Thursday 18 October 2012

Obey or pay

Once again, an editorial in a medical journal has left me virtually speechless, this time from the New England Medical Journal. In a recent Supreme Court ruling, Chief Justice John Roberts mentioned that the government has considerable power to tax “even in areas where it cannot directly regulate.” That comment was enough to give the maniacs of public health a whole raft of new authoritarian ideas. Brace yourself.

Roberts's opinion appears to invite more targeted, assertive interventions to promote public health. For example, instead of merely taxing tobacco sales, the federal government could require individuals to pay a tax penalty unless they declare that they haven't used tobacco products during the year.

It could give a tax credit to people who submit documentation that their body-mass index is in the normal range or has decreased during the year or to diabetic persons who document that their glycated hemoglobin levels are controlled.

It could tax individuals who fail to purchase gym memberships.

It could require taxpayers to complete an annual health improvement plan with their physician in order to obtain a tax credit, though that might be challenged under other parts of the Constitution.

Taxing people for not joining the gym? "Health fascism" doesn't sound like hyperbole any more.

Some interventions we've outlined would never survive the political process, given prevailing antitax sentiment.


But such sentiment may fade as the economy recovers or become less important if Democrats regain control of the House of Representatives.


Moreover, the Court decision affirms that Congress can facilitate passage of a tax by calling it something less controversial.

How about you call it a "fine"? That's the usual term for a financial punishment for not obeying the government. Or would calling something by its name be too "controversial" for you?

The Court has highlighted an opportunity for passing creative new public health laws, authorized by the taxing power; this opportunity now awaits its political moment.

It never ends, folks. It's us or them. I can only quote those great lines from CS Lewis which appear on the sidebar of this blog:

"It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."


Jean Granville said...

Tax is the weak spot of liberal democracy. You can tax whatever you want the amount you want, and you can punish people as harshly as you want if they don't pay.
I don't know about the ruling you are refering to, but it seems to me that this judge is a very bad constitutionalist. The power of taxation should be considered as implicitly limited according to the rules that limit the power of government in other respects. Not the other way around.
Of course, if we start to look at it this way, the problem is that most democracies have already gone far beyond such limits in many fields.

nisakiman said...

On this occasion, words fail me...

Ivan D said...

I know that you are not a big fan of comparisons with totalitarian regimes of the 20th century Chris, but it is getting harder and harder to resist making them.

Eric Crampton said...

It isn't surprising that some doctors would like to do this. More worrying is that the NEJM is publishing this kind of dreck now.

Ivan D said...

This is the journal that published Pell's fraudulent heart attack miracle and her ridiculous asthma paper. Editorial standards do not appear to be its strong point.

Anonymous said...

Needless to say Judge Roberts its the most hated man in america now-a-days unless your a communist. But whats striking is Roberts was totally against the obamacare law and even told other jurists then out of the blue the day before the final vote he changes his mind!

Anonymous said...

Report: Dalli middleman asked for €60mn
Today @ 12:58

.Mouth-tobacco producer Swedish Match has told Swedish paper Aftonbladet that a middleman for former EU commissioner John Dalli asked for €10 million immediately and a further €50 million later on to lift an EU ban on export of the product. Dalli has accused the firm of entrapment.

Only one thing this could have meant,the bribe was so big every underling at the EU COMISSION was going to get a piece of the action!