An appeals court ruled today that the federal government cannot compel individuals to participate in the new health care plan.
Such a plan can only succeed if all citizens participate. Otherwise, the healthy may opt out, thus concentrating costs with the remainder, which is no better than the present system, and probably much worse. Further, if it is true that individuals cannot be compelled to participate in this plan, then it is also true that no one can be compelled to participate in Medicare or Social Security. If the Supreme Court agrees with the appeals court, conservatives will have won their entire war, and the country is in for a dreadful and expensive time. This is exactly what Texas Governor Rick Perry says he wants.
Conservatives should be careful what they wish for, lest it be granted. Consider the consequences if individuals cannot be compelled to participate in any federal government program:
- No health care program of any kind can be part of American laws, including Medicare.
- If this is true, it is also true that the government cannot compel individuals to participate in any governmental program at all.
- This would include a military draft and extend possibly to the collection of taxes.
- There is even a question of limits of compulsion to obey any government law.
Conservatives have been lusting for just such a world since the beginning of time. What would such a world look like?
The most obvious difference would be that the role of government would be drastically reduced. Drastically. There would be virtually no safety net, social programs, no protection for individuals against the slings and arrows of outrageous fortune. You would have no community. You would stand completely alone and utterly dependent on the kindness of strangers who don’t particularly care about what happens to you.
We get daily hints what this would be like even today, with many millions unemployed and running out of benefits, and chances that new college graduates will find employment at an all-time low. As Barbara Ehrenreich said, her book Nickel and Dimed, about her unpleasant experience going underground and working at common jobs, is now ten years old, and was written during “good” times. Now things are far worse. A small part of the unemployed are finding work comparable to what they had. Most of those who do find work are paid less, with few if any benefits. The majority are unable to find work of any sort—it simply isn’t available. Perhaps the worst part of these developments is that the poor and unemployed are being demonized both officially and socially.
This is the new face of work in America. The largest part of it is low wage, and it will stay low wage, because it is a primary element of capitalism that workers shall be paid the least amount that owners can pay under the circumstances.
What that means is that the largest part of the labor force will earn something in the neighborhood of $12 per hour at present, or a maximum of less than $25K per year. A moment’s calculation will show that this is inadequate to pay for modest rent of, say $1000 monthly, health insurance of $1200, and retirement savings about the same, let alone the rest of life. This also presupposes that health insurance can be had at any cost. Any “pre-existing condition”, which can mean practically anything, will prevent the possibility of having any insurance at all. Under such circumstances, any significant illness is a death warrant, because the condition will go untreated.
If the Supreme Court doesn’t come up with a more rational ruling than several recent ideologically-driven rulings, the tough times we are experiencing now will be but a prelude to all-out disaster.