Americans, incl. large majority of Democrats, think mandate unconstitutional.

[angus]

the Dems' worse nightmare is to have Obamacare upheld by the SCOTUS.

I wondered about that too, although that angle doesn't get much publicity.  Still, in my layman's understanding states can, via the tenth amendment, make an argument against it.  Just because the court upheld it last year doesn't mean it will always.  Plessy v. Ferguson was overturned after a decade or so, and this can be as well.  Hopefully, it won't come to that.  South Dakota has already passed a nullification act.  Maybe other states will follow suit. 

[angus]

Fifty-seven years is not a decade,

Indeed.  It's somewhere between a decade and a century, I'd say, and it's probably why I said "a decade or so."  On a logarithmic scale it falls closer to a decade than a century, but this is certainly far beyond the scope of the thread and we needn't let it distract us.

and nullification, unlike this mandate, is known to be unconstitutional.

by whom?  by 72% of US voters polled randomly?  I doubt that.  But that's not a point I'm going to argue with you because I don't have the data to back that up.  What we do know is that The People recognize that they're being forced to do something by the government.  They don't like it.  They have a right not to like it, and although they might not all be lawyers, they have an inkling of idea that this bill is very, very wrong.  I'm not a lawyer either, and I could be wrong about this, but it really stinks.  And I am not alone.  Moreover, it doesn't necessarily depend upon the supreme court to do its job.  If we can install a GOP congress and president--and there's a chance, however slim, that we may be able to do this--then it won't come to that.  But if it does come to it, I"m not so sure that you can predict that the federal court can't be convinced that it is unconstitutional.  For example, many lawyers are already on the record saying that it violates the commerce clause.  I don't think that at least one wealthy opponent to the law will have trouble contracting at least one of those lawyers.  Big Brother, of course, will have its own highly-paid lawyers, but that's not always a guarantee of their success, fortunately.

[angus]

Weren't there several decisions that overturned parts of Plessy prior to Brown?

POssibly, but I'll admit that I was thinking that Brown was in the 50s and Plessy was in the 20s, but I wasn't quite sure of the dates so I said "a decade or so..."  Turns out that Plessy was, like, Eighteen Ninety-something, so tit's a good thing I said "or so."

The point still stands.  

And I really don't think we should get distracted by this minutiae.  I'd bet that we are all, Republicans, Democrats, LIbertarians, and Socialists, willing to stipulate that there have been some bone-headed decisions in the past, and that there will probably be some in the future.

But as far as the thread topic:  I'm not a legal expert, but to me it seems a fairly simple matter:  this law violates at least two clauses in the constitution.  Moreover, there are actually people who have graduated from law school who have said that as well.  

Even more important than any of that is the point that consigliere jmfcst made:  Let us exploit any bone-headed decision the supreme court makes regarding this case.  I'm pretty stoked about that, although it means selling ourselves out (at least a little) for a cause.  You know, the enemy of my enemy is my friend.  But in this case the cause seems worthy.

Let's see if that 72% have balls enough to step up and take one for the team.

[angus]

'Known' wasn't necessarily the right word. Nullification has been doctrinally unconstitutional in the immensity of Supreme Court precedent on the subject for well over a century. Closer to two.

That's fine.  I'm not preaching violent insurrection anyway--if a group really intends to nullify a law, I suspect that it should be prepared to back it up with arms, if necessary.  I was simply noting the willingness of entire states, via their legislatures, to do whatever they can legally do to end Obamacare.

Clearly this is either not something the public understood well as it was being enacted, or has changed its mind about.  In the democratic domain, laws might reflect the will of the people.  If they do not, then the people should change them.  I'm hoping for a democratic resolution rather than judicial oversight.

[angus]

It's quite frankly not about something the public has ever understood well at any point in the process.

Indeed.  When even members of congress claim that they can't be bothered with reading their own exceedingly long bills, why should the public?

