By Kathy Wang
On June 28, the US Supreme Court upheld the Patient Protection and Affordable Care Act (PPACA), including one of its most controversial provisions: the individual mandate. Starting in 2014, most Americans will be obliged to have health insurance in some form, or else pay a tax penalty based upon their income. With the decision likely to have a major impact on the upcoming elections, the Harvard School of Public Health, in collaboration with Reuters, presented a special forum webcast to discuss the state of health care and politics in the wake of the Supreme Court’s decision.
Reuters’ health care reporter Toni Clarke moderated the forum, which featured a panel of expert participants from public health, health policy, political analysis, business administration, and human rights. The panelists included:
- Robert Blendon, ScD, Professor of Health Policy and Political Analysis at Harvard School of Public Health
- Regina Herzlinger, PhD, Nancy R. McPherson Professor of Business Administration at Harvard Business School
- Wendy Mariner, JD, LLM, MPH, Edward R. Utley Professor of Health Law, Bioethics, and Human Rights at Boston University School of Public Health, and
- John McDonough, DPH, MPA, Director of the Center for Leadership at Harvard School of Public Health, Former Executive Director of Health Care for All, helped craft the health law as a senior Senate aide.
Blendon discussed the potential impact of the decision on the upcoming elections, and the panel agreed with his assertion that Governor Mitt Romney would focus largely on the PPACA as a tax and the effects on the economy, while President Obama would take a more health-focused perspective. While the proposed plan is now a hot-button political issue, McDonough commented that both Republicans and Democrats initially had a “shared sense in believing in universal health care and health insurance.”
The panelists also addressed the effectiveness of the tax penalty for those who refuse health insurance, the conflict between cost control and universality, the nature of insurance exchanges, and the demographics of those who would be newly covered. McDonough and Herzlinger referenced Massachusetts, as well as European countries with mandated universal health care, as offering an indication of the future of the US system.
Most important from a health and human rights perspective, the panel focused on the idea that all Americans are close to gaining accessible health care, regardless of disability, chronic illness, or socioeconomic factors. Mariner described the PPACA as possibly “the most important piece of social justice legislation since 1965,” and McDonough cited a Congressional Budget Office estimate that the plan would expand health insurance to an additional 32 million Americans. Of these, about half are very low income and covered through Medicare expansion; the other half includes those who are living at 133-400% of the federal poverty line or are chronically ill. Both groups would receive sliding scale subsidies to pay for health insurance.
Rally before a health care reform town hall meeting in West Hartford, CT. Sept. 2, 2009
Despite a turbulent political debate, this decision represents a victory for establishing acceptance of the universal right to health.
Watch the webcast here.
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