Tuesday, April 3, 2012

Listen to left to get healthcare right

Posted By on Tue, Apr 3, 2012 at 9:00 AM

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I was just getting used to the idea of Obamacare. Now this happens.

Last week, President Obama's law, aimed at reforming the three-legged rhinoceros that passes for America's so-called healthcare system, appeared to get a pummeling during hearings before the U.S. Supreme Court. The justices probably won't announce their ruling on the law's constitutionality until June but, based on what transpired over three days of oral arguments, most observers expect the law to be struck down. The only question seems to be whether the court will settle for throwing out the part of the law that calls for everyone who hasn't got it to purchase health insurance, or scuttle the whole thing.

You like not being discriminated against by an insurance company because of a pre-existing condition, like high blood pressure or diabetes? That could be gone. Have you gotten used to the idea of being carried on your parents' insurance plan because you're not yet 26? That could also be over with.

People advocating for the law seem to have forgotten what kind of Supreme Court they were dealing with. If anything, the court is more conservative now than it was in 2000, when, by a single vote, justices who had built their judicial reputations arguing for states' rights suddenly decided that judges in Florida were unqualified to sort out whether Bush or Gore had won their state.

For the first time in American history, a presidential election was decided by a 5-4 Supreme Court decision. As Justice Antonin Scalia wrote at the time, the court's intercession was justified in order to short-circuit a process in Florida that might, "threaten irreparable harm to petitioner (Bush) ... by casting a cloud upon what he claims to be the legitimacy of his election."

It's one thing to be a referee. It's another to have a rooting interest in how contests are resolved. Members of this court haven't been embarrassed about showing their partisan colors. Clarence Thomas' wife Ginni, for example, is head of Liberty Central, a Tea Party group that has stridently opposed Obamacare. This type of thing matters when rulings are likely to be decided by a single vote.

But, whatever the high court's shortcomings — and whatever they decide — we cannot lose sight of the real issue here, which is this country's need to fix healthcare. President Obama was right to see this as the dominant issue facing the country. Want to fix the economy? It can't be done without fixing healthcare first.

Our employer-based approach not only excludes or underinsures millions of people, it also puts big and small businesses behind an expanding 8-ball as managers who want to do the right thing are penalized by the ever-increasing cost of premiums. Let's face it: For years, the healthcare market in this country has utterly failed at correcting itself. The federal government has to intervene, not only to take the side of people who are being trampled by market forces that show no regard for their health and well-being, but in order to keep the larger economy from being sucked dry.

According to a 2010 Commonwealth Fund report, Americans spend twice as much as citizens in such countries as Britain, Canada, Germany, the Netherlands and Australia. But this doesn't mean our healthcare is twice as good. The U.S. lags behind these countries — all of which cover all their citizens — in terms of quality, efficiency, access to care, equity and the ability to lead long, healthy and productive lives. The report states that, "when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen."

Obama's fundamental mistake was to confuse the needs of citizens with those of the health insurance industry. Hence the individual mandate that would drive young, healthy adults into the insurance market, resulting in super profits for companies like WellPoint.

The irony is that this strategy was first advanced by a leading conservative think tank, the Heritage Foundation, back in 1989. Mitt Romney famously adopted the idea and tried it out — with success — when he was governor of Massachusetts. At the time, the individual mandate idea was the rightwing's answer to the single payer approach being promoted by the left.

The funny thing is that it showed signs of working. Since Obamacare passed, health insurers have, in fact, been adjusting rates and readying plans for the consumer stampede supposed to begin in 2014. While skepticism is warranted about how truly affordable the Patient Protection and Affordable Care Act would be, it's nonetheless disturbing that we may never have the chance to actually see how it works.

Adding insult to this injury is that, so far, there appears to be no Plan B. Republicans who have been hellbent on stopping Obamacare have nothing to suggest by way of an alternative, perhaps because they have basically killed their own idea.

As for the Democrats, it may be time for them to go back to the drawing board. They'll find a good idea waiting there. It's called Medicare for Everybody. If it's good enough for people over 65 (and it is, ask any senior, even a Tea Party member), it ought to work for the rest of us.

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