Some Thoughts On Health Care Reform

As many of you know, the major news of the week centered around the Supreme Courts review of the President's 2010 Affordable Care Act. The 3 major parts of the bill being debated are: 1) The individual mandate, which would require uninsured people to buy insurance, or face a penalty in some cases. 2) Can you remove the mandate, and maintain the integrity of the bill? 3) If you do remove the mandate, should the entire bill be scrapped, or can some provisions stand alone? These are the heart of the arguments that were presented over 3 days this week, to the high court. It is, and will become, one of the most important decisions the Supreme Court has issued in decades.


That being said, I think it fair that these same judicial heavy weights are the group that brought us the "Citizens United" decision, which scrapped over 100 years of precedent with regards to political finance reform. Sadly, like the nation itself, it is hopelessly divided along liberal and conservative ideologies. It would also be true to call the divide Republican vs. Democratic, it's simply a matter of semantics. The latest polling bears out the same divide among the electorate. Republicans dislike the bill by 75%, Democrats like the bill by 66%, and Independents are evenly divided at 40% for and against. We won't know the verdict until June, but the fact of the matter is that the decisions will be reached today.

The 2 major arguments come down to this: 1) Because of the unique nature of the health care market, which everyone will use at one time or another, can the government under the "Commerce Clause" of the Constitution force people to buy insurance, or face a penalty if they do not. or 2) It is unconstitutional for the federal government to force people to buy health insurance if they don't want to, and further; if you grant this power to Congress here, where do you draw the line in the future? For these arguments I offer 2 examples. First, while it is totally constitutional for the states to enforce these kind of mandates, ie: car insurance. The question then falls to whether the federal government can do the same? Is it "necessary and proper" to impose a similar mandate by the federal government, through the "Commerce Clause" in Article I, Section 8 of the Constitution? While there have been 236 years to more broadly define this power, I would point to my second point which is this, Social Security. Which in its simplest form is old age insurance, MANDATED by the federal government. As I see it, there is no credible distinction between this, and the Affordable Care Act. It is something everybody needs, so that those with insurance, don't end up paying for those who don't have it. It took monumental effort to achieve, and would be devastating to those already reaping the benefits of this legislation. It needs to be upheld, because if it is struck down, the current state of political affairs will not allow this issue to be addressed seriously for years, and the general welfare will suffer for it.

In closing I would add this. From the very inception of this legislation, the President, and the Democrats in Congress who drafted it, have NEVER, not even today, controlled the argument on the need for this legislation. It has been demonized by the Right for over 2 years, and if a greater effort was put into letting people know what this bill does for people had been pursued, we may not have even had the challenge that now lies before us at the Supreme Court. This bill is NOT an attack on Liberty, as some would have you believe. It is an imperfect, but necessary step in providing health care for the millions of uninsured Americans, who suffer daily through no fault of their own. My hope is that a majority of those 9 justices come to understand this, and uphold this crucial legislation.