Steven Pearlstein: Eat your broccoli, Justice Scalia
Like most Washington policy wonks, I spent too much of last week reading transcripts of the Supreme Court arguments over the constitutionality of the new health reform law. This was to be a “teaching moment” for the country, an opportunity to see the best and the brightest engage in a reasoned debate on the limits of federal power. Instead, what we got too often was political posturing, Jesuitical hair-splitting and absurd hypotheticals.
My first thought on perusing the briefs filed in the combined cases was to notice what wasn’t there: any involvement on the part of Corporate America.
For the past 20 years, big business has complained endlessly about escalating health-care premiums, which they correctly blamed on “cost-shifting,” including paying indirectly for the free care provided to the workers at firms that did not provide health benefits. They wanted an end to fee-for-service medicine that rewarded doctors for providing more care than necessary. Some even talked of reforms that would begin to move the country away from an employer-based insurance system.
If Obamacare is overturned, will that lead to single payer? And would that be a good thing?
By Ezra Klein,Jonathan Ernst Reuters Buttons reading 'Repeal Obamacare' are displayed at the American Conservative Union's annual Conservative Political Action Conference (CPAC) in Washington, Feb. 9, 2012. Last week, I wrote a column envisioning a world in which the Affordable Care Act is repealed and the Ryan budget is implemented. Here’s how I saw it going:
It’s unlikely that the model in the Republican budget will prove sustainable. That legislation would repeal the Affordable Care Act, cut Medicaid by a third and adopt competitive bidding for Medicare. The likely result? The nation’s uninsured population would soar. In the long run — and quite possibly in the short run — that will increase the pressure for a universal system. Because Republicans don’t really have an idea for creating one, Democrats will step into the void.
In reply, Will Wilkinson snarked:
Even if the Republicans win, they lose, and Democrats get everything they always really wanted! This sort of thinking is so wishful it’s almost touching.
This is, I think, part of the unfortunate tendency for disputes over health-care reform to be framed in terms of which political party they benefit. As the thinking goes, if the Supreme Court overturns the Affordable Care Act and then Medicaid gets cut by a third, that’s bad for President Obama and the Democrats and good for Republicans.
The Wall Street Journal: Unwitting Advocates of Single-Payer|
Take It From Me: Defending Obamacare is Super-Hard
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Young: What's really wrong with Obamacare
There is much consternation in liberal circles this afternoon, as the arguments before the Supreme Court about health care reform’s crucial individual mandate don’t seem to have gone very well. “A bad day for Obamacare’s supporters,” writes Ezra Klein. “I think this law is in grave, grave trouble,”said Jeffrey Toobin.
I tend to give more credence to the accounts that things weren’t actually that bad—the questioning during these proceedings is not predictive of the final outcome, and Justice Anthony Kennedy has plenty of room to side with the government—but it’s worth considering what would happen if, indeed, the individual mandate is junked.