Individual Mandate and the American Way

Author: Yvette Cowlishaw

Introduction
America’s movement to mandate health insurance coverage will fundamentally change the way America does business and will extend the reach of the government into American’s lives in an unprecedented manner. Since the introduction of the Interstate Commerce Act in 1887 (Nash et. al., 2011, p 515) the act has been used by the federal government to justify laws and agencies from the FDA to the Patient Protection and Affordable Care Act. Due to America’s long history of maintaining individual rights and leaving the power of the government in the hands of the people the Patient Protection and Affordable Care Act has caused concern amongst many Americans and has led to multiple court actions questioning the constitutionality of the act. Extending the reach of the American government into every American home by demanding the purchase of a product as a condition of citizenship will change the relationship of Americans with the American government.

Historical Background
For the first time in the history of America the American government has utilized the commerce clause (Article 1 Section 8 ) of the constitution to dictate to Americans that they will purchase a product. Section 1501 of the Patient Protection and Affordable Care Act (The Library of Congress) requires that each citizen of the United States is required to “maintain minimum essential coverage” and cites the Supreme Court ruling in United States v. South-Eastern Underwriters Association (322 U.S. 533(1944)) as the basis for insurance falling under the interstate commerce clause of the constitution. The most controversial part of this act is the Personal mandate that requires every American to purchase health insurance.
The Patient Protection and Affordable Care Act moves America far from the Articles of the Confederation that kept the rule of government close to the people (Skousen, 1981). Even as the American Founders moved from the Articles of the Confederation to the American Constitution they intended government to be “of the people and by the people” as President Lincoln stated in the Gettysburg Address and demonstrated by Skousen in The 5000 Year Leap (Skousen, 1981). Since the founding of America government has kept growing and in 2010 the Patient Protection and Affordable Care Act allows the federal government control over the purchasing habits of the American people in an unprecedented manner as discussed below.

Discussion and Evaluation
Supporters of the Patient Protection and Affordable Care Act claim that legislation is needed to keep insurance plans from engaging in unfair underwriting practices (Carman, 2011). Others feel that that many parts of the act, including the mandate and the dismissal of the Conscience Act (Lanham, 2011) oversteps the bounds of constitutional government reach into individual’s lives. While American healthcare needs to be reformed the reform must begin in the behaviors of the American people not in the halls of government.
The individual mandate has been brought to court by over 28 American states. As of November of 2011 the lower court decisions are evenly split and the question of the constitutionality of the mandate will ultimately be decided by the United States Supreme Court. The controversy over the individual mandate of the Patient Protection and Affordable Care Act extends well beyond the healthcare and demonstrates a growing shift in Americans view of their country.
Since 2007 there has been a rise of two groups with some similarities but also great differences. The fiscal conservative movement has become represented under the moniker of The Tea Party while the Occupy movement is representing the view that the top 1% of money holders owes support to the other 99% of Americans. This split in American’s view is not new but the legislation demonstrated in the Patient Protection and Affordable Care Act demonstrates the extent that the progressive (Nash et. al., 2011) movement has been able to influence American legislation.
Ultimately the Patient Protection and Affordable Care Act on its own is not the able to change America but it is the first time that a law has been passed that tells Americans what they must purchase because they are American. If the mandate is allowed to stand it sets the precedent that America’s government can tell Americans what they must purchase and where they must purchase said product. This power in the hands of the government will ensure that business will have to spend more time assessing future government legislative moves than they have in the past.
While legislation and taxation have influenced American business for generations a government that can dictate the features and marketplace for a product is a game changer for American business. In the past business has used various methods to determine the products the American public will buy and the sales channels needed to sell the product. The individual mandate in the Patient Protection and Affordable Care Act dictates the design of acceptable product specifications and creates a government maintained sales channel for the distribution/sale of the product. This precedent will allow the government to become the product designer and seller of any product they desire if it is ruled constitutional.
This governmental reach into the purchasing habits of every American has a twofold effect. It creates a precedent for government to mandate purchases by its citizens and makes the government the ultimate decider of product design undermining free market principles of supply and demand. This precedent has the potential to change both the business and government climate in America by allowing the government to dictate to the American consumer what products they will purchase and from where they will purchase said product. It also has the potential to further the system in which those with more resources are forced to provide for those with fewer resources.
In Overtreated Shannon Brownlee lays out the current American system and how over utilization and lack of coordinated care contributes to the growing cost of American Healthcare and uninsured populations (Brownlee, 2007). The question facing the American people is who is responsible to manage utilization and to coordinate care. The insurance concept of managed care was designed to place the insurance company and a primary care physician in this position but full managed care limited the consumer’s choice of specialists and hospitals and led to a backlash by the consumer (Walker, 2009 & AHIP, 2007). From personal experience I have learned that when the consumer manages care effectively both the care and the willingness of insurance to cover costs are raised. However, the complexities of the healthcare system and the lack of expertise of the American consumer has led to a lack of personal accountability of the American consumer (Brownlee, 2007).
While the American healthcare system needs improved the Patient Protection and Affordable Care Act is not the solution to the problem. The act does not address the actual problems of the system (JAMA, 2011, AHIP, 2011, Overtreated, 2007) and allowing the government to mandate the purchasing actions of individuals is too high a cost for America to pay to resolve the issue.

