OBAMACARE ON THE ROPES? Oy. Not looking good for the Affordable Health Care Act, is it? I was bewildered by last week's preliminary sunny analyses that claimed to prove beyond a shadow of a doubt that the "individual mandate" — the ACA's requirement that all citizens buy health insurance — was constitutional and that, come June, the US Supreme Court would validate Obamacare, huzzah! Many legal authorities said that, all right, but legal schmegal, this is a determinedly political court. To expect a decision on the legal merits is...unrealistic. Impractical. Delusional.
Golly, I hope hope hope I'm wrong. But optimism surely took a beating beginning last Monday. That was when the US Supreme Court actually began to hear arguments over the Affordable Health Care Act, and it shortly became clear that a majority of the justices were inclined in quite another direction.
So if you can stand it — this is, after all, only the supreme medical issue around, no contest, and will be for years to come — you can fully immerse yourselves in the 3 days of oral arguments. It's straight from the Supremes to you. Find the transcripts here. And find audio of the sessions here. Enjoy.
A SELECTION OF FACTS AND OPINIONS FROM GROUP BLOGS. Find news summaries and reportage at Capsules, the Kaiser Health News blog. There are several posts, and Shefali Kulkarni has even collected daily tweets for you there. See also KHN's regular coverage, including videos and webcasts about the present and future of Obamacare.
This is as good a place as any to heap praise on the KHN site and its staff, the finest in one-stop shopping for policy news about health and health care. Full disclosure, I'm a colleague of its Executive Editor Peggy Girshman. But I assure you without guilt that my glowing assessment of KHN's value as a resource is entirely objective. See for yourself.
Not that there aren't other resources too, many of them. Find posts by a series of experts on each day's arguments and related matters at the HealthAffairs Blog, from the journal Health Affairs. See in particular William Sage's mildly optimistic view, although you probably will need to be a health policy/legal wonk to follow all the arguments. (I.e., I couldn't, quite.)
Another such series is at the Health Care Blog. This is a kind of op-ed site for the health care industry. The site explains: "You can think of us as a little bit like the Huffington Post with a focus on medicine, science and the business of medicine." Oh, dear. Only a very little bit like HuffPo, let us hope for their sake.
The SCOTUSblog had me briefly fantasizing that Justice Clarence Thomas would break his famous silence if only he was allowed to blog. But no. SCOTUSblog is a US Supreme Court Blog, but its domain is .com, not .gov; it comes from Bloomberg. Notable lawyer and SCOTUSblog founder Tom Goldstein explains why the site crashed Tuesday and links to the several in-demand posts about the week's Obamacare events.
Lyle Deniston's mildly optimistic analysis of the mandate's future cheered me up a tad. It's one of the few hopeful ones I've seen, unless you count the sow's-ear-into-silk-purse musings of those who hope that disemboweling Obamacare will ultimately bring forth true single-payer health care in reaction. Read more about that line of thought below.
A handful of commentaries are to be found at the JAMA Forum from the Journal of the American Medical Association.
Reason's Hit&Run blog, of libertarian bent, has several posts arguing for an end to the mandate, and maybe to Obamacare. But they don't seem to be collected under a single URL, so you'll have to hit & run.
NPR is more organized, collecting all its Obamacare coverage under one URL here. This includes posts on its health blog Shots. But it also includes its food blog The Salt. Which led to a post analyzing the SCOTUS arguments for references to edibles. There were, it says, 9 mentions of broccoli. I guess this was supposed to be funny.
SEE ALSO SUPREME COURT/OBAMACARE COMMENTARY FROM INDIVIDUAL BLOGS. Ezra Klein at Wonkblog attempted to turn the possible forthcoming SCOTUS lemon into lemonade. He argued that trashing Obamacare would lead eventually to the single-payer system that many have long wanted and that Republicans loathe. It's an argument others are making too, but the key word here is "eventually." How many of us would live to see it? Especially those who can't afford the escalating cost of health insurance and will succumb prematurely to an array of fatal diseases. Or — I just don't get why the law's low-tax-small-government opponents don't get this — who will be cared for at public expense anyway.
See Kate Pickert at Swampland on what might replace the individual mandate.
High-profile economist Henry Aaron provided analysis of the three days in three posts at the Brookings Institution's Up Front blog. See also Aaron's "Scrapping Obamacare Would Be an Rx for Chaos" at the Health Care Blog.
At the Nature Newsblog, under the hed "Science at stake as US Supreme Court takes up health care" Meredith Wadman considers the fate of several little-known provisions of the Affordable Care Act that would have an impact on science. These affect translational sciences, the Food and Drug Administration, and comparative effectiveness research, and also institute regulations requiring drug and medical device makers to make public their payments to docs and teaching hospitals.
And finally, if you write about health care policy and Obamacare, consult the Association of Health Care Journalists. AHCJ has put a lot of effort into collecting background resources on the topic of health care reform; find them here.
At AHCJ's blog Covering Health, there's a string of posts on Affordable Care Act; find them here. In the most recent post, Joanne Kenen contemplates what to write about between now and the SCOTUS decision in June — and how to write about it. Her advice: keep an eye on your state to learn whether it is slowing implementation of the law in anticipation of its demise. Are people talking about state initiatives to take up the slack if need be? What are the hospitals’ and insurers’ and physician groups’ contingency plans? Kenen warns:
First of all, we are going to get spun – and the negativity about the oral arguments is going to help the anti-health law camp of spinners. (The “hey it’s hunky-dory, it’s all fine” advocacy world rings a little hollow at the moment – although they may turn out in June to be right.) Keep an eye out for that “the law is dead so let’s get real” drumbeat because if things are said often enough, in a media or political context, they can start becoming the new conventional wisdom and affecting how we report and write. We might get pushed by editors to be more forceful about predicting the demise of the law (or the mandate) than we are comfortable with. Push back – you can certainly say there are real questions about the law’s survival. You can’t pick out hymns for its burial.
I hope she's not talking about me.
Enough for now. Even if it is the supreme medical issue around, no contest, and will be for years to come.
