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The health care product is interstate commerce. People fly and drive all over the country being treated for their illness. The payment system is out of whack with the product. The employer paid system we have is a total mess. You can work for a NY based company that must comply with the New York rules for some employees, and the MO rules for others. The status quo is wrong in so many ways.
The health care industry, as a whole, is very likely interstate commerce. But, consider my or your purchase of an insurance policy. That policy will be determined by state regulations irrespective of other states. Many health insurance companies have subsidiaries incorporated in multiple states (as opposed to just branches). At this point, its characterization as interstate commerce becomes a tad hazy, in my opinion. But, as I have said, assuming my purchase of a health insurance policy is interstate commerce, that allows the federal government to bring the health insurance industry under regulation - not you and me. It would be similar if the Congress' authority to regulate banks were extended to mandate you and me to deposit funds in a member bank of the FDIC. The government cannot use its power to regulate one party in order to regulate a third party.
I agree completely that the employer-based system is a total mess. I really want the health insurance industry to be fixed; I just don't think the proposals that have been offered up to this point will do much to fix the systemic problems.