The Heartland Institute's Peter Ferrara tells you, over at The American Spectator. First, a brief explanation of why the whole law collapses without mandated insurance purchase.
Without the individual mandate, the rest of Obamacare is transparently unworkable, as President Obama and the Democrats themselves said during the jihad for its enactment. That is because the bill also includes what is known as "guaranteed issue" and "community rating." Under those provisions, an insurance company must insure whoever applies, and charge them no more than anyone else, no matter how sick or costly they are when they first apply...
The skyrocketing premiums cause younger and healthier individuals to drop their coverage. That forces insurers to raise premiums even more because the remaining pool is even sicker and costlier on average. The younger and healthier than flee even more, knowing they can automatically get coverage later if they become sick! ...
...without the individual mandate, the whole system inevitably collapses as described above.
He proposes a couple of free market solutions: block grant Medicaid to states to cover their poorest with income-based vouchers for private insurance, and create state high-risk pools to assist with private coverage when insurance is prohibitive. I would add the provision of insurance crossing state lines and (perhaps) the portability of insurance when changing jobs.
These are market solutions that maintain the private health care system while supplementing it for the most vulnerable. It still allows people to go without, if they're young, healthy, and elect to do so. Those individuals should be encouraged to buy low-cost catastrophic coverage so that unforseen disasters could be handled. That's encouraged, not mandated. But, as Mr. Ferrara notes, covering the masses was never really the goal.
The only reason President Obama and the Democrats would not even consider this approach is that it does not involve the government takeover of health care, which was the real goal all along, so the wise government could run health care in the interests of progressive "social justice" (which sometimes means denying people health care).
One area this essay doesn't touch is Medicare, which is in its own entitlement death spiral as the baby boomers reach 65. However, putting Medicare on a more sound footing does not require dismantling and turning over to the government the best medical care in the world. Retiree health care can certainly be addressed separately.
Everyone's worry is about Supreme Court swing vote Anthony Kennedy. Frankly, it's a little hard for me to understand how any of the nine justices, if they are truly versed in the Constitution, could conclude any differently than Judge Vinson. I'm certain the Justices Sotomayor, Kagan, Ginsberg and Breyer will find a way, but their minority opinion in the ultimate judging of ObamaCare will be a classic demonstration of contrived logic and avoidance of proper consideration of constitutional limits on federal power.
2/2/11 1005: And what would be a discussion of constitutionality and limits on federal power without a preposterous response from someone purported to be a constitutional scholar.
First, the higher prices and taxes aren’t Vinson’s problem if the bill itself violates the Constitution. Judges are supposed to rule on the facts and the law, not on the policy choices they like best. The prices and taxes are Congress’ issue to solve, within the limits of their authority under the Constitution. Prices might drop and taxes might go down if Congress nationalized all means of production, too, but that doesn’t make it legal or morally right.
Second, the role of the judiciary is to check the power of Congress and the executive. That’s why actual Constitutional scholars refer to the “checks and balances” of the three-branch federal system. Maybe Obama learned his Constitutional law at the same place Chuck Schumer learned civics, but applying a check to Congressional overreach isn’t “judicial activism,” it’s one of the main purposes of the federal courts. “Judicial activism” occurs when judges create laws from the bench in the absence of legislative action.
"Judges are supposed to rule on the facts and the law, not on the policy choices they like best." I hope the liberal bloc of SCOTUS remembers that.