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After another bad day for the Affordable Care Act at the Supreme Court, voices across the political spectrum are already pondering life after death for health care reform.  Conservative Ross Douthat and liberal James Carville agree that overturning the ACA will help President Obama get reelected.  Meanwhile, statements by Mitch McConnell and Mitt Romney seemed to confirm David Frum and Jonathan Chat's shared conclusion that Republicans will do nothing to help over 30 million American who would be denied access to health insurance.

But if Obamacare is euthanized by the Roberts Court, its demise may contain a poison pill for the conservative ideologues who brought it about.  That is, if Congress cannot mandate that Americans buy health insurance from private companies, the Republican dream of privatized Medicare and Social Security is probably over as well.

It's worth noting at the outset just how few Americans would actually be impacted by the individual mandate contained in the Affordable Care Act.  A recent analysis by the Urban Institute concluded:

What may be surprising, however, is that if the ACA were in effect today, 94 percent of the total population (93 percent of the nonelderly population) or 250.3 million people out of 268.8 million nonelderly people--would not face a requirement to newly purchase insurance or pay a fine.
As Ryan Grim noted, that's because "98 percent of Americans would either be exempt from the mandate -- because of employer coverage, public health insurance or low income -- or given subsidies to comply."  Last year, the Commonwealth Fund estimated that of the 52 million people who went without health insurance in 2010, half (26 million) would be covered by Medicaid under the Affordable Care Act.  While another 17 million would receive subsidies to buy coverage in the private market, only 3 million would have to take on the full cost themselves.  (That squares with the experience in Massachusetts, where Mitt Romney's wildly popular law has reduced the ranks of the uninsured rom 10 percent to a national low of two percent.)

Click chart to see full-size image.

But if Obamacare's individual mandate affects a comparatively small number of people, Medicare and Social Security are another matter altogether.  Virtually all working Americans pay the payroll taxes that fund the pensions and health care for millions of seniors today - and for themselves in the future.  And it is precisely those low-cost government insurance programs, the ones that have reduced poverty among the elderly by two-thirds, Republicans want to turn over to the private sector.

Just ask Paul Ryan.

Last spring, 235 House Republicans and 40 GOP Senators voted to ration Medicare, converting guaranteed government insurance into under-funded vouchers and leaving the elderly to the mercy of the private market.  Ironically, the Washington Post's Ezra Klein noted at the time, is that Ryan and his conservatives claimed his plan would lower costs while Obamacare would not:

The plan basically turns Medicare into the Affordable Care Act. It's the same idea -- regulated exchanges offering certified insurance products populated by subsidized buyers. If [the Ryan plan] will unleash ferocious innovation that holds costs down, then so too should the Affordable Care Act.
Now, a year after Ryan 1.0 was rightly blasted for ending Medicare as we know it, the House Budget Chairman is back with a revised version.  As ThinkProgress explained, "Beginning 2023, the guaranteed Medicare benefit would be transformed into a government-financed 'premium support' system." Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare."  Nevertheless, Ezra Klein documented, Ryancare and Obamacare still look similar:
Let's play a game. I'll describe a health-care bill to you. Then you tell me if I'm describing President Obama's Affordable Care Act or the budget released this week by Rep. Paul Ryan (R-Wis.).

The bill works like this: The federal government subsidizes Americans to participate in health insurance markets known as "exchanges." Inside these exchanges, insurers can't discriminate based on pre-existing conditions. Individuals can choose to go without insurance, but if they do so, they pay a penalty. To keep premium costs down, the government ties the size of the subsidy to the second-least-expensive plan in the market -- a process known as "competitive bidding," which encourages consumers to choose cheaper plans.

This is, of course, a trick question. That paragraph describes both the Affordable Care Act and Ryan's proposed Medicare reforms. The insurance markets in both plans are essentially identical. And for good reason.

In a nutshell, what Democrats have done for Americans under age 65 is what Paul Ryan wants to do only for those over age 65.  (Arguably, Ryan's plan does more by continuing to offer traditional Medicare as a "public option.")  But as Klein also emphasizes:

There's an added complication for Republicans. They have assumed huge savings from applying the exchange-and-subsidies model to Medicare. But they don't assume -- in fact they vehemently deny -- that those same savings would result from the identical policy mechanism in the Affordable Care Act. The Democrats haven't assumed significant savings from the exchange-and-subsidies model in either case.

