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Recently on Fox News, Shepard Smith discussed with Judicial Analyst Andrew Napolitano whether Harry Reid's health care bill has good facets, and more importantly, whether the government should have the right to administrate health care. Napolitano stated the states only have this power, and that the Constitution does not grand the federal government such power to provide health care as a government system.
I took issue with Napolitano's point, and have sent Fox News the following email. I thought it applies well to the subject and illustrates the flaws in such a perspective, one I have been hearing more and more of late.
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First of all, I wanted to applaud Shepard Smith for pointing out some of the logic about health care, and raising questions from both points of view on this issue. However, I have a great issue with Napolitano's dishonesty in stating the federal government has no authority to create a single-payer health care system.
From the Constitution, section 8, "Powers of Congress":
"The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States...."
"To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof."
First of all, "general Welfare" is exactly what Napolitano is complaining about, providing services for the good of all people, that take care of all a nation's people, including the weakest and poorest.
Secondly, that last statement, known as the "necessary and proper clause" is a catch-all that gives the Congress broad authority of the kind that Napolitano complains Congressmen were using. It is highly unlikely any real Congressman would state they were legislating what is not authorized by the Constitution, since this necessary and proper clause can be applied to virtually any situation and legislation.
However, even if Napolitano was right that the Federal government does not have the power to regulate a national health care system, and that this must be administered by the states (and he's not right), what I was frustrated to hear no mention of is the inclusion of a state opt-out clause in Senator Harry Reid's bill (Reid by the way is in many ways pro-life, hardly a typical Democrat), which essentially places the health care administration in the hands of the states.
After all, if a state doesn't want to be involved in the new health care bill, they can simply opt out and not participate. This is exactly the kind of state power over the process that Napolitano is very dishonestly and unfairly denying the bill uses.
Again however, I applaud Shepard's honesty in addressing the issue from both sides, even if he did not notice these points.
Sincerely,
Joshua Zambrano
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Hmmm. I just noticed something interesting here in the wording of the Constitution. Using your link, I found that in the Preamble, it says that it is the responsibility of the US Gov to "provide for the common defense, promote the general Welfare."
In Section 8, it says that it is the power of Congress to "provide for the common Defence and general Welfare of the United States."
Now, in my arguments against the encroaching welfare state that our government has enacted over the last 70-80 years, I always quote the Preamble as saying "promote the common welfare," rather than "PROVIDE for the common welfare." Now, I see that in section 8, the common welfare falls under the word PROVIDE, and Promote is no where in Section 8.
I hesitate to say that I am confused...but does anybody have some thoughtful insights as to why the wording is slightly different between the two? Could the be contradictory language, or am I just missing something between the two?
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This is a good point, and one I'd never noticed. However, it seems to be clearly part of the Constitution's original language, and perhaps something the Founders failed to notice.
Regardless, the effect is that the Constitution ends up stating that the Constitution is created in part to promote the general Welfare, and that Congress is empowered to provide for this general Welfare.
I don't see anything contradictory however. It's simply elaboration on the part of the Founders. First they stated the Constitution was created to promote the general Welfare, and then get into how this is to be done, by allowing Congress to make provision for this Welfare. The first deals with intention - just like any bill at the top will have a mission statement if you will, stating what the purpose of the legislation is. As you read into the bill, it will get into the nuts and bolts of how this is to be accomplished, and the term provide is used because now past the mission statement/preamble area, it's less about specifying intentions of the Constitution and more about the action to be taken to make this happen, i.e. provide.
For example, take a look at this version of the health care bill. Notice that the very first thing the bill does is state the purpose of the bill at the top. Likewise, the Constitution used the term promote at the top since it deals with purpose, whereas provide is a practical application sort of term to be used more in the body where steps are to be outlined.
At least, how I see it anyway. Hope that helps!
Jz
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I read through the Congressional Budget Office Report on Senator Reid's Health Care Bill and it is apparent that its principal thrust is to remove $450 billion from Medicare and transfer it plus a lot more to Medicaid. As a retiree on Medicare this makes me mad. During my working career I spent 10s of thousands of dollars on Medicare taxes and now between my wife and I we spend about $7800 per year on Medigap Insurance, Medicare Part B and Medicare Part D and this does not include the amount we actually spend on pharmaceuticals.
I agree that the issue of Social Security and Medicare costs need to be addressed, but removing it from Medicare and spending it on Medicaid does not help the long term budget crisis.
We need Congress to focus on reducing the cost of health care not create additional entitlement programs as they are doing with the current bills in congress.
