Conservatives and liberals may disagree about the constitutionality of the individual mandate requiring all uninsured Americans to buy health insurance from private companies or pay a penalty to the IRS.
But there is no debate about whether single-payer Medicare For All would be constitutional. No one — not even the most hard core, right-wing libertarians — disputes that the federal government has the constitutional authority to tax all Americans to pay for Medicare-style health insurance for all, as it pays for Medicare for everyone over 65.
Indeed the Republican Attorney General of Louisiana, Buddy Caldwell — who is one of the attorneys general opposing the Affordable Care Act (“ACA”) in the Supreme Court — is against the Individual Mandate because it props up the private health insurance agency and he prefers single payer. “Insurance companies are the absolute worst people to handle this kind of business,” Caldwell said last week outside the Supreme Court. “If you have a hurricane come up the east coast, the first one that’s going to leave when they gotta pay too many claims is an insurance company.” Caldwell went on to endorse the idea of a government backed single-payer system as “a whole lot better” than mandating private insurance.
As a legal matter, the constitutionality of the individual mandate should not be a particularly difficult law to uphold unless a radical right-wing majority of the Supreme Court is prepared to upend 75 years of jurisprudence on the Commerce Clause.
But as a political matter, the enthusiastic support for the individual mandate by liberals and Democrats should trouble real liberals. Private health insurance is a defective product that often isn’t there when people need it most. Even with government subsidies, the combination of premiums, deductibles and co-pays under the minimum policies required by the ACA could force many middle class Americans into medical bankruptcy or lead them to avoid preventive care and wait to see a doctor until they’ve become really sick.
Liberals should be troubled by the federal government forcing every uninsured American to buy a defective product from a for-profit health insurance company or be penalized by the IRS. Why do liberals want Uncle Sam to be the repo man for the likes of Aetna and United Health Care?