Topic: Health Care Law - AKA 'ObamaCare' - Upheld

[GCrites80s]

^^But what if a gym isn't really someone's thing? People like to play sports, ride bikes, run, all sorts of stuff. Gyms don't provide people with the visual, auditory, olfactory, adrenal and other nature-oriented rewards that some individuals need in order to be motivated to perform physical activity.

[Clevelander17]

There was an article in the Sunday Dispatch about how insurance companies in Columbus have found that MRI costs are all over the board. I can't find it online, but each hospital in town charges vastly different fees for MRIs. One charges $1300 where another might charge up to $4000. But the real deal is at dedicated MRI facilities away from hospitals. Some charge as little as $130 for the same procedure. That's how competition is supposed to work, but the industry has become so complex from there being so many different hands reaching for the money as it changes hands between the patient and the professionals that it's really tough for the pros (let alone the average person) to make sense of it all. That's why minimizing the number of greedy hands between you and the doc is best.

Interesting line of discussion here.  It seems to me that there is a real lack of transparency in pricing in the healthcare industry.  Occasionally when I'm looking for a new doctor I'll call around and ask about prices for regular appointments and rarely will I be able to get a straight answer.  It seems like this would be an important thing that an informed consumer should be able to find out and yet it's oftentimes difficult to get access to this information.  If competition were to ever be a key part of our healthcare system, it's stuff like this (and fair but honest doctor ratings) that patients will need to be able to easily research.

[StrapHanger]

^But most consumers don't pay the sticker price for appointments, only a fixed co-pay.  And I would guess most doctors have negotiated rates with major insurers, so there is no opacity in the pricing between the real consumer (the insurer) and the service provider.  In that sense, competition is already part of our system.  Or at least the incentives are there for it, assuming that insurers look to minimize out of pocket costs (among other goals) to maximize profits.  Admittedly things get a lot more complicated when sick people are seeking specialist care for which their insurer only pays a percentage of the cost.

[Hts121]

It seems like you're just being argumentative.  Probably a by-product of your profession.  Obviously I haven't vetted out how incenting people to be healthy works, but there's no penalty for anything.  Only a reward for certain behavior.  So no, that's not a fine or a tax.

It seems that speculation about my profession is the go-to card this month when a substantive response doesn't come immediately to mind.  Whatever makes you feel better..... but I think the obsession over my personal life (not just you) and any "by-product" thereof is a bit weird.  Back on topic.....  If what you propose is not a tax, then how would you propose paying for it?  Where would the "incenting" come from?  Or were you proposing a non-deficit neutral program?

[Clevelander17]

^But most consumers don't pay the sticker price for appointments, only a fixed co-pay.  And I would guess most doctors have negotiated rates with major insurers, so there is no opacity in the pricing between the real consumer (the insurer) and the service provider.  In that sense, competition is already part of our system.  Or at least the incentives are there for it, assuming that insurers look to minimize out of pocket costs (among other goals) to maximize profits.  Admittedly things get a lot more complicated when sick people are seeking specialist care for which their insurer only pays a percentage of the cost.

Yeah, you're probably right.  My insurance has some limits and doesn't always cover everything so I have to be a little more careful.  I still think that information would be nice to have for general consumption, but your point is valid, too.

[Gramarye]

just like many liberals lauding Roberts' decision now because of its result are somewhat disquieted about the limitations on the commerce power that may or may not be contained therein.

That's an interesting question I heard some conversation about this past week - is Roberts ruling on the commerce power precedent or mere dicta?  I suppose sine the other justices wrote their own opinions and the rest of the 'majority' did not reach the same conclusion, then it is not binding precedent.  Doesn't really matter to me.  We got to point B and we got there the way I thought it should have been explicitly done in the first place by Congress.