If the concept works as well as Ryan says it will, then the Affordable Care Act will cost far, far less than is currently projected. There's no compelling reason to believe competitive bidding will cuts costs for seniors but fail among younger, healthier consumers who, if anything, are in a better position to change plans every few years and therefore pressure insurers to cut costs.

Make that a second complication.  The first is this.  Despite all of thei right-wing rhetoric that "ObamaCare is a cancer in our government" and the individual mandate "endangers individual liberty," the Ryan House GOP budget plan for Medicare similarly features much the same requirement.  As Klein pointed out  above, "Individuals can choose to go without insurance, but if they do so, they pay a penalty."

Of course, they do today.  If you're rich like Mitt Romney, you can opt out of Social Security and Medicare.  But if you refuse the mandate to fork over your payroll taxes for Social Security and Medicare, you could face fines, prison or, in the case of employers, see your assets seized and your company shut down.  (The IRS web site offers plenty of examples of what happened to those scofflaws who tried to evade that requirement.)  As the New Republic's Jonathan Cohn highlighted last week ("If Medicare Is OK, Obamacare Should Be Too"):

In principle, is the basic obligation that comes with health care reform--to pay for a mutual protection scheme that some individuals might not find advantageous or desirable--really so novel?  

Hardly. It's an obligation most of us meet on a regular basis, every time we get a paycheck.

I'm speaking, of course, about Social Security and Medicare. Each program is a form of "social insurance" and each serves the same basic function: To protect us from financial shocks that we cannot anticipate or avoid. With Social Security, the shock is reaching retirement without enough income. With Medicare, the shock is high medical bills during old age. During our working years, we pay into these programs by handing over portions of our incomes, in the form of payroll taxes. And we don't have a choice about it, unless we want to start evading taxes.

Whatever you call it, the penalty for failing to obtain health insurance now mandated under the Affordable Care Act is little different from than paying into Medicare and Social Security.  (As Klein put it, "I don't believe our forefathers risked their lives to make sure the word 'penalty' was eschewed in favor of the word 'tax.'")  And the same Republicans who denounce Obamacare for forcing uninsured Americans to buy a product from private providers would do the same for Medicare and Social Security alike.  As for Paul Ryan and his proposed insurance mandate for the future elderly, House Speaker John Boehner acknowledged last year:
"It transforms Medicare into a plan that's very similar to the President's own health care bill."
But the conservative wrecking crew doesn't just want to mandate that Americans in their golden years buy health insurance in the private market.  Their retirement security, Republicans insist, should be left to the tender mercies of the marketplace.

In the past, Mitt Romney, Rick Santorum, Newt Gingrich and Paul Ryan all supported the privatization of Social Security along the lines President Bush proposed in 2005. (For his part, Santorum was the GOP's privatization point person in the Senate, distributing a sales kit to his members including such memorable talking points as "your audience doesn't know how trillions and billions differ.")  Bush wanted Americans to be able to divert up to a quarter of their Social Security contributions into "personal retirement accounts" managed by private financial institutions.  In a January 2005 town hall meeting with an African-American audience, President Bush condescendingly explained how it would work:

"Another interesting a personal savings account...which can't be used to bet on the lottery, or a dice game, or the track."

"Secondly, the interesting -- there's a -- African American males die sooner than other males do, which means the system is inherently unfair to a certain group of people."

Of course, privatizing Social Security isn't merely unfair; it's financially dangerous and wildly hated as well.

As George W. Bush and his Republican allies learned, draining the Social Security trust fund was slightly more popular than the Ebola virus. Worse still, as the Center for American Progress noted, the 2008 implosion on Wall Street which emptied millions of 401k's would have similarly gutted the private accounts the GOP so badly wanted to create. And, as Matthew Yglesias helpfully explained, there's always been the problem of adding trillions of dollars to the U.S. national debt:

"What privatizers want to say is that current retirees will keep getting benefits and future retirees will be okay despite our lack of benefits because we'll have private accounts. But current retirees can't get benefits if my money is in a private account. And my account can't be funded if I'm paying benefits for current retirees."
And if the Supreme Court strikes down the individual mandate for purchasing health care in the private market, it may not look so kindly on Republican demands that millions more Americans must do the same for their elder care and pensions.

