The same Supreme Court justices who gave us George W. Bush for eight years now are on a mission to destroy any sort of universal health care. The sea change in the American culture that they represent is one to freedom without responsibility.
My generation grew up with a universal mandate of military service that we could not escape by paying a $95 fine. Most of us freely accepted that responsibility. Was that constitutional? We didn’t ask.
If those justices really believe in responsibility commensurate with freedom, then they should repeal the laws that mandate that emergency rooms take all patients. Are those laws constitutional? Then the hospitals could provide a much less expensive hospice for children dying of untreated strep infection and a mass grave for the bodies. This approach to the problem somewhat would reduce the insurance costs for the rest of us, but only somewhat. Much of our excess cost is administrative — $100 million bonuses to insurance executives and pay for more insurance paper shufflers than we have doctors and nurses combined. The Obamacare cap on insurance company administrative costs at 20 percent already is under attack by a Republican bill in the House. This will be unnecessary if the whole law is ruled unconstitutional, as Justice Antonin Scalia implied.
Obamacare is most similar to the system in Germany, where I lived for many years. You can chose your insurance from any of a large number of private insurance companies. Everyone must be insured. The profits and administrative costs of these companies are limited by regulation. The aggregate cost on a per capita basis is slightly more than half of ours. The health outcomes are far better.
But they also have a much better educated electorate, practically and academically, and voter turnout averages 86 percent as compared with our less than 50 percent. One could say that we get the democracy that we deserve.