Here's to Your Health--Update

Let's simplify the debate currently before the Supreme Court over whether or not the individual health insurance mandate included as part of "Obamacare" is unconstitutional.  Essentially, those on the right claim the mandate violates the Constitution by requiring people to participate in economic activity (i.e., buy health insurance) whether they want to or not.  Many legal scholars find this argument  flawed, but, given the current right-leaning make-up of the Supreme Court, the individual mandate might indeed be struck down and, along with it, the entire edifice of healthcare reform: If people are not required to purchase health insurance, then the economics of the rest of the legislation--such as a requirement that insurers cover everyone regardless of pre-existing conditions--fall apart.

While I don't agree with their principles, I acknowledge that libertarian types who claim the individual mandate is unconstitutional might have a point.  When put in highly emotional terms--"The government is forcing you to buy something whether you want it or not"--the argument resonates.  But let's ask another question: Should people who cannot afford or choose not to buy health insurance be turned away from hospitals--even in case of emergency--because of an inability to pay?  If an old lady collapses on the sidewalk from a heart attack, should she be whisked to the nearest ER and treated, or should EMTs and other medical professionals withhold treatment until it can be determined that she has the means to pay for any necessary treatment?

All but the most extreme libertarians will agree that the woman should be treated.  I suspect that, if asked, a solid majority of people would be in favor of retaining current laws that require hospitals to treat everyone.  But if the law requires hospitals to treat everyone, then it seems eminently reasonable to require "everyone" to pay for these services.  In effect, "everyone" already does, whether through taxes or simply through higher co-pays or other costs for medical services.  All the individual mandate does is simplify this payment plan and spread it out among as many people as possible.

In short, unless you are the most passionate Tea Partier, you already support socialized medicine--at least in terms of the provision of services.  The individual mandate simply socializes the cost.