The Supreme Court on Obamacare

Much will be written about the Supreme Court’s disappointing decision in the next few days. I’ll just make three points, one about the program, one about the philosophy underpinning it, and one about politics:

PROGRAM: The mandate requiring consumers to purchase their own insurance was necessary to fund the other parts of the Obamacare package. An influx of premiums (or tax penalties) from those who won’t likely use the system very much will counter some of the additional expenses. But remember, the mandate has always been a compromise position for those on the left anyway. They really prefer a single-payer system and total control, but agreed to the mandate (and some other back-room deals) to pass what they could. They’re not finished. Expect them to move more aggressively toward a single-payer system.

PHILOSOPHY: The health care debate is about redistribution of income, not about access to care. Obamacare cannot deliver what it promises without both rationing and taxing the middle and upper classes at a higher level. The money just isn’t there without wealth redistribution. The access problem affects only a small percentage of Americans and can be addressed with other measures.

POLITICS: Congress can change the law if it wishes, but without a 2/3 majority this can only happen with the blessing of the president . Romney has been running as an anti-Obama big tent candidate. He has vowed to repeal Obamacare but has avoided specifics. This decision gives Romney a golden opportunity to define his candidacy if he chooses to pursue it. His prospects for success in November hang in the balance.

The battle is far from over, but we need leadership. We’ll see if Romney is up to the challenge.

17 thoughts on “The Supreme Court on Obamacare

  1. This is a gift to Mitt Romney and the Republicans. If they get serious they can win big in November. If they don’t, then the conservatives won’t turn out and Obama will win again.

  2. a blessing in disguise. romney must focus now. he can unite the party if he handles this right.

  3. This gift came as a total surprise, so much so that it is a game changer. Obama must now defend Obamacare, all 2,700 pages of it. If it had been defeated like they thought it would be, he could attack the Supreme Court, the Republicans and right wingers in general. He is much better attacking than defending. This is not just Romney. It now involves the House and Senate. Neither can look this gift horse in the mouth. They must take it apart page by page. Forget repeal and forget the mandate, which is just a token tax. Expose all the hidden taxes, regulations, impact on the states, the economy, the future of health care. Make voters understand that this is the law and this is the man who gave it to you. A tax disguised as a mandate, pass it then read it, etc. The best words Republicans can hope to hear are “yes, but you don’t have a plan”.

  4. Hey Aliza, why can’t these millions pay for their own healthcare? The rest of us can’t afford to pay for theirs and ours at the same time. Maybe they can give up their cell phones and buy their own policy. The number of people without health insurance who are willing to pay for it and can’t get it is very small. Besides, if insurers have to cover you after you get a costly condition, then why not just pay the Obamatax and then go to an insurance company if you have a big expense. Obamacare is not only redistributing even more income, but it’s dishonest and bad policy.

  5. Sort of, Aliza, but that doesn’t make it good policy. Romney is a flawed candidate. You didn’t answer my questions. Why can’t the uninsured pay their own bills when most have cell phones and many own their own homes? Why shouldn’t I drop my $5500 per year policy, pay the Obamatax (less than 1000), and then sign up for coverage again if I get really sick?

  6. GB77, Cellphone costs are nothing in comparison to medical bills. You can get a cellphone in Wal- Mart and pay $45 a month, about half a price of a single specialist co-payment visit. Even uninsured people need to live somewhere and in many cases the mortgage payments and the rent payments are similar. People are not insured from different reasons such as: they have pre-existing medical condition and insurance companies will not accept them and they cannot get insurance. They may be very sick and passed the insurance policy’s lifetime limit and have huge bills that they cannot pay. Sometimes insurance companies cancel the coverage, exactly when you need it, on technical reasons. People who lost their job also lose their insurance.
    This law will allow every citizen to have health insurance, like in every modern nation in the world. This is America, not a third world’s country.

  7. Aliza, so if a cell phone costs $500 per year, then why can’t someone without insurance get rid of their cell phone and their satellite dish (another $500 or $1000) and pay that before asking everyone else to pick up the tab? These are not essentials. Why do they get to use THEIR money to pay for these things but tell us that they need OUR money to pay for health care? Why do you think it’s impossible for low income Americans to pay for part or all of their own insurance when they spend freely on other things? IT’S SIMPLE MATH, WE CAN’T AFFORD IT!