Volokh Conspiracy has multiple detailed posts on that (and, as often happens among legal academics, a lot of qualifiers in front of guesses).  I would call it holding because there are 5 votes on the Supreme Court for that narrower interpretation of the Commerce Clause, and the principle of stare decisis is supposed to prompt lower court judges to rule on a given law in the fashion that they predict is least likely to be overturned on appeal--i.e., consistent with what the appellate courts above them have already stated.  Since a pure Commerce Clause mandate case would likely encounter 5 "no" votes on the Supreme Court, lower courts should rule against it.  However, the Supreme Court's own precedent regarding what a "holding" is doesn't read that way, giving lower courts room to make rulings that they might well believe would encounter 5 "no" votes at the Supreme Court, and so few cases make it up that high anyway that lower court judges have a great deal of room to ignore the Supreme Court in practice.  I'm not even fully sure if Roberts fully thought that through--I don't want to shortchange his intelligence, given his academic and professional history, but all evidence points to his Tax Clause holding being the product of an eleventh-hour switch, and Supreme Court justices are still human and can falter under time pressure and political pressure.  Moreover, while his four clerks are among the brightest young lawyers in the country, they still number only four, and redrafting at the last second in response to what candidly appears to be either a politically calculated or politically craven reversal (depending on your perspective) may not have left time to think through everything he would have wanted to, unless he really was planning this from the beginning.  Given both the clues in the opinions themselves and the leaks from within the Court, I consider the latter an unlikely possibility.

[Cleburger]

I'm here to tell you, the quickest way to fix healthcare is to get rid of all employee sponsored health care.  The majority of people around me opposed to government intervention are spoon-fed a plan by their employer.   If they were true "conservatives," they would join the ranks of the uninsured and shop for their families' insurance on the open market.   Only then would they know what a mess it is.   Only then would they know if their employers are screwing them or not.   Only then would they know that they cannot buy the same policy as someone 50 miles away in a different zipcode.

The "free market" doesn't exist in healthcare now.   Threats of socialism are only thinly-veiled protections for the current monopolies.   

I'm not saying Obama care is the solution.  But the current system sucks.   There has to be a better way.

So I challenge all my white collar friends to cancel their employer sponsored plan, flex spending accounts and other tax dodges, and shop on the open market as an individual.   Suddenly Obamacare wouldn't seem so bad....

[surfohio]

The "free market" doesn't exist in healthcare now.   Threats of socialism are only thinly-veiled protections for the current monopolies.   

Bingo. That's one of the reasons the partisan public debate is so annoying. Obamacare isn't socialism. And the current state of healthcare isn't proof that a free market solution failed.

[Hts121]

^^Public option.  It's a compromise between universal coverage and the current system.  It would be much, much more effective at controlling/lowering costs than the ACA and anything is better than the skyrocketing system we had before the ACA.

^^^I certainly wouldn't underestimate Roberts' intelligence and I'm not sure I'm buying the 11th hour conspiracy theory.  He might have switched his official vote at the 11th hour, but I would be fairly certain he had the bulk of the opinion he was switching to already written in some form.

[Gramarye]

^^^I certainly wouldn't underestimate Roberts' intelligence and I'm not sure I'm buying the 11th hour conspiracy theory.  He might have switched his official vote at the 11th hour, but I would be fairly certain he had the bulk of the opinion he was switching to already written in some form.

I don't think the 11th-hour switch qualifies as a "conspiracy theory."  There is a lot of evidence for it, both in the opinions themselves and in the Jan Crawford story (which appeared on CBS, not some fringe Web site).  I think it's the dominant belief of both supporters and opponents of the ACA.  Of course we'll never know for sure, but the greater weight of the evidence certainly leans that way.  That's the best one can generally do.

I'm also not sure that he had the bulk of the final opinion actually written before he switched his vote.  There might have been a bench memo from one of his clerks lying around somewhere on the possibility, but I would wager that there wasn't anything more than that, and maybe not even that.  Both supporters and opponents of the ACA noted that the writing of the lead opinion was not up to Roberts' normal standards and was somewhat disjointed in places, not signs of a product that was a long time in the making.

[Clevelander17]

I'm here to tell you, the quickest way to fix healthcare is to get rid of all employee sponsored health care.  The majority of people around me opposed to government intervention are spoon-fed a plan by their employer.   If they were true "conservatives," they would join the ranks of the uninsured and shop for their families' insurance on the open market.   Only then would they know what a mess it is.   Only then would they know if their employers are screwing them or not.   Only then would they know that they cannot buy the same policy as someone 50 miles away in a different zipcode.

