nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Thursday, March 11, 2010

Can States Oppose a Health Care Mandate?

Here's a chart published in the New England Journal of Medicine this week.  The free article is here.

The graphic shows those states who have passed opposition to mandatory enrollment, and those for whom it's in the works.


Is it possible for states to overrule federal law, should the current health care reform bills pass?  It's not a clear question.  While the Supremacy Clause of the US Constitution seems to say that no state can override a federal law, there are non-trivial arguments about what the Constitution has to say about those things that are reserved to the states.  By this I mean that the Constitution also says that if it aint listed "specifically" as being a power of the federal government, then that power is reserved to the states and the people.  To my knowledge there's nothing in the Constitution that says the federal government can make you buy a product if you don't want to.  And the Constitution is silent on health care.


Others argue that the law can require you to buy auto insurance, but this is not the same thing.  You can not buy auto insurance, just don't drive.  Millions in the US are in this situation.  But the mandate for health care is not one where there is an alternative of not seeking the "product" (driving).  If you don't see a need for health care coverage, that's not your decision to make.

Another argument is that the Commerce Clause of the Constitution gives Congress the power to regulate interstate commerce.  And, increasingly, the courts have said almost anything is interstate commerce, whether it goes across state lines or not.

There's a big "but" here:  the funding for universal care doesn't work now, despite what the Politicos say.  It REALLY won't work if people can opt out.  You must have the contributions of the healthy and young in order to pay for the sick.

I'm not a lawyer, but I can tell you from reading the writings of those who are, that they don't agree on this question of constitutionality.

Gonna be interesting.

Doc D

Opinions are entirely my own.

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