Aug 022012

From Hillary-care to Obama-care

By Cannon-Marie Green Milby

On October 4, 1957, the U.S.S.R. sent Sputnik, the first rocket-powered satellite, into orbit. The U.S. had been beaten to the punch and now feared that it was no longer number one in technological advances. In the weeks that followed, Newsweek warned that, unless the West stepped up its scientific development, Russia would be ahead in almost all fields in a few years. The U.S. Office of Education also published a study showing that Russia outranked the U.S. in every aspect of scientific and technological education. American education underwent a makeover, and the 22 million children born in the U.S. between 1946 and 1951 found themselves with the weight of the free world on their shoulders.

Fifty-five years after Sputnik, the children from 1957 have grown up and now represent the largest aging population the American health care system has ever faced. The United States leads the world in health care spending, which takes place within a system that excludes people from basic health insurance coverage on the basis of pre-existing conditions. Though the reasons may be different from the early days of the Cold War, the need for advancing science—and strong science education—is as urgent today: we will not solve the health crisis in the U.S. without it. However, in 2009 American students ranked twenty-fifth in the world in science and math.

Innovative science won’t fully address the looming health care crisis, though. We also need better public policy about heath care. Continue reading »

Aug 022012

The leek: a satirical take

By Horace Heller Hedley, IV

The U.S. health care system, long criticized for poor accessibility, lackluster overall outcomes, and low health benefits per dollar spent, now ranks sixth among the world’s developing countries. These results from a recent World Health Organization (WHO) survey covering nearly all national health care systems place the U.S. among the top four percent of developing nations—trailing only Columbia, Morocco, Chile, Dominica, and Costa Rica. These findings from the WHO’s paper “Measuring Overall Health System Performance for 191 Countries” are expected to vindicate defenders of the U.S. health care system.

“The 96th percentile among two-thirds of the world’s nations,” said Richard Johansen, Deputy Director of the conservative Heritage Foundation, a staunch opponent of the Affordable Care Act. “Does that sound like a system desperate for a costly overhaul?”  Continue reading »

Feb 082012

Affordable Health Care Act heads to U.S. Supreme Court

By Jack Stevenson

The health care legislation promoted by the Obama administration and developed into law by the U.S. Congress, the Affordable Health Care Act, will be reviewed by the U.S. Supreme Court to determine whether the law is constitutional. According to the Associated Press news agency, 26 states have filed legal challenges to the new health insurance law. The U.S. Court of Appeals in Atlanta, Georgia, ruled that the U.S. Constitution does not confer to the United States Congress the authority to require private citizens to buy medical insurance from a commercial for-profit insurance company. The U.S. Supreme Court will hear the case in March and will probably release a decision this summer.

The requirement for individuals to purchase medical insurance is called the “individual mandate.” The U.S. Supreme Court may decide if either the interstate commerce clause or the tax clause of our Constitution grants Congress the authority to impose a “mandate” that requires individual citizens to purchase medical insurance.

If you and your friends were discussing the merits of universal health care, it seems unlikely that anyone would suggest that it depends on the interstate commerce clause of our constitution. But that is exactly the issue before the Supreme Court or, at least, one of the issues. The U.S. Constitution grants the U.S. Congress authority to “lay and collect taxes” and also grants Congress the authority to “regulate commerce. . .among the several states” (interstate commerce). That yields a question: Does the requirement for individual citizens to buy health insurance from a for-profit insurance company constitute interstate commerce? If the answer is yes, then the Congress acted within its authority.

Another argument is that the requirement to purchase medical insurance or pay a financial penalty for failure to purchase insurance is actually a tax. The U.S. Constitution grants Congress the power to tax. The Court may decide whether the insurance purchase or penalty for failure to purchase is a tax. If it is not a tax, then the health insurance law could not be justified by the constitutional tax clause.

The Affordable Health Care Act also expands the Medicaid program. Medicaid is administered by the several states and the cost is shared by the federal government and the states. The adjutants general of 26 states object to the burden placed on the states by expansion of the program and contend that it constitutes federal “coercion” of the states. The Supreme Court will hear their argument.

The Court will also consider the relevance of the 19th century Anti-Injunction Act. The argument, here, is that the court should not decide an issue prematurely, that is, before the law is implemented. The major provisions of the Affordable Health Care Act take effect in 2014. Reliance on the Anti-Injunction Act doctrine would delay any Supreme Court challenge to the health care law until the year 2015. If the Supreme Court adopts this view, the Court would, we assume, not decide the individual mandate issue at the present time. However, the health care law runs to 975 pages, and it contains other miscellaneous provisions that the Court may or may not decide.

The new law requires insurance coverage from birth to age 65 when a citizen becomes eligible for U.S. Government Medicare. Forty percent of lifetime medical costs occur during those first sixty-five years of life. The commercial for-profit insurance companies will collect premiums for 65 years and sustain 40 percent of the lifetime medical costs. Sixty percent of medical costs occur after age 65 and become the responsibility of the tax supported U.S. Government Medicare program.

Supreme Court decisions are difficult to predict. However, the current Supreme Court headed by Chief Justice Roberts has been friendly to business organizations. The Affordable Health Care Act diverts a river of money, a continuous income stream, from citizens to health insurance corporations.

Whether the health insurance law, if implemented, will result in delivery of good health care, remains to be learned. During the past 79 years, 13 presidential administrations have looked at the health care question. None, to date, has found the magic potion.