Today’s Washington Examiner has an article about the concerns that Gun Owners of America has raised about the health care bill which is currently on the Senate floor. I am quoted therein, and I think that GOA has a good point. The Examiner article concludes with a contrary quote:
“It is very clear they are misreading the bill,” said Igor Volsky, a health care researcher for the Center for American Progress, a liberal think tank. “All this bill does is define what a wellness program is. It is a broad definition, but it is not broad enough to net gun ownership.”
Let’s look at the bill. The rules for a “Wellness Program” begin on page 87. In brief, if you participate in a Wellness Program, you can get a health insurance premium discount of up to 30%. Stated another way, if you don’t participate in a Wellness Program, you will pay a substantial insurance rate penalty for not doing so. The definition of a “Wellness Program” begins in paragraph (B) on page 88:
“(B) The wellness program shall be reasonably designed to promote health or prevent disease. A program complies with the preceding sentence if the program has a reasonable chance of improving the health of, or preventing disease in, participating individuals and it is not overly burdensome, is not a subterfuge for discriminating based on a health status factor, and is not highly suspect in the method chosen to promote health or prevent disease.”
This definition is extremely broad, and the assertion that it is not broad enough to encompass gun ownership appears to be incorrect. There is a very large body of “public health” scholarship which claims to show that gun ownership is a very large health risk to the family that has a gun in the home. I believe that much of this scholarship is of poor quality, and some of it is mere junk science. However, the existence of dozens of articles in public health and medical journals would almost certainly be enough for an anti-gun definition of “Wellness Program” by the Dept. of Health and Human Services to pass the deferential Chevron standard of review.
A regulation which said that a Wellness Program may (or “shall”) include a discount for not owning a gun (or not owning a handgun, or not owning a so-called “assault weapon”, or for not owning more than a certain number of guns) might be argued to be “overly burdensome.” But there’s no guarantee that a reviewing court would consider a mere discount for people who don’t own guns to be “overly” burdensome on gun owners.
Pages 29-30 of the Reid bill mention some of items that “Wellness and Prevention Programs” “may include.” The phrasing does not appear to exclude other items. In any case, the item for “Healthy lifestyle support” is broad enough to include almost anything.
To be clear: Senator Reid has a strong record on Second Amendment issues. When he was Minority Leader, he provided essential leadership for passage of the Protection of Lawful Commerce in Arms Act. I am certain that there was no intent by Senator Reid to do anything in the health bill to harm Second Amendment rights.
However, the bill would in fact make it easy for a HHS Secretary to write “wellness” program regulations which penalize some or all gun owners. I think it is politically unlikely that HHS Secretary Sebelius would immediately write such regulations. But since the Reid bill is intended to make permanent changes in American health care, no-one can predict what a HHS Secretary might do in 10 or 30 years, when political calculations might be different.
Solving the problem would be easy. Since Senator Reid has no intention of harming Second Amendment rights (or, presumably, of harming anything else in the Bill of Rights), there would appear to be little reason not to explicitly say so in the bill. An amendment might say something like: “No wellness program, nor anything else in this bill or any regulation, policy, or practice thereunder, may create any discount or any other incentive that discourages the ownership, possession, use, or carrying of firearms, air guns, or ammunition, or of any type or quantity of firearms, air guns, or ammunition. This aforesaid prohibition shall be broadly construed, and in case any conflict with any other provision of this bill, the prohibition shall control. Further, the prohibition on incentives against the exercise of constitutional rights shall also protect the exercise of each and every right in Amendments I through VIII of the United States Constitution.”
Undoubtedly a professional legislative drafter could write a better version of above. Explicit rights protection would prevent a future HHS Secretary from misusing the law in a way contrary to the intent of the sponsor, and contrary to what every advocate for the bill claims to want. At the same time, explicit rights protection would limit not one iota of what the bill’s advocates say they want to accomplish. Accordingly, one might expect that a rights protection amendment with strong and broad language would earn unanimous support if it were offered on the Senate floor.
bob says:
Gosh, giving a discount to people who don’t have guns in their house (and are thus much less likely to be injured by guns) is almost as insane as requiring people who drive cars to carry insurance.
November 24, 2009, 12:22 pmAllan says:
Hrumph. This provision is 2A neutral.
Your point that a wellness program could give discounts for not owning a firearm might be right.
But just as easily, wellness programs could include owning a gun. Indeed, if you ran the program it would. Your position has consistently been that individual ownership (and concealed carrying) reduces crime. Reduced crime means fewer shooting victims. Fewere shooting victims means less spent caring for shooting victims. Thus, owning and carrying a firearm is a net health care winner.
The provision can easily go both ways. Therefore, it is 2A neutral.
November 24, 2009, 12:23 pmGabriel McCall says:
A program complies with the preceding sentence if the program has a reasonable chance of improving the health of, or preventing disease in, participating individuals
The fact that preventing disease is specified separately from improving health makes it impossible to argue that preventing injury can be inferred within improving health. Non-gun-ownership does not either improve health or prevent disease. There’s an argument to be made that it may prevent injury, but that argument does not satisfy the conditions of the statute.
[DK: Avoiding serious physical injuries or premature death does not count as one way to "improve health"? Much later in the bill, there's a Wellness counseling program for people on Medicare, and that includes fall prevention. So it does not seem plausible that injury prevention is excluded from "wellness."]
November 24, 2009, 12:36 pmwlpeak says:
Isn’t the problem larger than just the 2A? Couldn’t any behavior be classified as ‘unhealthy’?
Couldn’t some hypothetical future evil conservative administration declare homosexuality unhealthy?
Couldn’t some hypothetical future evil liberal administration declare radio unhealthy?
Where is the limit? Wouldn’t it be easier to define a wellness program as one that promotes any of several health promoting choices? Or better yet, wouldn’t it be better just to let the private actors figure this all out for themselves?
November 24, 2009, 12:40 pmMalvolio says:
3/10 troll.
November 24, 2009, 12:41 pmBama 1L says:
Wellness programs already exist. Do any of them include measures aimed at reducing risk of accidental harm? I’d love to see one example.
November 24, 2009, 12:42 pmAllan Walstad says:
Sure, and so let’s give a discount if you don’t have (and are thus less likely to be injured by) knives, screwdrivers, lawnmowers, chain saws, pets, stairs to fall down, bath tubs to slip and fall in, scatter rugs to slip and fall on, electricity to get electrocuted by, hot water to get scalded by, stoves to get burnt by, buckets that toddlers can fall and drown in….
Better yet, get the feds’ noses and sticky fingers the hell out of this business.
November 24, 2009, 12:54 pmGene Madison says:
How can the 2nd Amendment be in danger by a power congress was never delegated?
Committee’s used to be created in order to propose amendments to a New Bill, in answer to a question.
The committee of the whole (or entire house) would vote on each amendment, and each representative was properly held accountable to every part. (None of that “oh, I didn’t like that either, but had to consider the whole, and not any one part.)
November 24, 2009, 1:04 pmJKB says:
Far more preventive would be to give a discount for children and individuals not participating in football programs. Childhood and college football participation is direct cause of expensive late in life knee replacements.
If they are going for guns, we might as well go for everything. Football is easily replaced with other sports but self-protection is harder achieve.
November 24, 2009, 1:06 pmJohn says:
I would think that those who do not have guns in their homes should not get the discount because they are more likely to be harmed by criminals.
November 24, 2009, 1:15 pmPreferred Customer says:
One might argue that it is much better from a 2A perspective to have the feds’ noses and sticky fingers in this business than private insurance companies. After all, if a private insurance company looks at the data and concludes that there is a higher actuarial risk for gun owners, it might decide to charge higher premiums or just stop offering insurance altogether to this cohort of people. Since there’s no state action there, you’ve got no claim that the private company is violating your rights (absent some sort of statute that gives that kind of protection). At least if the feds are doing it you have a plausible claim that denial of benefits = denial of a federally protected right.
November 24, 2009, 1:30 pmAnon says:
“However, the bill would in fact make it easy for a HHS Secretary to write “wellness” program regulations which penalize some or all gun owners.”
Certainly, but this isn’t limited to gun owners. Also applies to motorcyclists, bicyclists, horseback riders, skiers, rock climbers, football players, etc., to any activity that might involve a risk of injury.
