To all the members of the Libertarian movement, i am a recent Libertarian, coming from the left. You should take heed to this because we are a minority amongst the more conservative members. I am all for liberty, but I disagree with one facet of the libertarian movement; its healthcare. The liberty movement claims to be the moral figure, yet it wants people to not be able to see a doctor if they get sick but dont have money. It is immoral to say that you cant see a doctor for an illness- that you did not choose to get- because you are not giving money to a private entity in exchange for limited coverage. I agree with everything else the liberty movement personifies. I dont like the healthcare reform act, but its a very small step in the right direction, i hate that we are now being forced to purchase private insurance. i propose a compromise. A public option; its optional.

My main point is, you cant say that the new act violates the constitution. Article 1, section 8: "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States"
Steward Machine Company v. Davis, 301 US 548 (1937) gave the united states government the authority to establish a notional tax. and most recently the supreme court ruling on the healthcare reform act; affirming that it is a tax, authorized to be mandated under the constitution.

As Roberts wrote in his opinion, if the individual mandate is a tax, then it is Constitutional. But if it's a penalty, then it isn't Constitutional. The mandate was never sold to the American public as a "tax". It was sold as a "penalty".
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Sure you might call it sematics, but if you are sold a Bernina sewing machine, you expect to pay the price for a sewing machine. You don't expect to pay the price for a Bernina surger machine.

It's definitely an argument of semantics. But the constitutionality of the mandate absolutely hinges on this semantics argument. So it may be one of the most significant semantics arguments in the history of this country.

It's such a dumb decision, and the logic behind it is so mangled and stretched. People are mad at Roberts (as they should be), but don't forget there were four "liberal" judges who made the same argument and voted the same as he did. Four idiots and a sellout..... it's more like a kangaroo court.

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But the question should be asked directly to Obama, is the mandate a tax or is it a penalty as he said it was?

If he says it's a tax, then he lied when he sold the plan.

If he says it's a penalty, then it's un-Constitutional.


The problem is no one is asking the question because they read the decision as "it upheld Obamacare", when it really didn't. Roberts wrote that if the individual mandate is a penalty then it is un-Constitutional because it can't be covered by the Commerce clause. But if it's a tax, then it is Constitutional.

It's similar to this scenario. Let's say you want a son. So the baby is born and the the doctor tells you "if the baby has a penis it is a boy. And congrats you have a son. But if the baby doesn't have a penis, it is a girl, and you have a daughter." But since you want a son so much, you don't bother to inquire further or to take a look yourself and assume the baby is a boy. But the baby could very well be a girl too.

It's a very ambivalent ruling and the ambivalence will be resolved if someone is brave enough to just ask Obama on camera if this thing is a penalty, as he said it would be when he was selling it to the country, or if it is a tax.

This is the false notion that your argument is built upon.

An excerpt from Ron Paul's "The Revolution: A Manifesto":

"Before [Medicare or Medicaid] came into existence, every physician understood that he or she had a responsibility toward the less fortunate, and free medical care for the poor was the norm. Hardly anyone is aware of this today, since it doesn't fit into the typical, by-the-script story of government rescuing us from a predatory private sector. Laws and regulations that inflated the cost of medical services and imposed unreasonable liability standards on medical professionals even when they were acting in a volunteer capacity later made offering free care cost prohibitive, but free care for the poor was common at a time when America wasn't so 'governmentish' (to borrow a word from William Penn). We have lost out belief that freedom works, because we no longer have the imagination to conceive of how a free people might solve its problems without introducing threats of violence--which is what government solutions ultimately amount to."

The only caveat I'd apply to the above is that obviously not EVERY physician would offer free/voluntary medical care to those who can't afford it. However, the fact that many would, combined with the existence of charitable funds and community sourcing inevitable in a voluntary society, greatly outweighs the costs of violence-enforced government-mandated health care.

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Many physicians are already providing free medical care: that's why they are hesitant to do more.

I'm about to send 10 delinquent accounts to collections because these people have failed to pay their deductibles, even though their contracts with their health insurance companies state they are responsible for deductibles and copayments. So as it stands with these 10 deadbeats, they received free medical care---free electrocardiograms, free urine dip tests, free 45 minute office visits, and one guy had a free pulmonary function test---- a little over $600 of medical care. And the chances are slim to none that we'll even see 1/3 of that. What's really sad is that we've had people threaten to report us to the Board of Medicine if we don't call collections off them.

