Since the retirement of Sandra Day O'Connor, Swingin' Anthony Kennedy has been the swingingest swinger on the Supreme Court, the big Numero Cinco on all those 5-4 white-knuckle nail-biting final scores. So naturally court observers have been paying close attention to his interventions in the ObamaCare oral arguments. So far he doesn't sound terribly persuaded by the administration's line:

"The government is saying that the federal government has a duty to tell the individual citizen that it must act, and that is different from what we have in previous cases, and that changes the relationship of the federal government to the individual in a very fundamental way."

As John Hinderaker wrote at the Powerline blog, "In that last observation, Kennedy seems to be channeling Mark Steyn." Which is true. As I wrote in National Review only two or three issues back, "I've argued for years in these pages that governmentalized health care fundamentally transforms the relationship between citizen and state in ways that" – and here's the bit Justice Kennedy isn't quite on board with yet – "make it all but impossible to have genuinely conservative government ever again." So I'm naturally heartened to hear him meeting me halfway. This was one of the highlights of a week that a shellshocked Jeffrey Toobin, crawling out from under the rubble of the solicitor general's presentation, told CNN viewers was "a train wreck" for the government's case.

And yet, and yet... If you incline to the view that Obamacare is a transformative act, isn't there something slightly pitiful about the fact that the liberties of more than 300 million people hinge on the somewhat whimsical leanings of just one man? I mean, Kennedy seems a cheery enough cove, but who died and made him the all-powerful Sultan of Swing? "It is a decision of the Supreme Court," explained Nancy Pelosi a few years back in more congenial times for the Democrats. "So this is almost as if God has spoken."

That's not how earlier Americans saw it: "If the policy of the government upon vital questions affecting the whole people is to be irrevocably fixed by decisions of the Supreme Court," wrote Abraham Lincoln, "the people will have ceased to be their own rulers."

Which they have. Or it would not have come to this.

In February, George Jonas wrote up north that Canadians enjoyed more rights and freedoms in the days before all their rights and freedoms got written down in a big ol' "Charter of Rights and Freedoms" (1982). At this point, many readers will object that the constitutional documents of some effete pansy ninny monarchy like Canada are entirely irrelevant to a strapping butch manly self-reliant republic like America. Three words:

Ruth Bader Ginsburg. Finding herself with a bit of time on her hands, Justice Ginsburg swung by Cairo last month to help out the lads from the Muslim Brotherhood building the new Egypt: "I would not look to the United States Constitution if I were drafting a constitution in the year 2012," she advised them. Instead, she recommended the Canadian Charter of Rights and Freedoms and the European Convention on Human Rights. That's why the fate of the republic will come down to a 5-4 vote. Because four-ninths of the constitutional court think the American constitutional order is as déclassé as a 2006 BlackBerry.

"There seems to be an inverse relationship between written instruments of freedom, such as a Charter, and freedom itself," mused George Jonas. "It's as if freedom were too fragile to be put into words: If you write down your rights and freedoms, you lose them." That was generally the view of the Britannic part of the English-speaking world until the late 20th century: What's unwritten is as important, if not more so, than what is.

The Constitution of Australia, for example, makes no mention of the office of Prime Minister. The job exists only through custom and convention understood from the United Kingdom, where, likewise, it existed only through custom and convention: "statutory recognition" in London didn't come till 1937 – or over two centuries after dozens of blokes had been doing the job.

By contrast, on the Continent, where many constitutions date all the way back to the disco era (Greece, 1975; Portugal, 1976; Spain, 1978), if the establishment wants to invent a new "right" – i.e., yet another intrusion by government – it goes ahead and does so. If it happens to conflict with this year's constitution, they rewrite it. The United States is the only Western nation in which our rulers invoke the Constitution for the purpose of overriding it – or, at any rate, torturing its language beyond repair.

Thus, in this week's debate on whether Obamacare is merely the latest harmless evolution of the interstate commerce clause, the most learned and highly remunerated jurists in the land chewed over the matter of whether a person, simply by virtue of being born, was participating in a "market."

Had George III shown up at the Constitutional Convention to advance that argument with a straight face, the framers would have tossed aside the quill feathers and reached for their muskets.

A land of laws decays almost imperceptibly into a land of legalisms, which is why America has 50 percent of the world's lawyers. Like most of his colleagues, lifetime legislator John Conyers (a congressman for 47 years) didn't bother reading the 2,700-page health care bill he voted for. As he said with disarming honesty, he wouldn't understand it even if he did:

"They get up and say, 'Read the bill.' What good is reading the bill if it's a thousand pages and you don't have two days and two lawyers to find out what it means after you read the bill?"

It would be churlish to direct readers to the video posted on the Internet of Rep. Conyers finding time to peruse a copy of Playboy while on a commuter flight to Detroit. So let's take him at his word that it would be unreasonable to expect a legislator to know what it is he's actually legislating into law. Who does read the thing? "What happened to the Eighth Amendment?" sighed Justice Scalia the other day. That's the bit about cruel and unusual punishment. "You really want us to go through these 2,700 pages? Or do you expect us to give this function to our law clerks?"

