Contradictions

Obamacare appears to be heading to the Supreme Court for a showdown. Multiple federal judges in multiple districts have either ruled that parts of the legislation are unconstitutional or have ruled that they are constitutional. Many are calling for an expedited course--skipping the Appeals Court level--and going straight to the Supremes. Their arguments are persuasive.

The short version is the question: does the Congress have the right, under the commerce clause of the constitution, to force citizens to buy health insurance. This is called the individual mandate. The secondary question is: if the individual mandate is unconstitutional, is the whole bill unconstitutional?

I am no legal scholar and will make no predictions about how this will turn out...however, I recall the philosopher, social scientist, political scientist and trouble maker Hegal, who famously suggested that the argument that has the fewest internal contradictions should prevail. Following that logic, I would like to know that if the Supreme Court finds that Congress cannot compel citizens to buy health insurance, can hospitals and physicians and other providers begin to refuse to treat people who have no insurance and who refuse (or are unable) to pay? Decades ago, it became illegal for any health care facility to refuse treatment based on his or her ability to pay. Then the infamous HIPPA legislation made it illegal to even ASK patients in the emergency room if they had insurance before they underwent at least an initial medical evaluation. Health Care facilities have been giving out free care quietly and graciously for a long time. Now that Medicaid and Medicare and, increasingly, private insurance continue to reduce payments to providers, free care is becoming problematic.

So, if people refuse to buy insurance, would it not be consistent to say that providers should be able to refuse them free service? OK...I know what you are going to say. Car insurance covers people to drive and driving a car is a privilege not a right. No insurance, no license. Living is not a privilege, it is a right--one does not require a state license to keep breathing. There is also that pesky little document that says something like "life, liberty and the pursuit of happiness....".
Life is a right and the state would never take that right away. But wait....it does. The death penalty is still legal. So, the State does on occasion take a life away--so should one conclude that living is a privilege and not a right?

The reimbursement problem in healthcare is a huge problem which significantly adds to the cost of healthcare for all. If the Supreme Court is going to weigh in on this, perhaps they should write an opinion which clarifies in which direction this should head. I am certain that they have all read Hegal and are familiar with his argument. The real question becomes if they or any other of our leaders have the political will to gravitate toward a reasonable, consistent, non-contradictory policy. I am not holding my breath.