Much will be written about the Supreme Court’s disappointing decision in the next few days. I’ll just make three points, one about the program, one about the philosophy underpinning it, and one about politics:
PROGRAM: The mandate requiring consumers to purchase their own insurance was necessary to fund the other parts of the Obamacare package. An influx of premiums (or tax penalties) from those who won’t likely use the system very much will counter some of the additional expenses. But remember, the mandate has always been a compromise position for those on the left anyway. They really prefer a single-payer system and total control, but agreed to the mandate (and some other back-room deals) to pass what they could. They’re not finished. Expect them to move more aggressively toward a single-payer system.
PHILOSOPHY: The health care debate is about redistribution of income, not about access to care. Obamacare cannot deliver what it promises without both rationing and taxing the middle and upper classes at a higher level. The money just isn’t there without wealth redistribution. The access problem affects only a small percentage of Americans and can be addressed with other measures.
POLITICS: Congress can change the law if it wishes, but without a 2/3 majority this can only happen with the blessing of the president . Romney has been running as an anti-Obama big tent candidate. He has vowed to repeal Obamacare but has avoided specifics. This decision gives Romney a golden opportunity to define his candidacy if he chooses to pursue it. His prospects for success in November hang in the balance.
The battle is far from over, but we need leadership. We’ll see if Romney is up to the challenge.