Monday, April 9, 2012

Healthcare in the Courts: Checks and Balances or Partisan Gamesmanship?

As you no doubt have heard in the news, the legal challenges to Obama’s Affordable Healthcare Act have made it to the Supreme Court, arguments have been made, and now we await a decision. The Los Angeles Times carried a story about Reagan administration lawyers fearing judicial activism in the current Supreme Court. Charles Fried, solicitor general under President Reagan, said that “If the court were to invalidate the healthcare law, It would be more problematic than Bush v. Gore." President Obama has even shown some concern stating that "Ultimately, I am confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress."

So now we wait for the Supreme Court to make its decision on what has come to be known as Obamacare. The question is, will we be witnessing the checks and balances that we heard about in junior high school civics classes, or will it be partisan gamesmanship?

A Case for Single payer Universal Healthcare

During the waning years of the Bush (the younger) administration, I made a prediction that the U.S. would move toward a nationalized healthcare plan and that it would be industry that would push the government to get involved. My reasoning was that in the global economy, it is harder for U.S. companies to compete because they have to include employee healthcare in their production costs, unlike all other industrialized competitors on the global market.  At the time, I think it was estimated that $1,500 of the cost of every new American made automobile went to cover employee health benefits. If the government could free up industry, our companies could do much better in providing quality products in a competitive international market.  Well that just shows how much I know.

Since Barak Obama came into office to promote a more comprehensive healthcare plan, Republicans, the party of big business, have done nothing but block all efforts at healthcare reform.  Years ago my wife came up with an idea that made more sense than any I had heard before. She said that if we allowed all children from birth to age 18 to be covered by Medicare, then we be granting healthcare to the most vulnerable of our population: the children and the elderly.  Adults could be covered by insurance plans just as we are accustomed to doing. In this way, the productive citizens are contributing to their own healthcare plan and the crucial developmental year of infants and children will be covered just as are the elderly.  Of course, that made too much sense to even be contemplated in Washington, D.C.

The truth is, if we had a single payer universal healthcare system, it could be a boon for the economy and a shot in the arm for every entrepreneur.  I personally know of people who would like to launch their own business, but do not want to risk losing healthcare benefits they have in their present job. Indeed, there are many who are working at a job they don’t particularly like just to have insurance coverage.  So not only would big business benefit from not being saddled with healthcare costs, small entrepreneurs would have more freedom to do what the Republicans say this country is all about – start new businesses.

The Individual Mandate

What about that provision in the healthcare reform law that requires an individual mandate – in other words, requiring everyone to buy health insurance? That is the key to making this healthcare act affordable. Currently, everyone gets medical care when they show up at the emergency room regardless of whether or not they have insurance. If they don’t have insurance and are in the ER, they are at one of the most expensive points of healthcare delivery, and that cost is passed on to the hospital and to those of us who have insurance. In the past, both Mitt Romney and Newt Gingrich (and many other Republicans) have strongly favored the individual mandate. For many Republicans the individual mandate made sense. It was just good business. If everyone has to buy insurance, then that is more money in the pockets of the insurance companies. The Obama administration considered a public option that would be covered by a tax, but they opted for the individual mandate since it was a Republican idea anyway, and they did not see that a public option along with a new tax would pass in congress. So we ended up with a less effective hybrid bill in order to compromise with those who dislike taxes and government healthcare.

What incredible irony that a tax to cover a public option in healthcare would have been constitutional without question (we are already doing it with Medicare).  The individual mandate, that Republican idea, is now being challenged in the courts (by Republicans bent on overturning “Obamacare”) to determine its constitutionality.

By June, we will know the court’s decision.  Will it be a case of Republican activism in the Supreme Court?  Whatever the outcome, it will likely be a 5-4 decision – not a ringing endorsement in the court, however it turns out. It will be another reflection of the political polarization that is coloring so much of our country's actions and non-actions. If the law is upheld, maybe we can go on to improve healthcare accessibility. If it is struck down, I fear that with political gridlock and lack of congressional gumption we may not see any decent healthcare reform.  All of this argument about whether we can make people buy insurance sounds like a good case for bringing on a universal single-payer plan like other civilized countries have.


1 comment:

  1. Great post, Charles! As someone who is having to spend way too much time and money on/in the healthcare system these days, it would be nice to have national health care, like other civilized countries.


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