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You Are The Sucker, Forgetting Bush v. Gore Exists Edition

[ 213 ] March 29, 2012 |

Even if the ACA narrowly survives, David Frum is in for a rude awakening:

Even though the Solicitor General reportedly choked today, that doesn’t change the fact that the conservatives on the Court have spent most of their intellectual lives railing against judicial activism.

Well, this is technically true; conservatives on the court (and much more so off the court) do spend a lot of time railing against “judicial activism.” What the conservatives on the Court absolutely don’t do is oppose “judicial activism” in practice. And in this case, Scalia is virtually certain to vote to strike the law down.

One thing that the oral arguments in this case should accomplish is to make clear that when the Academy of the Overrated opens Scalia will get in on the first ballot. The performance of both Scalia and Alito throughout the oral arguments was an embarrassment — a succession of cranky and ignorant right-wing policy pronouncements and irrelevant hypotheticals with no pretense of engaging with the case law. Scalia’s attempt to invent a category of legislation that could be “necessary” but not “proper” — apparently because there might be alternative legislation that would be closer to the policy preferences Scalia got from listening to a third-rate winger talk show — was particularly special. If the Court wants to overrule McCulloch v. Maryland it really should do so explicitly…

UPDATE:  ”On Tuesday, [Scalia] pursued the absurd “broccoli” analogy to the point where he sounded like a micro-rated evening-drive talk-show host from a dust-clotted station in southern Oklahoma.”

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  1. howard says:

    Scott, my exact conclusion was “if nothing else, this should end the pretense that scalia is an intellectual.”

  2. Thers says:

    The one area where slippery slope arguments have credence is in the wake of Scalian jurisprudence after Bush v Gore. Namely, “my side wins, suck it.”

    Now who believes the SC isn’t stacked with hacks?

    Because it kind of is?

  3. Ben says:

    The problem is that fifteen years ago there was a case that dealt in part with this exact same issue. And the conservatives are using the same argument which Kennedy signed onto in a 5-4 majority.

    The argument is that when a law is carrying into execution a legitimate commerce clause power, but violates the principle of “state sovereignty”, it cannot be considered a “proper” execution and is unconstitutional.

    In Printz v. New York the Court/Kennedy held that creating a national background check database and requiring it be checked before a gun could be sold was justified under the commerce clause, but ordering state officials to carry out the federal program was a violation of “state sovereignty” and so was not a “proper” execution of that power.

    The argument in the current case plays paint by numbers with the framework of the previous case: mandating health insurance might be justified under the commerce clause, but in doing so there is a violation of “state sovereignty” and so is not a “proper” execution of that power.

    The funny part is the justification for how it violates “state sovereignty”: establishing a federal plenary police power violates state sovereignty because plenary police power is reserved for the states. And the mandate creates a federal plenary police power because . . . if Congress can tell you to buy life insurance, it can tell you to do anything!

    I mean it’s funny until you remember Kennedy was asking for limiting principles for the mandate, which is startlingly consistent with the idea that he still thinks that’s a valid argument.

    It’s less likely he’d ask about that if he was planning on doing as Scott suggests and just saying “McCulloch, bitchez” before dropping the microphone. Metaphorically.

    • Ted says:

      I completely disagree with your reading of Printz. Printz is a simple case with a simple rule: the federal government cannot order state government actors to do things.

      It can, as we saw with the drinking age law, threaten to withhold financial support to get states to do things or offer them financial support in return for doing things; it can, as with the example of the Clean Air Act, tell states that either they can make a regulatory program which falls within very specific guidelines and is subject to federal oversight or it will step in with its own regulatory program, it just can’t directly order around state governments (except state judges, who are different).

      While the dissent argues the power is Necessary and Proper, the majority doesn’t argue that it’s not, the majority argues that it offends an extra-constitutional principle of federalism so it doesn’t matter if its within Congress’s delegated powers.

      The ACA is not at all similar to the law in Printz. Where it asks states to do things, it does so either through carrots and sticks, as with the drinking age law and a number of other laws, or through the threat of stepping in if the state fails to act, as in the Clean Air Act. As there is no commandeering of state instrumentalities at issue, Printz offers no support for striking down the ACA.

      • Scott Lemieux says:

        Ted is right; the precedent is not on point. The “proper” issue was that there was an invasion of state powers not using the spending power. The “proper” Scalia and Alito were talking about seemed to be the claim that if there’s another way of doing something (that Scalia and Alito think is better) it’s not “proper.” *This* argument contradicts about 200 years of settled precedent.

        • Ben says:

          Ted, the majority in Printz doesn’t hold that the fact that the law is necessary and proper to the execution of Congress’s Commerce Clause power to regulate handgun sales is irrelevant because it violates an extra-constitutional principle of federalism. It explicitly holds that violations of state sovereignty cannot be considered to be proper to the execution of enumerated powers:

          Where, as here, a law violates the state sovereignty principle, it is not a law “proper for carrying into Execution” delegated powers within the Necessary and Proper Clause’s meaning.

          And Scalia says as much during arguments on Tuesday.

          And we’ve held in two cases that something that was reasonably adapted was not proper, because it violated the sovereignty of the States, which was implicit in the constitutional structure.

          The SG recognizes he’s talking about Prinz because he begins his reply by saying “This does not violate the norm of proper as this Court articulated it in Printz”.

          I’m not saying any of this argumentation is correct, btw, I’m just describing it.

          And Scott, a little later in the exchange Scalia explicitly says he’s talking about invasion of state powers:

          Scalia: An equally evident constitutional principle is the principle that the Federal Government is a government of enumerated powers and that the vast majority of powers remain in the States and do not belong to the Federal Government. Do you acknowledge that that’s a principle?

          Verrilli: Of course we do, Your Honor

          SCALIA: Okay. That’s what we are talking about here.

          He’s lockstep with the argument in the State Respondents brief (PDF) on page 35.

          In any event, even assuming the mandate might be construed as a means of executing the commerce power, rather than an exercise of a power that Congress does not have, it is not a “Law … proper for carrying into Execution” that power.

          It argues that the ACA creates a federal plenary police power by allowing federal regulation to compel individuals to live their day-to-day lives according to Congress’ dictates; this violates state sovereignty because plenary police power is reserved for the states; and, “precisely because the individual mandate rests on such an untenable theory of federal power, it “is not a ‘La[w] … proper for carrying into Execution’ the Commerce Clause and is thus, in the words of The Federalist, ‘merely [an] ac[t] of usurpation’ which ‘deserve[s] to be treated as such.’” Printz, 521 U.S. at 923–24 (quoting The Federalist No. 33, at 204 (A. Hamilton)).”

          That’s clearly the argument Scalia is talking about. I don’t know how you’re getting the claim that if there’s another way of doing something (that Scalia and Alito think is better) it’s not “proper” out of that.

          • Ted says:

            It’s true, upon looking again at Printz, that the majority does make some use of the necessary and proper clause and I was incorrect inasmuch as I claimed it had no relevance to their opinion. However, I maintain that Printz’s decision about propriety was entirely about the commandeering of state officers to enforce a federal law. The majority does not make any suggestion the federal program itself is not proper, even though it, at least arguably, infringes on state police police powers. And what about Raich? Is the Controlled Substances Act really less of an infringement on the police power than the ACA?

            I also think the claim that the ACA “allow[s] federal regulation to compel individuals to live their day-to-day lives according to Congress’ dictates” is an even more illusory distinction between the ACA and other federal statutes than the action/inaction distinction. The federal government tells me my “day-to-day life” can’t include growing or smoking marijuana; it tells (or would have told) me, the Court said legitimately, if I’m a farmer I can’t grow more than a certain amount of wheat; it tells me I need to give it a certain percentage of my income; it tells me, by blackmailing the states, that I can’t drink unless I’m a certain age; it tells me, if I run a business, how much I can pay my workers and what standards retirement plans I provide need to meet and how much I can pollute; and it tells me, and perhaps this is most on point, that I need to pay taxes to a health care plan for the elderly and disabled and poor that it administers. I really don’t see how the ACA is some new and frightening example of the federal government involving itself in my life. Do you agree that single-payer funded by a tax would be constitutional? If so, how is that less of an infringement on state power than the ACA?

            • Ben says:

              I think we hold the exact same opinions about Printz, Raich and the ACA. And the reason we’ve been talking past each other a bit is because I wasn’t all that clear as to what I was actually arguing.

              I’m making two claims, and only one of them is a normative claim about jurisprudence. Which would be: “Printz holds that violations of state sovereignty cannot be considered to be proper to the execution of enumerated powers.” You agree with that, right?

              The other claim I’m making is that Scalia and the state respondents are advancing an argument that tries to use the holding in Printz to claim that the insurance mandate should not be considered to be proper to the execution of a legitimate exercise of Commerce Clause power.

              I’m only trying to say that that’s the argument they’re making. I’m not saying I agree with that argument, because I think it’s total bullshit. Largely for the reasons you cite.

              But I think it’s worthwhile to point out what the actual argument is for two reasons. First is what I spelled out in my original comment: I think they’re using that argument because it was part of an opinion that Kennedy signed onto, and they’re trying to gussy up opposition to the ACA to look like an argument Kennedy already bought.

