Wednesday, April 18, 2012

SCOTUS v Patients Affordable Healthcare Act

The Supreme Court has now heard testimony and has probably even reached a judgment regrading the “Patients Affordable Healthcare Act”; though we're going to have to wait to know what it is until they finish writing their learned opinions on the subject. We're told by our President that it would be wrong because of the current crisis in healthcare in this country (a statement he later performed the Olympic backpedal on), for SCOTUS to even consider striking down the law.

There are a great many things wrong with this statement however, and that makes it hard to know where to begin responding to it. But let me try this simple one … Bullshit! I've spoken before about the responsibilities of the highest court in the land to address Constitutional issues, but let's at least get the facts straight.  The law currently under review by the court is not one designed to provide universal health care to citizens in this country and by its authors admissions, it does not. It was instead one passed in order to provide universal access to health care 'insurance' in this country. We could even say in this law's case, provide is far too tame a word; and that it's design is to mandate that everyone in this country be covered by some form of health insurance. (If not by private insurers, then by the government.) This law has far less to do with whether health care will be accessible than with who will pay for it.

Oh sure comes the response, but stop nitpicking and confess that there is in fact a crisis in healthcare in this country that must be dealt with. In fact, I do not concede this. If health care in this nation were so bad, then why does every national leader in world come to this country to receive treatments for serious illness, rather than stay in their own? Why are most medical breakthroughs made in this country rather than in others? There is no crisis of care in this country.  

There are however inequities as to access to treatments in this country based on their cost. (There are similar inequities to home ownership, automobile ownership, and luxury items.)   Where healthcare is concerned, we know that not everyone can get access to treatments that their doctors deem necessary to their continued health and perhaps even survival. Part of this has to do with health insurance industry, as issues of pre-existing conditions, approval of the treatments for general use, or cost vs efficacy continue to remain in a field filled with miracles and patent medicine. As often happens where such weighty issues where constant change is involved, there are invariably stories (some true) of seeming injustice and personal tragedy that go along with them. The question we should be asking ourselves however, is whether those in government are best suited to provide the answers to any of the questions. It's government after all, that got us into this mess in the first place.

During WWII, progressive saint President Franklin Delano Roosevelt imposed wage and price controls on the nation, in the misguided thinking that any one man or government could actually control a national economy. It and he couldn't of course, and clever employers who wanted better workers and could no longer offer them more in the way of wages, instead began to circumvent the spirit if not the letter of the law by offering benefit packages that included health care insurance to attract them. Forced by a competitive employment market, their competitors soon followed suit and another well-intentioned law was effectively bypassed, while reaping a full harvest of long-term, unintended consequences.

Skip forward some 20 years and we find ourselves in 1965 and see government enter into another well-intentioned effort, this time to provide health care insurance to seniors who were now unlikely to have it after leaving the employer who had provided it during their working career (because of the previously mentioned govt intervention). Congress therefore passed Title XVIII of the Social Security Act, better known these days as Medicare to address the issue. Not content with the scope and scale of the program however, it sought further redress and addition through program expansions in 1972, 2001.

Since providing medical insurance for our aged only (regardless of income), would be unfair to those younger who couldn't afford it, and whose employers didn't provide it, we at the same time added Title XIX to that same Social Security Act in order to provide even more potential government protection to yet another group. Of course the program known as Medicaid would be managed by the States, but with the Federal government monitoring.

These programs have existed now for some forty-seven years, and in typical government fashion their often obvious ineffectiveness is met with bureaucratic cries that the only way to fix the problem is to expand the programs. Having become the medical insurance provider for our elderly and impoverished, we must double down and make government the primary health insurance carrier for the nation. We must likewise turn control of the type and level of health coverage to what Congress believes is best for us; in spite of the fact that they will not be participating in the program.  Legislators it seems, have once more exempted themselves in favor of their own program of health care (much like they did with Social Security).

Having been told that it's wrong that we should have to deal with faceless insurance company employees and program managers, we're told that we'd be better off dealing with faceless bureaucrats instead. Having been convinced that evil insurance companies have and will provide little competence in serving our medical needs, we should instead turn our health care over to those whose efficiencies in the DMV and Post Office are legendary. Seeking to save us from being abandoned by the evil and unfeeling capitalists in the insurance industry, we should instead turn the quality of our very lives to the same government that has provided the kindness and compassion shown by those of the IRS.

Can anyone, with a straight face and a clear conscience point to something in its past or present that the government does better than the private sector in a truly free market environment? (And don’t point to national defense on me, as the limited efforts to sub-contract minor bits of even this have proven just as successful and often more cost-efficient than the government version; even with the normal graft and corruption of such contracts involved.)

No the Supreme Court should not rule against the “Patients Affordable Healthcare Act” because it extends the power of the Federal Government far beyond the limits placed on it by the Constitution.  Neither should it rule against the Act because of the current so-called health care crisis, because of the slim majorities and lack of bi-partisan support for the issue in the legislature, or because the President doesn't want them to rule his signature bit of legislation Unconstitutional (especially in an election year). Beyond all of these reasons, some more Constitutionally valid than others, they should rule against in order to save us from a government that's long proved itself incompetent under either party's rule to run such programs, and especially one that will forever place our health in its hands.


Roland Hansen said...

Tim, mi Amigo,
Tou make many valid points. That said, I am still a strong proponent and advocate of universal health care.
On another matter, you wrote, "Can anyone, with a straight face and a clear conscience point to something in its past or present that the government does better than the private sector in a truly free market environment?" My response is a simple "yes" and I refer all to the TVA, Tennessee Valley Authoriy.

Timothy W Higgins said...

That being said Roland, I too would like to see reform in health care insurance. I do not however want omnibus legislation that can never be effectively amended or improved; but would prefer to see issues addressed individually and in cooperation with market driven practices and not government replacement.

Timothy W Higgins said...

Mi Amigo, The government may have done the TVA, but I question whether the make work it created was within the limits of the Constitution, or was done as efficiently might have if it had been if left to the private sector.

I also wonder how many in the environmental movement are decrying its achievements (and would like to see them demolished), since they destroyed some natural habitats and inhibited the movements of many fresh water fish.