Monday, December 13, 2010

In Which The GOP Cuts Off Its Nose To Spite Its Face

You've really got to marvel at the absurd degree to which Obama Derangement Syndrome has taken hold of the GOP. The latest example manifests itself in a classic case of cutting off one's nose to spite one's face. The New York Times is reporting that a George W. Bush appointed Federal judge has declared the individual mandate portion of Health Care Reform to be unconstitutional:

In a 42-page opinion issued in Richmond, Va., Judge Hudson wrote that the law’s central requirement that most Americans obtain health insurance exceeds the regulatory authority granted to Congress under the Commerce Clause of the Constitution. The insurance mandate is central to the law’s mission of covering more than 30 million uninsured because insurers argue that only by requiring healthy people to have policies can they afford to treat those with expensive chronic conditions.
Of course, without the Individual Mandate, several key provisions of Health Care Reform are impossible to institute. Most significantly, without the individual mandate, it becomes economically impossible to legislate that health insurance companies be prohibited from denying coverage to individuals who suffer from pre-existing medical conditions. That is because, without the individual mandate, widespread gaming of the system would lead to the financial ruin of health insurers. And yet the decisions made possible by the individual mandate are among the most popular provisions of the law: At 71% support, a desire to see insurance companies prohibited from discriminating based on pre-existing conditions means its not even close.

The uninsured are not going away, and even if it were to be withheld at the Supreme Court level, this decision does nothing to ameliorate their plight. Indeed, the numbers of uninsured are only projected to rise without implementation of the current Health Care Reform law. So what would be the upshot of a Supreme Court decision upholding this ruling and killing the Individual Mandate? The upshot would be this: the problem of the uninsured only gets worse. More and more people fall off the insurance rolls. As health insurance becomes more expensive, healthy people take their chances and drop coverage. As health insurance rolls are increasingly composed of ill people who simply cannot afford not to have health insurance, prices for health coverage begin to spiral out of control. Eventually, public anger leads to a Democratic wave sweeping both houses of Congress and the Presidency with an unambiguous mandate to fix the broken health insurance system.

Democrats must now craft a new Health Care Reform act that solves the problem of vast numbers of uninsured Americans. Many options are explored. One possible avenue, a system made up of private insurers delivering universal coverage buyoed by an individual mandate that makes it profitable, has already been declared unconstitutional by the Supreme Court. Right-wing political pundits fulminate at even the slightest mention of a single payer system such as exists in Europe and Canada. There is, however, one potential venue to universal coverage that relies upon an institution that is beloved of its participants and is as American as apple pie: Medicare For All.

It's single-payer, universal coverage through the back-door. And if the GOP continues in its ultimately self-destructive path of putting up roadblocks to a Health Care Reform act that is modelled on (or at least very similar to) proposals that were developed by the American Enterprise Institute in the 1990's, than that's exactly where we are headed.

Honestly, the only reason I don't rejoice at this prospect is that I suspect it will take between 10 and 20 years to get there if we follow this path, and during that time millions of uninsured Americans will lose their homes, their belongings, their loved ones and their lives.

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