If the Supreme Court decides to tank the Affordable Care Act and returns us to the past system, James Carville may just be right that it will be a long term boon for Democrats. Health Care costs rose from 12% to 17% of GNP from the 1970s to the present. An estimated 45,000 uninsured die each year over inadequate health care. The uninsured population is approaching 50,000,000. People with pre-existing conditions will continue to be uninsurable. Insurance companies will continue to make money but denying coverage to keep their medical loss ratios low and their stock prices and bonuses high.
Cost shifting will continue to be the major financing vehicle for hospitals and physicians to cover deficits in service shortfalls in funding from Medicare, Medicaid and the uninsured care. Medical bankruptcy’s will continue to grow from the current 60% of bankruptcy’s. The cost of private insurance will continue to climb as the consolidation of hospitals exercise increasing leverage to cover their costs and gain a tidy profit. The number of uninsured will continue to rise as employers continue their effort to shift the cost increases to individual employees.
Costs and health care services will not improve in the future without a dramatic governmental intervention, more likely in the nature of a single payer system, whose time may well arise in the not too distant future. Republicans, Big Insurance, Big Pharma may do well to consider the ramifications of returning us to a healthcare system that was rapidly growing ever more unsustainable. If perception is reality, there will likely be a huge change in reality in the future based upon the Supreme Court engaging in “judicial activism” to turn over our future to our unsustainable past.