Credit: TMS illustration/Paul Tong

Go ahead, Supreme Court. Rip off the Band-Aid.

Last week the court heard arguments on whether the federal requirement that Americans buy health insurance is unconstitutional. The truth, of course, is that nobody knows.

That's because it's a theological question, like "what is literature?" The Constitution doesn't say anything about health insurance. But it's like the Bible: People can find almost anything in there, and then lay claim to the credibility of Scripture. For a while the Constitution said black people weren't citizens, at least according to the Supreme Court in 1857. The current justices presumably don't see it that way.

Since the Constitution offers little useful guidance on health insurance, today's justices will no doubt decide based on their own preferences and prejudices, just like their forebears would have done.

And you know what? I hope they throw out every bit of it.

That's not because I think the Patient Protection and Affordable Health Care Act -- "Obamacare" to its enemies -- is such a bad thing. On the contrary, I always liked the idea of mandatory health insurance (and subsidies for those who can't afford it), as did the Republicans who came up with the notion. But like Mitt Romney, who backed just such a plan in Massachusetts when he was governor, I've come to see the error of my ways.

Americans dislike a law requiring all to have health insurance. But they also dislike the soaring cost of health care, the way medical spending fuels government deficits, or the fact that we let people die for want of care -- or go bankrupt trying to pay for it. Did you know that ours is the only affluent country in the world where this kind of thing is routine?

In retrospect, the Obama reforms were both too complex and too modest. Obamacare was a way of making our crazy system fairer while slowing the growth in costs -- but the system would still be crazy. It's already the world's costliest by far, even while leaving 50 million uncovered. It's also fragmented, over-reliant on medical technology, and adept at turning the natural process of dying into an expensive mess.

Here's how crazy our system is: Because my wife has had cancer, we're not sure we could move to another state. What if we couldn't get coverage? American health care has made us prisoners of New York.

The Supreme Court now has a chance to toss out the Obama reforms en masse -- and as a result, I hope, our whole ugly, irrational and unsustainable health care system will finally get the truly massive overhaul it has needed for years -- if it doesn't collapse first.

Think of it: Without Obamacare, insurance companies can continue excluding pre-existing conditions like my wife's cancer. Young adults won't automatically be eligible for their parents' policies. And hordes of Americans will remain uninsured, except for the promise of limited care at an emergency room.

Sweeping away the Obama reforms will mean a lot of pain. But that may be what it takes to get us to see how badly our system is broken -- and to save the 45,000 lives lost annually (according to a Harvard study) for want of universal coverage.

The funny thing is, Uncle Sam already has a highly efficient health system. It's called Medicare. And until we get every last American on it, we'll never stop shoveling cash into administrative expenses and insurance-company profits.

Medicare for all isn't a new idea. Theodore and Franklin Roosevelt, Harry Truman, John Kennedy, Richard Nixon, Jimmy Carter and Bill Clinton all saw the need for universal coverage long before Barack Obama came along. How ironic if it's the Supreme Court that ultimately gets us there. Daniel Akst is a member of the Newsday editorial board.