Monday, March 26, 2012
Still, I can't give a fully-polished lawyer's argument, so I'll just offer a couple of impressions. One is that the Supreme Court is overdoing this. Three days of argument on a question that doesn't that much more difficult from lots of other questions they have to decide? Especially considering that the argument for upholding the statute seems much stronger than the argument for finding it unconstitutional. Part of me would like to see the Supreme Court issue a quick decision saying this is an easy case, of course this statute is constitutional, let's move on. On the other hand, this is a landmark piece of legislation that affects everyone in this country, so maybe it makes sense to give it special attention, just so everyone understands that the Court is giving this case extra special attention.
There are a couple of questions I'd like to ask the justices if I had the chance. One is to ask why are they not troubled by the fact that I'm already being taxed to pay for their health insurance. I'm being taxed to pay for every federal employees' health insurance. I'm being taxed to pay for every veterans' health insurance. I'm being taxed to pay for health care for poor people, and I'm being taxed to pay for the health care of everyone over the age of 65. So why exactly is it such a problem that the government is asking me to chip in to pay for my own health insurance? If it's good enough for federal employees and veterans, and the old and the poor, it ought to be good enough for the rest of us.
There is a practical reason why something like a mandate, or a tax, is required to make sure that everyone has access to health insurance. That is because the system is becoming unaffordable unless we have a way of making practically everyone pay into it. But there is also an evolution in our moral, and maybe also in our constitutional thinking that justifies the idea of universal health insurance, an idea that is taken for granted in every single other advanced country, but encounters enormous resistance only in America. That evolution would recognize health care as a right of every citizen. and has to concede that the every man for himself philosophy just plain won't work anymore to protect us from catastrophic health problems that can strike any of us. But the fact that we need to make that leap also explains why those opposed to the idea of universal health insurance are fighting so hard against it. Because this argument might be seen as the last stand of the every man for himself philosophy that some take to be fundamental to American values.
Lots of people hate the idea that the government is now in the business of making sure we all take care of each other. They hated Social Security; they hated Medicare and Medicaid; lots of them hate the whole idea public education; and they sure seem to hate the Affordable Care Act, even though it is based more on a private model than any of those prior pieces of socialistic legislation. But these self-reliant people who think they have no use for government are just going to have to recognize that if they get very sick, they are going to end up in the emergency room, or needing an expensive operation, and the rest of us are probably going to end up paying for it. So it's fair for them to pay too. And maybe it's good for lots of people to gather outside the Supreme Court and give vent to these feelings. If this very conservative Supreme Court votes to uphold the constitutionality of this Act, as they should, that will help establish that it is not inconsistent with fundamental American values to protect the right of every citizen to affordable health care when they need it.
UPDATE: Even though I don't have full confidence in the Supreme Court deciding this issue, unfortunately we can't leave it up to the people either. A new CBS poll says that only 25% want to keep the Affordable Care Act intact, while another 29% would keep the law but get rid of the mandate. Yet something like 85% support the ban on insurance companies' ability to reject people for pre-existing conditions. That means that a solid majority would like to be able to wait until they get sick before they have to buy health insurance. They would probably also like to wait until their house burns down before they have to buy fire insurance, but people seem to get that that would not work. Why is it so hard to understand that the same principle applies with health insurance?