    By the way, VERY FEW people ever get past the insurance lifetime limit and insurance companies do not ordinarily drop people who are sick. Insurance portability is also easy to address so that insurance is not tied to jobs. All of this can be managed with simple legislation. Obamacare is a whole lot more than any of these things!

  8. So Aliza, say I’m 30 years old, self-employed, making 100k, thus not eligible for Medicaid, and I decide to drop my insurance and elect to pay the penalty under Obamacare. It is $95 per year or something way cheaper than my insurance, and is collected by the IRS, which I assume means that I declare it on my tax return, to be filed at some future point. I get sick and call 911 and the ambulance driver asks me for my insurance card (which incidentally they do now). I tell her I’m covered by Obamacare and have elected to pay the penalty. Since she voted for Obama, she takes me on to Emergency, IV in place, and they admit me to the hospital and keep me for 48 hours, total bill $20,000. Who is my insurance company? Does the EMS responder sign me up on the spot? Maybe when I’m in the hospital, someone from an exchange will come over and take the app. If so, can I drop the insurance when I get out?
    I know I’m missing something obvious but so far I haven’t heard how this works. No one bothered to read the bill as they thought it would be defeated by the Supreme Court. But I do remember that there is no public option. Since this is now the law of the land, you would do us a great service by telling us how the mandate actually creates more insurance coverage.

  9. Arthur, I’m not Obama’s spokesperson. I advocate for the idea of this law, which I believe is fair and just. I’m sure that you can contact the Obama administration and they will be glad to assist you with all your questions. I wonder if no one read the bill, how can they so strongly resist it?

  10. Aliza, laws are not just ideas. Most people support the idea of having the best healthcare available to everyone, but that’s not the point. Obamacare tries to get there by redistributing wealth and restricting personal choices.
    EVERY BILL SHOULD BE STRONGLY RESISTED UNTIL IT IS FULLY UNDERSTOOD. You should not advocate for Obamacare if you don’t understand how it works. I oppose the bill because I’ve read it and I understand the details. It was Nancy Pelosi who said that Congress needed to pass the bill so that we could find out what was in it.

  11. Here are 3 reasons I oppose the Federal Government being involved in healthcare: (1) it shouldn’t, (2) it can’t run it (see Medicare and Medicaid) and (3) it’s broke. Back to Fred (the guy who dropped his insurance). In a previous post you said 32 million would now have health coverage. I assume this would include Fred, who just dropped his insurance, so I’m not sure what you meant by coverage. Since Fred is now “covered” under Obamacare, who writes the check to the hospital? The mandate is just a smokescreen. It will not force people to buy insurance. In fact, it may have the opposite effect. Individuals and businesses will pay the penalty and drop coverage. Obama wanted to pick up the slack by expanding Medicaid, but the Supreme Court made that difficult. Aliza, you don’t need to be a spokesperson to at least be aware of how something you support works. But this is a typical progressive response. Just trust us and everything will be fine. Can’t we just get past these details? After all, look at the great job we’re doing on the economy, welfare, jobs programs, Medicare, you name it. You should be happy that we’re offering to help since you’re incapable of doing any of this without us.

  12. GB77 and Arthur, I come from a country where this kind of law exists since 1994. I lived many years under this law, so I guess I have some notion of how it works. The details of Obamacare are a bit different. For ex. in my country there is no option to pay penalty and not be covered.

  13. Switzerland enacted an insurance mandate system in 1994, Israel a Two Tier system in 1995, so I’m assuming you are from one of those countries. Obama wanted a single payer system but had to settle for an insurance mandate. He had a majority in both houses when that was enacted and barely got it passed. He lost the House by 63 votes in 2010, the result of a backlash against Obamacare. We currently have a two tier system for senior citizens where the insured pays a monthly premium and usually carries a supplemental policy to cover what the government doesn’t pay. Premiums are also collected from the workforce through payroll taxes. Even with premiums and co-pays, Medicare is in the red about $500 billion per year. Reasons: We have an aging population where most of the health care costs occur. And we also have a dwindling workforce so less money is coming in through payroll taxes. But there are no proposals to do anything about this problem. This is what our government does. They obligate future generations based on slick talk and then when that doesn’t work out, they ignore the problem. That is why there is no confidence in this government to handle something like universal health care. Forgetting the political arguments, they simply can’t.

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