What the Obamacare Ruling Means

NOTE: This post is on both the TSAP blog and the Twenty-One Debunked blog

The recent Supreme Court ruling on the Affordable Care Act ("Obamacare") was a mixed bag overall. The individual mandate (which the TSAP does not support) was upheld, but as part of the government's taxing power rather than under the Commerce Clause. While it is clearly a stretch to say it is constitutional because it is a tax (just think of poll taxes), and thus unfortunately provides a roadmap on how to make an end-run around some parts of the Constitution in the future, at least the Court recognized that the Feds do not have unlimited power under the Commerce Clause. Thus, the ruling took some of the wind out of the sails of the dangerous Gonzalez v. Raich precedent in 2005.

One thing the Court did strike down was the primary mechanism for ensuring state compliance with the Medicaid expansion, namely the withholding of existing federal Medicaid funds as a penalty for noncompliance. This was basically the same form of coercion used by the feds to force states to raise the drinking age to 21 in the 1980s, which was upheld by South Dakota v. Dole in 1987. Since then, this power has been used to coerce the states to follow other mandates as well, and not just ones related to highways. Thus if there is any silver lining to the Obamacare ruling, it is the fact that it may make it easier for states to lower the drinking age (and possibly even legalize cannabis) without federal interference.

As we have noted before, the TSAP supports a single-payer healthcare system similar to what Canada currently has, which is also what President Obama originally wanted as recently as 2008. Anything less would be uncivilized.

Will Healthcare Deform Survive the Supreme Court?

The healthcare reform deform bill that was signed into law in 2010 and whose most controversial aspect, the so-called "individual mandate", will be phased in starting in 2014, is now being taken to the Supreme Court after an appeals court recently struck down the mandate.  And much more is at stake than just this particular law.  Regardless of which way they rule, a landmark precedent will be set that will influence future court decisions, rightly or wrongly.

We at the TSAP believe that the individual mandate is unconstitutional and must be struck down.  There are several reasons why such a mandate is wrong on principle.  Not least of which is that forcing people to buy an overpriced, defective product from a private company year after year under penalty of law is about as constitutional as a poll tax.  But what about the rest of the 2400 page law?

Many folks, especially those in the insurance industry, are terrified that getting rid of the mandate but leaving the rest of the law intact would create an unsustainable death spiral where people will wait until they get sick to buy insurance (due to the another provision that requires community rating and guaranteed issue, i.e. everyone pays the same and no one can be turned down), making costs skyrocket out of control.  While it would most likely hit the insurance industry's bottom line quite hard, the fear is really quite exaggerated.  For example, while Massachusetts currently has an individual mandate along with community rating and guaranteed issue, New York does the same but without the individual mandate, and yet the latter actually has lower premiums than the former.  Granted, both states have ridiculously high rates, but individual mandates don't appear to make rates any lower or make the system any more successful.   And New York's insurance industry is hardly in a death spiral.

The best solution, of course, is a single-payer system similar to Canada's.  An excellent plan can be found here, for example.  But will Congress have the intestinal fortitude to finally stand up to the greedy insurance industry and its deep-pocketed lobbyists, who will do everything they can to fight it?

Healthcare Deform Passes

The vote that would make or break the healthcare deform bill unfortunately passed.  As stated in previous posts, we stand firmly against this bill that amounts to nothing more than a giveaway to the insurance industry, as we believe that it will do more harm than good in both the short and long-term.

There does remain a slew of persistent myths about this bill.  Take a look at this list of myths and their corresponding truths.  Universal healthcare, it's not.  Equitable, it's not.  Affordable for most people, it's not.  Cost-saving, it's not.  Simple, it's not.  And so on. 

Unfortunately, the otherwise staunch progressive Dennis Kucinich now supports this bill, even though the already weak public option has been jettisoned.  And Obama struck a deal with the anti-abortion Democrats (such as Stupak) to gain the crucial extra votes needed to pass the bill.

