Thank You Failure, ACA Edition

It’s day two of healthcare reform’s trial at the Supreme Court — I know, I know, but that’s what this whole circus looks like. And honestly I’m feeling relatively Zen-like about the whole thing. I think we win either way.

I can honestly see SCOTUS ruling the individual mandate unconstitutional, which would empower a Teanut-led Congress to completely shred the law, instead of their current piecemeal approach. I can see this happening not because I understand squat about Constitutional Law but because I know the Supreme Court has a long history of making really crappy, stupid decisions. We’ve survived. Slavery was abolished despite Dred Scott, in fact, it probably hastened the Emancipation Proclamation.

In Buck v Bell, SCOTUS allowed the state to forcibly sterilize those it viewed as “genetically inferior.”Explained the New York Times on Saturday,

In 1924 Virginia ordered Ms. Buck, 18 years old, unmarried and pregnant, to be forcibly sterilized. Her legal guardian appealed, and the case made it to the Supreme Court. The winning argument blamed her pregnancy on hereditary weaknesses — in particular, her presumed feeblemindedness. Justice Oliver Wendell Holmes Jr.’s majority opinion entered history: “Three generations of imbeciles are enough.”

Let me just say: SCOTUS giving the government the authority to permanently sterilize people sure makes them telling us to buy health insurance look tame by comparison. But what do I know.

Anyway, here’s the thing. The Affordable Care Act was a crappy law, we all knew it. I think I called ita “shit sandwich.” But it was a starting place. It did a couple of good things, like end pre-existing conditions and lifetime benefit caps and yada yada. But really, it’s a Band-Aid on a serious problem which has had massive repercussions across the landscape of America’s economy and competitiveness. That’s the thing no one is really talking about: the problem is real. No one made up the50.7 million uninsured or the fact thatthe U.S. spends moreon healthcare than any other industrialized nation yet we have less to show for it. These are very real issues and they have very real ramifications. And they won’t go away by calling Obama a socialist.

Typically, Republicans are in denial. Take Mitch McConnell, for instance: all in favor of repealing “Obamacare” .. and then what?

But he doesn’t favor comprehensive legislation to replace it. “We would want to more modestly approach this with more incremental fixes,” he told me. “Not a massive Republican alternative.”

Two ideas McConnell mentions are allowing people to purchase health insurance across state lines and reforming medical-malpractice laws. Neither idea would do much to increase coverage, and McConnell didn’t mention one idea — changing the tax treatment of health insurance — that would, perhaps because his party hasn’t reached a consensus on it.

These tweaks the Republicans continually mention are not solutions to our massive healthcare crisis. They are baubles to corporations. They are not up to the task of solving a massive problem 100 years in the making and they will solve nothing. In some cases, they will make things worse.

If healthcare reform is repealed, there is no reset. We aren’t going back to the good ol’ days when doctors made housecalls and people didn’t have to choose between buying heart medication or paying the light bill. No, we’re going back to a really sucky, unworkable, crisis situation. This is obvious to anyone doing business in this country. I see repeal making “Medicare For All” that much more inevitable, and that will be a shiv in the heart of the private, for-profit insurance industry. They will only have themselves to blame for working so hard to undercut what was really a lifeline Congress threw their dying industry.

Mind you, I’m not hoping for failure. I want a win because I think Obama and the Democrats need this win, and I also think the law does some good things that people really, desperately need. But it’s just postponing the inevitable. Our healthcare system is massively fucked up and the private, for-profit insurance model is unsustainable. It’s going to change because it has to. Like the Dred Scott decision, a SCOTUS ruling against the Affordable Care Act could be the impetus that drives the change we didn’t get from Congress.

So, if we lose, fine. I’ll be singing this song:

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13 thoughts on “Thank You Failure, ACA Edition

  1. Eykis says:

    Excellent analysis and article. Thank You.

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  2. cwaltz says:

    I’m in the “could give two figs about a Democratic win” crowd but have adopted pretty much the same attitude as you. One way or another health care is going to be reformed if the GOP screws up their own plan to spite Obama(and basically this was the Heritage plan) then it only hastens a Medicare for All system. If not, well I figure it won’t be long before the insurance industry pushes too far and consumers demand that government exert better control over them and in the interim my under 25s will have coverage.

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  3. The only reason I think an Obama/Dem win is important is because SCOTUS ruling against healthcare reform will empower the crazies to do all sorts of heinous things. These are the people who took Bush’s squeaker of a win in 2004 as a FUCKING MANDATE HERE US ROAR AROOOOGA AROOOOGA.
    So, that’s kind of what I’d like to avoid.

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  4. HEAR us roar. Not Here.
    Sheesh.

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  5. Lex says:

    [[It did a couple of good things, like end pre-existing conditions …]]
    Having two brothers with Type 1 diabetes, I sort of wish you didn’t sound quite so blithe in acknowledging what, for them, may well be life-extending.
    Also, Southern Beale, I’m pretty sure you spelled it the way they did.

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  6. Jesse in Jersey says:

    You’ve nailed it. However, you forgot to mention that this will be hailed as a successful 37 dimension chess game gambit by Obama to get back to a single payer system, which he REALLY, REALLY wanted in the first place.

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  7. If I sound blithe it’s only because I’m making a point that’s been made a thousand gazillion times. It’s not because I’m making a statement on the importance of ending insurance company death panels.

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  8. joejoejoe says:

    I could see Kennedy voting against the mandate and for “severability”, which means the law goes forward only without the mandate. Nobody seems to have a problem with mandating people pay taxes to fund emergency room care or SSI in advance in case you just happen to be a widow or an orphan so the legal debate here is entirely political. Kennedy seems like he is in love with splitting the difference so that is his path. If both sides are mad he must be doing something right or something.

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  9. MapleStreet says:

    McConnel said, “We would want to more modestly approach this./..” **MORE MODESTLTLY**??? How in the world could you approach it more modestly???
    I couldn’t agree with you more that the current “Healthcare reform” is a sickening bandaid. I’ll also say that the repubs delayed and delayed, said they’d compromise and support ___ and then vote against it, etc. that we got an extremely crippled and vile bill.
    Perhaps the first of a long line of insults is calling this healthcare reform when it doesn’t change healthcaare. It is strictly payment reform. It changes only who pays and how. Even though it gives the insurance carriers a golden ticket of making everyone sign up for insurance, the largely Texas based insurers and largely repub backer insurers and still pulling the strings on their minions to sink it.
    We are still light years from making any reasonable changes to the healthcare problems pointed out in Institute of Medicine reportshttp://www.iom.edu/Reports.aspx from over a decade ago. Notably, of the reports listed on this web page, they list 161 reports filed under Quality and Patient Safety and 147 under Health Services, Coverage and Access. If you’re just starting reading their reports, I’d suggest the 1999 report, To Err is Human: Building A Safer Health System.

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  10. MapleStreet says:

    Oh, and about the consitutionality of making everyone sign up for insurance, I can’t remember the political honcho who a few years ago in a TV news talk show said that one easy way to handle that is to instead make a line item tax deduction for health insurance. That way it isn’t a tax, but if you buy insurance you get it off your taxes. Don’t buy insurance and you don’t get the write off.
    Considering the things which are deductible, this would be an easy way of doing it.

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  11. pansypoo says:

    would medicare for all make the rite more insane?

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  12. delagar says:

    That’s hard to picture — the Right more insane — but then I keep saying that and they keep proving me wrong, so.

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  13. If only the Individual mandate would be voted down as unconstitutional, insurance companies would revolt. they don’t want to be saddled with laws wherein they have to insure individuals even with pre-existing conditions.

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