July 01, 2012


By Melvin J. Howard

For the people by the people

You would think that the State and Federal Government would work together for the common good of its citizens. I would think health care reform would rank high on that scale. But you would be wrong the issue has become polarized and political and for this reason I worry that health care in this great nation of America with its run away costs and the non coverage of some of its most vulnerable citizens will continue to be a long dragged out debate with never ending challenges to the constitutionality of the law. At the heart of health reform is a legal debate surrounding THE COMMERCE CLAUSE. Basically, it is the scope of the federal government's power to regulate interstate commerce. The new healthcare reform bill places a requirement mandating all Americans must obtain some form of health insurance or risk being fined or penalized. Some GOP states argue "The Act represents an unprecedented encroachment on the liberty of individuals living in the Plaintiffs' respective states, by mandating that all citizens and legal residents of the United States have qualifying healthcare coverage or pay a tax penalty. The brief goes on to say that the Constitution nowhere authorizes the United States to mandate, either directly or under threat of perjury, that all citizens and legal residents have qualifying healthcare coverage. But it also states under the Constitution, Congress shall have the Power to Coin Money and Regulate the Value Thereof but we all know that is not the case today.

The GOP wants to argue that the federal government's power to regulate interstate commerce doesn't entail the power to create an individual mandate to buy health insurance, since the act of not buying health insurance shouldn't be seen as engaging in interstate commerce. But yet the GOP's counter-proposal for health-insurance reform is to "let families and businesses buy health insurance across state lines," which would clearly place health insurance in the category of "interstate commerce". That ought to give the federal government all the regulatory powers the states currently have to regulate health insurance and lets not leave out Massachussetts' health care system, with an individual mandate whose constitutionality has never been challenged in court. Also lets not forget Medicaid, which already is heavily subsidized by the federal government. National or multinational firms have increasingly dominated the industry, agriculture, services and finance, the government has the power to regulate national and international commerce and it has had increasing sway over economic regulation since the beginning.

Lets just take a look at what would happen without some key important mandates from congress in the form of the forgotten man: When A takes from B to give to C, the world is well aware of the benevolence of A and of the plight of C; but B is the forgotten man.

The relevant point for us is not that B is being treated unfairly; the point is that B isn't going to stand still for this. He'll look for ways to prevent A from stealing from him. He may begin avoiding or evading taxes; he may earn less so that less will be taken from him; he may move out of A's jurisdiction; or he may start pretending to be C.

The end result is a society in which everyone wants to be C (or A), and no one wants to be B. But B was the person who originally financed A's generosity; and without him, there will be little to redistribute. In addition, if C doesn’t have to pay for his own needs, it's inevitable that his need will grow larger. Society develops that it has boundless needs and no one to pay for them. We can see how this happens if, we look at one sample of the A-B-C process in the health care reform debate.

Health care advocates believe, for example, that people have a "right" to free medical care. Since no "rights" can be asserted against nature, the advocate must not be thinking of a right to live without disease. They are, in fact, thinking that no citizen should have to pay for medical treatment that it should be free.

But since nature doesn't provide medical care, it must come from other human beings. So one person's right to medical care is a claim upon some other person's time, energy, money, or knowledge. The man on whom this claim will be made is B, the forgotten man. Now the politician offers free medical care, but he never says, "You will have free medical care because we are going to force B to pay for it."

The plan becomes unrealistic from the start in that it assumes that B will submissively pay the bill without looking for loopholes. It's unrealistic, also, to believe that the costs of the program won't change when the economics of it change.

The politician sees that people presently spend $100 billion per year on medical care. So he plans to collect $100 billion on new taxes or ( medical insurance "contributions"), and use the money to pay for doctors, nurses, medicine, X ray etc. He believes that this will make medical care free.

But once the program is underway, the economics change drastically the 100 billion was what people had spent yearly when the money came from their own resources. Now that medical care is free their medical needs suddenly in­crease. Why forgo that operation, checkup, or treatment that might have some value.

Or if your lonely, why not go talk to your doctor? Or if you need a place to stay check into the hospital; they'll find something wrong with you many people will see that this is wasteful-for the nation. But for each individual, the con­sideration is always that it costs zero dollars to obtain something that might prove to be valuable so free medical care turns out to cost far more than $100 billion per year.

And after a while B decides that he’s tired of paying for what he deems these loafers and he checks into the hospital, too from stress.

Or at least he stops working so hard. His income is taxed to pay for free medical care and for all the other government programs. And so leisure (unpaid and therefore untaxed) seems more attractive to him. He earns less; and he saves less, too, because he'd just have to pay tax on the interest his savings earn. And because he and all the other Bs are earning less taxable income, the politicians have to raise tax rates even higher than they planned—to collect the money they need for free medical care.

Because even the government's resources are limited (it can't tax what doesn't exist), it is forced eventually to do something to limit the costs of the program. Naturally it won't end the program that’s political Armageddon; it will declare that a crisis exists and impose rationing.

So when the cost of free medical care has reached double or triple or quadruple the original estimate of $100 billion, the government announces that it will decide who gets to see the doctor first. You will have to go without—unless you have the right disease or fill out the right form or know the right people.

And most people will have no choice but to wait in line for free medical care. The billions spent on the program will have bid up the price of medical services; only the very wealthy (of whom there are fewer) will be able to afford to hire a doctor on their own.

Just as promised, medical care is free; it just isn't available. We would be sobered by the medical situation in Canada and some European countries. Government medical and "Social Security" pro­grams are far advanced there, compared to the U.S. The shortage of medical care is chronic because doctors emigrate to the U.S. and other countries where there are greater op­portunities to earn more money. Waiting lists sometimes are years long. Mr. B. has long since disappeared.

I've used this as an example of the way the health crises develops. The crisis is always a conflict between the government's goals and the actions of individuals. Many in­dividuals will sympathize with the government's position, but none will sacrifice his personal interest.

It isn't a matter of selfishness vs. unselfishness. Every indi­vidual acts in his own self-interest; that's a principle of hu­man action. The conflict is between the individual who selfishly pursues what he believes is best for himself and the politician who selfishly wants the individual to act under his direction. There is no right or wrong answer to this dilemma but in order to have true dialogue about how to cover the uninsured and to bring down health care costs in America. We must first acknowledge good ideas and implement them no matter what the source political or otherwise. So no one becomes the FORGGOTEN Man, Woman or Child!