SCOTUS decision... will it make a difference?... only to We the People who will get seriously hurt!!! Burocrats will win !!!!

June  3, 2012

SCOTUS ObamaCare Decision: Both Monumental and  Irrelevant

By Deane  Waldman

How  can anything be both earth shattering-monumental, and unimportant-irrelevant? As  everyone knows, SCOTUS (Supreme Court of the United States) will shortly  announce its decision about the ACA (Patient Protection and Affordable Health  Care Act of 2010). That decision will have profound policy implications  regarding the reach and scope of Federal government. At the same time, it will  have little impact on our daily lives in terms of health care.

The  time to consider this paradox is before the decision is announced.  Afterward, all anyone will talk about or even think about is political and  financial effects, winners and losers, gamesmanship. Any thoughts about how the  ACA will affect you, me, and our health care needs will be  ignored  in the score-keeping, especially various predictions about effects on the  general election in November.

While  we can do so, let's consider how the SCOTUS decision on the ACA will impact Mr.  and Mrs. Everyperson and their family in day-to-day  activities.

Suppose  SCOTUS strikes down the individual mandate*, that forces people to buy insurance  and penalizes them if they do not. This takes away a large revenue stream from  Washington. Otherwise, it changes nothing.

Striking  down the individual mandate is the most likely course that SCOTUS might take on  the grounds that the Federal government cannot force people to engage in  commerce nor penalize them if they choose not engage in such commerce. (Please  also note that buying health insurance is  not an "interstate" activity. Indeed, competition by insurance companies across  state lines is illegal.)

There  were arguments both for and against "severability," meaning that SCOTUS had to  either uphold or strike down the entire Act. The  Judges made clear that they were not limited in their choices. They could  decide to do whatever they thought was in keeping with Constitutionality. That  was their sole purview.

So  what might their decision do to us?

Will  striking down the individual mandate change the availability of health care  service for the average person? Since the number of insured persons will not  change from what it is now, the answer is no. Since ACA cuts in Medicare  reimbursements are unaffected (unless they go UP), there will be the same  shortage of providers able to care for Medicare patients.

Will  striking down the individual mandate change the expansion of the bureaucracy  in any way? Will it stop the creation of IPAB (Independent Payment Advisory  Board) and five other whole new Federal agencies? No.

Will  striking down the individual mandate stop the development of ACOs (accountable  care organizations), which are "accountable" to everyone except the patients?  No.

Will  striking down the individual mandate halt the creation of Health Exchanges,  which impose further Federal control of health care on the States and suppress  competition? No.

Will  striking down the individual mandate or upholding it for that matter solve the  problem of health care for illegal  residents  and the unfunded mandates for care? No way!

Will  striking down the individual mandate expand the number of jobs? Yes and no. It will massively increase the number  of administrative, legislative, and regulatory oversight positions, but not one  new doctor or nurse. Quite the contrary as the Medicare reimbursement cuts take  effect. The job expansion will do nothing to improve access to health care. It  will in fact reduce care as money is taken from care providers and given to  managers and overseers.

ACA  does of course spend money, huge sums of it. Estimates range between $1 trillion  and $2.7 trillion. That is more than has been spent on the wars in both Iraq and  Afghanistan.

What  do We The Patients get for all those expenditures? Answer: no more, or better,  or safer, or quicker health care. Just more regulations and more bureaucrats.

If  your teenager goes to the store and spends cash, she cannot spend more than is  in her wallet. If she uses your credit card, the sky's the limit. The same is  true for the Federal government. The loss of the revenue from a struck-down  individual mandate will not slow down the Federal spending spree because it can  do one thing that you and I, and the fifty States cannot: print money. So  whether SCOTUS upholds or strikes down, nothing of substance will change except  the size of the bill we are passing on to our children.

We  must accept that SCOTUS, whatever they decide, will not save us from the harmful  effects of the ACA. Only repeal can do that. And of course, repeal alone still  leaves us with a critically ill, dying in fact, healthcare system. Stopping the  bad medicine - ACA - only reduces the rate of decline for patient Healthcare. We  need to start practicing good medicine on this patient  Healthcare,  something we have never done before.

Keep  all this in mind when the hysterical reactions to the SCOTUS decision take over  the airways. Everyone will be talking about Obama, Romney, Pelosi, Boehner,  Justice Roberts, Sebelius, etc. No one will be paying any real attention to We  The Patients.

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