Affordable Healthcare Act: Supreme Court



Okay! So it came down to the questions, constitutionally federal government has the power to regulate the commerce, but, does it has power to promote commerce? Federal government has the power to mandate the people who decide to participate in a commerce, but, does it has the power to mandate the people who decide to not participate in an specific commercial activity? Federal government can mandate you if you participating in a commerce, but, can it mandate you if are going to be a future participant in a particular commerce? Is the argument, since federal government has already mandated, previously, the healthcare providers, specially hospitals to provide care, regardless of patient’s ability to pay and due to that the uninsured people are driving up the cost of insurance and healthcare for every one else, enrolling everyone into the larger pool, will reduce the cost of insurance and it will provide, the government and insurance companies an ability to provide cheaper healthcare to everyone, is valid? And is the penalties posed by Affordable Care Act are actually mandate or tax?

Apparently court agrees with government, on the grounds that even though you are young and healthy, right now, and do not need health insurance, you will need health care at some point and if you are not insured, it will drive the cost up. So, you better be insured, right now. And on the bases that the penalties on uninsured, in this act, are tax not a mandate.

To understand this issue, we need to have a look at the overall picture of healthcare situation in United States. Annual healthcare cost in United States has now surpassed over 2 trillion dollars. It is consuming about 18 percent of our GDP. If you break down 2.4 trillion dollars healthcare cost, it comes down to over 8000 dollars per person per year, in United States. Now the question is, who is paying this cost? Of course, tax payers and insured people. So, we are already paying over 8000 dollars per person per year as an indirect healthcare tax. Now, what will be the net effect of mandatory health insurance and penalties, on failure to get insured.

By a federal law, U.S. hospitals are already mandated to provide emergency care, regardless of persons ability to pay. Due to this reason, uninsured people frequently walk into Emergency Rooms, not just for sickness, but, also for things like food, shelter and protection from extreme weather. Now, emergency rooms are far more expensive then routine care. Plus, the people who walk in usually make a real or made up serious complaint / complaints. Under this situation, emergency room staff is obliged to run expensive exams and tests, which may not be necessary under routine care. This skyrockets the cost of healthcare. Due to this reason our healthcare cost is almost twice as much as of the second most expensive country in terms of healthcare, Luxembourg. This is in spite of the fact that we have much larger pool of population and technically speaking our cost should be much lower then Luxembourg.

Another factor is that uninsured and even insured people, because of financial disincentive from insurance companies, do not get appropriate preventive care. Due to this reason, statistically speaking, most people, specially young males, when access a healthcare facility, their complaint is already far more complicated and worse, compared to other developed countries, with universal healthcare in place. This, too, drives up the cost, a lot.

The fact that we are human beings and prone to sickness and accidents, each and everyone is bound to use healthcare at some point, in his or her lifetime, and not being insured could be disastrous. That is why, healthcare bills are the biggest cause of bankruptcies in United States.
The Obama administration’s argument is that by insuring everyone and making them liable to penalties, if they fail to get insured, will reduce the burden on tax payers and insured people. They will not have pick up the tab for uninsured people. Plus, better preventive and regular care will make healthcare providers to be able to tackle problems well before those are too complicated, in most cases. This will decrease the cost of healthcare and will hopefully reduce the premiums on insurance.
The Republican and Conservatives have their own arguments against affordable care act. First of all, they say, this is a mandate. and mandate to promote commerce, as opposed to regulate the commerce, are unconstitutional. They also say that this is a tax, and in a economic and financial crisis like this, we cannot afford another tax. They also say that government should not be mingling with people’s affairs that much. If this goes on, then, ultimately government will be regulating everything, resulting into a socialism like system. Problem is that the government already regulates almost every thing, from farms to industries, to businesses, to cars, to homes and food. Plus we already have mandates in place, like social security, medicare, car insurance, home owners insurance, emissions tests, etc., etc., for decades.
Republicans and conservatives, also fear that this will cause rationing of healthcare, resulting into death rows, specially for chronically ill old people. Government will decide who gets care, when and how much. Problem is that we are already having rationing of care. Only difference is that it is being done by insurance companies, right now.
There are also fears of long lines and waiting periods. Question is do you want a little longer lines or denial of care for 40 million Americans, including kids. This problem has become worse under economic crisis and high unemployment, when record number of people are losing their jobs and health insurance, every day.
A very big example of failure of our healthcare system is the ever growing industry of medical tourism. These, so called, medical tourism companies are shipping ever growing number of U.S. patients to India, Middle East, Africa, South America and even Cuba, where there are virtually no lines and waiting periods, and the procedures can be done at ten percent of U.S. cost. This is despite the fact that we produce and manufacture most of the technologies, equipment and drugs used in healthcare. Buying drugs from Canadian and other foreign pharmacies online, is another well known phenomenon, legally prohibited by congress. Statistics show that still millions of Americans are buying drugs online from foreign pharmacies, including India and China, which way surpass the U.S. ability to screen those packages and only about five percent of such suspected packages get screened. Although, this is also another example of government mingling too much with peoples every day life, but, since rich and powerful pharmaceutical lobbies are paying heavy to politicians and media, nobody is suing this law.
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