The surprise decision this morning came in two very quick waves. The mandate is deemed unconstitutional! Conservatives cheered for about 10 seconds, but then – apparently we see the mandate was somehow upheld by leveraging the power of taxation. Liberals, who had thrown their cups of coffee across the room in anger, now were the ones cheering (and meekly cleaning up the mess, apologizing to their co-workers for their premature outrage).
So there you have it. PPACA is here to stay (barring a Romney victory AND a super-majority in the senate come 2013). It’s time we figure out how to make the best of it, and quickly.
The huge and seriously flawed PPACA is a mix of good and bad, a Frankenstein monster of pieces that make sense, and pieces that don’t. Many say that the mandate was the only way to fund it- so with the surprise method of taxation as the mechanism to circumvent constitutionality of fining people for not buying a product, we have our mandate, and we have our funding. WILL IT BE ENOUGH is a question that is still under considerable debate, and many detractors of the bill point to the questionable math involved in saying that the PPACA would actually SAVE the US money in the long haul.
The good side of PPACA, everyone knows, is ACCESS. Everyone knows horror stories of friends and loved ones who have been denied coverage and suffered consequences. PPACA significantly increases access to coverage, and provides some very important consumer protections. It also takes some very tiny first steps needed to begin constraining health care costs.
The bad side however is that PPACA misses a gigantic opportunity. Most notably, it does nothing to make coverage more affordable or to slow the runaway train of escalating health care costs.
We need to keep working on it, and hack away at what is wrong, and add what is missing. Lawmakers owe it to their constituents to revisit the law and make some substantial changes. We need to focus on provider-side abuses, tort reform, and the right incentives to consumers to drive wellness and personal accountability, and removal of provider-side incentives that are not in the best interests of the patients’ health.
Bottom line, we need to make this thing work- be happy for the good side of PPACA and chip away at what it lacks. Very few people believe that health care in the US is perfect and cannot be improved- the question was, and remains, is the PPACA in its present form the vehicle to do so. Let’s make sure that happens.