[Anecdotes] It’s a tax!

Why should both conservatives and liberals cheer yesterday’s Supreme Court decision? Instead, Chief Justice Roberts’ argument for upholding the Affordable Care Act seems to have many conservative politicians reaching for the bottle to drown their sorrows and think tanks like the Heritage Foundation (aka the Founding Fathers of the Affordable care Act) licking their wounds. Soon, Rush Limbaugh ought to be dusting off his passport to catch the next plane to Costa Rica and Bill O’Reilly is finally supposed to admit on air that he is an idiot.

Despite all those unhappy people, most conservatives should be pleased that the Supreme Court ruling firmly limits Congress’ authority to regulate commerce to activity that is actually happening and thus defines the decision to forego purchasing a product (health care) as inactivity.

So feel secure that the government can’t make you buy health insurance, or broccoli, or  the newest Justin Beiber album.

But, and it’s a big but, Congress can tax you if you don’t buy those things.

Even though the Democrats and President Obama went to extreme lengths to avoid labeling the “individual responsibility penalty” as a tax, Chief Justice Roberts recognized what it is. It’s a tax. Tax-hating conservatives should take solace in that.

Another reason conservatives ought to like yesterday’s Supreme Court ruling is that the Court limited Congresses ability to put strings on the Medicaid expansion funds it wishes to spread across the nation. So places like Texas and Mississippi, where politicians want to keep poor people sick and uninsured, are free to leave millions uninsured.

Now to the liberals, who salvaged a victory by keeping alive the signature achievement of President Obama. Obviously they should be happy about that. The super-liberals (the PNHP-types) of course are still annoyed that the Affordable Care Act isn’t single-payer health care. But this does set the framework for a European-style managed competition arrangement for health insurers. It requires everyone who can afford it to buy insurance (or pay a penalty, i.e. a tax). So now, all the liberals really need to do is start moving America in the following direction to achieve universal health care:

• merge the population into larger and larger risk pools whether state-wide or eventually a single national one
• eliminate the profit motive from health insurance companies

Even if single-payer (or Medicare-for-all) is still a long way off, liberals can rally behind a where health insurers function as regulated non-profit utilities.