Recommendations
As stated in Overtreated (Brownlee, 2007) the actual issues of American healthcare are not inherent to health insurance but disconnects within the healthcare system itself. There is a multiple level approach that needs to be taken to address the healthcare breakdown in America.
First and foremost American healthcare consumers need to become empowered to be their own advocates and healthcare coordinators. This can be accomplished by the consumer’s willingness to participate in their own healthcare and in healthcare providers being willing and trained to treat consumers as partners. In addition both patients and healthcare providers (doctors, hospitals, specialists, pharmaceutical providers, etc.) need to become partners with the insurance agencies and vice versa.
The patients and providers need to view the costs spent on healthcare in the same manner they would view the same services if they were paying cash for the service. This awareness of cost would help keep doctors from over utilizing tests and specialists when they know full well that the likelihood of the test providing for the care of the patient is minimal.
In addition doctors need to maintain a relationship with the patient and all specialists the patient is referred to in order to assure no over utilization of the system or overmedication of the patient. In the current system doctors do not have the time or incentive to practice this level of patient management. Due to the existing payment structure of Medicare, Medicaid, and private insurance the doctor must move patients through the exam room every 15 minutes for a general visit and 30 minutes for a chronic condition visit. This economic need for quantity over quality motivates doctors and doctor administrative offices to encourage fast “diagnoses” or to move the patient off to a specialist.
Additionally the legal system needs reformed to discourage lawsuits against healthcare professionals where there is no intentional negligence or neglect on the part of the provider. Currently providers will over utilize services in an effort to assure they have left out no test in case someone sues them in the future. This is not based on the need of the patient but on the need of the doctor’s malpractice insurance company.
For the American healthcare system to not be a drain on American purse strings and for all Americans to be insured all parties involved in healthcare will have to change their habits and the consumer will have to take ultimate responsibility for their actions. More legislation will not resolve the American healthcare crisis but will continue to add to the reluctance of doctors to only recommend and utilize needed services. The American consumer has to be on the front line of the reform issue by changing their view of healthcare and utilization practices and demanding their healthcare providers coordinate care appropriately. It is also important for the consumer to seek out doctors that will participate in a doctor patient partnership.
While this sounds overwhelming and impossible to many people my husband and I are proof that a disabled person with a chronic condition can receive adequate care and help the insurance companies control costs when the patient and the patient’s family are willing to put a reasonable amount of time and effort into managing their own care and understanding their health insurance plan. 

