The Supreme Court is in the midst of hearings that will have wide ranging effects on the lives of every American. The Affordable Care Act (Obamacare) is an imperfect instrument, but it is the first such instrument to be put into law. It is an attempt to provide health care for every American, and Congress (Democrats in Congress) chose to require every American to purchase insurance or pay a rather nominal penalty. Many Democrats preferred a single payer system like Canada's, but they didn't think they had the votes, so they went with on that involved private insurers. When fully implemented there will be regulations and expectations placed on these carriers, including ending the practice of denying benefits for those with pre-existing conditions.
The only way that this requirement can work is if everyone is in the pool. If not, then costs can't be shared in a sustainable way.
Yesterday the merits of this mandate were argued and many observers believe that the votes will swing against the mandate. Today, there will be questions about whether the other parts of the law can stand without the mandate.
It's unfortunate that the naysayers have been able to misrepresent much of the Act, and that proponents, perhaps wanting a more perfect bill, have not stepped up to defend it. But consider what will be lost if this fails.
1. The insurance exchanges
2. Ban on denials for pre-existing conditions,
3. Ban on life-time caps on coverage
4. Gender will not be considered as part of setting policies
5. Young adults on family insurance to age 26
- And many more.
One of the stones thrown at the bill is that the government will determine what kind of care you receive -- especially end of life care. The fact is, right now, your insurance company makes that choice -- if you can afford insurance. And even under the Affordable Care Act, as with Medicare, if you can afford it you could get supplemental coverage, if you want. So, this is really a straw man argument.
So, the question I have isn't a Constitutional one -- the Supreme Court will decide that -- but rather what is the right thing to do for America's people? If the mandate fails, are you ready to go to a truly government program and extend Medicare to everyone. As I understand it Medicare is Constitutional, because it's a tax, and Congress can levy taxes and spend them according to its wishes. Since this is true, and because expanding the pool for Medicare would make it financially sound, wouldn't this be the best way forward?
Like many others I will watch with baited breath to see what happens. Perhaps many are correct -- if the mandate fails, then we'll get the chance to discuss the truly government program. Republicans want to repeal and replace -- is this their replacement option?
Ultimately, we need to ask the question -- is the current health care system working for the majority of Americans? And the answer is sometimes, sometimes not -- depends on your situation. But the bigger question is -- what is the right thing to do? That is, what is the just thing to do?