It is, of course, mildly interesting to speculate upon how tomorrow’s decision could influence whether a man who currently lives in a luxurious house in Washington will continue to live there for several more years or will instead be forced to move to a different luxurious house in Chicago. But you know what matters a whole lot more? Whether the Supreme Court decides to strip millions of Americans of their future access to health care.
Every year, hundreds of thousands of Americans file bankruptcy because they cannot afford their medical bills. Thousands more are locked into jobs their hate because they cannot risk losing their employer-provided health insurance while they have a preexisting condition. According to one study, about 45,000 people die every year because they do not have health insurance. So, in a very real sense, the Supreme Court is deciding tomorrow whether to allow tens of thousands of people to die every year until Congress is able to pass another health care bill. Something, by the way, which took seventy years to accomplish the first time around.
That’s a bit more important than whether or not Barack Obama is slightly more or slightly less likely to keep his job.
Not to the Villagers, who, by the way, have pretty good health care plans. And the same conservatives who are today going to more or less lynch Attorney General Eric Holder in the House today, supposedly over the death of a Border Patrol agent, are going to wildly cheer several million Americans losing their health insurance and some dying as a result.
Hell, they see those deaths as inevitable.
A rejection of health care egalitarianism, namely a recognition that the wealthy will purchase more and better health care than the poor. Trying to equalize health care consumption hurts the poor, since most feasible policies to do this take away cash from the poor, either directly or through the operation of tax incidence. We need to accept the principle that sometimes poor people will die just because they are poor. Some of you don’t like the sound of that, but we already let the wealthy enjoy all sorts of other goods — most importantly status — which lengthen their lives and which the poor enjoy to a much lesser degree. We shouldn’t screw up our health care institutions by being determined to fight inegalitarian principles for one very select set of factors which determine health care outcomes.
The rich live, the poor just die, you see. Most of us are one layoff and one accident or illness away from joining their ranks. Congress, meanwhile, concentrates on Eric Holder and ignores this, because that is the burden of the unwashed to bear, just as AmEx titanium black Centurion cards are the burden of the rich. Accept your fate and you'll be happier, citizen. We strongly suggest you do.
And so it goes. I'll update this when the decision is out.
[UPDATE] Called it. ACA survives, with some narrowing of the law forcing states to expand Medicaid.
[UPDATE 2] Chief Justice Roberts saved this law, literally. Alito, Thomas, Scalia and the dissenting conservatives led by Kennedy flat out said within the first sentence that they believed the entire law was patently and completely unconstitutional on its face. Roberts was apparently the deciding vote, and as Chief Justice he apparently stepped in as the fifth vote to uphold the law.