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Economists have long observed that there is an economic equivalence between a tax and a required purchase. The equivalence lies in the concept of fungiblity. In any business balance sheet, the loss of a credit (e.g., [by] a tax paid [to the government]) is equivalent to the gain of a debit (a purchase [is] required [from the government]). That all occurs within an economic frame, where economics is all that is considered.


Conceptually, however, a tax is normally understood in terms of a frame very different from a necessary purchase. Purchasing is in what we can call the commercial-event frame of buying and selling products, while what the government does is a credit-debit exchange and is necessarily in the taxation frame.


From a [ultra-] conservative perspective, nearly all taxation is governmental oppression, and therefore immoral, but purchasing is perfectly fine because it is based in the market, and conservatives [in general, not just the "ultras,"] have a moral preference for the market. Obama, hoping to avoid conservative opposition to taxation and needing a basis for regulation, chose to use the power of the commerce clause, which required [he use] the "health care is a product" metaphor. The metaphor was, as usual, taken literally. [Which possibility perhaps Obama failed to consider]


At first, Obama favored the public option, in which the government would be seen as a business competing with other businesses and selling health care at a lower price with better offerings. Medicare, run by the government, has only a 3 percent administration cost, while most health care corporations have administrative costs between 15 and 20 percent, mostly to verify and seek grounds to deny claims. Adding in profit demands, private health care spends about 30 percent of its total budget not on care but on administration and profit. This is a large part of what makes the U.S. health care system the most expensive in the world, though far from the best. The public option did not require a large, expensive staff to administer, and possibly deny, claims, nor did it have to make a profit. [To have Medicare-for-all] The government could have used the savings from administration, profit, and advertising to cover everyone. [However closing down private health care providers to replace it with Medicare-for-all would have increased the unemployment numbers from 2009 through 2014 by more than 5 million people overnight back in 2009.]


Crucially, however, in the public option, the metaphor of health care as a product was preserved, and conservatives [deceptively] objected that the public option would result in unfair competition. Given the market frame [predominant in the electorate's subconscious care of the right-wing propaganda in the news media], this was a position easy to argue for, and conservatives eventually prevailed, forcing the president to abandon the public option.  [Greens arguing for the public option made no difference then.] With the public option defeated, the president reframed. He went with a plan he took to be more favored by conservatives: the individual mandate, backed by [Democrat] Hillary Clinton and [Republican Mormon] Mitt Romney and proposed originally by the conservative Heritage Foundation. What the Heritage Foundation and Romney liked about the individual mandate was that it forced everyone to buy [private] insurance, thus giving the insurance companies tens of millions more customers and more profits. This version of health care was passed into law [as the Affordable Care Act that has by 2015 insured 7 million more individuals who had no insurance coverage until the ACA was passed].


Conservatives never argued against any of the law's specific provisions. For example, they never said that there should be preconditions or caps. Instead they reframed. They made a moral case against "Obamacare." (In choosing this name, they made Obama the issue, not the people and their health.) [This tactic also exercised, energized, made more influential on conscious choices, the sub-conscious racism of their base and of very many other U.S. voters especially those in the southern states.] The conservative moral principles applied were freedom and life, and they had [their reframed] language [so widely used and superficially all about by the electorate] to go with them [i.e. to support their points of view and subconsciously persuade others of the correctness of their points of view]. Freedom was imperiled by "government takeover," [all human] life [threatened] by "death panels." Republicans at all levels repeated this language over and over, changed public discourse [to use it as well], and thus changed the minds of the electorate, especially the independents. By 2010 Obamacare had become a dirty word, and the most radical Republicans won their elections and took over the House with a promise to repeal it. [Then look what happened to the U.S. House and Senate in the General Election of 2014!  The Republican's took over both houses of Congress and their say-no-to-any-government policy expcept military expenditures, adventures and increased surveillance of the public destroying more personal rights to privacy.]


What the Obama administration missed [in 2009 and 2010] was the opportunity to argue on the basis of the same moral ideals of freedom and life. [Perhaps if he had done so, Greens and progressive libertarians would have formed some more politically successful coalitions then.]  Serious illness without health care takes away your liberty and threatens your life. Forcing people to live without health care is an infringement on their liberty. But the White House did not choose to frame the issue with that moral counterargument [and seldom if ever did the Green Party]; instead they [the White House] discussed technical policy details. [The Greens and other progressive's call that all people should be covered cradle to grave, met deaf ears of the majority of the electorate then.]

Conservatives, meanwhile, were arguing their values. People should not be forced to pay for other people's goods [or in this case for others' well-being via affordable high quality health care]. The Public [Good] should be kept to a minimum. And the individual mandate constitutes a government takeover [conservatives claimed]: if the government can force people to buy particular products, it can force them to do [or buy] anything at all. Liberty [by this reframed, faulty, deceptive, and cruel logic] is imperiled.

In all of this, the Obama administration's [very poorly informed and essentially stupid] rationale inadvertently helped its opponents by adopting the product metaphor and placing health care in a market context. [Where it remains as of 2015 with few public efforts to reframe that discussion in favor of universal health care.]

In 2012 the Roberts Supreme Court took up the conservative frame. The conservative justices, taking the product metaphor literally, again argued that the individual mandate forces people to buy a particular product: health care. If the government can do that, it can force you to buy burial plots or cell phones or even broccoli! The government would no longer be regulating commerce but bringing it into existence. [Which supposedly would cut private enterprise out of the new health care products creation business, which it would not.] Citizens would be forced to pay for other people [i.e. for their welfare, their improved health care, their better education, their prosperity and thus for their having greater opportunites to realize in this life their full potential and apply their greater abilities and opportunites to help others in their community for the greater common good.  But instead such nefarious mandates were], thus denying individual liberty [by the cruel and selfish, self-centered logic of the market frame metaphor].  The result [therefore] would be a "government takeover."  [On pausing to reflect on that irrationality in 2015, who could have believed such garbage then?]

At this writing [of the authors in 2012] the Court [SCOTUS] has not yet decided, but one can see where this is going. Medicare and Social Security are likely next in line [for subversion and destruction], as is environmental legislation, [all of] which serves the public interest over the private and thus threatens the use of private property [and the continued take over of public lands, like state and national parks, and property like school buildings and public hospitals for private for-profit use... where expenses and greater profits now come from government taxes on the public plus the pubic's payment of higher fees for private services.  How insane is that?] At stake is the very idea of The Public [i.e. of the Public Good, of the common-wealth and our collective well-being living in a civilized society]. At stake is the view of democracy as a system in which citizens are bound [and required and inspired] to [help and care for their] fellow citizens, with each individual bearing social as well as personal responsibility [for others and for their community -- a small-c christian point of view for centuries, if seldom realized].