I’m surprised and mostly pleased that the Supreme Court has upheld President Obama’s Patient Protection and Affordable Care Act.
The Court’s ruling means, that unless Congress acts, in 2014 all Americans will be required to purchase health insurance in the most sweeping overhaul of the nation’s health care system since the Great Society. The Court, according to early analysis, redefined the mandate as a tax, skirting some Constitutional questions but offering a dramatic affirmation to Obama’s key initiative.
Update: Josh Marshall speaks for me here.
This is an imperfect law. But what’s most important is that it provides a structure under which the country can make a start not only on universal coverage — as an ethical imperative — but on doing away with the waste and inefficiencies created by the chronic market failure of the US health insurance system. Again, that matters. And I suspect that there’s no going back.