Small wonder President Obama chose not to delay the U.S. Supreme Court case on his health care reforms until long after the election. His advisers are clearly in the lab transforming the president's signature legislation into a potent election issue -- whether the justices leave it intact or rip it apart.
For starters, ignore the new CBS News poll showing that 47 percent of Americans give the Affordable Care Act a thumbs down, while only 36 percent approve. Older surveys suggest that many of the unhappy respondents actually wanted a larger role for government in health care (the public option, for example), not the smaller one conservatives demand. The bottom-line question for discontented liberals is, do they want a flawed federal health care plan or no plan? They can want the reform to happen without loving the final product.
Obamacare is head and shoulders above what we have today. That is the worst of most worlds -- growing health care insecurity paired with soaring health care costs. The better course for reform would have been folding everyone into Medicare. Under the health care plan for the elderly, government picks up most of the hospital bills, and enrollees may buy subsidized private coverage for doctor visits and such. It's simple and cheap to administer. Oh, but let's not go over this burnt ground again.
The key issue before the Supreme Court is whether the federal government can force the uninsured to buy health coverage. Those seeking to strike down the law see it as an abuse of federal power. Its backers counter that the U.S. Constitution's Commerce Clause says otherwise.
This much is obvious: If the individual mandate gets nixed, then the part of the law requiring insurers to cover those with pre-existing conditions goes with it. Americans will continue facing the terror of having a very sick family member and no medical coverage. And when an uninsured person shows up in the emergency room with a concussion, the people being coerced into buying his care will be the taxpayers and those with private coverage.
Of course, everyone has to have insurance for these reforms to work. You can't make private insurers cover the ill without ordering the young and hearty into the insurance pool.
Let us repair to the campaign trail. If the Republican candidate is former Massachusetts Gov. Mitt Romney, then the controversy over Obamacare will be largely neutralized. After all, Romney (to his credit) established a very similar universal coverage system in Massachusetts, individual mandate and all. Obama adviser David Plouffe unfurled this counterattack on NBC's "Meet the Press," saying, "Mitt Romney is the godfather of our health care plan."
Actually, Obamacare is more conservative than Romneycare because it includes mechanisms aimed at curbing the spiraling costs of health care. This is a conservatism that looks out for taxpayers and employers burdened by our wildly expensive and irrational health care system -- as opposed to pleasing campaign donors in the industrial-health-care complex.
Dear pollsters: Consider doing an Obamacare survey that measures something meaningful from a policy standpoint. In addition to the usual questions, give everyone you call a brief five-question quiz on what's actually in the Affordable Care Act. Then do a breakdown showing what those who got three of five questions right think about it.
Point is, Obama must educate the public on the virtues of the law, something he did a lousy job of during the legislative battle. Helping more Americans correctly answer three of those questions would do wonders for his poll numbers.
If the Supreme Court does serious damage to the law, Obama should be prepared with a politically appealing response. No doubt he's already polishing the arguments.