References

• American Founding Fathers (2005) The Constitution of the United States Pocket Edition (2nd Edition). Malta, ID: National Center for Constitutional Studies
• America’s Health Insurance Plans – AHIP. (2011) Retrieved from http://www.ahip.org/
• Carman, D. (2011, October 26) Cardiologist works to change ‘unfair’ health care system, Solutions. Retrieved from: http://www.healthpolicysolutions.org/2011/10/26/cardiologist-works-to-change-unfair-health-care-system/
• Brownlee, S. (2007) Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer. New York, NY. Bloomsbury USA.
• Congress (2009-2010) H.R. 3590 Patient Protection and Affordable Care Act, The Library of Congress Retrieved from: http://thomas.loc.gov/cgi-bin/query/F?c111:5:./temp/~c111tMBhuq:e406299:
• Lanham (2001, October 28) This Week in Washington: Respect for Rights of Conscience Act, Congressional Documents and Publications Retrieved from: http://ezproxy.ccu.edu:2087/pqdweb?index=21&did=2498779281&SrchMode=1&sid=2&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1320511109&clientId=5146
• Nash, G.B., et at, (2011), The American People: Creating a Nation and a Society, Volume 2 Since 1865, (Concise 7th ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.
• Skousen, W. C., (1981) The 5000 Year Leap. United States of America: National Center for Constitutional Studies.
• The Journal of the American Medical Association – JAMA. (2011) Retrieved from http://jama.ama-assn.org/
• Walker, D. M. (2009) Comeback America: Turning the Country Around and Restoring Fiscal Responsibility. New York, NY: Random House, Inc.

Read Full Post »

Fire them ALL

Fire them ALL.. Contract out as much as possible.. Hold an election for the deserters..

It don’t take rocket science to understand we don’t need a lot of fights about positions that are what use to be considered Public Servants or at least WANTING to make a difference.. People USE to want to help or be a part of making things better, be it by teaching the kids or forming policies for the people.. BUT most now are JOBS and WELL PAID JOBS.. Enough is tooooo much toooo much toooo much.. Stop it and FIRE THEM ALL.. Get back to Zero and start over..

Please please understand I have UTMOST respect for our teachers, law enforcement and fire fighters.. BUT they are all to serve and WANT to, not be there to make money in these times when all of us cutting WAY back.. It seems we have lost our way.. It is TIME to not have much of any of it Government, but probably private sector.. I guess that is what we might call contracted out..

Yep, you got it, most wages would probably be cut in half, but OH WELL, they are bringing it on themselves and with their actions I almost could care less anymore.. Sorry, but that is the insanity I see the last couple years… You got it, I am talking of TEACHERS UNIONS boycotting AZ.. that was insanity.. I am talking of all the less than acceptable demands being put on school districts while the teachers STILL can NOT teach, but have to walk a political tight rope as often the IN GROUP will get them fired.. YEP it is CORRUPT and the GOOD teachers are going to suffer anyway, so FIRE THEM ALL..

I know there is a lot that can be said and fought on this, but bottom line, enough is enough, just paint it ALL with a BROAD BRUSH and put a stop to it.. As for deserters.. Yep, it use to be a firing squad, but I am sure that is NOT acceptable, so fire them and elect new, or appoint a few that were runner ups against them.. Bottom line is.. NEVER let them feel comfortable returning back to the state they deserted.. AND yep, I know the Democrats have pulled it in several states in the years.. I know they deserted Texas a few years ago, and now I guess they have deserted Wisconsin the way it is said.. I am sure their have been others also, who knows.. GET RID OF THEM..

Life is NOT all as difficult as we make it or let it be.. Times are tough and we hear all this about change.. WELL, lets CHANGE it..  We had a saying in Vietnam.. “Don’t Tread On ME”. Well, we are all getting Tread on.. Get out the Broad Brush and lets start painting..

Read Full Post »

CO Governor

Hear the candidates debate. CSPAN Debate 9News Debate ABC Debate

Crazy times here in my hometown. Many people including many with big name recognition have jumped on the Tom Tancredo bandwagon. We are sticking with our support for Dan Maes for various reasons not the least of which is Tancredo’s past behavior.

