The Supreme Court, Health Care and the Current Political Moment

Did you see the article on the Internet that the Supreme Court could decide to throw out the ACA and instead impose single-payer? It said it was "Supreme Jury Nullification." Somebody else wrote they heard that if the Court declares the ACA unconstitutional then
Congress gets to have an up or down vote on Medicare For All. Then there were all the comments saying this was all a fantasy and absolutely not true.

I made this up, but something rather like it really is going on. Many are seeing the Supreme Court hearings as Single Payer v. ACA.  A more appropriate name for it is 1% v. USA or perhaps Radical Right v. American Democracy. These at least place the case in its
political context rather than treating it mainly as a health policy debate.

There is no need at this moment for another movement-wide policy debate between single payer and the ACA. The health care justice movement has long called for quality affordable care for ALL. The ACA does not go that far, and so it is appropriate to point that out. Just as the benefits are real the shortcomings are real. It would be a shame if defense of the ACA against right wing assault and being proud of the steps forward for women, for young adults, for those hurt by pre-existing condition loopholes and many more were accompanied by leaving out what every part of the movement has always believed in: health care justice for everybody and we won't stop until we get there.

Those who say it might even be better for universal health care if the ACA was thrown out, or say that the decision will not change the fact that we will still have to continue to fight appear to me to fundamentally be talking politics more than health care. A respectful
discussion, not a debate, over different assessments of the current political landscape is therefore appropriate, even more so if it can be conducted with building unity in mind rather than scoring points. What follows hopefully follows that path.



Supreme Court case is part of bigger battle for future of America

I find it helpful to see the court case as part of a fierce and vital battle over what kind of country we are going to be. There is a powerful, organized, well-financed assault on the modern (post 1929) state and on the advancements in democracy over the past century.

Destruction of the structures for the social distribution of a portion of society's wealth developed in the Depression, and then even more after World War II, has long been a goal of corporate leaders, and their political organizations have never been quiet about it.

Prop 13 in California was 35 years ago. It was an outlier then, but not anymore. Grover Norquist talked about shrinking government to the point where he could drown it in a bathtub years ago. The once hidden centers like the Koch Brothers and ALEC are now open for all to see.

The 1% don't want any wealth distributed socially, and they don't want any government obstacles standing in their way of taking it all. They have a head of steam and are not deterred by occasional setbacks or stumbles.

·       The shocking attempts to restrict the right to vote are part of it. For those my age this is unthinkable. It took 100 years from 1865 to 1965 to create a semblance of universal suffrage. That very structure is being battered. Voter ID is the 21st century Poll Tax.

·       The Citizens United declaration that corporations are people and can directly spend money on elections is part of this. The ruling says unions can do the same. Alas, corporations can spend all they want, while unions can spend all they have. This means
it is easier for corporations and harder for real people to be engaged politically.
·       The nationwide bi-partisan campaign against public education and public libraries, key components of modern democracy, it part of this full court press against modern democracy.

·       The direct legislative attacks on public sector unions are part of it, as well as the coordinated right-to-work drives in the Northeast and Midwest.

·       The court ordered end of gun control laws is part of this. Even more, their replacement with Stand Your Ground (License to Kill at Will) Laws.

·       The attempts to remove all government regulatory agencies through legislation, court challenges or defunding, and often all of them, are part of this.

The list could go on, and others are urged to help socially construct a fuller description of what is happening.

It is useful to see that the Supreme Court battle over the ACA is part of this attempt to delegitimize the modern state much more than a discussion over the best way to carry out health care reform. Ten or fifteen years ago it would have been unthinkable. Every element
of the ACA would have been seen as a good or bad political decision, not a constitutional challenge. The mandate was one way among many to do things that all knew had to be done. No Medicaid expansion has ever been challenged in this manner. But that was all before  the corporate – right wing felt they had to power for a full-scale attack on all fronts. That the nature of the Medicaid, as defective as it is, is facing its biggest test of legitimacy since 1965 is a sad marker of how far they have come and how much ground has we have lost in a relatively short time.  The court case provides another opportunity to shut down the public, social activities of society in the name of freedom.

In this context, overturning part or all of the ACA can best be seen as a political victory for the opponents of universal health care, independent of any analysis of the ACA.  It will be bad news. The struggle will continue, but under worse conditions.

Union organizers always say that the boss is the best organizer. And we all say that where there is repression there is resistance. I think there is more than enough repression around right now, so much that we don't need any more to come together in resistance.

Nick Unger is a veteran labor and health care activist and educator.  

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