To the satisfaction of too many and the disappointment of the rest it was as pronounced as it was divisive as the Supreme Court nine Justices split five-to-four to uphold as Constitutional all four points the court was petitioned to review. These four points are:
Whether the “individual” mandate is constitutional.
Whether SCOTUS has the authority to rule on a tax law even though it hasn’t come into effect.
Should the individual mandate be overturned, would it be cut from the rest of the law as a separate entity or will other provisions fall with it.
Whether the law’s Medicaid expansion is constitutional.
There is one item in this vote that has come as a huge surprise, nay, disappointment from today’s Supreme Court decision. Justice Kennedy was seen as likely to be the deciding vote with the rest of the court split evenly at four-to-four. As it has been reported, Justice Kennedy actually ended up writing the minority opinion claiming the side opposed to the Affordable Care Act’s Constitutionality while Chief Justice Roberts joined with Justice Elena Kagan, Justice Ruth Bader Ginsburg, Justice Stephen Breyer, and Justice Sonia Sotomayor who voted in favor of the Affordable Care Act’s Constitutionality. This is the Chief Justice Roberts of whom we were assured by President George W. Bush was a strict constructionist conservative who would dependably uphold a narrow interpretation of the Constitution as ably as any conservative or libertarian. Well, after today’s decision by Chief Justice Roberts, I would like to have my money back as he did not perform up to the standard under which he was presented. This is now all water under the bridge, over the dam, and now flooding the country. The only question now is, “What else will the government be allowed to insist through laws that we must purchase?”
Since it has now been set as precedent that the government can require as a mandate that every American citizen must purchase health insurance which must meet criteria and standards as described by the Federal Government, we are now left to anticipate the price of said insurance and what it will require from us in co-pay or other required remittance. As for what exactly this insurance must include is yet to be decided and will be the responsibility of the Secretary of Health and Human Services to decide. This will mean that with every new administration the requirements of healthcare may be changed and or modified by the next Secretary of Health and Human Services. This one fact is extremely likely to turn healthcare insurance and coverage into as significant a boondoggle as the IRS Tax Code. We can be guaranteed that almost every incoming Secretary of Health and Human Services will have their own pet requirements which they will add to the ever expanding list of coverage mandated under the Affordable Care Act. Then there will also be those items which the new President will also push to have included thus within a few decades the health insurance will be as incomprehensible as the income tax code has mutated to.
There is one very important and distressing inevitability resultant from today’s ruling by the Supreme Court. One of the restrictions placed on everybody’s health insurance is that it must contain a minimum of required coverage as well as other items which would be considered excessive or overly generous coverage which any insurer providing such are required to pay a penalty for providing coverage deemed as being too good. If this were the idea coming from anywhere other than the Federal Government one would find it incredulous. But wait, it gets worse. While you are allowed to retain your present coverage or whatever coverage you acquire by some set date, if after said date your coverage changes in any number of items such as coverage or inclusions among others, then you will be immediately required to take your insurance from the Federal Government provided health insurance. This begs the question of whether this would include changes to your health insurance coverage resultant from new mandates imposed by the Federal Government. Under such conditions, the rules could force changes every year until they reach a point where virtually everyone, if not everyone, would have necessitated a change in their health insurance terms and coverage. This would be an avenue by which the Federal Government could take a backdoor path forcing full Federal Government Healthcare Insurance. This would have absolutely no difference from socialized healthcare completely under the auspices of the Federal Government. Simply stated, we would then have been forced into a single-payer healthcare system under total control of the Federal Government.
We still need to also look deeper into exactly what might become a requirement for each and every American under the laws which will result from the permutations and mutations of the Affordable Care Act. We will eventually have, or may already have, a Secretary of Health and Human Services who believes strongly that preventive measures are absolutely necessary in order to lower the cost of healthcare which will sooner or later be the full responsibility of the Federal Government. Some of the items and stipulations which might come down the pike include forced exercise classes; regulated dietary plans should a government physician deem such was required to improve your health; maximum and minimum caloric intake for every citizen; the complete banning of unhealthy practices such as using tobacco or alcoholic beverages; legal denial of certain activities which could place a person in unnecessary risk of injury such as rock climbing, mountain climbing, riding motorcycles, climbing trees, playing many contact sports; and near countless more which is only limited by one’s imagination.
Then there is the last and far most insidious of likely consequences which we have observed in every country where socialized, government provided, health care has been implemented, rationing of healthcare. The reality behind this comes from the simple consequence of supply and demand, thus when the supply is not limited while the price remains constant that always results in uncontrollably high demand. For those who are covered by Government provided health insurance, they will have a set price while they will be presumably covered for all health concerns. We have already witnessed the results from such systems with the spiraling costs resultant from Medicare and Medicaid. Having worked in a major hospital for over a decade, I can relay that at some times healthcare is seriously rationed to the point of actual refusal of any life-saving measures. I have witnessed a DNR code (do not resuscitate) placed on a patient’s chart simply because the insurance coverage has run out and their care was no longer being provided. This was most often applied to elderly patients without any family members or where none were located. A DNR code simply means that no efforts are to be utilized if the patient should code, another word for die. We can fully expect that at some point, very possibly sooner than later, the government will implement some system for determining whether providing health care beyond routine procedures and items should be provided depending on criteria for each patient. Under such a system, those who have permanent ailments such as diabetes, heart problems, or any debilitating or chronic health issues would receive a lower level of overt care. Such patients very likely would be refused extensive or expensive operations or ongoing care and instead simply medicated for “discomfort” and left to nature’s course. President Obama has said as much on a few occasions. In more severe use of such criteria, those who are of advanced age or the very young would not be provided with extensive or expensive operations or ongoing care and similarly left to face a natural progression. These systems prorate the level of care tied directly to your ability to provide and contribute to the good of the society. Thus, retired or disabled citizens no longer contribute to the overall good of the society and have actually become a drain on resources, and thus are more likely to be denied extensive or expensive operations or ongoing care. The same applies to the very young, especially if the necessary treatment would not guarantee they would reach an age or level of ability to enter the workforce or otherwise be of a benefit to the society.
The United States of America took a definitive step towards a less caring and less civil society by this decision. What makes it all the worse is that this was enacted and presented as a compassionate and superior method of providing for the healthcare of every American, but it will soon become apparent that it is exactly the opposite. We cannot expect the mainstream media to cover any stories in the near-term which will reveal the dark side of the Affordable Care Act, but many will soon know of somebody or be that somebody with a horrific tale to tell. The Affordable Care Act will not prove to be the panacea that it was promised, instead it will very likely be a death sentence for many should it last more than a few years and most certainly should it last over one decade. Americans are about to receive the most telling and supremely expensive lesson in exactly how crass and course government really can be. One can only hope that this is quickly realized and that once a good many have been brought to their senses via the realities of denial of care which are sure to come and come soon, then they will lead the country back into sanity and the world’s best and most compassionate healthcare. It is sad, truly sad; that we will need to have this lesson taught within the United States and did not simply learn it through observation of the failure of government when given the responsibility and obligation of caring for the people.
Beyond the Cusp