Day 2 of being a good citizen: understanding healthcare reform. Or trying.

Today’s Good Citizenship task is to read two opposing opinions on the same topic. I chose healthcare – specifically the Patient Protection and Affordability Act and its challenged constitutionality – because quite honestly, I have no idea.

To be honest yet again, I had little hope that ANY of this reading would give me a true handle on the issue. It’s far too complicated, and I feel like I’d need a good two to five years of higher education to find a foothold in healthcare reform. But I DID learn some stuff. Just enough to sound passably intelligent on the topic, which is, I think, the most any of us hope to achieve on these issues. That, my friends, is a problem.

Anyway, here’s my reading list:

“Is the Health Care Law Unconstitutional” New York Times. Including several articles written by legal experts and professionals, this was by far the most helpful article. I learned two things in particular. The first is that health insurance simply doesn’t work for the gravely or persistently ill. It’s too expensive to take care of them without bankrupting everyone else, so we simply have to let Darwinism run its course (or else mandate healthcare, which may or may not be constitutional; I’m still not convinced and that doesn’t really seem to be the problem anyway.). Am I overstating that? Also, the key to understanding the constitutionality of this law has something to do with growing your own wheat at home and medical marijuana. I have no idea how, but it’s a very crucial point.

“Opposing Views: Voice on Health Care Reform” – Wall Street Journal. A much more practical take on the law, not relating to the constitutional issue so much as the pragmatic effects of the law. The most important thing I learned here was actually about me: when someone begins an article calling the law “ObamaCare” I immediately assume they aren’t smart enough to truly understand or offer any wisdom on the topic; they’re simply going to be regurgitating the opposition’s talking points. Good to know.

“Health Care May Prove Costly for Obama” – The Bottom Line, a publication of the UC Santa Barbara Journalism department. This offered an incredibly simplified, but useful overview of the topic.

“The Supreme Court ruling – what’s at stake for healthcare”Forbes. Written by a Democratic political strategist, Fox News commentator and vocal Obama opponent, this article seemed like the ultimate point-counterpoint all in one. It’s more like a tough luck piece. Basically, put on your seatbelts, people. It’s going to suck from here on out.

“Whatever Court Rules, Major Changes in Healthcare Likely to Last”New York Times. This article offers some conflicting facts and an interesting summary of how the states are reacting to the impending enforcement of the Patient Protection and Affordable Care Act. Some have already implemented a number of the provisions, some with great concern and complication and others – gasp! – positive results. Others are acting like spoiled children on a permanent hunger strike.

And now I’m going to bake. Buttermilk blueberry bread seems like the only reasonable next step.


10 thoughts on “Day 2 of being a good citizen: understanding healthcare reform. Or trying.

  1. What the question has to do with growing your own wheat at home is the question of the limits of the Commerce clause. The Commerce Clause holds that Congress can regulate interstate commerce. If I grow my own food, on my own land, to eat myself, am I engaging in an activity that substantially effects interstate commerce? If so, Congress claims authority to regulate my ability to produce my own food at home for myself. It seems as if no commerce is going on at all — I’m not buying anything, and I’m not selling anything — and certainly nothing interstate.

    However, Congress argues that the presence or absence of food affects the overall supply of food, and thus food prices nationwide; and thus, they can regulate how (and whether) you grow wheat or other foods for yourself. SCOTUS has so far seemed inclined to agree that Congress can do so; for example, Federal regulations on raw milk were upheld last year, even if you’re milking your own cow to drink the milk at home.

    The analogy to the individual mandate is that Congress is trying to use the Commerce clause to regulate a non-commercial, non-interstate act. If I’m buying nothing (i.e., I’m not buying health insurance), there’s no commerce to regulate; and insurance markets are not interstate by definition, because it is illegal to sell health insurance out of state. That’s why you have to change health insurance companies every time you move from one state to another — Blue Cross Blue Shield of Georgia is different from BCBS of Virginia, for example.

    So, does the Constitutional power to “regulate interstate commerce” mean that Congress can regulate non-commerce that is not interstate? If so, Congress has effectively unlimited power to regulate anything: everything at all is either commerce or not-commerce, and either interstate or not-interstate. If SCOTUS upholds the mandate, it has effectively voided the Constitution’s limits on Congress.

