Our friend Julie Ferguson of Workers’ Comp Insider hosted the Health Wonk Review today, with a “look to the future” edition full of predictions and thoughts about the future of healthcare. It’s a great edition – be sure to check it out.
One of my favorite articles in the HWR comes from Joe Colucci writing at The New Health Dialogue. Joe discusses the upcoming Supreme Court case regarding the Affordable Care Act. Last summer, I wrote about my hope that the court will hand down a decision – regardless of which way they decide – sooner rather than later. I think that in order to move forward with healthcare reform and plan for the future, we need certainty one way or the other in terms of the legality of the rules that govern the whole process.
Joe’s take on the court battle is that the Supreme Court is unlikely to go against the majority of the lower courts that have ruled in favor of the constitutionality of the individual mandate. And he’s got lots of other well-thought-out opinions on the subject – his post is a must read if you’re interested in the legality of the ACA.
Personally, I’m with Joe on this one. I believe that opting to go without health insurance is in fact opting to self-insure, since the likelihood of people needing no medical care at all is slim. For people who can truly afford to self-insure, there might be an argument to be made in terms of their right to do so (Rush Limbaugh? Maybe. The rest of us who don’t earn $33 million per year? Not so much). But for the majority of the population, being uninsured means that potential healthcare bills – especially the big ones – will be paid by the rest of the population via higher healthcare costs and increased health insurance premiums. There’s no realistic way for hospitals to recoup costs from uninsured patients who have no ability to pay, especially if the bills are significant. And it might be well within the boundaries of the law to require people to not pass that risk off onto other people.
I also believe that if the individual mandate is found to be unconstitutional, the ACA will need to be significantly revamped. The mandate is such a fundamental part of the whole picture, especially if we want to keep the provision that would make all individual policies guaranteed issue starting in 2014.
Time will tell. It will definitely be interesting to watch the continuing legal battles surrounding the ACA. I wouldn’t have predicted that our Denver Broncos would make it to the second round of the playoffs this year, so I should probably refrain from predictions in general. But I’m excited to see how it all plays out, one way or the other.