Looking on the bright side, the Supreme Court has ruled that something that President Obama has done is definitively not unconstitutional.
That’s probably the best that can be said of the 5-4 decision by the High Court today in upholding the ironically named Affordable Health Care Act.
On the downside for Obama, he goes into the final four months of the election campaign saddled with a decision that says he has raised taxes on some of the nation’s poorest people — for that is what the court said will be happening, 18 months from now, when the health insurance mandate part of the new Act takes effect, and people who have no employer-provided health plan, and no other kind of coverage, fail to buy a policy for themselves and their families. They will be socked with a bill by the IRS, and while the Obama administration and supporters of the act in Congress were at pains to say that the payment such people would be hit with would be a fine, the Justices in the majority were adamant that it would be a tax.
Also taking a hit were Republicans, who universally oppose what they have been deprecatingly calling “Obamacare.” Republicans, including their presidential candidate- in-waiting Mitt Romney, have vowed to eliminate the act after the November election if they win, though unless they do surprisingly well in the Senate and come up with close to a 60-40 majority — very unlikely — they will in truth be unable to do that.
Romney, who as governor of Massachusetts launched a state health plan that included an insurance mandate with a fine for not having insurance, which was clearly the model for the federal law, is in the awkward position of another Massachusetts presidential contender, John Kerry, who went down to defeat in part because he voted for an $87-billion bill funding the Iraq War and then voted against it, leaving him lamely explaining to reporters that “I actually did vote for the $87 billion before I voted against it.” Now Mitt Romney will have to be saying, for the next four months, that “I was for an insurance mandate before I was against it.”
Not an enviable position to be in as a candidate!
The real losers in the latest Supreme Court decision, however, are the people of the United States. Not those who will be required to go out and buy some over-priced, minimal coverage, rip-off insurance plan offered by the private insurance industry, or to pay a “tax” to the IRS for not doing so, but everyone.
This is because the Affordable Health Care Act is not affordable. It does little or nothing to control health care costs, which are destined to continue to gobble up an ever increasing amount of the total US Gross Domestic Product as well as of corporate profits and families’ incomes.
The new federal version of Romneycare simply prolongs the day when the US finally does what it should have done decades ago, should have done during the first Clinton administration, and should have done at the start of the Obama administration: namely expanding Medicare to cover all Americans.
Instead of going for this option when he had broad and enthusiastic support as the newly elected president, Obama deliberately shut out all discussion of the Canadian-style approach to national health coverage — a national program of government insurance for all, with doctors’ rates and hospital charges negotiated by the government — and instead devised a scheme that leaves the whole payment system in the hands of the private insurance industry, and effectively lets doctors and hospitals charge what they can get away with.
Obama did this because he was a huge recipient of money from all sectors of the health care industry — the insurance companies, the hospital companies, the American Medical Association, the big pharmaceutical firms, and the medical supply firms.
ObamaRomneyCare is at its core an enrichment scheme for nearly all elements of the Medical Industrial Complex, with the possible exception of the lowly family practice physician, nurses, and hospital workers.
There is a reason why Canadians, who have better health statistics than US citizens, as measured by access to care, life expectancy, infant mortality rates, etc., spend half as much as we Americans do on health care both as individuals and as a percent of national Gross Domestic Product. There is a reason why the US has far and away the costliest medical system in the world, and yet still has some 50 million people who cannot get preventive care, and who cannot be seen by a physician when they or their family members get sick or injured unless they go to a hospital emergency room.
On balance, Obama probably has a narrow win in the Supreme Court decision, because the alternative — having the Affordable Health Act ruled unconstitutional– would have been an unmitigated disaster for him. There are certainly bragging rights in being able to tell Republican critics that the Supreme Court, including its Chief Justice John Roberts, an appointee of George W. Bush, have ruled that it does pass Constitutional muster.
But it is a pyrrhic victory, both for Obama, who will now have to explain why it is a good thing to tax poor people who can’t come up with the money to buy a crummy mandated health insurance plan, and for the public, who are going to end up having to pay through the nose for this new law.
No “progressives” should be cheering this decision. It stinks.
DAVE LINDORFF is author of “Marketplace Medicine: The Rise of the For-Profit Hospital Chains” (Bantam Books, 1992)