Surprise — it’s a tax
I usually start framing my columns for the following week at least 10 days before they are due for submission. The problem with that is evident, as it makes each column about 14 days old at the time of publication. However, with a weekly publication there is no easy way around the news being stale, as the daily papers, not to mention TV or the Internet, present in what is close to real time.
This week I felt delinquent in not starting this column until Thursday, as I was determined to catch the ruling of the U. S. Supreme Court on what has grown to be called “Obamacare.” Following the oral arguments before the court, every level of pundit has vacillated between predicting just how much of the law, if any, would be left standing. The general consensus was that at least one of the key provisions, mandatory health insurance, would be struck down.
Surprise! With conservative Chief Justice John Roberts siding with those justices considered of liberal persuasion, it was the challengers to the law who were denied. What this means politically will now form the basis of an ongoing debate. But the real problem that still must be faced is what will the law bring about. The glib answer is that it confirms that health care is a right, and I agree, to a point. However, nothing can be a right for long unless it is affordable, and I do not believe that the affordable health care law, Obamacare, is close to affordable.
The administration commissioned all sorts of projections, including a large number from the Congressional Budget Office based upon the “what if’s” proposed by the administration. The craziest part of the projections was that they did not start counting costs until the assumed savings benefits were all in place and working as envisioned. This is little different from the Ponzi-like schemes of the recent past, where the swindlers promised impossible returns if only they were allowed more time for their financial magic to work.
I would argue that certain parts of the act, including many of those embraced by Republicans and Democrats alike, are simply flat-out unaffordable for health care providers, hospitals, pharmaceutical companies, the government and hence, last but not least, us.
I can buy the idea that heath care is a right as long as there are limits to the rights. This is not a society that is willing or ready to mimic the Calcutta view of human life. However, eternal life, for free, which some consider their right is, of course, impossible.
No health care plan will be affordable without rationing. Rationing can take many forms and I do not believe it should preclude those who can afford to purchase more health care than those who cannot from doing so.
Health insurance premiums, like withholding for social security, can be a fair as well as an appropriate tax, but it should not cause an insurance company to provide coverage for either preexisting conditions or hopeless conditions without graduated reimbursement from a giant pot to permit them to be economically viable. All insurance is a bet. If we legislate a change in the rules of the game, we must permit the actuaries to recalculate the risk and the companies to recalculate the premiums. Without the mandatory insurance requirement, the ability to create the massive pool disappears.
Today, the Democrats are celebrating and the Republicans are now re-promising to repeal the law after the November elections. Resourceful politicians can resolve the issue, but not if the politics ignores the economic realities or if it is a bait-and-switch dance. The Obama administration sought to prevail in the insurance mandate based upon the broad mandate of the federal government to control interstate commerce. They did not want to call it a tax. However, Chief Justice Roberts, who provided the critical and decisive fifth vote, simply ruled that as a tax it was fully constitutional, while putting a block on future uses of the interstate commerce act to gerrymander society. He did this even though the text of the statute does not call it a tax.
So the fight will go on. As President Obama and his chorus of supporters blather about how they have given us affordable health care, and as the Republican freedom fighters barf about how he has taken away our freedom, the problem will not solved. It is the Republicans who have the worst part of the argument until they have framed a sensible and wise replacement for the act that the electorate can understand and sustain.
Neither individuals nor the public purse will be able to claim savings from what has now been wrought, and without rationing of care, applied in some form, it will not be affordable in any case.