Those who don’t/can’t pay for health care shift cost to others

Make no mistake. All but a few Americans have access to health care, at least in emergencies. What tens of millions of Americans don’t have is health care coverage or ready cash to pay the bills.

So when sick or injured patents receive health care that they can’t afford or for which they are not insured, the costs are ultimately passed on to patients who pay their own bills, most of them through private or company-provided insurance.

Which makes the bottom line this: Those freedom-loving patriots who have been assailing the Supreme Court of the United States since Thursday morning for upholding the Affordable Care Act are fighting for the supposed right of the uninsured to receive treatment at the expense of the insured. Or perhaps they’re fighting for the right of some American men, women and children to suffer or die without treatment. It’s one or the other.

The Affordable Care Act attempts to answer the over-arching question: Who is going to pay for the care that most Americans take for granted? To the extent that the government can encourage insurance coverage through an individual mandate, the answer becomes: Everyone.

Unexpected alliance

In upholding the individual mandate, the conservative chief justice, John Roberts, joined by the four liberals on the court, recognized the cold fact we’re all in this together. Even the four dissenting conservatives recognized it by calling for the entire act to be invalidated, because without the individual mandate, the other provisions of the bill were unsustainable. The difference was that the four thought the individual mandate was unconstitutional, the majority did not.

In passing the ACA, Congress made the determination that the status quo — a doubling of health care costs every seven to 10 years and a steady increase in health care expenditures as a percentage of the GDP — was itself unsustainable. And Congress was right.

In a less poisoned political atmosphere, President Obama, and Democrats and Republicans in Congress could have worked together on a compromise bill that may have offered an even better response to the health care crisis. The basics of the bill are rooted deeper in Republican proposals of the past than Democratic ones, yet the AFA got not a single Republican vote. That’s a telling and damning indication of how impossible compromise has become.

Some of the right wing hyperbole Thursday was laughable. The end of America as we know it. A 21st century Dred Scott decision. An example of President Obama intimidating Chief Justice John Roberts like Hugo Chavez intimidates the Venezuelan Supreme Court. The rule of law is dead.

Nothing is dead, but seeking common ground and common sense solutions appears to be endangered.

Some of ACA’s provisions

What’s at stake is greater access to health insurance at affordable prices. Also, protection from being denied coverage because of pre-existing conditions, which is especially important when people lose employer-provided coverage and have to find private coverage. Tax credits that will help small businesses provide insurance coverage. Expansion of Medicaid coverage for low-income workers. Nondiscrimination against women by health care policies. Extended coverage under their parents’ policies for young adults still living at home. Closing of the “donut hole” in Medicare prescription coverage that can cost senior citizens thousands of dollars in deductible payments.

Polls show that any and all of those individual benefits are popular with voters. But when they are bundled together under the title of Obamacare and tied to the individual mandate that is necessary to make reform affordable, they become unpopular.

People want the effects of the medicine, they need, they just don’t want the bad taste. They want their broken bone to be set, they just don’t want the pain of the adjustment. Some people want it all, they just don’t want to pay for it.

Yesterday a scant majority of the Supreme Court spoke the truth: That’s not feasible, and it’s not the American way.