Is Healthcare an Appealing Subject?

With 26 Republican-led states challenging the constitutionality of “Obamacare,” it seems that the United States Supreme Court is about take on one of the most important judicial reviews in the history of those currently sitting on that distinguished bench. But whether or not individual judges believe that the underlying policies are sound or not, the federal appellate process has, for the most part, sustained the legislation: “After a year and a half of legal skirmishing, President Obama's embattled healthcare law has arrived at the Supreme Court riding a surprising winning streak and carrying a constitutional stamp of approval from prominent conservative judges.

“Only three of the 12 appellate judges who have reviewed the law have decided it is unconstitutional to require all Americans to have health insurance. Not a single appeals court judge has said the entire law must be tossed out, the position advocated by Florida and 25 other Republican states leading the legal assault.” Los Angeles Times, November 12^th. Only the US appellate court in Atlanta has struck down significant portions of the statute.

Arguments that the Congress has violated the rights of states to make such legislative decisions under the 10^th Amendment have pretty much fallen on deaf ears, even among conservative judges. “The string of appellate victories may not predict how the Supreme Court will decide the case. But some legal observers believe the recent decisions lay out a road map for preserving the law that may appeal even to some of the Supreme Court's more conservative members… ‘They show that smart, principled conservatives can decide this is within the broad reach of Congress' power, even if they might think it is bad policy,’ said Richard Garnett, a law professor at the University of Notre Dame who was a clerk to former Chief Justice William H. Rehnquist.” LA Times.

In fact, pundits are predicting that the Supreme Court may just follow suit: past cases decided by Bush-appointed Supreme Court Justices John Roberts and Samuel Alito have suggested that “judges should be wary of second-guessing political decisions. On the other hand, legal experts believe Justice Anthony M. Kennedy, usually the court’s swing vote on close cases, could vote for the challengers based on his strong commitment to federalism [states’ rights]. Justice Clarence Thomas is thought to be a firm vote against the law…

“The appellate decisions have done little to calm the partisan passions aroused by the healthcare law. Not since the 1930s has the Supreme Court faced such a distinctly partisan challenge over national regulation. The court's four liberals, all Democratic appointees, will almost certainly uphold the law. The outcome depends on its five Republican appointees, conservatives who cherish the idea that the Constitution puts limits on federal power that the court is duty-bound to enforce.” LA Times.

While the judicial system struggles with whether Obamacare is constitutional, many Americans are feeling the weight when lower income combines with serious illness. A new report released by The Commonwealth Fund, a private organization dedicated to improving healthcare access for lower income people in the United States was based on a fairly broad sampling. “Seeking to learn more about the experiences of sicker adults around the world, the group surveyed more than 18,000 adults who were in fair or poor health, had recently been hospitalized, and had had major surgery or a serious illness in the past year. The group looked at adults in 11 high-income countries where patients with complex care needs typically account for a disproportionate share of national health spending.”

“The findings: U.S. patients with complex care needs were much more likely than those in 10 other high-income countries to forgo needed treatment because of costs, according to the survey. Americans are also more likely to struggle with medical debt. In fact, 27% of the Americans surveyed were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1% and 14% of adults elsewhere. In the U.S., 42% reported not visiting a doctor, filling a prescription, or getting recommended care because of cost issues -- at least twice the rate of every other country but Australia, New Zealand, and Germany.

“Indeed, Americans spend more on healthcare than any other country: $7,960 per person in 2009, the latest figure available. Norway came in a distant second at $5,352, according to data cited by The Commonwealth Fund…. A big problem is the number of uninsured -- 50 million. Those folks typically get their health care in emergency rooms, which drives up costs for themselves, as well as for the hospitals and doctors that ultimately care for them.” DailyFinance.com, November 11^th.

When Europeans or Canadians lose their jobs, the blow is cushioned by the healthcare safety net that provides free medical care. When Americans lose their jobs, if they cannot afford to pay for continued coverage, they fall into a healthcare abyss. The continued sluggish economy reeling from unemployment and under-employment plus the increasing reliance on “contract employees” who are not accorded benefits suggest that even under the administration’s legislation, a whole lot of Americans will remain without coverage. But without the mandates of the new law – which also eliminates lifetime benefits caps and the right of insurance carriers to cancel or fail to issue policies because of pre-existing conditions starting in 2014 – the situation for a growing number of Americans is likely to get a whole lot worse.

Whether we are a society that cares about those unable to afford benefits accorded to better paid individuals is actually the hidden question behind the Supreme Court challenge. “‘There is an unevenness in health care in the U.S., compared to other countries,’ says Elise Gould, director of health policy research with the Economic Policy Institute, a nonprofit, nonpartisan think tank. ‘We have the best care in the world, but it really depends on who you are.’” DailyFinance.com I guess that means we really don’t have the best health care in the world… for most of us.

I’m Peter Dekom, and I wonder what ever happened to that notion of Judeo-Christian charity and kindness to our neighbors that so many preach but seem unable to practice?