              And, even though you and I know the argument is absolute and complete bullshit that would be embarrassing to take seriously, it does appear that the ruse is working because there’s evidence Kennedy is taking it seriously. When he asks the SG for “limiting principles” that wouldn’t give Congress unlimited power under the Commerce Clause, that’s completely consistent with him buying the argument Scalia and states respondents are making. Because the argument goes: mandate upheld => gives Congress unlimited power under the Commerce Clause => violates state sovereignty, therefore the mandate is not proper to the execution of a legitimate Commerce Clause power, therefore it’s unconstitutional. It could be that Kennedy is asking for why he shouldn’t put that train of reasoning into motion. And that’s worrying.

              The other reason to mention the actual argument that Scalia and states respondents are trying to make is that Scott seems to think that there’s no precedent for holding a law to violate the “proper” part of the necessary and proper clause. And there is. And the way in which Scalia and states respondents characterize the ACA, that precedent would apply. The problem is, that characterization is crazy as catshit.

              So I’m pretty sure that all the points you bring up, I agree with. About Printz, the ACA, Raich.

              Raich. Raich is the best goddamn part. Because Scalia’s concurrence dealt with this exact same issue: whether the principle in Printz meant that the CSA isn’t proper. And Thomas tried to make THE EXACT SAME ARGUMENT that Scalia and states respondents make about the ACA: it would create unlimited Congressional authority under the Commerce Clause, therefore violates state sovereignty, therefore not proper under Printz. And Thomas had a much stronger case, too, because the law in Raisch tried to regulate an activity that wasn’t commerce and that didn’t cross state lines, while, obviously, regulating health insurance does both.

              So how does Scalia then deal with a much stronger case for the exact same argument that Scalia now is advancing?

              Doesn’t even mention it. In fact, while making another point, he points out that Lopez and Morrison prevent piling on causal inferences to regulate non-economic activity based on how it affects economic activity.

              So I guess he thinks eating broccoli is an economic activity.

          • Hogan says:

            It argues that the ACA creates a federal plenary police power by allowing federal regulation to compel individuals to live their day-to-day lives according to Congress’ dictates;

            Uh oh; there goes Title 18 of the US Code.

  4. c u n d gulag says:

    Over-under until Scalia tells Liberals and Democrats “To get over it!”?

    I say April 2nd, since he wouldn’t want anyone to confuse the reactionary fools on the SC, with April Fool’s Day.

    Scalia – what a pompous ass!

  5. Davis X. Machina says:

    I expect it’s only a matter of time before the national motto “E pluribus unum” is replaced with Al Davis’ “Just win, baby.”

    The former is collectivist, and in a dead language known only to elitists to boot…

    The latter is in good demotic Murkan, and more in tune with our times.

  6. Bart says:

    After Bush v Gore, CU, etc., could Obama finally engage is a little nullification with this one?

    • Warren Terra says:

      Given that FDR faced more blatant partisan opposition on the court; had more public support, had more resources in Congress; had a method to overcome the Court of clearer legality than mere “nullification”; and basically lost the battle at the time (or at least lost the battle he chose to fight, though the Court also moderated its opposition); and is still vilified by nice, liberal historians for the effort – given all that, the prospects for Obama to achieve success either political or practical by substantively (rather than rhetorically) opposing the Court, say through “nullification”, seem slim indeed.

  7. Jesse Levine says:

    Next time a Dem has a chance to nominate, let’s not hear about a good person lacking the “intellectual firepower” necessary to counterbalance Scalia.

  8. DrDick says:

    The performance of both Scalia and Alito throughout the oral arguments was an embarrassment

    And this is different from every other day exactly how? It has been blatantly obvious from the outset that both are nothing more partisan hacks and third rate intellects, whose only gifts are the creativity by which they can construct a flimsy cover justify their desired outcomes.

  9. Mudge says:

    I’m glad we have the Articles of Confederation in mothballs so we can haul it back out.

  10. david mizner says:

    Ah, Frum. He’s done a savvy job these past couple of years reinventing himself in the David Brooks-Andrew Sullivan mold, a conservative liberals like. Which makes him all the more of a menace. Good post.

  11. JREinATL says:

    when the Academy of the Overrated opens Scalia will get in on the first ballot.

    No — Scalia cannot be vicariously rehabilitated by joining a club that includes Lenny Bruce, Walt Whitman, and Ingmar Bergman.

  12. elm says:

    I was wondering this last night: obviously Scalia et al have no problems being hypocrites on the ‘judicial activism’ question, but have there been any right-wing columnists or bloggers who have been consistent on this issue, i.e. have criticized the ACA but have said that it would be improper for the Court to insert it’s own policy preference into the debate?

    I haven’t seen any, but I spend much less time reading conservatives than others around here do.

    • Joseph Slater says:

      Orin Kerr, over at the Volokh Conspiracy, has in a series of posts noted that he is against the ACA as a matter of policy, but believes it is constitutional under existing precedent.

      • elm says:

        Good for Kerr, though Volokh Conspiracy does often veer from the conservative party line, so it’s not surprising it would be said there. Also, has Kerr criticized “activist judges” in the past? Because that’s really the consistency I’m looking for.

    • timb says:

      Charles Fried has been pretty annoyed

      • mds says:

        Isn’t Fried a supporter of the law, though? That means the “Policy I disapprove of isn’t automatically unconstitutional” list is still limited to Kerr.

    • Rarely Posts says:

      I’m pretty sure Judge Wilkinson of the Fourth Circuit wrote an Op Ed on this.

      It’s not a given that all conservative, Republican judges are partisan judicial activists (even if they often have conservative, incorrect approaches to legal reasoning). It’s a choice that the right-wing Justices make each time they do it.

  13. mike in dc says:

    But if you do away with McCulloch, don’t you also put a severe crimp on the ability of conservative lawmakers to pursue their own pet agendas? Wouldn’t that cut off a lot of the big business money they get, since the perception would be that they no longer need to bribe persuade them to oppose regulation since regulation would be largely inhibited?

  14. Sherm says:

    If the law is tossed because the mandate is unconstitutional in the eyes of the five politicians posing as supreme court justices, isn’t the republican party left with no viable solution for the burgeoning healthcare crisis?

    Although it would suck if the law was struck down, it could result in a more progressive solution sometime in the future as there will be no conservative alternative other than the free-market, Dickensian view, acceptable only to the nuttiest of the wingnuts.

    • JohnR says:

      ” ..isn’t the republican party left with no viable solution for the burgeoning healthcare crisis?”

      If I may veer into near-incoherent childhood-joke area for a moment, what you mean “solution”, Paleface? I’ll assume you have been asleep for the past several decades and just mention that Republican “solutions” tend to be limited to (a) Blame the Liberals and ignore the problem, (b) lower taxes on the wealthy, and (c) all of the above. You can’t fault them for this, as it’s worked consistently and profoundly.

    • Heighten the contradictions!

    • Scott Lemieux says:

      For Republicans and their constituents, there is no problem.

      • Sherm says:

        My upper-middle class, libertarian brother-in law who thinks that Obama is a “socialist” now concedes that there is a problem b/c he knows that without his resources, his sick, adult son in his late 20′s would be screwed (if not already dead).

        As more and more people are impacted by this crisis over the years, the every man for himself view held by perhaps one-third of the constituency will fall on deaf ears. Or, at least, that’s my hope.

        And, Scott, thanks for the excellent coverage of the proceedings.

        • Warren Terra says:

          My sympathies to your brother-in-law (and nephew), but the realization dawning upon him is aberrant and is likely for many Republican voters to be overwhelmed by a tide of bullshit. They’ll be told that Obamacare was an Evil Usurpation Of Liberty, and that some combination of God and The Free Market will see them through. They’ll be told the fault lies in Malpractice Lawyers, even though (1) we’ve done the experiment, and capping malpractice severely has no effect on malpractice insurance premiums, let alone on overall healthcare cost; and (2) Libertarianism is supposed to include suing for redress of grievances. They’ll be told that selling insurance across state lines will fix it. Heck, just this last week both Mitt Romney (who was once proud of extending access to health insurance) and Scalia (or was it Alito?) insisted that Pre-existing Conditions weren’t even a problem. And for wealthy people with government employment I suppose they’re not.

        • Rarely Posts says:

          Also, no-offense to your libertarian brother-in-law and his sick son, but this is exactly the typical Republican attitude–be opposed to anything that helps people in general until they or someone close to them suffers from a specific problem, and then develop concern for that limited situation.

      • Rarely Posts says:

        Yeah, our problem is that modern conservatives have adopted the “I’d rather be the first person in a hovel then the second person in Rome” attitude.

        They will do anything to increase their own power and decrease the power of others. They will do anything to increase their own status and increase the hierarchy in this Country. And, they don’t care if it reduces the Nation’s growth, development, and well-being. They’d rather live in a weaker, poorer, sicker nation in 50 years and be at the very top over an impoverished mass than be in a stronger, wealthier, healthier nation and be better off than a number of competing people from a broad middle class.

    • rea says:

      The problem isn’t that the Republicans have no viable solution–the problem is that the country has no viable solution.