The HHS gets significant rulemaking power here — a huge amount of deference.
Of course, as long as the “right” people are in charge, they won’t abuse that authority, right?
I feel healthier already.
November 24, 2009, 1:38 pmCountDuckula says:
Of course not. If you avoid an injury, how is your health IMPROVED? It isn’t. It just hasn’t gotten worse. You’d have to be intentionally twisting the English language to argue otherwise.
I mean, how many injuries do you avoid every second? Your health must be infinitely good by now! Every time you move part of your body, you’ve avoided pulling a muscle!
Oh look, I just stood up! I avoided falling down while standing up, so my health just improved. I took a step without pulling my hamstring, so my health just improved again!
So is “gun safety” included in any of these wellness programs? No? Then maybe we should read that explicit provision as unique to that explicit provision.
November 24, 2009, 1:40 pmPubliusFL says:
On the other hand, there are so many gun owners that that market forces would ensure that the higher premiums would only stand if they actually were closely related to a genuinely higher risk. Otherwise some insurance companies would realize that they could win the business of all the millions of gun owners by refusing to engage in irrational price discrimination.
November 24, 2009, 1:40 pmTheBadness says:
Hunting: an activity that can promote health and wellness by encouraging participants to get out of the car and tramp into field or forest, often climbing trees and/or building blinds. Quite active by parts, if not by whole.
Bonus points for bringing participants closer to nature and garnering proper appreciation for wild and open spaces.
Extra bonus points for promoting family togetherness, presuming dad/mom is teaching father/daughter how to do the hunting. Plus, most game is low in fat (as compared to farmed meat) and, where not endangered or on the cusp, a sustainable resource.
November 24, 2009, 1:41 pmAnon says:
Preferred Customer:
I trust the greedy insurance companies to maximize profit by insuring my high-risk activities. That’s a feature, not a bug.
They’ll only deny coverage to a cohort if the government restricts the rates they can charge or changes the “bet” after the fact. See, e.g., homeowner insurance companies pulling out of Louisiana.
November 24, 2009, 1:43 pmOff Kilter says:
I think there’s another big problem. It has become common and expected among primary care providers, especially pediatricians, to ask if there are guns in the house. I would hope any gun owner with half a brain, already knowing gun safety practices far better than the average non-gun-owning physician, says, “No.” So far, lying to your physician is not a crime.
But if lying grants you a financial benefit, does it not become a crime?
November 24, 2009, 1:45 pmCountDuckula says:
Or maybe that’s an absurd, obstructionist, “light-most-damaging” way of reading the bill that no sensible person would engage in unless he simply looking for excuses to oppose the bill?
November 24, 2009, 1:45 pmOrder of the Coif says:
We have a wellness program. I just lied on the questionnaire.
November 24, 2009, 1:46 pmMy Constitutionally protected conduct (like Mr. Lawrence’s) is nobody’s business but my own.
Gabriel McCall says:
[DK: Avoiding serious physical injuries or premature death does not count as one way to “improve health”? Much later in the bill, there’s a Wellness counseling program for people on Medicare, and that includes fall prevention. So it does not seem plausible that injury prevention is excluded from “wellness.”]
No. If someone is healthy, selling his guns will not make him more healthy. If someone is sick, selling his guns will not make him any better. It may remove a potential cause of future health reduction, but that is not the same thing as improving his health.
It’s important to note that disease prevention is specified separately from health improvement in the text of the bill. “The wellness program shall be reasonably designed to promote health or prevent disease.” The wellness program must have “a reasonable chance of improving the health of, or preventing disease in, participating individuals”. Under the definitions you want to use, it would be reasonable to think that preventing disease was synonymous with improving or promoting health, but if this were the case there would be no need to specify disease prevention separately. If disease prevention is not part of promoting or improving health, then by the same logic neither is injury prevention.
I would argue that fall prevention counseling also does not satisfy the language of “improving the health of, or preventing disease in, participating individuals”, but since I don’t know whether that program is intended to fall within the definition of “A Wellness Program” as we are discussing here, I can’t tell whether that’s an inconsistency within the bill or merely irrelevant.
November 24, 2009, 1:46 pmCountDuckula says:
LOL
laughing is supposed to be good for one’s health, so i thank you.
November 24, 2009, 1:46 pmADF Alliance Alert » “Health” bill provisions could endanger gun ownership says:
[...] Kopel has this post at the Volokh Conspiracy discussing how the health care bill could impact 2nd Amendment rights. Gun Owners of America has [...]
November 24, 2009, 1:47 pmCountDuckula says:
I wasn’t aware that insurance fraud was Constitutionally-protected conduct.
November 24, 2009, 1:47 pmwhit says:
my agency has a wellness program and we are required to participate (questionnaire, etc.) if we want to retain the best coverage. they ask if there is a gun in the household. i just find that ironic. we are a police dept. i would assume nearly every member has a gun in the home.
November 24, 2009, 1:49 pmJPG says:
No doubt, gun ownership increases the odds a gun related wound will occur. To assume, however, the risk is statistically significant – in consideration to the great pool of health hazards – is another thing. Yet, David Kopel seems to think the Wellness Program, or those who might rely on it, make(s) that assumption. I see no indication such is the case. Also, a distinction could be made between gun possession and access to guns, on many different levels.
I see no story here…
November 24, 2009, 1:52 pmPreferred Customer says:
True…but that assumes that 1) accurate and meaningful data can be compiled on this issue; to the extent it cannot an insurance company might err on the side of not insuring; and 2) the costs prevented by handgun/gun ownership are not external to the costs covered by the insurance (IOW, if handguns make it substantially less likely that one will be attacked/robbed but make it more likely that one will be injured accidentally, which seems facially plausible).
November 24, 2009, 1:52 pmDavid Nieporent says:
1) With a private company, there’s competition; if one doesn’t like what such a company does, one can go elsewhere.
November 24, 2009, 1:53 pm2) If there’s really a higher actuarial risk, then they should charge higher premiums; that’s a feature, not a bug.
3) A private insurance company is more likely to “look at the data” and make a decision based on it, whereas a government-run one is likely to take politics into account.
AlanW says:
Dude, sometimes a wellness plan is just a cigar…
As someone who mountain bikes, whitewater kayaks, backcountry skis and runs in cougar-infested woods (all activities that are probably more dangerous than they are healthy), I think taking gun rights as the starting place for your Big Brother paranoia is a leap of Bob Beamonesque proportions.
There must be more productive ways for you to spend your time.
November 24, 2009, 1:56 pmShelbyC says:
If private companies want to look at data and how it affects actuarial risk, fine. Folks are worried about the HHS secretary acting for political reasons, not actuarial ones.
November 24, 2009, 2:12 pmroad2serfdom says:
As usual on VC: Some opponents, group 1, saying of course people should be charged more if they have a gun. Others, group 2, saying you are paronoid that this would happen, that is crazy talk.
There is a history of a group of doctors and bureaucrats using “health” as a pretext for anti-gun actions. Not so much with pools. The real world risk factors do not matter to them.
If it is a non-issue as group 2 claims, why not add the ammendment? No harm in it right? Unless you are really in group 1.
November 24, 2009, 2:12 pmShelbyC says:
But there’s not a political lobby dedicated to banning any of those activities, is there? I’ll betya that “cigar” hurts when they shove it in.
November 24, 2009, 2:14 pmAllan Walstad says:
AlanW–I get that you engage in outdoor activities and gratuitous insults. Thanks for sharing.
November 24, 2009, 2:20 pmAllan says:
The secretary of HHS might take action for political reasons? How dare anyone raise such an assertion. That would be like accusing the secretary of the Interior having political goals. Former secretaries Watt, Babbit, and Norton certainly only acted in the best interests of the country.
And there are those who trust the actuaries? They, too, can be politicized. Anyone remember the battles involving the Social Security Administration’s chief actuary?
November 24, 2009, 2:21 pmAllan Walstad says:
Preferred Customer: If a private insurance company does not want to sell me insurance, or wants to charge me more because I own guns, I accept their right to do as they see fit with their own resources. “Win-win or no deal.” I also do have a fair amount of confidence that competition among insurance companies will give me alternatives. No one insurance company can force me to do business with them. The same is not true with regard to the feds. Kopel’s point is well taken, that vague bureaucrat-empowering language is subject to abuse year-in and year-out.
