Health Care: Still Waiting for Real Reform

Nope, no judicial bias on this court.

I have been following the Supreme Court’s hearings on the constitutionality of the Affordable Care Act with a great deal of detached ambivalence. Cynical as it may sound, I do not particularly care what happens to the new health care law, one way of the other.

On the one hand, I do not like the individual mandate, which is essentially a massive giveaway to the greedy, for-profit health insurance industry. A friend of mine recently offered this metaphor for the individual mandate: “Our for-profit health care industry is like a burning building. But rather than vacate the building, or try to put out the fire, the government has made everyone come inside it. Now we’re all in the building, but it’s still on fire.”

But another part of me is concerned that if the entire law is rejected, we will be left with no other choice but to revert back to the status quo—that is, a corrupt system in which those who can afford health insurance receive coverage, while those who cannot, well…they had best die quickly as former Democratic Rep. Alan Grayson put it two years ago.

The conservative Supreme Court is likely to declare the individual mandate unconstitutional. (As I noted in last week’s post, the current incarnation of the Supreme Court is the most conservative since the Harding administration.) What remains unclear at this point is whether the Court will only throw out that particular part of the law, or scrap the entire thing, altogether.

As Truthdig.com columnist and editor, Robert Scheer noted this week, the Democratic Party largely brought this judicial challenge on itself. From the beginning the Democrats refused to even consider single-payer, universal health care as a possible reform option.

In fact, during Senator Max Baucus’s (D-MT) initial health care hearings, single-payer proponents were promptly arrested for voicing support for the measure. (Protests begin at about 6:00. Note Sen. Baucus’s snide, condescending joke about, “needing more police.” Typical Democratic behavior, if you ask me.)

As has become the party’s default practice, the Democrats began the health care legislation with a compromise—in this case, the “Public Option” concept. While the Public Option was not single-payer, it still would have been preferable to the bill that was finally passed. Given the cynical nature the entire “reform” process followed, one would be justified in thinking the Democrats intentionally offered up the Public Option (already a weak compromise from single-payer) as a token bone to placate progressives fully anticipating to later bargain it away in the name of “bipartisanship.”

Democratic apologists now defend the Affordable Care Act, claiming it was the “best they could get passed,” (this at time when the Democrats controlled both houses of Congress and the White House, mind you). This is a pathetic cop-out. The for-profit, pay-or-die health care system in this country is fundamentally flawed. The current system needs to be dismantled and replaced with a national, healthcare-for-all structure. The watered down bill the Democrats passed is little more than a tweaking of the existing system. It is not reform.

Yet all may not be lost. In fact, the Supreme Court’s likely ruling against the individual mandate may actually present new opportunities for progressives to push for single-payer.

Nation reporter, George Zornick arrives at the same conclusion in a recent blog post (“If Mandate Fails, Single-Payer Awaits,” 3/27/2012). According to Zornick, there is no Constitutional gray-area when it comes to Medicare. He writes,

“There is no doubt about the constitutionality here [of adopting single-payer]—the government is clearly allowed to levy taxes to fund public benefits. Medicare, for example, is not challengeable on the same grounds as Obama’s health care reform. So if health care reform goes down, the next logical step may well be just extending Medicare to everyone.”

(Of course, Zornick then proceeds in the next sentence to repeat the mantra that single-payer/Medicare for all was not “politically possible in 2009.” Why it was not so, however, he does not explain.)

The state of Vermont is already experimenting with a single-payer-style health care program which it plans to slowly introduce within the coming years. If single-payer is good enough for Vermont, why not Maine? Indeed, the Democrats’ failure could create the perfect opportunity for a real, robust national discussion about single-payer, universal health care for all.