Health Care Reform: Three Different Perspectives

 Health care reform, as enacted by the Patient Protection and Affordable Care Act of 2010 (PPACA),  is a hot topic on the presidential campaign trail. The Supreme Court is presently considering the repeal of the "individual mandate" provision which requires the purchase of health insurance.   There are so many opinions floating around on PPACA  that it is difficult to weigh its pros and cons.  Below are three videos which may assist you.  While each presentation is different, I found myself asking a two part question. 

1 .If we could have our way, is it better to  repeal the individual mandate only OR toss the entire statute?
2. If PPACA is struck down in its entirety , do we want to return to the pre-health care reform days?  If we do not, what shall we do instead?

Health Care Reform: 2012 Update is an hour long video for the tolerant audience who wants to know the gritty details.  This has an excellent discussion of the dilemma of repealing the individual mandate or the whole statute.  The presentation also has a necessary but painfully comprehensive exercise in workforce analytics which employers will have to learn, even if the individual mandate is repealed. 

The Top Four Innovations in Heath Care Reform is a short and sweet list of four pros of PPACA:  a new system for health insurance, covered preventive care through the primary care physician, hospital and health system affiliations to share electronic records and to operate more efficiently, and nurse personal health coaches.  There is no discussion of the individual mandate constitutionality problem, the difficulty of administration or the projected cost of implementation.  

CNN Explains: Health Care Reform is a short review of the pros of health care reform:  that it eliminates the problem of the uninsured, bars denial of insurance based on preexisting conditions, allows children to stay on parent insurance policies until age 26, eliminates lifetime limits on insurance coverage, and expands Medicaid coverage.    The presentation implies that we all must pay for uninsured Americans who need medical care. However, the cost or constitutionality of the individual mandate is not mentioned.

If I had a crystal ball, I might predict that the Supreme Court will strike down the individual mandate as unconstitutional.  There are many provisions of the law which are "inextricably intertwined" with the individual mandate, so if the mandate provision goes down, it may take down the entire ship with it.  That sounds harsh, but the Supreme Court may not want to engage in the alternative of  performing a mind boggling rewrite of a gigantic piece of legislation.  I do know that I do not want to go back to the way things were before PPACA.  So if the law is repealed, we will be back to square one on our broken health care system.  We may want to prepare for a reopening of  Pandora's box if the Court decides to throw away the whole statute.