[ExI] Why Cities Keep Growing, Corporations and People Always Die, and Life Gets Faster

Damien Sullivan phoenix at ugcs.caltech.edu
Mon Jun 13 18:34:10 UTC 2011

On Mon, Jun 13, 2011 at 10:53:14AM -0700, spike wrote:

> >...Well, technically it's a tax increase that's waiveable if you purchase
> health insurance or can prove that you can't afford to...
> Interesting point, and a critically important point of law.  The health
> insurance company doesn't take into account your income, but only your
> health.  The tax structure doesn't take into account your health, but is
> scaled to your income.  It looks to me like the current version of the

The health insurance company won't be taking your health into account,
just your age and location.  It won't be taking your income into
account, but the federal government *will*, in providing subsidies for
the purchase of health insurance.

> health care act makes these two incompatible.  In recognition of this, the
> authors specifically refuted the notion that the health care requirement is
> a tax.  If they now change their minds on this, it will be the first example
> of a flat tax levied by the federal government.

I don't know what the authors say, but I've seen law-constitutionality
defenders make the tax argument.  And I see no moral distinction between
"it's a mandate enforced by a fine" and "it's not a mandate but there's
a bribe if you do it".

> Suppose they decide we can't have a federal flat tax of any kind, and
> somehow scale your health insurance bill according to your income.
> All the fed knows is your income; it has no way of knowing your actual
> property value.  So those who are property rich but have little income
> get their health insurance subsidized by the young and poor who are
> working themselves into the hospital trying to pay for the health
> insurance of their landlord.

Why should this be more of an issue here than it is with income tax and
means-tested programs in general?  Red herring.  And "property rich but
income poor" is probably either not a huge class -- property leads to
income -- or one that legitimately needs help, e.g. retired workers with
illiquid home wealth.  As for the subsidies, your framing is both
inflammatory and false: the poor, young or old, will be getting

It's a Rube Goldberg emulation of single payer: instead of raising taxes
and buying truly socialized insurance, we'll make everyone pay premiums,
give subsidies to the poor, and take taxes from the rich.  Instead of
paying Tax, the rich will pay premium plus tax; instead of paing little
tax, the poor will pay preimum minus subsidy.  Math comes out the same,
minus the inefficiency of the extra transfers and of supporting lots of
profit-seeking insurers instead of having a single public pool.

> When you say "prove that you can't afford to" one would suppose all you
> would need to do is show low income last year?  Hmmmm.

Just as getting the EITC is sensitive only to last year's income.  It's
not some special health-related problem.

> It isn't a simple problem, even if one is given dictatorial powers.

Yet it's one that's been solved dozens of times.

> clause.  This is most puzzling for the fed is applying the interstate
> commerce clause to a case which is specifically not interstate and is
> non-commerce.  

As the Supreme Court has applied interstate commerce to the home
production of wheat and marijuana for personal consumption, I figure
"specifically not interstate" is a dead letter or else a completely
arbitrary judicial standard.  Can't blame health care advocates for
operating within the current constraints.  If growing pot in your home
is subject to interstate commerce because of Idunno, being forced to pay
into a health care system you will take advantage of as needed seems
perfectly fair, and a hell less damaging to anyone.

-xx- Damien X-) 

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