Editorial: Health of the Nation

In the season of Independence Day, it’s always good to revisit this key question: Other than the coincidence that 300 million of us happen to live in one large political subdivision, what makes us all Americans?

This week we can reflect on three very empathic declarations of Americanism, and they all happened on the same day, Thursday, June 28.  That was the day that the Patient Protection and Affordable Care Act (ACA) was in great part upheld by the United States Supreme Court.

Oh sure, there were other important decisions announced by the Court last week, and in fact, a couple of them — one striking down much of Arizona’s immigration law, another declaring that juveniles cannot be mandatorily sentenced to life without parole, even on a murder conviction — will have tremendous lasting impact on our society.

Yet nothing that occurred at the Court last week has the symbolic importance of the health care ruling. By a majority of 5-4, the overall structure of ACA was left intact, including a requirement that most individuals procure health insurance or, if they choose not to, pay a penalty with their federal tax filings. Only a provision that would penalize states by stripping away existing federal Medicaid subsidies if they refuse to increase their Medicaid income eligibility limits was declared beyond constitutional legitimacy.

Despite the loud and insistent political voices declaring this result either a panacea or a disaster (it is neither) and using it as the linchpin for yet another ugly political season (it is), we find three aspects of the Court’s decision to reflect strongly on American character:

Constitutional genius: Thanks to our founders, we truly are a nation of laws, not men. Their wisdom continues to shine well beyond their lifetimes into what to them might seem an unrecognizable avatar of America.  The ACA passed through the gauntlet of the three branches of federal government — proposed by the President, approved by the Congress and scrutinized by the Court.  

All Americans, regardless of their substantive view of the outcome, should have the humility and decency to appreciate the brilliance that underscores this deliberate and inherently protective approach to governance. Jews in particular should understand that the measures of power restrained by separation provide more cover for minorities and the persecuted than any structure that would limit the authority to one branch alone.

Individual statesmanship: Chief Justice John Roberts claimed in his confirmation hearings that his and the Court’s job was simply to call “balls and strikes” in passing muster on laws, but he has instead resorted to political conservatism as the basis for many of his votes. In this instance, he at least to some extent placed leadership above his personal views, even though he did so by calling the mandate’s penalty a tax, refusing to embrace the Court’s historically expansive interpretation of the Constitution’s Commerce Clause. While we strongly disagree with how Roberts is tacking the Court toward the future, we do appreciate his recognition that the Court must have a voice distinct from that of the other branches, and that he plays perhaps the most significant role in ensuring that structural integrity.

Social Responsibility: Those who would choose to label any legislation that protects the unprotected as “socialism” utterly miss one essential element of historical American character, that of taking care of those among us who are in dire need.

There’s no one right way to tackle the issue of health care in this country.  Democrats tend to provide a more service-oriented result, and Republicans a more incentivized one built on personal responsibility.  The mandate itself was initially a conservative idea to ensure that costs could be driven down, and keeping most insurance in the hands of private companies guarantees their enrichment to the tune of billions of dollars. Yet those on the left accepted those aspects as a way to get it done when few other alternatives were politically available; legislative solutions are, by definition, compromises and imperfect.

But taking the position at this point that we shouldn’t find a way to ensure essential health care to our citizenry is, quite frankly, anachronistic and a good half century behind the times. To let our people, including the indigent and the tens of millions who work and still cannot afford coverage, get sick and die, is a nonstarter.  Something flawed at this point is far better than nothing, and to spend political capital trying to rescind this solution when there are dozens of other issues affecting the economy and people’s lives would be both unproductive and politically selfish.

Those who point at polls showing Americans as against ACA are entirely missing the point.  If polls dictate our national character, we’re no longer Americans. We’re selfish, bullying creatures who can snub our noses at the bottom rungs because they lack the political, social and economic will to have their interests represented in legislatures both national and local.  If this serves as the trend in a Citizens United world, it would be utterly erosive of our national character.

As Bruce Springsteen sings, We take care of our own. We are responsible for not only ourselves, but all of us. No, we won’t abandon our capitalism, our drive, our innovation, our spirit. But neither will we watch the weakest and least fortunate shrivel and fall by the wayside. It has never been our way. It ought not be our way now, or ever.