I just read a great post by Matt Yglesias in which he argues that John Roberts voted to uphold the Affordable Care Act's individual mandate because he wanted to prevent America from adopting socialized health care in the future. This is something I've often said to people when I talk to them about the ACA. In spite of all of the GOP's misinformation and rhetoric on Obamacare, the law really cannot be considered "socialist" in the traditional sense of the word.
Think of it like this: traditionally, liberals favored a single-payer system of universal health care in which everyone basically had Medicare. When Obama came into office, he embraced the individual mandate because he wanted to be bipartisan, since he had seen conservatives supporting the idea in the past. Hell, Mitt Romney even thought it was a good idea as a national model for health care reform. And thus, the Affordable Care Act was born.
With Republicans so vehemently opposed to a health care law that uses many of their ideas, what was next? If the law had been struck down by the Supreme Court, health care reform would not have just gone away as a major issue. Health care costs aren't just going to come down on their own in the U.S. So, inevitably, the issue would be brought up again in the future. However, the next time Democrats tried to pass health care reform, they would not seek a bipartisan consensus. With the individual mandate ruled unconstitutional, they would campaign on the idea of "Medicare for all." At that point, there would be no other way to ensure universal coverage with a balanced risk pool other than to socialize health care.
Thus, Roberts did the Republicans a great service by upholding the law. Had the law been struck down, health care in America probably would end up being socialized. Ultimately, the American people would get tired of half-measures for achieving health care reform. Without the option of a mandate for universal coverage, there's only one option left--single-payer. Not that I'm saying that's a bad thing, necessarily. Plenty of countries (Spain, France, UK, Sweden, Norway, Finland, Australia, Canada, New Zealand) have socialized medicine and they have better health outcomes than we do for less money. But I digress.
Basically, the point I'm trying to make here is this: Republicans are attacking the ACA as a "socialist" law. Had the law been struck down, what would eventually replace it would actually be socialized medicine. Be careful what you wish for, I guess.
P.S. I now have a Twitter account for this blog that I'll update with each new post, starting with this one. You can follow me on Twitter here. Get the word out!
P.P.S. I suppose that it would be possible for the policy debate to swing the other way on health care. That is to say that health care could presumably take on a decidedly more conservative/libertarian point of view, with less government intervention. There are a number of ways I could interpret this, I suppose. Some, like Senator Coburn of Oklahoma, say we should go down the road that Switzerland went down, but that likewise involves an individual mandate as well as government regulation of insurance plans to some degree. Other interpretations simply say that people will all pay actuarially fair prices for their insurance--that is, the sick will pay higher premiums and the healthy pay lower ones. It is possible that the debate could go this way, but I feel like Americans would not support a system in which sicker people were charged more than healthier people, in spite of what may or may not be logical or economically efficient. This is a debate worth having, I think, but I'm not sure how popular something like actuarially fair pricing of insurance plans would be with the American people.