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Why Will the Current Crisis in Health Care Continue Regardless of How the Supreme Court Rules?

By on June 17, 2012

Much attention now is on the Supreme Court which will announce its decision on the 2009 Health Care Reform Bill in the next two weeks. The ruling could be announced as early as tomorrow.

Right now there is a strong sense the Court, with its strong ultra-Conservative leaning, will over turn some aspect of the Law. Public polls already have found that the American public senses that the ruling will be arbitrary, strongly influenced by personal politics, regardless of the outcome. This is not good news for the Court, or anyone else, but not a surprise given some of its members’ recent behavior.

If the Act is overturned substantially, it will be back to Square One and the proverbial drawing board. Many of its supporters have privately conceded that the Law was not quite what we needed. It addresses Access more substantially than Cost. It shies away from a number of hot issues. Cost is the driver of the current crisis, and the loss of Access for over 47,000 Americans is a by-product of soaring costs. The Bill does address Cost, but the fixes are long-term, politically safe solutions that many feel will be inadequate in face of the forces driving up costs.

A Free Marketeer

There are two basic groups these days in the Washington debate. One are the Free-Marketeers who strongly believe regulators and government should back off and let the free unregulated marketplace make all Health Care decisions. There is some talk of common-sense measures in the future, but one man’s common-sense action is another man’s folly. This group wants the 2009 repealed as quickly as possible. If they prevail, health care will be rationed in the future solely based on the patient’s ability to pay or get someone else, government or employer, to pay. Rationing is already upon us.

 

The Social Insurance Crowd

The other group is the Social Insurance people. They wanted expanded access for most Americans and a mandate that all people participate, even if they need assistance in the process. That way we will have a huge pool of insured patients. The young will help subsidize the old, the healthy will help subsidize the sick, and the rich will help subsidize the poor. They will need to build on the incomplete reform actions taken in 2009. If they prevail, we will have health care rationed more around patient needs. We will also again see a healthy workforce in this country, poised to complete globally.

Neither side has truly addressed the Cost challenge, driven primarily by technology. Forty years ago, if you were 70 and had bad arthritis, you got a cane. Today you can replace two hips, two knees, two shoulders and even later replace the replacement. It’s wonderful, helping people live longer and more productive lives, but it costs much much more than the cane of 40 years ago. And, Remember, somebody always has to pay. That’s why the fighting over health care has been so heartfelt.

The King at the Beach

Nobody wants to mimic the tale of England’s King Canute and stand at ocean side and demand that the rising tide of new technologies subside. The result would be the same as in legend, wet feet, wet face, maybe worse. Both parties are allergic to the word rationing and its implications as well. That does not help the debate. Millions of baby boomers are about to move into the Medicare system.  A civil debate on rationing is needed soon very soon.

Just saying ‘no’ to the problem of Health Care Costs and Reform will be as effective as Nancy Reagan’s well-intentioned war on drugs in the 80’s. The tide of Health Care Cost is rising and we will all be swept up in it sooner or later. Mouths closed, brains on, ears opened, get ready for a tsunami on the subject of Cost coming to your seaside vacation retreat fairly soon.

Tom Godfrey

About Tom Godfrey

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