  15. Uncle Kvetch says:

    isn’t the republican party left with no viable solution for the burgeoning healthcare crisis?

    In the eyes of the Republican Party, there is no healthcare crisis. There is only a moral problem posed by people getting health care who don’t deserve it. But they’re going to fix that, don’t you worry.

    there will be no conservative alternative other than the free-market, Dickensian view, acceptable only to the nuttiest of the wingnuts

    The nuttiest of wingnuts are in control of the Republican Party for the foreseeable future.

    I think it’s well past time to think the “grownups” are going to step in at some point and put an end to all this foolishness. It’s foolishness all the way down.

    • Jesse Levine says:

      Question to all: So will the parameters of the next administration proposal be further towards government sponsored solutions or “market” solutions?

      • joe from Lowell says:

        Looking back at the defeat of Clinton’s proposal, the response was to create SCHIP – a very small, self-contained government solution.

        If the court strikes down the ACA, it is very unlikely in my view that this administration wades back into an effort to create a comprehensive proposal, and instead does what Clinton does: picks some low-hanging fruit.

      • Uncle Kvetch says:

        So will the parameters of the next administration proposal be further towards government sponsored solutions or “market” solutions?

        I’m not sure we’ll see another “administration proposal” — and if we do, I can’t for the life of me imagine what it might look like. I think we could be looking at another 20+ years of near-inertia on this issue, as was the case after the defeat of the Clinton plan.

        I’d be interested in hearing other folks’ takes on this.

        • DrDick says:

          Based on past performance and current political conditions, the administration will do nothing (and frankly nothing they did would get through the House), unless the Dems take both houses of Congress in the fall and maybe not then.

    • Sherm says:

      But there is a crisis in the eyes of much of the public, and its only going to get worse if the law is struck down. As more and more middle-class, college grads without jobs (or working as 1099 “consultants”) go uninsured and more and more money is taken from paychecks of middle class people every week to pay for insurance due to escalating costs, something will eventually need to be done. Its almost inevitable. At that point in time, what will be the republican alternative to a medicare for all approach?

      • joe from Lowell says:

        There is a crisis in the eyes of the public, and in reality, related to the continuing problem of oil price spikes – one that is only getting worse and doing more damage to this nation as time goes on.

        The Republicans’ response to this is not to try to solve the problem, but to exploit it in order to achieve unrelated ends.

        Why wouldn’t they just do the same thing with health care? Pass tort reform, claiming it’s a solution to the problem, and when it’s not and the issue continues to cry out for a solution, pass more tort reform.

        • Malaclypse says:

          But here is the thing. Let’s assume that the Republican party has three main bases: Koch libertarian lunatics, religious conservatives, and Chamber-of-Commerce/Nat’l Assoc of Manufacturers types.

          Insane billionaires are unpredictable. While well-funded, I’m guessing they are a relatively small player. Religious loonies may hate health care because it covers ladyparts, but in the end the loonies follow the party.

          So let’s look at this from the CoC angle. So, I run the finances of a mid-sized company. And I will tell you what long-term predication I am most comfortable assuming: every year – good year, bad year, doesn’t matter – my benefits costs will rise 13-18%. At least.

          If I could change one thing, it would not be regulations, it would not be corporate tax rates, it is that I want someone else to get that unsustainable rising cost off of my god-damn P&L. I say that not wearing my hippie socialist hat, I say that while wearing my uncaring accountant hat. You know what 18% growth means? In 5 years, my costs double. In ten, they have risen 450%. And in 20 years, my cost per person will have risen 2300%.

          Romneycare did not change that situation, nor will the ACA. Employer-based care is broken, probably beyond repair.

          If the CoC represents small businesses, where the owners need insurance, we’ll end up with Medicare for all. If they don’t, we’ll have HSAs that leave 95% of us dying early.

          Whatever the Supremes decide, the old system is going away. The question is what comes next.

          • Hogan says:

            And how many unnecessary deaths we see in the meantime.

          • Steve LaBonne says:

            Really, the same is true for big manufacturing corporations, not just small businesses (health care costs are a major drag on the domestic auto industry, for example). But I’ve been waiting for years now for the leaders of the real economy to figure out that their interests and those of the health care – industrial complex are diametrically opposed, and there’s still no sign of it happening. So I’m not holding my breath.

            • joe from Lowell says:

              The NAM used to regularly advocate for health care reform.
              Rick Wagoner of GM was very supportive of the idea in his testimony to Congress in 2008.

              • Steve LaBonne says:

                Yes, I remember Wagoner’s testimony, but there didn’t seem to be a whole lot of firepower behind it, and NAM was very much on the wrong side with ACA. I didn’t understand why they would do that then and I still don’t. They went with their fellow country club members over their own long-term economic interests.

                • joe from Lowell says:

                  One reading of this situation is that they want health care reform to relieve them of the burden of providing insurance entirely, and opposed the ACA because it left them holding the bag.

                • Steve LaBonne says:

                  I’ll go with that explanation just as soon as I hear them pushing for Medicare for all.

                • joe from Lowell says:

                  You sure you won’t dismiss with a reference to “firepower” if that happens?

                • Steve LaBonne says:

                  I will, and correctly, if it’s again limited to one guy.

                • joe from Lowell says:

                  Of course, it’s not “limited to one guy.” I was motivated to find one link.

                  Tell you what: if, unlike what the NAM and the Big Three and a lot of other major players in American industry were saying for years, there is actually only one guy, then go right ahead.

                • Steve LaBonne says:

                  I repeat again that there’s a simple test. If they want to get rid of the burden, they should be lobbying bigtime for Medicare for all. Wake me up when that happens.

                • joe from Lowell says:

                  Uh huh. Because “Medicare for All,” under that name, is the sole possible – not “politically acceptable to Steve LaBonne,” but “possible” – health care reform plan that could relieve large employers of health care costs.

                  Tell you what: how about, instead of me “waking you up,” you either 1) actually lift a finger to find out something about the topic of what American industry has been saying, or 2) stop holding forth on what American industry is saying about health care reform.

                • Steve LaBonne says:

                  Because Joe, like Nixon in Vietnam, has a secret plan for ending our dependence on employer-provided insurance and replacing it with something that’s not Medicare for all, and that plan is: hey, that’s a secret!

                  Really, you should take the rest of the day off from commenting; between this and your idiotic belief that doctors are paid in chickens by nonprofit hospitals, you really ain’t got it today.

                • Malaclypse says:

                  From an e-mail blast sent out by AIM, the MA state-level version of NAM:

                  It’s been two weeks since Associated Industries of Massachusetts (AIM) touched off by a firestorm by demanding on behalf of Massachusetts employers that the health-care system reduce the growth of medical spending within three years to two percentage points below the growth in the overall state economy.
                  The association set a clear and aggressive objective because we believe it is the only way to end the run-up in health insurance costs that has depressed economic expansion and job growth for more than a decade. It is also the only way to solve an impending crisis that could leave Massachusetts with a world-class heath care system that no one can afford.
                  Amid all the mind-numbing complexity and statistics of the health care debate, there is really only one that matters: the average cost paid by employers and workers to insure a single Massachusetts family though a health maintenance organization now stands at $15,864, according to the 2012 AIM Benefits Survey. The cost to insure an individual is $6,000.

                  Steve is right that there is no plan. Joe is right that there is a whole lot of concern. DrDick is right that a lot of the concern comes from parties best assumed to be evil. And Krugman is right that the only way costs come down in the long run is a more efficient single-payer plan.

                  And what happens in the short run is anybody’s guess. But in even the medium run, 18% annual growth can’t keep happening.

                • joe from Lowell says:

                  Because Joe, like Nixon in Vietnam, has a secret plan for ending our dependence on employer-provided insurance and replacing it with something that’s not Medicare for all, and that plan is: hey, that’s a secret!

                  Noooooo, but rather, because agitating for a solution to a problem, as the big manufactures have been doing (despite your ignorance of this fact) does not require having a implementable plan.

                  You bitch all the time about things you have absolutely no idea how to fix, Steve. Why is it so implausible to you that anyone else could do the same thing?

                • Njorl says:

                  I think business leaders are genuine in their expression of a desire to get health insurance off their plate. I also think that there is a tendancy to avoid stepping on another industry’s toes, unless in direct competition. No industrial leader wants to screw with an industry that comprises 19% of GDP.

            • Sherm says:

              Exactly. Its a huge external cost over which they have no control, and just one more reason for domestic companies to manufacture overseas, and one more reason for foreign companies to manufacture in Canada or Mexico rather than the US.

            • Malaclypse says:

              But the CEOs of big corporations are wealthy enough to decide HSAs-for-all is the solution. And actual small business owner, making less than 200K? They want real health coverage for themselves, not an HSA.

              And the one brilliant thing Romneycare did was make it so that all full-time employees, from the CEO to a janitor, need to be offered the same health benefits, with the same employer contribution (that actually goes beyond ERISA requirements, using methods that are both brilliant and boring).

          • DrDick says:

            Employer-based care is broken, probably beyond repair.

