A few weeks ago we marked the second anniversary of President Barack Obama’s Affordable Care Act, the comprehensive health care legislation that has come to be called “Obamacare.” This label was intended as derogatory by the Republicans, but has now been embraced by the President’s re-election campaign as a badge of honor.
Coinciding with this anniversary was an unprecedented three days worth of hearings before the United States Supreme Court. The case, which was brought by roughly half of the nation’s state attorneys general, will determine whether the Affordable Care Act will meet the test of constitutionality in whole or in part. In essence, the Court’s holding, to be issued in late June, will likely determine the life or death trajectory of “Obamacare.”
Rarely has any issue so exposed the polarized nature of government and society in general in this country. On one side would be those with serious and chronic health conditions such as cancer, diabetes, chronic heart disease, sickle cell anemia, and an almost endless list of maladies with similar gravity. On the other side would be those who can claim excellent health to this point and who thankfully have been able to rely on health insurance as a little-used fallback provision.
Then there are the polar opposites that carry on the heart of the heated policy debate. At the far right are those who may be referred to as the “Social Darwinists,” who are the ideological descendants of the British political economist Herbert Spencer. They proclaim that the survival of the fittest in both a social and economic sense should be the philosophy that carries the day. Those who suffer hardships are simply not the government’s responsibility, they say. At the opposite pole are those who would maintain that government has the ability to address all of our needs equally. They would be accused of embracing a Marxian approach to government. Reality, of course, is somewhere in the middle, but we have shown a distinct reluctance to go there of late.
Then there are the loyal followers of the Democrats and the Republicans. They believe that any hint of willingness to compromise is a sign of weakness and demonstrates a lack of appropriate allegiance to their fellow comrades in political arms. Hence, we as a nation find ourselves before the Court with the health care of millions of Americans and half a million Mississippians hanging in the balance.
There have been many myths and missteps strewn along the path that has led us here. At the center of debate has been the infamous “mandate” for all to purchase health insurance. This feature of the legislation was first advocated for by the prestigious conservative think tank, The Heritage Foundation, in a 1989 report. Following this report the call for a mandate was taken up by a number of Republican senators and congressmen. Ironically, Barack Obama was originally very much opposed to the mandate provisions. When the President began favoring the mandates, the Republicans moved toward opposing something that many of them had previously favored.
Then there is presumptive Republican Presidential nominee Mitt Romney’s misreading of the federalist components of the bill as well as his advocacy of the traditional myth of “free market” health care. Romney claims that only the states should be allowed to reform health care the way his State of Massachusetts has done. That ignores the fact that when states serve as laboratories of democracy the successful experiments performed there are best when they are adopted for the benefit of all citizens. This is precisely what happened in the case of “Welfare Reform” following its successful implementation under Republican Gov. Tommy Thompson in Wisconsin.
There is no “free market” when one who does not wish to participate must submit himself to the health care establishment based on the acquisition of a disease that he did not freely choose to acquire. A study in the American Journal of Medicine in 2009 revealed that 62 percent of bankruptcies in the U.S. were as a result of medical bills, and the vast majority of those filing for bankruptcy had health insurance. This is a very flawed example of the free market that nominee Romney has chosen to use.
Perhaps the most confusing set of polar opposites relates to the defense of provisions of a 2,700-page bill on the one hand and the virtual silence on the alternatives that would take its place on the other. The Court is trying to sort out the former. The Democrats are apprehensive, and the Republicans are almost giddy in anticipation that “Obamacare” will be struck down. One can assume that the insurance company actuaries are already busy with their computer models.
If “Obamacare” goes by the wayside it will be only hours before millions of Americans and a half million Mississippians will begin receiving letters that go something like this:
Dear Valued Customer, I regret to inform you that due to (A.) your preexisting medical condition and (B.) the fact that you have reached your life time maximum benefit, all future coverage will cease as of Aug. 1, 2012.
Who will the public blame then?