The ironies for the free-market worshippers on the right wouldn't end there.  Because the Supreme Court has already upheld Social Security's mandate that Americans buy a government product with their tax dollars, a single-payer federal health care system cherished by most liberals would almost certainly pass constitutional muster.  (This is another area where the question of whether the ACA's penalty for noncompliance is a tax is a major issue.)  But the Republican schemes of privatized Social Security and Medicare might not survive Supreme scrutiny.

If the Supreme Court throws out the Affordable Care Act, it may be throwing out conservatives' beloved privatization dream as well.  But for millions of Americans - the 50 million without health insurance, the 25 million more underinsured, the millions already deferring or rationing their health care and the hundreds of thousands facing medical bankruptcy each year - the end of the GOP privatization dream would just be the continuation of their own nightmares.

* Crossposted at Perrspectives *

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Comment Preferences

  •  I guess we all should be talking about... (17+ / 0-)

    ..."Ryan's Medicare Mandate".  It'll either kill his plan, or make the ACA look better.  Either way, it's win-win.

    Very well-done diary, BTW.

    We reach for the stars with shaking hands in bare-knuckle times.

    by TheOrchid on Wed Mar 28, 2012 at 01:02:37 PM PDT

  •  Avenging Angel - I think you make some good points (7+ / 0-)

    But i don't agree that if the mandate is rejected by the SCOTUS it would end conversations about privatizing Medicare or SocSec. As I understand the Medicare plan (which I don't support) you would be given a grant from HHS to buy a product. I would think that if one of those products was a Health Savings Account that it would be quite different than the ACA mandate. All the SocSec plans, including the GWB program, have been outlined as voluntary and would only allow you to take a portion of your future SocSec contributions and place them in a 401K type account. That too seems quite different that the ACA mandate and I don't see any constitutional issues with a voluntary program.  

    "let's talk about that"

    by VClib on Wed Mar 28, 2012 at 01:10:33 PM PDT

    •  I am so confused - should I be hoping that ACA is (2+ / 0-)
      Recommended by:
      Avenging Angel, TofG

      struck down?  any thoughts are welcome......

      •  The ACA Should Be Upheld (3+ / 0-)
        Recommended by:
        Noamjunior, notrouble, ozsea1

        As a matter of public policy and constitutional principle, the Affordable Care Act should be upheld.  In essence, the goverment is imposing something like a tax (insurance premium or penalty) for people to get a product (insurance) from private providers.  The government is functioning as a middle man (via the insurance exchanges).

        I think privatized Medicare and privatized Social Security are terrible ideas as a matter of public policy.  Private Medicare shifts costs onto seniors and will inevitably ration care as the "premium supports" fail to keep up with private insurance premiums.  Private Social Security is risky and in the near-term, would explode the national debt as trillions of dollars are draining from the TRust Fund.

        That said, I don't think privatized Medicare and Social Security are unconstitutional.  They are just terrible ideas.

    •  I Agree the Analogy is Limited (1+ / 0-)
      Recommended by:

      I titled the diary with a question because I wasn’t sure about my own answers.   I think you raised many of the difficulties with my take on this, ones I struggle with myself.

      That said, I think Cohn and Klein’s points are good ones.  Cohn suggests that the current Medicare system is a mandate to buy a product (elderly health insurance) from the government.  Klein argues that Ryancare’s transformation of Medicare uses an almost identical structure (participation in mandated, subsidies are provided in the form of “premium support,” etc.)  Ryan’s first version did not maintain the current government Medicare as an option.

      Some key differences?  With Medicare, Americans are mandated to pay now for a product current beneficiaries will get today and they them selves won’t get til later.

      I agree with you that a voluntary Social Security privatization scheme wouldn’t pose the same of mandate as the ACA.  But some conservatives want to privatize Social Security altogether and require that everyone set up a private retirement account.

    •  I think this is correct. (1+ / 0-)
      Recommended by:

      I don't like the Republican privatization plan at all (for a number of reasons, not the least of which is taking money out of public plans and then having to subsidize inevitable losses in the private plans), but my understanding of it is that it's a purely voluntary mechanism for moving one's own contributions into a private account.  Very different than the mechanism of the health care mandate sans originating public plan, so I don't think any decisions in the ACA case will limit that in any way.