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Charles Allen (11/20/2009)
I read through the Congressional Budget Office Report on Senator Reid's Health Care Bill and it is apparent that its principal thrust is to remove $450 billion from Medicare and transfer it plus a lot more to Medicaid. As a retiree on Medicare this makes me mad. During my working career I spent 10s of thousands of dollars on Medicare taxes and now between my wife and I we spend about $7800 per year on Medigap Insurance, Medicare Part B and Medicare Part D and this does not include the amount we actually spend on pharmaceuticals.
I agree that the issue of Social Security and Medicare costs need to be addressed, but removing it from Medicare and spending it on Medicaid does not help the long term budget crisis.
We need Congress to focus on reducing the cost of health care not create additional entitlement programs as they are doing with the current bills in congress.
Could you provide a link to this report, please? I'm not sure otherwise what you refer to, perhaps one of the blog posts on the CBO web site by the director of the Congressional Budget Office? I think I may have found what you meant though, is it this report?
I do notice on page 5 it provides a cost breakdown that seems to show a $436 billion subtraction of funds from Medicare and Medicaid to make room for the new Health Insurance Exchanges and Public Health Insurance Plan. On page 11, it mentions "CBO estimates that—given all of the reductions that would
result from other provisions—this arrangement would reduce Medicare spending by an additional $23 billion over the 2015–2019 period."
Page 17 however seems to suggest this is less about cutting current levels of spending than not providing the same level for inflation. "Based on the extrapolation described above, CBO expects that Medicare spending under the bill would increase at an average annual rate of roughly 6 percent during the next two
decades—well below the roughly 8 percent annual growth rate of the past two decades (excluding the effect of establishing the Medicare prescription drug benefit). Adjusting for inflation, Medicare spending per beneficiary under the bill would increase at an average annual rate of roughly 2 percent during the next two decades—much less than the roughly 4 percent annual growth rate of the past two decades. Whether such a reduction in the growth rate could be achieved through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care is unclear."
What concerns me is the wording on page 4, "Starting in 2014, the legislation would establish a requirement for such residents to obtain insurance and would in many cases impose a financial penalty on people who did not do so."
This seems as though it could end up further taxing those who can not afford health insurance. A recent poll showed that 71% of Americans oppose the individual mandate. While a universal health care system may be an attractive concept, most Americans do not agree that it should be enforced by taxing more heavily those too poor to afford it.
I suspect this provision alone will make the system so unpopular that it will result in perhaps even more than half the states opting out if they can't find a way to repeal it. Which raises another concern of mine. If states opt out, will their taxpayers still have to pay taxes for the services provided to other states? You wouldn't think so, but if so, it would be a huge flaw and injustice in the bill.
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Yes, that is the report. On page 2 it states that $599 billion increase over 10 years will be spent on proposed increases in insurance coverage then later in the paragraph cites the increases as CHIP, Medicaid and tax increases to small employers. Then on page 7 it states that the most nonelderly people with income below 133% of the FPL will be made elgible for Medicaid and the Federal Government will pay 100% of new enrollees through 2016 and average 90% after that.
I was probably a little broad in stating that it would all go to Medicaid, but the reduction in Medicare spending is going to Medicaid and other medical insurance subsidy programs.
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Charles Allen (11/20/2009)
Yes, that is the report. On page 2 it states that $599 billion increase over 10 years will be spent on proposed increases in insurance coverage then later in the paragraph cites the increases as CHIP, Medicaid and tax increases to small employers. Then on page 7 it states that the most nonelderly people with income below 133% of the FPL will be made elgible for Medicaid and the Federal Government will pay 100% of new enrollees through 2016 and average 90% after that.
I was probably a little broad in stating that it would all go to Medicaid, but the reduction in Medicare spending is going to Medicaid and other medical insurance subsidy programs.
I was originally confused, because it seemed cuts were being made to Medicaid and CHIP as well. If you look at pages 5 and 6, however, it seems to show where the cuts are being made. I had just taken a quick glance at the section, 'Medicare and Medicaid and other CHIP Provisions' and assumed all those cuts being made were to all 3, rather than just Medicare.
However, upon closer examination, I see that a $192 billion decrease is to 'Reductions in Annual Updates to Medicare FFS Payment Rates' while a $118 billion decrease is to 'Medicare Advantage Rates Based on FFS'. Only a $43 billion decrease is to 'Medicare and Medicaid Payments to DSH Hospitals'.
These are tiered decreases, meaning they take most effect starting in 2014, when the first 2 sections applying solely to Medicare result in combined decreases to Medicare funding of $25, 32, 40, 49, 58, 69, and 64 billion for each year respectively from 2014 to 2019.
