Nov ‘11
11
Constitutional Federalism – 50 States and the National Government
The ACA’s Individual Health Insurance Mandate . . . The national government has constitutional authority over national security and, over 220 years of expanding from 1 million to 306 million Americans, authority to provide for the economic security of citizens. You may not like the Social Security program, or Unemployment Comp, or Workers Comp, or Medicare, or Medicaid, or tax-free employer-paid health insurance policy.
But the U.S. Supreme Court (and Mitt Romney) says it’s constitutional economic security policy. Rick Perry may demur, but then he has a record to prove it by ignoring any state responsibility for accessing low income Texans to health care. So he can use taxes to compete against northern states for job creation.
Market Rules . . . Starting in the immediate post Civil War period, the U.S. Supreme Court has recognized Congress’ power to set and the Executive’s power to enforce (see Teddy Roosevelt) national rules by which private markets provide for a healthy economy and the common good. So it’s not “socialized medicine” for the ACA to declare as national policy that, while life and casualty insurance may continue to compete by 50-state rules, health insurance is very different because of the huge public subsidy under the business. Logic says taxpayers deserve value for that money which requires national rules enforced by 50 states and informed consumer choices (not just price, but value).
Ahmed Rashid is the clear-thinking author of Taliban (before any of us knew who they were) and of Descent into Chaos. A journalist and an insightful writer. His new book, Why Do Americans Hate Us?, raises the same issues.
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