This Stuff Matters


The Supreme Court wrapped up oral arguments yesterday in the case of deciding the constitutionality of the individual mandate, among other things. They’ve also conveniently put all of the transcripts and audio on one page. So what happens next?

The Supreme Court likely will decide whether the Obama administration’s signature legislative accomplishment is unconstitutional within 48 hours. But aside from the nine justices and a handful of law clerks, none of us will know what that decision is until the summer.

“By the end of this week, the justices will likely know, their law clerks will know, and the rest of us have to wait until June,” says Steven Engel, who clerked for Justice Anthony Kennedy from 2000 to 2001.

Hard to believe that we’ll have to wait until late June to know what happens tomorrow, but it is what it is. This week has been a roller coaster of surprise, disbelief, a lot of good (and bad, of course) writing, and on a more personal note: a revelation. I really care about this stuff. It matters.

This past week at work I heard nothing about the Supreme Court hearing oral arguments over the Affordable Care Act. I don’t think (based on past conversations) that any of them even have a general understanding of what the Act is, nor can recall anything but the vaguest strands of memory about a fuss several years ago. Some of them are young, others are my own age. Nothing about this situation surprised me.

But what should I make of this ignorance? People often view such a thing as a saddening state of affairs, and I suppose that’s generally correct, but part of me saw it a different way – that this group of citizens were largely able to go about their lives without having to worry about the market failures (or government failures, if that’s your thing) in healthcare. They just deal with it. Now of course that’s not the reality that many others face. Sooner or later, statistically speaking, some of those I work with will become quite aware of how these greater forces affect them. They’ll confront a health care system that binds and directs their lives in ways they wouldn’t have considered when the Supreme Court handed down a decision in the summer of ’12.

The point is that beyond the rhetoric of liberty, constitutionality, and the tyranny of “Very Important People” is that this stuff matters. Or as Aaron Carroll puts it, “This is not a game” :

Can we all develop a little humility here? Can we agree that our system of government is open to interpretation and reinterpretation and stop with all the surety?

No matter what happens, though, I can tell you what you won’t see here: gloating. This is not a game. It wasn’t then, and it isn’t now. This is about policy, and trying to make the health care system of the United States a little better in terms of quality, a little more cost-effective, and open to more people.

I often approach subjects in politics and policy rather amorally. Which is to say, I try to take nothing personally. I understand and recognize that my country is full of a diverse set of opinions, ideologies and beliefs. Unlike others I choose not to judge those aforementioned features of a pluralistic, democratic society based solely on whether or not they share my opinion, ideology or belief. Or to put it a different way – I won’t consider other positions as illegitimate simply because they are not my positions. As a general rule of thumb I try to take seriously people who take themselves seriously.

Well, I take this seriously. Health care reform isn’t about political wins, presidential legacies, or even whether an individual mandate structured as a tax penalty is constitutional. We’re talking about real people, their actions, and the consequences that create externalities for everyone.

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