Although it may not be decided fully until June, soon we will have a good idea of how the Supreme Court will rule on the Patient Protection and Affordable Care Act, otherwise called ObamaCare.
At this point in its deliberations the high court appears to be confounding pundits who predicted the court would sustain the law with little conflicting discussion. But the justices are taking seriously the question of how much power does the federal government have? Enough to require every adult citizen to buy health insurance? If so, might it also have power enough to require every citizen to buy a Chevy, since the government owns much of the company anyway?
Jim White
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To my knowledge, the Chevy question has not come up in court proceedings, but it illustrates that there must be limits to federal power. This is the heart of the question that seems likely at this point to remove the core of PPACA’s provision—and will perhaps lead to the entire law being struck down.
Without doubt, given the nearly 50 percent of Americans who oppose the law, many will rejoice. The other half will blame conservative justices appointed by Republican administrations for not supporting the law.
While my lack of legal expertise is probably obvious to all, let me nevertheless offer a disclaimer at this point. I cannot address the finer points of the arguments presented by the attorneys and heard by the justices. Before the issue was argued in Richmond on its way to the Supreme Court, I don’t ever recall hearing about the Anti-Injunction Act of 1867 which figured in the first day’s proceedings.
Neither am I qualified, though most Americans seem to be, to judge whether the Supreme Court justices are allowing their personal biases to sway their legal thinking. Although the losing side in a Supreme Court decision often blames the justices for their loss, I want to believe that the nine justices are able to put their own views on the shelf while considering whether a law violates the constitution. Call me a dreamer.
I have friends and family members who come from all sides of the health care question. Some are such rugged individualists that they hold that people should be responsible for themselves. If they can afford insurance, they should get it. If they can’t, they should pay their own doctor bills and hospital bills. If they can’t afford to pay them, they should suffer at home.
In my grandparents’ day, that’s the way it was. But in those days a hospital stay didn’t pose the threat of total financial annihilation as it does today. Not only that, do we really want to be the kind of society in which people die from treatable conditions simply because they can’t afford to go to the hospital?
Other friends say, “The constitutional question is a ploy. The conservative justices just don’t want to provide health care for the poor. We should nationalize health care and make sure every citizen gets the same level of care.”
While I am all for protecting the Constitution, we’ve got to do something! Estimates vary, but most agree that in the U.S. about 50 million people have no health insurance. While many of these Americans will simply not get the care they need, many others will choose to get their medical needs met through hospital emergency rooms. This reflects not only a tragedy of human suffering—needless in many cases—but also an economic disaster. Emergency rooms must treat everyone who comes in regardless of their ability to pay. Hospitals absorb these costs and pass them along to patients who do have health insurance.
The costs of providing health care in this country grow ever more painful and unsustainable. We spend $7,538 per person on health care, the highest rate in the industrialized world. Since 2001, health insurance premiums have risen 113 percent says the Kaiser Family Foundation. Businesses are affected. Even some churches have opted for an attractive alternative to a full-time employee: two part-timers who do not receive medical benefits. But what happens when a part-timer is hospitalized due to an accident or illness? What is the church’s ethical obligation to one of its own employees?
I suppose there are literalists even among moderate Baptists who will point out that Jesus said in Matthew 25:36 that we should visit the sick. He didn’t say we should keep them from getting sick nor even treat them if they were. But who can fail to understand the lesson of the Good Samaritan or what child does not understand that Jesus taught us to treat others as we want to be treated? Do we really think Jesus would be impressed by our saying, “Well, I know we wouldn’t give them health care, but, hey, we visited them when they got sick!”
But the cost of health care and the number of people uninsured are only parts of our problem. Contrary to popular opinion, the quality of health care in the U.S. has much room for improvement. According to Dr. Glenn D. Braunstein, chairman of the department of medicine at Cedars-Sinai Hospital, “For the enormous sums we plow into health care, we might at least expect every American to get needed medical care. Not so. We also might expect that we would live longer, healthier lives than anyone on the face of the earth. Also, not so.”
According to the Commonwealth Fund, a foundation supporting independent research on health care issues, compared to Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom, the U.S. comes in dead last in five areas of health system performance: quality, efficiency, access to care, equity and the ability to lead long, healthy productive lives.
Assuming the Supreme Court follows through with the now-expected striking of at least a portion of the PPACA, the question is how long it will take a Congress (that seems to prefer a broken system to allowing the other side to get credit for fixing it) to rise to the challenge of replacing it. Equally disturbing may be how long it takes Christian citizens to demand that something be done.
Jim White ([email protected]) is executive editor of the Religious Herald.