If "Obamacare" is Struck Down, Will It Lead to a Single Payer System?

There's an old saying "be careful what you wish for" that may come back to bit the GOP and conservatives in the ass big time if the conservative faction on the U. S. Supreme Court succeed it killing what the far right derisively calls "Obamacare." And what might that be? Demands for a single payer system so derided by the far right. When asked about individual parts of "Obamacare," a majority of Americans support these programs/policies. Now imagine that the Supreme Court strikes down Obamacare and these benefits disappear and millions find themselves uninsured or unable to afford sky rocketing health care insurance premiums. The resulting chaos and unhappiness might reignite a demand for a total overhaul of the health care delivery system and calls for a Canadian or European style health care system. Personally, I am all for it. As should be those who actually believe in the Gospel message of caring for the sick and the unfortunate. Here are highlights from a Washington Post column that looks at the possible fallout:

If Obamacare is struck down, the short-term implications are uncertain. Conservatives may be buoyed by an election-year victory; progressives may be energized by a ruling that looks more political than substantive. The long-term consequences, however, are obvious: Sooner or later, a much more far-reaching overhaul of the health-care system will be inevitable.

At the heart of the legislation is the requirement that individuals purchase health insurance or pay a fine. It became clear by their questioning that the court’s five conservatives — including Justice Anthony Kennedy, the swing vote who sometimes crosses the ideological divide and votes with the liberals — see this mandate as a significant expansion of the federal government’s reach and authority.

Verrilli gave him [Justice Kennedy] one. The market for health insurance is inseparable from the market for health care, he argued, and every citizen is a consumer of health care. Those who choose not to buy health insurance require health care anyway — often expensive care at hospital emergency rooms — and these costs are borne by the rest of us in the form of higher premiums.

I think Verrilli made his case. The court is supposed to begin with the assumption that laws passed by Congress are constitutional. Justices don’t have to like the Affordable Care Act in order to decide that it should remain in effect.

[I]t’s going to be a close call. What if they strike down the law? The immediate impact will be the human toll. More than 30 million uninsured Americans who would have obtained coverage under Obamacare will be bereft. Other provisions of the law, such as forbidding insurance companies to deny coverage based on preexisting conditions and allowing young adults to remain on their parents’ policies, presumably would also be invalidated; if not, they would have to be modified to keep insurance rates from climbing sharply. The United States would remain the only wealthy industrialized country where getting sick can mean going bankrupt.

Eventually, however, our health-care system will be restructured. It has to be. The current fee-for-service paradigm, with doctors and hospitals being paid through for-profit insurance companies, is needlessly inefficient and ruinously expensive. When people talk about out-of-control government spending, they’re really talking about rising medical costs that far outpace any conceivable rate of economic growth.

Our only choice is to try to hold the costs down. President Obama tried to make a start with a modest approach that works through the current system. If this doesn’t pass constitutional muster, the obvious alternative is to emulate other industrialized nations that deliver equal or better health-care outcomes for half the cost.

I’m talking about a single-payer health-care system. If the Supreme Court strikes down Obamacare, a single-payer system will go from being politically impossible to being, in the long run, fiscally inevitable.

America's refusal to learn from the successes of other nations drives me crazy. Yes, a single payer system would mean that doctors would cease to make near obscene salaries in some cases. But the availability of preventive care and no need to pass the costs of the uninsured to everyone with insurance would lower costs in the long run. Moreover, families would no longer see their finances wiped out by a serious illness - something I experienced some years back when first my oldest daughter was stricken with bacterial meningitis and then my former wife was stricken with cancer. Medical emergencies should not mean bankruptcy or something close to it - even for those with supposedly quality insurance coverage.