America has a serious problem with health care.
For decades costs have been increasing faster than inflation at a rate of more than two to one. Fifty million people are now uninsured and millions more have inadequate policies. Half of all personal bankruptcies are caused by crushing medical bills. Those with serious medical problems either cannot get insurance at all or are trapped in inadequate plans with no ability to shop for alternatives because of their preexisting conditions.
America's predatory insurers cherry pick, using "underwriting" to separate the healthy people they want to insure from those they don't and "claims adjusting" to deny coverage when we do get ill.
One-fourth of what we spend on health care goes to rapacious executive salaries, profits and administrative costs of our health care "industry." What do we get? Medical care that is among the worst among developed countries, leaving us with a low and declining life expectancy and as much as a third of our medical resources being spent on the last 90 days of patients' lives in fruitless and often painful efforts to prevent the inevitable.
With a campaign of misinformation, one of our political parties created a contrived "constitutional" challenge to the Affordable Care Act (ACA) reasoning that government does not have the power to create "individual mandates." The 5-4 Supreme Court decision with Chief Justice Roberts in the majority represents a departure for this Court from shameful partisanship.
The Court's ruling that the government's power to tax allows it to use incentives to direct policy is only common sense. Taxes have been used to encourage or discourage individual actions since the beginning of civilization. If a government lacks the taxing authority to address major economic dislocations, what happens? We are finding out right now watching the toothless European "government" trying to save its currency, the Euro.
As fond as the extreme conservatives on our Supreme Court are of 18th Century history, they seem to have forgotten the anarchy of this nation's existence for its first 10 years without a constitution. During that time we had eight presidents (George Washington is our ninth president—we prefer to think of him as our first) and essentially no unified government.
Our Supreme Court needs to remember that "those who forget history are doomed to repeat it." The Court's decision only narrowly protects the power of the federal government and in some respects endangers it.
The Court's majority of extreme conservatives (including Roberts on this issue) held that the commerce clause of the federal constitution does not allow the federal government to require people to enter into commerce as opposed to regulating it when they do.
This is a significant departure from existing precedent and endangers civil rights reforms of the 1960s. There too the argument was made that the federal government lacked the power to force owners of hotels and restaurants to serve all people regardless of race. The civil rights laws were upheld as an exercise of the commerce clause even though they too contained "individual mandates" requiring people to engage in commerce they did not want to engage in, the very thing the Court majority now holds "unconstitutional."
The libertarian doctrine of the Supreme Court's majority and others who support it threatens a return to the anarchy of the Articles of Confederation. The Federalists won the battle of strong central government versus weak or no central government twice, once with the adoption of the Constitution and once with the Civil War. That should be enough to decide the issue.
Finally we join the ranks of modern developed nations with (hopefully) universal health care properly regulated to end the abuses of the profiteers who dominate the "industry" that serves us today. Congratulations to both Governor Mitt Romney for pioneering health care reform during his tenure as the leader of Massachusetts and to President Obama and all those who helped him make it a national achievement.
The national level reforms are likely to be as successful as the reforms in Massachusetts on which they are based. If we protect it, health care reform will be our generation's most important legacy, comparable to the New Deal and its steps to regulate the banks and to reduce poverty among the elderly with Medicare and Social Security.
Of course, like those legacies of earlier generations, health care reform is likely to be attacked from time to time as well. It is up to us to protect it by only voting for elected officials who support it.