I don’t normally get up early to hear Supreme Court decisions. All their decisions are legally important, but many of them don’t directly affect my profession and the people I provide service to. This ruling about the constitutionality of the Affordable Care Act affects all citizens. Americans pay more for health care and get less return for their money than any other country. They pay not only for doctors, nurses and techs, but also an equally vast army of insurance industry workers.
The insurers have a coequal balance of power with the health care providers, much like the way the three branches of government exist in a system of checks and balances. We at the clinic get to recommend what procedures are needed for a patient. The insurers get to determine who must pay for it and at what cost. The Act is our first tentative attempt to fix that, because profit-driven corporations should not be the last word in who gets or doesn’t get affordable care. Health care is a right, not just a product subject to market forces.
I’m not a lawyer. I don’t understand all the subtleties of why the Supreme Court has decided to uphold the PPACA. Basically, the Chief Justice was the deciding vote in a 5-4 decision in favor of the act’s constitutionality. They ruled that Congress does have the power to penalize citizens who choose not to buy mandated insurance, not under the commerce clause (as the states objecting were arguing against), but under the power to tax given to the Legislative branch. This is similar to the reasoning used by other countries to require universal health care coverage. It’s a mandate that promotes the general welfare of all, so all should both be a part of the system, and help pay for it if they are able to. It’s a baby step toward adopting a single-payer system, which is what we really deserve.
I was pretty scared they would strike the law down. I didn’t see this line of reasoning coming. I know there will still be a huge political fight over it, but at least the question of whether the act is LEGAL is settled. I can put on my scrubs for work with a little extra spring in my step.