Map of life expectancy at birth from Global Education Project.

Tuesday, December 14, 2010

Unlike Glenn Beck and Sarah Palin . . .

I'm not a scholar of constitutional law. However, I can have an opinion about the practical, common sense implications of policies. The "individual mandate" to purchase health insurance has been the main focus of lawsuits by teabagging state attorneys general claiming that the Patient Protection and Affordable Care Act is unconstitutional. Now that the co-owner of a right wing consulting firm that made money in the past year by opposing the act, who also happens to be a federal judge (who would have thought that was permitted?) has ruled the individual mandate violates the constitution, there is much rejoicing to starboard. Most experts think the ruling is insupportable, and several judges have already dismissed similar lawsuits, but given the makeup of the Supreme Court, we would be very unwise to depend on what most lawyers understand to be the law.

That said, the only reason we have the individual mandate, instead of tax funded insurance, is because of the prevailing ideology. The difference is essentially semantic -- we have all sorts of federally required individual mandates. For example, I am required to pay for pieces of missiles and agribusiness profits. If I were required to mail checks to Raytheon and Dole, it might feel more offensive, but except for the price of the stamps it would pretty much amount to the same thing.

So we got the individual mandate, which requires us to mail checks to Aetna and WellPoint, because that seemed less "socialistic" than single payer national health care. The wingnuts don't like it anyway, so they're suing. But there would be absolutely no constitutional question whatsoever about raising taxes to pay for health care, which after all the federal government already does, just not universally.

The individual mandate is a much worse alternative for all of us, because a chunk of our money goes to the socially useless, parasitic insurance industry; it is much more difficult to create a properly progressive financing regime; and it is much more difficult to promote efficient and effective use of resources and stop the relentless suctioning of our national wealth into the pockets of drug companies, medical device makers, and overpaid medical specialists, among others.

I don't know about you but personally, I'm not giving up. With a Democratic House and Senate in 2013, we can fix this mess very easily by introducing a public option. Between now and November of 2012, we need to keep working to reframe the terms of this debate and purge the bullshit.

It can be done.

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