So what incentive would my bosses have to render more free medical care? They've already given away $600 worth of free medical care to people who can afford health insurance.

If we want a more voluntary society, then we 1. embrace the Free Market and 2. de-regulate.

By embracing the Free Market, you'll cut out the healthcare middle men (Government and health insurance companies). Physicians and patients can set their own fees. If a patient thinks an electrocardiogram is only worth $10, then he can find a physician who will provide that service for that amount. If he thinks it's worth $30, then he can find a physician who will provide that service for that amount. In other words, the patient becomes the consumer in the truest sense and will be able to dictate the market.

People will make the argument that "Well, patients will go to the cheapest guy in town even if that guy's a lousy doctor!". The answer to that is "you get what you pay for." With the current health insurance model, you pay a company X amount and you still see good doctors and lousy doctors.

By deregulating, you'll not only get the government out of your medical needs, you will also see an overall decrease in medical cost. Why does your doctor prescribe some really expensive medicine for your diabetes? Answer: because the treatment guidelines say to prescribe those medicines and to do otherwise is "substandard medical care" and your doctor can be sued (and will lose) for providing substandard care.

But no one wants to explore any non-insurance/non-government dictated healthcare model because they think "people will die in the streets if they have no health insurance!" No. People are currently dying in the homes because they HAVE health insurance and can't afford to pay the co-payments and deductibles in addition to the premiums.

you have to also admit that the private sector commits violence as well as the govt. it was the private insurance lobbyists that fought for the new healthcare reform. if you think private insurance does nto secretly love the new bill, you are fooling yourself. when medical insurance is mandated like car insurance, the private corps bank.

It's more like the private sector (read: "insurance companies" and "pharmaceutical companies") have bought the government, rather than commit violence on it.

You say that under a Libertarian / voluntary system, doctors will volunteer to give medical services. What if you require expensive medical services, like brain surgery, or radiation treatment, do you think that doctors will just give away expensive resources and valuable time to operating on the brain or intestines. what if the hospital is busy and has no surgeons available? donations will only go so far. I propose that the people of America establish a public option; its optional. this option will allow people to opt into a government run healthcare insurance. the program will not seek profit, but it also will give the people within the plan "standard" care; as it would be defined in the bill. the insurance companies can provide premium care; were you get services faster. doctors should also be willing to donate their time and resources, but there should also be standard care available to all people.

Libertarians, you accuse the government of being immoral and forcing you by gunpoint to pay taxes. bu how moral is it to allow fellow human beings to die because they cannot afford treatment, and their treatment is too expensive to just give away. It is not unconstitutional for a local and federal government to tax the people. it is unconstitutional for the governments to over-tax or tax you without you having representation of the people having an influence. "no taxation without representation."

I don't think that's what was said here. I think physicians would be paid for their services by the people who can afford to pay. For those who can't, physicians would be able to choose to give free/charity care.

For example, we buy our flu vaccine supply at a price of $12.50 per shot. In an insurance/government-less environment, we can charge our patients $14. 00 for that shot. The remaining $1.50 can either go to cover the flu shot of a patient who cannot afford the shot. This means for every 20 people who pay $14. 00 for their shot, we can give a shot to 1 person who cannot afford it. Or we can use that $1. 50 to help cover other services like an electrocardiogram, or even a physical exam.




Here is where the healthcare debate falters. There is a HUGE difference between out-patient (office-based) and in-patient (hospital-based) medical care. And these two should be separated in the debate.

Typically, if you are admitted to a hospital, your medical needs are greater than if you are seen in your doctor's office for a cough. So the expense of your treatment is greater at a hospital, than it is in a doctor's office.

But back to your question. Prior to the 1970s, hospitals had "free wards" or "charity wards" where people who could not afford hospital care were admitted. These "free wards" were staffed by hospital-employed physicians and nurses. The monies used for the maintenance of these "free wards" were gained through fund-raisers. Therefore, the people in the community could voluntarily donate monies to support these wards. There were also "free clinics" run by charitable, private organizations.




Then that hospital is not a hospital and should not call it a hospital. Hospitals are open 24 hours. And they have disaster plans that kick in when there is a mass casualty event like the shootings in Colorado. So physicians/surgeons are called in. Spaces for patients are made in hallways, tents, etc.