      Saint, n. A dead sinner revised and edited. - Ambrose Bierce

      by pico on Wed Mar 28, 2012 at 05:14:28 PM PDT

      [ Parent ]

  •  You can always choose to die a slow (4+ / 0-)

    painful death from untreated illness.

    If I threatened to torture you to death unless you did something, I'd be guilty of extortion. If the Republicans make the same offer, it is the free market.

    In theory, there is no difference between theory and practice; but in practice, there always is a difference. - Yogi Berra En théorie, il n'y a aucune différence entre théorie et pratique, mais en pratique, il y a toujours une différence. - Yogi Berra

    by blue aardvark on Wed Mar 28, 2012 at 01:10:45 PM PDT

  •  But Nancy was certian it was legal (5+ / 0-)

    Speaker Nancy Pelosi (D-Calif.) doesn't have much patience for conservative claims that an individual healthcare mandate is unconstitutional.

    Pressed on the issue by a reporter from a conservative website, Pelosi shot back: "Are you serious? Are you serious?"

  •  I've suspected all along that healthcare reform (7+ / 0-)

    was going to be overturned by the right wing nutjobs on the Supreme Court.

    Afterall, these are the same hacks who gave us 'Bush v Gore' and 'Citizens United'. They don't give a damn about returning fair judgements on anything, they care about playing politics.

    "He's the one, who likes all our pretty songs. And he likes to sing along. And he likes to shoot his gun. But he knows not what it means" - Kurt Cobain

    by Jeff Y on Wed Mar 28, 2012 at 01:25:27 PM PDT

  •  This is the teensiest, tiniest, teensy tiny..... (0+ / 0-)

    ...tiniest bit of comfort you could conjure.

    Thanks! "A" for Affort though.

  •  No No No! (8+ / 0-)
    Whatever you call it, the penalty for failing to obtain health insurance now mandated under the Affordable Care Act is little different from than paying into Medicare and Social Security.
    One I pay taxes into and receive benefits in return. The other is a direct order to purchase a product on the private market, under penalty of law. Totally different things, not at all the same.

    There is truth on all sides. The question is how much.

    by slothlax on Wed Mar 28, 2012 at 02:11:28 PM PDT

    •  It's the same (1+ / 0-)
      Recommended by:

      if you consider paying taxes to cover police and fire protection the same as being required by law to contract with private security companies.

      Which means not at all.

      The big difference is that taxes are a percentage of your income.  Being required to buy a private service means you pay the same as someone making twice your income, so long as you don't qualify for subsidies.

      Another big difference is the 16th Amendment.

  •  ...because the Supreme Court is so consistent (3+ / 0-)
    Recommended by:
    itskevin, FG, jello5929

    My guess they would have no problem denying ACA then green-lighting privatization along a party line vote.

  •  Unrelated to the case at hand, but ... (1+ / 0-)
    Recommended by:
    Angie in WA State

    Look at the green trace in the last graph. We could probably save a few bucks if we just started enforcing some regulations for workplace safety again.

    Why is there a Confederate Flag flying in Afghanistan?

    by chimpy on Wed Mar 28, 2012 at 02:26:55 PM PDT

    •  This is what I point out to my fellow Republican (1+ / 0-)
      Recommended by:

      business owners.

      If we had single payer based on taxation, not only would they no longer need to fork out for basic healthcare, but they would also not need to fork out for worker's comp.  Or medical bills under auto and homeowners and business insurance.  And tort claims would almost disappear as future medical bills would be covered without an increase in cost to the victim.

      They never think about that.

  •  My guess is that Roberts- (1+ / 0-)
    Recommended by:
    Nada Lemming

    --who is more pro-corporate than anti-obama zealot, will cross over and uphold the law. That seemed to be the tone he was setting during Tuesday's arguments... at least, he wasn't nearly as hostile to the mandate as was Kennedy, Alito or Scalia.

    Which is too bad; the mandate sucks.

