ACA Ruling (part 1 - The One Man Majority)

The Supreme Court ruling on the Patient Protection and Affordable Care Act is, well, complicated.  One of its most interesting features is that the "majority opinion", or the opinion holding legal weight, is  held in its entirety only by one man--Chief Justice John Roberts.  In this post we'll focus exclusively on his opinion, which is as follows:

1. The Anti-Injunction Act does not impede the States' ability to bring suit against the ACA
2. The Individual Mandate cannot be upheld under the Commerce Clause or the Necessary and Proper Clause
3. The Individual Mandate, being functionally identical to a tax and enforced under the Tax Code, is within the taxing powers of congress and therefore Constitutional
4. The Federal government unduly coerces the states in its conditioning all medicaid funding on the ACA's expansion of medicaid, only new funding may be so conditioned

Basically the only thing the entire court agrees on is (1).  The Anti-Injunction Act is a law saying that people can't sue to avoid a tax until they've actually paid the damn thing.  Roberts says that congress explicitly said that the penalty associated with the Individual Mandate is not a tax, and therefore the Anti-Injunction Act doesn't apply. (This gets a little weird later on, when the Individual Mandate is determined to be a tax, but the takeaway is just that congress has the power to say what things are and aren't taxes for the purposes of the law, but not for the purposes of the constitution.  That actually makes a lot of sense, since otherwise the Feds could do anything, call it a tax, and have it be constitutional.)

Roberts joins the conservative dissent in stating (2) that the Individual Mandate is unsupported by the Commerce Clause because it regulates inactivity, rather than activity.  Frankly, I think this distinction is weird and stupid, but I'll put off arguments until after I've gone through the dissenting opinions.

Roberts, along with the liberal dissent, points out (3) that because the Individual Mandate is exercised through the IRS,  is governed by the laws governing taxation, is levied at least in part to provide revenue, and is not punitive (it never exceeds the value of purchasing insurance, and is usually substantially less), it is a form of tax for constitutional purposes, and, as such, is constitutional under the taxation powers of congress.

Finally, in agreement with a large block of both liberal and conservatives (though some Justices still dissent), Roberts rules (4).  I don't fully understand this argument, but it seems like the basic claim is that federal-state programs have to be looked at as contracts between the federal government and state government.  The medicaid expansion greatly exceeds the scope of changes the states could have reasonably expected when signing on to the program, therefore their original contracts must remain valid regardless of whether they decide to expand their programs to the new medicaid levels.  That's the theoretical justification, which I find weak.  The practical justification is much stronger.  Basically, the amount of money involved in medicaid amounts to 10% or more of most states' budgets.  Giving up that funding would be fiscal suicide for most states.  Therefore, the states have no real choice but to accept the changes to medicaid.  The Justice rightly points out that a similar tactic could be used to coerce the states to enact basically any law, even those that the federal government has no right to enact, which would pretty much defeat the purpose of Federalism.

And just one more thing (still contraceptives)

The key question about whether Catholics are harmed by the contraceptive mandate is whether they are being asked to do something immoral.  I don't think they are.  The key questions about whether religious freedom is harmed by the contraceptive mandate are:
1. Is the mandate objectionable to some on the grounds of faith?
2. Is there a legitimate federal interest in overriding these objections (as in prohibitions on human sacrifice or (perhaps less legitimately) polygamy)?

It's clear that the answer to 1 is yes, but it's not clear that the answer to 2 is no.  The federal government heavily subsidizes employer provided healthcare, so one might reasonably think that if you take the subsidies you have to take the strings that come with them.  Furthermore, it seems possible that there's a legitimate federal interest in reducing healthcare costs, and perhaps even a right to reproductive freedom to be protected.  More below the fold.

Entitlement (edited for improvement)

EDIT: This post is badly written and reasoned.  I have other better opinions about this that I will one day expound upon.  I'm leaving this up as a sort of "history of Rory's thoughts" post, but it no longer reflects my views on this subject.

Today we will settle once and for all the argument about entitlement programs.  People hate these for all sorts of reasons.  Commonly cited:

1. We can't afford them
2. Big Government is bad
3. Government shouldn't enforce redistribution of wealth (related to 2); leave charity to the choice of individuals
4. Moral Hazard (Perverse incentive encouraging them what are poor not to do work)

In brief, my responses to 1-4 are as follows:

1. As they are now, agree
2. what does that even mean?
3. I am too angry to briefly address this, but it is stupid and I can prove it with Science and also Reason (related to 2)
4. Sure, there is moral hazard, but you know what else is morally hazardous? allowing innocent people to suffer and/or die when you could have given up money to stop it (related to 3, and 2)

Later, when I am less angry, I will write some stuff about how misguided beliefs 2 through 4 are.  For now, I will content myself with my proposal to remove the legitimate objection (that's number 1 for those of you who werent counting, or can't)

Once again, I propose a rights based approach.  Here's the deal: the thing I care about most is that people who are poor don't die or get sick or get injured on account of being poor.  I think that when that happens it is bad and also not good.  That's my primary concern.  So I figure, we should do with other entitlement programs what we've done with our most successful entitlement programs to date (education and the post), give them to everyone, everywhere, and make everyone, everywhere, pay for them.

In practice, I think it would look something like this:

1. Mail everyone a multi-vitamin with the stuff that peeps actually need in it (as much as medical science can anyway)
2. Mail everyone food stamps or maybe even actual food to the point where every person has the means of acquiring enough calories to be healthy
3. Guarantee FREE emergency and routine medical care (though only for bottom shelf medicines, treatments, &c)
4. Provide some baseline housing allowance to all people, payed directly from the government to the provider of housing (so the money can't be redirected to, you know, drugs or the like)

Please note that this system would apply equally to everyone.  Any purchases you made above and beyond this would of course be up to you, but there would be no reason for (for instance) health insurance companies to provide a basic coverage package, though there's still plenty of incentive to buy health insurance if you want to benefit from the pinacle of medical science and have the money to do so.  Furthermore, the government would be paying hospitals for all of their procedures, rather than forcing them to eat the cost of emergency medical care for the uninsured (as they currently do).  Likewise, the rich could put their housing allowance towards their second or third home, and would benefit as much (monetarily) as the poorest people.  The rich would also get their vitamins and food stamps, but would have the opportunity to go out and pay the premium on top of those food stamps to get nicer food or eat at restaurants and the like.

How would we pay for this? Taxes! and yes, stepped taxes, that means that the rich will pay out more in taxes than they take in in government living support.  On the upside, they will never ever ever have to feel guilty when they don't want to give a beggar money, on account of they KNOW BEYOND A SHADOW OF A DOUBT that that person has enough food, nutrients, shelter, and medical care. 

Incidentally, if we do this we can get rid of social security, medicare and medicade, which would be nice.  Since we're not providing any income or luxuries, people would still be motivated to find work, but if they didn't find work, no one's health would be at risk.  As a bonus, no one would ever die from neglect-by-society which, you know, could be cool.  Let me know what you think, and feel free to point out how I might be an idiot and am also almost certainly a communist.

EDIT: How does this save us money on entitlements?

This saves us money in a few key ways.  First of all, it lets us get rid of social security.  Secondly, it dramatically reduces the benefits provided to people (no cell phones, no cash-per-kid).  Thirdly, it eliminates the possibility of fraud and all of the resources that attempting to combat that would take up.  Fourthly, it simplifies the system, greatly reducing the administrative cost of running it.  The administration required to support such a system would basically be post office infrastructure, and maybe a way to connect landlords and their client's housing allowance.