Perhaps unwittingly, U.S. District Judge Henry Hudson of Richmond, Va., has enhanced the prospects for single-payer health reform. He did so Monday by ruling the individual mandate provision of the Obama administration's health law to be unconstitutional.
Hudson ruled that the so-called linchpin of the law -- the requirement that most Americans obtain insurance -- exceeds the authority granted to Congress under the Commerce Clause. While his decision has no immediate effect, and while this is certainly not the last word on the subject, it does cast a cloud over the law's prospects and adds another element of doubt over the law's ability to fix our broken health care system.
Judge Hudson and the American people should be aware that this kind of problem wouldn't come up under a single-payer national health insurance plan, an improved Medicare for all. Unlike the administration's law, which requires that people carry or buy health insurance -- generally from a private health insurance company -- or face a penalty, a single-payer plan would automatically cover everyone and be financed by taxes and federal appropriations, much like Medicare is financed today (but on an stronger foundation). Much of the funding would come from recovering about $400 billion presently squandered on private-insurance-generated administrative waste.
As my colleague Dr. Don McCanne, senior health policy fellow for Physicians for a National Health Program, has remarked: "Nobody is going to argue that Medicare is unconstitutional. We should fix it so it works better and then provide it to everyone."