November 24, 2009, 2:26 pmChrisTS says:
Could this [unlikely] problem be precluded by a requirement that precise contents of such programs be submitted for Congressional approval? Or, is that not doable?
November 24, 2009, 2:31 pmegd says:
Really? Can you point out a study that has shown this? Perhaps analyzing the number of accidental gunshot injuries against the number of self-defense related gunshot injuries? I’d love to see the study that shows gun ownership increases the odds of suffering a gunshot wound.
For those questioning whether gun safety and wellness are coupled, a quick google search turned up these two sites (inter alia), clearly including gun safety (trigger locks, safe practices) under the heading of “wellness.”
If locking up guns is considered a component of a “wellness program,” could the U.S. government require individuals to adopt safe gun practices as a condition of receiving a government benefit? I think the answer clearly is “yes.” Whether the government could restrict the ownership of guns under this program is less clear.
November 24, 2009, 2:31 pmPubliusFL says:
And write off the business of the 30-40% of U.S. households that own guns? Yeah, I can’t see that prospect prevailing in much of the market for very long. A few companies, perhaps, but others will see a lot of opportunity to profit from the overcaution of those few. And to the extent that gun ownership really does present a measurable increased risk for medical expenses due to accidental injuries, then slightly increased premiums are justifiable, as Mr. Nieporent points out. I trust insurance companies to make that determination on an empirical rather than political basis more than government bureaucrats. In any event, is anyone aware of any reason health insurance companies would be prohibited from taking gun ownership into account in pricing premiums or determining exclusions now?
November 24, 2009, 2:37 pmGordo says:
My question for the gun rights advocates here: I know you don’t think there is any empirical evidence that a gun owner is more likely to need health care than a non-gun owner, but if there were incontrovertible evidence, such as with smoking or not wearing seat belts, that there was a correlation between gun ownership and home possession and higher medical bills, why would you object to higher insurance premiums for such people?
Would you want the rest of us to subsidize your unhealthy behavior?
November 24, 2009, 2:41 pmGordo says:
The reason I’m asking is that, in the situation I described above, David Kopel’s proposed amendment would REQUIRE the rest of us to subsidize the unhealthy behaviors of gun owners.
November 24, 2009, 2:42 pmYankev says:
Why 3/10?
November 24, 2009, 2:44 pmseattle law student says:
Well I know that people in houses with only one level pay less for insurance than people with stairs… Also I personally am charged more for insurance because part of our house (the mud room) is still wired with knob and tube wiring.
November 24, 2009, 2:48 pmYankev says:
Perhaps they had in mind the military, rather than civilian, definition. Few of us have those in our homes, even those of us who own firearms.
November 24, 2009, 2:48 pmFederal Farmer says:
I’m not sure you’d be charged with fraud, however. The most likely outcome is if you get injured by your gun somehow they might try to avoid covering the injury. Oh wait…kindler, gentler now…I forgot.
November 24, 2009, 2:50 pmShelbyC says:
Of course the secretary of HHS will take actions for political reasons, as you seem to agree. And the whole problem here is that the bill allows the price of insurance to be based on political consderations, not economic ones.
November 24, 2009, 2:50 pmFederal Farmer says:
If it were somehow proved with science, not bias, as we see too often today, I, for one, would agree to a higher premium. I wonder why I have to support the unhealthy lifestyle of sport fanatics who sustain injuries quite frequently.
November 24, 2009, 2:52 pmGene Madison says:
Never understood under which power allows congress to delegate it’s legislative powers to others?
November 24, 2009, 2:59 pmClayton E. Cramer says:
If the nanny-staters were 2A neutral, you would be right. But they aren’t, so you are wrong.
November 24, 2009, 3:27 pmwolfefan says:
This is an example of why back during the “read the bill” discussions, folks who said bills should be concisely written in plain language that is accessible to all were, IMHO, dreamers. To deal with DK’s objection and similar objections regarding other activities, possessions, etc. would require a comprehensive listing of exactly what activities and the like are or are not prohibited and what precisely is meant by the words “wellness program” that would never be complete enough to answer all conceivable objections.
How would “accepted public meaning” approaches to interpretation apply here? IANAL – is there a different approach to interpretation at this level? Does the public at large think of a wellness program as somehow encompassing guns? The wellness program at my workplace is silent on the issue, but I need certification from my MD (as opposed to my firearms instructor) if I wish to participate. I suspect most other wellness programs are similar.
November 24, 2009, 3:28 pmNick B says:
So, what makes anyone think that in 50-100 years “no” can’t be misconstrued to mean “every” by a professional politician, who finds it in their interest? For the last 50 years “shall not infringe” has been taken to mean “do whatever you wish”.
November 24, 2009, 3:30 pmNick
Clayton E. Cramer says:
There’s absolutely no question that homosexuality is in that category–and not just because of AIDS. Homosexual men are about 2% of the population–yet they are 63% of all new syphilis cases. But you know darn well that HHS isn’t going to suggest gay men should pay higher premiums because of this risky behavior. So it really boils down to this: should the government, which responds to political pressure from well-organized lobbying groups, have authority to tell us what we can and can’t do?
November 24, 2009, 3:33 pmMalvolio says:
You mean, why isn’t it higher? Putting “Gosh” at the beginning telegraphs the troll and put parenthesis around the false part just makes it more obvious.
Why isn’t it lower? Because it was brief and brevity is the soul of wit.
November 24, 2009, 3:37 pmShelbyC says:
Er, maybe a little clarification of the scope of this question?
November 24, 2009, 3:44 pmSeaDrive says:
I think the statistics on suicide by firearm are pretty convincing, even without a formal analysis.
Of course, a successful suicide attempt doesn’t increase health care costs, but an unsuccessful attempt may be very costly.
November 24, 2009, 3:47 pmGabriel McCall says:
I think the statistics on suicide by firearm are pretty convincing, even without a formal analysis.
Not convincing unless you assume that someone who wants to commit suicide but cannot find a gun will just give up rather than choosing some other method.
November 24, 2009, 3:53 pmAnthony says:
Let’s say that solid actuarial evidence existed that gun ownership increased risk. For what reason should insurance companies be forbidden to raise your rates based on this fact? It’s not like being a gun owner is an involuntary status, nor does gun ownership have the normal trappings of a religion. In addition, as long as multiple wellness programs exist, does it matter if some of them forbid gun ownership? Presumably, the market would solve that problem one way or another.
In practice, this looks like a paranoid conspiracy theory seeking to drum up opposition to the health care bill, not a legitimate worry about gun rights. Protest when someone actually tries to write up such regulations.
November 24, 2009, 4:34 pmClayton E. Cramer says:
Okay. If the government has authority to set insurance rates because of risky behaviors, then they need to be consistent about this–and they need to be honest about risks. There are a number of behaviors that increase risk, and yet those that involve sexual behavior or IV drug abuse are not going to be treated the same as gun ownership.
November 24, 2009, 4:50 pmClayton E. Cramer says:
I agree that at this point, it’s more of a future danger than an immediate likely risk. Imagine, however, if there was a recent history of elites publishing articles in public health journals that argued that homosexuality and associated public health problems were an epidemic that needed governmental action to stop, and social conservatives had written this bill. Would it be paranoid to be concerned that they were going to use similar language in such a way?
November 24, 2009, 4:53 pmClayton E. Cramer says:
It turns out that a number of studies have been conducted of the effects of gun control on suicide rates, and most conclude that it changes only the method, not the result. (Gary Kleck’s Point Blank summarizes such studies.) One reason is that many other methods of suicide (hanging, throwing yourself off buildings or bridges) are only slightly less effective than guns. It turns out that the popular imagination overestimates the effectiveness of guns for suicide (although survivors are sometimes severely maimed by it), and underestimates the effectiveness of other methods. There is also reason to think that some of the low effectiveness methods are picked by those crying out for help, as opposed to seriously trying to kill themselves.
