For the second time, a federal judge has struck down key elements of President Obama's health care law, ruling aspects of it unconstitutional.
U.S. District Judge Roger Vinson said Monday that the federal government cannot require Americans to buy health insurance, siding with the 26 states that are fighting the law.
The Justice Department said it would appeal the ruling.
In December, a federal judge in Virginia issued a similar ruling, although two other federal judges had previously upheld the law. Many expect the constitutionality of the health care law will eventually reach the Supreme Court.…
The New York Times gives us the gist of Judge Vinson's ruling:
…In his 78-page opinion, Judge Vinson held that the insurance requirement exceeded the regulatory powers granted to Congress under the Commerce Clause of the Constitution. He wrote that the provision could not be rescued by an associated clause in Article I that gives Congress broad authority to make laws “necessary and proper” to carrying out its designated responsibilities.
“If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain,” the judge asserted.…“It would be a radical departure from existing case law to hold that Congress can regulate inactivity under the Commerce Clause.” If Congress has such power, he continued, “it is not hyperbolizing to suggest that Congress could do almost anything it wanted.”…
I believe Judge Vinson is incorrect
He presumes the purchase of health insurance is equivalent to the purchase of a new set of golf clubs, a magazine subscription, or even a car or a home. But it is not.
When a person chooses not buy health insurance, he is relying on a safety net. Hospitals are given federal dollars to treat the uninsured, and are forbidden by law from discharging these uninsured patients until their condition has stabilized. And this applies no matter the uninsured's state of residence or where in the US the accident happens. An uninsured New York City resident who has a heart attack in Newark, New Jersey gets treatment at the closest Newark Hospital – by law he is not sent back to NYC for treatment.
When a person doesn't buy golf clubs, he can't play golf, and no one is obligated to buy golf clubs for him.
But when a person does not have health insurance and gets seriously ill, hospitals are obligated by law to treat him and stabilize him, and the federal government pays for all or a majority of it.
These are not insignificant costs. Hospitalization for a heart attack can run more than $100,000. A serious cancer or other longer term illnesses can run much more.
Even the uninsured who use emergency rooms to get treatment for less serious illnesses – influenza, a bad cold, bronchitis, etc. – are relying on the federal government to pay for this because by law, hospitals must provide treatment and the federal government must pay for it.
This means non-emergency medical care is provided at emergency medical care prices. This costs the federal government hundreds of millions (if not billions) of unnecessary dollars each year.
As a society, we can choose to let these uninsured people suffer and even die without medical care.
But if we reject that option – a we clearly should – we are left with the choice of how to provide medical for the uninsured.
Judge Vinson looked at only half of the equation.
If health insurance were truly equal to golf clubs, Judge Vinson would have been correct.
But health insurance is not equal to golf clubs, and being denied health care is not equivalent to being denied a round of golf.
Judge Vinson may not understand that, but I think the framers of the constitution certainly would.
So what's the proper Jewish response to this? Does Judaism have skin in this game?
Yes, it does.
As I've noted previously, halakha, Jewish law, mandates that doctors provide needed care, regardless of a patient's ability to pay, much the way US law does.
At the same time, halakha mandates a person to spend his money to get medical care. It is not optional. Once a person has exhausted his personal funds, the community is mandated to pay the bills for him.
In today's complex world where medical can cost hundreds of thousands of dollars, halakha would mandate the purchase of health insurance for several reasons: because it provides access to medical care when needed, often at a far cheaper cost than the alternative while providing better care; because it pays for that care rather than forcing the community to pay for it; and because its purchase helps prevent a person from becoming a long term ward of the community.
Judaism is neither exclusively liberal or exclusively conservative. Instead, it is a mixture of both outlooks.
The Republicans' position on healthcare is for the most part not in concert with halakha and it should not be supported.