Health-care law's demise may permit best plan

U.S. District Judge Henry Hudson’s ruling that forcing people to buy health insurance (or pay a fine) is unconstitutional may be the death knell for President Barack Obama’s plan to cover the nation’s uninsured.
Talk about literal interpretation of the Constitution. Had the health-care law used different words and levied a tax (equal to the fine) on all Americans and provided a tax credit (equal to the fine) for those with health-care coverage, nothing of substance would have changed, and the judge would have had no objection.
It’s a sad legal system that confuses linguistics for principle. But adherence to original language may trump concern for original intent, even on appeal to the Supreme Court. If it doesn’t, Republicans in the House of Representatives have a fail-safe plan to derail the law’s implementation — block the program’s funding.
If you’re pleased by this prospect, think again. You or your loved ones may be next to join the ranks of the 50 million uninsured and learn firsthand that self-insurance doesn’t substitute for actual insurance when it comes to paying potentially astronomical health-care bills.
Don’t get me wrong. I think Obamacare is a third-best answer to our health-care woes. It adds another expensive entitlement — federally subsidized health exchanges, with no solid cost controls — to Uncle Sam’s continually skyrocketing Medicare and Medicaid obligations. Moreover, given the way the health-exchange subsidies and employer fines are structured the law will likely lead to the unraveling of employer-based health care, leaving the government paying the bills of the entire population.

Current System
The government’s involvement in health care, per se, is no sin. We’re already far down that path. Our private, employer- based health-care system is heavily subsidized — to the tune of $200 billion through federal and state income tax breaks. Medicare and Medicaid cost federal and state governments another $962 billion. And the uninsured are now being covered, albeit poorly, through emergency room and other services, at another $323 billion in public expense.
Add it up, and government health-care spending is $1.5 trillion, or more than 10 percent of gross domestic product. We’re spending another $1 trillion privately, making our total bill 17 percent of GDP. Germany’s population is older, but its total health-care bill is only 11 percent of GDP. At an extra 55 percent cost, we’re delivering unequal health care and worse outcomes. On average, Germans live longer and have lower infant mortality.