If the Supreme Court can be believed, which is a dubious claim, for sure, it is to issue its ruling on the Affordable Care Act, or more colloquially “health care reform” or Obamacare, some time this week. I, like many others, was hoping to receive a ruling last Thursday, Friday, or today, but like so many other acts in political theater, this one is set to be staged just so, to maximize the drama. In the world of politics, we should expect nothing less, however the fact that such a critically important issue with such pervasive implications has been reduced–or elevated–to such a highly polarizing political issue is, in itself, quite troubling.
What a luxury. What a disturbingly privileged position the US Supreme Court and Congress has created for itself. The language they have used to discuss this issue, dripping of anesthetic and robot-like inhumanity, has centered on obscure parts of the commerce clause and whether it is within the US government’s constitutional jurisdiction to mandate or prohibit “activity or inactivity” like the purchase of health insurance. This seemingly cold and calculated simplification of a complex social issue was, just two years ago, nearly unthinkable and almost without precedent in US law. Yet, here we are, two years later, awaiting how the nine Justices of the Supreme Court–politically privileged in every way–sees fit to rule on the constitutionality of the Affordable Care Act.
What a luxury. What a disturbingly privileged position the US Supreme Court finds itself, to rule on the constitutionality of the provision of a good it has absolutely zero chance of ever losing. For the US Supreme Court, the issue of healthcare was never one that was in need of reform, in fact it was formed quite well. For the US Supreme Court, it has never been a matter of “finding a job with benefits”, because the benefits afforded to these nine individuals are as vast as their robes are unflattering.
I can’t claim to be an avid fan of the “individual mandate” as the cornerstone of a movement toward universalizing healthcare coverage. I think this creates a tremendous boon for the health insurance industry, when the very last thing it needs is more power or advantage. However, what I do know is what it feels like to be dependent on a healthcare system in order to get through each day. The heart of the issue is not about the commerce clause. It’s not about the individual mandate. It’s not about the unreasonable and unsubstantiated fears of “socialized medicine”. The heart of this issue is how to allow people, who through no fault or decision of their own, are facing unimaginable difficulty are not made even worse off because they can’t secure the services they need.
I can’t imagine what my life would have been like over these past 22 years if I didn’t have health care coverage. I know that many others have not been quite so fortunate. However, I have lived every day for the past 22 years under the health insurance industry’s sword of Damocles, wondering when a necessary medical supply would no longer be covered, when a necessary service would be denied, or when a procedure would be considered “beyond medical necessity”. And, that says nothing of the fears that others legitimately have of reaching an “individual cap” in coverage or the inhumanity of the inability to take a job because it doesn’t provide adequate health insurance, or worse yet, the denial altogether of insurance coverage because life has already treated you unkindly with the onset of disease or disability. If the individual mandate was the only way, in the political world in which we live, that the health insurance industry would agree to alleviate some of these fears, then it seems quite worth the undertaking.
Irrespective of how the Supreme Court rules on this matter this week, the upholding or overturn of healthcare reform will say nothing of the divide between what many people need, and what many others believe they are entitled to. For many people, healthcare is not a talking point or a matter of political theater. It is the very issue on which their lives depend. They come from all backgrounds, all ethnicities, all ages, and all political ideologies. If the possibility that healthcare coverage is beyond the financial reach of some, or the medical eligibility of others, does not demand a need for reform, then the US Supreme Court has managed the unlikely feat of making itself even more distant from public realities.