However, the public has understood that we have been told for years that we spend more than 15% of our aggregate GDP on medical services and health care.  The public has understood that this expenditure, as a fraction of the aggregate GDP, has been increasing.  The public now is made to understand that actions taken by the congress will not only exacerbate that problem, but also force people to make purchases of products that they might not otherwise have bought. 

[angus]

Yes, and public health care would actually be much cheaper than that.

I think this could be done, but it is not what the grossly-misnamed Patient Protection and Affordable Care Act does.  The bill is a mixture of stopgap measures that promises to increases the budget deficit by $562 billion.  Well, the exact figure is a moving target.  Republicans put it a 700 billion over the first ten years while Democrats put it at 230 billion.  Obviously it depends upon what assumptions one makes.  Ostensibly, it was meant to provide insurance to the uninsured, but even there it fails since it leaves 23 million people uninsured who are allowed to opt out of the mandate.  

It's a bad bill, Nathan.  You can proclaim the glories of socialized medicine if you want, and I'd agree with you that such a program does have its advantages, and I'd argue with you that it also has some disadvantages.  But in any case that's not what this monstrosity of a bill is.  The PPACA is a series of complicated reforms to an existing structure, which is already a mixed public/private market.  It was also enacted in an underhanded manner.  You should not try to rationalize the fact that 72% of people in a wealthy, relatively well-educated nation see it for what it is:  bad legislation.

[angus]

The mandate is in fact an awful idea.

Medicare for everyone, full coverage, and price controls would be much more straightforward and less constitutionally difficult.

One problem that I assume Obama and the congress wanted to deal with before they got sidetracked and enacted the PPACA was the fact that once the baby boomer retirements really start to kick in, we'll have unsustainable deficits under the current system.  I assume that we'll eventually still have to deal with that problem.  It may be that price controls become necessary.

[angus]

One problem that I assume Obama and the congress wanted to deal with before they got sidetracked and enacted the PPACA was the fact that once the baby boomer retirements really start to kick in, we'll have unsustainable deficits under the current system.  I assume that we'll eventually still have to deal with that problem.  It may be that price controls become necessary.

Well every other rich country has LOWER health-care costs than us, so an actual ''government takeover'' of healthcare would help in reducing our expenditures on health.

Price controls are how many countries have standardized the process. All doctors have a price schedule, and whatever procedure, test, or evaluation they do has a pre-set amount that the doctor is reimbursed.

Be careful, that's inductive reasoning at best.  We have exceedingly high health costs for a number of reasons including, but not limited to, the fact that we lead terribly greedy, indolent lives, the fact that we are gluttons, and the fact we insist upon using the extend the lives of a handful of people by a few (very miserable) months or a few (even more miserable) years at great cost. 

Having said that, yes some form of price controls would no doubt alleviate the costs.  It's a tricky business, though.  The Price Theorist in me says that it will lead to shortages in services.

[angus]

Analyses have regularly shown that something like 20-25% of our healthcare costs are just administrative costs above and beyond the average of what every other rich country pays. Our system has a lot to do with our costs.

Of course, the unhealthy lifestyle most Americans lead has to do with that too, which is a separate issue.

The Price Theorist in you is ultimately wrong. I suggest reading The Healing of America, a book in which the author travels the world to recieve treatment for a bum shoulder, seeing other countries' health-care systems from the inside. Throughout the world, governments put price controls on medical services and the people in those countries have easier access to healthcare than Americans do.

Doctors don't make as much money, insurance companies don't make as much money, the country spends less money on healthcare, and people get better treatment and more access. It's worldwide.

http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346

yes, administrative costs are among those to which I allude when I said "among other things."  Also, there's generally inefficiency in billing, which has also been a subject for my ranting:

https://uselectionatlas.org/FORUM/index.php?topic=148227.msg3182258#msg3182258

I can't comment on the book you referenced because I haven't read it.  I'll try to get around to taking a look at it, or something by that same author, but remember that the specific shortages resulting from the price ceilings may not be what the author is measuring.