The political world is still blazing with reaction to the Supreme Court decision of Thursday upholding Obamacare, specifically the mandate that individuals purchase health insurance. I’ve got mixed emotions regarding the decision and the political fallout—which apparently makes me as out of place as I felt during the NBA playoffs when I had ambivalent feelings about LeBron James. Here are few of the conflicting thoughts I’ve got regarding both the legal and political aspects of the Court’s decision…
*I have a hard time finding fault with Chief Justice John Roberts. He was not asked to rule on the health care plan as a whole, or even whether he thought the individual mandate was a good idea. He had essentially one decision to make—is it unconstitutional to say that to avoid paying a tax amounting to 1 percent of one’s income, they must own health insurance? He led a majority opinion that said such a policy is constitutional.
Given that the worst aspect of the judiciary for the last 50-60 years has been judges writing decisions based on their own policy preferences, I don’t think we should condemn a judge who focuses strictly on the legal authority for a policy, not necessarily its wisdom.
*I’m going to preface this next point about the individual mandate with a brief anecdote. It was the fall of 2008 and a freelancer I was in conversation with us was griping how he didn’t own health insurance and was voting for Obama because of it. That person is probably dancing in the streets now over the decision. But, quite frankly, I like the fact he’s mandated to purchase coverage. Because if he doesn’t, he’ll show up in the emergency room—the most inefficient way to deliver medical services—and drive up costs for everyone else. His sorry posterior should be required to ante up and own his own health care coverage. States mandate the purchase of auto insurance and I haven’t heard anyone say this amounts to socialized auto coverage. Taken on its face, the individual mandate in the health care law is not unreasonable.
Those are the pro-mandate reactions I have. But there’s a flip side to the coin and it starts with a phrase used in the sentence above—“Taken on its face,” with regard to the mandate. Chief Justice Roberts had to take it on its face, but as voters we don’t have to. We can evaluate it as part of the overall legislation it was folded into. The market for health insurance is not going to function properly and help lower costs unless it’s allowed like to be like the market for auto insurance—people own their own coverage, separate from their employer and shop for a plan that fits their needs.
In that context, an individual mandate works. But the context built by Obama Care moves the other direction. It moves power away from individuals and into an alliance of the government and the health insurance industry. Is it an overreaction for me to feel like I’d rather be extorted by an alliance of the Gambino and Colombo mafia families than by a government-insurance company coalition? At least with the mob I won’t have to listen to any speeches and I might actually get some of the promised protection.
Furthermore, empowering individuals to own their own health insurance necessarily means allowing them to shop for a policy that meets their own needs and values. No family should be required to own a policy with “services” they have no intention of ever using, much less ones they consider morally objectionable. Given the Obama Administration’s mandate that the Catholic Church cover contraception in the policies for employees in its hospitals and other related businesses, we’re again moving in the wrong direction.
A mandate to purchase health insurance or pay a modest tax is not unconstitutional, and done as part of a true individual-centered health care reform, it would have a place. But in the context of a centralized plan focused on imposing the values of a left-wing political religion it has no place. It’s in the hands of the voters to insist on that change and elect the officials who will make it happen.