            The whole commercial health insurance system is broken beyond repair. Profit has no place in the healthcare system, at any point. that said, I think you overestimate the ability of corporations or business owners to understand their own self interest or to care about their employees. From what I have seen, let them all die on the street without healthcare would seem to be corporate America’s desired alternative

            • Malaclypse says:

              Most business owners are small enough that they participate in the same health market we do.

              Most business profits are directed towards rentiers who are insulated from the broken system.

              I hope that we reach a point where the former group realizes that their interests do not actually lie with the latter. I’m not confident. But all it really takes is the ability to actually understand a spreadsheet. It takes ability, not morality.

            • joe from Lowell says:

              The whole commercial health insurance system is broken beyond repair.

              You’re defining “broken beyond repair” to mean something different than Malaclypse. You would have defined the employer-based system in 1970 as “broken beyond repair,” even as it did a pretty good job providing health coverage to workers, for ideological reasons. He’s talking about the system no longer doing its job.

              Profit has no place in the healthcare system, at any point.

              So we should pay doctors with chickens?

              • Steve LaBonne says:

                “Not for profit” != “unpaid”. For-profit health care provision and insurance in the US are largely a product of the Nixon era, hardly existed before that, and exist only to a carefully circumscribed extent even in the most private-oriented systems in other advanced countries.

                • Malaclypse says:

                  “Not for profit” != “unpaid”.

                  Yep. The NHS is all not-for-profit, yet I believe doctors do indeed get paid in pounds sterling rather than pounds of poultry.

                • joe from Lowell says:

                  “Not for profit” != “unpaid”.

                  So doctors can be paid cost?

                  Oh, that changes everything. Nobody should be able to make a living in the provision of health care, but you won’t actually compel them to lose money by providing care.

                  For-profit health care provision and insurance in the US are largely a product of the Nixon era, hardly existed before that, and exist only to a carefully circumscribed extent even in the most private-oriented systems in other advanced countries.

                  What the hell are you talking about? You do understand that physicians have been highly-paid professionals in virtually every society in the world for millennia, right?

                • DocAmazing says:

                  Dude, you really need to look up average physician salaries and figure out what “highly-paid” means.

                  “Profit” is what is left over after salaries are paid, by the way.

                • Steve LaBonne says:

                  Joe is being uncharacteristically stupid today. There are plenty of highly paid employees of not-for-profit organizations.

                  First Rule of Holes, dude.

                • joe from Lowell says:

                  Dude, you really need to look up average physician salaries and figure out what “highly-paid” means.

                  LOL @ Dr. Privilege.

                • DocAmazing says:

                  I make less than an SF cop, no joke. Wanna tell me about privilege?

                • joe from Lowell says:

                  DrDick says:
                  March 29, 2012 at 12:47 pm
                  Profit has no place in the healthcare system, at any point.

                  Steve LaBonne says:
                  March 29, 2012 at 2:41 pm
                  Joe is being uncharacteristically stupid today. There are plenty of highly paid employees of not-for-profit organizations.

                  Why don’t you two put your heads together and see what you can come up with, because you’re going to have to do a lot better than this contradiction and posturing.

                • joe from Lowell says:

                  DocAmazing says:
                  March 29, 2012 at 2:44 pm
                  I make less than an SF cop, no joke. Wanna tell me about privilege?

                  Yep. Cops who work large amounts of overtime bring home a ton of money, and both you and those cops make a hell of lot more than the American median income.

                • DocAmazing says:

                  No contradiction.

                  “Profit” is what is left after salaries are paid.

                • joe from Lowell says:

                  Tell you what, po’ boy: give us the number. I dare you.

                  Tell us what you make in a year, followed by the statement “I am not a highly paid professional.”

                • joe from Lowell says:

                  DrDick says:
                  March 29, 2012 at 12:47 pm
                  Profit has no place in the healthcare system, at any point.

                  DocAmazing says:
                  March 29, 2012 at 2:46 pm
                  No contradiction.

                  “Profit” is what is left after salaries are paid.

                  So a doctor who is paid a salary than has to pay other salaries out of his salary?

                  Fascinating. Also: bullshit.

                • Hogan says:

                  jfl, the word “profit” actually means something specific, and it isn’t “a salary higher than the national median.”

                • DocAmazing says:

                  Because “more than the American medican income” equals “highly paid”.

                  Somebody snoozed in econ class, I see.

                • joe from Lowell says:

                  Of course, we all know how this ends: DocAmazing tells us that Profit has no place in the healthcare system, at any point. except the point he occupies.

                • Steve LaBonne says:

                  “Contradiction”? Still digging, I see. I often disagree with you, but I would not have thought you were this fucking stupid.

                  The Metropolitan Opera is a nonprofit organization. Do you think they pay the singers with chickens?

                • joe from Lowell says:

                  jfl, the word “profit” actually means something specific, and it isn’t “a salary higher than the national median.”

                  Then it’s a good thing that I never said “profit” was “a salary higher than the national median,” but rather, “highly paid.”

                  Reading. It’s fundamental.

                • Steve LaBonne says:

                  Profit also doesn’t mean “highly paid”. Do you own a dictionary?

                • joe from Lowell says:

                  DocAmazing says:
                  March 29, 2012 at 2:48 pm
                  Because “more than the American medican income” equals “highly paid”.

                  Somebody snoozed in econ class, I see.

                  How about instead of posturing, you give us the number, and let everyone judge for themselves, po’ boy?

                  Or you can stop this pointless posturing entirely.

                • DocAmazing says:

                  So a doctor who is paid a salary than has to pay other salaries out of his salary?

                  A doctor who is self-employed may pay himself a salary and pay his other employees wages or salaries out of business income.

                  An employed doctor who is paid a salary takes her salary home and doesn’t have to plow it into the operation of the medical business.

                  A self-employed physician who doesn’t pay her/himslef a salary won’t be self-employed long.

                  These are very basic concepts. It’s kind of embarassing to have to go over them like this.

                • Hogan says:

                  I never said “profit” was “a salary higher than the national median,” but rather, “highly paid.”

                  And that’s also not what “profit” means. But carry on with the prolier-than-thou dickswinging. If we can’t be entertained by trolls, at least we can have this.

                • joe from Lowell says:

                  Steve LaBonne says:
                  March 29, 2012 at 2:49 pm
                  “Contradiction”? Still digging, I see. I often disagree with you, but I would not have thought you were this fucking stupid.

                  Have you ever noticed that you lose your composure when a debate is going badly for you?

                  The Metropolitan Opera is a nonprofit organization. Do you think they pay the singers with chickens?

                  Of course not; I think those singers make a profit.

                  Once again, the blindingly stupid comment that began this:

                  Profit has no place in the healthcare system, at any point.

                • DrDick says:

                  Why don’t you two put your heads together and see what you can come up with, because you’re going to have to do a lot better than this contradiction and posturing.

                  Get back on your meds, Joe. As others have said, you clearly do not understand what “profit” means. It is what is left over after salaries and operating expenses.

                • joe from Lowell says:

                  A doctor who is self-employed may pay himself a salary and pay his other employees wages or salaries out of business income.

                  And we call that salary a profit, to that doctor. His business income isn’t profit, but his salary is.

                  An employed doctor who is paid a salary takes her salary home and doesn’t have to plow it into the operation of the medical business.

                  Yes, he takes that salary home. That is his profit.

                  These are very basic concepts. It’s kind of embarassing to have to go over them like this.

                  We don’t have to go over them, as nobody is having even the slightest trouble understanding them. You’re merely posturing, because of how badly this is going for you.

                • Steve LaBonne says:

                  So Joe really thinks an employee getting a salary is the same thing as a company making a profit. Wow. That’s the kind of gross ignorance I’d expect from a conservatroll. Just sad.

                • Malaclypse says:

                  Of course not; I think those singers make a profit.

                  But they don’t. Making a profit means, by definition, that it is possible to incur a loss. That’s simply what the words mean. Please, for the love of Cthulhu, let’s not get into a Brad Potts “but I want words to mean this” argument.

                • joe from Lowell says:

                  Hogan says:
                  March 29, 2012 at 2:52 pm
                  I never said “profit” was “a salary higher than the national median,” but rather, “highly paid.”

                  And that’s also not what “profit” means.

                  *facepalm*

                  No, Einstein “salary higher than the median income” is “highly paid.” I did not say that “salary higher than the median income” was “profit.” I said it was “highly paid.”

                  I would accuse you of playing dumb, but I don’t think you’re playing.

                  Seriously. Stop. You’re at that point of just needing to get me, and you’re making stupid mistakes because of your emotional state.

                • Malaclypse says:

                  And we call that salary a profit, to that doctor. His business income isn’t profit, but his salary is.

                  Not according to Schedule C of a 1040, or, more likely in the case of a doctor, the K-1 on the 1040. In fact it is the exact opposite.

                • joe from Lowell says:

                  Steve LaBonne says:
                  March 29, 2012 at 2:57 pm
                  So Joe really thinks an employee getting a salary is the same thing as a company making a profit.

                  Nope. ONCE AGAIN, I think that an employee making a salary is an employee making a profit.

                  Once again, the blindingly stupid comment that began this:

                  Profit has no place in the healthcare system, at any point.

