Medicaid, The ACA and the Mandate

Two recent articles in the New England Journal of Medicine brought up a new perspective on the US Health Care debate. The first article (here) suggested that the 26 Republican Governors challenging Medicare may be up to more than simply squirming under new Federal mandates. The second article (here) also suggested that the challenge to the Affordable Care Act (ACA) involving the mandate reveal how little the right-wing justices understand about insurance and how much they really wish to limit the power of the Federal government. I would go even further and say that the 26 Republican Governors and the four right-wing Supreme Court Justices might really be intent on destroying the Federal government.

I'm not sure what makes a mandate to purchase health insurance different when it comes from the State of Massachusetts or the Federal government. From a citizen's perspective, it's still a government mandate. The argument that there is some benefit in keeping government closer to the people in the States is, for me, also a little weird. Living in a State (Wisconsin) that has been hi-jacked by the extreme right wing is hardly more inclusive government. Somehow in Wisconsin it is more important that people carry concealed weapons rather than carry health insurance.

Basically, the 26 Republican Governors and the four right-wing Supreme Court justices might seem to be arguing that the Federal government cannot mandate anything. That would be a radical idea about government. Actually, I don't think that is what they are doing. The Federal government can mandate things the right-wing likes (military conscription, invasions of privacy in the name of Homeland security, concealed-carry shootouts at the OK Corral, etc.) and cannot mandate things the right-wing doesn't like (health care, spending for the poor, spending for the elderly, etc.).

It is interesting how the edifice of obscure constitutional arguments is being erected around such a simple, naked, political agenda. A nation with a corrupt legal and political system does not have a great future.