They went far enough prior to the health insurance era. Talk to physicians who practiced medicine in that era, they will tell you they liked volunteering their time and donating to these free/charity wards/clinics.



Unfortunately, the Obamacare public option is NOT optional, because you will be taxed if you don't have health insurance. Optional should mean just that: you don't have to do it and you won't be punished (ie: taxed or fined) if you don't.



This is similar to the current system in the UK and other socialized medicine countries where there is a 2-tiered healthcare system: a public system and a private one. Interestingly enough, most people in these countries try to get hospitalized in the private system because 1. the "better" doctors are in the private system, 2. you don't have to provide your own bedsheets and food, 3. you don't have as long a wait time for anything.

And let me tell you something....when I was in college, I used to work part-time at a VA Hospital. Sure, the vets got the tests----it might have taken a month to get it, but they eventually got it. And sure the vets got the care that met the "Standard"----even though my idea of "standard of care" means the doctor can order "Stat" procedures like ECGs can labs after 5 PM. But it doesn't explain why the Vets who could afford private insurance did not go to the VA clinics or the VA hospital for their care.

And I doubt things have improved in the VA System since that time because currently where I work, we have retired military and newly discharged military, coming to our office because they don't want to go to the VA even though they have VA benefits.

I don't think anyone said all physicians will be required to work free. Physicians, like everyone else, would be paid for their medical services.

And also, don't be too trusting of the government's concern for your health. In the last 3 years, the US Preventative Medicine Task Force has come out with guidelines that state screen mammograms and screening PSA (prostate-specific antigen) tests are unnecessary because they 1. don't change the number of breast cancer and prostate cancer cases, and 2. don't change the outcomes of those diseases. Therefore, screening women and men for these diseases are unnecessary and cost too much money. The whole purpose of a "screen" is to detect these disorders and begin interventions to either cure or delay the progression of the disease. The fact is, the government doesn't want to spend the money on the screenings and the interventions to keep these people alive.

Additionally, the private sector cost will increase when this system goes live. BEcause in the US, the private sector foots some of the bill the government uses. Here's a link the the CDC's vaccine price list:

http://www.cdc.gov/vaccines/programs/vf ... e-list.htm

Notice the public sector (CDC/government) price of the SAME vaccine is about 20- 30% LOWER than the private sector cost.

And note too the blurb at the top of the document:

"Contract prices are those for CDC vaccine contracts that are established for the purchase of vaccines by immunization programs that receive CDC immunization grant funds (i.e., state health departments, certain large city immunization projects, and certain current and former U.S. territories). Private providers and private citizens cannot directly purchase vaccines through CDC contracts. Private sector prices are those reported by vaccine manufacturers annually to CDC. All questions regarding the private sector prices should be directed to the manufacturers. "

In other words, the GOVERNMENT gets a 20-30% discount, but the private sector does not.

If you talk to the pharmaceutical companies, the private sector pays more in order to make up for the discounted price the Government pays.

For these two reasons, you're dreaming if you think having a 2 tiered healthcare system will decrease cost or improve healthcare.



I explained above how a non-government healthcare system worked in the past and will work in the future.

When Obama promoted the Affordable Care Act, he specifically said the mandate would have a penalty, not a tax.

Robert's decision says if the mandate is a penalty/fee under the Commerce Clause, it is unconstitutional, but if it's a tax it's not.

So, now the mandate is a tax, not a penalty like Obama said.

How moral is it for someone to promise to give you a turkey dinner with all the trimmings, then give you a bowl of Wheaties instead?

How moral/legal would it be if you bought a Louis Comfort Tiffany lamp on Ebay, and when it comes in the mail, you find it's a beeswax candle"?

How moral is it to bait and switch like Obama did?

i agree that this new healthcare reform bill sucks. what we should have is a public option where you can choose to buy into a government run not-for-profit; not a "nonprofit," where the only people that get paid are the doctors and nurses, and the people who actual facilitate healthcare services. the doctors should not limit the amount of patients they see under this public option, and in exchange the doctors will get a tax cut, to be determined.

Who are these people "who actually facilitate healthcare services" in your opinion?

