The Supreme Court Decision on the Health Care Reform Law

In the cacophony of criticism and crowing as to who is right and who is wrong following the opinion of the Supreme Court on the Affordable Care Act, I offer a still, small voice to note that, actually, both political parties – and the Court — are right … in part.


First, Democrats are right in that something must be done to contain health care costs.  Double-digit increases in any line of a budget or a business’ overhead are simply unsustainable. These startling increases in health care costs are unacceptable drags on the American economy.


The presence of these increases in your health insurance bill generates the assumption that the industry is over-charging.


In the interest of full disclosure, I have the honor to head up one of the best health plans in the country. We are a non-profit company that manages to a margin of 1-3 percent.  By definition, if our margin is 1 percent that cannot be the cause of a double digit increase.


In fact, dozens of factors prompt health care cost increases. Some of these are good, such as new drugs to control cancer or innovative surgical procedures that turn a three-day hospital stay into an outpatient visit. Some of these are not-so-good, such as the cost-shifting of the uninsured and government programs that underpay hospitals and doctors, which raises prices by up to 30 percent. Because the problem is compound and complex, any effective solution is intricate.  Democrats are right that any effective solution requires all of us to be a part of a system.


Second, Republicans are also correct, in that the most effective solution to the problem of spiraling health care costs is NOT a partisan piece of legislation, driven through Congress without a single Republican vote.  Now, truth be told, there is blame on both sides of the aisle for this partisan divide. The fact remains that a purely partisan Act of Congress is a terribly unstable framework for a long-term solution.


Republicans are also right that any solution requires more than a mandate; it requires rules that address market realities and individual choice.


Lastly, the Supreme Court was also right, in its decision not to intervene in this political process, appropriately noting that “it is not our job to protect the people from the consequences of their political decisions.”  In other words, having elected a President and a Congress, we should not be surprised that we get a health plan that implements their vision.  The appropriate response is not to look to the Court for a policy more to your liking; it is to strive for a different outcome in the next election.  The Supreme Court consists of nine judges who determine the constitutional parameters within which government must operate. They are not nine philosopher-kings (and queens) who set health care – or any other – policy.


Notwithstanding the correctness of Democrats, Republicans, and the Court on these issues, there is one truth that none of them has said:  ideology will not lower the costs of health care.  Higher quality care that leads to better outcomes, better access, and superior coordination of care are the ways to do that.


Our system inWestern Coloradoalready does those things pretty well compared to other parts of the country.  However – as any business or household inGrand Junctionwill tell you – we have not built a system with low costs. In fact, no community can build such a system in isolation.  It requires coordination between the health plan, the federal government (which writes the rules for Medicare), the state government (which writes the rules for Medicaid), the medical community, and each consumer.


We do not do that perfectly here. We just do it better than most other communities.  This ability to collaborate is not surprising.  It is in theDNAof manyColoradocommunities to approach difficult issues collectively, as a community. From allocating water in a draught to fighting fires, to getting a school district budget, to the JUCO tournament inGrand Junction, we address problems best by working with each other. This is our Western heritage of caring about each other.


Over the years, our cooperation has led to a high performing health system admired by both sides of the partisan divide.  Democrats can look toGrand Junctionand value the broad access to mainstream care for the poorest individuals in the community.  Republicans can look toGrand Junctionand see a private-sector solution, based on individual choice.


All this creates an opportunity for us be part of our country’s larger solution, and there is a concomitant obligation for us all to rise to the occasion.  In communities like Grand Junction and Montrose, we should make the effort to help turn down the heat and turn up the light.  What the country just might see is a better path to high quality health care that is both more accessible and more affordable.

5 Responses to The Supreme Court Decision on the Health Care Reform Law

  1. I pray people wake up in this election and realize this regime will stop at nothing until they have our souls. I am against this health care plan and will do my best to inform the ignorants of our society that voting for Obama is a death sentence on America.

  2. People need to realize that Americans want and need healthcare reform. As a business owner, I can’t offer health insurance that costs 20% of total wages to employees. Should the insured continue to fund the uninsured? We can’t afford it. Those of you with blinders on, whose employers and we taxpayers fund your health insurance, yes, you’ve got it good. But taxpayers and businesses cannot afford these costs, as they spiral out of control.
    I suggest naysayers pay their own (individually purchased) health insurance 100% out of pocket. Then the true costs will be more relevant and real to those truly ignorant of the problem.

  3. Good letter! This is not a POLITICAL partisan issue. Amy’s finger-pointing, fear-based comment is a perfect example of what keeps us in the mud with spiraling out of control costs. “the ignorants”? and a “death sentence”? Seriously? They have medications for false anxiety, maybe your insurance policy covers them.

    As a small business owner I pay my own way and the cost is obscene. My child has a disability and I fought insurance companies everyday to get his “covered” benefits paid. People bashing heath care reform are “the ignorant”. The only way you’re happy with the system is that an employer is paying an obscene amount for your policy. Good luck when you get REALLY sick, lose your job or become self-employed. See how you like it then. You too will join the ranks of the under-insured, or uninsured.

    While everyone is distracted playing the blame game, nothing happens, while we pay all those members of congress and the house to do little but warm seats and insult each other. Anyone else sick of the deleterious rhetoric with no solutions set forward? Although imperfect, at least the affordable health care act sets solutions in motion.

  4. Responding to the blog post, while I appreciate the conclusions that more is needed, I disagree with the assessment that the Affordable Care Act was simply (and thus flawed) a partisan piece of legislation pushed through without a single Republican vote. That mischaracterizes both the process and the piece of legislation. The final act that was approved didn’t have a single Republican vote–that is true. But it did have hundreds of specific included compromises and suggestions that were asked for by Republicans. The fact that not a single Republican voted for it is more an indication of how the extreme right of the GOP has hijacked the party than any indication of the legislation itself being partisan. Yes, more needs to be done to get costs down. But don’t perpetuate the misconception that this legislation was railroaded through because as a country we voted in a Democratic President and Congress. Plenty of Republicans had their hands in this piece of legislation. They just didn’t have the courage to vote for it.

  5. We are pleased by the thoughtful responses here, and we are encouraged to see the conversation grow so respectfully. This is a complex issue that we will continue to explore. Naturally, the process is more complex than the final vote, and we must maintain a civility and rationality throughout the conversations. We will focus on continuing to provide accurate and timely information. We maintain our stance that ideology will not lower the costs of health care. Thanks for joining in the conversation!

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