Busier this week, blogging may be lighter, as it was yesterday. Life intrudes, including the fact that the 12-year-old vehicle is in the shop all week, having some $2,100 worth of work done. Because, you know, I’ve got large piles of cash just sitting around, begging to be spent.
Following the health care case this week, that will be the subject of this weekend’s print edition (and we’re doing something different with our Perspective section this weekend, check it out). But David Frum has been hitting a few long balls on this issue; and I’d seen this argument elsewhere yesterday, the idea that if the individual mandate is thrown out, as conservatives want – how in the world could we ever privatize Social Security, as conservatives want, because the privatization plan contains – you guessed it – an individual mandate:
For many years, libertarians like those at the Cato Institute have advocated replacing Social Security with a mandate on all citizens to save for their retirement in a privately managed account.
Question: If it’s unconstitutional (as the challengers to the Affordable Care Act now argue) for government to require citizens to buy health insurance coverage from a private provider, how can it possibly be constitutional for government to require citizens to buy a retirement annuity from a private provider?
The logic of the challenger’s case is that the only constitutionally permissible way to provide for social needs is through a big government tax-and-redistribution program.
If the healthcare mandate is unconstitutional, how can compulsory private retirement accounts be permissible?
It can’t be, unless the conservative Supremes are willing to be utterly and completely inconsistent from ruling to ruling for political purposes.
Earlier Frum also noted – while predicting that Obamacare survives – that the Republicans who are so focused on killing it have absolutely no alternative to offer:
Because of the prolonged economic downturn, more Americans than ever have lost—or are at risk of losing—their health coverage. Many of them will be voting in November. What do Republicans have to say to them?
Make no mistake: If Republicans lose in the Supreme Court, they’ll need an answer. “Repeal” may excite a Republican primary electorate that doesn’t need to worry about health insurance because it’s overwhelmingly over 65 and happily enjoying its government-mandated and taxpayer-subsidized single-payer Medicare system. But the general-election electorate doesn’t have the benefit of government medicine. It relies on the collapsing system of employer-directed care. It’s frightened, and it wants answers.
“Unconstitutional” was an answer of a kind. But if the ACA is not rejected as “unconstitutional,” the question will resurface: if you guys don’t want this, want do you want instead?
In that case, Republicans will need a Plan B. Unfortunately, they wasted the past three years that might have developed one. If the Supreme Court doesn’t rescue them from themselves, they’ll be heading into this election season arguing, in effect, Our plan is to take away the government-mandated insurance of millions of people under age 65, and replace it with nothing. And we’re doing this so as to better protect the government-mandated insurance of people over 65—until we begin to phase out that insurance, too, for everybody now under 55.
That’s a different version of “all or nothing”—and one that invites the voters to answer: “nothing.”
The Republicans now are protecting the perogatives of those who have insurance and who like it just fine. And that most certainly includes the elderly, but not in perpetuity; theirs is a “plan” that benefits only the current elderly. Because here’s Paul Ryan lurking in the wings, saying that if you’re old now no sweat, if you get old later – bend over.
So the Republican approach is necessarily a short-term, right-now strategy. There’s nothing farsighted about it, there is –zero– plan for the future, the ideas that they do have – including buying insurance across state lines and limiting malpractice suits – nibble around the edges of the problem but can do no more.
The problem Obamacare sought to address then gets worse. And as Peter Morici noted earlier this week:
Eventually, the ratio of uninsured to insured would become too high to accommodate the acute needs of the uninsured, when they can’t pay in emergency rooms and hospitals, by passing costs on to the insured population. That would cause the insurance system to collapse.
At that point, Americans would have a choice — either watch folks without health insurance suffer and die when their financial resources run out — or finance health insurance for them by extending government run programs, such as Medicaid, to the entire uninsured population.
And the Republicans, understand, would oppose the latter.