Chipping in for good health

The battle over universal health care in many ways epitomizes the conflict over the welfare state — it all comes down to who should give how much and who should benefit.

If the Supreme Court in its wisdom decided to uphold the Affordable Care Act — thanks to Chief Justice John Roberts’ casting vote — it was only because the concept of universal health care is a social necessity, whether you call it a tax or a penalty.

The immediate issues before the nation’s highest court were a mere technicality — whether it represents the federal government’s power to regulate commerce or impose taxes — that masks the epochal nature of the law, which arguably parallels FDR’s Social Security and unemployment insurance.

At a time of middle class hardship, Obamacare ensures that those without jobs, or in low-paid jobs, and those with pre-existing conditions for no fault of their own can get medical attention and prescription drugs when they need them.

Some complain about the law imposing a financial burden on those who are healthy enough not to need insurance. But many of them use emergency rooms to see a doctor or get drugs. The new law should demonstrate that when it comes to availing of such services, there are no free lunches.

One of the fundamental principles of democracies and civil society is that everyone shares in the costs and benefits — be it roads, schools or transportation. All that we have done now is to add health care to that list, for good reason.

For the Democrats, a painful endeavor that finally has come to fruition — and for the Republicans, an equally painful campaign has turned into a liability. Neither side wants to talk about it in the next few months because neither expects the subject to score any brownie points with the swing voters who will decide their fates in November.

The Republicans are content to crow about the court’s labeling of the law as a tax — and hence a negative for an incumbent president in a year of unrelenting economic difficulty. And the Democrats are resigned to saying it’s time to move on.

Yet, ironically, how we handle health care is going be crucial to solving a big piece of the nation’s deficit crisis — by controlling runaway health care costs.