A physician investor’s take on the Supreme Court healthcare decision

Author: Bob Freedland

Covestor model: Healthcare

The U.S. Supreme Court is expected to rule Thursday on the constitutionality of various aspects of the Affordable Care Act, known popularly as “Obamacare.” It is thought that the individual mandate section may be challenged as a heavy imposition of the federal government on the individual in requiring each American to purchase a private product – that is, a healthcare policy from a private entity.

I am a physician and investor, not an attorney, and cannot therefore comment on the constitutional issues involved or whether the Interstate Commerce Clause applies. I do know that this requirement is very similar to the plan previously developed by the Heritage Foundation and advanced successfully by then Governor Mitt Romney for Massachusetts, which chose to ask each individual to purchase insurance, rather than what could be a more socialist-style approach of provision of healthcare by the federal government. So from my perspective, the rabid criticism of this approach from the right appears hypocritical at best.

But why require healthcare insurance? As a physician, I know that when Americans come to an emergency room in an acutely ill condition they are not turned away regardless of their insurance status. Instead, care is provided and that cost is spread to all other healthcare consumers. In that way, Interstate Commerce becomes involved.

Because Americans travel from state to state and do not stay in just their own home state when becoming acutely ill, it is common sense that irresponsible behavior cannot be long tolerated when the cost of that behavior is transferred to the rest of us. It’s much like the helmet laws that are fought on the basis of individual freedom and liberty, yet when that motorcycle victim gets rolled up to the emergency room, we care for him or her because it is the right thing to do. Medical staff do so whether or not the patient was wearing a helmet or carrying a health insurance policy.

Yet, with the growing cost of healthcare, millions of Americans can no longer afford to buy that insurance. More and more employers are finding that they too can no longer afford the generous policies of years past. They are cutting benefits and often dropping coverage altogether. Many Americans work at minimum wage jobs that provide little support for healthcare insurance. They are the working poor of this nation that need help. Not because it will help somebody or some corporation to make money, but because it is simply the right thing to do.

There is no doubt in my mind that bringing 31 million Americans into the health insurance tent will do wonders not only for promoting their health but also by boosting the healthcare industry with added sales of pharmaceuticals, devices and therapies. It will also bring business to all of the companies that support the delivery of that care.

If we can manage to bring these additional patients into that big tent of healthcare coverage, we’ll see many jobs created, ranging from construction jobs as hospitals and clinics are expanded, to employment for doctors, nurses, maintenance people, receptionists, administrators, secretaries, and allied health. These 31 million people will mean a big jobs boost for the economy as we become a nation that joins the rest of the Western world in recognizing that health care for every citizen is an obligation of every civilized society. Our haphazard system is incomplete and expensive, resulting in thousands of deaths related to lack of healthcare access and an infant mortality rate that places us far behind the rest of the West.

I haven’t talked about individual stocks. I guess even though I am a manager of a Healthcare model on Covestor, I am first a physician, second a concerned American, and thirdly a stock market investor.

Healthcare access for uninsured Americans will be good for business. Conversely, if the SCOTUS shall strike down the Affordable Care Act, I am sure that there will be plenty of people who still will be able to afford the products and services that America’s finest corporations provide.

But it won’t be the big help for business that some may think. It may allow us to keep taxes lower for those already able to afford higher taxes, but it will not help people without access to healthcare the opportunity to get their diabetes managed properly, their cancer detected early and treated properly, their hypertension addressed and their general health maximized.

Frankly, I am pessimistic about which way things will go. America appears to be swinging to the right and instead of facing the challenges of millions of American without access to healthcare, we are growing more worried about the loss of our individual liberty which for many means loss of our income through the tax responsibilities associated with caring for the neediest among us.

We live in an age where corporations have been defined as people, money defined as speech, and providing healthcare for the sick is likely to be defined as an infringement on the liberty of the rest of America. Health care access is actually one of the most important freedoms of all – liberation from disease and illness.

Good luck America.