                  I’m not even going to explain this to you anymore. I’m just going to mock you.

                • Hogan says:

                  the blindingly stupid comment that began this:

                  No, the blindingly stupid one was the one that suggested that not being paid in chickens equals profit. It got worse from there.

                • Steve LaBonne says:

                  I sincerely hope you don’t fill out your own tax returns, because you clearly have no idea what the words on the forms mean, and wouldn’t have any idea what to report on the salary line and what to report on the profit (or loss) from business line. The IRS would not be amused.

                  Really, you stepped in it here, simple as that. Just shut up and bow out gracefully; that way you can preserve some self-respect.

                • Here is a comment from one of our hosts that could stand some revisiting.

                • joe from Lowell says:

                  As others have said, you clearly do not understand what “profit” means.

                  Ask Mal how “you obviously don’t understand what it means” arguments turn out with me.

                  It is what is left over after salaries and operating expenses.

                  And people don’t (normally) pay salaries and operating expenses out of their salaries. They take those salaries home, as profit.

                  Once again, the blindingly stupid comment that began all of this:

                  Profit has no place in the healthcare system, at any point.

                  If this statement is to be believed, doctors should not be getting salaries beyond their expenses. They should not be profiting off their work.

                  Are you really so prideful, so determined to insist that the big bad bogeyman can’t be right, that you can’t admit that this is a dumb statement, and that, yes, doctors really should make money from their labor?

                • Malaclypse says:

                  Ask Mal how “you obviously don’t understand what it means” arguments turn out with me.

                  Like any argument with you ends. You dig in, fail to listen to others, in this case refusing to so much as think about the dictionary definition of a word, even though you love quoting dictionaries yourself. Eventually people tire of this and move on, allowing you to have the last word, which means you think you have won. That’s how they end. Always.

                  And with that, as far as I am concerned, you may have the last word, because I’m tired of arguing about definitions of words.

                • joe from Lowell says:

                  Not according to Schedule C of a 1040, or, more likely in the case of a doctor, the K-1 on the 1040.

                  OK, granted, in the technical jargon of IRS terminology, “profit” has a specific meaning beyond that used in normal conversation, in that some gain from economic activity, but not all, is called “profit” by the IRS, while some is not.

                  However, in normal conversation – as opposed to IRS forms – net economic gain is a profit.

                  And what’s relevant here is it’s usage in the blindingly stupid comment that began this exchange:

                  Profit has no place in the healthcare system, at any point.

                  This is not a statement about the jargon used by the IRS, but about the actual exchange of money. As you understood clearly when this began, this is a statement that nobody should make money from health care.

                • joe from Lowell says:

                  Wow, Mal. For you to post that little tantrum, and have it appear immediately above my reply to you, must make you feel very, very proud of yourself.

                  Yup, that’s me, refusing to give and inch or listen to what other people say. As everyone can see.

                • Hogan says:

                  Yes, joe, I’m sure you know what DocAmazing meant better than he does.

                • Malaclypse says:

                  OK, granted, in the technical jargon of IRS terminology, “profit” has a specific meaning beyond that used in normal conversation, in that some gain from economic activity, but not all, is called “profit” by the IRS, while some is not.

                  Thank you for admitting that I was right. That is rare from you, and I appreciate it.

                  However, in normal conversation – as opposed to IRS forms – net economic gain is a profit.

                  Not in any normal conversation I’ve ever had. I will grant that the accountant thing may change my perspective. But I’ve never had anybody who got a paycheck describe that check as “profit.”

                  And I’m willing to bet that I’m not the only person who think that it was someone other than me on this thread throwing a tantrum.

                • Hogan says:

                  net economic gain is a profit.

                  So non-profit corporations are not allowed to run surpluses?

                • joe from Lowell says:

                  Hogan says:
                  March 29, 2012 at 3:22 pm
                  Yes, joe, I’m sure you know what DocAmazing meant better than he does.

                  For the first time on the thread, I actually don’t understand something. When did I say that DocAmazing didn’t understand what he meant?

                • joe from Lowell says:

                  Mal,

                  Not in any normal conversation I’ve ever had.

                  You’ve never had a conversation in which someone uses the word “profit” to mean “gain” or “coming out ahead on the deal?”

                  That’s very odd.

                  And I’m willing to bet that I’m not the only person who think that it was someone other than me on this thread throwing a tantrum.

                  I didn’t say you were throwing a tantrum. Unlike the Docs and Steve LaBonne, you’ve kept your head and avoided them entirely.

                • Hogan says:

                  When did I say that DocAmazing didn’t understand what he meant?

                  You’ve insisted throughout that he must have meant “profit” in the sense that you understand “profit,” not in the sense that he, Steven, Mal and I (and many other people) understand “profit.” And every time it was pointed out that no, “profit” doesn’t usually mean that, you’ve insisted that of course it does, because that’s what you mean by it, therefore it must have been what he meant.

                • joe from Lowell says:

                  Hogan,

                  So non-profit corporations are not allowed to run surpluses?

                  401c3s, and the like, frequently run “profits” that are not “profits” to the IRS. There are extensive regulations about what they can do with their not-profit profits.

                  Yes, “non-profits” can make profits. They just don’t count as profits, under the IRS definition, even as they operate at a surplus. What “non-profits” really are are organizations that are limited in what they can do with money they take in as profit.

                  Getting beyond the semantic, there are actually some substantive issues here. Some “non-profits” pay exorbitant salaries to their leadership, for instance. Others build up enormous endowments that they don’t use for their missions. The are non-profits only in name, and in legal status.

                • Malaclypse says:

                  I didn’t say you were throwing a tantrum.

                  Wow, Mal. For you to post that little tantrum,

                  Is Boob spoofing JFL? If not, which of us is stoned?

                • joe from Lowell says:

                  Well, unlike the three stooges, you haven’t thrown a tantrum throughout the entire thread.

                  I’ll spot you that one rather unfortunate comment.

                • joe from Lowell says:

                  Hogan,

                  You’ve insisted throughout that he must have meant “profit” in the sense that you understand “profit,” not in the sense that he, Steven, Mal and I (and many other people) understand “profit.”

                  But, as I’ve been trying to point out, we don’t actually mean different things by the term “profit.” It actually does mean the same thing, to all of us.

                  The disagreement is about whether a specific situation fits the definition, not what the definition is. DocAmazing knows exactly what he meant by “profit,” and I didn’t correct him on that. I corrected him by pointing out that earning money above and beyond one’s expenses is a profit, regardless of how one characterizes it for tax purposes.

                  Take the situation of a doctor with his own practice. Whether he tells the IRS that he is the principal of a corporation taking home$100,000 in profits after his expenses, or that he is an employee of a corporation that pays him $100,000 in salary in addition to the other expenses, while the corporation itself just breaks even, this legal characterization does not actually change the fact that it’s the same bloody thing.

                • Malaclypse says:

                  I corrected him by pointing out that earning money above and beyond one’s expenses is a profit, regardless of how one characterizes it for tax purposes.

                  But this leads to absurditoes.

                  Under your definition, someone who earns 10 bucks an hour, works a shit-ton of overtime, and lives in a rathole while eating nothing but Ramen, earns a “profit” because s/he saves money; while someone who earns a salary of $1M a year, but spends all that and more, does not. Not only are you redefining words, but you are doing so in a way that leads to absurd results.

                  The way most people use language is that person one has a crappy wage, person two has a great salary, and both of their employers may or may not make a profit.

                  And the dictionary defines profit as

                  1.
                  Often, profits.
                  a.
                  pecuniary gain resulting from the employment of capital in any transaction. Compare gross profit, net profit.
                  b.
                  the ratio of such pecuniary gain to the amount of capital invested.
                  c.
                  returns, proceeds, or revenue, as from property or investments.
                  2.
                  the monetary surplus left to a producer or employer after deducting wages, rent, cost of raw materials, etc.: The company works on a small margin of profit.
                  3.
                  advantage; benefit; gain.

                  Profit involves a risk of, and return on, capital. Wages and salaries are not the same thing.

                • Malaclypse says:

                  And “absurditoes” is the best typo I have ever made.

                • joe from Lowell says:

                  Mal, you’re being willfully obtuse.

                  Under your definition

                  Under my definition, someone earning $1 million a year who spends it on diamonds and houses – that is, on expenses that have nothing to do with his job – is earning $1 million in profit. Did you really, in good faith, making an effort to engage in an exchange of ideas, read my words “beyond expenses” as referring to buy oneself goodies, as opposed to the “expenses” incurred bringing in the money?

                  You’re an accountant, you see the word expenses all the time, you know it doesn’t mean “anyone thing one spends one’s own money on.” Can I ask for a little more good faith, if you’re going to have a discussion here?

                • joe from Lowell says:

                  And while I’m pretty proud of “anyone thing one,” it is certainly no “absurditoes.”

                • joe from Lowell says:

                  Profit involves a risk of, and return on, capital.

                  So if I take a push mower I already own and charge my neighbors to mow their lawns, I don’t make a profit? In that case, I’m putting in no capital, but labor.

                  One cannot profit from one’s labor?