Here is an amazing article on this subject

When this election cycle started I promised myself that I would no longer just vote for the person who could win but that I would vote my convictions. While many may feel Tom is the conservative god I have watched him flip-flop too much over the years to believe he will stand firm. Dan might not be perfect but I believe he is a man of God and has integrity. I know so much about the people calling him a liar etc. that I don’t buy the allegations plus my spirit is not troubled by Dan. If I’m wrong or if I’m right and Dan still loses I will still be able to look myself in the eye when it is over unlike years past when I went along with the story line that I had to vote for the person that could get elected.

Read Full Post »

Updated pages

I just updated a bunch of pages/posts:

• The Other Hand – What is happening while we all watch big news items

• Colorado – crazy politics in my native state

• Nanny State in the U.S. – how we are being babysat in America

• How the Nanny State Works in the EU – Where is America headed

Please remember midterm elections are approaching fast. Make sure you vote!

Thanks,

Yvette

Read Full Post »

God Save AZ

Read Full Post »

Tax or Unconstitutional?

This week the DOJ (Dept of Justice) has come out and stated the health-care mandate (the one that states everyone must have insurance) is a tax. This appears to be their stance because that is the only way to apply any constitutionality to the mandate. Interestingly enough the President is stating it is not a tax in a recent New York Times article.

“For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” the president said last September, in a spirited exchange with George Stephanopoulos on the ABC News program “This Week.”

The presidents response feeds into all the legislation being presented by this administration. They feel it is their right to mandate behavior and the long lived American right to make our own decisions is offensive to this progressive movement.

This same mentality is evident in the Cap and Trade legislation, the recently passed fiscal reform bill as well as the many spending bills that have hit congress in this administration and even the Bush administration.

Angelo M. Codevilla writes a great article on the widening class system developing in America.

Never has there been so little diversity within America’s upper crust. Always, in America as elsewhere, some people have been wealthier and more powerful than others. But until our own time America’s upper crust was a mixture of people who had gained prominence in a variety of ways, who drew their money and status from different sources and were not predictably of one mind on any given matter. The Boston Brahmins, the New York financiers, the land barons of California, Texas, and Florida, the industrialists of Pittsburgh, the Southern aristocracy, and the hardscrabble politicians who made it big in Chicago or Memphis had little contact with one another. Few had much contact with government, and “bureaucrat” was a dirty word for all. So was “social engineering.” Nor had the schools and universities that formed yesterday’s upper crust imposed a single orthodoxy about the origins of man, about American history, and about how America should be governed. All that has changed.

While the American people truly embrace diversity those in power do their best to keep us fighting amongst each other so that they can solidify their kingship.

Read Full Post »

Why Dan Maes (CO Gov)

I want to take the time to tell everyone why Sean and I believe so strongly in Dan Maes. We have been following Dan’s campaign since the beginning of the year (2010). In this time we met with and talked to Dan and his staff many times. I was immediately impressed by Dan’s availability and his willingness to take the time to have a thoughtful discussion. I literally hounded him about when we could meet him and he traded multiple tweets with me to arrange for Sean and I to find an event near our rural home. When we finally met Dan his faith and strength of character became immediately evident. I still remember being floored by Dan’s yielding to God and his statement that if he was supposed to be the Governor than he just had to be faithful. At that moment Sean and I knew who we would support.

We were so impressed with Dan that we committed to represent him at our caucus where we were also voted in to be our area’s representatives to both local and state assemblies. In the months between caucus and assembly the media began to notice Dan and there were news items that concerned us so we would contact Dan and ask him to explain. On every occasion we received a direct and timely response directly from Dan. On one occasion Dan even took the step of calling us back when he lost the call while driving through the mountains on his way to/from and event. He has always engaged in thoughtful conversation with us and has always impressed us with his views and the reasons he holds those views.

At state assembly we were there to see Dan achieve victory. I have seen articles stating his victory was just because people don’t like McGinnis. The truth of the matter is that Dan took the time to meet one on one with anyone that desired to meet with him and he explained his positions to each individual and answered their questions. Keep in mind he did this in a private room one on one and not just in large meetings where you have to fight to get your question answered. This personal approach has been consistent with Dan and directly led to his victory at assembly. I will never forget how humble Dan was after the assembly victory and how he sincerely believes the victory is his supporters not his personal victory.

