New health care law should be preserved

As I sat in the Supreme Court this week for oral arguments on health care reform I felt privileged to witness the vibrancy of our democracy. A healthy back and forth discussion among the lawyers and among the justices started within the very first minute.

It's impossible to predict what the court will find, but I remain hopeful that the justices will determine that without a system to ensure that everyone has health insurance, millions will continue to forgo coverage and the cost for that care will be shifted to others.

For decades, Congress has grappled with the question of our nation's health care and its rising costs and the growing ranks of uninsured, whose trips to the emergency room and other health care facilities have a financial impact on every American.

The individual mandate is about both societal and personal responsibility. Few Americans expect hospitals to leave the uninsured at the curb when they show up sick. Ironically, it was a scholar at the conservative Heritage Foundation who so eloquently advocated for the individual mandate in 1989.

"If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance," Stuart Butler said. "If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services — even if that means more prudent citizens end up paying the tab. A mandate on individuals recognizes this implicit contract."

That mandate gained credence among conservatives throughout the 1990s, and into the early part of the last decade. Republican presidential hopeful Mitt Romney, as Massachusetts governor, used it as the backbone of his state's health reform law.

But its acceptance among Democrats has apparently changed all that. A policy with its roots in the right wing of the Republican Party is now panned as a vast government overreach by that same party's faithful.

Just as ironic, perhaps, was that all of the justices and lawyers taking part in this week's oral arguments seemed to agree that a tax could be levied on everyone to set up a single-payer, national health system. Yet somehow critics argue that a health reform law that maintains and builds on our private insurance system is unconstitutional.

Three months from now — or thereabouts — the justices will decide this case. Their decision will have long-lasting impact on everyone in our nation. Some could feel the effect sooner than others.

The 84,000 seniors and people with disabilities in the Medicare prescription drug program who received an average $580 discount in 2011 could see the so-called "doughnut hole" open back up.

The 57,000 young adults in Michigan who received insurance through their parents' coverage could no longer have that assurance.

And the three million Michiganians who received free preventive services could see that benefit disappear.

Of course, some of the most significant reforms — including the provision due to take effect in 2014 that bars insurers from denying care to people because of pre-existing conditions — could never materialize at all.

Along with millions of Americans who support this important law, I hope that's not the case.