So, in terms of immediate issues, the Healthcare decision was a mixed bag. On the one hand, Roberts pretty much made up that the mandate was a tax (since the President and Congress went to extreme lengths to make sure it was not a labeled tax in the bill) and is therefore Constitutional, leaving the individual mandate intact. On the other hand, the Supreme Court FINALLY put a limit on Congress’ powers under the Commerce Clause. However, what is absolutely shown from this decision is the necessity of economic freedom to secure social freedom.
The government having the power to effectively force you to buy health insurance is an obvious infringement on the individual’s social liberties; it is the government saying, “If you choose not to make the choice that we think you should make, then you will be taxed”. In general, many people who identify as “social liberals” or “cultural liberals” often see infringements on economic freedoms (such as increased taxation, increased regulation, etc.) as desirable, necessary evils, or at least not a fundamental threat to liberty. Meanwhile the same groups also almost unanimously decry infringements on social freedoms (including marriage, birth control, health insurance, food preference, etc.) as intolerable government overreaches. The healthcare decision provides an excellent example of why economic liberty must be seen as equally necessary to a free society by all Americans, but particularly social liberals. In particular, I want to underscore the inherent long-term threat of using taxes to try to encourage people to make a certain personal choice (such as the purchase of insurance).
Let me posit a scenario to demonstrate this from a different angle than the current healthcare issues. Rick Santorum is president along with a House and Senate of social conservatives. Court precedent says that they cannot make birth control illegal, but what they can do is tax it. Court precedent says that they cannot make pornography illegal, but what they can do is tax it.
Now some would correctly argue that the practice of taxing “unwanted” behavior or choices has been around for a very long time and that this has not happened yet, but that is not the point. When the case is being made for economic freedom and free markets, their advocates are not advocating a system of the past, but a new approach to government’s relationship to the economy. The system free marketers advocate for is one where the government cannot pick winners from a list of campaign contributors or losers from a list of opponents and does not tax behavior or choices that it disapproves of because it has been fundamentally changed to be denied the powers to do so. In such a system, social freedoms would be more secured than they are today because one of government’s primary weapons to dissuade certain social practices (the weapon of taxation) will have been taken from it.
This Supreme Court decision impresses upon us the need to get government out of our wallets in order to get it out of our personal lives. Liberty is not something that should be split into different sects. Economic liberty affects social liberty, as I’ve described. Social liberty affirms economic liberty (i.e. government not prohibiting the individual from spending his or her money on “socially unacceptable” ventures, such as gambling). They are connected, and both are absolutely necessary for a free society.
“The power to tax involves the power to destroy” First Supreme Court Chief Justice, John Marshall
This post ignores how individual freedom is affected by “free riders”. A “free rider” is someone who is uninsured but receives free health care services since they can’t pay for them, and harms all of us that have health insurance. If free riders didn’t exist (and infringe on the liberty of others), no mandate would be necessary. We also have this problem partly because of Reagan, who signed a 1986 bill saying anyone could receive Emergency Room care, regardless of their ability to pay. This is absolutely socialized medicine, and one of the least effective and most expensive types, and makes a mandate very compelling (as many GOP believed until Obama started pushing it). Further, having more uninsured people make health outcomes deteriorate for the rest of us with health insurance. High uninsurance rates results in an estimated 3-5% more deaths among those WITH insurance. So the issue isn’t as simplistic as you present it. A more challenging question is, how do you ensure that the millions of uninsured aren’t infringing on the freedom of others? http://www.washingtonpost.com/blogs/ezra-klein/post/%20high-uninsured-rates-can-kill-you-even-if-you-have-coverage/2012/%2005/07/gIQALNHN8T_print.html
As for your scenarios, I’d say they would likely be challenged in the courts, and if the Supreme Court found they violated any fundamental rights without a compelling and legitimate government purpose, then they’d stand. If it violated a less than fundamental right, the courts would only need to find that the laws had a rational basis. If it still stood, then those who disagreed with them would have to repeal or alter those laws through the legislative process. That’s how our democracy works, to my knowledge.
I don’t understand the desirability of getting the government out of your wallet in terms of health care, because I’ve never heard any GOP plan for health insurance. I also see no “libertarian health care plan” in existence that looks appealing (although I can point to government-run plans like Canada which are more popular, spend $3,600 less per person than us, with better health outcomes, or government’s highly regulating the private market like Switzerland which also spends 10.8% of GDP on health costs compared to our 17% with better outcomes).
I have no idea if the GOP or libertarians would even think universal care is desirable. But this is exactly the GOP in action- when they controlled the White House and Congress, they did nothing to control spiraling costs or increasing numbers of uninsured, in fact the “fiscally responsible” GOP passed an unfunded expansion of Medicare’s prescription drug plan to get the votes of seniors in 2004. The status quo as the GOP left it was +45 million uninsured, 1,000 children dying annually from having no insurance, 100,000 Americans dying annually of hospital-acquired infections, people committing crimes to get health care in jail, and fast-rising premiums. I have no doubt the ACA is better than what we had. In 2008, the GOP offered no solutions either, just things like tort reform and “death panels” hysteria. Now, Mitt Romney says he wants to keep all the ACA parts that poll well, but not the one part that reduces our spending (the mandate). The GOP is a joke, especially on health care.
The rich have no one to blame here but greed! I can not see how anyone with half a brain thinks people can survive without health insurance and health care. In fact as this article rightly points out, people have died and are dying because of greed and no health care. HMO’s should share the blame as they increased their profits wile people died, denying health care to people that were insured! One of the best run medical care systems in the US is medicare. Greed put us in this position, so now we must endure the pains to fix the problems and level the field.
Lastly, let me say I am not far Romney or Obama. Vote Ron Paul!