The Healthcare Games

The Healthcare Games

In 1948 when Orwell’s “1984” was published (get it?), few saw it as a prediction of a totalitarian future but rather as a documentary concerning current events in the Soviet bloc.

Today “The Hunger Games,” the best-selling young adult novels and films about a dystopian future, may be mistaken by some for fantasy but increasingly look like an allegory of the present chasm between an uberclass and the growing underclass.

In our real world the divide (so far) is less about food haves and have nots as about those with and without educational opportunities and even more so access to healthcare. Lack of education may stunt lives, but lack of healthcare can kill.

The latest installment in The Healthcare Games took place in the courts. This has become the central front in the conservative war to destroy Obamacare and replace it with nothing. In a drafting error, the law provides for subsidies to qualified citizens who apply through state exchanges.

The drafters failed to anticipate the hostility of Republican governors to healthcare for their own fellow citizens. In 36 of 50 states, governors declined to set up state exchanges. So the federal government, as the law allowed, stepped in to host exchanges through which subsidized health insurance could be bought.

Missing no opportunity to diss President Obama and make life miserable for the poor, Republican zealots went to court arguing that since the law said subsidies would be available for insurance bought through state exchanges, then insurance from a federal exchange ought not to be subsidized.

Well played! This is the kind of pettifogging legalistic quibble beloved of bullies, shysters and martinets and loathed by fans of commonsense which it clearly flies in the face of. It also contradicts the stated intent of members of Congress who passed the law. Republicans are supposedly all for judicial rulings based on original intent, but only in cases where it advances their agenda. The intenders are around to ask what they intended and it sure wasn’t to deny healthcare to people unlucky enough to be living in states with anti-Obama governors.

The DC Court of Appeals ruled (2 Republicans to 1 Democrat) to disallow subsidies unless obtained through non-existent state exchanges. The same day, the 4th Circuit Court of Appeals in Richmond in a similar case ruled 3 Democratic judges to Zero Republicans in favor of the clear intent of the law, to permit subsidies purchased on either state or federal exchanges.

The disagreement ought to guarantee an appeal to the Supreme Court for the next installment of The Healthcare Games. Since justice in America is clearly dispensed by partisan judges following an ideological, not a legal brief, the five right wing Supremes will presumably rule to deny subsidies to about 8 million recipients in 36 states. This isn’t a dystopian fiction, it is the reality of our dysfunctional government — hard at work increasing the divide between those who have a lot and those who have little.

Marie Antoinette said of the bread-less sans culottes , “Let them eat cake.” The equally clueless conservatives and their courts say to the doctor-less, “Heal thyself.” It’s the kind of idiotic catch-22 captured in the Band’s aptly named “The Shape I’m In:”

“I just spent 60 days in the jailhouse
for the crime of having no dough.
Now here I am back out on the street
For the crime of having nowhere to go.”

Except, maybe, the emergency room.

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