How to dramatically reduce costs, without “Medicare For All” (which would quickly mean Medicare For None).
One of the infuriating things about the health debate was the false notion that we who don’t want the government to take it over think that the system is fine, or don’t have any ideas how to fix it. The Left just doesn’t like them, and as with climate, it’s not about the policy, it’s about control.
A third suggestion would be to pass a federal law allowing insurance companies to sell insurance “across state lines.” This would allow much larger risk pools, and lessen the burden of insuring those with “pre-existing conditions.”
The Commerce Clause of the Constitution lists the power “To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes” as one of the enumerated powers of government, specifically Congress. “Regulate,” in 1789, meant “to make regular,” i.e. uniform. It didn’t mean “have the Executive Branch issue rules with the force of law which individuals must obey.” In fact, it explicitly says that the power is to regulate commerce “among the several states,” not “among individuals and businesses in different states.” The difference is profound. It was intended ward off erection of trade barriers by the governments of the several states against other states. Banning insurance across state lines is such a barrier.
So one of the few enumerated powers the Constitution grants Congress goes completely unused, and a bastardization of the concept is instead delegated to the Executive – which the Constitution does not say the Congress may do.
Well, yes, I agree with your interpretation. It would be nice if the Supreme Court agreed with it too, however, the past century or so would seem to indicate that they do not. It does not seem that the strategy of putting an occasional token Constitutionalist on the court has had any good effect either.
A strategy of occupying the Supreme Court and literally twisting their arms to reach our interpretations seems prone to failure. Getting new Constitutionalist justices approved over the next decade or two also seems doomed, because the politicians who approve them, Rs and Ds, like things the way they are, because the bureaucracy shields them from making unpopular decisions while still funneling money to their supporters.
So, we are left with the only strategy that might work: explaining the principles of a free society to the masses in such a way that they want them and demand they be defended and implemented. A long shot, I admit.
Michael S. Kelly;
I disagree that this idea would lower health-care costs. Different states have different rules and regulations on what needs to be covered by insurance policies sold in each state. United Healthcare, for one, has offices in most, if not all states. But they are headquartered in one state. Same for Blue Cross. I assume most of the rest of the insurers operate in a similar fashion. Allowing them to sell across state lines may decrease some bureaucratic redundancy, but cost reductions would be minimal. I believe your idea would lead to more federal control of the healthcare system, something I believe is the cause of most of our problems.
It has nothing to do with locations of headquarters or bureaucratic redundancy. It has to do with (prior to ObamaCare) different states’ rules on what must be covered (e.g., pap smears and mammograms for men, as ObamaCare policies must offer). Some states allow more flexibility, and lower cost (e.g., catastrophic only, with high deductibles, which is what I would want), but it’s currently illegal for people in other states to buy them.
What about one of those “state compact” thingies? If states can agree to game the Electoral College, could they not agree to this?
The “National Popular Vote” interstate compact is almost certainly unconstitutional, and would be immediately challenged on such grounds in the (impossible) case that enough states ever signed on.