Obamacare mandate isn't unconstitutional

Ok, maybe it is on principle if you think that buying insurance from a company in another state does not constitute interstate commerce. But it is unlikely that the courts will rule in favor of it being unconstitutional.

That being said, if you agree that an insurance company can't drop you when you get sick, or can't accept you if you are sick (two things that are in the the health law) then what do you do? The point of insurance is to have a wide pool of policy holders paying into a system. So now you have this big pool of money that you can spend on those policy holders that are sick and need care. Not everyone in the pool is sick. The healthy ones payments cover the costs of the sick ones. If everyone is sick then you are screwed, because health costs are so high. You can try to figure out how to tackle costs (that is called rationing) or you can insist that people who could need care at some point (everyone) must pay into the system. The mandate is needed simply because you are making insurers take people that will cost a lot of money. This is happening right now in hospitals that receive Medicare payments. Federal law states that hospitals that receive Medicare payments must treat people who come into the ER. So people that don't have health care coverage wait until they are really sick and at death's door before they go into the hospital. So now the hospital has spent all this money on people that can't pay and don't have insurance. So the hospital has to increase the rates it charges for its services. This causes premiums to go up for all of us who pay for insurance. So you must have a mandate if you are going to force insurers to carry everyone. Otherwise you abolish the insurers and just cover everyone under Medicare. Or you do something that I haven't thought of.

David Frum is getting a lot of flak over his Waterloo comments, but I have to agree with him. He then states his current political outlook with all the new FrumForum viewers who came to the site to bash Frum over his Waterloo piece. It's well worth a read. The best part is the last line:

I don’t think of myself as having gone squishy. I think of myself as having grown sober. And my conservative critics? On them, I think the most apt verdict was delivered by Niccolo Machiavelli, 500 years ago: “This is the tragedy of man. Circumstances change, and he does not.”

I recently had a Facebook discussion with one of the kids from my neighborhood in Idaho where I grew up. He is a staunch conservative who is convinced that the country is going down the tubes. He is a great guy and has a wonderful family and if I ever move back to Idaho I'll probably hire him to be my realtor. But I just can't agree with his politics. The Machiavelli quote above seems to suit him aptly.

I'm not sure if I've posted this before, but the state of Maryland sets prices for what hospitals can charge for care. But they do it in a very smart way. They don't set prices to be the same for all hospitals. They set prices based on what each hospital is paying its workers and who the hospital provides care to. Guess what? It's working!

Here is a lengthy but thoughtful essay on health care in National Affairs magazine.

And this whole "We don't work past 2pm" Senate rule being used by Republicans? Dumb dumb dumb dumb dumb dumb dumb.