Time for real health care reform

Many are saying that the Supreme Court showed judicial restraint Thursday in its ruling on the Affordable Care Act. But the opposite is true—at least in one critical respect.
Historians will likely say that the court showed an astonishing level of judicial activism. While Chief Justice John Roberts sided with the more liberal justices and found the law constitutional under Congress’ power to tax, the bill would never have passed if the penalty had been cast as a tax increase. Many politicians, including President Barack Obama, went to great lengths to assert it was not a tax.

Yet several aspects of the Supreme Court’s decision do demonstrate restraint. Roberts joined four other conservative justices in finding the individual mandate unconstitutional under the Commerce Clause. As for Medicaid, he agreed to limit the federal government’s power to compel the states to expand their programs against their will.

These decisions were appropriate, and represented an attempt to constrain the federal government’s growth and reach.
Reasonable people can differ, of course, and everyone is entitled to their opinion. Roberts’ opinion, however, happens to become the law of the land. Therefore, everyone is bound by it and we now need to discuss where we go from here.
Democrats must acknowledge that the law does not come close to dealing with the long-term fiscal challenges caused by rising health care costs. It may have increased coverage, but you can’t increase coverage and save money—that’s an oxymoron. In addition, both the Congressional Budget Office and the Office of the Chief Actuary of Medicare say that the health care law is likely to cost trillions more over time than its supporters claim.

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