Uphold healthcare reform
OUR OPINION: A workable solution for a pressing national problem
BY THE MIAMI HERALD EDITORIAL
HERALDED@MIAMIHERALD.COM
Something has to be done about healthcare in the United States. As the president of Blue Cross (now Florida Blue) told The Herald’s Editorial Board last week: “The costs are rising at a rate the private market won’t accept, and which the public sector — the government — can’t pay for.”
The indispensable need for change — to cut costs, provide universal coverage, increase efficiency and eliminate waste and unfair practices — will exist regardless of whether the Patient Protection and Affordable Care Act that Congress passed two years ago is upheld.
Last week’s three-day debate over the merits of the act before the Supreme Court gave the nation a valuable civics lesson. Lawyers for both sides engaged in a passionately argued yet respectful debate, and the justices eagerly jumped in with pointed questions and observations that steered the argument toward the most pressing issues.
The court should uphold the law. But whatever decision it makes, there can be no denying that reform in one form or another is coming our way because healthcare is too important to ignore.
In many ways, reform is already here. The linchpin of the Affordable Care Act is the so-called “individual mandate,” requiring everyone to buy healthcare insurance or pay a penalty in order to make universal coverage a fiscally sound reality. Ironically, that was the focus of much of the debate the justices heard, yet it doesn’t kick in until 2014, whereas many other provisions already have.
Thanks to the Affordable Care Act, some 2.5 million young people can stay on their parents’ insurance — today — until they reach 26. At least 250,000 small businesses have been able to claim a tax deduction to cover the healthcare of their employees. Prescription-drug discounts have saved seniors an estimated $3.2 billion. No one today can be turned down for insurance because of a pre-existing condition and insurance companies must devote at least 80 percent of premiums to medical care instead of profits or administrative costs.
In short, thanks to ACA, American healthcare is changing for the better. If the “individual mandate” survives the Supreme Court test, as it should, it will enshrine a basic principle of insurance, casting the net wide enough so that healthy patients balance those who are ill. But even if it doesn’t, other parts of the law are worth keeping — and must be paid for with a formula that allows insurance providers to offer services without going bankrupt.
Questions during last week’s debate made it clear that some judges are aware of this reality.
• If they deny the individual mandate, but keep the rest of the law, an uproar will ensue as insurance companies demand to know how they’re supposed to comply with the remaining provisions without an expanded premium base. The justices rightly seemed concerned about the consequences of going down this road.
• If the entire act is thrown out, the court will have upended a law whose beneficial effects are self-evident and which was enacted to remedy an intolerable situation — a broken healthcare system that excluded nearly 50 million Americans from insurance and whose costs were soaring out of control.
There is another fundamental reality that the court cannot ignore. The Obama administration devised an imperfect but workable and comprehensive solution to a pressing national problem. The Republicans offered none. Unless the court has a solution of its own, it should not turn back the clock.
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