He was making a narrow argument about "severability" – about whether the court could junk the "individual mandate" but pick and choose what bits of Obamacare to keep. Yet he was unintentionally making a far more basic point: A 2,700-page law is not a "law" by any civilized understanding of the term. Law rests on the principle of equality before it. When a bill is 2,700 pages, there's no equality: Instead, there's a hierarchy of privilege microregulated by an unelected, unaccountable, unconstrained, unknown and unnumbered bureaucracy. It's not just that the legislators who legislate it don't know what's in it, nor that the citizens on the receiving end can ever hope to understand it, but that even the nation's most eminent judges acknowledge that it is beyond individual human comprehension. A 2,700-page law is, by definition, an affront to self-government.

If the Supreme Court really wished to perform a service, it would declare that henceforth no law can be longer than, say, 27 pages – or, at any rate, longer than the copy of Playboy Congressman Conyers was reading on that commuter flight.

C'mon, Justice Kennedy. Obamacare vs. Playboy: It would be a decision for the ages – and an act of bracing constitutional hygiene.

©MARK STEYN

The ‘flexibility’ doctrine

By
The Washington Post
http://www.washingtonpost.com
March 29, 2012


Presidents Obama and Medvedev of Russia shake hands in Seoul, S. Korea


“On all these issues, but particularly missile defense, this can be solved, but it’s important for him [Vladimir Putin] to give me space. . . . This is my last election. After my election, I have more flexibility.”

— Barack Obama to Dmitry Medvedev, open mike, March 26



You don’t often hear an American president secretly (he thinks) assuring foreign leaders that concessions are coming their way, but they must wait because he’s seeking reelection and he dares not tell his own people.

Not at all, spun a White House aide in major gaffe-control mode. The president was merely explaining that arms control is too complicated to be dealt with in a year in which both Russia and the United States hold presidential elections.

Rubbish. First of all, to speak of Russian elections in the same breath as ours is a travesty. Theirs was a rigged, predetermined farce. Putin ruled before. Putin rules after.

Obama spoke of the difficulties of the Russian presidential “transition.” What transition? It’s a joke. It had no effect on Putin’s ability to negotiate anything.

As for the U.S. election, the problem is not that the issue is too complicated but that if people knew Obama’s intentions of flexibly caving on missile defense, they might think twice about giving him a second term.

After all, what is Obama doing negotiating on missile defense in the first place? We have no obligation to do so. The Anti-Ballistic Missile Treaty, a relic of the Cold War, died in 2002.

We have an unmatched technological lead in this area. It’s a priceless strategic advantage that for three decades Russia has been trying to get us to yield. Why give any of it away?

To placate Putin, Obama had already in 2009 abruptly canceled the missile-defense system the Poles and Czechs had agreed to host in defiance of Russian threats. Why give away more?

It’s unfathomable. In trying to clean up the gaffe, Obama emphasized his intent to “reduce nuclear stockpiles” and “reduce reliance on nuclear weapons.” In which case, he should want to augment missile defenses, not weaken, dismantle or bargain them away. The fewer nukes you have for deterrence, the more you need nuclear defenses. If your professed goal is nuclear disarmament, as is Obama’s, eliminating defenses is completely illogical.

Nonetheless, Obama is telling the Russians not to worry, that once past “my last election” and no longer subject to any electoral accountability, he’ll show “more flexibility” on missile defense. It’s yet another accommodation to advance his cherished Russia “reset” policy.

Why? Hasn’t reset been failure enough?

Let’s do the accounting. In addition to canceling the Polish/Czech missile-defense system, Obama gave the Russians accession to the World Trade Organization, signed a START Treaty that they need and we don’t (their weapons are obsolete and deteriorating rapidly), and turned a scandalously blind eye to their violations of human rights and dismantling of democracy. Obama even gave Putin a congratulatory call for winning his phony election.

In return? Russia consistently watered down or obstructed sanctions on Iran, completed Iran’s nuclear reactor at Bushehr, provides to this day Bashar al-Assad with huge arms shipments used to massacre his own people (while rebuilding the Soviet-era naval base in the Syrian port of Tartus), conducted a virulently anti-American presidential campaign on behalf of Putin, pressured Eastern Europe and threatened Georgia.

On which of “all these issues” — Syria, Iran, Eastern Europe, Georgia, human rights — is Obama ready to offer Putin yet more flexibility as soon as he gets past his last election? Where else will he show U.S. adversaries more flexibility? Yet more aid to North Korea? More weakening of tough Senate sanctions against Iran?

Can you imagine the kind of pressure a reelected Obama will put on Israel, the kind of anxiety he will induce from Georgia to the Persian Gulf, the nervousness among our most loyal East European friends who, having been left out on a limb by Obama once before, are now wondering what new flexibility Obama will show Putin — the man who famously proclaimed that the “greatest geopolitical catastrophe” of the 20th century was Russia’s loss of its Soviet empire?

They don’t know. We don’t know. We didn’t even know this was coming — until the mike was left open. Only Putin was to know. “I will transmit this information to Vladimir,” Medvedev assured Obama.

Added Medvedev: “I stand with you.” A nice endorsement from Putin’s puppet, enough to chill friends and allies, democrats and dissidents, all over the world.

letters@charleskrauthammer.com