In addition to my own experiences I have heard so many others mention how real and involved Dan is with everyone. One great example of Dan’s humility is when he not only appeared in a Fourth of July parade but at the end he helped break down the float. Ultimately this is Dan’s most winning trait – he is regular person who desires to serve the others in his state. There is no stench of an elitist about Dan and God willing he will never take on that stench.

Sincerely,

Yvette Cowlishaw

Read Full Post »

Happy 4th of July

On this most patriotic of American holidays I wish to share some encouragement for traditionalists and constitutionalists.

I just watched David Barton of Wallbuilders and he shared some wonderful news:

• There are 4 prayer meetings held by members of congress
• There is a Christian Caucus that prays before every session of congress
• 88% of the millennial generation believe in the constitution

Remember there are actually constitutionalists than progressives we have just been quieter. When all else fails STAND!

◊ Below is a powerful reminder of the meaning of our pledge ◊

Give me Liberty or give me death ~ Patrick Henry

“If there must be trouble, let it be in my day, that my child may have peace.” ~Thomas Paine

As for me an my house we will serve the Lord
~Joshua 24:15

Read Full Post »

AZ & Immigration

Holder hasn’t read Arizona law he criticized

Attorney General Eric H. Holder Jr., who has been critical of Arizona’s new immigration law, said Thursday he hasn’t yet read the law and is going by what he’s read in newspapers or seen on television.

Mr. Holder is conducting a review of the law, at President Obama’s request, to see if the federal government should challenge it in court. He said he expects he will read the law by the time his staff briefs him on their conclusions….The Washington Times

Neither has Janet Napolitano or this administration official (2:11).

I for one would prefer that my “leaders” got their information directly from the laws not from the media. Trusting you also want to read the laws here is AZ draft and final immigration law.

Read the Amended Arizona Immigration Law

Read the Original 16-Page Version of the Arizona Immigration Law

Ted Nugent can always make concepts easy to understand. In his article Profile or die -Survival means learning from experience – even if it hurts our wittle feelings Ted provides a great visual on the immigration debate then wraps it up in true Nuge style:

Call me weird, but I prefer saving human lives to protecting “feelings.” The alternative is extremely dangerous….The Washington Times

Latest news: 05/19/10

Arizona Official Threatens to Cut Off Los Angeles Power as Payback for Boycott

Debate over Arizona’s new immigration law has reached a boiling point

Costa Mesa joins AZ in enforcing existing Federal Laws…The Orange County Register

Here are a few more items to make you think:

1. There will be no special bilingual programs in the schools.
2. All ballots will be in this nation’s language.
3. All government business will be conducted in our language.
4. Non-residents will NOT have the right to vote no matter how long they are here.
5. Non-citizens will NEVER be able to hold political office
6 Foreigners will not be a burden to the taxpayers. No welfare, no food stamps, no health care, or other government assistance programs. Any burden will be deported.
7. Foreigners can invest in this country, but it must be an amount at least equal to 40,000 times the daily minimum wage.
8. If foreigners come here and buy land… options will be restricted. Certain parcels including waterfront property are reserved for citizens naturally born into this country.
9. Foreigners may have no protests; no demonstrations, no waving of a foreign flag, no political organizing, no bad-mouthing our president or his policies. These will lead to deportation.
10. If you do come to this country illegally, you will be actively hunted &, when caught, sent to jail until your deportation can be arranged. All assets will be taken from you.

Too strict?…… The above laws are the current immigration laws of MEXICO !!! ~ Jeremy T. Jarvi

Read Full Post »

Make Mine Freedom

This needs to go viral.

“Fun and Facts About America, John Sutherland Productions. Creative Commons license: Public Domain. This Cold War-era cartoon uses humor to tout the dangers of Communism and the benefits of capitalism.”

For more great vintage animation check out www.animationstation.info and subscribe to the podcast.

Read Full Post »