Mariner, Annas Weigh in on Health Insurance Mandate in NEJM
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- Published on Thursday, 26 August 2010 13:32
A court challenge brought by the Commonwealth of Virginia over the federal healthcare reform bill raises interesting questions about the reach of Congress' authority under the Commerce Clause, but the federal government has the "more realistic" view of how the Constitution should be interpreted, two Boston University School of Public Health professors argue in an Aug. 25 article in the New England Journal of Medicine.
"The fundamental legal problem is whether, if the federal government can penalize individuals for refusing to purchase health insurance, there is any principle that would limit the power of the federal government to penalize the failure to purchase other products, such as a daily newspaper to save the newspaper business from extinction," write Wendy K. Mariner, professor of the Health Law, Bioethics & Human Rights Department, and George J. Annas, chair and professor of the department. "The federal government's answer is that people simply cannot choose 'to avoid participation in the health care market'," since everyone needs medical care.
"We think that the federal government has the more realistic view of how the national economy functions and how the Constitution should function today," Mariner and Annas say.
In dissecting arguments on both sides, Mariner and Annas note that while the federal government has broad power to regulate economic activities affecting interstate commerce, no court has "explicitly ruled" that the federal government can regulate what some argue is an "absence of activity," such as not purchasing health insurance. The federal healthcare bill's key provision is a mandate requiring that all individuals purchase health insurance.
The professors say the outcome in the federal courts is "far from certain," and they predict that the case will ultimately be decided by the Supreme Court, which is "just as ideologically fractured as the Congress that passed this law." In the meantime, they say, politicians across the country will use the healthcare bill to argue that the federal government is "too big, is too intrusive into our individual lives, and spends too much money."
Read the full text of the article "Health Insurance Politics in Federal Court."
Submitted by Lisa Chedekel
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