As noted the Vinson decision is one which I believe will help lead a majority of the Supreme Court vote to overturn either the entire health care bill or at least the individual mandate. Vinson makes a strong case that the mandate is so integrally tied to the rest of the bill that it cannot stand without that feature. He also makes the point that the last congress in its wisdom chose to eliminate a severability clause from the legislation at the last minute.
But Judge Vinson also makes the point that the problem congress was trying to address is real. I think the way forward, if the Administration and the democrats were actually going to look at alternatives would be to start with some tort reform, add a little set of incentives to allow competition in the health insurance industry across state lines and for pre-existing conditions but at the same time to protect the basic notion of individual choice in the system (which I believe, contrary to the Administration's assertions to the contrary is diminished or destroyed in the bill). Markets actually do work. I would also support a change in the tax status of health benefits to help finance some of the changes but that may not be possible. That last change would put some more price discipline in the system. But based on how the Administration and the democrats handled the bill last year those thoughtful reforms are unlikely to be possible until a new president is elected or there is a GOP majority in the Senate.
Wednesday, February 02, 2011
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