|Oh look - the insurance premium|
must be due...
So while it seems almost inevitable that the Roberts Court will overturn the individual mandate, much of the remaining provisions of the ACA will probably survive intact, leaving an untenable legislative dilemma and a dysfunctional Congress utterly unable to address it. But at the same time, it will reopen the key question that, at some point, America is going to have to answer: Just what do we believe is the government's role in providing health care services to her citizens? Every other modern nation has already answered that question, both because it is basic and essential and because it is generally accepted that the well being of the population is of greater value and importance than corporate profits. Some nations provide single payer health services, where the government runs the hospitals and employs the doctors, while others look to private insurers and health care providers to provide the services, but they are carefully regulated and required to provide services to all. In the US we have had, up until now, the worst of both worlds - a rapacious health insurance industry and a private health care services sector that, due to its insistance on excessive profits, is by far the most expensive in the world.
It is appalling to consider that in America we have decided, collectively, that health care is a priviledge, one that must be earned, and American citizens must be allowed to become sick and even die if they cannot be profitable customers for this vast array of greedy corporations all ghoulishly holding out the promise of medical treatment if the patient can only come up with the money they demand. Is this really the system we want? A ruthlessly barbaric system where you can be denied treatment and left to die for no other reason than the treatment you need would reduce your profit value as a customer? Why on earth would we want that? There is certainly a reason why no other industrialized nation on earth embraces our "Pay or Die" approach to health care for their citizens.
Before the madness truly took hold of the American Political Right, the argument between left and right in the US could be boiled down to a fairly basic question of the role of government. Those of us on the more liberal side looked around and saw places where the market simply failed, where industry was unable or unwilling to provide important, even necessary services, and believed that government should provide those services, and we would set revenues to cover their costs. The conservatives, on the other hand, felt that private industry could better provide most services, and that the role of government should be more limited. A disagreement, to be sure, but one you could have logically, about any given set of services, from education to infrastructure to big science to, yes, health care. But now the Right has lost its bearings, and as it continues its headlong dash from Republicanism toward fascism it has ceased to be a conversation about specific government services at all. Instead, it has become a desperate ideological quest to protect every last dollar of wealth in the hands of every rich American and every Corporation - to prevent ANY money from going to any government program. A kind of an unsustainable scorched earth war on behalf of a tiny portion of the population against America itself.
So just as America has decided to stand alone in the world as the one nation who believes in allowing her citizens an unfettered right to as much lethal firepower as they can buy, in a gigantic, bizarre social experiment where a huge population divided by sectarian, racial and class hatred have a greater ability to wage war on one another than most militaries do, the US has also chosen to insist that her citizens, no matter how sick or desperate, must pay for medical treatment or go untreated. So when you hear someone once again droning on about American Exceptionalism, just remember it is in the context of "the exception to the rule" rather than "better than all others" that they speak.