Health Care’s Big Victory

Posted on behalf of Peter Galuszka, who is out of town today. — JAB

The U.S. Supreme Court’s surprising and wise decision backing the vast majority of the Affordable Care Act is a major victory for ordinary Virginians, tens of thousands of whom up to now don’t have or can’t afford health insurance.

The victory could be as big as Social Security or Medicare in terms of overall impact. It restores faith in at least one branch of government and helps the country move beyond the horrible partisanship that marked last summer’s debate over raising debt ceilings. It could set Barack Obama’s legacy after a fairly stumbling presidency and is a major boost for him in the upcoming election.

Virginia Republicans, led by Gov. Robert F. McDonnell, were predictably negative and sullen. McDonnell said he was “very disappointed.” The Richmond Times-Dispatch curiously trotted out the irrelevant Lt. Gov. Bill Bolling, its choice for the next governor, as the spokesman for the state’s Establishment against the decision. That might be expected, but what wasn’t was wild card Kenneth Cuccinelli’s rethinking of the ruling saying that maybe it isn’t so bad. This seems especially odd given that he made Obamacare on of the flashpoints in his politically charged legal activities as Attorney General

Now the ruling GOP elite has to, ahem, actually get on with the task of starting those health care exchanges to sell policies to people who have trouble getting them due to pre-existing conditions or lack of funds. They can stop whining about the “commerce clause” which SCOTUS neatly sidestepped by saying that ObamaCare is a tax and guess what, Congress CAN tax. Too bad, Libertarians and Tea Party types!

The big winners, besides the average man and woman, are hospitals and some doctors’ practices. Losers are Big Insurance and managed care, in other words, the very people who put lots of campaign bucks into the coffer of Rep. Eric Cantor so he can protect their rackets that hurt millions.

Unfortunately, the law doesn’t do much to bring transparency to health care pricing, which is based on two things (1) what Medicare says it is and (2) whatever deal hospitals and doctors negotiate with Managed Care.

You will probably hear a lot of whining from other bloggers about how this will bring Boomergeddon and disaster. It will be more expensive. But without clear pricing and choices, all this talk of the free market is a lot of hot air. So is the idea of “boutiques” in which the rich pay doctors to take care of them individually. But these 1 percenters already have insurance. The Average American is left out. Or was, at least, until Thursday.