Economics Lessons For The Court: Broccoli Isn't The Same As Health Care

Several opinion writers offer insurance primers for the justices.

The New York Times: Broccoli And Bad Faith
Given the stakes, one might have expected all the court’s members to be very careful in speaking about both health care realities and legal precedents. In reality, however, the second day of hearings suggested that the justices most hostile to the law don’t understand, or choose not to understand, how insurance works (Paul Krugman, 3/29).

Reuters: Here's Why Health Insurance Is Not Like Broccoli
The High Court never got clear on why health insurance is not like broccoli and can thus be constitutionally regulated. There are two important differences that inform the principle for limiting congressional power to compel people to purchase goods and services. First, as George H.W. Bush made quite clear, you need never eat broccoli. But unless you are a hermit in Alaska, you will use healthcare at some point in your life (Ezekiel Emanuel, 3/29).

JAMA: The Supreme Court Flunks Economics—And That's Bad News For Patients And Physicians
This week, we were treated to the spectacle of the US Supreme Court debating economics. They called it a discussion about the Affordable Care Act (ACA), but it was more economic than legal. They spent an enormous amount of time on markets for health insurance and food (broccoli, to be specific); they spent little time analyzing precedent. Between the 9 justices and the 7 lawyers, there were 16 people who took part in the debate. As best as I can tell, not one of them had any training in economics (David Cutler, 3/29).

Chicago Tribune: Stuck In The Muddle With You
I'm troubled by the concept of government forcing people to buy something from a private business ... I'm also in tune with the majority of Americans ... who favor the "guaranteed issue" provision in Obamacare that allows those with prior illnesses or existing medical conditions to buy private health insurance. The problem with these two points of view is that they're in direct conflict. If people can wait until they're sick or injured to buy a health plan, the insurance industry stands to become an ATM for the ailing. And those of us who pay for insurance anyway — at no doubt greater and greater cost — stand to become the suckers who finance the freeloaders (Eric Zorn, 3/30).

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