The diagnosis is in. Earlier today the U.S. Supreme Court ruled on the constitutionality of the sweeping health care law championed by President Barack Obama in an eagerly awaited decision that further divided an already divided nation.
The stakes for Americans could not have been higher: upholding the Affordable Care Act ("Obamacare" if you're inclined to call it that) is going to have an impact on the lives of every American. But what were the stakes for Canadians? Were we mere spectators to this theatre? Or did we have an interest in the outcome of the play? Why should it matter to anyone in Canada that the Affordable Care Act was upheld?
Without going into the minutiae of the 2,700 page bill, which weighs 108 pounds in its entirety, it provides health insurance to 32 million previously uninsured Americans (roughly the population of Canada), prevents health insurance companies from discriminating against applicants based on pre-existing conditions and forces most Americans to purchase a health insurance plan. Setting aside whether or not you believe health care is a human right or that Barack Obama is a socialist, consider for a moment the sheer scale of what this endeavor proposes: a population equivalent in size to that of Canada's acquiring health insurance by 2014, a very short period of time.
Now that we know the Supreme Court has decided the bill is constitutional, Canadians should turn their minds to how it will affect our interests. Thursday's decision means (presuming Mitt Romney does not become President in 2012 and repeal it) that 32 million uninsured Americans will enter a health care market in which supply is largely fixed -- there is no equally large mass of new doctors, nurses, radiologists and the like entering the medical profession to deal with this sudden bulge of customers.
Granted, the 32 million already consume medical services (largely in the form of emergency room visits) but even if they switch over to less expensive primary care doctors (saving the United States an enormous amount of money), where will the supply for these new doctors come from, "eh"?
These new patients will create a surge in demand for medical products and services. Skilled Canadian nurses and doctors, already in demand south of the border, will be drawn in even greater numbers from our own small pool of trained professionals. The "brain drain" so far as medical expertise goes, a drain that has been running unplugged for many years and has sucked a tremendous amount of medical talent out of our country, will widen.
Canadian companies who sell products to American hospitals or other health care providers now stand to earn hundreds of millions of dollars from the massive surge in demand for their services and the guarantee that the U.S.taxpayer will be footing the bill. The Affordable Care Act could actually be a mini-boom for Canadian companies who are positioned to service the American health care system.
The boom might not just be financial; domestic Canadian political groups who fear the slow creep of privately run clinics in Ontario and British Columbia are now likely energized. Their side has, in a sense, won an important argument in one of the last holdouts in the industrialized world to the idea that health care is some kind of a right.
Moves by provinces such as Alberta to allow the operation of private clinics will have less political currency as politicians will have to convince ordinary Canadians why they should run in the opposite direction of the American taxpayer -- towards private care instead of away from it.
The President has been successful in enacting the largest social program since Franklin Roosevelt's New Deal in 1936. It will be difficult for Mitt Romney to counter a resume with a legislative achievement this significant come November. Consider for a moment what the climate in Canada and the United States might have been if the bill was overturned this morning.
Here in Canada, it would serve as encouragement for groups who have been trying to convince Canadians that the cracks in our system (long wait times for surgeries or the use of diagnostic equipment) are doomed to become fatal fissures. They would feel as though they'd won a significant argument, that exchanging individual freedom for socialized medicine is an unfair trade. Canadians who themselves feel a quiet discontentment with our health care system would be more amenable to provinces experimenting with private clinics.
The bills' defeat would have given Mitt Romney political strategic missiles to lob at the President during his re-election campaign. Nearly all of his first term would have been spent working on a piece of legislation that did nothing for the American people. It could have been the beginning of the end for the Obama presidency,
America's justices will have decided more than a question of law today, they have have decided to a large extent the future direction, the future health, in a very literal way, of their nation. Let's hope they had the right prescription.