Would a single-payer system be less constitutionally problematic than a mandate?
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  Would a single-payer system be less constitutionally problematic than a mandate?
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Author Topic: Would a single-payer system be less constitutionally problematic than a mandate?  (Read 2194 times)
Jacobtm
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« on: October 12, 2011, 11:42:10 PM »
« edited: October 12, 2011, 11:43:56 PM by Jacobtm »

If Medicare was simply expanded to cover all Americans, would there be any constitutional problem with that?

If Medicare is constitutional, I don't see what the issue could be with simply including everyone, constitutionally speaking.
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Paul Kemp
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« Reply #1 on: October 14, 2011, 10:11:45 AM »

I've had similar thoughts and reasoning. I don't really have much to add at this point but I'd be interested in seeing some eloquent members debate the topic.
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True Federalist (진정한 연방 주의자)
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« Reply #2 on: October 14, 2011, 12:17:10 PM »

Depends on what you mean by single-payer.  If doctors were forced to be part of the single-payer system, then no it would be of doubtful constitutional validity.  But Medicare doesn't operate that way, and an all ages Medicare would likely withstand constitutional scrutiny unless we got a bunch of strict constructionists on the court who would also strike down pretty much the entire welfare state.
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Snowstalker Mk. II
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« Reply #3 on: October 14, 2011, 05:25:42 PM »

If it's basically Medicare for everyone, yes.
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anvi
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« Reply #4 on: October 16, 2011, 01:03:26 AM »
« Edited: October 16, 2011, 01:08:37 AM by anvi »

I don't advocate single-payer systems, being more a fan of the Bismarck system.  But I don't see any reason why a single-payer system, such as exists in the U.K. and Canada (though technically the Canadian system is not a "single-"payer system), would breech the U.S. constitution.  In such systems, the government simply pays medical expenses incurred from patient treatment, and finances the payments through taxation.  The constitutional controversy in the U.S. seems to be over whether the government can mandate the purchase of health insurance of its citizens.  No such mandates exist in "single-payer" systems; instead, governments levy taxes, which they are of course constitutionally empowered to do, and then pay for medical bills with those revenues.  

However, in Bismarck systems, by contrast, private (non-profit) health insurance companies pay for medical bills, and in these systems, individual mandates to purchase insurance do exist, as they must, so that universal coverage can be financed by those companies.  ("Single-payer" systems have private health insurance companies too, but only to pay for services that the government may not.)    
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Torie
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« Reply #5 on: October 20, 2011, 12:31:23 PM »

Yes, because in lieu of a mandate, the government is just handing out freebies funded by tax revenue. That is totally mainstream these days from a legal standpoint.
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