When erstwhile administration ally Supreme Court Justice Ruth Bader Ginsburg describes the president's signature initiative as needing either "a wrecking operation … or a salvage job" by the Court, and Justice Antonin Scalia ventures that merely having to read the health reform law would violate the Constitutional ban on "cruel and unusual punishment," Obamacare seems poised to perish.
While commentator Jonah Goldberg rightly argues for a conservative, originalist respect by the Court for the Constitution and Congress, the landmark case should also pave the way for a more conservative, measured approach by Congress.
Congress should refocus on carefully and systematically enacting pragmatic and popular solutions. Ramp up competition and tamp down costs by allowing consumers to purchase insurance beyond state borders, as with car insurance. Provide fiscally sustainable safety nets for the poor and high-risk pools for patients caught in financially crippling health crises. Focus on cutting rampant fraud and waste in Medicare while providing reasonable reimbursement rates to enable physicians to treat Medicare patients.
A systematic, pragmatic approach to health care reform and patient access also means stanching the hemorrhage of physicians from medicine, by enacting reasonable malpractice reform and protecting the conscience rights of physicians who follow the life-affirming principles of the Hippocratic oath.
The Jacobinic health care revolution based on radical ideology and rammed through Congress with backroom deals, deceptive accounting schemes and kickbacks has failed. Now Congress should democratically enact popular, prudent and pragmatic health care reform.