In a matter of days, the U.S. Supreme Court will hand down the highly anticipated decision on whether the Obama healthcare plan is constitutional. Predicting the court’s majority mindset is a crapshoot. Court observers say the decision could go either way. But whatever the outcome, one thing is certain -- needed healthcare reform will remain elusive. Neither those for it, nor those against it have presented a viable plan that will both give adequate coverage to all Americans and get the escalating costs under control.
The central concept of Obamacare is the individual mandate. Every citizen who can afford it must buy a healthcare policy. The reasoning for such a mandate is clear. If you don’t buy health insurance, then are forced to run off to the emergency room when the need arises, someone else must pay your cost. There is no free lunch.
The forced mandate concept was a Republican proposal conjured up by the conservative Heritage Foundation. Ronald Reagan signed on as did former House Speaker Newt Gingrich and a host of other Republican stalwarts. The idea was billed as the taking on of personal responsibility. If you and I have to pay the piper, shouldn’t everyone? Where else in our society can someone make absolutely no preparation for essential needs, and yet tap public funds to pay for goods and services of a million dollars or more? Isn’t this the ultimate welfare? There should be no free riders unless they are destitute.
The worst case scenario would be for the Supreme Court to throw out the individual mandate, but uphold the rest of Obamacare. A number of states took just that approach in the mid 1990s --expanding health benefits with no requirement that all their citizens buy a health policy. This would include such allowances as no exclusions for pre-existing conditions, letting children up to 26 stay on a family policy, and selling policies to anyone who asked. With these and other market reforms in place, and no requirement that everyone have coverage, insurance rates skyrocketed. The same will happen if the mandate is thrown out but the rest of Obamacare is allowed to stand.
Constitutional or not, the Obama plan dampens an incentive for employers to hire more workers. Any employer with 50 or more full time employees is to provide health coverage or pay a substantial fine. Recent polls show that as many as 30% of employers will opt to pay the fine, and not buy insurance because the insurance coverage costs more than paying the fine. This will lead to more employers dropping insurance and taxpayers being compelled to pick up more of the costs. And if Obamacare works just as proposed, there still will be some 30 million people who will remain uninsured, including 10 million illegal immigrants and many more citizens who are not able to pay the necessary out-of-pocket expenses.
So Obamacare either passes judicial muster but leaves large gaps in the ranks of those who want to be insured, or it fails the constitutional test and rates across the spectrum climb dramatically. If congress does go back to the drawing board, as they may well be forced to do, what is the alternative? The Republicans seem to offer the status quo with some built in benefits that will cause premiums to take off like a rocket. Here is the language in the most recent Republican “Pledge to America.”
“Health care should be accessible for all, regardless of pre-existing condition or past illness. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate lifetime spending caps, and prevent insurers from dropping our coverage just because you get sick.” If Obamacare is socialism, then what do you call this GOP program with its massive government intervention?
So let’s see what we have from both Republicans and Democrats. You as a citizen will be forced to buy your health coverage from an insurance company that siphons off some 27% in expenses so that it can pay huge salaries to their top brass. Take it or leave it. If you leave it, you pay a hefty fine. Both parties would seem to be at the beck and call of the insurance industry which pours millions of dollars into congressional campaign funds. Is this the best we can do?
The cost of providing healthcare in the U.S. is more than twice that of any other developed country with the exception of Canada. The cost of providing healthcare in the U.S. is $7,538 as compared to $4,079 in Canada, $3,698 in France, $3,733 in Germany and $3,129 in England. Yet, get this -- the life span in these countries is, on average, two years greater that of American citizens. Is this the “American exceptionalism,” where we are bankrupting many individuals, numerous businesses, and governing bodies across the country?
Attorney, writer, and political activist, Miles Mogulescu points out that: “Every other capitalist country has either single-payer systems paid for by taxes or a highly regulated utility. America is the only capitalist country with a private profit-driven insurance system. With a multiplicity of payers, there’s no single entity that can negotiate more efficient delivery systems and lower prices with medical providers.”
Conservative Louisiana Republican Attorney General Buddy Caldwell has endorsed the government backed single payer system, saying it’s “a whole lot better” than mandating private insurance. But universal healthcare just doesn’t work very well in other countries, critics say. They often point out how bad the Canadian system is. So who do you ask to find out?
In the hit series “24,” when our government gets into a serious jam, they call on rogue intelligence agent, Jack Bauer, played by actor Kiefer Sutherland, who uses torture and all kinds of illegal methods to help the president fight the terrorists. Rush Limbaugh loves the show and has visited the “24” set. Sutherland happens to be the grandson of the guy who founded the Canadian healthcare system. Here is what Sutherland has to say about Canada’s single payer approach: “Private health care does not work. America is trying to change their system. It’s too expensive to get comprehensive medical care in the U.S. Why on Earth would we in Canada want to follow their system here? I consider it a humanitarian issue. This is an issue about what is right and wrong, what is decent and what is not.”
What all this means is that whatever the outcome of the soon to be released Supreme Court decision, the effort to find a satisfactory solution to America’s troubling healthcare crisis is still a ways off. The costs continue to rise, and the piper is demanding to be paid. It’s like the mechanic said in those old oil filter commercials. “You can pay me now, or pay me much more later.”