Under the current system, these people include health insurance companies, administrators (CEOs, COOs, VPs, secretaries, etc.), billing people, accountants, and other people who do not deliver direct patient care.




Unfortunately, doctors have to limit the number of patients they see. Why? Because doctors (and nurses) are people and they get tired. Studies have shown that the heavier the patient load (the number of patients a physician/nurse sees per hour/per day/per week) the more medical errors.

So just from a patient safety point of view (which directly effects quality of care), there has to be a cap on the number of patients a physician/nurse sees per hour, per day, per week. The Libby Zion case in New York City is a perfect example of how patient safety and quality of medical care suffer when physicians are tired and overworked.

And if it's anything that scares a physician the most, it's a medical malpractice lawsuit. Even if they are tax exempt, meaning they won't have to pay any taxes if they work in the public option system, the fact that they can be sued for medical malpractice won't have physicians clamoring to get on that public option provider list. you might have some doctors sign onto something like that, but once they realize that they're still on the hook for medical malpractice, you'll see the numbers of volunteers decrease.

I don't think that the government is a necessity for oppression, to be honest. It helps, but it's not necessary. Let's not forget nepotism and established institutions, which are in fact perpetuated by property rights.

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Glad to hear it; we need some spice in these forums.

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“They see only their own shadows or the shadows of one another, which the fire throws on the opposite wall of the Cave.”
~Plato, The Republic

I've been a libertarian since I was born I think I've always hated authority. And this hatred has only grown over time.

Philosophically speaking, I became a libertarian sometime in 2008 after I read Herbert Spencer. Spencer is really great, it's impossible to say whether he's left or right. I remain a disciple of his, despite the fact I don't agree with all his ideas (obviously). The main reason I get called right-wing is because of my rather strong Social Darwinist views which stem from my belief that ultimately everyone must take responsibility for their own actions.

Other than that I think I have a very healthy lefty strain in me. I wouldn't mind, for example, organizing a society where "occupancy and use" is the rule for property in land. I am also radically suspicious of any large build-ups of capital, so I'd be much more comfortable living in a very small self-sufficient community with other like-minded individualists. I'm also a bit of a nature freak

So it all balances out for us libertarians in the end I think. As long as we're all careful not to step on other people's toes, we'll all be happy together without any authoritarian presence in our midst.

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"Here, every citizen is king; for he has plenitude of power, he reigns and governs." - P.J. Proudhon

We seriously need more green-minded people in the movement. I get irritated when the left is granted a monopoly on being green. The greenest people I know are libertarians/conservatives. I see nothing wrong nor "communist" about leaving the earth in a good condition for future generations.

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“They see only their own shadows or the shadows of one another, which the fire throws on the opposite wall of the Cave.”
~Plato, The Republic

In all honesty I don't really care about future generations, but I just love nature. It's a very selfish love Sometimes I walk around the forest and imagine that the trees are all really Ents on the inside. On a funny side-note, my mother thinks I'm a libertarian/anarchist because she was reading The Lord of the Rings while she was pregnant with me (I now read it once a year every year as a ritual to affirm my anti-authoritarian spirit).

I'm vegetarian and I'd never kill an animal, unless it was really necessary. My moments of deepest thought and reflection are always related to nature. I don't think I could live without it.

And I really agree that commies have monopolized the "green love". They are not entitled to this position at all. Being "green" and putting nature preservation ahead of other values in life is a personal choice, not an element of political ideology.

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"Here, every citizen is king; for he has plenitude of power, he reigns and governs." - P.J. Proudhon

I've started reading Thoreau lately for a few reasons: Most read Thoreau in high school or college but I never did so I never really understood how much of an impact he made on the Individualist philosophy. Are you a fan of his work? For some reason reading your posts reminded me a bit of him.

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Liberty: "the conceptual extension of the idea, that your rational mind grants you the exclusive right to your body & products of your labour."

It's definitely worth reading Thoreau. He's very anti-political although I must admit I only read Walden, and that was a few years ago, so I'm not an expert. I would really be into his kind of lifestyle though - the nature, the tranquility, the poetry. Sometimes I am a bit of an isolationist at heart. After all, conflicts only arise where people are involved
As Stalin used to say - "no person, no problem". Except I'm sure you know he meant something else...

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"Here, every citizen is king; for he has plenitude of power, he reigns and governs." - P.J. Proudhon