The Patient Protection and Affordable Care Act, President Barack Obama’s signature health care reform bill, had its three days in the Supreme Court last week, and by most accounts it did not go very well. Nothing is certain until the Court delivers its ruling in June. But if it does declare the bill unconstitutional, this is what — in my yes-we-canniest of dreams — I would like to hear the President say:
My fellow Americans,
The Supreme Court issued a decision today that I don’t think was right. It declared that Congress does not have the Constitutional authority to compel Americans to purchase health insurance.
I personally believe that this “individual mandate” was a crucial part of the health care law. It’s not there just because I think it’s good for Americans, just because Washington fat cats like me know what’s best for everyone. It’s there because health care reform requires insurance companies to provide coverage to applicants with pre-existing conditions. Without the individual mandate, people would only bother to buy insurance once they got sick, insurance companies would go out of business, and the entire industry would collapse. The individual mandate was never about big-government paternalism; it was about protecting private enterprise.
But you’ve all heard these arguments before. I won’t repeat them. Nor will I reprise the regrettable performance I gave during the emotional aftermath of the hearings last spring, and complain of judicial activism just like conservatives do whenever they lose a case. The Supreme Court justices are good people who were just doing their jobs.
What I will do in the face of the legal lemons I have been handed is make lemonade. I will propose an alternative foundation for universal health coverage. And to my political opponents who have accused me throughout my Presidency of orchestrating a government takeover of health care, I’ve got news for you:
You ain’t seen nothing yet!
If there is any sector in our economy in desperate need of government intrusion, it is those profiteers of death, those deniers of coverage to the sick and the poor, in the health insurance industry. So here today, I am announcing that I will stake my entire re-election campaign on the pledge to enact a single-payer health care system for America.
I have always preferred single-payer to the compromise on a compromise we actually wound up with. Also known as “Medicare for all,” it would be funded entirely through taxation, and would therefore not require the individual purchase of insurance policies. As in most other industrialized democracies, health coverage would be automatic, rendering the mandate unnecessary and sidestepping any Constitutional objections.
Of course, Republicans will scream “socialism,” just like they always do. But before you get swept up in their vintage red-baiting rhetoric, please consider what kind of health care plans they will offer up instead. I can tell you right now what Republicans will give you, whether in the House, the Senate, or the Oval Office: more of the status quo. A country in which, despite its riches, 50 million people lack health insurance, and tens of millions more are inadequately covered; in which people are forced into bankruptcy — or worse, into early graves — by medical bills; in which your friends, your relatives, your neighbours, your co-workers, live one unlucky diagnosis away from destitution.
If a drop of socialism in our capitalistic sea is what it takes to right this wrong, then slap a beard on my face and call me Fidel. Some things are more important than political labels. I believe that most of you understand this, and if the Republicans don’t, then it is up to you to teach them on November 6.
Thank you. And may God bless . . .
Et cetera, et cetera.