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The Real Winners
by Paul Krugman
June 28, 2012
So the Supreme Court —
defying many expectations — upheld the Affordable Care Act, a k a Obamacare.
There will, no doubt, be many headlines declaring this a big victory for President
Obama, which it is. But the real
winners are ordinary Americans — people like you.
How many people are we
talking about? You might say 30 million, the number of additional people the Congressional Budget Office says will have health insurance thanks to
Obamacare. But that vastly understates the true number of winners because
millions of other Americans — including many who oppose the act — would have
been at risk of being one of those 30 million.
So add in every American who
currently works for a company that offers good health insurance but is at risk
of losing that job (and who isn’t in this world of outsourcing and private
equity buyouts?); every American who would have found health insurance
unaffordable but will now receive crucial financial help; every American with a
pre-existing condition who would have been flatly denied coverage in many
states.
In short, unless you belong
to that tiny class of wealthy Americans who are insulated and isolated from the
realities of most people’s lives, the winners from that Supreme Court decision
are your friends, your relatives, the people you work with — and, very likely,
you. For almost all of us stand to benefit from making America a
kinder and more decent society.
But what about the cost? Put
it this way: the budget office’s estimate of the cost over the next decade of
Obamacare’s “coverage provisions” — basically, the subsidies needed to make
insurance affordable for all — is about only a third of the cost of the tax
cuts, overwhelmingly favoring the wealthy, that Mitt
Romney is proposing over the same
period. True, Mr. Romney says that he would offset that cost, but he has failed
to provide any plausible explanation of how he’d do that. The Affordable Care
Act, by contrast, is fully paid for, with an explicit combination of tax
increases and spending cuts elsewhere.
So the law that the Supreme
Court upheld is an act of human decency that is also fiscally responsible. It’s
not perfect, by a long shot — it is, after all, originally a Republican plan,
devised long ago as a way to forestall the obvious alternative of extending Medicare to cover everyone. As a
result, it’s an awkward hybrid of public and private insurance that isn’t the
way anyone would have designed a system from scratch. And there will be a long
struggle to make it better, just as there was for Social
Security. (Bring back the public
option!) But it’s still a big step toward a better — and by that I mean morally
better — society.
Which brings us to the nature
of the people who tried to kill health reform — and who will, of course,
continue their efforts despite this unexpected defeat.
At one level, the most striking
thing about the campaign against reform was its dishonesty. Remember “death
panels”? Remember how reform’s opponents would, in the same breath, accuse Mr.
Obama of promoting big government and denounce him for cutting Medicare?
Politics ain’t beanbag, but, even in these partisan times, the unscrupulous
nature of the campaign against reform was exceptional. And, rest assured, all
the old lies and probably a bunch of new ones will be rolled out again in the
wake of the Supreme Court’s decision. Let’s hope the Democrats are ready.
But what was and is really
striking about the anti-reformers is their cruelty. It would be one thing if,
at any point, they had offered any hint of an alternative proposal to help
Americans with pre-existing conditions, Americans who simply can’t afford
expensive individual insurance, Americans who lose coverage along with their
jobs. But it has long been obvious that the opposition’s goal is simply to kill
reform, never mind the human consequences. We should all be thankful that, for
the moment at least, that effort has failed.
Let me add a final word on
the Supreme Court.
Before the arguments began,
the overwhelming consensus among legal experts who aren’t hard-core
conservatives — and even among some who are — was that Obamacare was clearly
constitutional. And, in the end, thanks to Chief
Justice John Roberts Jr., the court upheld that
view. But four justices dissented, and did so in extreme terms, proclaiming not
just the much-disputed individual mandate but the whole act unconstitutional.
Given prevailing legal opinion, it’s hard to see that position as anything but
naked partisanship.
The point is that this isn’t
over — not on health care, not on the broader shape of American society. The
cruelty and ruthlessness that made this court decision such a nail-biter aren’t
going away.
But, for now, let’s celebrate.
This was a big day, a victory for due process, decency and the American people.
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