LION AND THE LAMB: Health care and the Supreme Court

Opinion

June 19, 2012

LION AND THE LAMB: Health care and the Supreme Court

By R.C. Braun, M.D. Chronicle contributor The Crossville Chronicle Tue Jun 19, 2012, 03:27 PM CDT

CROSSVILLE — The Supreme Court had hearings in March regarding the constitutionality of the Affordable Care Act (ACA, often referred to as ObamaCare). A decision is expected before the end of June.

There are three possible scenarios for a decision by the Supreme Court:

1. The entire act is declared constitutional as enacted, and full implementation can follow.

2. The entire act is declared unconstitutional and is struck down.

3. Specific sections of the act are determined to be constitutional and can be implemented, while other sections are rendered null and void.

One significant problem is that millions of Americans are already benefitting from provisions of the act, and reversing these benefits creates many problems. Examples include: rules that prohibit insurers from denying coverage for people with pre-existing conditions, canceling coverage when people get sick, or imposing annual or lifetime caps on coverage.

In "Talking Points" Sahil Kaptur writes, "If the Supreme Court strikes down Obamacare, Republicans claim a huge short-term victory, but they may end up big losers in the long run. The future of the nation's health care system would be thrown into disarray, and conservatives may be forced to swallow a more bitter pill." The average American does not comprehend how close to total disarray our health care system already is. A number of health care advocates would welcome such a collapse as the only way to start from scratch in developing a health care system that works for all.

For many, the mandate requiring purchase of health insurance from private insurers is the main objection to the ACA. They would agree to the other parts of the act. However, it should be apparent that the already active benefits of the act shown above are totally unworkable without the enlarged insurance pool provided by that mandate. The Affordable Care Act is a "seamless garment," with parts that are interdependent.

So, if the Supreme Court affirms the constitutionality of the Affordable Care Act, would that solve all of our health care problems? Not by a long shot! The bill is a very imperfect bill leaving many problems still to be fixed. Most notable is the stranglehold of the health insurance industry, which has succeeded in this bill in ensuring its dominance and profits.

However the Supreme Court rules, we still have lots of work to do to develop a health care system that works for all. Someday we will learn that this can be done only through a unified system, such as Medicare for All, or Single Payer Health Care.

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