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Federal vs State Health Care Dispute Tests Constitution PDF Print E-mail
Written by Warren Mass   
Friday, 15 January 2010 16:21

MSNBC.com reprinted a report from Kaiser Health News on January 15 headlined: “Feds vs. states: Who should run health market?”

The main focus of the report is the differences between House and Senate versions of the healthcare legislation still being hammered out in Congress. As the report notes:

This issue [whether states or the federal government will have more clout in a proposed health insurance marketplace] is one of the key disputes in the current negotiations between leaders of the House and Senate as they meld their health bills. The House, which would establish a national exchange run by the federal government, argues that setting a uniform program would help protect consumers. The Senate, which wants each state to create and run its own exchange, says states have more experience overseeing insurance plans and know their residents’ needs better.


The report quoted from a statement sent recently to House and Senate Democratic leaders by officials of the National Association of Insurance Commissioners: “State insurance regulators have a proven track record of swift and appropriate action to protect insurance consumers, while there is no evidence that a federal regulator could or would perform comparably.”

In contrast to the (relatively) pro-state position taken by the commissioners, the author also quoted from Rep. John Garamendi (D-Calif., pictured at left), former California Insurance Commissioner and a proponent of a strong federal role in regulating any new health care program. Which is not unexpected, since the federal government always regulates what it funds.

"You start with a strong federal regulatory environment, one that has the rules clearly written and one that has a mechanism to enforce those rules," said Garamendi.

A news release posted on Garamendi’s House website, entitled “Leaders Warn Premium Hikes, Health Insurers’ Abusive Practices Could Continue Without Stronger Regulation,” quotes the congressman’s following statement:

"As a former insurance commissioner, I know firsthand that health insurance can burden people with unaffordable coverage unless we demand accountability from insurance companies," said Garamendi, California’s first elected insurance commissioner and former chair of the California Senate Health Committee. "As we merge the House and Senate health care bills, we must not leave consumers and small businesses unprotected from insurance company greed. The House bill creates a national exchange that will give consumers an opportunity to get health insurance at a lower cost with expanded benefits, and it will provide more oversight. This is superior to the Senate bill, which expects all states — regardless of size, wherewithal, or existing insurance infrastructure – to manage new marketplaces in smaller state exchanges."


The statement posted by Garamendi notes some distinct differences between the House and Senate health care plans, worded in language obviously biased in favor of the House version:

  • “The House bill includes a federal health insurance marketplace rather than weaker state insurance exchanges.”
  • “The federal exchange contained in the House bill would ensure immediate implementation and provide a national watchdog to unite fragmented markets and subject them to uniform accountability regulations.”
  • “The Senate’s plan to give states responsibility for creating and monitoring exchanges could allow insurers to game local systems and undermine implementation of health reform from the start.”

The statement also quotes Karen Pollitz, a Georgetown University “health policy expert,” who said:

Accountability provisions under the Senate bill aren’t strong enough. The federal government simply must step up and play a strong, proactive, pro-patient role in health insurance regulation. In addition, there needs to be a national exchange – both to reinforce new market regulations and to ensure that all consumers get reliable, accurate, and accessible information to compare plans. Especially with so many states facing fiscal and economic crisis, they just don’t have the resources to rigorously and flexibly manage exchanges. (Emphasis added.)


But the obvious bias in favor of the House plan by Garamendi and his allies in the House and academia should not lead the observer to conclude that the Senate plan must be — by virtue of being attacked by the more blatant proponents of federal regulatory power — a model of constitutionality and free market economics.

If it were simply a matter of who should regulate the insurance industry, the federal government or the states, the answer could be established by a simple reading of the Tenth Amendment:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.


Since, in Section 8, the area of the Constitution where powers are delegated to Congress, there is no mention of any power to establish, provide, or regulate health care, this power is reserved to the states or private citizens by default.

And while the Senate plan may be less intrusive than the House plan, because it gives states responsibility for creating and monitoring exchanges related to “health reform,” it is important to keep in mind that before the federal government can “give” responsibility to the states, it must first usurp that responsibility. Health care, by not being mentioned anywhere in the Constitution (just as health, education, agriculture, and numerous other “human services” are not mentioned) is simply not among the powers delegated to Washington. The federal government constitutionally cannot share power it does not rightfully possess in the first place.

So the argument between those who favor the Senate plan and those who favor the House plan is pointless.

Both plans should be rejected.



 

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Stophel said:

0
 ...
"Feds vs. states: Who should run health market?”

The answer is, of course, neither one.
 
January 15, 2010
Votes: +2

rprew said:

1484
 Stophel is correct
Health care should be run by the market, not by any government.
 
January 15, 2010
Votes: +2

Kenneth Creech said:

0
 ...
In my lifetime I have lived 26 years with no insurance, 2years in USAF covered by military medicine, 35 years with I B M insurance and finally 11years with medicare. Not to bad in a free country for a poor boy with only a high school and 2 year technical background. Seems pretty ridiculous now that I am a senior citizen the government wants to reduce my access to health for which I paid regular into my retirement under the social security program. It would have worked too if the scoundrels in Washington had used it the way it was supposed to be used.
 
January 15, 2010
Votes: +2

sorry said:

0
 Kaiser is a problem, seriously
When I lived in Hawaii and worked for a county department we had Kaiser insurance that came with the job.
When I had a urine test, thinking it was infection, they said I was not infected, but pregnant and that they would schedule the abortion for monday morning so I wouldn't miss any work.
I had not asked for an abortion.
I went into emotional shock.
I flew to San Diego and begged the welfare department for help.
They said that to apply for foodstamps took some time,
and they told me that without foodstamps, having spent all my money
to leave Hawaii and arriving broke,
that my baby would suffer food nutritional deprivation and be born
disabled,
and therefore, they said that the only way they would
give me foodstamps right away was if I would
agree to an immediate abortion,
and then they'd give me food stamps for myself.
KAISER, GO TO HELL!
FEDERALLY FUNDED ABORTIONS, GO TO HELL!
 
January 15, 2010
Votes: +3

Pat Henry said:

0
 ...
The above comment points out, as I have said before, the ultimate agenda of the whole "health care" juggernaut. It is communist, yes. But the end of such ideology is hatred of the human race and destruction of God's creation ("abolition of private property"), lying and deceptive rhetoric notwithstanding.

Endgame by Alex Jones, and Dr. Stan Montieth's CD series on Population Control helps connect the dots, manifesting the convergence of the evil side. Yes, there is an axis of evil, but it is not promoted by "network" media.
 
January 18, 2010
Votes: +3

Stophel said:

0
 ...
The State considers all of us its property.
 
January 18, 2010
Votes: +0

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Our valuable member Warren Mass has been with us since Monday, 23 June 2008.

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