One example is what happened in D.C. after the 1976 handgun freeze went into effect. There was a pretty dramatic reduction in gun suicides–but non-gun suicides rose at the same time. Adjusting for population change (which gun control advocates seemed to have missed when they were writing papers on the subject), the net reduction in suicides was a statistically insignificant 1.5%.
November 24, 2009, 5:00 pmzippypinhead says:
I think there’s a pretty good argument that under Heller, any Federally-sponsored (or after McDonald, state-sponsored) “wellness” program that overtly discriminates against one’s Second Amendment right to keep firearms in the home for self-defense should be struck down. The problem, unfortunately, is that other than a “public option” health plan or OPM-negotiated plans that cover public employees, there would be a counter-argument that “wellness program” price discrimination against firearms owners is fundamentally private activity by participating health insurers.
Though this post did make me wonder if the swimming pool manufacturers’ trade association ought to be up in arms (pun intended) about the likelihood that a health insurance “wellness” program might penalize insureds who are reckless enough to own or use the unduly hazardous product their members sell?
November 24, 2009, 5:01 pmAnthony says:
It’s not paranoid to think people might try to make use of this bill for any of a variety of unsavory purposes. It’s just grossly unlikely to work, at least with substantial popular support, and if that popular support exists, amending the bill to eliminate a bothersome requirement wouldn’t be hard.
November 24, 2009, 5:09 pmFederal Farmer says:
What if they “Hide the Decline”? Not like that’s never happened before…
November 24, 2009, 5:11 pmeyesay says:
Order of the Coif wrote: “I just lied on the questionnaire. My Constitutionally protected conduct (like Mr. Lawrence’s) is nobody’s business but my own.”
Many life insurance policies ask if the insured is a general aviation pilot. I would not relish being the widow of a general aviation pilot trying to collect on a life insurance policy obtained under false pretenses of not being a general aviation pilot.
November 24, 2009, 5:24 pmeyesay says:
Clayton E. Cramer wrote, “… the net reduction in suicides was a statistically insignificant 1.5%.”
Not to weigh in on the merits of your argument, but please be aware that there is a difference between statistical significance and practical significance. A 1.5% reduction may be practically insignificant, but if the statistical difference is not just noise (random fluctuations) then the effect is statistically significant.
November 24, 2009, 5:35 pmDan Weber says:
Is there anything stopping (say) the NRA from making their own wellness plan, if all the other ones suck for gun owners? They can easily meet the other definitions of a wellness program while remaining agnostic about guns.
November 24, 2009, 5:45 pmeyesay says:
David Kopel wrote, “I think it is politically unlikely that HHS Secretary Sebelius would immediately write such regulations. But since the Reid bill is intended to make permanent changes in American health care, no-one can predict what a HHS Secretary might do in 10 or 30 years, when political calculations might be different.”
Gosh, why are you so worried about this? Handgun ownership rights are strongly ascendant right now. The Supreme Court has reversed the decades-old theory that the Second Amendment guarantees a collective right, and declared that the Second Amendment guarantees an individual right. A growing fraction of U.S. citizens are handgun owners, and this is not likely to change, if only because the guns have a long service life.
But if, against all odds, the politics change, and most Americans become non-owners of handguns and decide that the risks of gun ownership outweigh the benefits, and if many years from now, it becomes clear that gun ownership is a measurable health hazard, what is the big deal if insurance companies give a discount to gun owners, just as they do now for nonsmokers, consistent seat-belt wearers, and those who do or don’t practice certain other behaviors?
November 24, 2009, 5:46 pmInstapundit » Blog Archive » HEALTH CARE BILL bad for gun owners?… says:
[...] HEALTH CARE BILL bad for gun owners? [...]
November 24, 2009, 6:17 pmThe GOA Position on Health Care | Snowflakes in Hell says:
[...] Dave Kopel has a look at the subject, and doesn’t think GOA is nuts on this one. The question for gun rights groups is whether they want to insert themselves into a contentious political debate over something that’s only tangentially related to their single issue. I think it can go either way, so while I’m normally not very complimentary of GOA’s political acumen, I don’t think they are wrong for raising concerns about what affect a massive government health care bill is going to have on our Second Amendment rights, even if the implications are only theoretical at this point. [...]
November 24, 2009, 6:28 pmNobody Really says:
There a few problems with this. First, it isn’t allowed for other types of risks (no pre-existing conditions are allowed to raise rates or exclude coverage) so actuarial risk is just not a factor in this bill, so to single out gun ownership is strictly political. Homosexuality or Pool ownership, despite their well documented actuarial risks to health care costs would never be tolerated.
Second, although it isn’t a religion, it is an equally protected Constitutional right, so it would seem that determining risk factors based on it by *government* action is highly questionable.
The bottom line, regardless of any specific 2A issue, is that this clause is a back door to allow discrimination of health care prices (up to 30% of the total price) based on whatever an appointed government official decides is appropriate, with very broad power. There is no requirement of consistency. Enter the politics.
The fact that such wellness programs will be offered by the free market is rather besides the point, since the Government has to decide what qualifies.
November 24, 2009, 6:46 pmPCP Doc says:
I think taking gun rights as the starting place for your Big Brother paranoia is a leap of Bob Beamonesque proportions.
There must be more productive ways for you to spend your time.
You are wrong. As a primary care doc for a couple decades I see that the bureaucratic glacier that slowly ground out cigarettes is now turning on guns. PCPs didn’t come up with those gun questions; a govt. functionary did. Gun owning hick rubes need to be molded by their betters. Doctors are now the agents of change. Get used to it.
November 24, 2009, 6:48 pmJPG says:
John is driving his car on the highway, whereas Mary plans to stay home and eat a sandwich. Which of Mary and John is more likely to have a car accident today?
Please note I didn’t address the statistical significance, which is another issue, but I guess you misread or I wasn’t clear.
November 24, 2009, 7:29 pmleesus says:
is this to be applied fairly? A swimming pool is a zillion times more dangerous than a handgun. Will there be discounts for not owning a pool? Same for sports. Gun injuries are dwarfed by sports injuries. Will we also raise rates for people that play sports?
Even worse: The gay community accounts for 90% of all AIDS cases. AIDS is whacking people faster than all the gun death combined, and is incredibly expensive to treat.
What is the legal take on that? Can they immediately rasie taxes on our gay friends because statistically they are riskier than gun ownership?
November 24, 2009, 7:35 pmDonald Sensing says:
I would argue that a homeowner who does not possess a firearm is much more likely to receive serious and expensive-to-treat injuries than a firearm owner. As John Lott showed, more than a million crimes are prevented each year by an intended victim merely brandishing a gun. Sounds like a health benefit to me.
November 24, 2009, 7:43 pmArthurKirkland says:
If access to a medical procedure such as abortion — which almost surely would reduce health care costs — is to be disadvantaged by health care legislation, why would it be more objectionable to disadvantage gun ownership? As with abortion, if gun ownership isn’t banned, what is the problem?
November 24, 2009, 7:44 pmAnthony says:
Does the bill have any clauses that forbid listing a home swimming pool as a factor in a wellness program? If not, why expect gun ownership to be noticed any more than anything else? It’s not that I particularly think gun ownership should be a factor in a wellness program, it’s that there’s no real need to mention gun ownership as a factor at all.
Incidentally, home hazards are already a factor for insurance — they affect your liability insurance rates just fine. I don’t have any philosophical problems with altering injury insurance rates based on owning a swimming pool, though I’m not sure it’s a good idea in practice.
November 24, 2009, 7:51 pmThe Volokh Conspiracy » Blog Archive » Health bill and gun ownership | Health Blog says:
[...] more: The Volokh Conspiracy » Blog Archive » Health bill and gun ownership Uncategorized a-good-point-, a-has-raised, america, care-bill, concerns, currently-on-the, [...]
November 24, 2009, 7:56 pmPurple Kooaid says:
how are you avoiding the pesky question of “Do you own a gun”. I’m changing pediatricians and the new questionnaire asks. My only dilemma is I live in a high crime city and afraid that if someone in the office sees I don’t own a gun, they might take advantage of this.
November 24, 2009, 8:00 pmKen Arromdee says:
Because there’s no similar anti-swimming-pool lobby pushing for swimming pool bans.
