Some of the legal questions related to the individual mandate are, at least partially, policy questions. In particular, what does the individual mandate do? And can the law stand without it?
The argument conservatives are making right now is that the individual mandate regulates "economic inactivity." That's not a description anyone had heard of it back when conservatives were co-sponsoring bills with the individual mandate, and it's not what the policy's creator had in mind when he developed it. But that doesn't make it untrue.
To believe it, however, you need to adopt a very narrow definition of what's being affected here: Namely, the decision to purchase or not purchase health-care insurance. The more traditional view is that the individual mandate is one of a slew of rules and regulations bringing order to something much broader: The American health-care system, which all of us participate in. That's the view of the 38 health economists and academics who signed this brief (pdf). "There is no such thing as 'inactivity' or non-participation in the health care market," they wrote. "As the District Court" -- which ruled for the Affordable Care Act -- "recognized, virtually all Americans will, at some time during their life, require health care, either because of illness, accident, or the wear and tear of age."
Because health services are so expensive, the costs are defrayed over many years. That's what insurance does. And because we are a humane society, we have rules and regulations in place to ensure that people can get treated even if they don't have insurance. In that way, you may not be interested in the health-care system, but if you get hit by a bus, the health-care system is interested in you -- and that's true even though you weren't making an economic choice to become "active" in the health-care system when you stepped into the street. You were, by virtue of our laws and regulations and taxes, already an active participant. The authors of the brief make this point -- and its connection to the individual mandate -- well:
The requirement to obtain a minimal level of health insurance is predicated on the unique characteristics of the health care market -- the unavoidable need for medical care; the unpredictability of such need; the high cost of care; the inability of providers to refuse to provide care in emergency situations; and the very significant cost-shifting that underlies the way medical care is paid for in this country. Those characteristics do not obtain in other markets and, without them, the predicate for the kind of regulation adopted in Section 1501 does not exist. Hence, affirming Congress’ power to adopt Section 1501 will not open the door to unfettered expansion of federal power over individual liberty, as Appellants fear.
To make this more concrete, when an uninsured person breaks a leg and needs hospital care, that care is paid for by the rest of us. It'd be a bit odd for your economic inactivity to cost me money. But your decision to remain without insurance does cost me money, because you're an active consumer of health-care risk and an active participant on a health-care market that affords you certain benefits. When you don't purchase insurance, you've not decided against participating in the American health-care system. You're just not participating responsibly. To quote Mitt Romney:
Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on the government is not libertarian.
Then there's the question of severability -- can the law work without the mandate? The legislation does not specifically say that it can. And the Obama administration, in a calculated gamble to persuade the Court that the mandate passes constitutional muster through the "necessary and proper" clause, is currently arguing that it can't. This, at least in part, led Judge Vinson to void the entire bill. "In the final analysis, this Act has been analogized to a finely crafted watch,and that seems to fit," he wrote. "It has approximately 450 separate pieces, but one essential piece (the individual mandate) is defective and must be removed. It cannot function as originally designed."
The irony of all this is that one of the central arguments in the Democratic campaign for the presidency was between the Obama campaign, which didn't think health-care reform required an individual mandate, and the Clinton campaign, which thought it did. I was on Clinton's side in that debate, but the case is more nuanced than the Obama team allowed then or is admitting now. The legislation will work much better with an individual mandate. But many people will be covered, and many goals achieved, in the absence of the mandate.
BBC Online is meeting its obligation to commission 25 percent of eligible production work from external suppliers - but must make wide-ranging changes to the process, a review by its regulating BBC Trust has concluded (release, review)
The BBC has met the quota requirement every year since it was recommended by the 2004 Graf report. Last year, it commissioned external interactive producers for work totalling £20 million.
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But a Deloitte review in to the quota commissioned by the trust slates the system for lack of transparency, management, direction and value for money.
Consequently, the trust - whilst it is not raising the quota - has ordered BBC Online to “discuss with industry what form strategic goals for a quota system might take”, and to simplify the current process.
This BBC Trust review has been many months in the making - the BBC executive had already known the outcome and recommendations before Friday’s publication and has partly responded - it has already agreed to give the trust, after speaking with industry, a review within three months. The trust says the whole issue requires “urgent attention”.
Deloitte’s review (highlights):-
“The BBC is complying with the requirements set out in the BBC Agreement. However, the Online independent supply quota does not appear to be working well in practice. Whilst steps have recently been taken to remedy the issues surrounding it, both the BBC and the independent sector recognise there is a lack of: communication around how the commissioning for online takes place, clarity around how the quota is calculated and tracked; and, consistency and efficiency in commissioning practices. Most significantly, interviews demonstrate a strong belief in the independent sector that BBC online commissioners select suppliers to pitch for commissions based on the commissioners’ personal knowledge, rather than any rounded evaluation of who is equipped to deliver quality and value for money.
“There is a high degree of external scepticism as to whether reported performance is real or the result of an accounting allocation.
“Overall BBC Online expenditure is expected to go down rather than up
“There are issues with the management of the current arrangements that impact the value for money and quality BBC Online achieves for licence fee payers
“BBC Online has failed to provide sufficient transparency to the sector in terms of: strategic direction, emerging opportunities, decision making processes, and reporting of performance relative to the quota.
“An average commission size in FY 2009/10 of less than £5,000 and only 17 commissions over £100,000
“The revenues of the top 100 interactive agencies totalled c. £790m in 2009. In 2009/10 the BBC spent c. £20m externally as part of the BBC Online quota. Although the BBC will spend more on digital content (for example on those areas excluded from the eligible base), in absolute terms the impact that the BBC makes on the online content sector is limited.
“In this context, BBC Online’s c. £20m of ‘eligible’ annual spend lacks the scale to have as significant an impact on the shape of market as the BBC does in TV broadcasting.”
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bench craft company credit card
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David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
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bench craft company credit card
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
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bench craft company reviews
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
bench craft company reviews
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
bench craft company me
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
bench craft company me
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
bench craft company credit card
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
bench craft company me
Small Business <b>News</b>: Ladies Make The <b>News</b>
David Siteman Garland inspired this roundup (Thanks, David!) with a post on 35 visionary women entrepreneurs that just happened to include the founder of Small.
'Idol' <b>News</b> Beat: Siobhan Magnus Records, Plus Alex Lambert <b>...</b>
Remember way back when Season 9's Alex Lambert claimed, via Twitter, to be living on the streets? Then a rep from 19 Entertainment, which has a development.
Michelle Malkin » CBS <b>News</b> reporter Lara Logan sexually assaulted <b>...</b>
CBS News reporter Lara Logan sexually assaulted, beaten in Cairo; Update: Unhinged NYU fellow attacks Logan as “war-monger”
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