“Constitutional” Ruling on US Healthcare Reform Is Critical

Published in Mainichi
(Japan) on 1 July 2012
by (link to originallink to original)
Translated from by Richard Burck. Edited by .

Edited by Peter McGuire

In Japan’s view, the ruling was foreseen. The U.S. Supreme Court ruled that the Obama administration’s Affordable Care Act (ObamaCare), a reform of health care in the U.S., is constitutional. The ruling is likely an advantage to President Obama, who is seeking re-election in November. With powerful political influence, the law, unerring in judgment, gives health care to nearly 50 million uninsured Americans.

However, the U.S. is a country based on individualism and self-reliance. Loud voices of opposition protest that subjecting the uninsured to a fine infringes upon individual liberty. There is also opposition to the U.S. spending $940 billion over 10 years. Judging the Democratic Obama administration’s health care bill to be unconstitutional, Republican governors took their case to the Supreme Court.

The Supreme Court ruled that the fine for not purchasing health insurance could be interpreted as a tax. Taxes are constitutional; therefore, so is the fine. For this reason, the Supreme Court has no business upholding or overturning the law, and its implementation cannot be stopped.

Nine judges serve on the Supreme Court: Four are from the President’s Democratic party, and five are Republican. Surprisingly, Chief Justice Roberts, who was nominated by the former Republican President Bush Jr., determined the law to be constitutional, which led to a 5-4 decision saving the law. When the law’s constitutionality was challenged, American society was in inevitable shock, and President Obama’s re-election campaign was given the yellow light. It seems that the Supreme Court wants to avoid political involvement and leave the issue to the voters in November’s election.

While the Affordable Care Act was a big achievement for the Obama administration, Republican presidential candidate Mitt Romney, a former governor of Massachusetts, declared that he will repeal the health care bill on day one if he is elected president. Even if Obama wins re-election, the Republicans could win a majority in the Senate and House and repeal the law.

There are all kinds of public opinions strongly opposing the health care reform. The opposition is characterized by arguments against government intrusion into the affairs of individuals and fears that the healthcare bill will raise taxes and increase the federal budget deficit.

But national healthcare was the U.S.’ “unfinished dream.” Since the Democratic Johnson administration in the 1960s instituted Medicare for people 65 and older and Medicaid for poor people, no major reforms were made to health insurance in the U.S. For the U.S., the only advanced nation without health care for all, this constitutional ruling should be critical.


社説:米医療保険改革 「合憲」の判決は重い

日本から見ると、しごく当然の判決と映る。事実上の国民皆保険をめざして米オバマ政権が導入した医療保険改革法(オバマケア)について、米連邦最高裁は「合憲」との見解を示した。11月の大統領選で再選をめざすオバマ大統領には追い風だろう。政治的影響はともあれ、5000万人近いという無保険者に適正な医療を与えることは、決して間違っていないはずである。

だが、米国は個人主義と自助努力の国だ。無保険者に保険加入を義務付け、従わなければ罰金を科す改革法の条項を「自由の侵害」ととらえる声も強い。米政府が10年間で約9400億ドル(約75兆2000億円)をつぎ込むことへの反発もある。民主党オバマ政権に批判的な共和党の州知事らが違憲訴訟を起こし、憲法の番人たる連邦最高裁の判断が注目されていた。

連邦最高裁の判断はこうだ。保険に加入しない場合の「罰金」は、課税とみなすこともできる。そして課税は憲法によって許されているのだから、現段階で裁判所はそれを禁じたり許可したりする役目を負わない。従って改革法の施行を止めることはできない、というわけだ。

9人の連邦最高裁判事のうち5人は共和党の大統領、4人は民主党の大統領による任命だが、ブッシュ前大統領(共和)に任命されたロバーツ長官が意外にも合憲側に回り、5対4でからくも合憲判決になった。仮に違憲となれば米社会の激動は必至で、オバマ大統領の再選にも黄信号がともる。連邦最高裁は政治への深入りを避け、秋の大統領選にゲタを預けたようにも見える。

というのも、オバマ大統領が改革法を大きな業績とする一方で、共和党の大統領候補になるロムニー前マサチューセッツ州知事は、自分が当選したら最初の日に改革法を撤廃すると言明しているからだ。仮にオバマ氏が再選されても、同時に行われる連邦議会選で共和党が上下両院の多数派になれば、やはり改革法撤廃は現実味を帯びてこよう。

各種世論調査では改革法への反対が賛成を上回る。「個人のことに政府は口を出すな」という米国人特有の気風に加え、関連予算増大による政府財政の困窮や増税を懸念しているのだろう。それも米国の現実だ。

だが、国民皆保険は米国の「見果てぬ夢」だった。60年代に民主党のジョンソン政権が、65歳以上を対象とする「メディケア」、貧困者対象の「メディケイド」という公的保険を導入して以来、医療保険の大きな改革は実現していない。「先進国で皆保険のない唯一の国」とも言われる米国は、今回の「合憲」判断を重く受け止めるべきだろう。
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