As many had hoped and many had feared, “Burwell” has won out over “King” in the latest major spat at the Supreme Court (SCOTUS) as to the intent of a single clause of the Patient Protection and Affordable Care Act (a.k.a. “the ACA” and “Obamacare”).

To the more than mild surprise of this commentator, SCOTUS actually voted 6 to 3 in favor of the defendant in its interpretation of the intent of Congress in the language of the Act. (I had thought that 5 to 4 was a more likely outcome … one way or the other.) As a consequence, many millions of Americans who believe they have benefited from access to affordable health care because of Obamacare will be able to continue to take advantage of that perceived benefit … and many others will continue to rage against what they see as an intrusion into how they wish to live their lives.

Obamacare never was — and it still isn’t — a perfect solution to the labyrinthine series of convoluted systems that have been patched together over the past 120-odd years to constitute the modern American healthcare marketplace. One only has to read a few sections of the opposing opinion of the three judges who voted in favor of “King” as opposed to “Burwell” to realize just how deeply we are split as a society about all of this — philosophically and emotionally as well as legally.

Whether one agrees in principle with the concept behind Obamacare (that every American citizen should be entitled to at least basic, affordable healthcare services) or takes the opposing conceptual opinion (that access to healthcare is not a “right” and that the federal government should not be able to enforce such a right on individuals and states that do not wish to be so encumbered), what is becoming increasingly clear is that the path forward will only become harder if we cannot recover the art of the political compromise.

There are a lot of things other than Obamacare over which Americans are severely split in their opinions. The fact that I do not happen to believe in any form of absolute deity should not and does not stop me from upholding certain “rights” that are and should be available to those who do have such beliefs. Equally, those who do have such beliefs should have no right to force me to live my life according to theirs. The abortion controversy is a defining issue for that particular failure to find compromise, although it is actually perfectly reasonable to not believe in an absolute deity and still find abortion repugnant. Access to firearms is another such issue.

It is high time for us all to get past the idea of absolutes in the “rightness” of a vast range of social and political issues. … Sadly, it may take us another 150 years or more. As we have seen from the recent events in Charleston, South Carolina, there are those who continue to believe that just because one has white skin coloration one is in some way necessarily “superior” to those who do not. Apparently, after nearly 500 years of American experience of that problem, we haven’t managed to sort that one out.

America was founded on the idea that King George III had no absolute right — either directly or through the English parliamentary system — to dictate how Americans should live their lives. But the founding fathers had to struggle mightily to find compromises with regard to what they themselves thought was “reasonable” in instituting a form of government that seemed to them to be “reasonable” for this new country. The outcomes were based on compromise. Compromise is and long has been at the heart of good governance and every good social system: it is high time we recovered that art, and ditched the problematic concept of “absolute rights” — once again. It is, after all, the 800th anniversary of the signature of Magna Carta by King John. He didn’t like it one bit, but even he knew he had to compromise under the circumstances. The founding fathers of America liked Magna Carta … and they liked it a lot!



About Mike Scott

Mike Scott is a highly experienced health care communications strategist with Calcium. He is also a board member of three different patient advocacy organizations. To get more detail, see his profile on LinkedIn.

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