    The Goldstone Report: Still accurate, relevant, and damning.

    by DFH on Wed Mar 28, 2012 at 02:27:24 PM PDT

    •  I wouldn't say Kennedy was hostile... (1+ / 0-)
      Recommended by:

      Skeptical, yes, but not hostile. He usually couched the more extreme criticisms in conditional language (e.g. "if it is true that..."), and later in the session he suggested that the insurance system may in fact be unique, and he seemed to have a pretty clear understanding that young people not obtaining insurance were taking on risk that the system needed to price in. Obviously, this is all from memory, and paraphrased, but I could easily see him talking himself into supporting the mandate, albeit with some reluctance. I could also easily see the opposite.

  •  I'm sure they'd come up (1+ / 0-)
    Recommended by:

    with some acrobatic justification - and the conservative Supremes would probably just use some convoluted reasoning to go along with it.

    For instance: If you redo the entire tax structure and then offer a tax credit for obtaining insurance (as I believe Ryan's plan does), that could be seen as encouragement, not penalty via mandate. I could easily see the court being swayed by that, even though in practice it seeks to achieve the same thing.

  •  What has bothered me about the Repub (1+ / 0-)
    Recommended by:

    Medicare Privatization is this:

    Where are the private insurers who are going to volunteer to cover elderly Americans for a reasonable price?

    Where are the private insurers who are going to volunteer to cover elderly Americans who have preexisting conditions?

    UNLESS...all seniors are required to participate in the plan [MANDATE] in order to create a large enough pool to make the risk manageable.

    Sound familiar?

    So, yes, striking down the individual mandate could well have an impact on Medicare privatization.

    Liberals: Taking crap for being right since before you were born. - Driftglass (and the amazing Professional Left Podcast at

    by briefer on Wed Mar 28, 2012 at 02:42:27 PM PDT

  •  I agree with everything, except this... (5+ / 0-)
    Recommended by:
    HCKAD, anninla, ozsea1, Nada Lemming, output

    where you are closing you note:

    Because the Supreme Court has already upheld Social Security's mandate that Americans buy a government product with their tax dollars, a single-payer federal health care system cherished by most liberals would almost certainly pass constitutional muster.
    Am I to understand that you are equating "a mandate to purchase a government product" with "a mandate to purchase a private product"?

    Because I can tell you that I do not see an equality in the comparison.


    The government 'products' of Social Security and Medicare Insurance DO NOT create huge profits or high-paid executive salaries. Therefore the cost of these programs in restrained.

    But the PPACA forces us to purchase a private product which DOES have those built-in costs a government 'product' lacks. We're being told to enrich private corporations. This is loathsome to me.

    I am willing to participate in a national taxing system to provide services which, as an individual, I could never reasonably afford (police and fire services, highways and city streets, public schools, public hospitals, etc).

    I don't understand why the Right is so adverse to LOWERING the costs of our system, which if they are not restrained sometime soon could actually bankrupt the whole country in about 30 years or less.

    The only truly rational approach to healthcare is the sort used by the rest of the civilized world - a National Healthcare Plan offered by the Government, paid for out of taxes on individuals and business, and with healthcare service itself provided by private doctors and hospitals.

    Let the Private Insurers cover the secondary market in Healthcare like they do in Britain and Germany and Switzerland: for things like private rooms and elective surgery. Let them profit off of THAT, but not off the sick and dying who are today too poor to buy insurance or work a job that provides insurance as a benefit.

    * * *
    I like paying taxes...with them, I buy Civilization
    -- SCOTUS Justice O.W. Holmes Jr.
    * * *
    "A Better World is Possible"
    -- #Occupy

    by Angie in WA State on Wed Mar 28, 2012 at 03:12:02 PM PDT

    •  There won't be an opportunity (2+ / 0-)
      Recommended by:
      Nada Lemming, coffejoe

      to seriously discuss single payer or any other non-ACA health care reform plan again for a generation.  Assuming the bill is overturned, the whole topic of health care reform will be so politically tainted that nothing will be achievable for the foreseeable future.  People are afraid of what the government might do to them, and very few ever felt any beneficial results from the bill that was passed, because it was designed to not take effect for five years.

      The really fucked up this one.

      The five years deal, in particular, was a huge blunder.  It WAS foreseeable that it would provide opponents with that much time to try to repeal it, to overturn it in the courts, to demonize it as the cause of all evils in the economy, to scavenge off parts of it piecemeal in legislative add-ons to other bills.  And there was always the possibility (dim as it is) that they could just vote out Obama and then not implement it at the executive level or sabotage it beyond repair.  All by 2014.

