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Column: Obamacare Ruling is a Conservative Win

Tina Dupuy


Market-based mavens, you've got your way.

Passionately opposed to socialized medicine, President Reagan called for a mandatory health insurance program while governor of California. It was legislation that sounded, well, sound, but was never going to be law. It was the "abolish the Fed" position of its day.

But Reagan did supply socialized medicine to the poor. Prior to Reagan's presidency and his signing of the Emergency Medical Treatment and Active Labor Act (EMTALA), people with no means to pay could be turned away at hospitals. EMTALA was an unfunded mandate that led to astronomical health care costs over the next few decades. People who couldn't afford insurance got health care in the ER and those who could afford insurance footed the bill. Which is, you know, socialism. The solution was to have an individual mandate to purchase private health insurance. But again, that was never going to pass.

In fact for over 40 years spanning seven presidents, American health care got worse and more expensive. At this same time other industrialized nations improved upon single payer models and hybrids of private and public models. Americans' health care system devolved into a have and have not parable: Best in the world if you have money, worse than you could imagine if you don't.

In 2000, the World Health Organization ranked us as 37th in the world. We paid more for less. An illness could cause bankruptcy. Our health system was very unhealthy.

But then came "change." In the original proposal by Obama, the Affordable Care Act included a public option, referred to as "Medicare you can buy into." This public option was wildly popular with doctors and supported generally by a majority of voters. It was a perfect way of creating competition in the market place, setting a bar for private insurance companies. It was also, as noted by its opponents, an easy transition into a single payer system, putting American health care on par with the rest of the industrialized world. But the public option died in the Senate.

The public option was dead. Now in the wake of this second Supreme Court decision upholding the existing compromised ACA law, the public option is cremated, buried and gone. There's no political will for Medicare for all.



Tina Dupuy is a nationally syndicated op-ed columnist, investigative journalist and stand-up comic.