November 24, 2009, 8:18 pmdave says:
Bob comment 1,
once again an anti-gun nut ignores the very real daily use of guns for SELF DEFENSE, which is no less fitting a concept for overall ‘health improvement.’
My wife, who was shot to death a few years back by a man WITH a gun, might be much HEALTHIER today if she’d had one. Needless to say, I now have several, and my present wife is an excellent shot.
You buy car insurance to demonstrate RESPONSIBILITY for OTHER PEOPLE’S PROPERTY AND HEALTH, not to protect your own property or health. Whereas owning a gun is for one’s OWN protection. The analogy is absurd on its face, Bob.
November 24, 2009, 8:29 pmmpw280 says:
Can we penalize parents of teens that skateboard, roller blade, extreme pogo, or any of these other asinine “sports” that result in all those great videos on youtube? Also, by the same token if you are a member of a street gang you should be ineligible under the public option as well. mpw
November 24, 2009, 8:31 pmShelbyC says:
So you’d be ok with a law making health insurance more expensive for folks who don’t agree not to get an abortion?
November 24, 2009, 8:32 pmDon Meaker says:
When I was sued by my first ex-wife it was asked if I had guns. I said yes, and ran through the list of rifles and shotguns. The judge interupted, and said those aren’t guns. I ran through the list of pistols/revolvers. “Those are guns! Why do you have them?”
I answered “Because I am an American and I can. Because they are fun. Because they are useful. and I had some before I was divorced.”
“Why did you buy the 9mm for your {second} wife?”
“Because she is small, and had trouble with the .45″.
“That is reasonable.” the Judge intoned. Gosh I miss Texas.
November 24, 2009, 8:38 pmArthurKirkland says:
Where do the nanny-staters stand on same-sex marriage?
November 24, 2009, 8:51 pmArthurKirkland says:
I doubt it.
I see no reason to treat gun ownership differently from abortion in the context of being disadvantaged by health care reform.
November 24, 2009, 8:53 pmAnthony says:
Requirements should match the purposes of the bill. Since getting an abortion is far less of a health risk than actually having a baby (not to mention vastly cheaper), that’s contrary to the stated purpose of the measure, and thus inappropriate.
November 24, 2009, 9:02 pmJRH says:
We just finished our ‘Health Assessment’ questionnaires (or whatever it was called) at my employer. The only questions that I can recall that dealt with lifestyle (other than smoking and drinking) were questions about whether I ride motorcycles and how much I ride motorcycles. I ride a lot and I answered honestly. Now I’ll wait and see if they give me my ‘wellness discount’ anyway.
November 24, 2009, 9:17 pmAbogado says:
The correct response to the question from the pediatrician “do you own a gun?” is “none of your business.” Remember the doctors work for you, not the other way around. As least so far. The obvious solution to this is to prevent the passage of this ridiculous legislation. And if it passes the solution is to refuse to comply.
November 24, 2009, 9:21 pmKevin R.C. O'Brien says:
I have had gun questions on health questionnaires from the National Guard, the VA, and on the medical history form requested by my GP. I didn’t answer any of the questions. Indeed, I didn’t turn in any of the last five or six Guard questionnaires, and don’t reply to the VA’s stuff any more (or even open the envelopes).
But the hole in the law Kopel points out is bigger than just gun policy, although that seems to be a favorite line of jihad in the medical field this week. The whole new field of Healthcrime might including smoking (even other things than tobacco!), eating ice cream, or adventure sports, or risky sexual practices.
Once this bill passes, your body is a temple — for that peculiar religion that makes a god of government. The priests and pharisees get to decide how the temple will be cleaned and sanctified. Even if you like the tendency of one clan of priests, do you want to give them that power, in the knowledge that the other clan will get back in sooner or later?
November 24, 2009, 10:05 pmNobody Really says:
I agree, the health care legislation should not mandate that insurance cover purchasing a gun, nor should federal money be used to subsidize the purchasing of a gun, despite the fact that gun ownership may reduce the amount of crime victims making trips to the emergency room.
Now, for a more useful analogy, how would you feel if, due to the increased risk of infertility (treatment for which is more expensive than a typical healthy delivery), the bill allowed abortion to be considered a pre-existing condition entitling an increase in premium of close to 43% (that is the increase represented by a 30% discount)?
November 24, 2009, 10:17 pmrpt says:
In other words, health care reform will take away your guns. What’s the nextconservative interest group to get connected?
November 24, 2009, 11:45 pmSDN says:
80 million gun ownwers? I’d LOVE to have that market for insurance policies.
See, that’s the best thing about the private sector: if there’s a market, I can make money at it. And I can take my business elsewhere. Kind of hard to do that when Big Nanny Government is involved.
November 25, 2009, 9:17 amSeaDrive says:
The question was gun-shot injuries, not injuries due to suicide. In your scenario, not being able to find a gun avoids a gun shot injury.
November 25, 2009, 9:25 amYankev says:
I did not recognize this as 3 points out of 10; I wondered if there was a significance to March 10 that was escaping me.
November 25, 2009, 9:36 amYankev says:
You mean like the EEOC’s use of statistical disparity to “prove” discriminatory hiring practice, depsite legislation saying that statistical
November 25, 2009, 9:39 amdisparity is not proof?
Yankev says:
Don’t statistics show that suicide attempts by firearm are more likely to be successful? And given that end of life care is the most costly, you have just argued that gun ownership LOWERS societal health care expenditures.
I demand my gun owner’s discount!
November 25, 2009, 9:41 amYankev says:
Résumé
November 25, 2009, 9:44 am(Dorothy Parker)
Razors pain you;
Rivers are damp;
Acids stain you;
And drugs cause cramp.
Guns aren’t lawful;
Nooses give;
Gas smells awful;
You might as well live.
Yankev says:
Unless of course someone else finds a gun and discharges it in your direction. That’s what makes the arguments of rpt and others so silly.
November 25, 2009, 10:08 amMichael says:
Playing football is a great argument. You could say it does a good job of keeping one in shape as you one could say that palying football increases your risk of physical injury especially as one gets older. Would High Schools now be allowed to have a team? If they had one would they pay a penalty for it?
November 25, 2009, 10:19 amScrummie02 says:
Just lie. If they ask if you have a gun tell them nope. Problem solved. Unless they search your house how will they know?
November 25, 2009, 10:30 amGlenn Bowen says:
I bought a house, years ago, through a real estate agent; she was a naturalized citizen, having been born in Germany prior to WW2. When I asked her a little about being in Germany, she related the point that, after awhile, one had to be connected to the government/party in some way or another, to whatever degree, to get anything.
The “Wellness Program” is about control, manipulation, and punishment for not going along with the government before the gun issue even raises itself.
Fascism.
November 25, 2009, 10:33 amClayton E. Cramer says:
Generally (although not always) in support of it.
November 25, 2009, 11:39 amClayton E. Cramer says:
Not 90%. The numbers fluctuate a bit, but it is often about half of new AIDS cases. IV drug users and those who have sex with them are most of the other half.
November 25, 2009, 11:44 amRPT says:
I made no argument re gun law, only that this appears to be a political scare tactic argument why gun owners should oppose health care reform. My best client has a CA CCW permit. Why do infer so from a simple comment? It makes one think that there is some default position that anything any everything that you don’t like can be opposed because it will or might in some attenuated way “take away your guns”. I’m waiting for some newly revealed AGW email to be noted that proves the AGW people want to do so.
November 25, 2009, 11:54 amAnthony says:
If that number had any remote connection to the real expected cost to the insurance company (ignoring savings from not covering pregnancy and for surgical abortions often being used to avoid more expensive medical problems, the real cost is basically zero for medical abortions, very low for surgical abortions), it might be rational. Much the same applies to gun ownership: I don’t have any fundamental issue with people being expected to pay based on the real expected costs of gun ownership, but that cost is poorly known, almost certainly below 1% of overall health care, and for at least some people will be negative.
I wouldn’t object to a requirement that a wellness program must be able to show health effects comparable in magnitude to the savings. For the expected wellness programs (Don’t smoke! Maintain a healthy weight! Less salt! Protect yourself from the sun! Exercise!) that’s not a difficult bar to pass.