The "free market" doesn't exist in healthcare now.   Threats of socialism are only thinly-veiled protections for the current monopolies.   

I'm not saying Obama care is the solution.  But the current system sucks.   There has to be a better way.

So I challenge all my white collar friends to cancel their employer sponsored plan, flex spending accounts and other tax dodges, and shop on the open market as an individual.   Suddenly Obamacare wouldn't seem so bad....

Are you referring to the partial anti-trust exemption that the health insurance industry has?  I think that that definitely stifles competition.

[Clevelander17]

Gramarye or Hts, could either one of you explain in layman terms the implications of the idea that this law might set a precedent on the limitations of commerce power?  Not sure I'm following what Roberts would be getting at if that's what he ultimately aimed to do with his decisive vote.

[Hts121]

The commerce clause has traditionally been interpreted as the most wide-reaching provision in the constitution for facilitating the passage of federal legislation.  It allows Congress to not only regulate interstate commerce, but anything that meaningfully affects interstate commerce.  It was used to pass many civil rights laws, for instance.  It is a way for the federal government to step in and regulate in areas that are normally reserved for the states.  This is important because once the federal government regulates something then the supremacy clause applies and any conflicting state law is effectively superseded by the federal law on the same topic.  It's the provision that is most often used to "impose Boston values on Mississippi" if you catch my drift.  States' rights proponents have often begged the question of "where does it end"?  Roberts' opinion was that the commerce clause is not so expansive as to allow the individual mandate, thereby identifying a limitation on Congress' power to regulate under the commerce clause not previously recognized.

[Living in Gin]

I'd rather impose Boston values on Mississippi than force Boston to live by Mississippi's values.

[Gramarye]

And many people in Texas would rather impose Texas values on Massachusetts than vice versa.  One major point of federalism is to prohibit both and allow different states to have different values for their peoples.  The other was to have states as a vertical check and balance against the entire federal government, just as the three branches of the federal government were intended to horizontally check and balance each other.

And I'll second Hts' exposition of the Commerce Clause issue.  I'll also add that the Commerce Clause has been invoked not just for civil rights laws, but it also forms the basis of almost every enabling act and regulation of the EPA, the Department of Labor, the Department of Commerce, the Department of Energy, the Department of Education (its spending programs are valid under the Tax Clause, but its regulations are more aptly Commerce Clause), the FCC, the FDA, and more.  Our antitrust laws are founded on the Commerce Clause.

Pure taxing and spending programs operate outside the Commerce Clause, so Social Security, Medicaid, Medicare, and unemployment would survive without it.  There are separate enabling clauses in the constitution for the army, navy, and militia, as well as for roads.  However, in practice, ever since the New Deal, a *huge* portion of the federal government has been dedicated to actually regulating commerce and also social legislation enacted under the Commerce Clause.

[surfohio]

Gramarye or Hts, could either one of you explain in layman terms the implications of the idea that this law might set a precedent on the limitations of commerce power?  Not sure I'm following what Roberts would be getting at if that's what he ultimately aimed to do with his decisive vote.

Conservative criticism:
http://chasingjefferson.blogspot.com/2012/03/boundless-commerce-clause.html

The Framers never intended this clause to be an all-empowering provision authorizing Congress to do anything it deems a good idea, or to regulate private activity on private property just because if enough people did it it might “affect” interstate commerce. 


The controversial decision:
http://en.wikipedia.org/wiki/Wickard_v._Filburn

Wickard arguably marked the end to any limits on Congress's Commerce Clause powers. The Court's own decision, however, emphasizes the role of the democratic electoral process in confining the abuse of the Congressional power, stating that, "At the beginning Chief Justice Marshall described the Federal commerce power with a breadth never yet exceeded. He made emphatic the embracing and penetrating nature of this power by warning that effective restraints on its exercise must proceed from political rather than from judicial processes."

[Gramarye]

And to the extent that Roberts' opinion did recognize some limits on Congress' power under the Commerce Clause to basically run the entire economy, that does represent a step back away from Wickard, which is probably the one decision that economic libertarians despise most in the entire oeuvre of the Supreme Court, barring universally disgraced decisions like Dred Scott and Korematsu.