      •  Just to Clarify... (1+ / 0-)
        Recommended by:

        ...I was comparing Social Security (in which Americans are taxed to buy a retirement plan from the government) to single-payer, federal health care (in which Americans would be taxed to buy a health insurance plan from the government.)

        I agree with Dumbo that, sadly, we won't see a single-payer program out of Congress any time soon.

        •  disagree (3+ / 0-)
          Recommended by:
          WisePiper, output, Angie in WA State

          If it's shot down, a massive mobilization for single payer should happen.  It could have happened in reconciliation, but it lacked one key vote; Obamas.  This time around, if they do reconciliation, and they will have to, Obama will have been transformed into an advocate with the right amount of outrage and pressure.  

          "Democrats shouldn't assume they have our vote. They have to earn it." Oops! I changed my sig. Oh well, Markos said it better than I did anyway.

          by Nada Lemming on Wed Mar 28, 2012 at 04:39:55 PM PDT

          [ Parent ]

          •  Disagree (0+ / 0-)

            The argument that maybe Obama should have signed a single payer system is just a ruse created by the conservative justices. In fact, the individual mandate is more acceptable to the conservative justices than a single payer system.

            You must understand, that conservatives believe that a single payer system would be a bigger violation of the constitution than the individual mandate. If the individual mandate constitutes socialism and is unconstitutional, the single payer constitutes communism which is obviously unconstitutional.

            •  That is not what the arguments (2+ / 0-)
              Recommended by:
              Angie in WA State, Nada Lemming

              are hinging on.

              The Feds have the absolute right to extract income taxes and spend it on things like health care.

              ACA does not use income taxes, and forces people to pay money directly, without any income consideration unless you are poor.  

              Given Medicare has been upheld, it is an obviously Constitutional way to proceed to extend it to everyone.

              And I actually know a lot of conservatives who support single payer.  They're not all stupid.

            •  You did not respond at all (1+ / 0-)
              Recommended by:
              Angie in WA State

              to my point.  Plus, we already have single payer, it's called MEDICARE.  It's already here.  How could they strike that down? Sheesh.  

              "Democrats shouldn't assume they have our vote. They have to earn it." Oops! I changed my sig. Oh well, Markos said it better than I did anyway.

              by Nada Lemming on Wed Mar 28, 2012 at 08:32:36 PM PDT

              [ Parent ]

    •  The Truth (1+ / 0-)
      Recommended by:

      The conservatives never really objected to the individual mandate in principle. After all, it was their idea. What they object to is universal health care per se, because in their view, universal health care constitutes socialism. They believe that it is immoral for government to help the needy and poor. They believe that this creates dependency and makes people lazy.

      When conservates were for the Individual Mandate. They framed the issue as Individual Responsibility. This was good framing and the Tea Party people supported the bill. When they were against it, they framed the issue as Obama Care to those who hated Obama, and as a violation of individual liberty to main stream America. Conservatives are very good at framing, and when debating a liberal can easily convince the audience that cheese grows on the moon and all of the heavenly bodies orbits around the earth.

      Conservatives actually do believe that Social Security and Medicare are unconstitutional. If they could they would strike down those laws. But the Supreme Court justices are very smart, and won't strike down the law until they know that opposition to these programs would be strong enough to prevent a constitutional amendment legalizing Social Security, Medicare, Medicaid etc... So they wait for the proper time to bring about their conservative, theocratic and libertarian utopian society.

    •  Also, SS and Medicare are charged for (1+ / 0-)
      Recommended by:
      Angie in WA State

      by a percentage of income.

      If you lose your job and suddenly have zero income, you don't lose your coverage.

      Private products don't work that way.

  •  Yes, there's always a silver lining in being (1+ / 0-)
    Recommended by:

    perpetual losers.  (NOT.)

    Conservative Ross Douthat and liberal James Carville agree that overturning the ACA will help President Obama get reelected.
    Yup.  The right gets to keep moving the ball towards our end zone, and we get to self-righteously complain about it.  We've got 'em right where we want 'em!

    Do you see the problem here?

    •  I See No Silver Linings (1+ / 0-)
      Recommended by:
      Nice Ogre

      I only mentioned Carville and Douthat as examples of pundits on either end of the spectrum agreeing in their speculation.

