Government is already involved with the majority of health care

US District Judge George Steeh of Michigan ruled last year that the constitution permits the federal government to require individuals to obtain health insurance coverage.

This lawsuit was filed by a Christian legal organization called the Thomas More Law Center, as well as others.   Other lawsuits are in the works in numerous other states.   These suits are filed primarily by Libertarian-types who don’t want to be forced to buy health insurance if they don’t want to.  Republican leaders are jumping on this “overreaching federal government” bandwagon and playing into fears that tomorrow we will wake up and be all forced to sing the praises of Lenin, Marx, and Engels.

The funny thing is that the government already is heavily involved with the vast majority of health care delivered in this country via Medicare and Medicaid.  So this whole “government hands off my health care” crap is ridiculous.  The government is already monumentally involved and always will be.  What it needs to do it work to control costs, increase coverage, and of equal importance, increase access.  To do this people, it has to be “involved” sorry to say.  One way to do this (at least to increase coverage and control costs – increasing access is another issue), many experts agree is to mandate that all people who are financially able, to purchase insurance.  Many young otherwise health people elect not to spend money on insurance, thus leaving those with chronic diseases as the main individual purchasers.  It does not take a degree in economics to see the problem here. Anyway, these young healthies can buy plans that cover catastrophic things (like ruptured appys, and fractured limbs, etc) that would be cheap and affordable – thus spreading the risk.

Anyway, to the Libertarian/Tea Party/Everymanforhimselfers: you are part of this society and we have to work on big problems as a society, not as individuals.  If  you refuse to buy insurance, your sick countrymen (and probably sooner or later you will be in this boat – sick and screwed with no insurance) will suffer.   Now, I am not saying the health reform act was perfect – far from it, but this part, the mandate to buy insurance is probably the most important part of it  – it is the only thing that will allow those with pre-existing conditions to ever be able to buy an affordable plan.  If they can’t, guess what happens? They get sicker and sicker and eventually become disabled and get onto Medicare!  They continue to incur larger and larger costs as they deteriorate over time.   Guess who’s paying now?  All of us via our taxes!    Of course we have to work on other major social problems that feed into this (obesity, inactivity, smoking, drug abuse, poverty, etc) – but the mandate is essential.

It will be interesting to see how these other suits play out. I am sure some judges will decide the opposite of this judge, but in the end I think the mandate will stick – and we will get used to it and move on – just like we did with ending slavery, allowing women to vote, Medicare, and Social Security.

“ER Stories” is an emergency physician who blogs at his self-titled site, ER Stories.

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