Beginning next week, the Supreme Court will hear arguments over the legality of the Patient Protection and Affordable Care Act. They must first consider whether or not the challenge can move forward and then if the individual mandate is or is not legal under the Constitution. Here, Peter R. Kongstvedt, MD, FACP, a member of the Senior Health Policy Faculty at George Mason University and principal of P.R. Kongstvedt Company, shares his thoughts on the Court's outcome.
Peter R. Kongstvedt, MD, FACP, Senior Health Policy Faculty, George Mason University/Principal, P.R. Kongstvedt Company: Despite the SCOTUS having a 5/4 conservative majority, the only vote that is perceived to be locked in is that of Justice Clarence Thomas who will vote to repeal the mandate and may even argue against severability since that would overturn the entire ACA. It's also good odds that the more liberal Justices, itself a highly relative adjective, will support the ACA in its current form. But the remaining Justices are a cipher at this point. The arguments on both sides are logical, whether or not you agree with them. The reasons one or more might support the mandate are that the uninsured still consume services, so it isn't a clear cut case of requiring people to buy something they would otherwise never, ever use; and overturning the mandate sets a precedent that might be applied in unknown ways in the future (you can argue the exact point to support overturning it). In a way, it's a balance between societal good — spreading the risk, and an individual good — and freedom to not pay for something even if you end up using it later.
Said another way, they must affirm or deny that famous philosophical dictum "The needs of the many outweigh the needs of the few" uttered by Leonard Nimoy's Spock in "Star Trek II: The Wrath of Khan" (OK, utilitarianist philosopher and auto-icon Jeremy Bentham [1748-1832] had a similar quote: "It is the greatest good to the greatest number of people which is the measure of right and wrong.")
Share your thoughts on the PPAPA challenge's outcome! Email Laura Miller at Laura@beckershealthcare.com.
Peter R. Kongstvedt, MD, FACP, Senior Health Policy Faculty, George Mason University/Principal, P.R. Kongstvedt Company: Despite the SCOTUS having a 5/4 conservative majority, the only vote that is perceived to be locked in is that of Justice Clarence Thomas who will vote to repeal the mandate and may even argue against severability since that would overturn the entire ACA. It's also good odds that the more liberal Justices, itself a highly relative adjective, will support the ACA in its current form. But the remaining Justices are a cipher at this point. The arguments on both sides are logical, whether or not you agree with them. The reasons one or more might support the mandate are that the uninsured still consume services, so it isn't a clear cut case of requiring people to buy something they would otherwise never, ever use; and overturning the mandate sets a precedent that might be applied in unknown ways in the future (you can argue the exact point to support overturning it). In a way, it's a balance between societal good — spreading the risk, and an individual good — and freedom to not pay for something even if you end up using it later.
Said another way, they must affirm or deny that famous philosophical dictum "The needs of the many outweigh the needs of the few" uttered by Leonard Nimoy's Spock in "Star Trek II: The Wrath of Khan" (OK, utilitarianist philosopher and auto-icon Jeremy Bentham [1748-1832] had a similar quote: "It is the greatest good to the greatest number of people which is the measure of right and wrong.")
Share your thoughts on the PPAPA challenge's outcome! Email Laura Miller at Laura@beckershealthcare.com.
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