Time will tell how “historic” yesterday’s Supreme Court decision on the Affordable Health Care Act of 2010 will eventually become. I often wonder how those determinations were made in years when it would have taken a month for the whole country to even find out what had happened. Down the road, I’m sure yesterday’s events will be interpreted for students sitting in a classroom as “historic,” one way or another.
There’s an awful lot of talk, it seems, from a lot of people who launch off into speculation to draw their conclusions, rather than serious consideration of exactly what the impact of this legislation will be for the “average American,” whomever that might be. I got a very interesting perspective on the whole thing, driving from Pittsburgh to Washington, DC yesterday, having to change radio stations several times to keep the dial set on a news and talk station. Facts are hard to discern in all the rhetoric. Bear with me, and understand that what I am laying out here is my own perspective.
From the right, the reaction to the decision was, well, somewhat predictable, but at the same time had a lot of surprising elements. Chief Justice John Roberts, whom I’ve always though of as being thorough and thoughtful, a great combination for a SCOTUS Justice, was suddenly public enemy number one. Now I realize, it must be quite difficult for the extreme right side of the media, and of politics as well, to accept the fact that someone they considered a close friend and an ally, and whom they lauded and applauded when he was selected by former President Bush in the wake of a previous failed appointment, didn’t follow the expected partisan agenda in rendering his decision (how refreshing is that?!). The same voices who proclaimed certainty that he would end abortion and solidify a 5-4 conservative majority on the court were calling him everything from a closet liberal to Satan incarnate. I really don’t think he’s changed at all. What I think is that we haven’t, until now, been able to see the whole scope of his perspective. He is serving in a lifetime appointment, which removes him from the regular cycle of raising funds and running for office. He can be less partisan, and more judicial as a result, and I think that’s what we saw in this particular ruling.
It is very clear that the Republican politicians who have spoken out on this issue, and there are many of them, don’t want people to have the ability to get beyond their spin down to the facts. They understand that a majority of Americans believe that the current health care system is broken, and needs to be fixed, and they want you to think that they have a better plan. But it seems fairly clear, from yesterday’s reactions and rhetoric, that they think the way things are right now are just fine. They have no alternative plan. Their main reasoning behind their opposition to this particular plan seems to be to prevent President Obama from getting any credit for it. The general pattern of Republican reaction to the decision was to put out a couple of their standard talking points, and then launch into speculation about the actual costs and ultimate results of “Obamacare.” Keeping in mind that they were fairly certain the court would overturn the whole thing, I’m not really buying their argument, and ultimately, at least among those voters who give serious thought to stuff like this, their rhetoric will look like paranoia, and their exaggerations will cost them a lot of support.
The Democrats haven’t ventured as far into fantasyland as the Republicans appear to have done, but their perspective also seems a bit skewed. Given the current economic situation, their figures tend to reflect the best possible scenario, not necessarily reality. There are some specific points in the legislation which are popular enough to secure it, and most of their senators and congressmen, against much of a reaction at the polls in November. The provision that preserves coverage for people with pre-existing conditions is extremely popular, as is the provision requiring children to be insured, the prescription drug discounts for senior adults, and the provision that requires companies to keep individuals on their parent’s insurance until they turn 26 years of age. Other aspects of the bill, particularly the purchase “mandate,” are not so popular.
As far as the political “shot in the arm” that yesterday’s decision will allegedly give to one side or the other, that remains to be seen. A slim majority of Americans, in the range of 51 to 49 percent in most polls, register opposition to this legislation. But keep in mind that about 10 to 12 percent of the opposition comes from those on the left who think that this bill was a compromise that falls short of the kind of comprehensive health care coverage they were seeking. Both sides will be galvanized to get out the vote, and neither side is going to see a landslide result from it.
As long as Americans think of health care, and health care financing as a “for profit” enterprise, or an “industry,” the system will be flawed, and what is billed as the best medical care in the world will still be limited to those in an economic class with the resources to access it. When the cost to the patient includes a 25% upcharge to cover those who don’t pay when they seek care, and 30% profit margin for those who write the checks, the problems with health care, and the need to reform the system, will not go away.