[Hts121]

Conservative criticism:
http://chasingjefferson.blogspot.com/2012/03/boundless-commerce-clause.html

The Framers never intended this clause to be an all-empowering provision authorizing Congress to do anything it deems a good idea, or to regulate private activity on private property just because if enough people did it it might “affect” interstate commerce. 

What the Framers' intended - which, absent some writing signed by all of the Framers endorsing that interpretation, is impossible to state with any certainty - is never the primary question even though people like to play that card when it suits their needs.  It is secondary at best to what they wrote.  We can never change or adapt what they intended if that intent is no longer suitable for the modern world.  We also should never assume that "the Framers" agreed upon any singular intent/scope/etc.  The divide between the Framers was no so much different than the divide we see between politicians today.  They strongly disagreed with each other on many points.  What they ultimately agreed upon was phraseology.  What they wrote is right there for all of us to see and capable of being changed/adapted as society evolves.  I give "the Framers" a little more credit than most in acknolwedging that they realized this reality.

[surfohio]

Conservative criticism:
http://chasingjefferson.blogspot.com/2012/03/boundless-commerce-clause.html

The Framers never intended this clause to be an all-empowering provision authorizing Congress to do anything it deems a good idea, or to regulate private activity on private property just because if enough people did it it might “affect” interstate commerce. 

What the Framers' intended - which, absent some writing signed by all of the Framers endorsing that interpretation, is impossible to state with any certainty - is never the primary question even though people like to play that card when it suits their needs. 

.....

What they ultimately agreed upon was phraseology.  What they wrote is right there for all of us to see and capable of being changed/adapted as society evolves.

I disagree with you 1,000 percent.

What the drafters of the Constitution Intended is every bit as valid- if not moreso- than the four other types of legal argument for interpretation.

Finally, the method of changing the Constitution as society evolves is conveniently laid out IN the Constitution via the Amendment Process.

[Hts121]

Again, you are assuming there was a singular intent agreed upon by the Framers.  The only thing they "agreed upon" (and I'm sure there was even some serious dissent here too) is what they wrote.

Regarding your last sentence, I wasn't suggesting anything else.  I know of no other way to change the constitution than to amend it.  The point being that their inclusion of an amendment process demonstrated that they clearly "intended" for what they wrote to be capable of being changed if the need arose.  Point further being that their "intent" in the late 18th Century should not be taken as scripture or "the WORD" today.

[surfohio]

Again, you are assuming there was a singular intent agreed upon by the Framers.  The only thing they "agreed upon" (and I'm sure there was even some serious dissent here too) is what they wrote.

Regarding your last sentence, I wasn't suggesting anything else.  I know of no other way to change the constitution than to amend it.  The point being that their inclusion of an amendment process demonstrated that they clearly "intended" for what they wrote to be capable of being changed if the need arose.  Point further being that their "intent" in the late 18th Century should not be taken as scripture today.

Again, you are assuming there was a singular intent agreed upon by the Framers.  The only thing they "agreed upon" (and I'm sure there was even some serious dissent here too) is what they wrote.

Regarding your last sentence, I wasn't suggesting anything else.  I know of no other way to change the constitution than to amend it.  The point being that their inclusion of an amendment process demonstrated that they clearly "intended" for what they wrote to be capable of being changed if the need arose.  Point further being that their "intent" in the late 18th Century should not be taken as scripture today.

I'm not suggesting there's no weakness to the original intent position. Certainly "singular intent" is one area to contest an original intent position. That doesn't discount the value and importance of utilizing intent in trying to understand the meaning and breadth of a law.

Your second paragraph...I'm not clear on what you're saying.

"The point being that their inclusion of an amendment process demonstrated that they clearly "intended" for what they wrote to be capable of being changed if the need arose."

Certainly!

"Point further being that their "intent" in the late 18th Century should not be taken as scripture today."

Perhaps not scripture (these are fallible human beings writing down words) but again, it's valuable to try and understand the context in which these laws were intended.

