Urban Insurance

During the banking crisis a back in 2008, the common cry was “Too big to fail,” well in the case of the Affordable Care Act, perhaps it was “Too big to succeed.”

The Supreme Court is in its third day of hearing arguments on the legislation that has sparked fury on both sides; in-fact defeating in the bill became the core-value behind the “Tea-Party” movement.  Putting aside the over-the-top claims that “ObamaCare would result in “Death-Panels” that would start killing grandparents, doctors would be reduced to working for minimum wage and that we would wake-up to find America healthcare reduced to treating patients with leaches; the real concerns were cost and mandate.It is the”Mandate” that is being tested in the Supreme court.

Today several conservative justices attacked the requirement in the Obama administration’s healthcare law that Americans must have health insurance. One of the questions that many people are asking is “Why are people required to have health insurance or buy health insurance?”.  Clearly there is long legal president for governments requiring people to pay taxes, taxes that in part are used to pay for benefits including Medicare.  But it is less clear if the government can require that you buy a product or service.  In Illinois Auto Insurance is mandatory.

Justice Anthony Kennedy asked the administration’s lawyer, “Are there any limits,.”

Chief Justice John G. Roberts Jr. questioned whether the government might have the right to require Americans to buy cellphones to be better prepared for emergencies.

Justice Antonin Scalia  took the concept of mandates to the extreme questioning  whether the government can require Americans to buy broccoli. “If the government can do this, what else can it … do?” Scalia asked.

The line of questions does not bode well for the administration’s ability to prevail, and a Supreme Court loss could likely see the entire Affordable Care Act collapse   

The question that perplexes many is “Why does the government care if I choose not to buy health insurance?” The answer involves two reasons, the first is what to do when a person who chose not to buy insurance becomes ill or injured. Can we, or do we, want to be a society that would leave people dead or dieing in streets? Historically in America the uninsured can not be turned away from an emergency room until their condition is stable. This treatment is often many times more expensive than it would have been had they seen a doctor sooner. There are also State and County hospitals and clinics that treat those without health insurance. If everyone had the ability to seek medical help earlier in their illness, the cost would be dramatically lower. 
The second reason behind the mandate is that if people wait just until they became seriously ill before they signed up for coverage, this would substantially increase premiums for everyone in the pool.

The irony of the debate is that the idea of the mandate had been a source of common-ground by both democrats and republicans. Insurance pools were a republican idea, and Mitt Romney’s plan was in large part the blueprint for the health-care bill he now opposes.  Furthermore  so many of the individual parts of the Affordable Care Act are widely popular, particularly not being turned down due to prior conditions and extending the time a parent can choose to keep their child on their policy.

In the end, nothing man will create will ever be perfect, and anything created by a committee will  fall even further from the mark. The health care plan has it’s flaws. I give it credit for addressing the inequalities in our healthcare system by reducing the number of uninsured who are “Locked-out” of the best care. I also take issue with it for not doing more to contain costs. America’s population is aging and the cost of medical services are rising at an alarming rate. More and more people can not afford to pay their Health Insurance, businesses are dropping coverage for employees due to escalating premiums, and the government is deep in debt its self. 

 It appears we will soon see if the Affordable Care Act, was too big, or too controversial to succeed; what is clear is that the problems that led to need to address healthcare in America will continue irregardless of the Supreme Court ruling.