November 25, 2009, 12:34 pmYankev says:
Sorry, rpt, anyone who proffers the supposedly self evident proposition that gun owners are at greater risk of GSW than non-gun owners immediately makes me suspect their logic, data and intent.
November 25, 2009, 12:50 pms lee says:
And that insurance company would be looking at deeply flawed data or grossly misinterpreting existing data regarding the safety of homes with guns.
November 25, 2009, 1:05 pms lee says:
Merely having the gun in the house is not the contributing factor to the increased danger that might be present for occupants of the house. Much more important is the type of owner who is in possession of said gun. We find that it is the drug dealing criminal who ends up shooting or getting shot in the house with the gun and then gets included in the statistics that are cited by alarmists. Oh, can’t forget the suicides either, nevermind that they can just as easily commit suicide using a length of rope or a car in the garage.
November 25, 2009, 1:16 pmAnthony says:
Huh? It’s fairly obvious that it’s impossible to have a gun accident unless a gun is present, so a gun is clearly a contributing factor in risks of gun accidents. It’s just that gun accidents, while they make news when they happen, aren’t particularly common.
For those who are curious, the CDC did a study on health effects of firearms laws, and basically found inadequate data.
November 25, 2009, 1:34 pms lee says:
I got through most of the comments here but aren’t we all missing the real problem, the real flaw here?
These Wellness Programs and such don’t take into the fact that people perceive benefits or positives from some activities that can be called risky (such as mountain climbing, or smoking the occasional cigar). They only look at the negatives but don’t balance it with the positives that an individual may receive. We as individuals are constantly weighing the pros and cons to decide if it’s worth smoking that cigar with close friends, or taking a weekend to climb a new mountain for the adrenalin rush.
Am I wrong here? Because these programs only look at the negatives and do not weigh it against the positives for any one individual, these programs and the idea (logic?) they are based on seem flawed to me.
November 25, 2009, 1:34 pms lee says:
I think you are mistaking an enormously small and statistically insignificant increase in danger as something meaningful. Of course, unless you happen to be a drug dealing ex-con who needs some guns to protect your stash?
Are you referring to the common myth that guns are 43 times more likely to kill a family member than a criminal?
November 25, 2009, 1:40 pms lee says:
Off topic, I have to comment on how nice and civil the discussions on this site are compared to so many other websites. It’s really nice to not have to wade through a bunch of emotional intarweb screaming that is so common elsewhere. Love this website.
November 25, 2009, 1:44 pmAnthony says:
No, I am correctly observing that ‘small’ and ‘zero’ are not the same thing. If you want to claim it’s insignificant I’m not going to argue the point (it is, at least, below the threshold of convenient measurement), but it’s nonsensical to say the presence of a gun is never a contributing factor.
November 25, 2009, 2:12 pmJPG says:
I agree. I do not argue gun ownership significantly increases the risk a gun related incident will happen (compared to other – mostly environmental – factors), let alone in regards to global health issues. One would need to have seriously pissed some gods in this life or another to have such a bad karma (or be very imprudent) so that he/she gets a bullet in the leg from an accidental discharge. However infinitesimal the chances are this will happen to any gun owner today, they are greater than if no loaded weapon was involved, that’s for sure. Some justly point out owning guns deters gun related incidents from happening. While you can farely easily be documented, you’d have, in all fairness, to demonstrate gun ownership doesn’t statistically accentuate crime. In my opinion, too many parameters need to be taken into account for this to be done, therefore I’ll never be satisfied in a broad statistical perspective and I’m highly skeptical of any data that is shown to me from any side on this issue.
This being said, I do not consider guns to be significantly linked to actual health issues. David Kopel argues those in charge of Wellness Programs would/could use their programs as a way to promote an anti-gun agenda. I find that to be a wide stretch of the imagination, to be polite…
November 25, 2009, 2:17 pmBobba says:
Did anybody here actually read that section of the bill for himself or herself? That section is covered under the larger section defining what is considered discrimination based on health status. The 30% that it is talking about specifically refers to this: if a wellness program with an eligibility requirement based on a health status offers a value to the beneficiary exceeding 30% of cost of coverage, then it is in violation of being discriminatory.
It DOES NOT say – let’s give a 30% insurance discount to anybody with a wellness program! READ THE DAMN BILL, PEOPLE.
November 25, 2009, 2:27 pmSeaDrive says:
I’m on DK’s side on this one. There are many examples of elected representatives using areas of discretion allowed by law for political ends. The flip-flopping of policies based on abortion views is notorious. On the gun side, many states have passed gun control statues that lean heavily on the discretion of the local police chief, and the effective gun control climate is different from city to city within those states, and it changes based on the incumbent chief LEO. (So much from the rule of law, and not the rule of men!)
November 25, 2009, 2:31 pms lee says:
Hi Bobba :)
I don’t think anyone here is arguing about the percentage points – it could be 20%, it could be 50%. That is not the issue.
The issue is, can a broadly defined Wellness Program be used to discriminate against certain groups of people and unfairly penalize them by some percentage, say 30% in this case.
Sound fair?
November 25, 2009, 2:44 pmJPG says:
But those in charge of fighting crime rightly ough to have an effect on gun control. Guns and crimes are naturally linked to each other, on both sides of those who wish to fight crime and those who wish to commit crimes. What is the likeliest effect, in the worse case scenario, of these Wellness Programs on gun owners? They will be denied a 0.5% reduction on their primes if, and only if, those in charge truly insist on gun ownership being taken into account? Or maybe is there something I’m missing?
November 25, 2009, 2:46 pms lee says:
Putting aside crime statistics and criminal behavior studies, why 0.5%? Wouldn’t the failure to participate in a “wellness program” potentially disqualify you from up to 30% in savings?
What is the average savings in current health plans for individuals who qualify and participate in a wellness program?
November 25, 2009, 2:55 pmJPG says:
I’m simply assuming there would be different Wellness Programs with distinct targets. I guess we’d both agree a program granting the same benefits to a) an obese, chips-eating, booze drinker, sedentary drinker who doesn’t own a gun and b) a fit athlete, non-smoker who eats vegetables, seldom drinks and quit smoking, such program would call for some tweaking…
I made up the 0.5% figure since no one could argue gun ownership to be as meaningful (healthwise) to a sane a balanced diet, or exercise, thirty percent being a max to be reached, all probable programs considered as a whole. But I believe the figure is more likely to be a flat 0%.
November 25, 2009, 3:11 pmBobba says:
The analysis is entirely out of context to begin with. The part of the bill that it discusses is under a larger section that defines how a Wellness Program is considered discriminatory based on pre-existing health status. It does NOT say, as the analysis implies, “Let’s give a 30% insurance discount to people with a Wellness Program.”
And the 30% specifically refers to one TYPE of Wellness Plan that the section discusses, not ALL Wellness Plans. It refers to plans which target beneficiaries that meet a health status. What it is talking about is, IF an employer offers a rebate for programs that are specifically for, for example, diabetes, then it is considered discriminatory if that rebate exceeds 30% of employee cost of coverage. It does not say, an employer MUST offer a rebate of 30% for health insurance if an employee participates in a Wellness Plan. Again, the text in question here does NOT define a Wellness Plan. It defines what is considered DISCRIMINATORY in a Wellness Plan.
November 25, 2009, 3:13 pmRPT says:
I said nothing about this proposition. I have no such knowledge. I observed only that the “take any my guns” fear is being used as an argument against health care reform. Maybe it is a good argument, maybe not. You know better than I.
November 25, 2009, 3:20 pmSKI says:
Not in the context of the hyperventilating comments (see the charge of “fascism!” above). The bill puts limits on what PRIVATE insurance companies can discount based on “wellness criteria.
If we apply the twisted logic of this thread, the Government is actually LIMITING the discrimination that can happen towards gun owners. I say twisted because, as was pointed out above, the “logic” used ignores the plain language of the words.
November 25, 2009, 3:36 pmYankev says:
Churls just want to have guns.
November 25, 2009, 4:29 pmBrian K says:
That’s an easy question. people on this site like guns and don’t like abortion. it’s as simple as that. all the legal, moral, ethical backbending is little more than an attempt to justify what they already think.
