Health Care Reform is Constitutional and Incomplete
Perhaps the struggle to reform our health care system has gone back even farther. George Washington likely died as a result of improper bleeding, but had written fiercely for the expression of government at federal level. However, it was clear he and our founding fathers stood for law and reform represented by such types of legislation that can only be described as socialist. The articles of confederation that were adopted by our young country - had created chaos . States actively attacked other states with laws that restricted trade. The commerce clause, which is the current underpinning of the constitutionality of the lobbyist-written "individual mandate" in healthcare reform - effectively ended the trade wars that had developed between the states and brought to our country a sense of unity. More than any article of the constitution, the commerce clause - correctly applied, brings harmony.
What 72% of America called for, when Healthcare Reform was enacted - was the right of a single citizen to be able to receive Healthcare from the government. The lobbyists, who had successfully influenced the 1993 Republican Party to create the "Individual Mandate" - spent nearly 1.2 million dollars a day to influence our process and succeeded in the rewrite this to require us all to buy Insurance from American Corporations. This, if anything - should make you wonder whether or not we are in fact a democracy.
But we are already required, when we get our car registration - to purchase Auto Insurance. Just as if you were sick, and were travelling from one state to the next and had to be hospitalized by ambulance - the idea is that if you were driving your car from one state to the next, you would be covered if you suffered an accident. The roads are a shared resource.
Healthcare Reform writes, in its lobbyist-written language - that the Hospitals are also a public resource. Why? Because they are. No hospital will ever refuse you. If you are hurt, or fall sick - they will take you in and heal you. Sometimes at thousands of dollars of their own expense.
But what happens now is that , afterward - nearly 60% of all bankruptcies in America , for the middle class - are resultant of an unexpected medical expense. We now struggle - all of us - to either pay the bill of someone else, who might have been a member of the nearly 42 million people in the United States who carry no insurance. The system struggles to pay for them.
But more importantly, we struggle to pay bills that are unreasonably inflated as a result of artificial market force. The cost of individual procedures are commonly inflated by hospital billing - even to the point of installing automatic price increase mechanisms in the software that is used to invoice procedures. These increases are , in a socialist fashion - currently passed to the uninsured or underinsured.
Everyone has a story they have either heard in the first person or second person - about a person who suddenly got a huge bill from a hospital or clinic - that their post-Nixon insurance company decided they wouldn't pay. Many have heard of people going broke as a result. This is largely due to the fact that the current healthcare system in America , actually does not work properly for citizens who have no healthcare. The way that would 'fix' it, would be to require everyone to have insurance.
The United States can and will find this constitutional, if anything because the Constitution itself is a document that defines the powers of the Federal government and there is already precedent that such requirement is constitutional. The most important question is not whether this law is constitutional - because this is just the veil of distraction that the republican party wish us all to focus upon. The Supreme Court, in their finding - will more than likely decide for the constitutionality of the law in general, even if some aspect of it is rewritten as a result of the process.
The real test of the reform is whether or not the very simple modification that was proposed by Alan Grayson - will be one day added. The opportunity for any individual, to cash buy into Medicare or some form of the current Government Healthcare Insurance offered to members of Congress and other Federal Employees (see also GEICO, the government employees insurance company). Such coverage , unlike the "individual mandate" , would create a normalizing effect on hospital billing as procedural and diagnostic billing would be forced to adapt to the price pressure of the 800 pound gorilla that would result as a mass number of Americans who are now uninsured or underinsured , would flock to the program.
That is when the reform will be complete. Because that is the day that not only everyone will be insured, but the healthcare system that currently accounts for 1 in every 6 dollars spent in the United States - and from which this fragmented system results in America achieving the rank of 46th in the world for life expectancy, and 18th in the world in terms of preventable death decline as a result of medical innovation.
America is the only country in the world that does not have some form of single payer system. The only industrialized country in the entire world that does not care for its own citizens in this way. We also suffer massive numbers of the underinsured. This has created a culture within our society of a "break and fix" approach to medicine. Insurance companies, controlling both the legislative and legal side of tort reform, billing, and care administration (talk to your primary care "gatekeeper" lately?) .. often practice actuarial conservatism and apply it towards the blanket refusal to consider the wise expense of spending a little to avoid alot later down the road. Patients in other countries - actually pay more to the doctor by being healthy, than by being sick. In America, sadly, it is the reverse. The Insurance Companies seem to refuse to pay anything until it is an emergency - and many of the uninsured do not show up for care until they are in the Emergency room.
But we are all paying for their visits, so it's an easy decision to simply require them to carry insurance. This gives us at least a base upon which they can enter a broken system. A system that will be fixed when we have an option to single payer buy-in to something like Medicare. At which point there will be a unity between government administration of at least one of those insurance entitities - and the agencies of environmental protection, food and drug, and the general accounting office. Such an entity will easily see the longer term costs of avoiding preventative care and institute price normalization as only an 800 pound gorilla can, to allow a free market their adoption.
Even though they receive free care, it is estimated that nearly 44,800 people die each year in the united states because they are uninsured. We can all agree the system is broken. After the existing reforms are found constitutional, whether or not the lobbyist-written individual mandate will be considered userful - the battle to complete the reform should begin again in earnest. The central argument to the provision of healthcare reform in the United States , should not be centered around keeping Insurance Lobbyists happy. Healthcare in the United States needs to be fixed .
Update: 3/28/12 - After listening to the Supreme Court deliberate on the constitutionality of the Individual Mandate, I confess I have learned something. The mandate really isn't a good idea - it wasn't when the Republicans proposed it in 1993, and it isn't today. It really does change the way the Federal Government relates to the individual, and it will likely be struck down. The second, was the level of surprise that I found when Solicitor General Verrelli - who was supposed to be arguing for the law, seemed at odds with the idea that the Supreme Court Justice suggested - that a national healthcare system would be more appropriate than asking someone to go out and buy it from a company. He stated that we "used market effeciencies"... instead of "imposing" a solution. But in fact, correct solution was the simplest one: a cash buy option made available for all, into Medicare and Medicaid.