I normally keep to state and local topics. When I stray to national issues, they usually involve tax policy.
I can’t avoid sharing my thoughts on what could be the constitutional issue of a lifetime – whether the federal government can compel a citizen to purchase a product or service. I’m referring to health care, of course.
However, it is also a tax issue.
The Sixteenth Amendment of the Constitution empowered Congress to levy taxes on income. There are fringe groups who claim otherwise, but court decisions have tossed their arguments time after time.
The power to tax is overwhelming accepted as the law of the land. To the protestors I say: if you cannot deal with it, start your own constitutional amendment process. Regardless of how responsible or irresponsible the government is in spending our tax dollars, in the words of former Chief Justice Oliver Wendell Holmes, “Taxes are what we pay for civilized society.” Another way of putting it is, “You don’t get something for nothing.” Try defending the country without taxes.
We are obligated to pay taxes.
So, are the financial penalties imposed by the individual and employer mandate provision of the Patient Protection and Affordable Care Act a tax or a forced purchase of a service?
Given the financial assistance (direct or indirect), the federal government provides hospitals to help cover unreimbursed costs, I would classify the penalties as a tax – they help in the recovery of costs from those who use medical services free of charge.
The penalties are one of the few facets of legislation I actually liked.
No tax could recoup the free ride some segments of illegal immigrants receive for emergency services (there are some who do pay in full, and others to a limited extent), or from the scofflaws who willfully do not file tax returns; therefore, would avoid the mandate. There are other remedies for dealing with these groups, none very effective, but that is a whole other topic.
It is not as if other areas of health care did not deserve attention, it is just that Congress and the President bit off more than they could chew. They created a divisive firestorm which will serve as the proverbial bloody shirt for years, maybe decades, to come. It’s not the first time that has happened. And the consequences have always been brutal.
Many pundits and politicians love to ask the question, “What was the intent of our Founding Fathers,” when it comes to any interpretation of a law’s constitutionality.
Health insurance did not exist in the Eighteenth Century. It is highly unlikely the original signers gave the concept any more thought than the ramifications of the internet on freedom of speech. Even Ben Franklin was not thinking about electronic social media when he was flying kites in lightning storms.
In those days, people accepted death. You might say they lived with it; were surrounded by it. By today’s standards, life back then was the equivalent of surviving a plague. If you read the biographies of our greatest leaders, almost all of them would be filled with the tragic loss of loved ones, many of whom were young, from horrible deaths due to yellow fever, typhoid, smallpox, etc.
If they had a fraction of today’s medical technology, they may have included a right to health care in the Bill of Rights.
But that is speculation.
We are on our own to make the right decision. The Supreme Court will not be the ultimate judge even if they vote in favor of it.
The Health Care Act will be revisited over and over again as the inevitable financial ramifications, unintended consequences and loopholes become apparent. We will also identify the provisions we like. The Act will be modified over the years as often as tax laws are, with occasional overhauls, too.
In the end, that might be the best we could hope for.
Because, then, we might have a decent system, not a super sized law.