The legal battle over President Barack Obama's health care law may be over, barring further courtroom challenges. But the political battle shows no sign of abating.
That means we're in for a war of words in which truth is likely to get caught in the crossfire between left and right.
Take the case against the individual insurance mandate on which the Supreme Court ruled last week. According to most liberal pundits, the challenge to the constitutionality of the mandate compelling all Americans to have health insurance was a naked political ploy based on fringe right-wing ideas. According to most conservative pundits, the mandate's unconstitutionality is so obvious (to everyone but the liberal bloc on the Supreme Court) that Chief Justice Roberts could only save it through some tortured legal reasoning redefining the mandate as the tax that Obama said it wasn't.
Not so fast, everyone. The anti-mandate argument as extreme right-wing dogma? If it were, it's unlikely Justice Anthony Kennedy, never one to toe a conservative party line, could have been persuaded to go along. The pro-mandate argument as liberal ideology run amok? More than one conservative federal judge found the mandate constitutional before the Roberts opinion. Perhaps the simple truth is that there are solid legal arguments on both sides of the issue.
Or take the claim from conservatives that "Obamacare" is overwhelmingly unpopular because it represents socialism and Americans want none of that. In fact, the polls show a far more complicated picture. More people oppose than support the individual mandate, though in most polls the margin is fairly slim (45 percent for, a little over 50 percent against). However, some of the law's most "socialistic" provisions, such as the one that forbids insurers from discriminating between healthy and sick people in issuing policies -- which makes no sense in market terms -- are supported by as many as 85 percent of Americans. A 2009 CBS/New York Times poll found that two-thirds of Americans consider health care a "right."
Liberals have made their own share of dubious health care assertions. Take the claim that medical bills cause two-thirds of bankruptcies, presumably due to lack of universal insurance. A closer look at the studies from which this claim originates shows that in many cases, medical expenses (which may total little more than $1,000) are just one component in the financial woes that lead to the bankruptcy filing, and three-quarters of the filers have health insurance.
Indeed, both sides bandy about claims that are somewhat self-contradictory. Reform proponents claim thousands of the uninsured are dying for lack of health care -- and that the uninsured get free care, passing on the costs to the rest of us. The reality? No one knows how many die for lack of health insurance (some studies show that insurance status has no effect on mortality; others find that, for many conditions, mortality is higher for Medicaid patients than for the uninsured).
Meanwhile, some reform opponents claim no American who needs care is going without -- yet they also complain that reform will drive up costs by bringing more people into the health care system. But are people really going to seek care they don't need just because they have insurance? Overconsumption is mostly an issue of lawsuit-wary doctors ordering unnecessary tests.
While repeal of the Affordable Care Act is unlikely, there is plenty of room to amend the law to make it less costly, less intrusive, and more effective. But any such effort must start by looking at facts.