If you are reading this blog, well, I'm sorry.
Seriously, if you are reading this, it means that we will have to wait another few days before knowing the fate of the Patient Protection and Affordable Care Act. See, we've got a plan in place to do deadline reporting the minute the Supreme Court's ruling is issued. We've got lawyers lined up to offer immediate analysis, we'll call into a few of the million press conferences that are promised for as early as 10 minutes after the decision drops, and we'll wade through the billions of press releases that are sure to flood our in boxes. Be sure to check the H&HN website for immediate reaction and H&HN Daily for more detailed reaction.
This blog is Plan B, as was last Thursday's (honestly, I'm getting a little tired of playing second fiddle to Chief Justice Roberts). As I was leaving the office last Friday, my colleague Haydn Bush reminded me that I was on tap for today's Plan B blog and asked if I knew what I was going to write about.
"Nope," I said, secretly hoping that the Supremes would actually bail me out this morning. I knew that there would be little time to research and write this weekend. My twins were having their 7th birthday parties this weekend – a Lego Stars Wars theme for my boy; an American Girl Doll theme for our daughter. Could I really be expected to write following the two-day, two-party extravaganza? Besides, my son got his first Light Saber. We had to do battle.
But here I am, late Sunday night, the kids tucked happily way in their beds dreaming about the next great adventures for Luke and Kit, knowing that I have to write something just in case nothing happens Monday morning (and sadly, my wife and I go another day without watching our DVRd episodes of the History Channel's "Hatfields & McCoys").
So what am I going writing about?
Well, during this lengthy debate over health reform, and leading into the November election, one thing has continued to gnaw away at me — the "who wins and who loses" nature of the debate. Our friends in the mainstream press, 24-hour pundits, bloggers, tweeters, everyone is so focused on which side will win when the justices finally speak. The LA Times had an article Sunday in which the reporter notes: "If the court were to strike down the mandate while upholding the rest of the sweeping law, both sides could claim victory. The Republicans could say Obama and the Democrats were slapped down for violating the Constitution. The president and his allies could say the insurance reforms and the expansion of Medicaid would provide better healthcare to millions of Americans."
I spent the first dozen-plus years of my career in DC covering Congress and the executive branch, so I'm all too familiar with the way our political process works. It's true; both sides of the aisle will be looking for a political advantage once the ruling comes down, although House Speaker John Boehner has reportedly told fellow Republicans that there will be "no spiking of the ball" if the court knocks down all or part of the law. Still, what troubles me — as with so much in our political system these days — is that we seem to have forgotten what's really at the core of the legal debate: a health system that is failing too many people. Republican, Democrat, Tea Party, Green Part, Independent, there's really no arguing that fact. As the CDC reported last week, the number of uninsured totaled 46.7 million in 2011. Now, that's down from 58.7 million in 2010, but still, 46.7 million is heck of a lot of people, and it doesn't take into account the millions more who are underinsured.
Yet for as staggering as that number is, it is just a number. Those of you who work in or run hospitals see the reality of it every day — patients coming to your facilities for treatment with little or no means to pay for it, or delaying treatment until the pain is unbearable.
So, the court's ruling will come out later this week and we, along with other media outlets, will dissect and analyze it to death. We'll try our best to put in context what it means for those of you who operate hospitals and health systems. Politicos on both sides will continue to make their case that tax credits or mandates or universal coverage are the best way to fix the problem. At the end of the day though, the most important thing will be how it impacts that parent who just entered your ED with a crying child in their arms.