Health care decision leaves Americans divided


Medical students and professionals participate in a news conference in support of the Patient Protection and Affordable Care Act outside the U.S. Supreme Court Building on March 26, 2012 in Washington, DC. Today the high court, which has set aside six hours over three days, will hear arguments over the constitutionality of the act.


Chip Somodevilla

The Supreme Court’s long-awaited ruling on the Affordable Care Act — known to both admirers and critics as “Obamacare” — has been characterized as a compromise, meaning it made almost everyone a little bit happy and a little bit sad.

“Looks like they split the baby on this one,” said one political activist in Denver.

Even CNN and Fox News were confused, announcing originally that the law had been struck down, based on partial information saying that the Court had ruled that the attempt to justify the Act on the grounds of interstate commerce was unfounded. But Chief Justice John Roberts, a staunch conservative, found a way to uphold the law on the basis of the government’s right to levy taxes.

Compromises have been few and far between in this increasingly polarized political landscape, and so perhaps we should all welcome this rare event.

But judging by the level of anger surrounding the ruling, matched by the almost total ignorance of its provisions and effects among the general population, nothing has been solved by Thursday’s decision. Instead, the battle will continue — right up until Nov. 6, when voters can finally have their say.

A recent USA Today/Gallup poll indicated that Americans are evenly divided — 46 percent to 46 percent — on whether or not they favor the Affordable Care Act. The split reflects the deep chasm between Democrats and Republicans: 85 percent of Republicans want the Act repealed in its entirety, while 65 percent of Democrats want the bill maintained or expanded.

This is not a debate over health care, or even about the proper role of government in our society. It is politics, pure and simple. Republican challenger Mitt Romney — himself the author of a similar health care bill in Massachusetts, lost no time in weighing in.

"If we want to get rid of Obamacare, we're going to have to replace President Obama," Romney told a news conference on Thursday.

Over the past several months, I have spoken to dozens of people about the health care act. Reactions are split fairly neatly along party lines, although neither side had a monopoly on logic.

“This is not America,” fumed Dr. Debra Russell, a self-described neuropsychotherapist in Beaufort, South Carolina. “This is socialism, communism. I never thought I would see this sort of thing in my country. It is as bad as FDR.”

Many conservatives hold Franklin Delano Roosevelt as the architect of America’s ruin. FDR’s New Deal reforms that helped bring the United States out of the Great Depression, but inserted the federal government into many aspects of citizens’ lives that had not been regulated before.

“Obamacare is allowing the government to make medical decisions it has no qualifications to make,” said Russell. “Besides, it was done under the table, forced on the American people over New Year’s.”

The Senate actually voted on Christmas Eve, 2009, but small details hardly matter. It is the “socialism” label that has been the most damaging, taking millions of Americans back to the rhetoric of the Cold War, and a “1984” society.

“I am not at all in favor of that Obama health care law,” sputtered an elderly, well-heeled grand dame in Columbus, Mississippi. “We might have some problems with our medical system, but at least we’re free.”

When her interlocutor posited that Sweden had a national health care system, and they, too, were fairly free, the woman erupted.

“Well, I certainly do not agree with everything that goes on in that country,” she said.

A small business owner in Tucson, Arizona, was firmly opposed to all things Obama. Regulation was strangling his livelihood, he said, and the Act would signal the death knell of the American way of life.

“It will put an end to the insurance industry in America,” he said.

When told this was not true, that the ACA allowed for a wide variety of health insurance providers, he remained unconvinced.

“Then what is this ‘individual mandate’ all about?” he inquired.

He had no idea what the provisions of the Act were, he just knew it was unremittingly bad.

One octogenarian in Tucson dismissed the entire debate out of hand.

“We should go back to the days of the old country doctor,” he said. “You went to the doctor you chose, and you paid him. What’s wrong with that?”

My favorite naysayer was Jacob Shuck, a 23-year-old in Davenport, Iowa, who railed against Obamacare as an infringement on his individual liberty.

“I don’t believe in health care,” he grinned. “I’m young and healthy, I should be able to choose whether or not to buy insurance.”

Shuck, of course, did not have to choose — he was covered by his father’s policy under a provision of the Act allowing young people up to 26 to be carried on their parents’ insurance.

On the Democrats’ side, emotions ran just as high, but with a slightly different focus.

Dr. Louis Borgenicht, a pediatrician in Salt Lake City, Utah, was adamant that something had to be done. His only problem with Obamacare was that it did not go far enough.

“Health care is a mess in this country,” he said. “Everything is wrong, and of course it is difficult to tackle it comprehensively. Personally I am for a single-payer system. It would avoid the insurance hassles. But some changes are absolutely necessary.”

One economist in Colorado who had worked in the area of health care reform for years was jubilant when the ruling came down on Thursday.

“The health care bill was upheld!!!” she wrote, just minutes after the decision was announced. But she concedes that even well-intentioned people are largely uninformed.

“I have friends who are convinced that there is no big problem here. They say that most people are covered by their employers. But we have 46 million uninsured people in America. What about them?”

Many of these people will be able to find coverage now, assisted by a provision of the Act that grants subsidies for the lowest income families.

But the road will be long and arduous, and debates over government interference and forced broccoli purchases will likely continue.

Still, there is no cloud without a silver lining.

Rush Limbaugh, the arch-conservative radio host whose toxic rhetoric has landed him in hot water more than once, has owed to leave the country if the Affordable Care Act is upheld.

On a program that aired in March, 2010, Limbaugh told a caller, quite erroneously, that if the health care bill passed, the federal government would be the only ones providing insurance, and all doctors would be forced into a federal program.

“If this thing passes, and it’s five years from now, and all this stuff gets implemented, I’m leaving the country,” he said. “I’m going to Costa Rica.”

Good choice. Costa Rica has universal health care — courtesy of a government-sponsored insurance program.