Another PPACA Constituionality question

Two interesting columns this morning on the Supreme Court’s
upcoming consideration of the Affordable Care Act, a.k.a. Obamacare.
Jonathan Cohn, one of the very best writers on this subject, cuts to the chase:
If the individual mandate — the requirement that everyone purchase
health insurance — is unconstitutional, then Medicare and Social
Security must be unconstitutional too, and vice versa. It seems to me
that this argument is dispositive — unless the distinction is made
between Obamacare’s mandate of a private product and Medicare’s mandate
of payment into a public health-insurance system (and, as Cohn argues,
about 25% of Medicare recipients participate in private plans). You
can’t allow the mandated taxation required for Medicare and Social
Security and disallow an individual-mandate universal health care
system. Republican commentary on this subject, especially among the
candidates for President, has been fundamentally dishonest, as Charles
Krauthammer demonstrates once again.

Krauthammer, you may recall, essentially came out for a single-payer
system a few years ago — health care vouchers provided by the
government, according to income. (I’m in favor of that too.) Today, he’s
gone completely over the top in the opposite direction:

If Obamacare is upheld, it fundamentally changes the
nature of the American social contract. It means the effective end of a
government of enumerated powers — i.e., finite, delineated powers beyond
which the government may not go, beyond which lies the free realm of
the people and their voluntary institutions. The new post-Obamacare
dispensation is a central government of unlimited power from which
citizen and civil society struggle to carve out and maintain spheres of
autonomy.

Wow. So, essentially, socialism — the term that wingers often use,
inaccurately, to describe a single-payer system — is constitutional, but
a government mandate to participate in a private, free-enterprise form
of insurance is not? Republican attempts to distance themselves from
the Republican idea of an individual mandate do tend toward the hilarious.

Krauthammer is right on a separate point: that the Obama plan does
little to control health care costs. Of course, Republicans in Congress
want even less control over costs, as they demonstrated this week with their vote to abolish
a crucial Medicare panel that would attempt to control costs by
suggesting best practices as established by the electronic compilation
of health care data. This is the dreaded “death panel” of Sarah Palin’s
fevered imagination. It seems the only sort of cost control that
Republicans favor is free-market competition — another lovely fantasy
that has never been proved, and is probably unprovable, in the severely
limited, quasi-public health care market.

One hopes the Supreme Court will review all this with clear eyes. I, for one, would be surprised if Obamacare is overturned.