  2. Which is all a way of saying that the question of constitutionality has nothing to do with improving healthcare. It’s a question of preserving or upholding the Constitution’s power to check or not Congress’s power on commerce, depending on how you see it. But really either way, we’re going to get sick and bankrupt and die.

  3. Well, not quite. Insofar as government health care plans can help with that problem, they’re perfectly constitutional at the state level. The Tenth Amendment explicitly reserves all authority not delegated to the Federal government “to the states, or to the People.” Thus, a state-level plan of the same type wouldn’t be open to constitutional challenge on these grounds — e.g., Mitt Romney’s plan in MA, which was the model for Obama’s health care reforms, has never come under constitutional challenge. MA has every right to institute such a law; but it isn’t clear that the Congress can do so at the Federal level.

    That may seem arcane, but really, it’s an important point. We have a country that is pretty diverse, where people have strongly different values and thoughts about what is right and wrong. A Federal solution is one-size-fits-all, and such solutions lead to culture wars. A state solution is not like that: if you really hate it, you can move to the next state over. You aren’t free to move countries in the same way.

    Thus, preserving this Federalist limit is of benefit to both liberals and conservatives: it gives us a chance to both live in the kind of place we want to live in. It also has the added benefit of preserving the checks and balances on Congressional power.

  4. There’s a kind of natural law at work here. You can only vote more benefits for everyone as long as you can tax (or borrow) to pay for the benefits. Taxes come from businesses, which either pay the taxes themselves, or pay workers salaries which are taxed. Businesses prefer low taxes, and thus will trend toward states with lower taxes.

    Thus, Georgia is unlikely to become too lonely because it will be a vibrant job market. Other states like California will have to organize their budgets within the realm of reality because they will otherwise risk losing jobs. Thus, we avoid both the problems of bankruptcy and overtaxation: the system balances, which was always the point of a checks-and-balances system.

  5. Yes, but if you’re employed, at least by a company that is large enough and can afford it, you have health insurance anyway and wouldn’t be making a where-to-live decision based on that state’s health insurance. The fabulous and interesting entrepreneurial and freelance types, however, will be moving to the states that make us the best deal. Also, it’s a pain in the ASS for health insurance to be limited to your state. At least for those of us who can’t sit still.

  6. Mom’s a good citizen too! Here are her thoughts on her chosen topic, Aspergers and Autism:

    I have had some wonderful students who have various combinations of these symptoms and I wanted to learn more about how to help them be successful in school. This video, though long, is worth the entire time. It is presented by a professor who herself has Asperger’s Syndrome. It is both scientific and practical in its explanation of the spectrum. She talks about the positive things that these people are best at doing that non-Asperger/Autistic people are not so suited for. She talks about what to do to help these people as kids find their places in school where they are most comfortable and where they find friends of similar interests instead of bullies who tease them. She talks about how to help them deal with frustrations. She talks about medications and when they are worth the risks and when they are not. She talks about natural ways of dealing with symptoms such as Omega 3 in the diet. It really is amazing and I am glad that I decided to do this challenge with you! I hope anyone who is interested finds this video helpful.

  7. Yeah, OK, but look at this too.

    There’s an educational video from that time, called “Understanding Asperger’s,” in which I appear. I am the affected 20-year-old…. “Understanding Asperger’s” was no act of fraud. Both my mother and her colleague believed I met the diagnostic criteria laid out in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

  8. I read his article and the article about the new definitions as opposed to the old definitions for autism and Asperger’s. Obviously, there is still much that needs to be learned about these exceptional kids. The problem with that is, I have some of them now and I don’t have time to wait for more studies to decided whether they are or are not defined in these terms. I need the practical, day to day, ways to meet their educational and emotional needs so that I don’t do more harm than good. It sounded as though some of the reasoning in redefining was financially motivated in order to safe the school systems and/or the insurance companies the cost of serving these kids. If they deny the problem, then they don’t have to pay to try to fix it. That leaves me and my kids on our own to figure out what to do. These kids are worth helping and I will continue to try. With or without a diagnosis.

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