The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
June 28--The Supreme Court has finished its business for the week, and no miracles ensued. We still have the most expensive health care system in the world, costs rising by double-digits, eating government and business alive. We have a mess of an immigration system, with legal immigration difficult to impossible, 12 million people living in the netherworld, government feared and discredited, and our largest industries facing the prospect that soon they may have few legal workers and no recourse.
It was either a good week or bad depending on your political preferences, but court rulings are rarely saviors, and criticism alone won't solve problems. The Affordable Care Act, aka Obamacare, survives, but won't do much if anything to quell the growing costs of health care that bring governments to the brink, throttle down economic growth, threaten jobs and wages, discourage hiring and add to record federal deficits. Opposing the Affordable Care Act and criticizing its many faults is a fine and possibly fruitful political position. Undoing it, if that's possible, won't help much, if at all. And you can beat your chest and complain about illegal immigrants, or seek favor among those who sympathize with them, but riding an issue is not resolution.
If you are naturally optimistic you can believe that Monday's Supreme Court ruling, striking down three of four disputed provisions of Arizona's anti-immigrant law, might bring true comprehensive national immigration reform closer, simply by calling attention to congressional inattention. Would-be reformers are timid. President Obama once talked about the need for reform and to resolve the status of 12 million people whose presence is illegal but deportation intolerable. The president can throw political favors to perceived voting blocs, and delay deportation of students not much threatened with deportation, but that is not reform. Republicans, according to many political observers, are struggling to come up with a coherent policy that won't simultaneously offend their anti-amnesty base and alienate Latino voters crucial in several states. All the Supreme Court left them was Arizona's show-me-your-papers clause, requiring police to check the immigration status of people stopped for other reasons if they suspect they might be in the country illegally. This is the clause most likely to invite racial judgment, be highly offensive, and lure further court cases. Mitt Romney accuses Obama of failing to lead on the issue, and that's true, but what now?
When the Affordable Care Act was being debated in 2010, health care consumed 16.2 percent of the United States' gross domestic product, a breathtaking figure. The yearly burden was $2.3 trillion, about $7,681 per person per year. Government, federal and state, paid more than half the bill through Medicare, Medicaid, employee insurance and tax subsidies. The government share then came to $4,500 per year per person, more than many other countries spend in total, said the New York Times.
Fast forward to the momentous month of June 2012, and total health care spending is now 17.9 percent of GDP. Washington Post columnist Robert J. Samuelson pointed out that government actuaries project it will reach 19.6 percent in the next decade. In 1980, he said, it was 9 percent.
The Supreme Court didn't solve that problem today. Overturning Obamacare wouldn't have solved it. Sustaining it won't solve it. Universal health care is a laudable goal but by itself won't control costs or rid the system of the perverse economic incentives that drive them up, mostly paid by the young to the benefit of the old.
We have many judges and politicians who can pick a law apart. We have too few building us up.
Tracy Warner's column appears Thursdays and Fridays. He can be reached at firstname.lastname@example.org or 665-1163.
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