No one knows what the outcome will be, but it was certainly welcome news when we learned recently that the U.S. Supreme Court will rule next summer on the constitutionality of ObamaCare.
And while it is not the Court's job to rule on the merits of the legislation itself -- only on the considerable constitutional issues the misguided law presents -- the Court will nevertheless do the nation an enormous favor, in terms of policy as well as liberty, by tossing out this abysmal piece of legislation.
The consequences of ObamaCare are already afflicting the nation. Since it passed -- to the surprise of no one who understands how markets work -- the cost of health premiums has risen by 9 percent. Hundreds of companies have sought and received waivers, which are being doled out with all the wisdom you would expect when political considerations take front and center.
Many other employers will simply wait until the right time to end health benefits entirely and push them off on the federal government. The so-called health exchanges mandated by the law will add an enormous new budgetary burden to states, which explains why 26 state attorneys general have already joined in lawsuits challenging the constitutionality of the law.
The $200 billion annual cost of ObamaCare, as estimated by the Congressional Budget Office in its usual static fashion, will rise precipitously as demand soars and supply tightens. The ability of government to tax so as to cover these costs will quickly reach its limit. Rationing, which apologists for the law claim will not happen because the wording says so, is inevitable under such conditions.
Entitlements based on shoddy economics are usually revealed soon enough as the shams they are, and this has already started with ObamaCare. The Obama Administration was force to admit in October that the Community Living Assistance Services and Supports (CLASS) program, supposedly a major element of ObamaCare's cost-control function, is economically unfeasible and will not be implemented.
Remember when opponents of the bill pointed out that Democrats were double-counting some $500 billion in "savings" as a way of claiming ObamaCare actually reduced the deficit? The CLASS program was at the center of those phony claims. No one who was paying attention at the time is surprised it has now been abandoned.
Most of these are not constitutional questions, save possibly for the matter of turning state officials into federal agents for the purpose of establishing the exchanges. But this certainly is: If the Supreme Court upholds the constitutionality of ObamaCare's mandate that everyone purchase health insurance, there will henceforth be no limits whatsoever on what Congress can force the citizenry to do under the pretense of following the Commerce Clause of the Constitution.
That cannot be allowed to happen.
But as horrible as ObamaCare is -- and it is very horrible indeed -- we should acknowledge that fundamental reform of America's health care system ought to have been achieved long ago. The economics of health care have been skewed since World War II, when Congress established tax incentives only for employer-provided health insurance.
This raised the cost of insurance, such that individuals could scarcely afford it, and that made it all but impossible to obtain coverage on your own, to keep it if you lost your job, or to obtain it anew upon becoming employed again if you happened to have a medical condition.
Defenders of ObamaCare claim they fixed this problem by banning the denial of coverage for those with pre-existing conditions. But the manner in which they did this is unconstitutional (forcing everyone else to buy coverage so as to expand the risk pool) and will prove prohibitively expensive, as limits on the price of premiums for those already sick will inevitably distort prices upward for the healthy, many of whom never wanted the policies in the first place.
When Republicans had the chance in the past, they should have implemented reforms that put more power in the hands of doctors and patients, less in the hands of insurance companies, and none in the hands of government bureaucrats. The expansion of Health Savings Accounts, which empowers individuals to pay their own bills up to a pre-determined amount rather than relying on health insurers, was a good start. But reforms should have gone much farther.
In the current system, because most people rely on insurance companies to pay for everything -- even routine doctor visits -- costs are driven higher because consumers are desensitized to the prices being paid. The insurance covers it, they figure, so what do they care?
This especially adds costs for employers. If you have ever seen the video from 1994 in which I challenged then-President Bill Clinton on the economic assumptions behind HillaryCare, it came down to the fact that as an employer, I understood the real cost impact of the government's proposed mandates. He did not.
But I'll give him this: The negative impacts of HillaryCare would have been nothing compared to the devastation ObamaCare will cause if it is allowed to stand. That's because ObamaCare doubles down on all the factors that make the current system so expensive. It relies even more on insurance. It imposes more mandates. It pushes control of the health care relationship further from doctors and patients.
The right kind of reform empowers individuals to control this economic relationship, and empowers individual doctors to make the right decisions about patient care. H.R. 3000, currently sponsored by U.S. Rep. Tom Price (R-Georgia) is a good start. It makes access to health coverage economically feasible for everyone, while making the patient the owner of his or her own coverage, thus making it portable if the patient changes jobs. It empowers doctors to make care decisions and gives employers more flexibility in how they manage incentives and other details of their plans. It also reforms the medical liability system -- a major driver of rising costs in health care.
The nation's health care policy ultimately comes down to who will have power in the economic relationship. If power is concentrated in the hands of patients and doctors, rationality will return and costs will go down. Access to care will rise. If power is concentrated in the hands of insurers and bureaucrats, costs will soar and treatment decisions will be taken out of the hands of doctors and patients -- as everything will become about preserving the "system."
We need to fix health care in this country, and this time we need to do it right. I hope the Supreme Court tosses ObamaCare out because of its clear unconstitutionality. But if the Court does not, I eagerly await my opportunity to sign its repeal, along with a new reform that puts the power in health care relationships where it belongs -- with the people.