Question

Explain what you think Justice Scalia meant with his "broccoli" argument, and your personal stance on what you think this case says about health care reform and health policy development in the United States

Answer 1

the theory of a "broccoli mandate" was brought up by three of the Supreme Court justices against the Obama administration's Patient Protection and Affordable Care Act.

During the oral arguments on the Affordable Care Act, Justice Scalia challenged the Solicitor General, Donald Verrilli: “everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli.” Chief Justice Roberts commented that if the Court approves the insurance mandate: “All bets are off,” meaning that there would be no limit to what Congress could do in regulating interstate commerce. Justice Scalia said he wanted a ‘limiting principle,’ so that the federal government, whose powers are constitutionally limited, would not be given unlimited sway over individual behavior.

fate of the health reform legislation is now in jeopardy in part because some Supreme Court justices have so far failed to grasp such principles.

The government defended the mandate that nearly everyone carry insurance by arguing that almost everyone is in the market for health care at one time or another during their lives. People who are not insured may at any time become seriously ill or suffer major injury. The health care they will need is often costly and many people will not be able to pay for it. Under the Emergency Medical Treatment and Active Labor Act of 1986 hospitals must treat everyone who needs emergency care regardless of ability to pay. As a result, hospitals and other providers get stuck with bad debts. To make up their losses on the uninsured, they must charge those who have insurance more than the cost of their care.

In the jargon of economics, those with insurance are forced to ‘cross subsidize’ those without it. And that, in turn, boosts the cost of insurance, which is already high enough, reduces its affordability, and thereby increases the ranks of the uninsured.

Health Care reform:-

A big part of the debate and oral argument that preceded the Supreme Court's ruling on healthcare reform was whether being required to purchase health insurance-the so-called individual mandate-was akin to being forced by the government to buy broccoli.

The Government argues that the individual mandate can be sustained as a sort of exception to this rule, because health insurance is a unique product. According to the Government, upholding the individual mandate would not justify mandatory purchases of items such as cars or broccoli because, as the Government puts it, "health insurance is not purchased for its own sake like a car or broccoli; it is a means of financing health-care consumption and covering universal risks." . But cars and broccoli are no more purchased for their "own sake" than health insurance. They are purchased to cover the need for transportation and food.

The inevitable yet unpredictable need for medi­cal care and the guarantee that emergency care will be provided when required are conditions nonexistent in other markets. That is so of the market for cars, and of the market for broccoli as well. Although an individual might buy a car or a crown of broccoli one day, there is no certainty she will ever do so. And if she eventually wants a car or has a craving for broccoli, she will be obliged to pay at the counter before receiving the vehicle or nour­ishment. She will get no free ride or food, at the expense of another consumer forced to pay an inflated price.