Supreme Court must rule against insurance mandate
By Jason Sagall
web posted March 26, 2012
Rene Descartes postulated, "I think, therefore I am," and unwittingly acknowledged his own existence (the first "I") in the premise before concluding, as if revelation, that he exists. It was an unsuccessful attempt at a philosophic axiom, flawed by its circularity and its logical inversion of the fact that thought presupposes existence.
Ayn Rand counter-postulated, through the voice of hero John Galt in Atlas Shrugged, "I am, therefore I'll think," in which she recognized and removed Descartes' error and then followed the axiom contained in the premise by consciously embracing the fundamental choice and concomitant responsibility of using one's mind in the service of one's own life.
Rand's premise and avowal is the epitome of individualism--the core precept of the U.S. Constitution. That doctrine recognizes the autonomous nature of the individual and protects the right of every citizen to exist unforced. With this right comes the personal responsibility to act by one's own mind, according to one's own judgment--and to afford others the same independence.
On March 26, when the U.S. Supreme Court considers the constitutionality of the Affordable Care Act's mandate that everyone buy health insurance or pay a penalty, it must do so from the context of an individual's right to be left alone. The court must disregard the spurious causal connections cited in an attempt to reify non-action into an act of force and a violation of rights when a person refrains from buying a health plan. It must also recognize that the intent of the Constitution's interstate commerce clause is to guard against punitive regulations imposed under the guise of some socio-economic "greater good."
In the federal circuit courts last year, the U.S. Department of Health and Human Services defended the insurance mandate by implying that it actually protects rights, while obfuscating the issue with an appeal to economic consequences. They start with the assertion that the human potential for sickness makes each human's consumption of health care goods and services virtually inevitable and uniquely unpredictable. If a person chooses not to purchase health insurance, the government continues, he is thereby negatively impacting others and the industry as a whole, now and potentially later--now because his funds are not available in an insurance pool, and potentially later because he may not pay for goods and services he consumes. The federal government, then, under its commerce power, should preclude the possibility of such deviant, no-purchase behavior and its cost-shifting effects with a law to force the personal responsibility of all Americans to buy a government- approved health plan or pay a penalty.
All citizens, repeat: "I exist; therefore I am a tool of the State."
The Obama administration paints each American as innately incapable of paying his way by individually chosen means and timing. But even if the consumption of medical services were literally inevitable for everyone (which it is not), is non-payment by every individual inevitable? Are you personally fated to be a burden on the "system" unless the government decides how you will handle your finances or what commerce you will engage in and when?
In giving significance to the unpredictability of illness, the defenders of the sweeping mandate actually make "personal responsibility" completely impersonal. They say that "cost-shifting" must be curbed, while forcing providers to cover free emergency care and insurers to offer more expansive policies. The realities of risk assessment and the profit-and-loss decisions that make the insurance industry viable cannot be replaced with Obamacare's insurance mandate and "guaranteed issue" provision, which systematically shift costs and responsibility onto everyone but the person liable.
When President Obama says "no more freeloaders!" he means that no more should there be a way to distinguish freeloaders from those who would choose true personal responsibility.
Obamacare denies the autonomy and accountability of the individual and establishes the homogeny and anonymity of a faceless collective. Politicians want to judge and dictate your personal actions, present and future, based on statistical generalizations derived from an economic aggregate.
But don't call it the socialization of health care.
The sole purpose of the Constitution's interstate commerce clause, which grants Congress the negative power "to regulate commerce with foreign nations, and among the several states," is precisely to disallow mandates and penalties in the course of trade or lack thereof.
The Supreme Court must see past the smoke and mirrors presented by the Obama defense. And it should indeed enforce the government's commerce power--to rule against the insurance mandate, which penalizes individuals in a clear and direct manner for making choices in their economic activity that others wildly mischaracterize as infringing on their own lives.
But will the justices fully grasp what our founders knew would be fundamentally at stake?
If an individual is not left free to act--or refrain from action--with his own
mind as his guide, then he is not free to think. 
Jason Sagall is an analyst with Americans for Free Choice in Medicine. Copyright © 2012 Americans for Free Choice in Medicine. All rights reserved.