Wednesday, February 2, 2011

Goin' a-Courtin'

You may have heard that earlier this week, a federal judge in Pensacola has ruled the new Health Care for All Act (or The Job Killing Socialist Manifesto, depending on your political stripe) as unconstitutional. The basis for the ruling, as I understand it, was that there is no constitutional allowance for the federal government to mandate that private individuals purchase a specific product (like health insurance).

I can’t say I’m really upset by this interpretation, especially as the government-subsidized purchase of private health insurance it made very little sense to me. It seems an inherent contradiction that the same insurance companies that have been labeled as significant contributors to the crisis in health care...and reaping massive profits as a result...should be rewarded by an infusion of public dollars. Of course, both Republicans and Democrats were perfectly happy to give public money to the large Wall Street firms that drove the current recession, so I guess I shouldn’t be surprised. And I recognize that both the subsidy and the individual mandate are political compromises made to garner support for passage of the law, and that compromise is the essence of policy. But I’m still not thrilled with it. If health care coverage for all Americans is as critical as we are told (and I personally believe that it is), then the logical solution is to establish a baseline, no-frills, economy-class, bring-your-own-snacks level of care for all. If the private sector can add services on top of this baseline, and individuals choose to make those purchases, so be it.

Commentators on television and radio have made it clear that no matter who won this round in Federal Court…and so far the score is tied at two decisions apiece…the battle won’t be over until the issue hits the Supreme Court. While I understand that the Supremes have an unpredictable streak (and have ever since Diana Ross left to pursue her solo career), unless there is a sudden retirement on the bench the chances are a conservative court will at least hold the individual and employer mandates within the act as unconstitutional. And while technically the rest of the Act could still be legit, in reality the financing for the entire scheme falls through if the individual and employer mandates are not in place.

What I know for sure is that these court decisions are pure theater, much like the show put on by the Transportation Security Administration. They obscure the real issue, which is an irretrievably broken system of care. Nobody has ever denied that fact. I can’t think of any voter who is unaffected by a lack of access to care or runaway costs, nor a policymaker of any stripe who will say the status quo is just fine, thanks for asking. Nor can I, despite all the posturing about keeping government out of health care (and right now between 45- 55% of all health care costs in this country are borne by governmental agents), can I find anyone willing to forgo their own Medicare or Medicaid benefit, nor any policy maker willing to take them away.

(And for the record, and because with my fetish for linguistic accuracy it drives me nuts when people say it, government funded healthcare programs are not evidence of socialism. Socialist health programs involve government ownership and control of all elements of care. Nobody has ever threatened to nationalize the hospitals or make all health care workers government employees. Even the subsidies for health care coverage within the new law go to support vibrant private sector insurance companies. So get over it.)

Last November, Republicans were able to whip up the public against health care reform with a large helping of clever rhetoric and a side of fearmongering. But if the health care reform law is declared unconstitutional, people have a right to expect something else to be offered in it’s place. The GOP may have owned the last election and are drawing even in the legal war. But without a real plan of their own, one that enhances access to care while controlling costs, they are sure to lose the war. Either that, or we as people in need of care most assuredly will.

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