November 25, 2009, 5:52 pmYankev says:
As far as legal, show me where abortion is mentioned in the bill of rights. As far as moral or ethical, show me where mere gun ownership terminates a life.
November 25, 2009, 6:21 pmGC83 says:
Do you mean to say that anti-gunners aren’t the most injured/killed by guns? Every male throughout my family’s history had been gun-owners, and none had ever been injured or killed by a gun. However one criminal was shot while breaking into my cousins garage. To say that merely owning a gun increases your chance of being injured by a gun is ludicris! I’d say that your chances of not being shot greatly increase when criminals know you’re armed. Of course there are those panzies who shouldn’t even hold a gun since their fear of them is enough for them to hurt themselves. Bob, i suggest that you post a sign in your yard expressing your anti-gun position which states that you have no weapons in your house. See how long it takes for some lunatic to rob your house. Those who have guns make your life alot safer, you’re just to ignorant to see it.
November 25, 2009, 6:57 pmGC83 says:
So legal, law abiding gun owners need to foot the bill, while the criminal gun owners pay nothing since they do not own any registered guns. Hmmmm, sounds fair to me. Was this part of the bill written by Bob?
November 25, 2009, 7:09 pmreadery says:
People will do what they will in 10 or 30 yars regardless of what we do today.
That said, I don’t think it’s helpful to limit the discussion specifically to gun ownership. A narrower definition of “wellness program” might be helpful to prevent new government oversight of a variety of personal conduct that has some correlation with health of survival but which lies outside of physical fitness, diet, preventative care, and similar specifically health-oriented programs.
November 25, 2009, 7:30 pmihealth 360 says:
I wonder if this “Wellness Program” includes filling the swimming pool with dirt or prohibiting teenagers from driving or outlawing McDonald’s or other more likely causes of health risk in the family.
November 26, 2009, 12:45 ams lee says:
We agree on this…
1) Wellness programs are defined in this bill (paragraph (B) on page 88).
2) Wellness programs may be used to provide a discount not to exceed a maximum of 30%.
What (I think) we are discussing is…
Whether the definition given in (1) is overly broad and can be used to discriminate against gun owners using some (questionable) research which concludes that gun ownership is a health risk.
Am I missing completely missing the point guys? I really don’t see what Bobba is pointing out.
November 26, 2009, 3:21 amGuy says:
Oh darn, you figured it out, AGW was just a trial run for the real plan – using universal healthcare to take away your guns.
Why do about a quarter of the people on this thread sound like this is being proposed? Nobody is proposing that wellness programs require you to not own a gun. People are worried that someone, somewhere, someday, might make such a proposal. Is it my imagination or are pro-gun people becoming increasingly paranoid as they become more powerful and more unchallenged? It’s like the ammo shortage because everyone thinks Obama’s going to outlaw guns, even though the Democrats learned long ago that they lose points in public opinion anytime the issue of guns comes up, and have made absolutely no indication whatsoever that they intend to push gun control.
Did you hear about the Stupak Amendment? Why you guys are making gun ownership rights look like they’re in imminent threat because of some distant action by some agency that might hypothetically decide a wellness program must require non-gun-ownership? That is incredibly speculative. Meanwhile the Democrats bent over backward and agreed to seriously marginalize abortion access (not speculatively- but in fact) just to get the bill passed.
November 26, 2009, 5:29 amJPG says:
Yes, you missed the entire limitative part of the provision, which is key to understand Bobba’s point on the wellness programs and was left out by David Kopel and his minions in this discussion…
November 26, 2009, 1:53 pmGene Madison says:
Providing a discount for doing something is a coersive technique, contrary to Liberty. It is equal to a fine to those who do not comply.
It will likely be used as a tool to reward campaign contributors. (By promoting the use of their products to receive the discount.)
A great deal of fraud like this already exists. Do you save money when you use your Kroger/safeway/Ralphs card? Or are those who don’t have such a card fined for not having it?
Most “Deals” aren’t deals… They’re just normally overpriced. That is why rebates were so popular… Most people forget to send it in…
If we have learned anything over time… It’s that government shouldn’t be incentivizing responsibility. Incentives for doing your job is ridiculus, and often leads to corruption.
November 26, 2009, 4:04 pmThere needs to be zero influence by congress in repaying campaign contributions with tax dollars.
Bobba says:
Like I keep saying, this section of the bill does not mandate, or even explicitly permit, giving a discount to anybody for participating in a Wellness Program. So how would the government penalise anybody for NOT participting in a Wellness Program? It doesn’t empower the government to give these discounts either.
The entire section is on prohibiting discriminatory practices in health benefits, and that quoted text above as well as the 30% is to define what would be considered a discriminatory Wellness Plan which an employer provides. The point is to prohibit discriminatory practices in the health benefits which private businesses offer their employees. In fact, the existence of this section might serve to eliminate wellness programs that discriminate based on gun ownership. Granted, without government subsidies on healthcare, this may be a non-issue. But then without this provision, private businesses would also be free to discriminate against beneficiaries based on arbitrary reasons which may or may not include gun ownership.
This entire context is something that Kopel failed to mention in his post above. And the fact that he suggested it can be used by HHS Secretary to penalise gun owners is plain laughable. The section doesn’t enable the HHS Secretary to impose discounts/penalties. It enables her to prohibit Wellness Programs that are discriminatory. There were Republicans, specifically in the Gang of 14, who collectively thought to themselves, “Are you nuts?” when it was suggested during the GOP-controlled Congress that they eliminate filibusters, because Republicans themselves have used filibusters and will probably be using them soon in the future. Well, all it takes is for a pro-gun ownership HHS Secretary to get in office and the existence of this section will enable him or her to make sure gun owners are not discriminated against in employer-provided wellness programs. Without this provision, however, there is less legal backing for him or her to do so.
In fact, the GOA flyer which the Washington Examiner quoted actually has more of a point than does Kopel. But Kopel likewise failed to mention the context of the message in the flyer. The connection that the GOA made between the bill and gun control is “post traumatic stress disorder or something similar”. Kopel himself, however, in his post above, uses the GOA to launch his message but makes a jump from healthcare to gun control without bothering to mention the link which the GOA made.
Kopel’s analysis here is a hackjob, plain and simple.
November 26, 2009, 5:00 pmGuy says:
I dunno if this makes any difference. People were worried about hypothetical actions of a future administration, right? So the gun control lobby could get Congress to mandate rebates in wellness programs for people who don’t own guns, it would just take one bill. This is no less bizarre a fear than the initial one suggested by Kopel’s analysis. Obviously, the sane response is to prevent this by voting down the health care bill, right?
November 27, 2009, 2:04 amBobba says:
That is a perfectly legitimate worry. Kopel could well have discussed the fact that this bill may be opening a floodgate of government decision-making in health care, but that’s not what he’s doing in his post above. In fact, the section of the bill in question empowers the administration to, if it so chooses, BAR private businesses from offering rebates in wellness programs for people who don’t own guns. The focus of that section of the bill is NOT to enable the government to offer discounts and rebates based on arbitrary and discriminatory reasons, the focus is to enable the government to prevent private businesses from doing just that. In light of government subsidies in healthcare, that is a good provision to have. But another likewise perfectly legitimate worry is that private businesses may offer rebates for not owning guns even if those rebates receive nothing from government subsidies. That could happen without any government health care reform whatsoever. The topic of Kopel’s analysis could easily be applied to private business practices, but that is a point that he does not bring up, nor does he bring up the fact that the section of the bill in question may actually be used to prevent discrimination against gun owners, because his message is opposition for government intervention. That’s all and well, but it’s entirely too dogmatic once you try to narrow the scope into the fine prints of a bill. And in this particular case, the analysis was simply out of context.
November 27, 2009, 3:36 amGuy says:
When will these people including Kople embrace the government and all the good it does?
November 27, 2009, 12:04 pmGordo says:
Here’s a good summary of this non-issue, which appears to be another chapter in the sequel to Hofstader’s “The Paranoid Style of American Politics.”
November 27, 2009, 12:25 pms lee says:
Can you spell it out for me? Which line on which page describes the limitative part that you are talking about?