[Gramarye]

The only thing that we can be sure that "the Framers" intended was to draft the Constitution.  They issued no other collective expressions of their intent.  The Federalist Papers were written by certain individuals who, while influential, remain only a subset of the Framers.  Other contemporary treatises are likewise flawed as legal authority.  We turn to them for some guidance when it is unclear what the Framers may have intended, just as we may turn to other documents surrounding a contract when the contract itself is ambiguous, but even when they get to come into play at all, they are non-binding and always subordinate to the primary text.

[327]

How about this:

The framers meant the commerce clause to mean exactly what it says.  Centralizing control over interstate commerce was a central purpose of making a constitution in the first place, arguably the #1 driving issue.  In that sense there is no reason to believe they would have wanted that power to be mitigated.  Of course, in their day, interstate commerce was a much smaller proportion of overall commerce.  But they intended for the clause to be scaleable, without the need for an amendment process every time the balance between interstate and intrastate shifted.  Congress controls interstate commerce period. 

I believe the modern "states' rights" position is anti-constitutional.  What they're really advocating is a return to something like the Articles of Confederation, which would be catastrophic for business, just like it was in the days before the constitution.  Don't like regulations?  Have fun replacing 1 book of them with 50.

[slumcat]

There has been a lot of discussion about the commerce clause and the individual mandate.  This is all well and good, but I'm surprised there isn't more discussion on the Court's decision to allow for the Medicaid expansion, but only if it is voluntary--in other words, states can opt out.  The Medicaid expansion is the one part of the law most observers expected to be entirely upheld.  This could really become a can of worms.  For example: please recall that the way we got the national 21 drinking age was by tying it to highway funding.  States can still set their own drinking age...but it better be 21 or you loose all your highway funding! It's the carrot and stick approach and the same rationale used in the ACA to try to compel Medicaid expansion.  Seems like the carrot and the stick were OK back then when the drinking age was debated...but oh, not now! 

Also, let's not forget that of the 30 million Americans expected to get new coverage under the ACA, fully half of that projection was based on new Medicaid enrollments, not individual mandate enrollments.  Seems like the benefit of the law just got potentially cut in half...which is why I view the ruling as a "mixed bag" rather than an upholding of the law. 

[Gramarye]

How about this:

The framers meant the commerce clause to mean exactly what it says.  Centralizing control over interstate commerce was a central purpose of making a constitution in the first place, arguably the #1 driving issue.  In that sense there is no reason to believe they would have wanted that power to be mitigated.  Of course, in their day, interstate commerce was a much smaller proportion of overall commerce.  But they intended for the clause to be scaleable, without the need for an amendment process every time the balance between interstate and intrastate shifted.  Congress controls interstate commerce period.

I actually agree with this.  The real problem is not the fact that more commerce has become interstate in the modern world, but that the definitions of "interstate" and "commerce" themselves seem to have expanded.  As one of my law school professors noted during his Supreme Court Term in Review session (which he did for the entire UVA legal community) after Raich came out: "In this case, the Supreme Court considered the question of whether the Interstate Commerce Clause permits Congress to regulate activity that is neither interstate nor commercial and found, of course, that the answer was yes."

No one is arguing that the FCC is unconstitutional, for example, even though the Framers would have no f'ing idea what a radio or TV was.

I believe the modern "states' rights" position is anti-constitutional.  What they're really advocating is a return to something like the Articles of Confederation, which would be catastrophic for business, just like it was in the days before the constitution.  Don't like regulations?  Have fun replacing 1 book of them with 50.

No, we're more in favor of rolling back the Great Society and (to a lesser extent) New Deal welfare state and the exponentially more intrusive central government that arose at that time and has largely continued to this day, with Wickard as one of its bedrocks.

As for regulations: First, in many instances, duplicative state and federal agencies regulate the same activity, so we already have a patchwork of 50 state regulations in addition to federal regulations.  Second, the exit option is much easier to exercise to move from state to state than country to country, so if New York alone had passed some ludicrous and Byzantine overreaction to a problem (e.g, Sarbanes-Oxley), firms could have fled to secondary American financial centers rather than taking most of their business to London, as many did.  Third, and most importantly, when there really is general agreement on the public benefit of a given law, it tends to get adopted in many states with significant uniformity.  The Uniform Commercial Code is not a federal law; it's a law that has been passed in substantially identical form by all 50 states.  That is the most prominent example, but there are others: the Uniform Fraudulent Transfer Act is the law in most states (outlawing giving all your money away or selling your car to your brother for $1 right before creditors try to collect from you, basically).  Federalism allows states to go their own way, but on many issues, most states will freely decide to go the same way.