      The bottom line: if SCOTUS undoes the ACA, tens of millions of Americans will suffer and it's hard to imagine any scenario by which Washington is able to address the crisis any time soon.

      •  I know, you see no silver lining. (3+ / 0-)
        Recommended by:
        Avenging Angel, coffejoe, sneakers563

        But I'm disgusted with Democratic consultants who manage to take joy in losses for this reason.  I'm thinking in particular of Mudcat Saunders, who said it was probably better for Democrats if Scott Walker's union-busting bill were pass in Wisconsin because it would activate Wisconsin voters against Republicans.  That may have been true, but it was STILL not something to wish for.

        I'd rather be the party that makes progress but pisses off the Republicans.  Losing to gain leverage is an idea that only appeals to people who don't really care about the underlying issues.

    •  And calling the entire spectrum (1+ / 0-)
      Recommended by:

      The distance between Douthat and Carville is DLC logic.  If Carville is liberal in AAs world, AA is a right winger.  But then so is the beltway media, who could have written that sentence.  And they would agree that single payer is a pipe dream, since it's been repeated ad nauseoum.  

      "Democrats shouldn't assume they have our vote. They have to earn it." Oops! I changed my sig. Oh well, Markos said it better than I did anyway.

      by Nada Lemming on Wed Mar 28, 2012 at 04:43:19 PM PDT

      [ Parent ]

      •  We don't know if it's a pipe dream. (2+ / 0-)
        Recommended by:
        output, Nada Lemming

        Because it was never pursued, pilloried as being "impractical" in order to quash anything that might derail the pipe dream du joir, the ACA.

        We may very shortly get the coroner's report on ACA saying that in black and white text that it was a legal pipe dream.  If when that happens, there will be no more debate possible about whether ACA was a pipe dream.

  •  When our institutions fail we may still take (3+ / 0-)
    Recommended by:
    Avenging Angel, Nada Lemming, output

    comfort in irony.

    The frog jumped/ into the old pond/ plop! (Basho)

    by Wolf10 on Wed Mar 28, 2012 at 04:05:40 PM PDT

  •  The Answer is No (1+ / 0-)
    Recommended by:

    That's because the Supreme Court is partisan. If the Republicans want to privatize Social Security (even though it creates commerce that is regulated) the Supreme Court will uphold the law.

    The Supreme Court will only strike down progressive legislation. That is why the Supreme Court would find Cap and Trade unconstitutional. In this case, the new market for polluting rights would be deemed as the government creating commerce so it can be regulated.

    The Supreme Court is controlled by the Republican Party. It will do what the Republican Party asks them to do.

    •  Bush v Gore (1+ / 0-)
      Recommended by:
      Nice Ogre

      proved that the court can find some twisted logic to come up with any result it wants.

      We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

      by denise b on Wed Mar 28, 2012 at 05:31:51 PM PDT

      [ Parent ]

    •  Except the mandate isn't progressive (1+ / 0-)
      Recommended by:
      Nice Ogre

      it was a Republican idea, and opposed by Obama during his campaign.

      IMHO, in my 50 years, and life in many countries including this, I have only ever known an inescapable government mandate to be legal either through a Constitutional law, or by income taxes.

      If this law was passed under Bush, we would be far more upset about it than we are now.

      So we are all hypocrites.

      We support this, but we oppose it for people over 65.  All of a sudden, we have so-called "progressives" crying about "dead-beats" abusing the system, and cutting off emergency treatment for those less fortunate.

      What the hell?

      We think the mandate as is stands is the be-all-and-end-all, when the same result could be achieved without mandates, but putting a waiting period on a new policy without prior coverage - just like with life insurance.

      Income taxes would have been the right way to go with this, but we were all too eager to appease the Republicans and uphold Obama's promise for no new taxes on those making less than 250K (even though that has been violated), that we ended up in this mess.

      •  I Actually Agree With You (0+ / 0-)

        However, after reconsideration, I do see some merits with this law. I do believe a single payer system would be better, but if this law goes down, we won't have near universal health insurance for at least another 20 years. The Democrats would have learned their lesson from Clinton and Obama that tackling health care is politically costly and in the end yields no results.

        Rather, if this law goes down, the pressure will be to do tort reform and other health care reforms that reduces converage and not expand it.

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