I just went through the bill again at http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf and the sections describing the wellness program start on…
Page 84 line 15 (j) PROGRAMS OF HEALTH PROMOTION OR DISEASE PREVENTION
and continuing to
Page 85 line 12 (C) CONDITIONS BASED ON HEALTH STATUS FACTOR
and then specifically to
Page 87 line 6 (3) WELLNESS PROGRAMS SUBJECT TO REQUIREMENTS
Without quoting verbatim, here is what I am reading.
IF there is a wellness program, and IF a health status is a requirement of the program, then it MUST MEET the following 5 program REQUIREMENTS starting at page 87 line 14 (my summary)…
A) Discount can not exceed more than 30% of total cost unless Secretary of Labor, Health and Human Services, and the Treasury deem appropriate extending the discount up to a limit of 50% of total cost.
B) “The wellness program shall be reasonably designed to promote health or prevent disease”
C) Has to be available at least once a year.
D) Has to allow medical waivers.
E) Full disclosure of terms and reasonable alternative standards(?).
Requirement B) coupled with the loose definition of a wellness program is what troubles me.
Ok, I fully admit I may have missed something. So please point out this “limitative part” that you are both referring to because I don’t understand.
Signed,
November 28, 2009, 6:04 amKnucklehead :)
Dr. WEW says:
There is another answer you can give to the question: “None of your GD business!”
December 19, 2009, 11:22 amMike says:
Using the reasoning for giving discounts for people not having guns in the house then discounts should be given for not having having forks and spoons. Since the tools seems to be the problem lets remove the tool.
December 22, 2009, 7:08 pmLewsta says:
David Kopel argues those in charge of Wellness Programs would/could use their programs as a way to promote an anti-gun agenda. I find that to be a wide stretch of the imagination, to be polite…
I do not, and here, in part, is why: it is simple fact that, in the main, those vigourously promoting this sham of a health care bill are also, in the context of being elected leaders in this country, at LEAST as vehemently opposed to private gun ownership. On its face, I find this overlapping set disturbing.
add to this the fact that, to be legal to operate in the proposed healthcare insurance environment, ALL insurance policies MUST meet certain government mandated parameters, what we WILL surely be dealing with is NOT a free market scenario. (truth be told, though few want to see this, we do not have such a market now. NO ONE can sell a medical care insurance policy that does NOT include a large number of services which I, personally, will never call for, yet I MUST pay for them for others covered in the mandated pool of insureds (coverage such as contraception, substance abuse recovery, other types of “counselling”; further, I also am forced to pay for high risk activities engeged in by others in the pool, and which I avoid for various moral/health reasons, as smoking, unrestrained sexual activity, drug use, certain extreme sports activities. While I do not contribute to the risk pool being insured against, I am now FORCED, by government mandate, to bear the risk as though I were IN that class of insured. Is anyone here naive enough to think, given the present lack of free market insurance provision, this will suddenly change under this legislation? Might I enquire what mind-altering substance you have been ingesting?
This bill, at its root, has little to do with truly improving our healthcare industry, and everything to do with government expansion and control. Since those who promote this bill are, in the main, also opposed to private gun ownership, I see no stretch whatsoever in wanting to guard against any possibility that this monstrosity of legislation could, buried within it, contain provisions to pave the way for denial of our God-given rights as assured under the first thirteen ammandments to our Constitution. As someone already mentioned, “shall not be infringed” (our right to arms) has been conveniently tossed on the garbage heap of government control by special interest groups. Ever tried to get a Conceal Weapons Permit in California? Without one, I can’t even carry a loaded weapon in that strange republic. Not even in my car. There are also a number of weapons that state refuses to allow me to own, were I resident (I am not, and will not willingly become one until they rejoin the Union, what’s left of it). If government by the whim of those in power has brought California to that point, and that in not many years, why should I believe those wielding the power, and promoting this legislation, (and, meanwhile, also blatantly opposing MY right to arms) will NEVER use this legislation to do so? It would not surprise me in the least if this issue were one of the driving forces furthering this legislation. We’ve already learned of a few dozen rotten back-room deals to gain more votes for this farce, It is no stretch to think these same operatives, in their back room dealings, have wilfully determined to make room for the effective infringement of our right to arms as a part of the package.
Don’t believe me? Go and read the full text of the United Natioins Treaty on the Rights of the Child, which our fearless and unscrupulous leaders currently favour. Buried in the later parts of it are provisions that certainly WILL provide for the disarming of entire nations on the basis that “guns in homes are bad for children, therefor no one can have guns in their homes”. To carry it past the masses, the mantra “its for the children” will become ubiquitous. How different is that from “its for your health”?
Yes, healthcare in this nation needs reforming, but THIS treasonous lot of nonsense is NOT the answer. Our legislators are selling us down the river, using force, coercion, bribery, stealth. they are refusing to HEAR us, We the People. And anyone willing to completely trust our fearless leaders to do us nothing but good in this bill is delusional. There ARE soldiers, well armed, hidden within the wooden horse they are rolling toward us.
Before you call me paranoid, take a few days and read of the rise of the Third Reich earlier in the last century. Noot only bwithin Germany were the people asleep, but in the rest of the West as well. Some sounded the alarum, but no one wanted to hear it, so they were run off in shame. Imagine their surprise when the very things they had warned against came to pass. Harry Reid’s tactics in railroading this bill through the Senate have been deplorable, and, I rather suspect, illegal. I can only hope someone has the eyes to see how, and the spine to stand and call “enough”. But, somehow, I doubt this will happen in time.
December 23, 2009, 3:21 pmWolfman says:
To call Mr. Kopel’s concerns a “…wide stretch of the imagination” demonstrates a shocking lack of awareness of modern history and policy trends. Over the last thirty years or so, various leaders of the anti-gun/anti-freedom lobby have suggested making guns-and their banning-a public health issue, deliberately ignoring the positive role guns in private hands play in maintaining public order and providing voluminous misinformation to back up their position. Massachusetts-a state to which I am moving from far more gun-friendly Missouri-succeeded, through the activism of former attorneys general Scott Harshbarger and Thomas Reilly, in subjecting gun possession to scrutiny under “product safety” laws. More to the point, the “health care” legislation under consideration represents a massive increase in Federal government power, and given the history of misuse of the “public health” mantra to implement gun restrictions, it would be surprising if the proponents of this misbegotten legislation didn’t insert-either now or later-wording to harm the interests of gun owners. By now it should be abundantly clear that both House and Senate versions of this mess will do nothing meaningful to control costs, and much which will increase costs, and that controlling cost is not the objective of the bills-controlling US is the point. Step back from this a moment, and consider the notion that, in our Republic, we will be forced to purchase something-health insurance in this case-at the point of a gun, so to speak. Buy it or be fined (or go to jail). This is government at its coercive worst. “Gun control” is as natural a companion to coercive government as butter is to bread. The gun controllers never stop trolling for ways and means to implement their statist agenda, and this bill is a natural hiding place for just such deviltry.
December 26, 2009, 12:28 amTwisted Logic says:
Just because I’m paranoid doesn’t mean they’re not out to get me….
Sorry I do not buy any of the paranoia being portrayed here, in fact this is exactly why I left the NRA, this kind of single issue silliness and complete irrationality.
This is a non-issue and all justifications used to say otherwise (like so many above) make great case studies for abnormal psychology journals. Yes there are SOME people who want to take away guns, but until the 2nd amendment is abolished, stop the whining.
December 28, 2009, 1:27 pmDave Kopel’s Second Amendment Newsletter | The American Jingoist says:
[...] David Kopel The Volokh Conspiracy November 24, 2009 http://volokh.com/2009/11/24/health-bill-and-gun-ownership/ [...]
December 31, 2009, 7:31 pmBud Berry says:
You people are so far out in right field that you see a guy trying to grab your guns behind every tree.
March 26, 2010, 9:41 amWhat a waist of time. Do something constructive.
john says:
As my favorite saying goes “Better to have it and not need it than need it and not have it” and I’M NOT referring to the health care bill recently passed. Driving is a privilege, not a constitutional right. Try changing that and see what happens.
August 22, 2010, 9:41 amhow to make a gun says:
The thought process of some people just astounds me.
August 28, 2010, 3:01 pm