[surfohio]

The only thing that we can be sure that "the Framers" intended was to draft the Constitution.  They issued no other collective expressions of their intent.  The Federalist Papers were written by certain individuals who, while influential, remain only a subset of the Framers.  Other contemporary treatises are likewise flawed as legal authority.  We turn to them for some guidance when it is unclear what the Framers may have intended, just as we may turn to other documents surrounding a contract when the contract itself is ambiguous, but even when they get to come into play at all, they are non-binding and always subordinate to the primary text.

Certainly what we're talking about is where text is ambiguous, seemingly contradictory or non-existent.

Again, when it comes down to analyzing Supreme Court decisions I cannot recommend this book enough:

http://www.amazon.com/Five-Types-Legal-Arguments-Wilson/dp/0890891079

Organized simply and logically, The Five Types of Legal Argument shows readers how to identify, create, attack, and evaluate the five types of legal arguments (text, intent, precedent, tradition and policy). It also describes how to weave the arguments together to make them more persuasive and how to attack legal arguments. In this book, Huhn demonstrates exactly why the legal reasoning in a case is difficult to analyze. Each type of legal argument has a different structure and draws upon different evidence of what the law is. Thus this book does not merely introduce readers to law and legal reasoning, but shows how the five different legal arguments are constructed so that various strategies can be developed for attacking each one.

[327]

If Sarbanes-oxley was an overreaction... do you think Gramm-Leach-Bliley was?  I do.  Integrated foreign banks were described as a boogeyman scary enough to restructure our entire banking system. 

As for welfare programs, including health care, I don't understand how they're a federalism issue at all.  Unless you're suggesting that each state should have its own economic system, which brings me back to my earlier point.

[Hts121]

I'm reposting something bfwissel posted in the Ohio Politics thread:

Has Medical Malpractice Tort Reform Enacted any Positive Change in the United States?
http://www.feldmanshepherd.com/blog/2012/03/has-medical-malpractice-tort-reform-enacted-any-positive-change-in-the-united-states/

Of course, the "repeal and replace" crowd are largely of the opinion that any meaningful national health care law must include tort reform (many in the general public would even argue that is all we need).  In the link above, there are some interesting statistics which go to my often stated response that using tort reform to control/lower health care costs would be like feeding a tic-tac to a whale.  It also hints at the point I have previously raised that it is more than blatantly hypocritical for the proponents of "states' rights" to try and institute tort reform on a national level.  Tort reform should be and is traditionally enacted on a state-by-state basis.  Ohio is in control of its own courts as is every other state.  I would be very interested to see how Scalia would rationalize his opinion allowing Congress to pass tort reform to be applied to all 50 states.  There also is the hypocritical notion that the "politicians in DC" know better than a jury selected from a fair cross section of the local community.

Speaking of Scalia (and sorry for taking us a bit off-topic, but this ties in).... he is under a bit of fire for recent rhetoric and dicta....

Scalia's Critics Fault Justice Over Politics

Justice Antonin Scalia ended his 26th year on the Supreme Court with a string of losses in the term's biggest cases and criticism that he crossed a line from judging to politics.

Scalia's willingness to do battle with those on the other side of an issue long has made him a magnet for critics. But some of his recent remarks stood out in the eyes of court observers.

His dissent in the Arizona immigration case contained a harsh assessment of the Obama administration's immigration policy and prompted a public rebuke from a fellow Republican-appointed judge.

Scalia's aggressive demeanor during argument sessions even earned him some gentle teasing from his closest personal friend on the court, Justice Ruth Bader Ginsburg. Speaking at a Washington convention, Ginsburg said the term's high-profile cases may explain why Scalia "called counsel's argument 'extraordinary' no fewer than 10 times."

