By Wednesday, there only remained a handful of protestors on either side to occupy the sidewalk outside of the Supreme Court, while inside, arguments over the severability of the individual mandate and PPACA's impact on Medicare were heard. Yesterday, when the individual mandate itself was discussed, we saw just how much that really is the heart of this issue. Does the government really have the authority to make all Americans buy a product, even if it is for their own best interest? It is something we have seen play out time and again on the state level, with the enforced purchase of personal auto liability coverage for car owners, and with the enforced purchase and use of helmets by motorcycle riders.
But such actions are far less common on the federal level. With health insurance, it is different, or so the federal government argues. While some states, such as Massachusetts, have implemented their own universal health care programs, the idea was that this was an issue of economic security for all Americans, regardless of state, and so the time had come for a federal solution. Regardless of the outcome, this debate is far from over.
The insurance industry - the ones who most likely have the most to lose immediately from all of this, has remained oddly quiet (compared to the furor raised by other groups, such as Americans for Prosperity), preferring to speak through its trade groups and through its distribution channels. If PPACA is overturned, as many hope will happen, there will be a number of agents to cheer it. But what if it is upheld? Then what? Perhaps it will be as some executives have already privately admitted: that it is best just to learn to live with PPACA, come what may.
As we will cover the analysis of the Supreme Court's three days of arguments, in advance of their expected decision some time in June, let's take a look at some of the arguments made on the streets outside of the Supreme Court, where people held a fierce public debate of their own. Some of it offered great insight to how complex a problem reforming health care really is. Others merely offered pure emotion. But all are part of a crucial dialogue that will shape not just how we use healthcare, but how much our government can involves itself in it.