The struggle over the Affordable Care Act (aka, Obamacare) is facilely cast as a battle between Left and Right. Nothing could be farther from the truth. A tussle between the dominant factions of the Democratic and Republican Parties it certainly is in a superficial and temporary way, until the kabuki politics of the presidential campaign is over. But a battle between Left and Right, it most assuredly is not. Obamacare is opposed by the Left, which has long sought Single-Payer (Medicare for All) as a proven way to universal and egalitarian coverage. But many Leftists have been too cowed by Democratic operatives or by Obama loyalists in their midst to speak their convictions. Now that silence has been shattered.
Recently 50 physicians, all strong supporters of Single-Payer, along with the Left wing non-profits, Single Payer Action and It’s Our Economy, have joined conservative and libertarian opposition to Obamacare. They have submitted to the Supreme Court an amicus brief which is a dagger aimed at the noxious heart of Obamacare, the individual mandate which codifies in law the domination of the health care system by the insurance companies. The brief states:
Amici thus submit this brief for the purpose of disputing the primary tenet of the Government’s position, that Congress cannot regulate the national healthcare market effectively unless it has power to require that citizens purchase insurance from private insurance companies. On the contrary, as set forth herein, Congress has already demonstrated that it can regulate healthcare markets effectively by implementing a single payer system such as Medicare or the VHA (Veterans Health Administration).
And in case the dagger failed to pierce its mark with that, the brief plunges deeper:
Government contends that the provision is not only “reasonable” but also “necessary” to its broader regulation of the national healthcare market. In particular, the Government contends that the individual mandate is “key to the viability of the Act’s guaranteed-issue and community-rating provisions.” But while it might be true that these provisions will adversely impact private insurers’ profits, and that the individual mandate offsets this adverse impact by guaranteeing the private insurers a large stream of new customers who are required by law to purchase insurance, that is not sufficient to render the individual mandate constitutional. If it were, Congress could “reform” any private industry – whether it be automobiles, coal, pharmaceuticals or any other – by enacting legislation requiring every that American purchase the industry’s goods or services in exchange for some perceived public good the industry provides. Yet Congress has never before enacted such a mandate.
The amicus brief makes no argument against other features of Obamacare, for example, regulation of insurance companies and coverage of those with pre-existing conditions. Such “severability” has been advocated by many, most recently by Columbia law professors, Abbe Gluck and Michael Graetz in a New York Times Op-ed on March 23. But the Obama administration has resisted this separation and many Left groups have been pushed into silence for fear that they will be seen as opposing the “good” features of Obamacare. Severability, never mentioned by Obama loyalists, provides a simple way to oppose the nefarious features of Obamacare and yet allow the other features to go forward.
Much of the rest of the brief is devoted to describing the superiority of single-payer systems, most notably affordability and equality of care. The simplest argument for Single-Payer is that it works as advertised, as can be seen readily in Canada or France, for example.
It is a grave misperception to regard Obamacare as a stepping stone to Single-Payer, as promoted by Obama loyalists. It is not. In fact, it is a massive obstacle. Once in place it will create the impression that universal coverage with cost controls has been achieved, postponing genuine change to another day. And until that day there will be much needless suffering, even as we spend ever more on health care.
Quite simply, Obamacare is the preferred option for both the Republican and Democratic establishments and their backers in the financial sector. Romneycare, its older, Republican twin, has failed to deliver on the promise of cost control and decent care for all. Instead it has delivered a captive population up to the tender mercies of the insurers. Obamacare is more of the same. The coinage Obomneycare says it all.
The real struggle is not between Left and Right but between the top, which favors Obomneycare, and the bottom, the 99% in the parlance of the moment. Hence it is no surprise to see groups of diverse political philosophies, even divergent ones at first sight, rise from among the vast majority to oppose this latest scheme to make money from human illness in the guise of health care reform.