In June, on the last day of its spring term, the Supreme Court of the United States upheld the Patient Protection and Affordable Health Care Act. Before the argument, conservatives had said that the Act contained an unconstitutional federal mandate to buy insurance that would be the same as federal mandate to eat broccoli. The decision went against them, but now they have opened a campaign on slogans of freedom from broccoli to give them an election victory in November.
Among themselves and most conspicuously this last week conservatives are at war over legal doctrines: the tax clause versus the commerce clause. Arguing thus, much of the jargon among pundits has obscured the real significance of this decision and this moment in American history.
The Affordable Care Act expands coverage, saves money, and is the most humane and decent thing this government has done in 30 years. In the long run it will be more important than fighting Taliban in Afghanistan. It will be more important than getting rid of Saddam Hussein. It is, at last, a step toward increased compassion and inclusion already demonstrated by other civilized nations and we finally are moving in that direction.
There are two parts to this discussion. The first is that this is a huge, concrete, practical, and immediate benefit to the American people. The second is the legal argument. For a moment, forget the legal argument. Tax versus commerce is a smokescreen. The fog of the legal jargon may cause us to miss the historic accomplishment:
After years of quibbling and delay, finally, some improvement has been laid down for the desperately broken American health care system and the Supreme Court has given its blessing.
Basic coverage will extend to 30 million who have not had it. This, by itself, will cut at the single most common cause of bankruptcies in our current ailing economy. That is good for individuals; it is also, incidentally, very good for businesses. Thirty million is a lot of people who will be more likely to pay their bills.
No single benefit for so many people has been passed by the Congress and signed into law since Social Security and Medicare were first adopted. That’s coverage for a population roughly the size of 3 New York cities who have just been given a new foothold in life: they will have a greater degree of financial security. If they get cancer or are hit by a car, or just have a baby, they will not be forced to miss house payments and lose their homes, cut back on meals, or quit school. This is huge. Consider 30 million: think of the number of all the people in three of our largest cities offered a helping hand by the Congress and the President and upheld, now, at last, by the Supreme Court.
Coverage has been expanded for young people who are at home until age 26. Women will get coverage and not be disallowed because of previous spousal abuse or because they have previously been pregnant. Pre-existing conditions can no longer be an excuse not to insure.
Medicare drug benefits have already been expanded, beginning in 2011, and if you are elderly you will pay less for drugs each year between now and 2020. Yes; that’s right: less each year until 2020. Thanks to this Act.
For those who have been worried about the super-fatted calf, the bloated insurance companies, the Cignas and United Health Cares who have competed between themselves to reduce the amounts that they actually spend on health care, (increasing returns to stockholders), they will have to pay at least 80% on health. No more shaving health benefits to improve stockholder equity. Now they have to stay in the health business and not just the profit business. In addition these companies will now face competition. New state insurance exchanges will give consumers an option to compare costs and not be stuck with the traditional system.
At the same time, all this is designed to reduce the federal deficit in ten years. That’s right: reduce the deficit. Go to HealthCare.gov to check it out. The president first saw this program as a way to cut back on the huge costs to our economy of rising health care charges, the inflationary drive of those costs, and the need to rein them in. This Act is not only compassionate; it is intended to halt cost escalation and save money.
This is a tremendous victory for the American people.
Now we have to see if we can hold onto it. Mitt Romney, as the leader of the right wing counterattack, says he wants to do away with it, to roll it back, to go back to the squabble and design stage, to start over as if we had not already been talking about this for 40 years. An avalanche of right wing advertising is about to flood the airwaves telling us how all these extraordinary benefits are worse than doing nothing and that we should go back to doing nothing.
That will be the choice presented to the American people in the next four months and in this election. Return to the squabble and distress of a broken system, on the one hand, restart the battles in Congress all over again, re-ignite the Tea Party against the liberals, or, on the other hand, shout hurrah! and get on with being a civil country.