                • John Protevi says:

                  Profit involves a risk of, and return on, capital.

                  So if I take a push mower I already own and charge my neighbors to mow their lawns, I don’t make a profit? In that case, I’m putting in no capital, but labor.

                  One cannot profit from one’s labor?

                  I am not an economist, but AFACT, in this scenario the lawnmower is the capital and the money you get from the neighbors is the revenue, which is the return on the capital. You’d have to figure out costs in this scenario, such as the gas and oil for the lawnmower, sharpening the blades, the percentage of the cost of the food you eat that went to generating the calories expended in pushing / riding the lawnmower, and so on. If the revenue exceeds the cost, then you’d have profit. If not, you’d have loss. Or at least that’s how I would put it.

                • joe from Lowell says:

                  BTW, Mal: One dictionary you were able to find defines profit that way.

                  The American Heritage Dictionary says:
                  prof·it (prft)
                  n.
                  1. An advantageous gain or return; benefit.

                  Merriam-Webster:

                  1prof·it noun, often attributive \ˈprä-fət\

                  Definition of PROFIT

                  1: a valuable return : gain
                  2: the excess of returns over expenditure in a transaction or series of transactions; especially : the excess of the selling price of goods over their cost
                  3: net income usually for a given period of time

                  So, no, whatever this disagreement has been, it has not been me “not understanding what profit is.” That is an obnoxious feint beloved of those who’d prefer to define their way to victory instead of discuss ideas on their merits.

                • Ben says:

                  Joe, I think I can explain how you’re getting confused. You’re combining colloquial usage of “profit” with the economic concept of “profit”. (The economic concept is different from the accounting concept).

                  You keep saying that you think profit is the difference between revenues and costs.

                  And it is!

                  It’s the difference between total revenues and total costs. But only for a firm.

                  The reason it’s only for a firm is because the economic definition of total cost includes opportunity cost.

                  And no one uses the concept of opportunity cost to refer to an individual and their compensation. “Yeah, I quit my $200,000/year corporate lawyer job to focus on my family. So now I’m a schoolteacher and make -$160,000/year.” That’s what she would say if she were talking about how much profit she made.

                  And if you say “that might be what profit technically is, but in its colloquial use profit just means “coming out ahead after expenses for a job”, and I was talking about the colloquial use”, that ain’t gonna fly. Because no one talks like that. That is waaaayyy too specific. You have never heard anyone say “last month I made a profit of $1,000 because that’s the difference between my wage and gas, car insurance and business attire which are my only expenses related to my job.” You’ve never said “I need to start biking or taking the bus so my profit will be higher.” Etc.

                  Nope. If you introduce revenues and costs into the concept of profit, that means that you’re not using profit in the colloquial sense, which means you’re using it in the economic sense, which means Dr. Dick’s original comment which you keep referring to makes complete sense.

                • joe from Lowell says:

                  Ben, let me throw two scenarios at you:

                  1) A doctor spends money to buy some equipment that lets him provide more services to more patients, and as a result, takes home more money.

                  2) A middleman somehow figures out a way to take a cut of health care spending without first investing capital.

                  Do you really think that Dr. Dick is saying that there is no room at any point in the health care system for #1, but that he’s fine with #2?

                  If you answer “No” to this question, then the problem here is not that I am confused, or using the wrong definition. If you think that Dr. Dick would object to #2, but consider #1 perfectly valid, then he introduced what you are calling the “colloquial definition” into the discussion right from the beginning, and I merely pointed out that his idea, or the way he expressed it, was wrong.

                • joe from Lowell says:

                  Also, Ben, “you seldom hear it phrased this way” is not a valid argument, but a species of the fallacy “appeal to popularity.” Oh, joe, your terms are wrong, because you never hear anyone say it that way! Uh…so what?

                  As for firms vs. individuals, this is a legal fiction. If a doctor with his own practice calls himself the principal of a firm that turns a profit of $100,000 a year, or calls himself an employee of a firm that pays him $100,000 a year while just breaking even, it’s the same thing.

                • Malaclypse says:

                  As for firms vs. individuals, this is a legal fiction. If a doctor with his own practice calls himself the principal of a firm that turns a profit of $100,000 a year, or calls himself an employee of a firm that pays him $100,000 a year while just breaking even, it’s the same thing.

                  Technically, this is incorrect.

                • joe from Lowell says:

                  It’s true that you never hear anyone say their salary is “profit,” but you do frequently hear them say, and even state on their tax returns, that they have expenses (or costs) which reduce their income – which means that it is false to claim that introducing the concept of costs automatically rules out conceiving of personal, as opposed to corporate, income from being categorized as profit. That we do so in common conversation is just a convention that does not mean anything on the conceptual level.

                • Malaclypse says:

                  you do frequently hear them say, and even state on their tax returns, that they have expenses (or costs) which reduce their income

                  In general, only on Schedule Cs or K1s, which are for business income.

                  And with that, I take off my accountant hat for the night, and go back to being just a hippie socialist ;-)

                • joe from Lowell says:

                  Technically this is incorrect.

                  I have already acknowledged that the existence of the legal fiction.

                • joe from Lowell says:

                  In general, only on Schedule Cs or K1s, which are for business income.

                  Huh? Child care expenses, mileage, business expenses…these are all deductable on 1040s. What am I not getting?

                • joe from Lowell says:

                  And with that, I take off my accountant hat for the night, and go back to being just a hippie socialist ;-)

                  As if. Next you’ll be telling me about some, I don’t know, hip-hop gangsta accountants or something.

              • joe from Lowell says:

                Steve LaBonne says:
                March 29, 2012 at 2:51 pm
                Profit also doesn’t mean “highly paid”.

                I didn’t say it did.

                You people are really flailing here.

                • DocAmazing says:

                  You people are really flailing here.

                  Ah. Irony.

                  Back to work!

                • joe from Lowell says:

                  Oh, look, that little posturing thing you do when you’ve gotten your ass handed to you.

                  My cat does the same thing after he takes an embarrassing fall, too, but he manages to convey a modicum of grace.

                • Steve LaBonne says:

                  We’re not posturing, we’re laughing at the way you keep digging even after your hole is a couple of miles deep. And we’re not laughing WITH you.

                • joe from Lowell says:

                  Steve LaBonne says:
                  March 29, 2012 at 3:05 pm
                  We’re not posturing, we’re laughing at the way you keep digging even after your hole is a couple of miles deep.

                  Is that why you keep finding increasingly-emotional ways to avoid addressing the point?

                  Claiming that nobody, at any point, in the health care system should make a profit off their services is blindingly stupid.

                  Continued insults and posturing don’t make you look less foolish for refusing to acknowledge this, but more.

              • Malaclypse says:

                I did not say that “salary higher than the median income” was “profit.” I said it was “highly paid.”

                Yes, you did. You did here:

                The Metropolitan Opera is a nonprofit organization. Do you think they pay the singers with chickens?

                Of course not; I think those singers make a profit.

                • joe from Lowell says:

                  Uh, Mal? There’s nothing in there about “higher than median income.”

                  Did you mean to quote something else?

                • Malaclypse says:

                  You said that the singers, who are paid a wage (I don’t believe singers can be salaried), made a profit. It is right there, with no ambiguity at all. “I think those singers made a profit.” And they did not. They made a wage.

                  Either every single person on this thread is stupid, or you are not communicating clearly. And I’m enough of an arrogant bastard to refuse to believe that I am stupid. I also think the subthread has gone off the rails on a silly digression.

                • Sherm says:

                  Why are we discussing physicians’ salaries? The objectionable profits are those made by the insurance companies, which are nothing more than leaches that suck money out of the system without providing any services. Classic middle men.

                  I don’t begrudge physicians their high salaries. They are heard-earned, and needed as an incentive to ensure that intelligent, hard-working people seek such positions, rather than jobs on wall street.

                  And as DocAmazing referenced above, you might be surprised at the incomes earned by primary care physicians relative to their training. Its only the specialists and surgeons who rake in the big bucks. There are a lot of doctors working their asses off for 100k per year, after spending tons of money on grad school.

                • joe from Lowell says:

                  Ah, so the “higher than median wage” part was what was confusing.

                  I will freely admit that my statement did not take into account the possibility that the wages paid to the singer does not exceed their expenses, and that they do not end up making a profit. I find this unlikely, because people keep showing up for work, but I guess it’s possible.

                  I also think the subthread has gone off the rails on a silly digression.

                  Of course it has. For some reasons, the Doctors and Steve LaBonne decided that, instead of just acknowledging that it’s stupid to claim that nobody should make a profit by providing health care – a position they clearly don’t even support, since they won’t say it – they decided to play some little semantic game, and pretend that taking home a profit isn’t a profit unless yoor teh corporashuns.

                • Steve LaBonne says:

                  Sherm, Joe is the only one talking about them, and only because he can’t admit that he stupidly misunderstood the plain everyday meaning of the word “profit” and thought it meant anybody being paid at more than subsistence level. It’s classic Joe.

                • joe from Lowell says:

                  Sherm,

                  Why are we discussing physicians’ salaries?

