Originally Posted by ziggy29
IMO, that's the beauty of federalism. We have 50 states in various regions with different cultural and economic values.
I agree with all you wrote, but we do have to face two problems with individual state solutions:
-- The small sizes of many states will lead to serious inefficiencies compared to a single US-wide approach.
-- The adverse selection/race-to-the-bottom problem. If MA gets out in front and institutes "free" medical care and bread-and-circuses for all residents, lots of folks will move there who need expensive medical care. This happens to some degree with state aid to the poor, but it's not a big problem because poor people often don't have the resources to pull up stakes and move to the high-benefit states. A person who needs a kidney transplant, cancer treatment, etc would have a very big motivation to move to where the free care was. I suppose a residency duration requirement (as we do for state universities) or some type of medical underwriting might be put into place, but that adds complexity.
What I like BEST about the state-run solution is that it's entirely within the traditional scope of the US constitution. And, if the states want to get together to form larger, more efficient pools with common laws and mutual recognition of eligibility for care, that's just fine--everyone benefits. If it works, residents of states that hadn't signed on would push their states to join the group. Like the the Powerball consortium!
Originally Posted by donheff
They ought to be studying what may have gone wrong here. Both on the constitutionality of the mandate and on whether they should have included a sever-ability clause. On groundbreaking social programs affecting the entire country it is a disaster to get the underlying constitutionality wrong. Keep in mind, this reversal does not invalidate the concept of universal health care, just the specific approach taken. Congress should have foreseen the problems and addressed them.
Yes. The constitutionality issue hasn't been settled yet, but is certainly not the laughing matter implied by the Speaker
. The fact that this wasn't even seriously considered before the law was finalized and voted on is now a problem for everyone.
This isn't a Republican or Democrat issue--both sides seem content, in their turn, to pass legislation and let the Supreme Court decide if it is constitutional. These legislators have sworn to uphold the Constitution, that should mean, on the most fundamental level, not violating it. The courts should be the "second check", not the only one.