The TSAP supports truly universal, single-payer healthcare for all Americans, similar to what currently exists in Canada.  Anything less would be uncivilized.  We believe that healthcare is a human right.   This bill, however, is a major step in the wrong direction, and in many ways will be worse than the status quo.

Fortunately, the worst aspect of it (the individual mandate) will not take effect until 2014.  You read that right, it's four years from now.  Thus, there is technically still time to fix the bill's numerous flaws if Congress wishes.  But there is probably a snowball's chance in hell of that happening as long as we keep electing spineless Democrats and reactionary Republicans.   Voters this November should take note, and throw out the leftovers. 

Otherwise, we can look forward to spiraling healthcare costs, people being forced under penalty of law to pay exorbitant premiums, more bureaucracy, higher taxes, larger budget deficits, and little to show for it all except richer insurance companies and more IRS agents to bully Americans into buying their fundamentally defective product.  We're all officially serfs now, except the rich of course.  This is an outrage and must be fixed ASAP!

The Un-American Solution

The House recently passed their version of healthcare deform, with all the bad stuff (e.g. individual mandates) and a very limited public option. Plus the Stupak Stupid Amendment about abortion. It's all a giveaway to the greedy insurance companies, like the bailouts were for Wall Street, at taxpayer expense. But it will finally "fix" healthcare, right? Wrong--that's like throwing all of us into a pool full of sharks, and maybe one or two small dolphins, and expecting no one to be eaten. In a nutshell, it would "force everyone, with some small exceptions, to buy an overpriced, defective product, year after year, or face a stiff financial penalty," according to one highly astute critic. Since when did a right (to healthcare) become mandatory anyway?

Aside from the ethical implications, there are also constitutional ones to consider as well.  Some supporters of the plan say the General Welfare Clause somehow gives the feds the power to force people to buy private insurance.  But there is absolutely no precedent for that in this country, and for good reason.  Car insurance is a poor comparison since it is only forced by the states, not the feds, and driving on public roads (as opposed to merely existing) is a privilege rather than a right.  And while the clause gives the feds (and by extension the states) the power to tax and spend, forcing people to buy something from a private entity is clearly not the same thing.  And the current attempt to make an end run by disguising it as a (punitive) tax fails since such a tax on personhood is a direct tax that is unconstitutional when done by the feds unless apportioned among the several states according to population (which it clearly is not).  But I guess the Constitution, the supreme law of the land, is now "void where prohibited," and we might as well just replace it with the phrase "anything goes."  How did America sink so low?

But this will most likely not pass the Senate, thank God. There is no way this can survive a filibuster, especially a bipartisan one. Republican Senator Tim ("Dr. No") Coburn said he will do so by reading the entire mammoth bill out loud on the floor. Read the bill? That's a first for Congress! Hey, how about we do that for EVERY bill that comes to the floor from now on? Takes too long? Well maybe we should put a limit on how many pages a bill can have.

And maybe more people will read between the lines. The healthcare deform bill is really just a capitulation to the insurance industry, plain and simple. Let it die a quick death in the Senate, and may it never be resurrected in a similar form.  The American people agree:  only 32% say Obama's (really Congress's) plan is a good idea, a new low, while nearly half (47%) say it is a bad idea.

Also being debated is that the Senate bill also may expand Medicare to everyone over 55 instead of having even a weak public option for all ages.  At the expense of younger people, of course, who will be taxed to pay for it AND be forced to buy private insurance!  If so, that is intergenerational robbery on an unprecedented scale.  But hey, as long as the ruling Boomers benefit, to hell with their kids and grandkids, right?  Wrong.

The TSAP believes in a single-payer healthcare system for all Americans, funded by progressive taxation, not regressive premiums and penalties. Few Americans know that there is currently an excellent bill in Congress that would do exactly that, but is currently stalled.  Healthcare is a human rights issue above all else. Anything less would be uncivilized.