Ten lawyers who appear regularly before the Supreme Court, including two former Scalia law clerks, were interviewed for this story and said they too had taken note of Scalia's recent comments.

http://abcnews.go.com/Politics/wireStory/scalias-critics-fault-justice-politics-16714405   

[Gramarye]

If Sarbanes-oxley was an overreaction... do you think Gramm-Leach-Bliley was?  I do.  Integrated foreign banks were described as a boogeyman scary enough to restructure our entire banking system.

I think TARP was the misguided policy there.  Allowing some of those unstable titans to collapse to earth might have hurt some people in the short run--but those people almost inevitably ended up hurt anyway, as the bankers took Uncle Sam's money and then started calling loans and accelerating foreclosures.  Gramm-Leach-Bliley combined with TARP was the worst of all worlds.  In the ideal world, the regulations that GLB loosened would never have been there in the first place, so GLB would have been unnecessary--but the market would have been allowed to wreak its creative destruction upon the banking sector.  The unstable conglomerates would have fallen (and many of their principals might well have faced shareholder actions for breaches of various fiduciary duties), and the country would be in significantly less debt.  The foreclosures would most likely proceed, just as they did anyway, but that alone is not a bad thing for the economy because of how high property prices had gotten.

As for welfare programs, including health care, I don't understand how they're a federalism issue at all.  Unless you're suggesting that each state should have its own economic system, which brings me back to my earlier point.

I wasn't.  It was a separate point, as this thread seems to have developed several sub-conversations.  (However, I do support restructuring Medicaid as a block grant program to the states, which is more in line with federalism principles than the current universal-entitlement model.)

[Boreas]

^Lehman Brothers was allowed to die to honor your principle of "moral hazard", then the  banking system proceeded to blow up nonetheless.  When "insurance giant" UBS was about to die, even treasury secretary Hank Paulson in the Bush government realized that they were living in a fantasy world and the government had to intervene.

... The unstable conglomerates would have fallen (and many of their principals might well have faced shareholder actions for breaches of various fiduciary duties), and the country would be in significantly less debt.  ...

What was the bill for the bailouts?  Do you have a number?
It was a single digit percentage of the debt burden caused by Bush's multitrillion dollar tax cuts.
Or that war

[Gramarye]

^Lehman Brothers was allowed to die to honor your principle of "moral hazard", then the  banking system proceeded to blow up nonetheless.  When "insurance giant" UBS was about to die, even treasury secretary Hank Paulson in the Bush government realized that they were living in a fantasy world and the government had to intervene.

You mean Paulson and the administration and Congress caved to their big donors on Wall Street and sheltered them from the consequences of their actions.  A second failure would not have been as damaging as Lehman because allowing Lehman to fail--which was the correct decision--caused most of the short-term effects of allowing moral hazard and creative destruction to run their course to get priced into the market.  Fannie, Freddie, AIG, Bear Stearns, UBS ... the world could survive without them, and they were absolutely not worth $2.5 trillion to save (with more contingent liabilities still remaining).  Heck, the bailout of General Motors and Chrysler combined was about $80 billion ... a rounding error against the $2,500 billion spent on the banks, let alone the $12,200 billion the government was willing to spend on the banks.

What was the bill for the bailouts?  Do you have a number? It was a single digit percentage of the debt burden caused by Bush's multitrillion dollar tax cuts.  Or that war

According to the New York Times, the numbers are $12.2 trillion authorized and $2.5 trillion spent, even the smaller of which is significantly more than we spent on the wars in Iraq and Afghanistan combined.

[Keith]

What was the bill for the bailouts?  Do you have a number? It was a single digit percentage of the debt burden caused by Bush's multitrillion dollar tax cuts.  Or that war

According to the New York Times, the numbers are $12.2 trillion authorized and $2.5 trillion spent, even the smaller of which is significantly more than we spent on the wars in Iraq and Afghanistan combined.

Actually no, the smaller of which is in line with the cost of the wars according to the CBO or a bit less according to a study by Brown University. These numbers look a bit larger than some DOD estimates of the cost because those don't take into account the extra cost of VA benefits, interest on the amount borrowed to pay for the war, replacement costs for equipment worn out earlier than expected, or even the cost of paying hazardous duty pay and hostile fire pay to soldiers in combat zones. In other words, every estimate of the cost of the war is dependant upon what you include when adding up the cost.

