Today, the Roberts Supreme Court will hear the first of three days worth of oral arguments about the constitutionality of the Affordable Care Act, colloquially known as Obamacare. Some suggest (and I am inclined to believe) these oral arguments are largely ceremonial, intended to signal to the public that Chief Justice Roberts and his fellow justices take the issue very seriously, when, in actuality, the Court’s decision will be based, almost entirely, on their reading of the briefs already filed. Regardless, the extended oral arguments will, throughout the course of the next three days, better inform and educate the public about the underlying arguments both for and against health care reform, and to me, no matter how you stand, that is a good thing. Indeed, the last time the Supreme Court allowed such a robust discussion on a case was in Miranda v. Arizona, and the ruling in that case, which established a citizen’s right to a “Miranda” warning, was also a good thing.
Still, when critics point out that three days worth of oral arguments aren’t necessary, they’re not suggesting that this case isn’t monumentally important, just that it’s cut-and-dry. And it is. Despite what opponents of President Obama’s health care reform act may suggest, the federal government has always maintained the ability to regulate significant interstate commerce. This right is enshrined in the Commerce Clause of the Constitution and in decades of case law. Opponents of the individual mandate are advancing a strain of libertarian fundamentalism that has never been accepted as the rule of law in this country. They are disingenuously or perhaps myopically arguing that Americans have a fundamental right to not contribute to or participate in a system from which they derive a benefit (whether one’s ability to access health care is past, present, or future, whether it’s exercised now or guarded for later on, it exists nonetheless). It’s a rigidly ideological position that holds very little basis in reality.
Many, if not most, of the same stalwarts for non-intervention on health care argued vociferously to spend our blood and treasure on a misguided war in Iraq, a war based on false pretenses and bad intelligence, and no doubt, they also held fast to the belief that Americans who believed the war to be unjust could not merely withhold their taxes or their obligation to contribute. When it comes to national defense and security, no matter how outrageous the expense and regardless of whether we disagree with the mission, we are all obligated to contribute, for the sake of our shared security. People who, like me, opposed to Iraq War didn’t argue some fantastically laissez faire position about the constitutionality of “inaction” or advance the notion that we somehow have a right to opt out of participating when the government mandates our dollars be spent on things we ideologically oppose, whether it’s a product, an insurance package, or a couple of wars. Provided those things are mandated in order to protect either the security or the economic solvency of the nation, Americans have always understood their obligation, even if it requires shared sacrifice.
So, the argument that mandating people to participate in insurance somehow erodes the freedoms enshrined by the Constitution is nothing more than politicized hogwash. Because we all rely on the goods and services of others, we are all mandated to contribute money to the government each and every single time we buy anything. Anything. America has not and has never been the selfishness-as-virtue dystopia envisioned by Ayn Rand. Her vision of a world in which individualism reigns supreme may make for good (sorry, sub-par) fiction, but it’s baseless: Human beings are interdependent; Americans rely on the sanctity of the social contract, not only for our security but also for our economic well-being.
In the case of Obamacare, here’s what we’re facing: An expansion of health care to more than 40 million people and thus an overall reduction in spending, a decrease in average premiums, guaranteed coverage for the millions of Americans who, like me, have a pre-existing medical condition, protection for anyone under the age of 26. And at what expense? Well, a paltry 4% of big businesses that employ more than 50 people will now be obligated to provide coverage that they should have already provided (or otherwise pay a fine), and the payroll tax will slightly increase in a few years for people making more than $200,000 a year. Working-class conservative folks who just instinctually oppose everything Obama and those heathen Democrats should really pay attention to this: While your friends couch their opposition in philosophically naive rhetoric about buying “products,” while they pretend to worry about the constitutionality of requiring them to participate in a government program, the dirty little secret is: They’re mainly opposed to the rich paying slightly more in taxes in order to ensure for the health and economic security of people just like you. That’s it, in a nutshell. And to be sure, opponents of Obamacare will stop at nothing to advance their argument: They’ll distort the findings of the non-partisan Congressional Budget Office; they’ll blame Obamacare for every health care-related company that has ever gone bankrupt during the last few years. It’s non-sense, of course, a manufactured excuse for the institutional incompetence.
Make no mistake: Obamacare is a good word. If you don’t believe that you are intrinsically tied to our health care system and therefore owe nothing to ensure its solvency, then, please, do the rest of us a favor: Personally reimburse each and every doctor, nurse, and hospital employee you have ever encountered since the moment of your birth, because otherwise, the rest of us still shoulder that burden.
Indeed, “Obamacare” is a good word. You and I, thanks to pre-existing conditions, have a lot to be thankful for because we can no longer be turned down for PRIVATE insurance coverage. Although I think you’ve probably been understandably cautious to avoid discussing your highly personal stake in the law, I think it’s worth noting that this is a momentous provision, emblematic of the health care law’s down-to-earth, common sense approach to fixing the health insurance market.
I don’t want to dismiss your comments about the motivations cited by opponents of Obamacare, but I do think they need some supplementing. I would characterize what you’ve written above as the short/medium term motivations. However, your comment about the Commerce Clause always being recognizes as giving the power to Congress to regulate precisely the kind of commerce at issue in health insurance reform is not exactly consistent with the Supreme Court’s entire body of commerce clause decisions. Without digressing into a long narrative on the twists and turns of two centuries of commerce clause jurisprudence, it should suffice to say that the long-term motivation behind the opposition to the health care law stems from opposition to an interpretation of the Commerce Clause that essentially justifies the establishment of the modern regulatory state. You and I agree that the Commerce Clause does grant such powers to Congress. Enemies of the EPA, the FTC, FDA, SEC, etc. disagree with us and hope to capitalize on this case (the one argued before the Court this week) to press their argument for a severely restricted interpretation (and arguably out of touch with reality) of what exactly constitutes “commerce.” (As if the democratically elected Congress and the President don’t know what commerce is, but the Supreme Court does.)
There needs to be greater recognition of this long-term goal to put this radical agenda in proper perspective.
Lamar -thanks for pointing out the fact that we are paying for this healthcare bill and the current healthcare system largely because we have allowed so many people to get away with using it for free. If you want care, you need to pay something for it. Also, it’s dangerous to let people go around thinking that they can just be uninsured and will get great free care. it’s not true. You may get care, but you’ll get it behind everyone else that’s out there with insurance, and you won’t be choosing where to get your care, because you’ll be dependent on the state or the county. If you develop a serious disease, you are risking alot.
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