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Dr. Behzad Mohit Headshot

The Supreme Court Knows Best -- or Does It?

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With the Supreme Court decision on the constitutionality of the Affordable Health Care for America Act (ACA) looming, the conversation on health care in the United States is louder than ever. However, as the debates on health care, and specifically the ACA, abound, no one except those with political agendas is really fired up about whether or not it matters how the Supreme Court rules on this case.

The judicial branch is an arm of the government in which the American people have historically placed a strong amount of trust. However, less than half the people polled in last year's Gallup poll approved of how the U.S. Supreme Court is handling its job. According to last month's NY Times and CBS poll, 44% of Americans currently approve the Supreme Court's performance. It's all part of a trend in the last decade, of lower and and lower approval ratings. Except for a 42% approval rating in 2005, people have less confidence now in the Supreme Court than they did at any other time in the last decade. In the 2000s, approval was 50%, and in the 1980s it was as high as 66%. But now the court is more partisan than ever, and belief in an impartial Supreme Court has been shattered.

Should anyone care what the Supreme Court decides when later this month it rules on the constitutionality of the Affordable Care Act? For practical purposes, the answer is yes, as the decision has the potential to affect every person's health, and the monthly expense outlay of every American household. But what good is the judicial branch, if it deals in partisan politics like Congress rather than the wisdom of justice? We are today looking at the most conservative Supreme Court in modern history. According to an indicator called the Quinn-Martin Score, the court is more conservative in degree than the most liberal court ever was liberal: it is now further from the center than the late 1960s courts were under Chief Justice Earl Warren. Considering these figures, one is compelled to ask whether or not the upcoming Supreme Court decision will have any great impact on the way Americans feel about the issue of health care.

Purportedly nonpartisan, the Supreme Court is increasingly viewed as a political entity, with 5-to-4 rulings in a handful of high profile cases. Americans are starting to wonder whether or not constitutional law is the real driving force behind Supreme Court decisions. Instead of championing objectivity and fairness, the Supreme Court is becoming a divisive force, driven by political partisanship.

Whatever the Supreme Court decides, we need a health care system that covers all Americans. We need it to be free of the profit motive that biases all participants -- the pharmaceutical industry, hospitals, doctors, and health educators. Our health should come first. It is a necessity. Some things are poorly served by the profit motive, and health is a prime example because there is a knowledge gap between sellers and buyers of the product. Providers know everything, and patients know next to nothing about what they buy, with their lives hanging in the balance. This is a prime example of an inefficient market.

In the book, Universal Health Care System for the United States: A Disruptive Innovation, it is proposed that the best health care system for our country should be a private, single-payer, non-profit insurance company. Obama's health care plan is a band aid approach to a deep and festering wound. At best, it diverts attention from the multi-trillion dollar fiasco of the present system. It should be replaced with a single, non-profit insurance company that Americans could voluntarily opt into. It would provide affordable rates, and would be free of corporate profit bias. It would put peoples' health first. It would be voluntary -- no coercive "individual mandate" penalty scheme necessary. Finally, it would be something all Americans could embrace: it would be non-partisan. Existing health care companies would simply compete alongside it, ensuring an atmosphere of creativity and innovation.

The plan suggested in Universal Health Care System for the United States: A Disruptive Innovation would save at least an estimated $1 trillion per year, without cutting service to anyone (current health care expenditures are over $2 trillion annually). Briefly, it would save $364 billion per year on Medicare and Medicaid claims processing alone. Doctors would spend their time healing patients, rather than filling out forms, and practicing defensive medicine. The plan would save $120 billion in billing fraud, and cut provider overhead by another $150 billion. It would save 30 percent of health costs by eliminating unnecessary tests and procedures, generated by the profit motive, that either do nothing for patients or actually harm them.

Will the Supreme Court approve the Affordable Care Act? It matters, but only insofar as it affects Americans who continue to be taken advantage of by a system of for-profit health care. As long as the profit motive exists in health, legislation can only partially mitigate the damage. Which is why the Act has to bend over backward with an individual mandate to coerce people into buying into a flawed, for-profit system. With such low confidence in the decision-making of the Supreme Court, why should we place such a high value on its Affordable Care Act decision? These are the wrong issues to focus on right now. Health care, even as envisioned by the Act, needs major revision.

It may be years before the rift in the Supreme Court is healed and legitimacy is restored. We cannot wait. We have to act to establish a system that works for people, not vested interests. Health is simply more important than partisan squabbling and the politics of the court. It is time that we took a stand, once and for all, against institutions that profit at the expense of the health of American citizens. We, as a nation, could have access to affordable, high-quality care and should be released from the many-headed monster of the current health care system in our country. I cannot help but wonder what you readers think of all this.

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