However, taken in light of what we pay for Medicare each and every year, this is hardly that much. I will show you from the U.S. budget (just click the top XLS link and scroll down to Section 570, 'Medicare', in the Excel Spreadsheet) what would be getting subtracted from yearly Medicare government spending to pay for the bill:
2010: $458 billion expected for total Medicare expenses. Reid's bill would subtract $0 billion according to the CBO Report. Total of $458 billion expected for Medicare spending.
2011: $502 billion expected for total Medicare expenses. Reid's bill would subtract $8 billion according to the CBO Report. Total of $494 billion expected for Medicare spending.
2012: $513 billion expected for total Medicare expenses. Reid's bill would subtract $12 billion according to the CBO Report. Total of $501 billion expected for Medicare spending.
2013: $571 billion expected for total Medicare expenses. Reid's bill would subtract $19 billion according to the CBO Report. Total of $552 billion expected for Medicare spending.
2014: $637 billion expected for total Medicare expenses. Reid's bill would subtract $25 billion according to the CBO Report. Total of $612 billion expected for Medicare spending.
2015: $657 billion expected for total Medicare expenses. Reid's bill would subtract $32 billion according to the CBO Report. Total of $625 billion expected for Medicare spending.
2016: $726 billion expected for total Medicare expenses. Reid's bill would subtract $40 billion according to the CBO Report. Total of $686 billion expected for Medicare spending.
2017: $757 billion expected for total Medicare expenses. Reid's bill would subtract $49 billion according to the CBO Report. Total of $708 billion expected for Medicare spending.
2018: $787 billion expected for total Medicare expenses. Reid's bill would subtract $58 billion according to the CBO Report. Total of $729 billion expected for Medicare spending.
2019: $878 billion expected for total Medicare expenses. Reid's bill would subtract $69 billion according to the CBO Report. Total of $809 billion expected for Medicare spending.
All of this is pretty easy to see if you just look at pages 5 and 6 of the CBO report's tables and contrast them with Section 570 of the U.S. Budget Excel Spreadsheet I hyperlinked.
In other words, yes, Reid's bill would cut chunks off of Medicare, but compared to what we are spending on Medicare each year, this is pretty negligible. Even for the largest yearly cut of $69 billion in 2019, that's only a cut of .79% (less than 1%) of the total amount spent that year, $878 billion.
I know politicians are growing concerned about the spending for Medicare, Medicaid, and Social Security. Reid probably figured just by skimming a bit off the slated figures for Medicare he could balance the budget, without harming Medicare too much. The skimming helps pay for the new Health Insurance Exchange and Health Insurance Plans programs being created.
Anyway, when taken in perspective like this, it doesn't look all that bad, when you realize what we're already spending each year on Medicare. A less than 1% decrease in funding isn't all that bad - especially if the bill does result, in more efficient system management.
Again, my main concern right now is the individual mandate. That is the one thing that still worries me about this bill, and I expect it to get kicked out of the bill at some point or another, and possibly an alternative policy put in place instead.
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RE: Joshua Zambrano
In other words, yes, Reid's bill would cut chunks off of Medicare, but compared to what we are spending on Medicare each year, this is pretty negligible. Even for the largest yearly cut of $69 billion in 2019, that's only a cut of .79% (less than 1%) of the total amount spent that year, $878 billion.
Joshua,
With reguard to $69 billion representng a cut of only .79% (less than 1%) of the $878 billion projected for 2019, I believe that your decimal point is misplaced. It actually represents a cut of 7.9%, which is considerably higher than suggested.
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Oh, you're right. It seems I did my math a bit too fast, sorry. Thanks for the correction. I can change the post above if you want, or leave it, or post the correct amounts. Now that it is around 5-10% cuts though, you're right that it does make more of a difference. I still think it isn't that sizable, however, a new issue is now recognized in this debate.
After Admin_Alexa made some good points, I further examined the bill, and realized they did not do away with either the abortion language or the unlimited spending clauses of the earlier bills. Please read this thread to see what I think is an even more dangerous and important factor related to spending.
The bill in short, has 65 different unlimited spending clauses. Thus, while specific amounts as in this case are a concern about what the bill will do, it is actually pointless in trying to discuss an exact amount, since the unlimited spending clauses of the bill do not allow a specific dollar amount to be assigned to the bill.
In essence, the bill writes itself a blank check using an equivalent phrase to "There is authorized to be appropriated such sums as may be necessary to carry out this section." In other words, "whatever money this section needs can be spent out of the General Treasury".
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Joshua Zambrano (11/24/2009)
In essence, the bill writes itself a blank check using an equivalent phrase to "There is authorized to be appropriated such sums as may be necessary to carry out this section." In other words, "whatever money this section needs can be spent out of the General Treasury".
wow....... blank check sections who would have thought they would allow that... Is that constitutional? Aren't they suppose to some how apportion spending? A budget or something?
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