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I'm just sayin' - SCOTUS has decided; so now what?

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Now that the Supreme Court of the United States (SCOTUS) has decided on the constitutionality of Obamacare, what are we to make of it and how will it affect all of us as we go forward? I have postponed comment in this column on Obamacare in order to see what would be the ruling. Let's start with a few points of agreement and disagreement.

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I think everyone agrees that health care in the U.S. needed to be revised and available for all, and I believe in large part that the quality of healthcare in the U.S. is the best in the world. That is due to our health care professionals and health care facilities around the country. So quality is not the arguing point. The issue has always been the costs and efficiencies of our system.

Health care consumes about 20 percent of the GDP, and it typically increases each year well beyond the rate of inflation. It would seem there is room for improvement on how health services are delivered and paid for. In addition, about 30 million people in the U.S. have no health care insurance, either by choice or circumstance, so addressing the health care issue makes sense for all Americans; but available, cost effective health care is a huge challenge for lawmakers.

The majority of both political parties agree on some points in the health care law, i.e. 1) pre-existing conditions should not prevent someone from obtaining insurance; 2) insurability should be transportable from one job to another; 3) children up to age 26 should be allowed to stay on their parents' insurance policy if the parents have insurance; 4) some form of liability limits should be applied to health care lawsuits (tort reform) in order to keep liability insurance costs down; 5) wellness issues and rewards for a healthy lifestyle should be built into any health care plan; and 6) health care should be available to all with help provided for those who cannot afford insurance. Beyond these issues, the policies of a national health care plan differ widely between Democrats and Republicans, and the differences are rooted in the ideology of each party.

Democrats ultimately would like health care to be a national, one payer/provider system and controlled by the federal government. Under this system, decisions about what health care is available and how it is delivered is decided in Washington, D.C. Obamacare already has created more than 100,000 pages of new regulations.

Republicans would like health care to be about personal choices and responsibilities, available through the free market, and all insurance companies allowed to sell in all states, thus promoting competition (not the case right now).

SCOTUS decided that Obamacare is constitutional from a public policy standpoint but not the mandate wherein everyone must purchase insurance or pay a penalty. The mandate violates the Commerce Clause of the U.S. Constitution (Article 1, Section 8, Clause 3). The decision by the Supreme Court basically says that the health care law is OK, but the mandate is not, and that the mandate is essentially a tax and should be called a tax. If Congress wants to tax us more, that is their prerogative. It is not the court's responsibility to decide on tax issues or public policy issues. SCOTUS only decides on whether or not those policy issues are constitutional.

So now it is up to the people to decide, come November. But then again, I'm just sayin'.

* * *

America's doctors, nurses and medical researchers are the best in the world, but our health care system is broken.

- Mike Ferguson, American politician

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