What happens if “Obamacare” gets shot down by the Supreme Court? The most troubling part of the law, even from a Liberal’s perspective, is the individual mandate–the deal “we” cut with the insurance industry to buy their support for a system of increased regulation. It has always seemed wrong that the government could require individuals to purchase products from private businesses, and a sort of “devils-bargain” that Democrats and others had to make. It seems like a system of private taxation. Maybe it’s always been that way–if you have insurance, it’s already taken out of your taxes (and away from your employer) almost automatically before you get your paycheck, but at least it wasn’t technically required that you surrender another 10-15% of your paycheck to the corporation of your choice.
An AP article today posits that this is not the first or last mandate, comparing it to the Medicare payroll tax. But the analysis quickly leads down an interesting path…we can tax people to support a system that may not benefit them directly, but we cannot force them to buy insurance from private providers? Well then, it seems the solution is obvious: single payer health insurance. That’s the train of thought Robert Reich picks up today in his article where he sees an opportunity for the potential collapse of the individual mandate to open the door to what we should have done all along.
Reich’s argument is that Obama and the Democrats could turn the tables on opponents of health care reform if the court strikes down the mandate. Because Republicans would not support single-payer, Democrats tried making a deal with insurance companies and that deal may be struck down. So now, the choice (for opponents) can become to make a deal with the lesser-devil (Liberals): in exchange for concessions about what is required to be covered, Republicans could accept the validity of some form of single-payer system–or, if they cannot stomach that, they can just embrace the idea that their party really is just a bunch of angry social Darwinists who would love to see the poor and uninsured die off and save us the trouble of having to deal with them.The key point is that the court may essentially remove the insurance industry from the negotiations.
Once we have a single payer system, we’ll have a radical shift. The waste, fraud, and abuse–secretly perpetrated by the insurance companies–will be cut loose as their product becomes not a required purchase, but a supplement for those who seek better coverage than the basic level to be provided by a National single payer system. Of course conservatives, libertarians, and most Republicans will go apoplectic and cry about how wasteful the government is, but at least we might start with a clean slate and some degree of transparency. In all their hatred of government, they ignore the fact that we have none of that now with the existing system. All the ridiculous technicalities and tricks used to avoid paying out claims could be moved to a single, publicly accountable organization.
Perhaps this has been the plan all along–if so, it’s brilliant. It was critical to get something passed–to move the political football forward in some direction so the other side could make their move. If the Supreme Court strikes down Obamacare it may actually move us closer to the day when every American has the quality of health coverage the rest of the free world takes for granted.