                  Because the original statement,

                  Profit has no place in the healthcare system, at any point.

                  means that doctors should not be making money beyond their expenses, and that’s clearly wrong. Of course they should take home a profit.

                  But, because it was me that pointed out the problem with the statement…well, you know how these three are.

                • joe from Lowell says:

                  Sherm,

                  The objectionable profits are those made by the insurance companies, which are nothing more than leaches that suck money out of the system without providing any services.

                  Exactly. The reasonable point isn’t “There should be no profits at any point in the health care system,” but rather, where those profits should be. I’ll go one step further: I don’t begrudge a group of physicians who enter into a partnership a reasonable, even a substantial, profit from that business.

                  There are a lot of doctors working their asses off for 100k per year, after spending tons of money on grad school.

                  Indeed, but given what we know about poverty and the shrinking middle class in this country, can we please do without the poor-mouthing from people who “merely” make a $100k a year, even with loans to pay back?

              • joe from Lowell says:

                Steve LaBonne says:
                March 29, 2012 at 3:04 pm
                I sincerely hope you don’t fill out your own tax returns, because you clearly have no idea what the words on the forms mean, and wouldn’t have any idea what to report on the salary line and what to report on the profit (or loss) from business line. The IRS would not be amused.

                Actually, Steve, I’ve gotten a tax return every single year I’ve filed my own taxes, so I clear understand well enough.

                Your little posturing, combined with an ability to acknowledge even the most inarguable point (doctors should earn a living, not merely cover their expenses), does not vanish in a puff of posturing.

                Why can’t you just bring yourself to acknowledge that it is blindingly stupid to say that nobody, at any point, in the health care system should make a profit?

                • Steve LaBonne says:

                  The word profit still does not mean what you think it means. And no, it’s not everybody else who’s out of step, it’s you.

                  Doctors earned good livings long before there were for-profit companies running either hospitals or health insurance organizations. And they earn good livings in the many countries where for-profit care and insurance are not allowed at all, or allowed only for “luxury” but not basic care. You are just being stupid because your ego won’t allow you to admit that you misunderstood something. That’s pathetic.

                • joe from Lowell says:

                  Money earned above expenses is profit.

                  This does not change because you’re too small a man to acknowledge error.

                  That you insist on continuing this semantic pointlessness can only be understood as an admission that the original statement is wrong. I have no interest in either the semantic silliness, or in your emotional problems.

                  Of course there needs to be profit at some point in the health care system. Doctors, for instance, need to make a living, or there won’t be any doctors.

                  We could have had a discussion about where profit is, and is not, appropriate in the health care system, but that would have required three little children with old grudges and wounded pride to rise above themselves.

                  I didn’t misunderstand anything. I understood, perfectly clearly, that insisting that there can be no profit at any point – even at the point of the individual doctor – in the health care system is absurd.

                  I even understood the point you were trying to make, and did my best to point out where it goes wrong, but you just couldn’t admit that I might have right. So, instead, we get this silliness.

                • bobbyp says:

                  I don’t begrudge a group of physicians who enter into a partnership a reasonable, even a substantial, profit from that business.

                  OK by me. However, in neoclassical micro, economic profit does not occur in long run equilibrium under conditions of pure competition. See also “normal profit” and “social profit”. This is not be be confused with accounting profit which only takes into account explicit costs (i.e., does not account for opportunity costs).

                  So one must be a bit careful as to how you are using the term, and I can see where a misunderstanding could arise.

              • Hogan says:

                DocAmazing knows exactly what he meant by “profit,” and I didn’t correct him on that. I corrected him by pointing out that earning money above and beyond one’s expenses is a profit, regardless of how one characterizes it for tax purposes.

                And when DocAmazing said there’s no place for profit in health care, as many people have said before him, that’s not what he (or they) meant by “profit.”

                • joe from Lowell says:

                  …which is why I pointed out that he’s leaving out certain situations, because there are many situations, such as the one I just explained to you, in which someone earns a profit, and DocAmazing would certainly have no problem with it.

                • DocAmazing says:

                  Actually:
                  1. DocAmazing never said that. You could, as they say, look it up.
                  2.DocAmazing knows enough to state that “profit” is something businesses declare; individuals who are not incorporated receive wages and salaries and benefits.

                • joe from Lowell says:

                  1. DocAmazing never said that.

                  No, he just spent hours heatedly defending it. What a devastating rebuttal.

                  DocAmazing knows enough to state that “profit” is something businesses declare

                  So what you were so passionately, heatedly defending was a point about how highly paid doctors and insurance CEOs structure their corporations and income statements to the IRS, and not a statement about who earns money through the provision of medical services. Right, I believe you.

                • joe from Lowell says:

                  Blue Cross/Blue Shield is structured as a nonprofit health insurer. In 2011, its CEO earned $11.3 million. But you can come up with a narrow enough definition of “profit” to pretend that he didn’t make any.

                  If anyone is dumb enough, or merely holds enough of a personal grudge against an internet commenter, to take you at your word, then they would conclude that you are advocating for the health care system to operate in this manner.

                • joe from Lowell says:

                  So to sum up: I objected to the claim that nobody should profit in the health care system.

                  The rebuttal to this was to hide behind semantics and pretend that the claim was merely about how to report income to the IRS.

                  When people respond to a substantive argument by hiding behind semantics and implausible hair splitting, they probably should just man up and refine their original claim.

                • Steve LaBonne says:

                  To sum up accurately, Joe: you made a stupid mistake because you (rather amazingly) didn’t know what the word “profit” means, thereby totally and comically misunderstanding what people were talking about and derailing the discussion, then you compounded the stupidity by being completely unable to admit your mistake, further derailing the thread with your obnoxious but still comical flailing. Very impressive. If I moderated this blog I’d have banned you many comments ago.

                • DocAmazing says:

                  No, he just spent hours heatedly defending it.

                  No, DocAmazing works for a living. He does hit-and-run short posts between patients and late-night phone calls from patients’ parents. He did not, in fact, have anything to say about that particular statement, let alone hours’ worth. Again, you could look through the thread.

                  So what you were so passionately, heatedly defending was a point about how highly paid doctors and insurance CEOs structure their corporations and income statements to the IRS, and not a statement about who earns money through the provision of medical services. Right, I believe you.

                  No, I made two quick points, which you could very easlily go back and read–first, that you conflate the word “profit” with”income” or “salary” or “wage”, and it really isn’t the same thing, as professional accountant Malaclypse tried patiently to explain to you. The other point I made is that, despite your zeal to be the only working-class guy in the room, most doctors don’t make anything like the money that you seem to think that they do, and a bunch of us work for less that a hundred k a year, and have to pay all of our licensure and loans and malpractice insurance and so on out of that.

                  I realize that what Steve or Malaclypse or DrDick or Hogan really write on this or any other thread doesn’t matter; your recollection of what’s been written will be colorful, your definitions of words will be fluid, and your use of junior-high creative-writing vocabulary words like “posturing” will be dazzling. It’s always amusing to read a thread with your wilder posts on it, because trying to figure out where you originate your ideas taxes even a Dadaist

              • Hogan says:

                Absurditoes–absurdities that go crunch.

              • joe from Lowell says:

                John Protevi,

                in this scenario the lawnmower is the capital

                But I stipulated “that I already own” in order to highlight that I’m putting no additional monetary value into the operation. The only input that brings this enterprise into existence is labor.

                Let’s lose the lawn mower. Let’s say I weed their gardens, or babysit their children.

                • Malaclypse says:

                  But John is right – the lawnmower is capital, whether it is long-owned or not. A GM stock my great-grandpappy bought gets a bit of profit.

                  And I’ve hired babysitters. Not one has described the money she got (and yes, sadly, it always has been a she) as “profit.”

                  But let us bury what are clearly semantic differences, and seek common ground and productive discussion: Who is worse, Darleen’s Anonatrolls, or her pseudonymed flying monkeys?

                • joe from Lowell says:

                  It doesn’t really matter what your babysitters’ vocabulary is like. They probably never described used the terms “gross income” or “value generated from labor,” either.

                  Once again, the blindingly stupid statement that began all of this is:

                  Profit has no place in the healthcare system, at any point.

                  And yet, he goes on to affirm that he’s perfectly fine with doctors making “let’s-not-call-them-profits, ok?” Clearly, he is not differentiating between doctors who kick in some money to add equipment that will raise their income, and doctors that do not. Rather, he’s making a distinction between people who provide health services and people who act as middlemen. Do you think he’d be ok with middlemen who do not make capital investments before taking their cut?

              • joe from Lowell says:

                John Protevi,

                in this scenario the lawnmower is the capital

                But I stipulated “that I already own” in order to highlight that I’m putting no additional monetary value into the operation. The only input that brings this enterprise into existence is labor.

                Let’s lose the lawn mower. Let’s say I weed their gardens, or babysit their children.

                Actually, I like the weeding example. Under Mal’s definition, if I bring my own bucket, I make an astounding 6000% profit on an investment, but if I use their bucket, I don’t make a profit.

