Healthcare

The Supreme Court’s decision upholding the health reform law is the healthcare version of Y2K. The build-up, the anticipation, the belief that something momentous would occur, and then…nothing. The Court’s ruling was the least disruptive ruling possible.
 
The status quo reigns.

It might be said that all Supreme Court decisions are equal, but some are more equal than others. Upon being handed down, each decision has undeniable legal, political, and policy dimensions. What makes any one decision a “landmark” – think of Lochner v. New York, or Brown v. Board of Education, or Roe v. Wade – is that its repercussions on the law, on politics, and on policy usually last for decades if not longer.

Today NFIB v. Sebelius will take its place in that select group of cases.
 
Today, the Court upheld all the major provisions of the Affordable Care Act, including the controversial individual mandate. Surprisingly, it was Chief Justice John Roberts who provided a decisive vote for the majority, rather than Justice Kennedy who had increasingly become the swing vote on numerous important cases after the retirement of Sandra Day O’Connor.
 
Legally, the 5-4 decision is another indication of the stark ideological divide in the Court when it comes to a whole host of issues. To be fair, this ideological divide predated Chief Justice Roberts’ appointment. Yet today’s ruling needs to be seen in the context of other high profile cases over the last decade, including Bush. V. Gore in 2000 and Citizens United in 2009. In NFIB, it is once again evident that there is little consensus in this Court on the powers of Congress or the role of the Supreme Court to limit those powers.
 
We may never know all the reasons why Roberts chose to vote with the liberal wing of the Court. Regardless, no Chief Justice prefers divided decisions, especially on landmark decisions. Think of Chief Justice Warren securing a unanimous vote in Brown, or Justice Blackmun a 7-2 vote in Roe – or even Justice Henry Billings Brown, who wrote the now disgraced majority opinion in Plessy v. Ferguson that was signed by all of his colleagues except one. The Court’s legitimacy is always on the line, never more so in high profile cases. Unanimous or near unanimous decisions provide the Court a certain amount of cover. A decision like this is more of a cacophony – and moves us in the opposite direction. Ultimately it may reflect on Roberts’ stewardship for years to come when the books are closed on his tenure.

Tomorrow, the Supreme Court is expected to deliver its ruling on the constitutionality of President Obama’s health care law. Whatever the court decides, it is clear to see that the president’s plan is not working.  Americans who already had health insurance coverage have continued to see their premiums dramatically increase each year, and those without coverage are being forced to buy more insurance than they actually need or can afford.

It’s been nearly three years since my husband lost his heroic battle with pancreatic cancer. Patrick received his diagnosis in January 2008, and like most patients, he had to beat extremely tough odds to survive.
 
We knew it would be a difficult battle, but he fought his disease with incredible determination, even as the cancer weakened his body, that shining, positive spirit of his never let up.

Small business is as American as baseball and apple pie.  Much like rooting for underdogs in baseball, in Washington we love cheering the success of small business and entrepreneurship. Why is it, then, that small business seems to come up short when politicians try to reform the tax code, reduce the deficit, fix health care, and cut red tape caused by excessive regulation?  Maybe it is because small business has its share of enemies. Periodically, a few economists opine that small firms are not the principal job creators, that business failures threaten our economy, and that the profit motive of entrepreneurs is evil. When activists in Washington disagree with small business, they attack the trade and membership organizations that advocate for their members in our nation’s capital.

While the country awaits the Supreme Court’s decision regarding the fate of the Affordable Care Act, the Obama Administration is moving forward aggressively to determine which health benefits are essential and should be covered by insurance companies under the law. Irrespective of the court’s decision, the subject of regulations soon to be issued by the Department of Health and Human Services will have a real and significant impact on millions of Americans. To this end, it would befit the agency to keep certain facts in mind. Nearly half of Americans suffer from at least one chronic disease, and the treatment of these diseases accounts for 83 cents of every dollar spent on healthcare in the United States.

More than two years ago, Democrats in Congress passed the president’s healthcare law on a partisan basis. Later this month, the Supreme Court is expected to announce its decision on the constitutionality of the healthcare law. It is my hope that the Supreme Court will rule in favor of patients over big government by striking down the law.

The first U.S. AIDS patient was officially diagnosed on April 24, 1980, and seemingly overnight America was gripped by an epidemic that has since taken the lives of more than a half million people, torn apart thousands of families, and instigated numerous measures to stem the rate of transmission. During the height of the epidemic in 1985, the government enacted a blanket policy which bans any man who has had sex with another man (or “MSM”) even once since 1977 from ever donating blood.

The future of healthcare in America may be wrapped up in these three letters: A-C-O, the Accountable Care Organization (ACO).

This model to provide high-quality, cost-effective care received momentum from the Affordable Care Act (ACA), but it will continue regardless of the Supreme Court’s decision this month. Why? Because an ACO is a sensible, efficient, and patient-centered way to keep people healthy and then care for them during illness.

“Too little progress has been made in identifying, learning from, and ameliorating medical error. It is clearly time to actively explore and test alternatives to the medical liability system.”
 
Those words come from Healthcare at the Crossroads: Strategies for Improving the Medical Liability System and Preventing Patient Injury, a landmark report on patient safety from The Joint Commission, the independent nonprofit that sets standards and accredits U.S. health care organizations. They were written seven years ago.