[StrapHanger]

Fannie, Freddie, ... the world could survive without them, and they were absolutely not worth $2.5 trillion to save (with more contingent liabilities still remaining). 

This is off topic, but unless you mean survival of the world literally (which would be a high standard to hold anything to), I wouldn't include Fannie and Freddie in that list. Qualitatively different from the other financial institutions on your list.  Which is not to forgive them for any of their many sins.

[Hts121]

What was the bill for the bailouts?  Do you have a number? It was a single digit percentage of the debt burden caused by Bush's multitrillion dollar tax cuts.  Or that war

According to the New York Times, the numbers are $12.2 trillion authorized and $2.5 trillion spent, even the smaller of which is significantly more than we spent on the wars in Iraq and Afghanistan combined.

Actually no, the smaller of which is in line with the cost of the wars according to the CBO or a bit less according to a study by Brown University. These numbers look a bit larger than some DOD estimates of the cost because those don't take into account the extra cost of VA benefits, interest on the amount borrowed to pay for the war, replacement costs for equipment worn out earlier than expected, or even the cost of paying hazardous duty pay and hostile fire pay to soldiers in combat zones. In other words, every estimate of the cost of the war is dependant upon what you include when adding up the cost.

And you didn't mention that TARP monies are being repaid or have been repaid...  http://money.cnn.com/2011/03/30/news/economy/tarp_program/index.htm

To whom do we send the bill for the wars?  We are going to need a sizeable lump sum to not only cover direct costs (medical care, loss of equipment, expenses) but also indirect costs such as the wide-ranging effects of PTSD and TBI.

I personally hated the bank bailouts.  Very hard pill to swallow.  It's easy to sit back and criticize now, predicting what might have been had we not issued the bailouts.  However, I believe there was a very strong consensus amongst experts (not just politicians "in the pockets of the Wall Street cronies) of all political leanings that letting the dominos fall at the end of Bush's 2nd term was simply too risky given the potential consequences.

[Gramarye]

What was the bill for the bailouts?  Do you have a number? It was a single digit percentage of the debt burden caused by Bush's multitrillion dollar tax cuts.  Or that war

According to the New York Times, the numbers are $12.2 trillion authorized and $2.5 trillion spent, even the smaller of which is significantly more than we spent on the wars in Iraq and Afghanistan combined.

Actually no, the smaller of which is in line with the cost of the wars according to the CBO or a bit less according to a study by Brown University. These numbers look a bit larger than some DOD estimates of the cost because those don't take into account the extra cost of VA benefits, interest on the amount borrowed to pay for the war, replacement costs for equipment worn out earlier than expected, or even the cost of paying hazardous duty pay and hostile fire pay to soldiers in combat zones. In other words, every estimate of the cost of the war is dependant upon what you include when adding up the cost.

The CBO estimate is the estimate of the present and future cost of the wars, whereas the NYT smaller figure is the amount actually spent to date.  If you believe that we are out of the woods on the financial crisis (and I certainly hope we are, but we have to concede the possibility that we aren't), then the smaller NYT figure may end up being close to the final figure.  However, if we slip back into recession, the actual costs will begin to rise again into that $9.7 trillion zone of potential-but-not-yet-actual costs.  Also, there are indirect costs of even just making that commitment, even if we ultimately never have to make good on those guaranties.  (Think of a parent who co-signs or guarantees a loan for his or her child.  If the child pays, the parent never has to.  However, while that guaranty exists, it *still* affects the financial profile of the parent.  It may even appear on his/her credit report--I'm not even sure about that one.)

Fannie, Freddie, ... the world could survive without them, and they were absolutely not worth $2.5 trillion to save (with more contingent liabilities still remaining). 

This is off topic, but unless you mean survival of the world literally (which would be a high standard to hold anything to), I wouldn't include Fannie and Freddie in that list. Qualitatively different from the other financial institutions on your list.  Which is not to forgive them for any of their many sins.

The world (or at least America) does need something like Fannie and Freddie; there is market demand for that service.  That is not the same thing as we need Fannie and Freddie.  That function could be served by another entity--one that provided the service without being as much of a racket.