                • John Protevi says:

                  There is a concept of “human capital,” most famously associated with Gary Becker, that would look at all human activities (or at least skill development, maintaining a proper appearance, etc) as investments yielding returns in wages. But I don’t think this is the way most people talk about profit, and it’s certainly not w/o its detractors among economists: http://en.wikipedia.org/wiki/Human_capital#Marxist_analysis

                • joe from Lowell says:

                  I’m with the economists. Conflating actual human activity and characteristics with mere economic value is a false, pernicious doctrine. It’s also much beloved by libertarians.

              • Ben says:

                Also I feel the need to point out that your original objection to Dr. Dick’s comment doesn’t make sense.

                But, as I’ve been trying to point out, we don’t actually mean different things by the term “profit.” It actually does mean the same thing, to all of us.

                The disagreement is about whether a specific situation fits the definition, not what the definition is.

                You know that’s not true now, right? Dr. Dick was using the economic concept of profit. It doesn’t matter that if he meant the colloquial use of profit he would be incorrect. Because he didn’t.

          • Warren Terra says:

            Mal, the problem with your argument is that we’ve done the experiment, in spades. And the results are clear: the Republicans are more beholden to the crazies (insanely wealthy insane ideologues, Christian Millenialists, Gun Nuts, Racists, Fox News Blowhards) than to the business community that backs them. This is why you see the business community terrified that the nutters they got elected will let the Export-Import Bank die, even though it makes money for the government while supporting small and medium-sized businesses in the US. This is why the US Steel industry was allowed to die, even though its problem was not manufacturing costs but rather health and pension benefits, a cost that in other wealthy countries and even less wealthy countries is born by the state. This is why industry generally hasn’t been pushing to be relieved of the direct cost of healthcare.

  16. Uncle Kvetch says:

    But there is a crisis in the eyes of much of the public

    There was a crisis in the eyes of the public in 1993, too.

    I don’t mean to be flippant but I really think the breaking point is a long way off yet.

    • Uncle Kvetch says:

      Sorry for my replies not threading properly — sometimes it works, sometimes it don’t.

    • Sherm says:

      Don’t get me wrong. I’m not talking about within the immediate aftermath of a ruling, I’m talking 10-20 years down the road. Its much worse now than it was in 93, and it’ll be that much worse 20 years from now.

      • Warren Terra says:

        Serious health care reform was attempted under FDR (30s), under LBJ (60s), under Clinton (90s), and under Obama (2009-10). It appears to generally take thirty years for the Democrats to work up the courage to try once more to embrace this porcupine, even knowing the importance of the issue, because of the political cost they bear. On the one hand, Obama’s attempt was arguably a decade early by that measure, consistent with the rising pressure from increasing medical costs; on the other hand, the political costs for Democrats have been increasing as well, with both Clinton and Obama paying huge prices in off-term elections – that is to say, the Congresspeople whose votes are necessary see that working on health care reform is likely career suicide. If the Court destroy the ACA, we will revisit this issue at some point – but I’d not speculate whether it would be so little as twenty years before that happens, given the huge political disincentives involved and the utter nihilism of the Republican opposition to this and all other Democratic policy interests.

        • Sherm says:

          Excellent analysis. But with the exploding cost of healthcare, the problem is worsening exponentially, which could hasten things a bit. I also think that the democrats would be better served politically by addressing it as an economic issue.

  17. wengler says:

    This thread was kind of like Libya all over again.

    Sometimes with joe you just gotta disengage.

  18. DrDick says:

    It is, but, as everyone knows, only conservatives read his book.

  19. Davis X. Machina says:

    I wasn’t aware of any billy-goat shortage…

  20. joe from Lowell says:

    Isn’t that already the Alinsky way?

    There are those who believe that a justice of the United States Supreme Court should be bound by standards that rise above, say, those proper to someone who agitates at neighborhood meetings.

    None of these people, it seems, vote Republican.

  21. Malaclypse says:

    Blame those who crafted this law for the terrible job done that landed it here.

    Okay. The Heritage Society and Mitt Romney suck.

    Glad we found common ground.

  22. timb says:

    You might want to look at precedent before you complain about anything. Justice Scalia has already said the Federal Government can tell you, as an individual, that you cannot grow pot. Wickard tells us about wheat production.

    More interesting, as the Chief Justice noted, the mandate is a choice. You know you are required to buy insurance. If you do want to, then you can pay the tax penalty. It regulates a market.

    If single payer is legal and Constitutional, then how is anything short of it unconstitutional?

    Everything else is sophistry.

  23. Kurzleg says:

    Alito doesn’t understand the difference between insurance risk pooling and insurance underwriting.

  24. DrDick says:

    Since Alito, et nauseum, proclaim themselves originalists who are bound by the wishes of the founders, perhaps the fact that the founders themselves were quite explicitly in favor of mandates, especially health insurance mandates.

  25. Katya says:

    Actually “Can you create commerce in order to regulate it?” is not a fair representation of how proponents have justified the law. The point of the mandate is that everyone is already in the health care market, or will be, and the mandate is a way of ensuring that they pay for the health care they are already using, because if they don’t, the rest of us do.

    Blame those who crafted this law for the terrible job done that landed it here.

    Yeah, the Heritage Foundation sucks.

  26. Njorl says:

    The funeral analogy is not apt.

    Everyone effectively uses health insurance, not health care. You could live your whole adult life without seeing a doctor, then die in a plane crash. No health care would be used. When you are young and healthy and opt not to buy insurance, you are still insured. If you get sick, you will be treated even if you can’t pay. If you don’t get sick, you don’t use health care, but you are still insured. You have (very bad) health insurance which you are not paying for. The ACA makes people who don’t pay for real insurance pay for the de facto insurance costs they create.

    Everybody dies. Finding some way to fund the disposal of bodies is necessary, but it is not necessary to do it through funeral insurance.

  27. joe from Lowell says:

    Kennedy’s question “Can you create commerce in order to regulate it?” was certainly a fair representation of how the proponents have justified this law.

    No, it’s not. The argument of the law’s proponents is that every single person in our society is, and will continue to be, engaged in health care market.

  28. joe from Lowell says:

    Blame those who crafted this law for the terrible job done that landed it here.

    Uh, yeah, because partisan Republicans would never have brought legal challenges to a different universal health care law.

    Pelosi never should have been walking in that neighborhood. It’s her fault.

  29. Scott Lemieux says:

    Right. Commerce is “being created” only if you ignore how the health insurance actually functions, or try to lean on the ridiculous, irrelevant distinction between the “health care market” and the “health insurance market.”

  30. Eddie Dean says:

    The point of the mandate is that everyone is already in the health care market, or will be, and the mandate is a way of ensuring that they pay for the health care they are already using, because if they don’t, the rest of us do.

    Everyone that is born will die so they’re ‘already in the market’.
    Can we now federally regulate the funeral industry?

    Everyone is ‘already in the market’ for food, energy, water. Still want to federally regulate those as well?

    The point is where does this end?

    Everyone that is bors

  31. Scott Lemieux says:

    And I’ll also add, even if the analogy were less specious, so what? The president’s commander in chief powers allow the president to do all kinds of stupid things far more destructive than requiring you to buy broccoli or whatever, but that doesn’t mean the powers don’t exist.

  32. snoey says:

    >You could live your whole adult life without seeing a doctor, then die in a plane crash.

    Maybe not in a plane crash, but in most cases if you go off and die by yourself you’ll consume some pathology.

  33. John says:

    Yeah, if your “parade of horribles” is that the government could mandate that people buy funeral insurance, that’s really not very horrible at all.

  34. joe from Lowell says:

    If single payer is legal and Constitutional, then how is anything short of it unconstitutional?

    The difference between the ACA and a single payer system is not merely a quantitative one.

  35. Uncle Hinkle says:

    ….originalists who are bound by the wishes of the founders…

    It’s the best objective way to interpret laws.

    Of course, objectiveness may not be your goal.

  36. Wang-Chung says:

    As a citizen, I demand life insurance.

  37. timb says:

    We’ll disagree, but I will still love you

  38. timb says:

    You have it. it’s called Survivor’s benefits and Disabled Widow’s Benefits and it’s payable out of the Social Security Trust fund.

    Boggles my mind how little the people of this country know about their government

  39. joe from Lowell says:

    Good for you, buddy. Get 60 senators and 218 reps, and a President who’ll sign the bill, and Bob’s your uncle.

  40. timb says:

    And not buying insurance is a choice also

  41. joe from Lowell says:

    Sure we can regulate the funeral industry.

    Everyone is ‘already in the market’ for food, energy, water. Still want to federally regulate those as well?

    Uh…are you under the impression that there aren’t federal regulation on agriculture, food safety, energy, and water? Those regulations are less than those in the ACA, because of the decisions Congress made about policy, but they still exist.

    The point is where does this end?

    Where Congress decides. Do you imagine that dreaming up what you consider to be unwise treaties would count as an argument against the constitutionality of the Senate ratifying NEW START?

  42. joe from Lowell says:

    What is this supposed to have to do with either my answer, or the question?

  43. DrDick says:

    So you are saying that the conservatives have to uphold ACA? Because that is the upshot of your assertion.

  44. timb says:

    Down boy. Just making an observation, as it relates to commerce

  45. Ben says:

    Self-contradictory trolling > Tebow

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